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Wu JR, Iwanaga K, Chan F, Lee B, Chen X, Walker R, Fortuna KL, Brooks JM. Positive Organizational Psychology Factors as Serial Multiple Mediators of the Relationship between Organization Support and Job Satisfaction Among Peer Support Specialists. J Occup Rehabil 2023; 33:121-133. [PMID: 35933569 DOI: 10.1007/s10926-022-10054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Research has demonstrated the effectiveness of peer support specialists in helping people with severe mental illness increase community tenure, decrease hospitalization, boost treatment satisfaction, improve social functioning, and increase quality of life. OBJECTIVE The purpose of the present study was to evaluate positive organizational psychology constructs as serial multiple mediators of the relationships between perceived organizational support and job satisfaction among peer support specialists. METHODS One hundred and twenty-one peer support specialists from the Texas statewide peer certification training programs and the National Association of Peer Supporters participated in the present study. These peer support specialists completed an online survey composed of self-report measures related to perceived organizational support, positive organizational psychology factors, and job satisfaction. A serial multiple mediation (SMMA) analysis was conducted to evaluate autonomous motivation to work, work engagement, and organizational commitment as mediators of the relationship between perceived organizational support and job satisfaction. RESULTS The SMMA model accounted for 49% of the variation in job satisfaction scores (R2 =. 49, f2 = 0.96 [> 0.35], a large effect size). Autonomous motivation to work, work engagement, and organizational commitment were significantly associated with job satisfaction after controlling for the effect of perceived organizational support. CONCLUSIONS Perceived organizational support increased autonomous motivation to work, work engagement, organizational commitment, and job satisfaction. Peer support specialists are integral members of the interdisciplinary mental health treatment team. Leaders of community-based mental health and rehabilitation agencies who are committed to hire and retain peer support specialists must provide strong organizational support and develop interventions to increase peer support specialists' autonomous motivation to work, work engagement, and organizational commitment as a job retention and career development strategy.
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Affiliation(s)
- Jia Rung Wu
- Department of Counselor Education, Northeastern Illinois University, 5500 North St. Louis Ave, 60625, Chicago, IL, USA.
| | - Kanako Iwanaga
- Department of Rehabilitation Counseling, Virginia Commonwealth University, 900 East Leigh Street, 23298, Richmond, VG, USA
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 1000 Bascom Hall, 53706, Madison, WI, USA
| | - Beatrice Lee
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, 460 Erickson Hall, 48824, East Lansing, MI, USA
| | - Xiangli Chen
- Center for Employment and Disability Research, Kessler Foundation and Rutgers University, 120 Eagle Rock Avenue, 07936, East Hanover, NJ, USA
| | - Robert Walker
- Massachusetts Department of Mental Health, 25 Staniford St, 02114, Boston, MA, USA
| | - Karen L Fortuna
- Geisel School of Medicine, Department of Mental Health, Dartmouth College, 03766, Lebanon, NH, USA
| | - Jessica M Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
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Sippel LM, Myers AL, Brooks JM, Storm M, Mois G, Fortuna KL. Risk and protective factors in relation to early mortality among people with serious mental illness: Perspectives of peer support specialists and service users. Psychiatr Rehabil J 2022; 45:343-351. [PMID: 35797164 PMCID: PMC9822841 DOI: 10.1037/prj0000522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Individuals with serious mental illness (SMI) experience a 10-25-year reduced life expectancy when compared to the general population that is due, in part, to poor health behaviors. Yet, in spite of the development of health promotion and self-management interventions designed for people with SMI to promote health behavior change, the mortality gap has increased, suggesting that relevant factors are not being addressed. The objective of the present study was to explore potential contributors to early mortality among individuals with SMI by drawing from the lived experience of certified peer support specialists and service users (SUs). METHOD Face-to-face semistructured interviews were conducted with a convenience sample of SU participants (n = 17) and certified peer specialists (n = 15). Qualitative data were analyzed using a grounded-theory approach. RESULTS We identified a final set of 27 codes relating to five overarching themes that relate to both risk factors and protective factors for early death: social connectedness (24.1% of coded items), treatment (21.3%), coping (21.3%), physical health and wellness (18.5%), and resilience and mental health (14.8%). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings add to the literature supporting the powerful role of social processes in shaping health in people with SMI beyond social determinants of health (SDOH; e.g., income, employment) and health behavior change. Interventions that reduce loneliness and isolation in combination with addressing more conventional SDOH may have the most potential to reduce early mortality in people with SMI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Fortuna KL, Brooks JM, Myers A, Sivakumar B, Lebby SR. Effectiveness of a Digital Peer Support Training Program Designed for Rapid Uptake Among Peer Support Specialists Pilot Study. Psychiatr Q 2022; 93:783-790. [PMID: 35708827 PMCID: PMC9201261 DOI: 10.1007/s11126-022-09984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/28/2022]
Abstract
Peer telemental health recently became Medicaid reimbursable during the COVID-19 crisis, increasing the need for standardized training on digital peer support (DPS) services. DPS has the potential to reduce barriers to services and expand the reach of peer support specialists. The 4-h Digital Peer Support Training program was developed to train peer support specialists for rapid uptake in providing digital peer support during the COVID-19 crisis. The purpose of this study was to examine the impact of the 4-h DPS course for peer support specialists. Surveys were administered to examine pre-post changes in DPS course for participants (N = 75) related to attitudes/ beliefs towards DPS, ability to use/ engage in DPS, and organizational readiness to implement DPS. Data were analyzed by conducting paired samples t-tests. Linear mixed models were used to explore significant results further. Statistically significant (< .05) changes were observed related to readiness to use DPS, attitudes/ beliefs towards DPS, and ability to use/ engage in DPS. The 4-h DPS course may be beneficial in providing diverse groups of peer support specialists with a standardized training framework. Widespread dissemination of the DPS short course may be beneficial in rapidly equipping peer support specialists with the skills and resources needed to expand the reach of peer support services during the COVID-19 crisis and beyond.
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Affiliation(s)
- Karen L Fortuna
- Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Concord, NH, 03301, USA.
| | | | - Amanda Myers
- Rivier University, 420 S Main St, Nashua, NH, 03060, USA
| | | | - Stephanie R Lebby
- College of Nursing and Health Sciences, The University of Vermont, Burlington, VT, 05405, USA
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Collins-Pisano C, Rivera J, Johnson M, Mois G, Brooks JM, Myers AL, Mazina DE, Storm M, Wright M, Berger N, Kasper A, Fox A, MacDonald S, Schultze S, Bohm AR, Fortuna KL. Introduction to the Co-Production of Supervision Standards for Digital Peer Support: A Qualitative Study (Preprint). JMIR Hum Factors 2022. [DOI: 10.2196/40607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Venegas MD, Brooks JM, Myers AL, Storm M, Fortuna KL. Peer Support Specialists and Service Users' Perspectives on Privacy, Confidentiality, and Security of Digital Mental Health. IEEE Pervasive Comput 2022; 21:41-50. [PMID: 35814864 PMCID: PMC9267391 DOI: 10.1109/mprv.2022.3141986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As the digitalization of mental health systems progresses, the ethical and social debate on the use of these mental health technologies has seldom been explored among end-users. This article explores how service users (e.g., patients and users of mental health services) and peer support specialists understand and perceive issues of privacy, confidentiality, and security of digital mental health interventions. Semi-structured qualitative interviews were conducted among service users (n = 17) and peer support specialists (n = 15) from a convenience sample at an urban community mental health center in the United States. We identified technology ownership and use, lack of technology literacy including limited understanding of privacy, confidentiality, and security as the main barriers to engagement among service users. Peers demonstrated a high level of technology engagement, literacy of digital mental health tools, and a more comprehensive awareness of digital mental health ethics. We recommend peer support specialists as a potential resource to facilitate the ethical engagement of digital mental health interventions for service users. Finally, engaging potential end-users in the development cycle of digital mental health support platforms and increased privacy regulations may lead the field to a better understanding of effective uses of technology for people with mental health conditions. This study contributes to the ongoing debate of digital mental health ethics, data justice, and digital mental health by providing a first-hand experience of digital ethics from end-users' perspectives.
