Professional Support Networks Research Articles

The to be, or not to be, of acting autistic.

Autistic characters are becoming more common in film and television, and a growing number of production companies are making efforts to hire autistic actors to play autistic characters. The purpose of this study is to learn about the experiences of professional autistic actors who have played autistic characters in professional media productions. We also explored autistic actors' impressions of the autistic characters they have seen on screen. We interviewed nine professional autistic actors, who discussed their experiences as professional actors playing autistic characters. Interviews revealed the following themes, including (1) the advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Throughout the interviews, the actors discussed instances when they needed to identify as being autistic to take advantage of autism-focused employment opportunities, and other instances when they felt more comfortable not identifying as autistic. Actors' professional support networks were knowledgeable about autism and advocated for the inclusion and employment of autistic actors. They appreciated the growing number of autistic characters on screen but hoped more production companies invest in authentic casting initiatives. Actors compel production companies to move away from overplayed stereotypical and misleading portrayals. The actors' recommendations for future autistic characterizations are described.

Cultivating Resilience: Multiple Case Study of School Heads’ Leadership in Integrated Senior High Schools

School leaders must be resilient in order to navigate the always shifting challenges in the field of education. This study employed a qualitative multiple case study, having three (3) distinct cases aimed to explore the perspectives of the school heads on resilient leadership in integrated senior high schools of Division of Davao de Oro. There were three (3) participants and six (6) informants underwent in-depth interviews. Participants were chosen through a purposive sampling technique. Each data was analyzed through thematic analysis and cross-case analysis. Case 1’s unique characteristics were resource management and optimization, hierarchical communication and strategic delegation, and crisis management and contingency planning. Participant experiences were complex stakeholder management, innovative problem-solving, and resilience amidst bureaucratic challenges. In times of challenges, the coping mechanism was structured decision-making processes delegation and team empowerment professional support networks. The policy recommendations were promotion of interpersonal communication skills, development of community engagement strategies, and investment in staff well-being programs. Further, Case 3’s unique characteristics were the following: strategic financial management and sustainability, stakeholder engagement and partnerships, brand differentiation and market positioning. The experiences were cultivating philanthropic relationships, navigating parental expectations, and ensuring financial sustainability. The coping mechanisms were strategic partnerships and fundraising initiatives, ethical leadership and values integration, and self-care and well-being practices while the policy recommendations were introduction of ethics and values integration policies, creation of leadership succession plans, and investment in infrastructure and technology. Moreover, cross-case analysis shows each case about distinct characteristics and commonalities such as strategic vision and planning, effective communication and collaboration, and resource management and optimization. Each case has distinct experiences, the common themes were resourcefulness and creativity, and community engagement and collaboration. Their coping mechanisms were effective leadership practices and ethical leadership and well-being. Their policy recommendations were leadership development policies and data-informed policies. This suggests that resilient leadership was crucial for school heads in managing and leading integrated senior high schools, despite the challenges and circumstances they faced in their workplace. Both teachers and learners benefit from the leadership styles promoted by the school heads.

LIVED EXPERIENCES OF RECEIVING TEACHERS IN HANDLING BEHAVIORAL ISSUES OF STUDENTS WITH SPECIAL NEEDS

This qualitative phenomenological study provides a comprehensive exploration of the challenges, strategies; coping mechanisms, and insights experienced by receiving teachers in addressing behavioral issues among students with special needs in inclusive education settings. Through in-depth focus group discussions with five receiving teachers from Island Garden City of Samal, Davao Del Norte, the study exposes the real struggle and complexities of managing diverse behavioral concerns. The thematic analysis uncovers the intricate web of both academic obstacles and behavioral manifestations, prompting the development and implementation of tailored strategies, including individualized behavior plans and collaborative problem-solving approaches. Moreover, the study highlights the vital role of coping mechanisms, such as seeking support from colleagues and prioritizing self-care practices amidst the demanding educational landscape. The insights gleaned from teachers lived experiences underscore the transformative potential of empathy, adaptability, and inclusive teaching methodologies. Ultimately, the research advocates for targeted professional development initiatives and collaborative support networks to empower receiving teachers to effectively navigate the unique challenges presented by students with special needs, especially students with behavioral issues. By promoting inclusive and supportive learning environments, this study contributes significantly to the enhancement of special education practices and resources. KEYWORDS: Special Education, Behavioral Issues, Receiving teachers, research, teaching, Inclusive Education, and special education practices.

