Rapport Building Research Articles

Building a Sense of Community Online: Rapport Building Activities for a Remote Learning Environment.

Building a Sense of Community Online: Rapport Building Activities for a Remote Learning Environment.

MITIGATING RAPPORT THREATS ON SOCIAL MEDIA

This study aims to find out the strategies applied by people on social media in mitigating rapport threat behaviors and tries to formulate the rapport building behaviors from the applied strategies. The research is done to see whether the strategies work well in rapport threatening atmosphere in various situations taken from social media interactions. The data for this study were obtained from a number of online chats and discussion on several social media apps such as, Facebook, Whatsapp, Youtube and Instagram. The interactions were some chats, comments, discussion and arguments in Bahasa Indonesia. The data were taken from the interactions that cause offenses or threat on the interpersonal rapport of the people chatting on the social media. The method applied for this study is descriptive qualitative to identify the people’s strategies on social media to mitigate some rapport threat behaviors in the social media interactions. The study shows that people apply a number of strategies to mitigate the threats to the interpersonal rapport. The strategies are apologizing, complimenting, expressing gratitude, using emoji, using honorifics to address others, choosing the appropriate words, choosing the relevant topic and organizing information to be told to others. It is clearly shown from the study that there are a number of rapport threat behaviors in social media interactions but the people interacting on the social media have certain strategies which in turn become the rapport building behaviors to mitigate the threat.

Implementing a Health Care Professional-Supported Digital Intervention for Survivors of Cancer in Primary Care: Qualitative Process Evaluation of the Renewed Intervention.

BackgroundPrimary care plays an important role in supporting survivors of cancer; however, support is limited because of practitioners’ perceived lack of expertise and time. A digital intervention for survivors of cancer could provide an efficient way for primary care staff to support survivors of cancer without the need to accumulate expertise and skills to help patients make behavior changes; providing very brief support alongside this could maximize adherence to digital interventions. Renewed is a digital intervention that combines web-based behavior change advice with brief health care practitioner support from a nurse or health care assistant. Knowledge about the views and experiences of primary care staff providing support alongside a digital intervention for survivors of cancer is sparse, limiting the understanding of the acceptability and feasibility of this type of intervention.ObjectiveThis study aims to explore supporters’ experiences of providing support to survivors of cancer using Renewed, understand potential barriers to and facilitators of the implementation of Renewed in practice, and investigate the strengths and weaknesses of the intervention from the perspective of health care professionals.MethodsThis was a qualitative process evaluation nested within a large trial evaluating Renewed. A total of 28 semistructured telephone interviews were conducted with nurses and health care assistants. Data were analyzed using inductive thematic analysis.ResultsFour themes were developed during the analysis, which reflected the factors that supporters identified as hindering or enabling them to provide support alongside Renewed Online: Renewed Online as an acceptable digital tool with some improvements, confidence in enacting the supporter role, practicalities of delivering support alongside a digital intervention, and managing a patient-led approach. The analysis suggests that supporters perceived that a digital intervention such as Renewed would be beneficial in supporting survivors of cancer in primary care and fit within current practices. However, barriers to providing support alongside the intervention were also identified, including concerns about how to facilitate rapport building and, in a minority, concerns about using a nondirective approach, in which most advice and support is provided through digital interventions, with brief additional support provided by primary care staff.ConclusionsThese findings add to the literature on how best to provide support alongside digital interventions, suggesting that although most practitioners cope well with a nondirective approach, a minority requires more training to feel confident in implementing this. This study suggests that the barriers to providing formal support to survivors of cancer in primary care could be successfully overcome with an approach such as Renewed, where a digital intervention provides most of the support and expertise, and health care practitioners provide additional brief human support to maximize engagement. Strategies to maximize the chances of successful implementation for this type of intervention are also discussed.