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Affiliation(s)
- Maria D Venegas
- Department of Veterans Affairs GRECC, Bedford, VA, 01730, USA
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Brooks JM, Umucu E, Fortuna KL, Reid MC, Tracy K, Poghosyan L. Prevalence of lifetime nonmedical opioid use among U.S. Health Center Patients aged 45 years and older with psychiatric disorders. Aging Ment Health 2022; 26:179-185. [PMID: 33291958 PMCID: PMC8187460 DOI: 10.1080/13607863.2020.1855105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Despite recent concerns over the increase in opioid misuse among aging adults, little is known about the prevalence of lifetime nonmedical opioid use in underserved, vulnerable middle-aged and older patients with psychiatric disorders. This study aims to determine the lifetime prevalence of nonmedical opioid use among underserved, vulnerable U.S. adults aged ≥45 years with psychiatric disorders. METHOD A nationally representative sample (n = 3,294) was obtained from the 2014 Health Center Patient Survey which collects data on psychiatric disorders, opioid use, and other health information from underserved, vulnerable U.S. primary care populations. Predictor variables included self-reported panic disorder, generalized anxiety disorder, schizophrenia, or bipolar disorder. The outcome variable was self-reported lifetime nonmedical opioid use. Frequencies, counts, and unadjusted and adjusted logistic regression models were conducted with the cross-sectional survey dataset. RESULTS Patients with bipolar disorder had the highest lifetime nonmedical opioid use rate (20.8%), followed by schizophrenia (19.3%), panic disorder (16.5%), and generalized anxiety disorder (14.5%). Nonmedical opioid use was significantly associated with bipolar disorder (OR 3.46, 95% CI [1.33, 8.99]) and generalized anxiety disorder (OR 2.03 95% CI [1.08, 3.83]). CONCLUSION Our findings demonstrate a high prevalence of lifetime nonmedical opioid use in underserved, vulnerable middle-aged and older health center patients with psychiatric disorders. Given the prevalence, health center professionals should monitor, prevent, and treat new or reoccurring signs and symptoms of nonmedical opioid use in this high-risk group of aging patients with psychiatric disorders.
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Affiliation(s)
- Jessica M. Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Karen L. Fortuna
- Geisel School of Medicine, Dartmouth College, Concord, NH, USA
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA
| | - M. Carrington Reid
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kathlene Tracy
- Psychosocial Division, Addiction Institute within Icahn School of Medicine at Mount Sinai (AIMS), New York, NY, USA
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Brooks JM, Wu JR, Umucu E, Storm M, Chiu CY, Walker R, Fortuna KL. Key components of recovery predict occupational performance and health in peer support specialists. Psychiatr Rehabil J 2021; 44:212-218. [PMID: 34516154 PMCID: PMC8443126 DOI: 10.1037/prj0000479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: The primary purpose of the study was to explore and identify how components of recovery are associated with occupational performance and health among peer support specialists. Methods: One hundred and twenty-one peer support specialists were recruited from statewide peer certification training programs and the International Association of Peer Supporters. Study respondents completed a survey package including demographic questions and psychometrically sound self-report measures. Two hierarchical multivariable linear regression models were conducted to evaluate whether the recovery components of the process of recovery, social support for recovery, and work self-determination (i.e., work autonomy, work competence, and work relatedness) were associated with indicators of occupational performance (i.e., work engagement) and health (i.e., job satisfaction). Results: Work autonomy was associated with the occupational performance indicator, while the process of recovery and social support for recovery were the only recovery components associated with the indicator for occupational health. Conclusions and Implications for Practice: Findings support the importance of work self-determination and social support and recovery for occupational performance and health among peer support specialists. Mental health and rehabilitation professionals should address these key components of recovery when working with and supporting the work well-being of peer support specialists. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jessica M Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Jia-Rung Wu
- Department of Counselor Education, Northeastern Illinois University
| | - Emre Umucu
- Rehabilitation Counseling Program, University of Texas at El Paso
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign
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Poghosyan L, Brooks JM, Hovsepian V, Pollifrone M, Schlak AE, Sadak T. The Growing Primary Care Nurse Practitioner Workforce: A Solution for the Aging Population Living With Dementia. Am J Geriatr Psychiatry 2021; 29:517-526. [PMID: 33622594 PMCID: PMC8855473 DOI: 10.1016/j.jagp.2021.01.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/24/2022]
Abstract
Redesigning the healthcare workforce to meet the needs of the growing population of persons living with dementia (PLWD), most of whom reside in the community and receive care from primary care providers, is a national priority. Yet, the shortage of adequately trained providers is raising concerns that the primary care system is not equipped to care for PLWD. The growing nurse practitioner (NP) workforce could bridge this gap. In this review, the authors synthesized the existing evidence from fourteen studies on the utilization of NPs to care for PLWD in primary care. Although the authors found that most NPs were engaged in co-management roles, emerging evidence suggests that NPs also serve as primary care providers for PLWD. Findings describe the impact of NP care on the health system, PLWD, and caregiver outcomes. The authors conclude that the optimal utilization of NPs can increase the capacity of delivering dementia-capable primary care.
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Affiliation(s)
| | | | | | | | | | - Tatiana Sadak
- School of Nursing, University of Washington, Seattle, WA
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9
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Brooks JM, Umucu E, Storm M, Chiu C, Wu JR, Fortuna KL. Preliminary Outcomes of an Older Peer and Clinician co-Facilitated Pain Rehabilitation Intervention among Adults Aged 50 Years and Older with Comorbid Chronic Pain and Mental Health Conditions. Psychiatr Q 2021; 92:561-571. [PMID: 32827098 PMCID: PMC7897749 DOI: 10.1007/s11126-020-09831-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study aimed to examine the acceptability, feasibility, and preliminary effectiveness of an older peer and clinician co-facilitated Behavioral Activation for Pain Rehabilitation (BA-PR) intervention among adults aged 50 years and older with comorbid chronic pain and mental health conditions. This was a mixed-methods research design with eight participants aged 55 to 62 years old with mental health conditions including schizophrenia spectrum disorder, bipolar disorder, major depressive disorder, personality disorder, and adjustment disorder. The quantitative data were assessed from observational methods, a pain rating scale and related measures. We used semi-structured interviews for qualitative feedback on experiences with the BA-PR intervention after participation. Overall, the participants had positive experiences following receipt of the BA-PR intervention. The recruitment and adherence rates for participants were 72.7% and 100%, respectively. Approximately 75% of the participants remained enrolled in the study. Findings from a paired t-test showed the BA-PR intervention was linked to significantly reduced prescription opioid misuse risk, t (7) = 2.42, p < 0.05. There were also non-significant reductions in pain intensity and depression severity, in addition to improvements in active and passive pain coping strategies and behavioral activation.The BA-PR intervention is the first pain rehabilitation intervention specifically designed for middle-aged and older adults with comorbid chronic pain and mental health conditions. Our findings indicate promise for the BA-PR intervention to potentially reduce prescription opioid misuse risk, pain, and depressive symptoms. However, a quasi-experimental study is needed before rigorous effectiveness testing.
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Affiliation(s)
- Jessica M Brooks
- Columbia University School of Nursing, 560 West 168th Street, New York, NY, 10032, USA.
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, TX, 79902, USA
| | - Marianne Storm
- Faculty of Health Sciences, Department of Public Health, University of Stavanger, 4036, Stavanger, Norway
| | - Chungyi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA
| | - Jia-Rung Wu
- Department of Counselor Education, Daniel L. Goodwin College of Education, Northeastern Illinois University, 5500 North St. Louis Avenue, Chicago, IL, 60625, USA
| | - Karen L Fortuna
- Geisel School of Medicine, Department of Mental Health, Dartmouth College, Lebanon, NH, 03766, USA.,CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, 03766, USA
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Brooks JM, Iwanaga K, Chan F, Lee B, Chen X, Wu JR, Walker R, Fortuna KL. Psychometric validation of the Job Satisfaction of Persons with Disabilities Scale in a sample of peer support specialists. Psychiatr Rehabil J 2021; 44:93-98. [PMID: 32191104 PMCID: PMC8034488 DOI: 10.1037/prj0000411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The primary purpose of the study was to evaluate the psychometric properties of the Job Satisfaction of Persons with Disabilities Scale in a sample of peer support specialists. METHOD A total of 121 employed peer support specialists with lived experience of a serious mental health condition were recruited for this study from statewide peer certification training programs and the International Association of Peer Supporters. Respondents completed an online survey on job satisfaction and related constructs. A principal components analysis was used to explore and identify the instrument subscales. RESULTS The findings identified 2 factors: (a) the 9-item job satisfaction with intangible benefits factor and (b) the 5-item job satisfaction with tangible benefits factor. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The Job Satisfaction of Persons with Disabilities Scale demonstrates good-to-excellent psychometrics. The use of this scale among peer support specialists within training and supervision practices in psychiatric rehabilitation settings is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Kanako Iwanaga
- Department of Rehabilitation Counseling, College of Health Professions, Virginia Commonwealth University
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Beatrice Lee
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Xiangli Chen
- Department of Rehabilitation Psychology and Special Education, School of Education, University of Wisconsin-Madison
| | - Jia-Rung Wu
- Department of Counselor Education, Daniel L. Goodwin College of Education, Northeastern Illinois University
| | | | - Karen L Fortuna
- Geisel School of Medicine, Department of Mental Health, Dartmouth College
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Polenick CA, Perbix EA, Salwi SM, Maust DT, Birditt KS, Brooks JM. Loneliness During the COVID-19 Pandemic Among Older Adults With Chronic Conditions. J Appl Gerontol 2021; 40:804-813. [PMID: 33641513 DOI: 10.1177/0733464821996527] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The COVID-19 pandemic may intensify loneliness among older adults with chronic conditions who are at high risk of severe illness, but little is known about factors associated with loneliness during the pandemic. We considered factors linked to loneliness among 701 adults aged 50 years and older with chronic conditions from Michigan (82.5%) and 33 other U.S. states. Participants completed an anonymous online survey between May 14 and July 9, 2020. About two thirds (66.4%) reported moderate to severe loneliness. The fully adjusted regression model revealed that being a person of color, having a spouse or cohabiting partner, and more emotional support were associated with lower levels of loneliness. Higher anxiety symptoms, more worry about COVID-19 infection, and more financial strain because of the pandemic were linked to greater loneliness. These findings inform strategies to support a vulnerable subgroup of older adults during this pandemic and in future public health crises.