Supporting best practice in the management of chronic diseases in primary health care settings: a scoping review of training programs for Indigenous Health Workers and Practitioners.

Background To improve diabetes management in primary health care for the Aboriginal and Torres Strait Islander peoples population, training programs that are culturally and contextually relevant to the local context are required. Using a scoping review methodology, the aim of this review was to describe the characteristics of chronic disease management training programs for Aboriginal Health Workers and Practitioners, their effectiveness on knowledge and skills, and client-related outcomes, and the enablers, barriers to delivery and participation. Methods Following protocol parameters, a systematic search was conducted in relevant databases and grey literature. Two independent reviewers screened the title and abstract of each paper to determine if the study met the inclusion criteria. Results Of the 23 included studies, most were developed with stakeholders, profession facilitated and delivered by cultural facilitators. All training programs included content knowledge, two included a professional support network, four provided on-the-job support and six had follow-up support post-training. Modes of delivery ranged from didactic, storytelling and hands-on learning. Two studies reported significant improvement in participants' knowledge and confidence; one reported improvement in knowledge (12.7% increase pre-post training), and an increase in confidence in both clinical and non-clinical skills. Enablers (relevance, modes of learning, power of networking, improved knowledge, confidence and clinical practice) and barriers (adult learning capabilities, competing work-family commitments) were reported. Few studies reported on knowledge transfer into clinical practice and client-related outcomes. Conclusions Multifaceted training programs for Aboriginal health workers are well received and may improve workforce capability.

Healthcare social network research and the ECHO model™: Exploring a community of practice to support cultural brokers and transfer cultural knowledge

BackgroundProject ECHO® networks at Children’s Health Queensland Hospital and Health Service (CHQHHS) are communities of practice designed to mitigate services and systems fragmentation by building collaborative partnerships addressing priority child and youth health needs. Aboriginal and Torres Strait Islander people experience the negative impacts of fragmentation in addition to historical challenges of absent or culturally inappropriate health services. Access to culturally safe and responsive services can be improved by engaging Aboriginal and Torres Strait Islander Health Workers and similar roles in an online community of practice, supporting the integration of cultural and clinical knowledge and self-determination of Aboriginal and Torres Strait Islander consumers in decisions affecting their health.Analysing professional support networks and knowledge sharing patterns helps identify enablers and barriers to partnerships. Using social network research, the multilevel network inclusive of ECHO network members and their colleagues was studied to identify interdisciplinary and cross-sector advice exchange patterns, explore the position of cultural brokers and identify common relational tendencies.MethodsSocial network theories and methods informed the collection of network data and analysis of advice-seeking relationships among ECHO network members and their nominees. Registered members from two ECHO networks were invited to complete the Qualtrics survey. Networks analysed comprised 398 professionals from mainstream health, Aboriginal and Torres Strait Islander Community Controlled Health Organisation, education, disability and child safety service settings.ResultsBrokers were well represented, both those who hold knowledge brokerage positions as well as cultural brokers who incorporate clinical and cultural knowledge enabling holistic care for Aboriginal and Torres Strait Islander patients (38 individuals, 17% of network). Professionals who occupy brokerage positions outside the ECHO network tend to be more connected with co-members within the network.ConclusionsThis study is the first application of contemporary social network theories and methods to investigate an ECHO network. The findings highlight the connectivity afforded by brokers, enabling the coordination and collaboration necessary for effective care integration. Inclusion of cultural brokers in an ECHO network provides sustained peer group support while also cultivating relationships that facilitate the integration of cultural and clinical knowledge.

