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Wurtz HM, Mason KA, Willen SS. Introduction: Student Experiences of COVID-19 Around the Globe: Insights from the Pandemic Journaling Project. Cult Med Psychiatry 2024; 48:4-22. [PMID: 38460059 DOI: 10.1007/s11013-024-09848-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 03/11/2024]
Abstract
The COVID-19 crisis has taken a significant toll on the mental health of many students around the globe. In addition to the traumatic effects of loss of life and livelihood within students' families, students have faced other challenges, including disruptions to learning and work; decreased access to health care services; emotional struggles associated with loneliness and social isolation; and difficulties exercising essential rights, such as rights to civic engagement, housing, and protection from violence. Such disruptions negatively impact students' developmental, emotional, and behavioral health and wellbeing and also become overlaid upon existing inequities to generate intersectional effects. With these findings in mind, this special issue investigates how COVID-19 has affected the mental health and wellbeing of high school and college students in diverse locations around the world, including the United States, Mexico, Brazil, China, and South Africa. The contributions collected here analyze data collected through the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, along with complementary projects and using additional research methods, such as semi-structured interviews and autobiographical writing by students. The collection offers a nuanced, comparative window onto the diverse struggles that students and educators experienced at the height of the pandemic and considers potential solutions for addressing the long-term impacts of COVID-19. It also suggests a potential role for journaling in promoting mental wellbeing among youth, particularly in the Global South.
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Affiliation(s)
- Heather M Wurtz
- Research Program on Global Health and Human Rights, Human Rights Institute, University of Connecticut, 405 Babbidge Road, U-1205, Storrs, CT, 06269, USA.
- Department of Anthropology, University of Connecticut, 354 Mansfield Road, Unit 1176, Storrs, CT, 06226, USA.
- Population Studies and Training Center, Brown University, 68 Waterman Street, Providence, RI, 02912, USA.
| | - Katherine A Mason
- Population Studies and Training Center, Brown University, 68 Waterman Street, Providence, RI, 02912, USA
- Department of Anthropology, Brown University, 128 Hope Street, Providence, RI, 02912, USA
| | - Sarah S Willen
- Research Program on Global Health and Human Rights, Human Rights Institute, University of Connecticut, 405 Babbidge Road, U-1205, Storrs, CT, 06269, USA
- Department of Anthropology, University of Connecticut, 354 Mansfield Road, Unit 1176, Storrs, CT, 06226, USA
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Niu Z, Heckman CJ. Digital Educational Strategies to Teach Skin Self-examination to Individuals at Risk for Skin Cancer. JOURNAL OF HEALTH COMMUNICATION 2022; 27:790-800. [PMID: 36625227 DOI: 10.1080/10810730.2022.2157910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Skin cancer is the most common cancer in the United States, and early detection of melanoma may lead to diagnosis of thinner and more treatable cancers, resulting in improved survival rates. This study examined the effects of message interactivity (high vs. low) and imagery (cartoon, real human character, or customized imagery preference) on accuracy of identifying abnormal skin lesions (ASL) and skin self-examination (SSE) intention. This study employed a 3 (cartoon character vs. real person vs. customization) x 2 (high interactivity vs. low interactivity) between-subjects online experimental design. Participants at risk for skin cancer were randomly assigned to one of the six conditions and completed a survey after reviewing the educational materials. Univariate analyses were conducted to detect group differences on the accuracy of identifying ASL and intention to conduct SSE in the next 3 months. Among 321 participants who completed the study, the mean age was 36.61 years, 56.7% were females, 76.1% had a college or higher degree, and over 60% self-identified as non-Hispanic White. Individuals in the high interactivity and customization group (compared to the low interactivity and cartoon group) were more likely to accurately identify ASL. Individuals in the high interactivity and customization or low interactivity and real person imagery groups (compared to the low interactivity and cartoon group) reported higher intention to conduct SSE in the next 3 months. These results suggest that customization and interactivity may be beneficial for educational programs or intervention design to improve both melanoma identification and SSE intention.