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Umucu E, Reyes A, Carrola P, Mangadu T, Lee B, Brooks JM, Fortuna KL, Villegas D, Chiu CY, Valencia C. Pain intensity and mental health quality of life in veterans with mental illnesses: the intermediary role of physical health and the ability to participate in activities. Qual Life Res 2020; 30:479-486. [PMID: 32974882 PMCID: PMC7515555 DOI: 10.1007/s11136-020-02642-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 01/14/2023]
Abstract
Purpose The purpose of this study was to examine the intermediary role of physical health quality of life and ability to participate social roles and activities in the relationship between pain intensity and mental health quality of life in veterans with mental illnesses. Methods This is a cross-sectional correlational design study. Our participants are 156 veterans with self-reported mental illness (Mage = 37.85; SDage = 10.74). Descriptive, correlation, and mediation analyses were conducted for the current study. Results Pain intensity was negatively correlated with physical health QOL, ability to participate in social roles and activities, and mental health QOL. Physical health QOL and ability to participate in social roles and activities were positively associated with mental health QOL, respectively. Physical health QOL was positively correlated with a ability to participate in social roles and activities. Study results indicate that the effect of pain intensity on mental health QOL can be explained by physical health QOL and ability to participate. Conclusions Specific recommendations for practitioners include implementing treatment goals that simultaneously focus on physical health and ability to participate in social roles and activities for clients who present with both physical pain and low mental health QOL.
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Affiliation(s)
- Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA.
| | - Antonio Reyes
- Division of Special Education and Counseling, CA State University - Los Angeles, Los Angeles, CA, USA
| | - Paul Carrola
- Department of Educational Psychology and Special Services, The University of Texas at El Paso, El Paso, TX, USA
| | - Thenral Mangadu
- Department of Public Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Beatrice Lee
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Jessica M Brooks
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA
| | - Karen L Fortuna
- The Geisel School of Medicine at Dartmouth, Dartmouth College, Concord, NH, USA
| | - Diana Villegas
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Carolina Valencia
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
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Fortuna KL, Myers AL, Walsh D, Walker R, Mois G, Brooks JM. Strategies to Increase Peer Support Specialists' Capacity to Use Digital Technology in the Era of COVID-19: Pre-Post Study. JMIR Ment Health 2020; 7:e20429. [PMID: 32629424 PMCID: PMC7380901 DOI: 10.2196/20429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Prior to the outbreak of coronavirus disease (COVID-19), telemental health to support mental health services was primarily designed for individuals with professional clinical degrees, such as psychologists, psychiatrists, registered nurses, and licensed clinical social workers. For the first the time in history, peer support specialists are offering Medicaid-reimbursable telemental health services during the COVID-19 crisis; however, little effort has been made to train peer support specialists on telehealth practice and delivery. OBJECTIVE The aim of this study was to explore the impact of the Digital Peer Support Certification on peer support specialists' capacity to use digital peer support technology. METHODS The Digital Peer Support Certification was co-produced with peer support specialists and included an education and simulation training session, synchronous and asynchronous support services, and audit and feedback. Participants included 9 certified peer support specialists between the ages of 25 and 54 years (mean 39 years) who were employed as peer support specialists for 1 to 11 years (mean 4.25 years) and had access to a work-funded smartphone device and data plan. A pre-post design was implemented to examine the impact of the Digital Peer Support Certification on peer support specialists' capacity to use technology over a 3-month timeframe. Data were collected at baseline, 1 month, 2 months, and 3 months. RESULTS Overall, an upward trend in peer support specialists' capacity to offer digital peer support occurred during the 3-month certification period. CONCLUSIONS The Digital Peer Support Certification shows promising evidence of increasing the capacity of peer support specialists to use specific digital peer support technology features. Our findings also highlighted that this capacity was less likely to increase with training alone and that a combinational knowledge translation approach that includes both training and management will be more successful.
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Affiliation(s)
- Karen L Fortuna
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Concord, NH, United States
| | - Amanda L Myers
- Department of Public Health, Rivier University, Nashua, NH, United States
| | - Danielle Walsh
- Department of Psychology, Framingham State University, Framingham, MA, United States
| | - Robert Walker
- Massachusetts Department of Mental Health, Boston, MA, United States
| | - George Mois
- School of Social Work, University of Georgia, Athens, GA, United States
| | - Jessica M Brooks
- School of Nursing, Columbia University, New York, NY, United States
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Fortuna KL, Muralidharan A, Goldstein CM, Venegas M, Glass JE, Brooks JM. Certified Peer Specialists' Perspective of the Barriers and Facilitators to Mobile Health Engagement. ACTA ACUST UNITED AC 2020; 5:318-323. [PMID: 33163620 DOI: 10.1007/s41347-020-00138-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined certified peer specialists' perceptions of the barriers and facilitators to mobile health (mHealth) engagement. A total of 267 certified peer specialists from 38 states completed an online survey. Of this sample, 74 certified peer specialists completed open-ended questions. Data were analyzed from the 74 respondents who responded to open-ended questions. Certified peer specialists identified previously unidentified facilitators including the augmented use of certified peer specialists in combination with mHealth to improve engagement. One emerging theme identified was the belief that mHealth interventions may promote social isolation if not designed appropriately. Certified peer specialists appear to prefer using tablets instead of smartphones. Integrating certified peer specialists' perspectives of barriers and facilitators to mHealth engagement may promote initial and sustained mHealth engagement among consumers with serious mental illness. Future research using implementation science frameworks should examine these previously identified barriers and facilitators to mHealth engagement as correlates and/or predictors of engagement among service users.
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Affiliation(s)
- Karen L Fortuna
- Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Lebanon, NH, USA
| | - Anjana Muralidharan
- VISN 5 MIRECC Baltimore VA Medical Center Annex, 10 N Greene St, Baltimore, MD 21201, USA
| | - Carly M Goldstein
- The Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI, USA
| | - Maria Venegas
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH 03766, USA
| | - Joseph E Glass
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466, USA
| | - Jessica M Brooks
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, USA
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15
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Fortuna KL, Naslund JA, LaCroix JM, Bianco CL, Brooks JM, Zisman-Ilani Y, Muralidharan A, Deegan P. Digital Peer Support Mental Health Interventions for People With a Lived Experience of a Serious Mental Illness: Systematic Review. JMIR Ment Health 2020; 7:e16460. [PMID: 32243256 PMCID: PMC7165313 DOI: 10.2196/16460] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/27/2019] [Accepted: 01/01/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Peer support is recognized globally as an essential recovery service for people with mental health conditions. With the influx of digital mental health services changing the way mental health care is delivered, peer supporters are increasingly using technology to deliver peer support. In light of these technological advances, there is a need to review and synthesize the emergent evidence for peer-supported digital health interventions for adults with mental health conditions. OBJECTIVE The aim of this study was to identify and review the evidence of digital peer support interventions for people with a lived experience of a serious mental illness. METHODS This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures. The PubMed, Embase, Web of Science, Cochrane Central, CINAHL, and PsycINFO databases were searched for peer-reviewed articles published between 1946 and December 2018 that examined digital peer support interventions for people with a lived experience of a serious mental illness. Additional articles were found by searching the reference lists from the 27 articles that met the inclusion criteria and a Google Scholar search in June 2019. Participants, interventions, comparisons, outcomes, and study design (PICOS) criteria were used to assess study eligibility. Two authors independently screened titles and abstracts, and reviewed all full-text articles meeting the inclusion criteria. Discrepancies were discussed and resolved. All included studies were assessed for methodological quality using the Methodological Quality Rating Scale. RESULTS A total of 30 studies (11 randomized controlled trials, 2 quasiexperimental, 15 pre-post designs, and 2 qualitative studies) were included that reported on 24 interventions. Most of the studies demonstrated feasibility, acceptability, and preliminary effectiveness of peer-to-peer networks, peer-delivered interventions supported with technology, and use of asynchronous and synchronous technologies. CONCLUSIONS Digital peer support interventions appear to be feasible and acceptable, with strong potential for clinical effectiveness. However, the field is in the early stages of development and requires well-powered efficacy and clinical effectiveness trials. TRIAL REGISTRATION PROSPERO CRD42020139037; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID= 139037.