Experiences of Prometric Endeavor Nurses in Pakistan; A Qualitative Descriptive Study

Background: The landscape of global health professional certification is increasingly dominated by computer-based testing (CBT), such as the Prometric exams, which assess the competencies of nursing candidates for international practice. These exams are pivotal for nurses in Pakistan aiming for employment abroad, presenting unique challenges and opportunities that reflect both the individual and systemic dimensions of professional certification. Objective: This study aimed to explore the experiences of nurses in Pakistan who have undertaken Prometric exams, focusing on the challenges faced, strategies employed for preparation, and the motivational factors influencing their journey. It sought to provide insights into the complexities of navigating international nursing certification processes. Methods: A qualitative descriptive study design was implemented from May to October 2023, involving semi-structured interviews with 13 nursing graduates in Peshawar, Pakistan, who had participated in Prometric exams. Participants were selected using non-probability purposive sampling. Data analysis was conducted using a modified thematic analysis of Braun and Clarke’s framework, allowing for the identification of themes, sub-themes, and codes related to exam experiences. Results: The study's demographic analysis revealed a predominance of male participants (76.92%) with the majority holding a Bachelor of Science in Nursing (84.61%). Five main themes were identified: Challenges Faced, Strategies Followed, Insight into Prometric Exams, Suggestions for Future Nurses, and Inspiration Figure. These themes encompassed a range of sub-themes including test center allocation limitations, effective preparation methods, understanding exam patterns, and the crucial role of personal and professional support networks. Notably, challenges such as content preparation, language barriers, and socioeconomic factors were highlighted, alongside strategies for overcoming these hurdles. Conclusion: Nurses in Pakistan facing Prometric exams encounter a spectrum of challenges that require multifaceted strategies and support systems for successful navigation. The study underscores the importance of comprehensive preparation, informed decision-making regarding exam and country selection, and the cultivation of resilience and motivation. Future research should expand to include a broader range of health professionals and adopt mixed-methods approaches to deepen the understanding of international certification processes.

An Investigation of the Professional Resilience Strategies Used by Experienced Occupational Therapists.

There is a paucity of research into the strategies occupational therapists use to maintain career longevity professional resilience. The objective of the study was to identify the strategies used by occupational therapists to maintain their professional resilience. Descriptive statistics were used to analyze data from a cross-sectional survey that investigated the professional resilience strategies used by experienced occupational therapists. Valid responses were received from 489 occupational therapists from 29 countries. The most used professional resilience strategies were maintaining a belief in the value of occupational therapy, taking time for reflection on positive outcomes, using personal time management strategies, and engagement in informal and formal professional support networks. A range of professional resilience strategies are used by experienced occupational therapists in health and social care settings. The findings can be used by managers and workplace organizations to support their occupational therapy workforce.

"We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers.

Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.

Citizen Science: Schoolteachers’ Motivation, Experiences, and Recommendations

Citizen science offers teachers a way to bring authentic scientific research into their classrooms by providing both teachers and their students with opportunities to contribute to authentic research. The potential of citizen science for science education has already been highlighted in various fields and by various stakeholders. More and more studies underpin this potential by providing evidence for the learning outcomes achieved through participation in citizen science projects. In formal education settings, teachers are the gatekeepers for teaching innovations and, hence, the ones who decide whether to engage students in citizen science. However, the expertise of teachers who have already participated in citizen science with their students has not been studied on a broad international level. Therefore, to investigate their experience and learn from their expertise, this study employed a concurrent triangulation design and invited teachers to participate in a survey (N = 56) and an interview (N = 11), independent of their country of residence, their school type, and their teaching subject. The results provide insights into teachers’ motivation, the engagement techniques and types of activities they used, the challenges they faced, and their recommendations for implementing citizen science in formal education settings. The present findings have important implications for the design of professional development programmes and support networks for teachers in citizen science.

Patterns of distress and psychosocial support 2 years post-displacement following a natural disaster in a lower middle income country.

