Virtual Group Research Articles

A consensus-based agreement on a definition of a process variable: findings from a New Zealand nominal group technique study.

Musculoskeletal pain and disability are leading causes of reduced health and significant economic costs worldwide. Individualised, and evidence-based treatment approaches for specific musculoskeletal conditions aimed at improving patient outcomes and costs have not been successful. Recently authors have suggested that the 'process' of how care is implemented within a health system needs to be considered as an influencer on patient outcomes. With the rising prevalence of musculoskeletal conditions and the burgeoning costs associated with their treatment, it seems timely that new research focusing on process variables and their influence on patients with musculoskeletal conditions is explored. Before such studies can take place, a modern definition of a process variable within a musculoskeletal care pathway is needed to anchor future research endeavours. Therefore, the aim of this study was to establish a consensus-based definition of a process variable within a musculoskeletal care pathway, based on a New Zealand setting. This study used a virtual nominal group technique and took place in July 2023 using a Microsoft Teams platform. A nominal group technique employs a structured approach to generate information and solutions to problems that can then be prioritised through group discussion and consensus. It is unique because it allows expert participants to explore using in-depth inquiry, areas previously unidentified or not yet investigated. There was an inclusion criterion and the participants completed pre-work before the two-hour five stage virtual meeting. The Auckland University of Technology Ethics Committee (AUTEC) approved this study (AUTEC 23/94). The study included eight participants (five male, three female) who had extensive experience with the New Zealand ACC insurance scheme and the design, implementation, and administration of musculoskeletal care pathways. The consensus definition was 'A health process variable is any modifiable factor in a health process or pathway that can be quantified and measured and that if varied may achieve a different operational or patient outcome'. This study of New Zealand-based experts has formed a consensus-based agreement for a definition of a process variable in a musculoskeletal care pathway. This is an important first step in developing our understanding of process variables, and further research is needed to establish the link between process variables and their influence on the outcomes of patients with musculoskeletal conditions.

The Effect of Virtual Laboratories on the Academic Achievement of Undergraduate Chemistry Students: Quasi-Experimental Study.

Experimentation is crucial in chemistry education as it links practical experience with theoretical concepts. However, practical chemistry courses typically rely on real laboratory experiments and often face challenges such as limited resources, equipment shortages, and logistical constraints in university settings. To address these challenges, computer-based laboratories have been introduced as a potential solution, offering electronic simulations that replicate real laboratory experiences. This study examines the effect of virtual laboratories on the academic achievement of undergraduate chemistry students and evaluates their potential as a viable alternative or complement to traditional laboratory-based instruction. A quasi-experimental design was implemented to examine the cause-and-effect relationship between instructional methods and student outcomes. The study involved 60 fourth-year BSc chemistry students from Dilla University, divided into 3 groups: a real laboratory group (n=20), which performed real laboratory experiments; a virtual group (n=20), which used virtual laboratory simulations; and a lecture group (n=20), which received lecture-based instruction. Quantitative data were collected through tests administered before and after the intervention to assess academic performance. The data analysis used descriptive and inferential statistics, such as means and SDs, 1-way ANOVA, the Tukey honestly significant difference test, and independent-sample t tests (2-tailed), with a P value of .05 set for determining statistical significance. Before the intervention, the results indicated no significant differences in academic achievement among the 3 groups (P=.99). However, after the intervention, notable differences were observed in student performance across the methods. The real laboratory group had the highest mean posttest score (mean 62.6, SD 10.7), followed by the virtual laboratory group (mean 55.5, SD 6.8) and the lecture-only group, which had the lowest mean score (mean 43.7, SD 11.5). ANOVA results confirmed significant differences between the groups (F2,57=18.429; P<.001). The Tukey post hoc test further revealed that the real laboratory group significantly outperformed the lecture-only group (mean difference 18.88; P<.001), while the virtual laboratory group also performed significantly better than the lecture-only group (mean difference 11.7; P=.001). However, no statistically significant difference was found between the real laboratory and virtual laboratory groups (mean difference 7.12; P=.07). In addition, gender did not significantly influence performance in the virtual laboratory group (P=.21), with no substantial difference in posttest scores between male and female students. These findings suggest that computer-based laboratories are a viable and effective alternative when real laboratories are unavailable, enhancing learning outcomes when compared with traditional lecture-based methods. Therefore, universities should consider integrating computer-based laboratories into their practical chemistry curricula to provide students with interactive and engaging learning experiences, especially when physical laboratories are inaccessible.