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Affiliation(s)
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Jessica M LaCroix
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Rockville, MD, United States
| | - Cynthia L Bianco
- The Giesel School of Medicine, Dartmouth College, Concord, NH, United States
| | - Jessica M Brooks
- Geriatric Research, Education and Clinical Center, James J Peters VA Medical Center, New York, NY, United States
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Anjana Muralidharan
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Rockville, MD, United States
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16
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Umucu E, Wu JR, Sanchez J, Brooks JM, Chiu CY, Tu WM, Chan F. Psychometric validation of the PERMA-profiler as a well-being measure for student veterans. J Am Coll Health 2020; 68:271-277. [PMID: 30601708 DOI: 10.1080/07448481.2018.1546182] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/16/2018] [Accepted: 11/03/2018] [Indexed: 06/09/2023]
Abstract
Objective: The current study aims to validate the PERMA-Profiler, a well-known well-being measure, among a sample of student veterans. Participants: A sample of 205 student veterans were recruited from universities across the United States. Method: Cross-sectional research design was used in this study. Measurement structure of the PERMA-Profiler was evaluated using exploratory factor analysis (EFA). Convergent, divergent, and criterion-related validity was tested using Pearson correlation coefficients and Kruskal-Wallis test. Results: The EFA results yielded a two-factor solution for student veterans. Factors are named as emotional character strengths and performance character strengths. Conclusions: The PERMA-Profiler is a multidimensional scale with good reliability and acceptable levels of convergent, divergent, and criterion-related validity. The PERMA-Profiler can help researchers and practitioners better gauge well-being in student veterans. Implications will be discussed.
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Affiliation(s)
- Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, Texas, USA
| | - Jia-Rung Wu
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Wisconsin, Madison, USA
| | - Jennifer Sanchez
- Department of Rehabilitation and Counselor Education, University of Iowa, Iowa City, Iowa, USA
| | - Jessica M Brooks
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Rehabilitation and Health Services, University of North Texas, Denton, Texas, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, Illinois, USA
| | - Wei-Mo Tu
- Department of Rehabilitation and Health Services, University of North Texas, Denton, Texas, USA
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Wisconsin, Madison, USA
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17
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Fortuna KL, Brusilovskiy E, Snethen G, Brooks JM, Townley G, Salzer MS. Loneliness and its association with physical health conditions and psychiatric hospitalizations in people with serious mental illness. Soc Work Ment Health 2020; 18:571-585. [PMID: 32973412 PMCID: PMC7508301 DOI: 10.1080/15332985.2020.1810197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Explore the association between loneliness and psychiatric hospitalizations, functioning, and physical health conditions in people with serious mental illness. METHODS Data were included from 349 individuals with serious mental illnesses, aged 18+ years, who participated in two consecutive cross-sectional survey studies conducted between 2013 and 2018. RESULTS A higher number of psychiatric hospitalizations in the past six months was associated with greater loneliness. The Short-Form-12 mental component score was a highly significant correlate, accounting for a significant amount of variance in loneliness scores. The physical component score and the bodily pain subdomain of the Short-Form-12 were also significantly associated with loneliness, with individuals with lower physical functioning and greater bodily pain reporting more loneliness. Having a higher total number of health conditions, higher total number of conditions that cause pain, and the presence of at least one respiratory condition were found to be associated with greater loneliness. DISCUSSION Loneliness may be an important dimension of health as related to health conditions associated with pain, functioning, and psychiatric hospitalizations among people with serious mental illness. These finding reinforce the powerful role of socio-cultural and environmental factors in shaping whole health in people with serious mental illness.
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Affiliation(s)
- Karen L. Fortuna
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, 03766
| | - Eugene Brusilovskiy
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
| | - Gretchen Snethen
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
| | | | - Greg Townley
- Portland State University, Department of Psychology, Portland, OR, 97207
| | - Mark S. Salzer
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
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18
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Storm M, Fortuna KL, Brooks JM, Bartels SJ. Peer Support in Coordination of Physical Health and Mental Health Services for People With Lived Experience of a Serious Mental Illness. Front Psychiatry 2020; 11:365. [PMID: 32457662 PMCID: PMC7225331 DOI: 10.3389/fpsyt.2020.00365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Engaging peer support to augment and enhance traditional mental health services presents novel opportunities to improve service engagement and delivery. However, there has not been an in-depth analysis of the processes and methods behind the coordination of physical health and mental health care by peer support specialists. STUDY AIM To explore the potential of peer support specialists in community mental health centers and as a means to improve coordination of physical health and mental health services for people with a serious mental illness. METHODS We conducted 28 semi-structured qualitative interviews with peer support specialists and mental healthcare professionals in community mental health centers in two states (blinded for review) in the United States. Data were triangulated to explore peer support specialists and mental health professionals' perspectives. RESULTS We found five themes characterizing the role of peer support services in the coordination of physical health and mental health services for individuals with serious mental illness: (1) Advocacy in interprofessional meetings, clinical teams, and advisory councils; (2) Sharing lived experiences and connecting with available resources and services; (3) Preparing for mental health and physical health care visits; (4) Mutuality; and (5) Affiliations, funding, and sustainability of peer support services. CONCLUSION This study suggests that peer support specialists can uniquely contribute to the coordination of physical health and mental health services for individuals with serious mental illness.
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Affiliation(s)
- Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Karen L Fortuna
- Department of Psychiatry, Dartmouth Centers for Health and Aging, Lebanon, NH, United States.,Department of Psychiatry, CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | - Jessica M Brooks
- Columbia University School of Nursing, New York, NY, United States
| | - Stephen J Bartels
- Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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19
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Fortuna KL, Torous J, Depp CA, Jimenez DE, Areán PA, Walker R, Ajilore O, Goldstein CM, Cosco TD, Brooks JM, Vahia IV, Bartels SJ. A Future Research Agenda for Digital Geriatric Mental Healthcare. Am J Geriatr Psychiatry 2019; 27:1277-1285. [PMID: 31196619 PMCID: PMC7059198 DOI: 10.1016/j.jagp.2019.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 12/23/2022]
Abstract
The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances, does not rely on mental health clinics to offer real-time interventions. As technology increasingly becomes essential in the everyday lives of older adults with mental health conditions, these technologies will provide a fundamental service delivery strategy to support older adults' mental health recovery. Although ample research on digital geriatric mental health is available, fundamental gaps in the scientific literature still exist. To begin to address these gaps, we propose the following recommendations for a future research agenda: 1) additional proof-of-concept studies are needed; 2) integrating engineering principles in methodologically rigorous research may help science keep pace with technology; 3) studies are needed that identify implementation issues; 4) inclusivity of people with a lived experience of a mental health condition can offer valuable perspectives and new insights; and 5) formation of a workgroup specific for digital geriatric mental health to set standards and principles for research and practice. We propose prioritizing the advancement of digital geriatric mental health research in several areas that are of great public health significance, including 1) simultaneous and integrated treatment of physical health and mental health conditions; 2) effectiveness studies that explore diagnostics and treatment of social determinants of health such as "social isolation" and "loneliness;" and 3) tailoring the development and testing of innovative strategies to minority older adult populations.
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Affiliation(s)
- Karen L Fortuna
- Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH.
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Colin A Depp
- Stein Institute for Research on Aging, Department of Psychiatry, University of California, San Diego, CA
| | - Daniel E Jimenez
- University of Miami Miller School of Medicine, Center for Cognitive Neuroscience and Aging, Miami, FL
| | - Patricia A Areán
- University of Washington, Department of Psychiatry & Behavioral Sciences, Seattle, WA
| | - Robert Walker
- Office of Recovery and Empowerment, Massachusetts Department of Mental Health, Boston, MA
| | - Olu Ajilore
- Mood and Anxiety Disorders Program, Department of Mental Health, University of Illinois, Chicago, IL
| | - Carly M Goldstein
- The Miriam Hospital, The Weight Control and Diabetes Research Center, Providence, RI; Alpert Medical School of Brown University, Department of Mental Health & Human Behavior, Providence, RI
| | - Theodore D Cosco
- Gerontology Research Center, Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Jessica M Brooks
- James J. Peters VA Medical Center, Geriatric Research, Education and Clinical Center, The Bronx, NY
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20
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Brooks JM, Petersen C, Kelly SM, Reid MC. Likelihood of depressive symptoms in US older adults by prescribed opioid potency: National Health and Nutrition Examination Survey 2005-2013. Int J Geriatr Psychiatry 2019; 34:1481-1489. [PMID: 31134673 PMCID: PMC6742518 DOI: 10.1002/gps.5157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/22/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To investigate the relationships between depressive symptoms and opioid potency among adults aged 50 years and older reporting use of one or more prescription opioids in the past 30 days. MATERIALS/DESIGN Adjusted multiple linear regression models were conducted with 2005-2013 files from a secondary cross-sectional dataset, the National Health and Nutrition Examination Survey (NHANES). Respondents were community-dwelling, noninstitutionalized adults 50 years or older (n = 1036). Predictor variables included a positive screen for minor depression symptoms (Patient Health Questionnaire [PHQ-9] score greater than or equal to 5 and less than or equal to 9), moderate depression symptoms (PHQ-9 greater than or equal to 10 and less than or equal to 14), and severe depression symptoms (PHQ-9 greater than or equal to 15). Criterion variables included weaker-than-morphine analgesics (eg, codeine and tramadol) and morphine-equivalent opioids (eg, morphine and hydrocodone), which served as the reference category, as well as stronger-than-morphine opioid analgesics (eg, fentanyl and oxycodone). RESULTS Prevalence rates for symptoms of minor depression, moderate depression, and severe depression were n = 236 (22.8%), n = 135 (13.0%), and n = 122 (11.8%), respectively. Severe depression was significantly associated with high-potency opioid use (odds ratio [OR]: 2.27; confidence interval [CI], 1.16-4.46). In post hoc tests, severe depression remained significantly associated with high-potency opioid use only among respondents without arthritis (OR: 5.80; CI, 1.59-21.13). CONCLUSIONS Compared with older adults without depressive symptoms, older adults with severe depressive symptoms are more likely to be taking high-potency opioid medications. Future prescription opioid medication research should prioritize investigations among older adults with pain-related diagnoses, other than arthritis, reporting preexisting or new symptoms of severe depression.