Displacement due to natural disaster exposure is a major source of distress, and disproportionately affects people in low- and middle-income countries (LMICs). Public mental health resources following natural disasters and displacement are often limited in LMICs. In 2017, the population of one island in Vanuatu, a lower-middle income country, was displaced due to volcanic activity. Following the launch of a public mental health policy in 2009, psychosocial support interventions are increasingly available, providing an opportunity to assess relationships with distress following displacement. 440 people contributed data. We assessed distress using a local adaptation of the Impact of Event Scale-Revised, and types of psychosocial support available and received, including from health professionals, support groups, and traditional networks such as chiefs, traditional healers, and church leaders. We analyzed relationships between distress and psychosocial support, controlling for sociodemographic covariates. Professional and group support was reported available by 86.8-95.1% of participants. Traditional support networks were widely used, especially by men. Availability of professional support predicted lower distress among men (p < 0.001) and women (p = 0.015) ( = 0.026-0.083). Consulting church leaders for psychosocial support was associated with higher distress among men (p = 0.026) and women (p = 0.023) ( = 0.024-0.031). Use of professional and group support was lower than reported availability. Increased collaboration between professional and traditional support networks could help respond to mental health needs following natural disasters in LMICs with limited infrastructure. Providing training and resources to church leaders might be a specific target for improvement. Promoting use of available services represents a continued public health need.

Understanding the experiences of people with posttraumatic stress disorder (PTSD) during the COVID-19 pandemic: A qualitative study.

There has been great concern about the psychological implications of the coronavirus disease 2019 (COVID-19) pandemic on wellbeing and mental health worldwide. Previous pandemics have been associated with an increased risk of posttraumatic stress disorder (PTSD); however, the experience of a pandemic for those with preexisting diagnoses of PTSD has not previously been researched. We aimed to understand the experience of the COVID-19 pandemic for people with a diagnosis of PTSD before the pandemic. Ten people, who were under the care of a specialist outpatient clinic for adults with PTSD during the COVID-19 pandemic, took part in semistructured interviews. Thematic analysis was used to analyze the interview transcripts. Themes were identified relating to changes in how a sense of threat was experienced during the pandemic, with both factors increasing and decreasing threat recognized; challenges related to trying to cope with the pandemic; and resources that helped with coping. Recommendations for clinicians working with people with PTSD during a pandemic are made. These include assessing for changes in the person's sense of threat and changes in triggers; supporting adaptation of prepandemic ways of coping and engagement with personal and professional support networks; and being alert to a possible increase or change in safety-seeking behaviors and addressing in the treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Navigating grief and pregnancy loss through online story telling

Miscarriage, a common experience, is uncommonly discussed in personal and professional support networks. The normal reaction of grief from a miscarriage in addition to other external factors can lead to complicated grief, a condition that has negative mental health implications on the bereaved mother. Through the lens of Worden’s tasks of meaning, a content analysis was conducted on six public blog posts in which women openly shared their grief experiences. The authors discuss the need for more training in social work practice regarding reproductive health and the intersection of reproductive health and mental health.

Survey of Barriers and Facilitators to Prescribing Buprenorphine and Clinician Perceptions on the Drug Addiction Treatment Act of 2000 Waiver

As opioid-related deaths continue to climb, methods to reduce barriers to prescribing buprenorphine for individuals with opioid use disorder (OUD) are needed. Recent conversations by state and federal authorities targeting low-threshold buprenorphine aim to reduce some barriers to prescribing buprenorphine; however, what remains unclear is whether removal of the requirement to obtain a waiver for prescribing buprenorphine through the Drug Addiction Treatment Act of 2000 (an X-waiver) will be enough to increase access to buprenorphine. To assess barriers and facilitators of obtaining an X-waiver and prescribing buprenorphine. This mixed-method survey study was conducted between September and December 2020; 607 office-based Texas clinicians were surveyed after they attended a buprenorphine X-waiver training course. All attendees between March 2, 2019, and February 28, 2020, were eligible to receive this survey; 126 responses were received (20% response rate: 81 physicians, 37 nurse practitioners, and 8 physician assistants). Data analysis was performed October 2021. Surveys measured the extent to which clinicians experienced 9 previously identified barriers during the waiver process and in prescribing buprenorphine. The survey included open-ended items assessing facilitating factors to obtaining a waiver and to prescribing buprenorphine for OUD. The barriers were analyzed using χ2 tests of homogeneity. Qualitative data were analyzed using a constant comparative method. Among 126 clinicians who responded, 61 (48.4%) had received an X-waiver; of these waivered clinicians, 22 (36%) were prescribing buprenorphine and 39 (64%) were not. "Complexity of X-waiver process," "Perceived lack of professional support and referral network," and "Getting started" were significantly different barriers among waivered and nonwaivered clinicians. Significant differences in barriers experienced between prescribers and nonprescribers were "Getting started" and "Accessing reimbursement for treatment." The most frequently mentioned facilitators involved changes to the waiver training and the need for networks connecting experienced clinicians with those in the initial stages of readiness for prescribing buprenorphine for OUD. This survey study's results contribute new understanding of facilitators to obtaining the X-waiver and to prescribing buprenorphine. Furthermore, these findings suggest that to increase access to compassionate evidence-based treatment for OUD, clinicians need ongoing support and mentorship from experienced and knowledgeable clinicians. Interventions aimed at improving access to buprenorphine should focus on facilitating such networks to increase the number of clinicians who obtain an X-waiver and prescribe buprenorphine for OUD.