"It's Great to Exercise Together on Zoom!": Understanding the Practices and Challenges of Live Stream Group Fitness Classes

The COVID-19 pandemic greatly changed many people's daily lives. Because of the temporary closure of gyms and fitness centers, many people started to take group fitness classes online. The abrupt transition to synchronous online exercise brought lots of uncertainty and challenges to fitness instructors and participants. This study aims to understand how people teach and participate in live stream group fitness classes, the challenges they have encountered, and their practices to address these challenges. We conducted semi-structured interviews with 11 instructors and 14 participants who had experience teaching or taking live stream group fitness classes on Zoom during the pandemic. Our interviews showed that instructors saw teaching online as a new, more cognitively demanding experience than teaching in-person classes; they found limited resources to create a professional workout space, experienced stress and anxiety, had limited information and approaches to give participants feedback, and faced difficulties with rapport building. Participants found it hard to give real-time reactions while exercising far away from their laptops; they receive less customized instructions, and they have difficulty engaging in private chats. Despite the challenges, we envision CMC in exercise is an opportunity for new design and interactions. We propose design recommendations, including using smartwatches to give real-time reactions and smart garments to generate tactile feedback. Health and biometric data can be shared with instructors and other participants during exercise for safety purposes and to create social connections.

Rapport building by Chinese celebrities on Weibo and Facebook

AbstractThe paper examines how Chinese celebrities build rapport with their followers on social media, with a comparison between the Chinese mainland (on Weibo) and Hong Kong (on Facebook) celebrities. Rapport building is conceptualized as language use in promoting social bonding and emotional involvement and as achieved via at least two aspects: use of relational acts and choice of interactional features. Twelve months of postings by twelve most-followed Weibo and Facebook celebrities from the Chinese mainland and Hong Kong in 2017 have been retrieved and analyzed. It is found that the prevalent relational acts commonly used by both Weibo and Facebook celebrities to build rapport with their followers include sharing information, retweeting information and directives, among others; and the commonly prevalent interactive features include the use of colloquialism, emoji & emoticons, and hashtags or @, and the like. Nonetheless, significant differences also exist in that while Weibo celebrities tend to use more acts of showing stance, Facebook celebrities use more acts of showing appreciation; Weibo celebrities tend to use more colloquialism, emoji & emoticons, and internet slang, Facebook celebrities tend to use more English codemixing and vernacular expressions. Finally, the paper concludes with a discussion and explanation of the commonalities and differences between Weibo and Facebook celebrities.

Caring for Older Adults Experiencing Homelessness in the Inpatient Psychiatry Setting: Challenges and Recommendations

The older adult population is rapidly growing in the United States and across the globe. The Institute of Medicine estimates that the number of older adults with mental health or substance use disorders will reach 10.1 million to 14.4 million people by 2030. A particularly vulnerable subgroup within this aging population is the subset experiencing homelessness. According to a 2017 report by the U.S. Department of Housing and Urban Development, homeless adults >50 years old increased from 22.9% to 33.8% between 2007-2017. Moreover, the number of people >62 years old living in shelters or transitional housing increased during the same time period to 76,000, a growth of 69%. This challenge is likely to worsen in the next decade as adults >65 years old experiencing homelessness is expected to triple between 2017-2030. Amongst the general population of adults experiencing homelessness, there is a higher prevalence of mental health and substance use disorders compared to the general population. Mental health care of older homeless adults can be negatively affected by systemic issues associated with homelessness. Such factors include victimization while being homeless, involvement in the criminal justice system, medication nonadherence, and complex case management issues. Homeless individuals, especially women, with mental illnesses experience higher levels of victimization compared to their housed counterparts. A systematic review found that the on-year prevalence of criminal victimization among adults with major mental disorders was up 35% for violent victimization and 28% for nonviolent victimization. Additionally, the lifetime victimization rate ranged between 74% and 87%. Data also show that 63% to 90% of homeless individuals with severe mental illness have been arrested at least once, 28% to 80% have been convicted of a crime, and 48% to 67% have been incarcerated. These issues may affect rapport building by the treatment team and disposition planning. Furthermore, not attending an outpatient mental health appointment after a psychiatric hospitalization is associated with an increased risk for rehospitalization. A 2007 study determined that patients who attended a follow-up appointment had a 1 in 10 chance of being rehospitalized, whereas patients who did not attend (or were not offered) an appointment had a 1 in 4 chance of rehospitalization. At San Francisco General Hospital, a chart review during a 4-week period between February and April 2020 revealed that 83% of unhoused patients did not show up for their outpatient mental health appointment following discharge from a psychiatric unit. Proposed solutions to help older adults who first experience homelessness late in life include developing more affordable housing, boosting rental assistance (Housing Choice Vouchers), increasing wages, Supplemental Security Income, Social Security Disability Insurance, and state supplemental income. Another proposal is Permanent Supportive Housing (PSH), a program that provides housing paired with supportive services such as case-management, individual and group therapy, and peer support. Veteran-specific PSH has been used to reduce homelessness in chronically homeless veterans (United States Interagency Council on Homelessness, 2018). PSH is also less restrictive and less expensive than nursing home placement of chronically homeless individuals. The At Home/Chez Soi randomized controlled trial from Canada, showed that rent supplements and mental health support services improved housing stability for homeless adults with mental illness.