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Affiliation(s)
- Jessica M. Brooks
- Geriatric Research, Education, and Clinical Center, James J. Peters VA, Medical Center, Bronx, NY
| | - Curtis Petersen
- Quantiative Biomedical Sciences, Geisel School of Medicine at Dartmouth College, Lebanon, NH
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH
| | - Stephanie M. Kelly
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH
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21
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Fortuna KL, Venegas M, Umucu E, Mois G, Walker R, Brooks JM. The Future of Peer Support in Digital Psychiatry: Promise, Progress, and Opportunities. Curr Treat Options Psychiatry 2019; 6:221-231. [PMID: 33796435 PMCID: PMC8011292 DOI: 10.1007/s40501-019-00179-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE This selective review highlights promising findings and future opportunities relevant to digital peer support services. This review considered literature published in peer-reviewed scholarly journals within the past 36 months. RECENT FINDINGS Digital peer support spans multiple technology modalities: peer-delivered and smartphone-supported interventions, peer-supported asynchronous technology, artificial peer support, informal peer-to-peer support via social media, video games, and virtual worlds. Digital peer support is an emerging area of research that shows promise in improving mental health symptoms, medical and psychiatric self-management skill development, social functioning, hope, and empowerment. SUMMARY As the science of peer support in digital psychiatry advances, peer support specialists will likely have an increasingly important role in the mental health workforce-from providing evidence-based, fidelity-adherent interventions to expanding their reach to vulnerable populations and communities.
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Affiliation(s)
- Karen L. Fortuna
- The Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH, 03301, USA
| | - Maria Venegas
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, 03766, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - George Mois
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA
| | - Robert Walker
- Massachusetts Department of Mental Health, 25 Staniford St, Boston, MA, 02114, USA
| | - Jessica M. Brooks
- Geriatric Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY, 10468, USA
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22
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Petersen CL, Brooks JM, Titus AJ, Vasquez E, Batsis JA. Relationship Between Food Insecurity and Functional Limitations in Older Adults from 2005-2014 NHANES. J Nutr Gerontol Geriatr 2019; 38:231-246. [PMID: 31144612 DOI: 10.1080/21551197.2019.1617219] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Food insecurity refers to the physical, social, and economic inability to access and secure sufficient, safe and nutritious food. Food insecurity has been found to be associated with poor health status, obesity, and chronic disease. To date, a relationship between food insecurity and functional limitations has not been described in of older adults. Methods: We examined 9309 adults ≥60 years old from the 2005-2014 National Health and Nutrition Examination Surveys (NHANES). Food security was categorized as full, marginal, low, and very low. Functional limitations were assessed as having difficulty in physical, basic or instrumental activities of daily living. Results: Of adults ≥60 years old (mean age: 70.5 ± 0.08, 51% female), the prevalence of full, marginal, low, or very low food insecurity was 7572 (81%), 717 (7%), 667 (8%), and 353 (4%), respectively. The prevalence of any functional limitations was 5895 (66.3%). The adjusted odds (OR [95%CI]) of having any functional limitation in marginal, low, and very low food security levels compared to full food security are: 1.08 [1.02-1.13], 1.16 [1.10-1.22], 1.14 [1.07-1.21], respectively. The association between levels of food insecurity and functional limitation is modified by race/ethnicity. Conclusions: Functional limitation is significantly associated with increasing food insecurity in older adults.
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Affiliation(s)
- Curtis L Petersen
- a The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,b Department of Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,c Quantitative Biomedical Sciences Program, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
| | - Jessica M Brooks
- d Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,e Department of Rehabilitation and Health Services, University of North Texas , Denton , TX , USA
| | - Alexander J Titus
- b Department of Epidemiology, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,c Quantitative Biomedical Sciences Program, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA
| | - Elizabeth Vasquez
- f Department of Epidemiology, School of Public Health, SUNY Albany , Albany , NY , USA
| | - John A Batsis
- a The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,g Sections of General Internal Medicine and Weight & Wellness Center, Dartmouth-Hitchcock , Lebanon , NH , USA
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23
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Fortuna KL, Brooks JM, Umucu E, Walker R, Chow PI. Peer Support: a Human Factor to Enhance Engagement in Digital Health Behavior Change Interventions. ACTA ACUST UNITED AC 2019; 4:152-161. [PMID: 34337145 DOI: 10.1007/s41347-019-00105-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this report is to develop a theoretical model based on empirical evidence that can serve as a foundation for the science of peer-support factors that facilitate engagement in digital health interventions for people with serious mental illness (SMI). A review of the literature on how peer-support specialist interaction with consumers with SMI in digital health behavior change interventions enhances engagement. Unlike relationships with other health providers, peer-to-consumer relationships are based on reciprocal accountability -meaning that peer-support specialists and consumer mutually help and learn from each other. Under the recovery model of mental illness, reciprocal accountability suggests autonomy, flexible expectations, shared lived experience, and bonding influence engagement in digital interventions. Separate yet related components of reciprocal accountability in the context of digital health intervention engagement include (1) goal setting, (2) task agreement, and (3) bonding. Hope and sense of belonging are hypothesized moderators of peer-support factors in digital health interventions. Peer-support factors help people with SMI learn to live sucessfully both in the clinic and community. Peer-support specialists add value and complement traditional mental health treatment through their professional training and lived experience with a mental illness. The proposed model is a pioneering step towards understanding how peer-support factors impact engagement in digital health behavior change interventions among people with a lived experience of SMI. The model presents proposed factors underlying the reciprocal accountability processes in the context of digital health intervention engagement. This model and related support factors can be used to examine or identify research questions and hypotheses.
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Affiliation(s)
- Karen L Fortuna
- The Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA.,CDC Health Promotion Research Center at Dartmouth, Lebanon, NH 03766, USA
| | - Jessica M Brooks
- James J. Peters VA Medical Center, Geriatric Research, Education and Clinical Center, 130 W Kingsbridge Rd, The Bronx, NY, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, 500 W University Ave, El Paso, TX 79968, USA
| | - Robert Walker
- Massachusetts Department of Mental Health, Office of Recovery, 25 Staniford St, Boston, MA 02114, USA
| | - Phillip I Chow
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
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Brooks JM, Petersen CL, Titus AJ, Umucu E, Chiu C, Bartels SJ, Batsis JA. Varying Levels of Food Insecurity Associated with Clinically Relevant Depressive Symptoms in U.S. Adults Aged 60 Years and Over: Results from the 2005-2014 National Health and Nutrition Survey. J Nutr Gerontol Geriatr 2019; 38:218-230. [PMID: 31074705 DOI: 10.1080/21551197.2019.1611520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Food insecurity refers to restricted or uncertain access to and ineffective utilization of nutritious and safe foods. Although food insecurity is linked to poorer physical health consequences among older adults, national estimates are not well known on food insecurity and depression. Using the 2005-2014 National Health and Nutrition Examination Survey, this study examines the associations between varying food insecurity levels and clinically relevant depressive symptoms (defined by PHQ-9 ≥ 10) among adults ≥60 years old (n = 7969). Rates of clinically relevant depressive symptoms in marginal, low, and very low food security were 12.3, 16.3, and 25.2%, respectively. Marginal, low, and very low food security were significantly associated with clinically relevant depressive symptoms: odds ratio (OR) = 1.12 (95% confidence intervals [CI] 1.07-1.18), OR = 1.07 (95% CI 1.03-1.12), and OR = 1.24 (95% CI 1.16-1.32), respectively. Given the intersection of food insecurity and depression, geriatric health professionals should work to improve health and nutrition programs for older adults at risk for or experiencing both public health concerns.
