Supportive Messages Research Articles

An Experimental Test of Mediated Supportive Communication and Resulting Outcomes

The present study integrates theories of mediated and supportive communication to investigate the influence of communication context (i.e., channel) and content (i.e., quality) on support outcomes. 162 friend-dyads participated in an experiment by engaging in a supportive conversation that occurred either face-to-face, via video chat, or via text messaging and was manipulated to reflect either low- or high-quality support. Results showed channel richness, as operationalized by perceived synchronicity and bandwidth, varied across all three channels, and significantly predicted support receivers’ cognitive reappraisal and emotional improvement. Moderation analyses offered support consistent with the dual process theory of supportive message outcomes, such that the positive relationship between perceived bandwidth and support outcomes diminished as support quality increased. As one of the few experimental studies of enacted support reflecting varying quality levels across three distinct communication channels in the context of established friendships, implications for mediated supportive communication are discussed.

Examining the Attributional Links Between Message Quality and Outcomes of Emotional Support Received on Facebook

ABSTRACT Facebook users can receive high quality emotional support in response to their posts, but not all emotional support is of the same quality nor does it all benefit support receivers. Receivers’ perceptions of supportive messages influence the outcomes they experience. This study assessed support receivers’ attributions for the helpful support offered to them on Facebook to understand how their perceptions of the causes of that support may explain why some messages produce more beneficial outcomes than others. Participants (N = 147), who comprised predominantly white, female Facebook users in the United States, identified the most helpful comment on a recent support-seeking post on Facebook, rated the extent to which they made three types of attributions (dispositional, interpersonal, and medium) for the comment, and rated their corresponding emotional improvement. Raters coded the level of verbal person-centeredness (VPC) of each comment. Supportive messages with higher levels of VPC corresponded with more dispositional attributions and fewer medium attributions. Dispositional attributions also explained why the level of VPC of the most helpful comments was positively associated with emotional improvement.

Leveraging behavioral science and artificial intelligence to support mental health in the workplace: a pilot study.

Many American employers seek to alleviate employee mental health symptoms through resources like employee assistance programs (EAPs), yet these programs are often underutilized. This pilot study explores the design of a behavioral science-based email campaign targeting engagement with stress management and mental health resources via an EAP, among employees of a large home builder in the Southeastern US. Behavioral designers created a behavioral science intervention using a multi-step design approach and evidence based behavioral strategies. For this pilot intervention, employees received either a treatment message [i.e., behavioral science message assembled and delivered via the behavioral reinforcement learning (BRL) agent] or a control message (i.e., a single generic, supportive message with a stock photo) with a call to action to utilize their EAP. A total of 773 employees received emails over the course of 1 year. Engagement was high, with an 80% email open rate. Over 170 employees (22%, 159 treatment and 14 control) clicked the CTA and logged into the EAP site at least once. This pilot study suggests that using behavioral science and artificial intelligence can improve employee usage of EAP, specifically with the intention of exploring mental health and stress management resources, compared to benchmark rates of 5% per year.

Franchising the Disenfranchised: A Qualitative Content Analysis of Support Messages in American Miscarriage Sympathy Cards

Miscarriages are a common and unfortunate pregnancy experience; however, parents’ grief over the loss of their unborn child continues to be disenfranchized. One suggestion that miscarriage grief is beginning to be seen as a legitimate loss is with the existence of miscarriage sympathy cards. These cards, similar to other loss sympathy cards, are designed to convey condolence to grieving parents. The purpose of this study was to examine how American miscarriage sympathy cards might help to franchise miscarriage grief and to identify the types of bereavement support message strategies presented in the cards. The qualitative content analysis of miscarriage sympathy cards (N = 63) identified that miscarriage cards primarily rely on death euphuisms to talk about miscarriages and rarely acknowledge parents’ loss as real. Cards presented several support message strategies, the most common being expressing care and concern, providing a religious perspective to explain the loss, and providing a philosophical perspective to explain the loss. Miscarriage card messages also relied on hypothetical memories parents would never experience as a way to help parents remember and honor their unborn child. These results suggest that although the existence of miscarriage sympathy cards imply miscarriage grief is franchised, the language and messages used show that parents’ grief could still be disenfranchized as people struggle with how to offer condolence after a miscarriage.