The Lived Experiences of Learning Cognitive Behavioral Therapy: a Qualitative Study of Psychiatry Residents.

The purpose of this qualitative study was to investigate the lived experiences, beliefs, attitudes, and needs of psychiatry residents learning cognitive behavioral therapy (CBT). Eight general psychiatry residents beginning their outpatient psychotherapy training in July 2020, answered open-ended questions about their experiences learning CBT in October 2020. The residents learned CBT through didactics, role-play, observation, video review, and individual and group supervision. Participants were asked to describe their experiences broadly, reflect on the simple and challenging aspects of learning, identify the most and least helpful learning modalities, and share thoughts or personal reflections activated through their journey. Written data were analyzed using Colaizzi's phenomenological methodology, including the extraction of significance statements and collapsing of meaning statements into key thematic clusters. Verification strategies were used to ensure the trustworthiness and credibility of data analysis. Participants found various learning modalities effective, most notably individual and group supervision. While rapport building and mood checks were least challenging, many found adhering to structure or implementation of advanced techniques to be the more arduous parts of learning. Patient progress tended to stimulate resident engagement, whereas incomplete action plans or lack of observable treatment gains led to some automatic negative thoughts. Many participants applied CBT techniques to themselves to address their own automatic thoughts, biases, or behavioral patterns. The results of this study offer valuable insight about learners' experiences of becoming a therapist that could help normalize residents' experiences and help educators guide residents through the learning process.

COVID-19 Pandemic Impacts on Children with Developmental Disabilities: Service Disruption, Transition to Telehealth, and Child Wellbeing.

The COVID-19 pandemic has resulted in substantial service disruption and transition from in-person services to telehealth for children with developmental disabilities. However, there is limited knowledge about the specific dimensions and consequences of the disruption and transition. This study aims to examine the extent of service disruption and transition, the experiences of client children and their caregivers with telehealth vis-à-vis in-person services, and the impacts of the disruption and transition on child wellbeing. The cross-sectional study collected data from parents of children with developmental disabilities using an online survey. McNemar’s tests were used to compare service changes before and after the pandemic outbreak, and multivariate analyses were used to examine how service changes were associated with child wellbeing. Results show that more than two-thirds of the children experienced reduction in service amount, and one-third lost services for more than two months in about five months into the pandemic. While telehealth had comparable features relative to in-person services, it had lower ratings with respect to diagnostic accuracy, treatment effectiveness, and rapport building. Service disruption/transition and social isolation were associated with behavioral and emotional deterioration in children. However, child and family stress may have confounded these adverse effects. We concluded that the magnitude of service disruption and transition was large in the first half year after the pandemic outbreak, and the amount and duration of service loss varied substantially across clients. Diagnostic accuracy, treatment efficacy, and rapport building were areas in which parents had major concerns toward telehealth relative to in-person services. However, such drawbacks may partially be due to the limited logistics in telehealth implementation during the pandemic. Service disruption and transition seemed to contribute to family stress, which played a direct role in eroding child wellbeing. Implications of these findings for future research and practices are discussed.

Cultural responsiveness in applied behavior analysis: Self-assessment.