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Affiliation(s)
- Jessica M Brooks
- a Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,b Department of Rehabilitation and Health Services, University of North Texas , Denton , TX , USA
| | - Curtis L Petersen
- c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA.,d Department of Epidemiology, Geisel School of Medicine at Dartmouth College , Lebanon , NH , USA
| | - Alexander J Titus
- d Department of Epidemiology, Geisel School of Medicine at Dartmouth College , Lebanon , NH , USA.,e Program in Quantitative Biomedical Sciences, Dartmouth College , Lebanon , NH , USA
| | - Emre Umucu
- f Department of Rehabilitation Sciences, University of Texas at El Paso , El Paso , TX , USA
| | - Chungyi Chiu
- g Department of Kinesiology and Community Health, The University of Illinois at Urbana-Champaign , Champaign , IL , USA
| | - Stephen J Bartels
- a Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College , Lebanon , NH , USA.,c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA
| | - John A Batsis
- c The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College , Lebanon , NH , USA.,h Department of Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth , Lebanon , NH , USA.,i Centers for Health and Aging , Lebanon , NH , USA
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Brooks JM, Polenick CA, Bryson W, Naslund JA, Renn BN, Orzechowski NM, Almeida M, Bartels SJ. Pain intensity, depressive symptoms, and functional limitations among older adults with serious mental illness. Aging Ment Health 2019; 23:470-474. [PMID: 29356566 PMCID: PMC6054897 DOI: 10.1080/13607863.2017.1423025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine pain-related activity interference as a mediator for the relationship between pain intensity and depressive symptoms among older adults with serious mental illness (SMI). METHOD Ordinary least-squares regressions were used to investigate the mediation analysis among older adults with SMI (n = 183) from community mental health centers. Analyses used secondary data from the HOPES intervention study. RESULTS Higher pain intensity was associated with greater pain-related activity interference. Higher pain intensity and pain-related activity interference were also associated with elevated depressive symptoms. Finally, greater pain-related activity interference significantly mediated the association between higher pain intensity and elevated depressive symptoms. CONCLUSIONS These findings demonstrate that pain and depressive symptoms may be linked to functional limitations. Clinicians and researchers in the mental health field should better address pain-related activity interference among older adults with SMI, especially among those with higher pain intensity and elevated depressive symptoms.
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Affiliation(s)
- Jessica M. Brooks
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH, USA,Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
| | | | - William Bryson
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - John A. Naslund
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Brenna N. Renn
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Nicole M. Orzechowski
- Section of Rheumatology, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Margaret Almeida
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH, USA
| | - Stephen J. Bartels
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH, USA,The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
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Umucu E, Iwanaga K, Wu JR, Brooks JM, Ditchman N, Flowers-Benton S, Chan F. Preliminary Validation of a Short Form of the Perceived Stress Questionnaire for Use in Clinical Rehabilitation Counseling Research and Practice. Rehabilitation Research Policy and Education 2018. [DOI: 10.1891/0889-7018.32.4.232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BackgroundThe purpose of this study was to develop and validate a short form of the Perceived Stress Questionnaire (PSQ) in people with spinal cord injury (SCI).MethodsThe sample consisted of 274 individuals with SCI. Measures administered were the PSQ-20, Center for Epidemiological Studies-Depression Scale, and Rand Short-Form 36 General Health Scale.ResultsResults showed that after selecting two items from each subscale of the PSQ-20, factor analysis results supported a unidimensional measure for the PSQ-8. The PSQ-8 total score demonstrated a high correlation with the PSQ-20 total score. The reliability of the PSQ-8 was adequate and similar to the PSQ-20. The PSQ-8 measurement correlated well with the external correlates of depression and health status. The mediation analysis indicated depression as a partial mediator for the relationship between perceived stress and health status, indicating people with higher levels of perceived stress had poorer health outcome in this study.ConclusionsThis study provides evidence to support the psychometric properties of PSQ-8 in people with SCI. The PSQ-8 is a brief, reliable, unidimensional, and psychometrically sound measure of perceived stress that can be used in clinical rehabilitation and mental health counseling research and practice.
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Brooks JM, Titus AJ, Polenick CA, Orzechowski NM, Reid MC, MacKenzie TA, Bartels SJ, Batsis JA. Prevalence rates of arthritis among US older adults with varying degrees of depression: Findings from the 2011 to 2014 National Health and Nutrition Examination Survey. Int J Geriatr Psychiatry 2018; 33:1671-1679. [PMID: 30229563 PMCID: PMC6422526 DOI: 10.1002/gps.4971] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 08/06/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Arthritis and depressive symptoms often interact and negatively influence one another to worsen mental and physical health outcomes. Better characterization of arthritis rates among older adults with different levels of depressive symptoms is an important step toward informing mental health professionals of the need to detect and respond to arthritis and related mental health complications. The primary objective is to determine arthritis rates among US older adults with varying degrees of depression. METHODS Using National Health and Nutrition Examination Survey 2011 to 2014 data (N = 4792), we first identified participants aged ≥50 years. Measures screened for depressive symptoms and self-reported doctor-diagnosed arthritis. Weighted logistic regression models were conducted. RESULTS Prevalence of arthritis was 55.0%, 62.9%, and 67.8% in participants with minor, moderate, and severe depression, respectively. In both unadjusted and adjusted regression models, a significant association between moderate depression and arthritis persisted. There were also significant associations between minor and severe depression with arthritis. CONCLUSIONS Arthritis is commonly reported in participants with varying degrees of depression. This study highlights the importance of screening for and treating arthritis-related pain in older adults with depressive symptoms and the need for future geriatric psychiatry research on developing integrated biopsychosocial interventions for these common conditions.
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Affiliation(s)
- Jessica M. Brooks
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH, USA,University of North Texas, Denton, TX, USA
| | - Alexander J. Titus
- Program in Quantitative Biomedical Sciences, Dartmouth College, Lebanon, NH, USA,Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | | | - Nicole M. Orzechowski
- Section of Rheumatology, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | | | - Todd A. MacKenzie
- Biomedical Data Science, Dartmouth College, Lebanon, NH, USA,Department of Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA,The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA,Centers for Health and Aging, Lebanon, NH, USA
| | - Stephen J. Bartels
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH, USA,Centers for Health and Aging, Lebanon, NH, USA
| | - John A. Batsis
- Department of Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA,The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA,Centers for Health and Aging, Lebanon, NH, USA
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Umucu E, Brooks JM, Lee B, Iwanaga K, Wu JR, Chen A, Chan F. Measuring dispositional optimism in student Veterans: An item response theory analysis. Military Psychology 2018. [DOI: 10.1080/08995605.2018.1522161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, Texas
| | - Jessica M. Brooks
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
- Department of Rehabilitation and Health Services, University of North Texas, Denton, Texas
| | - Beatrice Lee
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, DeKalb, Illinois
| | - Kanako Iwanaga
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, DeKalb, Illinois
| | - Jia-Rung Wu
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, DeKalb, Illinois
| | - Ada Chen
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, DeKalb, Illinois
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, DeKalb, Illinois
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Brooks JM, Deiches J, Xiang X, Batsis JA, Chan F, DiMilia P, Chiu C, Thompson K, Bartels S. Differences in Self-Reported Physical Activity, Exercise Self-Efficacy and Outcome Expectancies, and Health Status by Body Mass Index Groups in People with Chronic Pain. J Rehabil 2018; 84:46-52. [PMID: 32089565 PMCID: PMC7034931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The study purpose was to determine how self-reported lifestyle physical activity levels, exercise self-efficacy and outcome expectancies, and health status differ by body mass index for persons with chronic pain. From U.S. clinics and community networks, 209 adults reporting chronic musculoskeletal pain were recruited for the cross-sectional survey. Data were analyzed using analysis of variance. Participants with self-described obesity reported the lowest physical activity, reduced exercise self-efficacy and positive outcome expectancies, and poorer health status. Promoting graded activity while addressing motivational factors from health behavior theory for people with chronic pain and obesity should be encouraged in rehabilitation programs.
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Sánchez J, Muller V, Chan F, Brooks JM, Iwanaga K, Tu WM, Umucu E, Crespo-Jones M. Personal and environmental contextual factors as mediators between functional disability and quality of life in adults with serious mental illness: a cross-sectional analysis. Qual Life Res 2018; 28:441-450. [PMID: 30244361 DOI: 10.1007/s11136-018-2006-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine personal and environmental contextual factors as mediators of functional disability on quality of life (QOL) in a sample of individuals with serious mental illness (SMI). METHODS A cross-sectional analysis of 194 individuals with SMI (major depressive disorder = 38.1%; bipolar disorder = 35.6%; schizophrenia spectrum disorder = 25.8%) recruited from four psychosocial rehabilitation clubhouses was undertaken to test a multiple regression model assuming that personal (i.e., resilience, social competence, and disability acceptance) contextual factors and environmental (i.e., family support, support from friends, and support from significant others) contextual factors would mediate the relationship of functional disability on QOL. The bootstrap test for multiple mediators was then used to test for the significance of the indirect effects functional disability on QOL through the mediators. RESULTS In the simple regression model, functional disability had a strong relationship with QOL; however, after introducing the potential mediators, its effect was significantly reduced indicating partial mediation effects. The final regression model yielded a large effect, accounting for 44% of the variance in QOL. Controlling for all other potential mediating factors, social competence, disability acceptance, family support, and support from friends were found to partially mediate the relationship between functional disability and QOL. Bias-corrected bootstrap procedure results further supported the mediation model. CONCLUSIONS The findings from the study provide good support for the inclusion of person-environment contextual factors in conceptualizing the relationship between functional disability and QOL for individuals with SMI.