The pre-match talk: A multiple-method examination of youth-elite football coaches’ motivational content

Pre-match meetings are popular scenes in team sports, with coaches typically gathering the full squad within the dressing room and sharing their thoughts before the warm-up and/or competition. Whilst researchers have outlined the effects of informational or emotional talks, little is known about the actual verbal strategies that coaches adopt to influence their players. Therefore, this study examined the motivational content of football coaches’ verbal behaviours and underpinning perceptions of pre-match talks’ delivery. Five coaches ( Mage = 36.2 years) working at a La Liga academy were involved in six pre-match talks ( n = 30) and one semi-structured interview each. Talks were analysed using a two-stage coding process after adaptation of validated and motivationally relevant instruments, and interviews were assessed following thematic analysis procedures. Game strategy units were the most commonly employed topic across all coaches, which involved ‘neutral’ behaviours such as role description, game objective specification, and opposition statements. These were complemented with autonomy and competence supportive messages such as facilitating choices/opinions, offering rationales, supporting past performance, or ego-oriented and social climate support dimensions, depending on the coach. Data suggested that contextual factors could strengthen or attenuate the use of these verbal behaviours/dimensions. Build-up play contents were more likely to feature autonomy support game strategy comments than defending aspects, whereas lower-ranked and underdog opponents were associated with increased disapproving past performance and ego-involving statements compared to when facing higher-ranked opponents or playing derbies. Thus, it is suggested that the use of autonomy-, competence- and relatedness-supportive dimensions in addition to task-oriented messages should be reconsider by coaches if attempting to convey a need-supportive motivational climate.

Text messaging intervention to support patients with chronic pain during prescription opioid tapering: protocol for a double-blind randomised controlled trial

IntroductionIncreases in pain and interference with quality of life is a common concern among people with chronic non-cancer pain (CNCP) who are tapering opioid medications. Research indicates that access to...

Mobile Phone Text Messages to Support People to Stop Smoking by Switching to Vaping: Codevelopment, Coproduction, and Initial Testing Study.

SMS text messages are affordable, scalable, and effective smoking cessation interventions. However, there is little research on SMS text message interventions specifically designed to support people who smoke to quit by switching to vaping. Over 3 phases, with vapers and smokers, we codeveloped and coproduced a mobile phone SMS text message program. The coproduction paradigm allowed us to collaborate with researchers and the community to develop a more relevant, acceptable, and equitable SMS text message program. In phase 1, we engaged people who vape via Twitter and received 167 responses to our request to write SMS text messages for people who wish to quit smoking by switching to vaping. We screened, adjusted, refined, and themed the messages, resulting in a set of 95 that were mapped against the Capability, Opportunity, and Motivation-Behavior constructs. In phase 2, we evaluated the 95 messages from phase 1 via a web survey where participants (66/202, 32.7% woman) rated up to 20 messages on 7-point Likert scales on 9 constructs: being understandable, clear, believable, helpful, interesting, inoffensive, positive, and enthusiastic and how happy they would be to receive the messages. In phase 3, we implemented the final set of SMS text messages as part of a larger randomized optimization trial, in which 603 participants (mean age 38.33, SD 12.88 years; n=369, 61.2% woman) received SMS text message support and then rated their usefulness and frequency and provided free-text comments at the 12-week follow-up. For phase 2, means and SDs were calculated for each message across the 9 constructs. Those with means below the neutral anchor of 4 or with unfavorable comments were discussed with vapers and further refined or removed. This resulted in a final set of 78 that were mapped against early, mid-, or late stages of quitting to create an order for the messages. For phase 3, a total of 38.5% (232/603) of the participants provided ratings at the 12-week follow-up. In total, 69.8% (162/232) reported that the SMS text messages had been useful, and a significant association between quit rates and usefulness ratings was found (χ21=9.6; P=.002). A content analysis of free-text comments revealed that the 2 most common positive themes were helpful (13/47, 28%) and encouraging (6/47, 13%) and the 2 most common negative themes were too frequent (9/47, 19%) and annoying (4/47, 9%). In this paper, we describe the initial coproduction and codevelopment of a set of SMS text messages to help smokers stop smoking by transitioning to vaping. We encourage researchers to use, further develop, and evaluate the set of SMS text messages and adapt it to target populations and relevant contexts.