Culture has a substantial impact on a wide range of behaviors related to behavioral research and services such as rapport building, preferences for specific targets and treatments, communication, and even the quality of health care. The need for professionals in the field of applied behavior analysis (ABA) to incorporate culturally responsive practices is underscored by the current and projected increase in diversity in the United States. Further, the update to the Ethics Code (BACB, 2020) supports addressing diversity in behavior analytic practice. Self-assessment of one's values, biases, and culture are a critical step in delivering culturally responsive services. The purpose of this paper is three-fold: a) to introduce a framework for cultural responsiveness in ABA, b) to showcase research and practice recommendations from within and outside the field of ABA in the area of self-assessment, and c) to inspire research in self-assessment to support cultural responsiveness in ABA.

Special Report: Stress and Distress During Pregnancy—How to Protect Both Mother and Child

Special Report: Stress and Distress During Pregnancy—How to Protect Both Mother and Child

“It was a no-brainer”: A qualitative study of factors driving previvors’ decision-making when considering risk-reducing salpingectomy with delayed oophorectomy

ObjectivePrevivors are becoming more aware of the option of risk-reducing salpingectomy with delayed oophorectomy (RRS-DO) to mitigate their risk of ovarian cancer. In this qualitative study, we explored the clinical and non-clinical factors that impacted previvors’ decision-making to pursue RRS-DO as a risk reduction strategy. MethodsSemi-structured telephone interviews were conducted with previvors and transcribed verbatim. Using ATLAS.ti® software, two primary investigators interpreted data through thematic analysis. After coding four interviews, the investigators discussed discrepancies between codes with a moderator and resolved and refined code. The investigators applied the universal codebook to all interviews and revised the codebook using an iterative approach. Examining codes within and across interviews allowed for major themes and patterns to emerge. ResultsInterviews were conducted with seventeen previvors (ages 31–46). 6 (25%) previvors had a BRCA1 mutation, 7 (41%), a BRCA2 mutation, 3 (13%), a Lynch-related mutation, and 1 (6%), other (MUTYH mutation). At the time of interview, 12 previvors (71%) were planning (6) or had undergone (6) RRS-DO, 4 (23%) were planning (1) or had undergone (3) risk reducing salpingo-oophorectomy (RRSO), and 1 (6%) was undecided. Three major themes emerged: motivating factors for selecting surgical risk reduction option, barriers complicating surgical decision-making, and facilitating factors for surgical decision-making. RRS-DO-focused previvors prioritized avoiding menopause, and they also emphasized that self-advocacy and building rapport with providers facilitated their decision-making. ConclusionBy understanding previvors’ priorities and experiences, physicians can better partner with previvors as they navigate their ovarian cancer risk reduction journey. This will ultimately optimize shared decision-making.

Benefits, challenges and contributors to the introduction of new hospital-based outpatient clinic pharmacist positions

BackgroundPharmacists working within interprofessional teams in the outpatient setting are well placed to address medication-related problems before and after hospital admission. Therefore, exploration of these roles is warranted. Objective(s)To explore pharmacists' and other health professionals' perspectives of the impact of pharmacists working within interprofessional teams in outpatient clinics. Furthermore, we endeavoured to identify both the challenges and contributors to success with the introduction of pharmacists into these settings. MethodsThis qualitative study involved semi-structured interviews with both hospital outpatient clinic pharmacists and other clinic health professionals to gain an in-depth understanding of how the introduction of pharmacists into clinics impacted clinic processes, patient care, and relationships with other health professionals. Participants were recruited from the outpatient clinics who had recently added a pharmacist to their service. Participants involved in setting up the roles were invited to participate in a voluntary interview, the transcripts from which were analysed into themes and sub-themes using an inductive and deductive approach. ResultsA total of 34 staff were interviewed of which 68% were female and 74% were aged between 31 and 50 years. The cohort included 16 outpatient pharmacists, nine pharmacist team leaders, five clinic nurses and four clinic doctors (specialist consultant or registrar). Three overall themes were identified: the benefits, the contributors, and the challenges of introducing clinical pharmacy services to outpatient clinics. When establishing a clinic role, pharmacists' awareness, adaptability, and strong communication were shown to be key traits to building rapport and trustworthiness with the established clinic team. ConclusionsWhen pharmacists are integrated into multidisciplinary outpatient clinics they and their colleagues believe that they provide benefits to the patients and the clinics. Decision makers need to be cognizant of factors that contribute to, as well as those that impede, the successful implementation of outpatient pharmacist roles.