“Having Support at Work ‘Is Different’ and Important”: A Qualitative Study of Virtual Peer Discussion Groups With Medical School Faculty

Abstract Purpose In response to the need to support health care professionals during the COVID-19 pandemic, an innovative, peer-led discussion group program for medical school faculty, called CIRCLE (Colleague Involved in Reaching Colleagues through Listening and Empathy), was developed at Rutgers Health. This article describes results of a qualitative analysis of the participants’ experiences, explores virtual communication platform use during this peer support program, and identifies the program’s beneficial elements. Method CIRCLE was inaugurated in October 2020 at Rutgers New Jersey Medical School and Rutgers Robert Wood Johnson Medical School using evidence-informed topics. The inaugural CIRCLE peer-led discussion groups included 50 physicians who met twice monthly in groups of 5 to 8 between October 2020 and April 2021. Deidentified transcript data were iteratively reviewed using conventional content analysis, including familiarization, thematic framework creation, indexing, charting, mapping, and interpretation. Themes were grouped into 4 conceptual framework categories based on social support theory in the context of work-related stress: emotional, appraisal, informational, and instrumental support. Results Themes emerged based on the framework: emotional support (connecting on a deeper level, importance of support at work, COVID-19 made virtual connections needed), relevant appraisal support (feeling “not alone,” safe space to connect and share), informational support (sharing self-care strategies), and instrumental support (incentives to join are helpful but connection leads to engagement, some structure but “not too much” is important, virtual modalities are convenient and conducive to connection). Conclusions Benefits of peer discussion groups include deeper connections at work, reduced isolation, safe sharing, and exchange of information on self-care. Connection and balancing structure and autonomy were important to engagement. Virtual modalities were viewed as feasible, convenient, and conducive to connection. This article highlights the benefits and convenience of virtual peer-led discussion groups for medical school clinical faculty and provides evidence for content development of these programs.

How Doctors Talk About Medical Errors: A Qualitative Study of Junior Doctors' Experiences.

During the last three decades, an increased amount of research on errors in health care has been conducted. Studies show that physicians find it challenging to handle errors because of the blame and guilt that errors cause. Communicating with colleagues has been identified as vital for coping with errors and for creating a just culture; however, many physicians do not usually discuss their errors. Knowledge about how junior doctors experience errors is vital to ensure that they both receive emotional support and learn from errors. To capture junior doctors' perceptions and experiences, we used a qualitative, exploratory design based on virtual focus groups. We conducted seven virtual focus groups with 22 junior doctors from 11 specialties. We defined three main themes: (1) how the junior doctors conceptualized medical errors, (2) how they experienced talk about errors among colleagues, and (3) the context in which this talk took place. The participants experienced errors as challenging elements in their working life; however, they struggled to define it. They described inconsistencies regarding the reasons for discussing errors within the learning environment, with some being experienced as constructive (providing education and support) and some as destructive (involving blame and shame). There was a discrepancy between the wish to normalize error and the lack of sharing between colleagues. Our study shows that error in health care is a complex phenomenon that challenges junior doctors' navigation in clinical practice. Despite efforts to implement an open and just culture, this has not yet been achieved.

Preceptor Perspectives Using Entrustable Professional Activity-Based Assessments During Advanced Pharmacy Practice Experiences.