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Affiliation(s)
- Zhaomeng Niu
- Department of Health Informatics, Rutgers School of Health Professions, Piscataway, New Jersey, United States
| | - Carolyn J Heckman
- Section of Behavioral Sciences, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
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Sjömark J, Svanberg A, Viirman F, Larsson M, Poromaa I, Skalkidou A, Jonsson M, Parling T. Antepartum and labour-related single predictors of non-participation, dropout and lost to follow up in a randomised controlled trial comparing internet-based cognitive-behaviour therapy with treatment as usual for women with negative birth experiences and/or post-traumatic stress following childbirth. BMJ Open 2022; 12:e063214. [PMID: 36442895 PMCID: PMC9710351 DOI: 10.1136/bmjopen-2022-063214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Internet-based interventions are often hampered by high dropout rates. The number of individuals who decline to participate or dropout are reported, but reasons for dropout are not. Identification of barriers to participation and predictors of dropout may help improve the efficacy of internet-based clinical trials. The aim was to investigate a large number of possible predictors for non-participation and dropout in a randomised controlled trial for women with a negative birth experience and/or post-traumatic stress following childbirth. SETTING A childbirth clinic at a university hospital in Sweden. PARTICIPANTS The sample included 1523 women who gave birth between September 2013 and February 2018. All women who rated an overall negative birth experience on a Likert scale, and/or had an immediate caesarean section (CS), and/or severe postpartum haemorrhage (≥ 2000 mL) were eligible. METHODS Demographic, antepartum, and labour-related/postpartum predictors were investigated for non-participation (eligible but denied participation), pre-treatment dropout (prior to intervention start), treatment dropout, and loss to follow-up. Descriptive statistics and logistic regression were used in the data analysis. RESULTS A majority (80.3 %) were non-participants. Non-participation was predicted by lower level of education, being foreign-born, no experience of counselling for fear of childbirth, multiparity, vaginal delivery (vs CS and vacuum-assisted delivery) and absence of: preeclampsia, anal sphincter injury and intrapartum fetal distress. Pretreatment dropout was predicted by the absence of severe haemorrhage. Treatment dropout was predicted by vaginal delivery (vs immediate CS), vertex presentation and good overall birth experience. Loss to follow-up was predicted by vaginal delivery (vs immediate CS or vacuum-assisted delivery) and absence of intrapartum fetal distress. CONCLUSIONS Mothers with no obstetric complications were more likely to not participate and dropout at different time points. Both demographic, antepartum and obstetrical variables are important to attend to while designing procedures to maximise participation in internet-delivered cognitive-behavioral therapy. TRIAL REGISTRATION NUMBER ISRCTN39318241.
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Affiliation(s)
- Josefin Sjömark
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Agneta Svanberg
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Frida Viirman
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Inger Poromaa
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | - Thomas Parling
- Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services Region Stockholm, Stockholm, Sweden
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Dadkhahtehrani T, Khalili M, Torabi F, Heidari Z. The effect of expressive writing on fear of childbirth among nulliparous pregnant women: A randomized controlled trial. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Qian J, Sun S, Zhou X, Wu M, Yu X. Effects of an expressive writing intervention in Chinese women undergoing pregnancy termination for fetal abnormality: A randomized controlled trial. Midwifery 2021; 103:103104. [PMID: 34348194 DOI: 10.1016/j.midw.2021.103104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore the efficacy of an expressive writing intervention on promoting psychological well-being of women who have had a diagnosis of fetal abnormality. DESIGN AND SETTING An open, randomized controlled trial with parallel group design was conducted at a tertiary hospital in China. 100 women were randomly assigned into either the expressive writing (EW) intervention group or the control group, and 80 women eventually took part in all the phases of the study. Psychological variables including post-traumatic growth (PTG), post-traumatic stress disorder (PTSD) and resilience were assessed at baseline, immediately after the intervention and 1-month follow-up. PARTICIPANTS Women who have had a diagnosis of fetal abnormalities and decided to terminate pregnancies. INTERVENTION Women in the intervention group were asked to write three 15 min essays in regard to their experiences with the fetal abnormalities. FINDINGS The intervention group had significantly higher level of PTG (p = 0.003) and lower level of PTSD symptoms (p = 0.023) immediately after the intervention, as compared with the control group. In 1-month follow-up, intervention participants demonstrated significant improvement in PTG (p = 0.014) but insignificant reduction for PTSD symptoms. No significant effects were observed in both groups in terms of changes over time in resilience. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE EW is efficacious for improving women's PTG and easing their symptoms of PTSD to some extent. Medical staff should pay more attention to this population's psychological status. In the future, EW interventions need to be conducted in larger samples with more severe symptoms of PTSD to validate its effectiveness. The efficacy of longer and more frequent writing interventions should also be investigated.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoli Zhou