Sleep health and aging: Recommendations for promoting healthy sleep among older adults: A National Sleep Foundation report

ObjectivesSleep is a key health indicator in older adults; however, many older adults may experience less than ideal levels of sleep health. The objective of this report is to summarize the proceedings of the National Sleep Foundation’s Sleep Health and Aging Conference. MethodsThe National Sleep Foundation held a Sleep Health and Aging Conference with sleep scientists and stakeholders in the field of aging. The primary goal of this conference was to identify critical sleep health recommendations for older adults. ResultsEssential recommendations aimed at promoting sleep health in older adults focus on light exposure, physical activity, meal timing, environmental conditions, and sleep schedules. Suggestions for promoting sleep health behavior change in older adults include tailored messaging and community support. ConclusionsThere are unique challenges and opportunities around promoting sleep health in older adults, efforts toward change should include individual, community, and societal foci.

‘It’s Too nice’: Adapting iSupport Lite for Ethnically Diverse Family Carers of a Person with Dementia

ABSTRACT OBJECTIVES Resources to support dementia carers from ethnically diverse families are limited. We explored carers’ and service providers’ views on adapting the World Health Organization’s iSupport Lite messages to meet their needs. METHODS Six online workshops were conducted with ethnically diverse family carers and service providers (n = 21) from nine linguistic groups across Australia. Recruitment was via convenience and snowball sampling from existing networks. Data were analyzed using thematic analysis. RESULTS Participants reported that iSupport Lite over-emphasized support from family and friends and made help-seeking sound “too easy”. They wanted messages to dispel notions of carers as “superheroes”, demonstrate that caring and help-seeking is stressful and time-consuming, and that poor decision-making and relationship breakdown does occur. Feedback was incorporated to co-produce a revised suite of resources. CONCLUSIONS Beyond language translation, cultural adaptation using co-design provided participants the opportunity to develop more culturally relevant care resources that meet their needs. These resources will be evaluated for clinical and cost-effectiveness in future research. CLINICAL IMPLICATIONS By design, multilingual resources for carers must incorporate cultural needs to communicate support messages. If this intervention is effective, it could help to reduce dementia care disparities in ethnically diverse populations in Australia and globally.

Well-being outcomes of a family-focused intervention for persons with type 2 diabetes and support persons: Main, mediated, and subgroup effects from the FAMS 2.0 RCT

AimsType 2 diabetes self-management occurs within social contexts. We sought to test the effects of Family/friend Activation to Motivate Self-care (FAMS), a self-care support intervention delivered via mobile phones, on psychosocial outcomes for persons with diabetes (PWDs) and their support persons. MethodsPWDs had the option to enroll with a friend/family member as a support person in a 15-month RCT to evaluate FAMS versus enhanced usual care. FAMS included 9 months of monthly phone coaching and text message support for PWDs, and text message support for enrolled support persons. ResultsPWDs (N = 329) were 52% male and 39% reported minoritized race or ethnicity ; 50% enrolled with elevated diabetes distress. Support persons (N = 294) were 26% male and 33% reported minoritized race or ethnicity. FAMS improved PWDs’ diabetes distress (d = -0.19) and global well-being (d = 0.21) during the intervention, with patterns of larger effects among minoritized groups. Post-intervention (9-month) and sustained (15-month) improvements were driven by changes in PWDs’ self-efficacy, self-care behaviors, and autonomy support. Among support persons, FAMS improved helpful involvement without increasing burden or harmful involvement. ConclusionsFAMS improved PWDs’ psychosocial well-being, with post-intervention and sustained improvements driven by improved self-efficacy, self-care, and autonomy support. Support persons increased helpful involvement without adverse effects.

Hand Hygiene Messaging Design in the Workplace: Views From the Workforce-Introduction.

The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences. Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH. A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods. Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued. This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging.

User Evaluation of a Chat-Based Instant Messaging Support Health Education Program for Patients With Chronic Kidney Disease: Preliminary Findings of a Formative Study.