To explore Advanced Pharmacy Practice Experience (APPE) preceptor perspectives including implemenation recommendations, barriers, and facilitators to using entrustable professional activity (EPA) assessment in pharmacy experiential education. Two 90-minute virtual focus group sessions were conducted to elucidate preceptor perspectives on EPA integration into APPEs through semi-structured discussion. Preceptors with experience utilizing entrustment-supervision (ES) scales with EPAs for assessments for at least four APPE learners in the last year were eligible. The primary outcome was a description of implementation guidance for assessing learners using an EPA framework. Secondary outcomes include descriptions of barriers and facilitators to using an EPA framework in APPE learner assessment. All sessions were recorded, transcribed, and analyzed using inductive thematic analysis. Eleven APPE preceptors representing nine institutions participated. Commonly identified implementation recommendations were regular, repetitive preceptor education using case vpractice ignettes, student orientation to assessment expectations, clear delineation of minimum competency level, frequent discussions with preceptors, and use of institutional resources. Identified barriers were the abstractness of entrustability, subjectivity of the ES scale and preceptor assessments, unclear grading schemes, length and complexity of the assessments, and EPA applicability to the specific practice setting. Commonly identified facilitators were clearly defined scales and expectations, preceptor education, student education, pass/fail grading schemes, and shorter, more frequent assessments. EPA-based assessments can be used by preceptors for workplace-based assessments during APPEs. Faculty/preceptor development and student orientation with benchmarking and clear expectations are needed to support implementation.

Night Shift Work and Sleep Experiences in Older Night Shift Nurses.

Working at night leads to misalignment between the biological clock and the work/sleep schedule, resulting in sleepiness and impaired performance during the night shift and poor quality, shortened sleep during the day; this is greatly impaired in older individuals. To describe night work and sleep experiences from the perspective of older (aged 50-65) nurses. Seven virtual focus groups were formed comprising 19 older nurses who worked regular 8-hour night shifts (at least 6 consecutive hours between midnight and 6 am) to learn about their shift work and sleep experiences. Two facilitators and 2 research assistants independently reviewed and coded the transcripts using qualitative content analysis. Nine themes were identified in 3 domains: (a) night shift challenges and difficulties, including first night shift is most difficult; never feel rested working nights; and personal health concerns and benefits from working nights; (b) sleep challenges and difficulties, including inconsistent sleep timing when switching between nights and days; extended (24+ hours) time awake before and after consecutive nights; difficulty maintaining long and sound daytime sleep; and napping before night shifts for better performance; and (c) family and social challenges and support, including childcare, family, personal obligations, and social activities affect sleep; aging of self and children influences sleep and prioritization of sleep. The findings help understand challenges and struggles to obtain adequate sleep and safe work performance in older night shift nurses. These insignts are critical for designing and implementing feasible and acceptable interventions to improve sleep in this high-risk occupational group.

Participatory Action Research and Knowledge Dissemination in Virtual Photovoice: Methodological Insights.

Despite the methodological spread of virtual photovoice, alignments to and potential advances for the participatory action research (PAR) and knowledge dissemination (KD) components of in-person photovoice are poorly understood. Detailing the PAR and KD processes, practices, and products drawn from a virtual photovoice study examining men's experiences of and perspectives about equitable intimate partner relationships, the current article offers three thematic findings. The first theme Processes and pragmatics for selecting representative photographs describes adapting established analytics of preview, review, and cross-photo comparisons to categorize and select images from a large collection of participant-produced photographs (n = 714). Specifically, detailed are the reconciling of researchers deciding which images and accompanying narratives to include guided by PAR principles. Theme 2, Democratizing and disrupting in-person PAR with virtual focus group polls (VFGPs), chronicles participant voting through Zoom to collectively decide and subsequently discuss their favorite photographs. While anonymity for the poll was democratizing in terms of participant equality for voting on the photographs, connecting men virtually from diverse locales could differentiate cultural norms. The third theme KD pledges and pitfalls with online photovoice exhibitions details the potential benefits and challenges for reaching diverse end-users. Evident was the importance of marketing and media for driving traffic to the online exhibition, and the centrality of interactivity for fostering engagement to build and adjust photovoice e-health interventions. With virtual photovoice continuing to grow in popularity post COVID-19, this article offers important methodological lessons for adapting and advancing components of in-person PAR and KD.