The effects of building and maintaining rapport on cooperative mock eyewitness recall

AbstractAlthough building rapport before an investigative interview is recommended—and sometimes empirically beneficial—to eyewitness memory, no research has experimentally examined the effects of maintaining rapport during a witness interview on adult eyewitness recall. As a result, the present study assessed the impact of rapport on eyewitness recall accuracy by comparing a pre‐interview rapport only condition with a maintained rapport condition (where rapport was built before and maintained during the interview) and a no rapport control condition. Results revealed no benefits (or detriments) of building initial rapport—or any additional benefits of maintaining rapport—on witness recall quality, quantity, or ‘don't know’ responses. Our findings suggest that rapport or its maintenance may not directly affect eyewitness recall. However, as rapport is a humane eyewitness interviewing technique with some empirical support, we still advocate for its continued use.

Mixed Methods Process Evaluation of a Sanitation Behavior Change Intervention in Rural Odisha, India

BackgroundProcess evaluations of public health programs are critical to understand if programs were delivered as intended and to identify improvements for future implementations. Here we present a mixed methods process evaluation of the Sundara Grama intervention, which sought to improve latrine use and safe child feces disposal among latrine-owning households in rural Odisha, India.MethodsThe Sundara Grama intervention was delivered to 36 villages in Puri district by a grassroots non-governmental organization (NGO) and included eight activities: palla performance, transect walk, community meeting, community wall painting, mother’s meeting, positive deviant household recognition, household visit, and latrine repairs. The process evaluation quantitatively assessed fidelity, dose delivered, and reach, and qualitatively examined recruitment, context, and satisfaction. Quantitative data collection included an activity observation survey, activity record, and endline trial survey. Qualitative data collection included an activity observation debrief and in-depth interviews with NGO mobilizers. For the quantitative data, a ‘delivery score’ was calculated for each activity, as well as the proportion of target participants in attendance. Qualitative data were analyzed using thematic analysis.ResultsMean delivery scores, reported as a percentage, were moderate to high. Household visit activities (97% general visit, 96% positive deviant visit) and the mother’s meeting (81%) had the highest delivery scores, followed by the palla (77%), transect walk (77%), and community meeting (60%). Activities were attended, on average, by 30% to 73% of latrine-owning households. Several factors aided delivery, including pre-intervention rapport building visits and village stakeholder support. Factors that hindered delivery included inclement weather, certain recruitment strategies, and village social dynamics.ConclusionsOverall, the Sundara Grama intervention was implemented as intended and achieved good reach. The findings suggest education-entertainment strategies, like the palla, and multi-level communication approaches are particularly beneficial. The results also showcase the importance of examining the implementer experience and broader context.

Evaluation of a simulation-based learning experience using a prenatal telehealth scenario with prelicensure nursing students

Telehealth learning activities are lacking in undergraduate nursing curricula. The onset of COVID-19 has placed an emphasis on the value of telehealth and highlighted the importance for innovative measures for prelicensure nursing student learning using simulation-based learning experiences (SBLEs). A prenatal telehealth SBLE was evaluated by 95 participants using the Simulation Effectiveness Tool—Modified. Open-ended responses were also obtained. The mean score was a 2.92/3.00 (n = 95) and several students gave positive reviews in the open response section of the survey. Open responses after the simulation showed positive aspects of learning regarding communication and building rapport with patients in telehealth settings. Incorporating telehealth SBLEs can be perceived as effective, and aid nursing curricula with increasing exposure and learning about telehealth nursing care and communication for prelicensure students.

Introducing an integrated model of cross-cultural assessment

Objective With increasing levels of cultural diversity, it is important that mental health services are relevant and accessible to new migrant populations. Efforts have been made to bring attention to the unique experiences and needs of culturally and linguistically diverse (CALD) sub-groups in clinical settings, resulting in various frameworks and professional development workshops. While some of these strategies have raised awareness and persuaded service providers to accommodate different populations, few are effective and genuinely impact consumer outcomes. Conclusion This paper proposes an integrated cross-cultural assessment framework comprising both clinical and organisational components to improve cross-cultural clinical encounters and consumer satisfaction. The framework underscores the importance of the therapeutic alliance through the building of rapport and trust. Moreover, the framework is designed to be organisationally feasible, and locally and practically oriented.