Improving access to prosthetic services in Western Nepal: a local stakeholder perspective

Purpose Evidence of effective strategies to improve access to assistive technology (AT) like prostheses is limited, especially in rural and remote areas of low- and middle-income countries where unmet needs are the greatest. This study aimed to identify barriers and facilitators to accessing prosthetic services in rural areas of western Nepal and explore strategies to improve access from the perspective of local stakeholders. Method Semi-structured interviews were conducted with 13 service providers and consumers. Barriers and facilitators of access were highlighted and potential solutions to overcome access barriers were explored using thematic analysis of transcripts. Results Six themes concerning barriers and facilitators arose: awareness and literacy of prosthetic services, attitudes and belief systems, financial supports, geographical access, health system and referral processes, as well as service provider capacity and regulation. Six themes regarding potential solutions were also identified: awareness campaigns, procurement pathways, referral pathways, subsidised and shared costs of AT, professional support networks and development opportunities, as well as task shifting and sharing. Conclusions While facilitating interventions support access to prosthetic services, they remain insufficient to overcome several barriers that continue to inhibit this access. Nevertheless, real opportunities to alleviate barriers and address the unmet need exist and must be explored. Implications For Rehabilitation It is advised that rehabilitation professionals, particularly those delivering prosthetic services in rural and remote settings of Nepal, consider piloting alternative service delivery strategies which utilise resources accessible to them in order to overcome several existing barriers to AT access e.g., task shifting. Rehabilitation professionals in Nepal have the opportunity to support others working in low-resources settings to expand professional development opportunities through online and digital platforms. Gathering and sharing data on the current state of prosthetic and AT service delivery within Nepal is highly valuable to the development of the prosthetic rehabilitation profession and ultimately equity in access to appropriate AT. Proposed interventions identified within this study can potentially serve to guide stakeholders in rural and remote settings of other LMICs in developing strategies to overcome barriers to AT access suitable to their context.

Structural Barriers and Narratives of Chinese Social Workers’ Coping Strategies

ABSTRACT Chinese social workers struggle to remain in this emerging profession; structural barriers are a challenging issue. This qualitative research explored the structural barriers Chinese social workers encounter and the coping strategies they utilize through interviews and focus group discussions with 49 experienced social workers. Two themes concerning structural barriers emerged: (a) constraining structural contexts; and (b) immature professionalization. Three categories of coping strategies were identified: (a) building a partnership and integrating resources; (b) utilizing a professional and personal social support network; and (c) improving organizational governance and strategic management. The barriers and coping strategies differentially impacted various career stages.