Abstract 4125957: Feasibility and Acceptability of Behavioral Weight Loss Programs for Men in Trade and Labor Occupations

Objective: Men who work in trade and labor occupations experience high rates of obesity and related cardiovascular disease due to high rates of sedentary leisure time and poor diet. Despite this, they are underrepresented in weight control programs. This pilot randomized trial evaluated the feasibility and acceptability of a 6-month program tailored to this occupational group versus a non-tailored standard-of-care behavioral weight loss program. Methods: Men with overweight or obesity working in trade and labor occupations were randomly assigned to either a tailored program or the DPP Group Lifestyle Balance program delivered via 16 one-hour virtual group sessions. In-person assessments were conducted at baseline, 3, and 6 months. Semi-structured interviews and self-report were used to assess the acceptability of the interventions. Feasibility was assessed using recruitment metrics and proportion group sessions and study assessments completed. Results: Participants (N = 28; median 44.0 years, interquartile range (IQR): 38.5-54.5), median 31.8 BMI, IQR 31.1-39.6) were recruited into the study over 7 months, and 71% and 79% were retained for assessments at 3 and 6 months, respectively. Overall, participants attended a median of 7 of the 16 group sessions (IQR 2.5-11.5). The tailored group completed a median of 11 of 16 weekly online progress reports (IQR 5-15). All participants reported that they would recommend the programs to other men and felt confident that they would continue using the strategies learned in the programs. Though the trial focused on feasibility rather than efficacy, median weight losses at 6 months were -3.0% in the tailored group (95% CI -9.3, -0.6) and -1.9% in the standard group (95% CI -7.4, 2.0). Conclusions: Results suggest that both the tailored and standard weight loss interventions were well received by this group, but engagement was low. Future research should focus on understanding how to increase engagement rather than exclusively tailoring the program to this occupational group to enhance this group's involvement with cardiovascular disease prevention programs.

Psychosexual well-being following spinal cord injury: Perspectives of adults with spinal cord injury and rehabilitation clinicians.

This study aimed to identify important mental health topics for people with spinal cord injuries (PwSCI) and garner insights from health care clinicians working with this population. In doing so, we identified psychosocial adaptations in the context of sexuality, intimacy, and reproductive health. A qualitative, phenomenological approach was used, with 60-90-min virtual focus groups involving PwSCI, rehabilitation clinicians, and psychologists. Themes were identified through deductive and inductive transcript analysis. Eligibility for PwSCI included: (a) SCI for ≥ 1 year, (b) 18+ years, (c) U.S. residency, (d) conversational English skills, and (e) cognitive capacity to provide informed consent. Clinicians required ≥ 5 years of rehabilitation experience. Sixteen PwSCI, eight rehabilitation clinicians, and four psychologists participated. Three major themes emerged: (1) The effects of SCI on relationships with noninjured significant others with subthemes of (a) internalized and partnered ableism in intimate relationships and (b) navigating care partner dynamics and resource gaps; (2) sexual self-esteem with subthemes of (a) gender role adaptation and (b) body image concerns; and (3) challenges in sexual and reproductive health with subthemes of (a) family planning and self-advocacy in health care settings, (b) access to specialized care, and (c) health care provider competence. This report illuminates the complex effects of SCI on their relationships with noninjured partners, revealing how internalized and partnered ableism can heighten feelings of inadequacy and alter relationship dynamics. These findings underscore the need for more research, support, and services in sexual and reproductive health for all PwSCI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A mixed method service evaluation of Electronic Prescribing and Medicines Administration (EPMA) within 10 community hospitals in England