“D’yuh like porridge”: Social talk as a relational, interactional, and clinical component of surgical consultations

Background: Small talk and social talk are often recommended to doctors as rapport building strategies for consultations. These types of talk occur across different activities in clinical consultations. Aim: To explore how small talk and social talk are used in surgical consultations. Methods: Using conversation analysis, we examined the sequential positioning and action ascription of small talk and social talk in a sample of video-recorded surgeon-patient consultations from New Zealand and Australia. Results: Small talk and social talk sequences almost always do more than build rapport in surgical interactions. Rather, they contribute in complex ways to all three institutional agendas of a consultation – clinical, interactional, and relational. Discussion: This study broadens previous topic-based analyses and binary or linear conceptualisations. We show that small talk and social talk provide a rich resource for enabling different actions within consultations as well as managing relationships (e.g. managing transitions between activities, facilitating sensitive discussions or examinations, and supporting treatment planning). Conclusion: This study has provided a basis for further research to more fully understand the complexities of small talk and social talk in clinical consultations, as well as considerations of how such evidence might best be applied within training and assessment for clinicians.

Human versus machine: investigating L2 learner output in face-to-face versus fully automated role-plays

To examine the utility of spoken dialog systems (SDSs) for learning and low-stakes assessment, we administered the same role-play task in two different modalities to a group of 47 tertiary-level learners of English. Each participant completed the task in an SDS setting with a fully automated agent and engaged in the same task with a human interlocutor in a face-to-face format. Additionally, we gauged students’ perceptions of the two delivery formats. Elicited oral performances were examined for linguistic complexity (syntactic complexity, lexical variety, fluency) and pragmatic functions (number and type of requests). Learner performance data across the two delivery modes were comparable although learners spoke slightly longer in the SDS task and used significantly more turns in the face-to-face setting—a finding that may be due to participants deploying more social rapport building moves, clarification requests, and backchanneling. The attitudinal data indicate that, while many learners liked both delivery formats, there was a slight preference for the face-to-face format, mainly due to the presence of body language. Overall, results show that fully automated SDS tasks may constitute a feasible alternative to face-to-face role-plays. Nevertheless, when possible, learners should be given a choice in task format for both learning and assessment.

Reflections on the nature of rapport within suspect interviews

ABSTRACT Rapport building has been highlighted as an effective and ethical means of eliciting information from suspects within criminal investigations. The purpose of this contemporary comment is to distinguish between what we have termed ‘interrogative rapport’ from rapport-building practices that occur in other professional contexts. To support this distinction, we advance the following arguments: (1) interrogative rapport is actively and intentionally created by the interviewer; (2) the goal of actively building rapport is to persuade the suspect to comply with requests for information; (3) interrogative rapport is inherently deceptive; and (4) the interviewer’s goal of rapport building—the elicitation of information from the suspect—is independent of, and often in opposition to, the suspect’s best interests. We believe that by acknowledging the outlined elements of interrogative rapport, more nuanced discussions concerning both rapport and persuasion within suspect interviews will result.

Perspectives on facility dogs from pediatric hospital personnel: A qualitative content analysis of patient, family, and staff outcomes

An increasing number of children's hospitals feature full-time resident facility dogs, which are specially trained to work alongside pediatric healthcare professionals to improve the patient experience. This qualitative study aimed to describe the role that facility dogs play in the lives of patients, families, and hospital staff. A total of N = 73 pediatric healthcare professionals that worked with 46 facility dogs across 17 children's hospitals in the US completed a set of open-ended questions in an online survey. Responses were analyzed via a conventional thematic analysis and organized into themes and sub-themes. Facility dogs were described to benefit pediatric healthcare professionals' daily lives through improving stress and wellbeing, staff relationships, and job-related morale. Negative impacts included increased burdens and responsibilities in the workplace. Facility dogs were also described to benefit patients and families by helping build rapport, providing a comforting presence and positive resource, and normalizing the hospital environment. In conclusion, facility dog programs were found to be a promising complementary intervention to benefit both staff as well as and patients and families. Future research is warranted to examine short-term and long-term implications of facility dog programs for staff, patient, and family wellbeing.