Artificial intelligence-driven chatbots are increasingly being used in health care, but few chat-based instant messaging support health education programs are designed for patients with chronic kidney disease (CKD) to evaluate their effectiveness. In addition, limited research exists on the usage of chat-based programs among patients with CKD, particularly those that integrate a chatbot aimed at enhancing the communication ability and disease-specific knowledge of patients. The objective of this formative study is to gather the data necessary to develop an intervention program of chat-based instant messaging support health education for patients with CKD. Participants' user experiences will form the basis for program design improvements. Data were collected from April to November 2020 using a structured questionnaire. A pre-post design was used, and a total of 60 patients consented to join the 3-month program. Among them, 55 successfully completed the study measurements. The System Usability Scale was used for participant evaluations of the usability of the chat-based program. Paired t tests revealed significant differences before and after intervention for communicative literacy (t54=3.99; P<.001) and CKD-specific disease knowledge (t54=7.54; P<.001). Within disease knowledge, significant differences were observed in the aspects of CKD basic knowledge (t54=3.46; P=.001), lifestyle (t54=3.83; P=.001), dietary intake (t54=5.51; P<.001), and medication (t54=4.17; P=.001). However, no significant difference was found in the aspect of disease prevention. Subgroup analysis revealed that while the findings among male participants were similar to those of the main sample, this was not the case among female participants. The findings reveal that a chat-based instant messaging support health education program may be effective for middle-aged and older patients with CKD. The use of a chat-based program with multiple promoting approaches is promising, and users' evaluation is satisfactory. ClinicalTrials.gov NCT05665517; https://clinicaltrials.gov/study/NCT05665517.

Barriers and facilitators to ART adherence among ART non-adherence people living with HIV in Cameroon: A qualitative phenomenological study.

Antiretroviral therapy (ART) needs to be taken for life with near perfect levels of adherence for it to be effective. Nonetheless, ART non-adherence is still observed in sub-Saharan African (SSA) countries such as Cameroon. The objective of this study was to assess the factors influencing non-adherence and or adherence among people living with HIV (PLWH) who have experienced non-adherence to ART in Cameroon. A descriptive qualitative study of PLWH who have experienced non-adherence with ART in Cameroon was conducted. Data were collected using in-depth interviews. Collected data were analyzed using the NVIVO 12 software. In total, 43 participants participated in this study. The Southwest and Littoral regions each contributed 15 (34.88%) of participants, participants' mean age was 37.1 years (SD: 9.81) and majority 34 (82.93%) were females. ART adherence barriers include those related to patient (forgetfulness, business with other things, unwillingness to swallow drugs daily), medication (side effects), health service (arrogance of caregivers, occasional drug shortages at treatment centre, poor counseling of patient), stigma (fear of status disclosure), use of alternative treatment (traditional medicine, prayers and deliverance), resource limitation (limited food, limited finances), environmental/social (limited or no home support), and political instability (disruption of free circulation by ghost towns, roadblocks and gunshots in some regions). ART adherence facilitators include social support (family and peer support), aligning treatment with patient's daily routines (align ART with schedule of family members), use of reminders (phone alarm, sound of church bell), health sector/caregiver support (messages to patient, financial support, proper counseling), and patient's awareness of HIV status/ART knowledge (awareness of HIV positive status, Knowledge of ART benefits). ART adherence barriers in Cameroon include those related to patient, medication, health service, stigma, use of alternative treatment, resource limitation, environmental/social, and political instability. ART adherence facilitators include social support, aligning treatment with patient's daily routines, use of reminders, health sector/caregiver support, and patient's awareness of HIV status/ART knowledge. Given these barriers and facilitators, continuous information provision and consistent support both from patients' families and caregivers are needed to improve adherence among patients. Further studies including many regions and larger samples using both in-depth and focused group discussions as well as quantitative approaches are required to uncover the burden related to ART non-adherence.

Exploring Sociodemographic Characteristics, Adverse Childhood Experience, and Mental Health History as Predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada.

The COVID-19 pandemic has increased psychological disorders among adolescents and young adults. This study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 scale and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD). Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis. 343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09-250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43-361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55-200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays. The prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader contextof mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.

A multi-site intervention using influencers to communicate about syringe service programmes.