Abstract Introduction Electronic Prescribing and Medicines Administration (EPMA) was implemented in 13 adult inpatient wards across 10 community hospitals within one NHS community trust in England, March 2023, replacing paper drug-charts. EPMA, integrates with patients’ electronic health records, includes prescribing, administration, closed-loop supply, discharge prescribing, electronic-tasking between clinicians and provides a medicines audit trail. Laptops enable remote access. Aim To evaluate EPMA against expected safety, quality and efficiencies benefits, assess clinicians’ acceptance of EPMA and impact on pharmacy practice compared to paper-drug charts. Methods Mixed methods1 evaluation conducted in November and December 2023. This evaluation included assessing twenty-six expected multi-dimensional benefits as being achieved, partially achieved or not achieved post-EPMA implementation based on quantitative and qualitative data. Online anonymous surveys were emailed to all eligible clinicians: prescribers, nurses and pharmacy staff working on 13 inpatient wards, containing closed and open questions, adapted according to clinical group for different aspects of EPMA including questions to assess clinicians’ acceptance of EPMA2. These data were analysed using descriptive statistics in Excel. Pharmacy staff working on the inpatient wards and the dispensary were invited to attend separate virtual focus groups for pharmacists, pharmacy technicians and dispensary staff, respectively. These were recorded and transcribed via Microsoft Teams. Eight pharmacists, six pharmacy technicians and five dispensary staff agreed to participate. A semi-structured interview guide was used covering EPMA’s impact on practice, communication, patient safety, benefits and challenges. Thematic-analysis3 of the focus group interviews were undertaken by IA. Themes were validated with pharmacists and pharmacy technicians, respectively. The NHS Health Research Authority decision tool confirmed this evaluation was not NHS Research therefore did not require NHS ethics review or approval. Sussex Community NHS Foundation Trust approved this service evaluation. Results Of 26 expected multi-dimensional benefits post EPMA, 77% were achieved or partially achieved with 13% not achieved. Thirty-seven inpatient ward clinicians responded to the survey: eight prescribers, fifteen nurses, six pharmacists and eight pharmacy technicians. This showed clinicians underutilised some functionalities, although 100% felt confident using EPMA. Overall, 81% of clinicians stated medication safety had improved with EPMA, 16% felt it was the same and 3% felt it was worse, with 92% not wanting to return to paper drug-charts. Clinicians requested further prescribing developments. Thematic analysis identified four themes for pharmacists: maintaining visibility with prescribers, moving towards targeted interactions with prescribers but reducing opportunistic interactions, being increasingly available due to remotely accessing EPMA and improving patient safety through increased prescription checking; and three themes for pharmacy technicians: expanding role, improving workflow and enhancing communication with clinicians. The dispensary staff focus group emphasised that EPMA adversely impacted dispensary workflow. Discussion/Conclusion EPMA achieved some expected benefits. Clinicians have accepted EPMA, perceiving improved medication safety compared to paper-drug charts. Pharmacists are exploring ways of adapting their practice. Pharmacy technicians are enhancing their roles. Recommendations include EPMA system improvements, additional EPMA training, reviewing dispensary and pharmacists’ workflow. EPMA needs time to embed in practice. Limitations of the evaluation included no focus groups for prescribers and nurses, and limited baseline data pre-EPMA.

Development and Implementation of a “Virtual Team Coordination Application” for Enhanced Remote Work Efficiency

With the contemporary increasingly computerized and distanced workplace, effective group coordination is fundamental for maintaining coherence, productivity, and cooperation. The Virtual Group Coordination Application aims to ease communication, task management, and cooperation between staff using Microsoft PowerApps. This application acts as a central platform in which the clients can design and track errands, monitor progress, and cooperate through open dialogue, thereby dealing with common problems remote teams face. The application comes with some of the powerful features found in PowerApps, delivering a native UI, through which employees are able to navigate through several functionalities, including a task and deadline track as well as the exchange of documents. In addition, it integrates tools to update as well as alerts to ensure that tasks are completed timely, which then fosters accountability and better overall crew performance. The application also highlights information security and client jobs to ensure that all sensitive information is only accessible by an authorized work force. Applying the security job idea of PowerApps, the application ensures that its group information remains intact as it provides a customized adjustable experience tailored to the specific needs of various associations. In general, the Virtual Group Coordination Application is a comprehensive solution designed to promote virtual cooperation, collaborate in the best ways possible, and support productivity in an offsite work environment.

Virtual support group initiative for mental health professionals in the COVID-19 pandemic.

As a result of the coronavirus pandemic, mental health professionals have faced the challenge of helping their clients cope with pandemic-related distress on top of ongoing therapeutic issues. This article describes a telehealth-delivered peer/mutual support program for mental health professionals during the pandemic and the key themes identified by participants. An interdivisional American Psychological Association task force formed a working group to identify practical ways to provide mental health professionals with direct support during the pandemic. A mutual support program, the Clinician Support Collaborative, was initiated using virtual video technology. This article describes the program and themes that emerged, including the challenges and benefits of using virtual video technology to host mutual support meetings. Mutual support meetings were conducted on a weekly basis in 2020 and 2021, with mental health professionals and trainees in the Americas, Australasia, and India participating. Key themes identified included the logistical, therapeutic, and privacy concerns participants faced when shifting to telehealth, professional isolation, compassion fatigue, moral injury, burnout, stigma, disparities, and the intersection of personal/family stressors and work stressors. Recommendations for future use of virtual video technology to provide mutual support by and for mental health professionals are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Virtual Support Group Initiative for Mental Health Professionals in the COVID-19 Pandemic