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Affiliation(s)
- Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, N346 Lindquist Center, Iowa City, IA, 52242, USA. .,Iowa Consortium for Substance Abuse Research and Evaluation, The University of Iowa, 2662 Crosspark Road, Coralville, IA, 52241, USA. .,I-SERVE (Iowa-Support, Education, and Resources for Veterans and Enlisted), The University of Iowa, N122 Lindquist Center, Iowa City, IA, 52242, USA.
| | - Veronica Muller
- Department of Educational Foundations and Counseling, Hunter College, City University of New York, 695 Park Avenue, Room W1123, New York, NY, 10065, USA
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 431 Education Building, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Jessica M Brooks
- Department of Rehabilitation and Health Services, University of North Texas, 218 Chilton Hall, 410 Avenue C, Denton, TX, 76203, USA
| | - Kanako Iwanaga
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 431 Education Building, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Wei-Mo Tu
- Department of Rehabilitation and Health Services, University of North Texas, 218 Chilton Hall, 410 Avenue C, Denton, TX, 76203, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 101 Campbell Building, 500 West University Avenue, El Paso, TX, 79968, USA
| | - Mileidy Crespo-Jones
- Department of Rehabilitation and Counselor Education, The University of Iowa, N346 Lindquist Center, Iowa City, IA, 52242, USA
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Brooks JM, Huck G, Iwanaga K, Chan F, Wu JR, Finnicum CA, Brinck EA, Estala-Gutierrez VY. Towards an integration of the health promotion models of self-determination theory and theory of planned behavior among people with chronic pain. Rehabil Psychol 2018; 63:553-562. [PMID: 30211605 DOI: 10.1037/rep0000245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE People with chronic pain and related disability often report motivational difficulties with engaging in health-promoting behaviors. Although health promotion models of self-determination theory (SDT) and theory of planned behavior (TPB) have been shown to explain the motivational processes behind health behaviors in the general population, there is limited theoretical research among persons with chronic pain. This study examined the integration of such theories relevant to physical activity and exercise behavior among pain populations. RESEARCH METHOD Secondary data analyses were conducted using cross-sectional surveys from 198 participants with chronic musculoskeletal pain recruited from U.S. clinics and community networks. The primary outcome was self-reported physical activity and exercise participation. Predictor variables included pain intensity, functional disability, and SDT and TPB measures. Hierarchical regression analysis was conducted to examine the associations between these variables. RESULTS Findings demonstrated that in the first step, functional disability was associated with physical activity and exercise; and in the second step, all SDT factors were associated with physical activity and exercise. In the final step of the model, only certain SDT and TPB factors were associated with physical activity and exercise. CONCLUSIONS Despite preexisting pain and functional disability, the findings suggest that health behavior factors from both SDT and TPB are associated with physical activity and exercise participation. This line of research should encourage rehabilitation professionals to recommend regular physical activity and exercise, while simultaneously addressing and monitoring the SDT and TPB factors that are well-timed and appropriate for persons with chronic pain through motivation-oriented rehabilitation approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | - Kanako Iwanaga
- Department of Rehabilitation Psychology and Special Education
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education
| | - Jia-Rung Wu
- Department of Rehabilitation Psychology and Special Education
| | | | - Emily A Brinck
- Department of Rehabilitation Psychology and Special Education
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Brooks JM, Umucu E, Huck GE, Fortuna K, Sánchez J, Chiu C, Bartels SJ. Sociodemographic characteristics, health conditions, and functional impairment among older adults with serious mental illness reporting moderate-to-severe pain. Psychiatr Rehabil J 2018; 41:224-233. [PMID: 30160508 PMCID: PMC6123826 DOI: 10.1037/prj0000316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare adults aged ≥50 years with serious mental illness reporting moderate-to-severe pain to older adults with serious mental illness without pain with respect to sociodemographic characteristics, health conditions, and functional impairment. METHOD Secondary data analyses were conducted using baseline assessments of 183 participants recruited for the Helping Older People Experience Success (HOPES) study from three community mental health centers. The primary outcome was self-reported, nonexperimentally induced, moderate-to-severe pain (referent = no-to-mild pain). Predictor variables consisted of sociodemographic characteristics, health conditions, and functional impairment. We conducted univariable and multivariable logistic regression analyses to examine the associations between these variables. RESULTS Sixty-one participants (33.3%) from our sample reported pain. Pain was associated with all of the sociodemographic and health-related factors in univariable analyses. In the multivariable model, only older age, pain-related activity interference, and physical and emotional health-related social limitations were significantly associated with pain. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The presence of moderate-to-severe pain in older adults with serious mental illness is associated with pain-attributable impairment of activities and social problems above and beyond the substantial functional limitations routinely experienced by this high-risk, high-need group. Given the high rates of preexisting conditions and persistent social impairment among these older adults, our findings suggest that pain may contribute to worse overall functional outcomes. Future research and clinical interventions focused on improving outcomes should include an evaluation of pain as a contributor to decreased functioning and assess the need for early intervention, nonpharmacological pain management, or other health promotion services in psychiatric rehabilitation. (PsycINFO Database Record
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Affiliation(s)
- Jessica M Brooks
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso
| | - Garrett E Huck
- Department of Rehabilitation and Human Services, Penn State Hazleton
| | - Karen Fortuna
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
| | - Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa
| | - Chungyi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign
| | - Stephen J Bartels
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College
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Brooks JM, Kaya C, Chan F, Thompson K, Cotton BP, Sánchez J, Fortuna K. Validation of the Behavioural Regulation in Exercise Questionnaire-2 for adults with chronic musculoskeletal pain. Int J Ther Rehabil 2018; 25:395-404. [PMID: 32133037 PMCID: PMC7055823 DOI: 10.12968/ijtr.2018.25.8.395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/AIMS The Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) has demonstrated reliability and validity in the general population; yet the psychometric properties have not been tested among rehabilitation populations, such as persons experiencing chronic musculoskeletal pain. The objective of the current study was to examine the factorial structure and psychometric properties of the BREQ-2 in a sample of adults with chronic musculoskeletal pain. METHODS Adults with chronic musculoskeletal pain (n=211) were recruited from clinical and community networks in the United States. Data were collected using a cross-sectional online survey and analysed using confirmatory factor analysis, multiple indicators multiple causes analysis, and correlational techniques. Participants completed the BREQ-2 and other measures relevant to self-determination theory, including outcome expectancies, self-efficacy and family and friend support for physical activity and exercise. FINDINGS Results indicated the intercorrelated model fit the data well. The five factors of amotivation, external regulation, introjected regulation, identified regulation and intrinsic regulation toward physical activity and exercise demonstrated good reliability and construct validity. CONCLUSIONS This study provides evidence of factorial and construct validity for the BREQ-2 among people with chronic musculoskeletal pain. Implications for rehabilitation practitioners and researchers are discussed.
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Affiliation(s)
- Jessica M Brooks
- Department of Rehabilitation & Health Services, University of North Texas, Denton, Texas, USA
| | - Cahit Kaya
- Department of Educational Sciences, Giresun University, Giresun, Turkey
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | | | - Jennifer Sánchez
- Rehabilitation and Counsellor Education, University of Iowa, Iowa City, Iowa, USA
| | - Karen Fortuna
- Department of Psychiatry, Dartmouth College, Lebanon, New Hampshire, USA
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Cotton BP, Bryson WC, Lohman MC, Brooks JM, Bruce ML. Characteristics of Medicaid recipients in Methadone Maintenance Treatment: A comparison across the lifespan. J Subst Abuse Treat 2018; 92:40-45. [PMID: 30032943 DOI: 10.1016/j.jsat.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 02/08/2023]
Abstract
Methadone Maintenance Treatment (MMT) is utilized by an increasingly broad age-range of individuals with opioid use disorders. The present study aims to (1) describe health, behavioral, and psychosocial characteristics among adults aged 50 years and older compared with younger adults enrolled in MMT, (2) describe socioeconomic and clinical characteristics by age and time in MMT and (3) investigate whether age influences the associations between duration of MMT and health and psychosocial characteristics. Our sample consisted of 1364 recipients from four MMT programs (age ranged from 18 to 77 years; mean: 38 years: standard deviation: 11.1 years) in Southern New England Using descriptive analysis and logistic regression, we determined that one-third (33%) of adults 50 years of age and older had been admitted or readmitted into MMT within the previous 6 months, 27% had been in treatment for 7-47 months, while 40% had been in treatment for at least 4 years. Psychosocial problems and smoking were both common (>80%) at the time of MMT enrollment but declined with longer duration of MMT for all age groups. The prevalence of metabolic conditions was associated with increased duration of MMT for younger adults for both age (1.03; CI 1.02-1.05; p < 0.001) and time in treatment (1.29; 1.12-1.44; p < 0.001; interaction term 0.0996; CI 0.993-0.998). Tailored strategies to enhance engagement, retention, and prevention among MMT recipients should include considerations of age, health status upon enrollment, duration of treatment, and developmental context.