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Mengwei Wu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Ayers S, Crawley R, Webb R, Button S, Thornton A. What are women stressed about after birth? Birth 2019; 46:678-685. [PMID: 31612558 DOI: 10.1111/birt.12455] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Having a baby is associated with a variety of stressors, change, and adjustment. This study aimed to identify what women find stressful during the early postpartum period in contemporary Western society. METHODS Women (n = 148) 6-12 weeks postpartum wrote anonymously about a situation they found stressful as part of the Health after Birth Trial (HABiT) of expressive writing. Transcripts were analyzed for categories of stressors and cross-cutting themes. RESULTS Five categories of stressors were identified. Stressors in pregnancy, labor, and the early postpartum period (49.3%) included physical and emotional difficulties, and insensitive treatment by health professionals. Stressors related to adjusting to life with a baby (35.8%) included difficulties coping with a new baby, parenting, juggling responsibilities, changes to physical health, and loneliness. Stressors related to the baby's health (32.4%) included infant digestive problems, acute health problems, long-term impact, and neonatal intensive care unit experiences. Stressors related to breastfeeding (23.7%) included pressure to breastfeed, feeling like a 'bad mum' for not breastfeeding, or wanting to breastfeed and not being able to. Other stressors related to changing relationships (18.2%): with their partner, children, and other family members. Cross-cutting themes that emerged in different stressor categories were women making negative self-appraisals (eg, a bad mum, failure), feeling guilty, and lack of support from others. DISCUSSION Our findings emphasize the importance of exploring stressors and psychological well-being with women to provide support, help women's adjustment postpartum, and ensure interventions are offered when appropriate.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | | | - Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Susan Button
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London, UK
| | - Alexandra Thornton
- Centre for Maternal and Child Health Research, City, University of London, London, UK
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Ayers S, Crawley R, Button S, Thornton A, Field AP, Flood C, Lee S, Eagle A, Bradley R, Moore D, Gyte G, Smith H. Evaluation of expressive writing for postpartum health: a randomised controlled trial. J Behav Med 2018; 41:614-626. [PMID: 30291538 PMCID: PMC6209049 DOI: 10.1007/s10865-018-9970-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/20/2018] [Indexed: 02/07/2023]
Abstract
Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect the health of women. There is some evidence that expressive writing can have positive effects on psychological and physical health, particularly during stressful periods. The current study aimed to evaluate whether expressive writing would improve women's postpartum health. A randomized controlled trial was conducted with three conditions: expressive writing (n = 188), a control writing task (n = 213), or normal care (n = 163). Measures of psychological health, physical health and quality of life were measured at baseline (6-12 weeks postpartum), 1 and 6 months later. Ratings of stress were taken before and after the expressive writing task. Intent-to-treat analyses showed no significant differences between women in the expressive writing, control writing and normal care groups on measures of physical health, anxiety, depression, mood or quality of life at 1 and 6 months. Uptake and adherence to the writing tasks was low. However, women in the expressive writing group rated their stress as significantly reduced after completing the task. Cost analysis suggest women who did expressive writing had the lowest costs in terms of healthcare service use and lowest cost per unit of improvement in quality of life. Results suggest expressive writing is not effective as a universal intervention for all women 6-12 weeks postpartum. Future research should examine expressive writing as a targeted intervention for women in high-risk groups, such as those with mild or moderate depression, and further examine cost-effectiveness.Clinical trial registration number ISRCTN58399513 www.isrctn.com.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Rosalind Crawley
- School of Psychology, University of Sunderland, Chester Road, Sunderland, SR2 7PT, UK
| | - Susan Button
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Alexandra Thornton
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Andy P Field
- School of Psychology, University of Sussex, Brighton, BN1 9QH, UK
| | - Chris Flood
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Suzanne Lee
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Andrew Eagle
- Central and North West London NHS Foundation Trust, London, W10 6DZ, UK
| | - Robert Bradley
- Brighton and Sussex University Hospital NHS Trust, Eastern Road, Brighton, BN2 5BE, UK
| | - Donna Moore
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Gill Gyte
- National Childbirth Trust, 30 Euston Square, London, NW1 2FB, UK
| | - Helen Smith
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, BN1 9PH, UK.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore
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