Supplemental Material for Virtual Support Group Initiative for Mental Health Professionals in the COVID-19 Pandemic

UNVEILING FACTORS INFLUENCING RESEARCH HESITANCY AND LIMITED RESEARCH ENGAGEMENT AMONG FILIPINO BEGINNING TEACHERS

This descriptive qualitative study explores factors contributing to research hesitancy and limited research engagement experienced by Filipino beginning teachers. By employing in-depth individual interviews and a virtual focus group discussion, the study gathered insights from 21 purposively selected beginning teachers. Participants were required to meet all inclusion criteria to be part of the study. Template analysis was used to interpret the data gathered. The participants highlighted poor research foundations, demanding work conditions, lack of mentoring, perceived lack of professional competence, and preoccupation with personal issues as factors contributing to their research hesitance and limited research engagement. A significant finding revealed that many beginning teachers are preoccupied with personal issues, which often hinder their ability to balance personal and professional responsibilities. This highlights the complex interplay between personal struggles and professional challenges that novice educators face, an underexplored area in research. Studying the topic qualitatively allowed for a deeper understanding of these various challenges, bringing to light personal and professional struggles that may not have been fully captured through quantitative methods alone, providing a more complete picture of the issue. Findings also suggest a need for targeted interventions, such as enhanced research instruction, structured mentoring systems, manageable teaching responsibilities, and in-service training, to empower and support beginning teachers in their research journey. This study has significant implications for teacher preparation programs and school administrators, aiming to foster a research-oriented culture and enhance research engagement among early-career educators. Further investigation into how personal issues affect research skills development could help design more effective support strategies.

Comparing Pain Outcomes and Treatment Adherence Between In-Person and Virtual Interdisciplinary Pain Rehabilitation Programs at the San Francisco VA Health Care System.

This study compares clinical pain outcomes between patients in a pain treatment program that was conducted in-person, compared to a virtual program. In-Person (N=127) and Virtual (N=101) pain treatment programs were compared based on patient-reported, practitioner-collected, and medical record data. The patients were measured at baseline and post treatment (week 12 for In-Person and week 8 for Virtual patients). We employed last observation carried forward (LOCF) to handle missing data. Both the In-Person and Virtual groups were similar in regard to all baseline outcomes, except the In-Person group having significantly more co-morbidities at baseline, with particularly more cases of mental, behavioral, or neurodevelopmental diseases. Both groups demonstrated significant improvements in the pain-related measurements of pain interference and pain catastrophizing thoughts, but neither group displayed a change in average pain across treatment. Further, both groups improved significantly on emotional well-being scores, but not on physical functioning scores. No significant differences existed between groups on outcomes, except for pain catastrophizing, which was higher in the Virtual group at both time points. The Virtual group had lower rates of dropouts compared to In-Person, while the In-Person group had a larger proportion reach a clinically meaningful change in pain-related outcomes, defined as a >30% improvement. While some changes were unique to the In-Person program, overall, patients in the Virtual program achieved similar treatment outcomes, suggesting that it can successfully treat Veterans seeking pain management, with less need for in-person facilities for both patients and clinicians.

Pilot Randomized Controlled Trial of IN FOCUS: A Mind-Body Resiliency Intervention for Fear of Cancer Recurrence.