Fostering a diverse regional community of physician-scientist trainees

Among the many academic challenges faced by dual-degree MD-PhD students is access to professional support networks designed to overcome the unique academic and personal barriers to physician-scientist training. In the current study, we hypothesized that regional access to a student MD-PhD conference, termed the Southeastern Medical Scientist Symposium (SEMSS), would enhance medical and/or graduate training by fostering such relationships between physician-scientist trainees, doing so by discussing both the challenges of physician-scientist training and effective strategies to overcome them. In the current study, we used a mixed-methods approach to evaluate the overall usefulness of SEMSS over a ten-year period (2010-2020) to identify key areas of particular benefit to trainees. The authors used conference registration data to compile self-reported demographic and regional attendance, followed by a post-conference survey to gauge attendee satisfaction. Over the reporting period, SEMSS was attended by equivalent proportions of MD-PhD and undergraduate students, among which were a high-percentage of students from underrepresented minority (URM) groups relative to the national MD-PhD applicant pool; nearly one-third of URM students attendees later matriculated into MD-PhD programs, far exceeding the national MD-PhD matriculation rate. Among the benefits reported by students were “opportunities to network with peers” and opportunities to learn about the physician-scientist career track. Therefore, we therefore propose regional MD-PhD conferences as an effective model to promote diversity within the physician-scientist training pipeline.

Moms, Memes, and Mitigating Pandemic Stress: Exploring Themes and Implications in an Academic Mamas’ Facebook Group

This article pairs autoethnography with a thematic analysis of memes in a private Facebook group made up of academic mothers during the first year of the COVID-19 pandemic. The analysis illustrates the challenges members faced during the pandemic related to their roles as mothers, academics, caregivers, and partners and how they used memes as a mechanism for virtual support in 2020 and 2021. Group members used memes to communicate about four primary themes: the stress and humor that arose from pandemic conditions, mothering during the pandemic, work–life tensions, and pressures for research productivity. Throughout the themes, humor offered a foundation for support and connection. The analysis provides insights into the potential for professional support networks online and how humor, shared via social media, can create space for vulnerability and connection among colleagues. The authors also consider the ambivalent dynamics that online social support offers. While it may reduce tension and provide emotional comfort, it also has the potential to uphold gendered expectations at home and at work.

Building a sustainable rural physician workforce.

Building a sustainable rural physician workforce.

Why do doctors work in rural areas in high-income countries? A qualitative systematic review of recruitment and retention.

To identify and assess the drivers and barriers to recruiting and retaining doctors in rural communities of high-income countries. A systematic review and thematic analysis. Publications were sourced from medical and scientific databases online. Qualitative, mixed-methods and review studies from peer-reviewed journals published since 2000 that discussed recruitment or retention of doctors to rural areas in high-income countries. Identification and assessment of themes in the literature pertaining to recruitment and retention of rural doctors. Recurrent themes were assessed for relevance and applicability to current rural shortages. A thematic analysis was completed on 41 papers assessed as in scope of the review. Papers were scrutinised for relevance to established rural recruitment and retention strategies. Key themes were rural background, education and training, personal and professional circumstances, and integration with the community. While rural origin has long been promoted as the key factor for recruiting rural doctors, initiatives targeting only these individuals ignore a potentially larger cohort of future rural doctors. Rurally focused medical education and training need to encompass students and doctors from all backgrounds. The major barriers to rural recruitment are family-unit considerations for partners and children, concerns over isolation and a poor perception of rural practice. Attracting doctors to practise rurally is only half the challenge however, and strategies to retain rural doctors need a greater focus on personal and professional support networks and community integration. Additional strategies are needed to retain international and bonded doctors restricted to rural areas.

Can a couples' intervention reduce unmet needs and caregiver burden after brain injury?

To examine the effectiveness of the Therapeutic Couples Intervention (TCI) on caregiver needs and burden after brain injury. Individuals with brain injury and their intimate partners/caregivers (n = 75) participated in a 2-arm, parallel, randomized trial with a waitlist control. The TCI consisted of 5 2-hr sessions, with a sixth optional session for parents. The Family Needs Questionnaire-R (FNQ-R) and the Zarit Burden Interview (ZBI) were secondary outcome measures. After adjusting for baseline characteristics, caregivers in the TCI group demonstrated reduction in unmet needs for 5 of the 6 FNQ-R subscales, whereas those in the waitlist control group did not. ZBI scores improved significantly for TCI caregivers but not for controls. At the 3-month follow-up, benefits were maintained for the ZBI and 4 of the 6 FNQ-R subscales (Health Information, Emotional Support, Professional Support, and Community Support Network). The present investigation provided evidence that, following brain injury, a structured couples intervention can reduce unmet needs and burden in caregivers. Future multicenter research examining long-term durability of treatment gains and specific characteristics of positive responders is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).