In the USA, syringe services programmes (SSPs) provide a range of harm reduction services and have numerous benefits for communities. However, stigma, misconceptions about SSPs and changing policies/legislation remain a challenge to effective implementation. This study reviews the implementation of two digital interventions, Appalachian Influence and Shared Influence, which used social media influencers and digital volunteers to communicate positive information about harm reduction and SSPs. The intervention was designed to deliver accurate and supportive messaging in locally relevant and meaningful ways. Messaging was informed by interviews with subject matter experts and community organisations, and was integrated into prompts used by local influencers (paid individuals with more than 1,000 followers) and digital volunteers (unpaid individuals with no following requirement, who joined the project independently). In the first 6 months of implementation, Appalachian Influence and Shared Influence engaged a total of 9,014 individuals, 236 of whom were paid influencers and 8,778 of whom were digital volunteers. Paid influencer posts achieved a total of 868,943 impressions, 42,432 engagements and 1,567 comments. Comments on paid influencer posts were overwhelmingly positive, with 87.4% positive and 0.8% negative. Interviews showed the importance of understanding local realities, leading with compassion and emphasising the 'human' aspects of dependency and addiction in messaging. This study shows the potential to implement an influencer-led social media intervention to reach people with authentic and compassionate messaging about harm reduction and SSPs. Future research should examine intervention effectiveness and how this approach can be applied to other stigmatised topics.

LoRaHop: Multihop Support for LoRaWAN Uplink and Downlink Messaging

LoRaWAN is one of the most popular protocols to build low-power wide area networks. Unfortunately, it adopts a star topology, which limits network coverage and may also cause an unnecessary decrease in energy efficiency as well as scalability. In fact, end-devices that are deployed far away from a gateway need to increase their transmission power or spreading factor to sustain reliable communications, which increases their energy expenditure as well as the size of the collision domain. The only alternative is the deployment of additional gateways or dedicated relay nodes, which results in higher costs and deployment efforts. In this work, we introduce LoRaHop, an extension of LoRaWAN that enriches end-devices with the ability to form a mesh network and to seamlessly relay packets to/from a gateway, thereby providing LoRaWAN networks with multi-hop support for both uplink and downlink messaging. LoRaHop leverages concurrent transmissions to enable a reliable and efficient data collection or dissemination over the mesh network, as well as to simplify network formation. Furthermore, LoRaHop embeds a mechanism that simplifies rendezvous across devices and that minimizes the impact of mesh operations on existing LoRaWAN transmissions. We implement LoRaHop on off-the-shelf LoRa end-devices (ensuring their interoperability with commercial LoRaWAN gateways and network servers), and evaluate its performance on an outdoor testbed. Our results show that LoRaHop can effectively extend the coverage of a LoRaWAN network while improving reliability by up to 98.33% and reducing energy consumption by up to 48.02%. Our findings further demonstrate that using LoRaHop to create a multi-hop LoRaWAN network that communicates using low spreading factors brings significant benefits in terms of energy efficiency and scalability compared to the use of a single-hop LoRaWAN network using high spreading factors.

The “How” and “Why” Behind Clinical Site Visits: A Qualitative Study Exploring Director of Clinical Education Perspectives

Introduction. Several studies have investigated stakeholder perspectives regarding clinical site visits (SVs). An SV is one of the many ways of building strong relationships through collaborative communication. This study explored perceptions of directors of clinical education (DCEs) about why SVs are important, why they prefer certain methods of communication over others, and how they prioritize their decision-making process regarding structure and communication methods used. Literature Review. Barriers to conducting SVs exist, including scheduling challenges, time, and cost. Some studies suggest preferences for using in-person communication. Subjects. Fifteen DCEs from across the United States. Methods. Subjects participated in one-on-one semi-structured interviews. Transcripts were analyzed using a grounded theory approach and thematic analysis. Results. Six themes emerged from the data: (1) communication is vital, (2) SVs are fact-finding missions that serve multiple purposes, (3) flexibility is essential, (4) showing up in person has a strong impact, (5) DCEs strategically schedule in-person SVs, and (6) faculty assistance can be valuable. Some of the purposes of an SV include learning about the clinic's expectations, gathering data to ensure that the student is having a good experience, keeping current with curricular trends and contemporary practice, and building and nurturing relationships. Faculty may be able to assist in conducting SVs when properly trained. In-person SVs show a powerful message of support to students and clinicians. Discussion and conclusion. Similar to other stakeholders, DCEs value SVs for building, maintaining, and strengthening clinical and academic relationships. Site visits also bridge curricular gaps, support stakeholders, and help DCEs do their job. Directors of clinical education are strategic when considering SV structure, communication methods, and prioritizing student and clinician needs. Results were used in conjunction with prior findings of our mixed-methods explanatory sequential study to create recommendations, which will empower DCEs to advocate for resources to continue conducting SVs, particularly in-person SVs, especially under certain circumstances. Future research should explore clinician perspectives, specifically related to preferred communication methods, structure of the SV, and meeting with faculty other than the DCE.