Fear of cancer recurrence (FCR) is prevalent and distressing among survivors of cancer. Evidence-based mind-body and cognitive-behavioral skills lack integration and testing in scalable formats. This pilot randomized controlled trial (NCT04876599) tested a synchronous, virtual mind-body group resiliency intervention for FCR (IN FOCUS). Adults with elevated FCR (FCR Inventory severity ≥ 16; 16-21=elevated, 22-36=clinically elevated) after completing primary treatment for non-metastatic cancer were randomly assigned (1:1) to eight weekly sessions of IN FOCUS or usual care (UC; synchronous, virtual community group support referral). Feasibility metrics included ≥ 70% retention per arm (primary outcome), ≥ 75% attendance in ≥ 6 sessions, ≥ 75% adherence to relaxation skills practice ≥ 3days per week and by delivery fidelity (% content covered in video-recorded sessions). Acceptability was assessed quantitatively via ratings of enjoyableness, convenience, helpfulness, odds of future use, and satisfaction (benchmark ≥ 80% of ratings ≥ 4 on 1-5 Likert scale) and qualitatively via individual exit interviews. Linear mixed models explicated slopes in FCR (secondary) and resiliency (exploratory; Current Experiences Scale) from baseline to 2months (primary endpoint) and 5months using intention-to-treat. From July 2021 to March 2022, 64 survivors enrolled (25-73years old, M=7years since diagnosis). IN FOCUS was feasible and acceptable (91% retention; attendance median=7 sessions, 97% relaxation practice adherence, 95% content fully covered; 82% of acceptability ratings ≥ 4). Interviews (n=59) revealed benefits in both arms. By 2months, compared to UC, IN FOCUS reduced FCR to a medium-to-large effect (Mdiff=-2.4; 95% CI=-4.2, -0.7; d=0.66). By 5months, FCR effects had attenuated (Mdiff=-0.16, 95% CI -1.97, 1.65; d=-0.04), although levels of resiliency had increased with a medium-to-large effect (Mdiff=10.0; 95% CI=4.9, 15.1; d=0.78). For survivors of non-metastatic cancer, a synchronous, virtual mind-body resiliency program for FCR is feasible, acceptable, and seemingly beneficial compared to a community group referral.

Virtual connection and real community: the qualitative experience of participating in a videoconferencing-based psychotherapy group for postpartum depression and anxiety

BackgroundGroup psychotherapy, an effective treatment for common postpartum mental disorders (e.g. depression, anxiety), has increasingly been delivered virtually since the pandemic. This study aims to understand experiential aspects of participating in videoconferencing-based group psychotherapy in the postpartum period.MethodsOur urban academic ambulatory hospital has delivered group psychotherapy for women (cis and trans) and non-binary individuals of female sex with postpartum depressive and anxiety symptomatology via videoconferencing since 2020. One therapist-facilitator conducts weekly 60-min group therapy sessions with 5-6 participants for eight weeks. Group participants were invited to complete a semi-structured qualitative interview on their experience. Using an interpretive description approach, we conducted reflexive thematic analysis to code anonymized transcripts and construct themes. Facilitator interviews were used for triangulation and additional context.ResultsOf 134 patients in video psychotherapy groups over 11 months, 14 completed an interview, as did all group facilitators (n = 3). Overall, participants felt the experience with videoconferencing group therapy was beneficial for their mental health. Three themes were constructed: (1) “Moving Towards a New Normal”: The group helped participants normalize feelings and experiences around transition to parenthood, and accessing health care virtually was now considered to be normal practice, although some wanted an element of choice. (2) “Virtual Connection, Real Community”: Connections were made virtually, yet participants felt a real sense of community. Facilitators played an important role fostering an environment in which participants could create lasting bonds. Participants noted challenges with feeling comfortable virtually and provided pragmatic and structural suggestions for enhancing the creation of community. (3) “Trade-offs to Virtual Engagement”: Participants made positive and negative trade-offs (e.g. no informal interactions, travel, isolation at home, childcare challenges) to maximize their experience and were able to be more authentic in their self-presentation to the group.ConclusionsPeople with postpartum depression and anxiety who participated in videoconferencing-based group psychotherapy appreciated the sense of community within their groups to normalize their experience transitioning to parenthood. Participants had to make trade-offs to access virtual groups, but felt the experience was worthwhile and helped improve their mental health. Findings will help inform continued delivery of virtual group mental health services.

Tele-collaborative outreach to rural patients with chronic pain: pragmatic effectiveness trial protocol for the CORPs study.

Despite the increased availability of evidence-based treatments for chronic pain, many patients in rural areas experience poor access to services. Patients receiving care through the VA may also need to navigate multiple systems of care. To examine the effectiveness of a remotely delivered collaborative care intervention for improving pain interference among veterans with high-impact chronic pain living in rural areas. We will conduct a four-site pragmatic effectiveness trial of remotely delivered collaborative care for high-impact chronic pain. Participants (n = 608) will be randomized to the Tele-Collaborative Outreach to Rural Patients (CORPs) intervention or to minimally enhanced usual care (MEUC). Participants randomized to CORPs will complete a biopsychosocial assessment and five follow-up sessions with a nurse care manager (NCM), who will collaborate with a consulting clinician to provide personalized recommendations and care management. CORP participants will also be invited to a virtual 6-session pain education group class. Participants randomized to MEUC will receive a one-time education session with the NCM to review available pain services. All participants will complete quarterly research assessments for one year. The primary study outcome is pain interference. This trial will oversample veterans of female birth sex and minoritized race or ethnicity to test heterogeneity of treatment effects across these patient characteristics. We will conduct an implementation process evaluation and incremental cost-effectiveness analysis. This pragmatic trial will test the real-world effectiveness of a remotely delivered collaborative care intervention for chronic pain. Study findings will inform future implementation efforts to support potential uptake of the intervention.

How Racism and Discrimination Impacts Black Young Women’s Sexual Health: The Influence of Racial and Sexual Stereotypes on Educational Access

PurposeStructural racism and racial discrimination may increase adverse sexual health outcomes in Black adolescent girls. However, the influence of racism on sexual health has not been well-described in qualitative studies. The purpose of this study was to explore definitions of structural racism and determine how experiences of racial discrimination impact sexual health and decision-making in a sample of adolescent Black girls. MethodsBlack girls aged 13–19 years were recruited from an ongoing longitudinal study. Virtual focus groups and individual interviews were facilitated, inquiring about understandings of structural racism, experiences with discrimination, and factors that influence sexual health decision-making and healthcare-seeking. Transcripts were professionally transcribed and coded by two independent, blinded team members. Thematic content analysis was used to identify emergent themes. ResultsFour themes emerged as follows: (1) slavery and medical racism in the United States impact the sexual and reproductive health (SRH) choices of Black girls; (2) stereotypes and oversexualization of Black girls are considered a barrier to SRH education; (3) adults serve as both barriers and facilitators to SRH and resource utilization; and (4) Black girls often seek information from friends or social media outlets to make SRH decisions. DiscussionReproductive health education for Black girls should integrate historical influences of systemic oppression. Practitioners should include reproductive justice to build trust in clinical and community spaces. Engaging caregivers in health education may reduce barriers for youth to engage in care.

Effectiveness of Virtual - Compensatory Cognitive Training (V-CCT) for improving cognition in persons with schizophrenia - a multi- centre randomized controlled trial

BackgroundCognitive deficits are the core component in persons with schizophrenia which impacts their socio-occupational functioning. Also, cognitive deficits cause significant impairment with the person’s quality of life [3]. Hence, targeting such a pivotal aspect in persons with schizophrenia through suitable interventions is very important. Developed countries have designed various cognitive remediation programs using computers involving high-end software which cannot be generalized to low-resource settings, like India, due to various factors including sociocultural factors, educational standards, and living standards of the patient population. Compensatory cognitive training (CCT) was developed to be “brief, practical, low-tech” and found to be effective in the west [9]. As there are no structured cognitive intervention modules in India, we have adapted the English CCT manual to be used for an urban population in Chennai, India. CCT was found to be feasible in face-to-face group sessions in our setting [12] and is found to be feasible and acceptable as virtual one–one intervention (unpublished data). Therefore, this study aims to evaluate the effectiveness of V-CCT in enhancing cognition and socio-occupational functioning.MethodsThe proposed study will be a multicenter assessor-blinded randomized controlled trial at two clinical sites in Chennai, India. The preparatory phase of the study would include translation of the manual to the local language, recruitment and training of research assistants, and pilot testing using the translated manual. The second phase will be the main randomized controlled trial (RCT), during which a total of 160 persons diagnosed with schizophrenia will be recruited from both sites. After obtaining informed consent, baseline assessments will be conducted on cognition, functioning, self-esteem, and quality of life. Participants will be randomly assigned to either the virtual CCT group or the control group using a computer-generated randomization table. End-line assessments will be conducted 6 weeks after the baseline by research assistants who are blinded to the randomization post-intervention.DiscussionIf V-CCT is found to be effective, it will be available for use in Tamil for persons with schizophrenia, and it will have an effect on their functioning, quality of life, and self-esteem.Trial registrationThe study is registered under Clinical trial registry-India (CTRI), and the registration number is CTRI/2024/04/065267. Registered on April 2024.