The effects of inoculation and narrative messages on texting and driving among college students

PurposeResearch is needed regarding how to influence young adults’ patterns of cell phone use while driving, amid social pressures to stay connected to their peers. Such insight could form the basis of a social marketing campaign. This study aims to explore the potential of inoculation and narrative messages as strategies to protect (i.e. generate resistance against) negative attitudes toward texting and driving.Design/methodology/approachUsing a three-phase experiment, the investigation explored the impact of different communication message strategies (i.e. inoculation, narrative, control) aimed at reducing texting while driving.FindingsResults indicated that, for college students exposed to messages in support of texting and driving, inoculation messages were superior to both narrative and control messages. These findings can guide the development of strategic social marketing interventions.Practical implicationsSocial marketing scholars and practitioners should consider weaving inoculation messages throughout social marketing campaigns focused on this important issue.Originality/valueTo the authors’ knowledge, this is the first study to evaluate and compare inoculation and narrative strategies in the context of texting and driving.

When do the effects of single-session interventions persist? Testing the mindset+supportive context hypothesis in a longitudinal randomized trial.

Single-session interventions have the potential to address young people's mental health needs at scale, but their effects are heterogeneous. We tested whether the mindset+supportive context hypothesis could help explain when intervention effects persist or fade over time. The hypothesis posits that interventions are more effective in environments that support the intervention message. We tested this hypothesis using the synergistic mindsets intervention, a preventative treatment for stress-related mental health symptoms that helps students appraise stress as a potential asset in the classroom (e.g., increasing oxygenated blood flow) rather than debilitating. In an introductory college course, we examined whether intervention-consistent messages from instructors sustained changes in appraisals over time, as well as impacts on students' predisposition to try demanding academic tasks that could enhance learning. We randomly assigned 1675 students in the course to receive the synergistic mindsets intervention (or a control activity) at the beginning of the semester, and subsequently, to receive intervention-supportive messages from their instructor (or neutral messages) four times throughout the term. We collected weekly measures of students' appraisals of stress in the course and their predisposition to take on academic challenges. Trial-registration: OSF.io; DOI: 10.17605/osf.io/fchyn. A conservative Bayesian analysis indicated that receiving both the intervention and supportive messages led to the greatest increases in positive stress appraisals (0.35 SD; 1.00 posterior probability) and challenge-seeking predisposition (2.33 percentage points; 0.94 posterior probability), averaged over the course of the semester. In addition, intervention effects grew larger throughout the semester when complemented by supportive instructor messages, whereas without these messages, intervention effects shrank somewhat over time. This study shows, for the first time, that supportive cues in local contexts can be the difference in whether a single-session intervention's effects fade over time or persist and even amplify.

Professional Fulfillment: A Pilot Study to Decrease Burnout in Clinical Academic Neurology Faculty

A pilot project, NeuroMessage, was implemented to improve professional fulfillment for full-time academic clinical neurologists through restructuring administrative non–patient-facing support. It was a targeted intervention to improve the number and quality of clinical messages received through an appropriate triage system. A messaging triage algorithm was developed to decrease physician time spent on in-basket messages. The administrative team and a research assistant were trained to manage nonclinical messages. Although the program did decrease total participant in-basket messages, the neurologist subjects did not find the intervention decreased time spent on responding to in-basket messages or improved physician job satisfaction. Improved triaging and additional administrative support for in-basket messages did not notably decrease time spent on managing in-basket messages. Further research may help understand what types of clinical support may be helpful to improve burnout. Clinical support to triage messages, so that only rare urgent messages get through to the physician, should be studied to see if aligning duties that are uniquely suited for a physician improves personal achievement and decreases burnout.