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Affiliation(s)
- Brandi P Cotton
- University of Rhode Island, College of Nursing, Kingston, RI, United States.
| | - William C Bryson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC, United States
| | - Jessica M Brooks
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States; Department of Rehabilitation & Health Services, University of North Texas, Denton, TX, United States
| | - Martha L Bruce
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Fortuna KL, DiMilia PR, Lohman MC, Bruce ML, Zubritsky CD, Halaby MR, Walker RM, Brooks JM, Bartels SJ. Feasibility, Acceptability, and Preliminary Effectiveness of a Peer-Delivered and Technology Supported Self-Management Intervention for Older Adults with Serious Mental Illness. Psychiatr Q 2018; 89:293-305. [PMID: 28948424 PMCID: PMC5874159 DOI: 10.1007/s11126-017-9534-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To assess the feasibility, acceptability, and preliminary effectiveness of a peer-delivered and technology supported integrated medical and psychiatric self-management intervention for older adults with serious mental illness. Ten older adults with serious mental illness (i.e., schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder) and medical comorbidity (i.e., cardiovascular disease, obesity, diabetes, chronic obstructive pulmonary disease, hypertension, and/or high cholesterol) aged 60 years and older received the PeerTECH intervention in their homes. Three certified peer specialists were trained to deliver PeerTECH. Data were collected at baseline, one-month, and three-month. The pilot study demonstrated that a three-month, peer-delivered and technology-supported integrated medical and psychiatric self-management intervention ("PeerTECH") was experienced by peer specialists and participants as feasible and acceptable. PeerTECH was associated with statistically significant improvements in psychiatric self-management. In addition, pre/post, non-statistically significant improvements were observed in self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment. This pre/post pilot study demonstrated it is possible to train peers to use technology to deliver an integrated psychiatric and medical self-management intervention in a home-based setting to older adults with serious mental illness with fidelity. These findings provide preliminary evidence that a peer-delivered and technology-supported intervention designed to improve medical and psychiatric self-management is feasible, acceptable, and is potentially associated with improvements in psychiatric self-management, self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment with older adults with serious mental illness and chronic health conditions.
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Affiliation(s)
- Karen L Fortuna
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA.
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA.
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Peter R DiMilia
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA
| | - Matthew C Lohman
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Martha L Bruce
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA
| | - Cynthia D Zubritsky
- Center for Mental Health Policy and Services Research, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jessica M Brooks
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Stephen J Bartels
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA
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Brooks JM, Iwanaga K, Cotton BP, Deiches J, Blake J, Chiu C, Morrison B, Chan F. Perceived Mindfulness and Depressive Symptoms Among People with Chronic Pain. J Rehabil 2018; 84:33-39. [PMID: 30686840 PMCID: PMC6345569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
The study purpose was to evaluate pain catastrophizing and psychological distress as mediators for the relationship between perceived mindfulness and depressive symptoms in people with chronic pain. We conducted an online cross-sectional survey with 211 adults with chronic musculoskeletal pain recruited from U.S. clinics and community networks. A serial multiple mediation analysis was performed using ordinary least-squares regressions and a bootstrap testing approach. Pain catastrophizing and psychological distress, independently and jointly, mediated the relationship between mindfulness and depressive symptoms. Rehabilitation counseling professionals should consider targeting mindfulness, pain catastrophizing, and psychological distress in psychosocial treatment for people with chronic pain.
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Cotton BP, Lohman MC, Brooks JM, LaGasse LL. Perinatal substance use, residential instability, and negative behavioral outcomes among adolescents: Lessons from the maternal lifestyle study. J Child Adolesc Psychiatr Nurs 2018; 30:149-155. [PMID: 29602191 DOI: 10.1111/jcap.12188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 11/27/2022]
Abstract
PROBLEM Both housing instability and prenatal substance use are known risk factors for behavioral problems among adolescents. METHODS The purpose of this study was to investigate the association between residential instability (residential mobility and homelessness) and delinquent behaviors among adolescents enrolled in the maternal lifestyle study (MLS), a 16-year research study that explored short-term and long-term effects of in-utero exposure to cocaine and/or opiates (N = 736). Logistic regression was used to measure the association between housing problems with youth crimes, school delinquency, and substance use at 11, 15, and 16 years of age. FINDINGS Both high-frequency residential mobility and homelessness were associated with deviant behaviors across the entire sample of children born with in-utero cocaine/opiate exposure and those without. CONCLUSIONS Psychiatric nursing care of youth should include a comprehensive assessment of residential instability to identify risk and target potential interventions.
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Affiliation(s)
- Brandi P Cotton
- College of Nursing of the University of Rhode Island, Kingston, RI, USA
| | - Matthew C Lohman
- Epidemiology & Biostatistics of the University of South Carolina, Columbia, SC, USA
| | - Jessica M Brooks
- Department of Psychiatry of the Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Brooks JM, Titus AJ, Bruce ML, Orzechowski NM, Mackenzie TA, Bartels SJ, Batsis JA. Depression and Handgrip Strength Among U.S. Adults Aged 60 Years and Older from NHANES 2011-2014. J Nutr Health Aging 2018; 22:938-943. [PMID: 30272097 PMCID: PMC6168750 DOI: 10.1007/s12603-018-1041-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Sarcopenia is a gradual loss of muscle mass and strength that occurs with aging. This muscle deterioration is linked to increased morbidity, disability, and other adverse outcomes. Although reduced handgrip strength can be considered a marker of sarcopenia and other aging-related decline in the elderly, there is limited research on this physical health problem in at-risk groups with common biopsychosocial conditions such as depression. Our primary objective was to ascertain level of combined handgrip strength and its relationship with depression among adults aged 60 years and older. DESIGN Unadjusted and adjusted linear regression models were conducted with a cross-sectional survey dataset. SETTING Secondary dataset from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS Community-dwelling, non-institutionalized adults ≥60 years old (n=3,421). MEASUREMENTS The predictor variables included a positive screen for clinically relevant depression (referent=PHQ-9 score <10). The criterion variable of combined handgrip strength (kg) was determined using a dynamometer. RESULTS Mean age and BMI were 69.9 years (51.5% female) and 28.8 kg/m2, respectively. Mean combined handgrip strength in the overall cohort was 73.5 and 46.6 kg in males and females, respectively. Three hundred thirty-six (9.8%) reported symptoms of depression. In unadjusted and fully adjusted models, depression was significantly associated with reduced handgrip strength (B = -0.26±0.79 and B = -0.19±0.08, respectively; p<0.001). CONCLUSION Our findings demonstrate handgrip strength has a significant inverse association with depression. Future longitudinal studies should investigate the causal processes and potential moderators and mediators of the relationships between depression and reduced handgrip strength. This information may further encourage the use of depression and handgrip strength assessments and aid in the monitoring and implementation of health care services that address both physical and mental health limitations among older adult populations.
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Affiliation(s)
- J M Brooks
- Jessica M. Brooks, Postdoctoral Fellow, Department of Psychiatry, 46, Centerra Parkway, Lebanon, NH. USA 03766 E-mail: , Phone number: (603) 653-3436
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Abstract
OBJECTIVES Tobacco smoking and physical inactivity are among leading behavioral risk factors for ill health in older adults. This study considers how smoking is associated with physical activity. DESIGN Using a Life-Course model, data are analyzed regarding this relationship, controlling for, and interacted with, life-course and other factors. Daily smokers and sometimes smokers were hypothesized to engage in less leisure-time physical activity than those who never smoked, while those who stopped smoking were expected to do more than never smokers. Analyses were performed using SAS-Callable SUDAAN. SETTING AND PARTICIPANTS Secondary data from ten years of a national sample of adults aged 18 and over of the National Health Interview Survey, 2001-2010, are used (N = 264,945, missing data excluded, of 282,313 total cases). MEASUREMENTS Daily smokers, occasional smokers, and smoking quitters are compared to never smokers with regard to requisite physical activity (150 minutes per week of moderate, 100 of vigorous, and/or 50 of strengthening activity). Life-course measures include birth cohorts, age, and year of survey, as well as gender, race/ethnicity, and education. RESULTS Overall, hypotheses are supported regarding daily smokers and quitters; but the hypothesis is strongly rejected among sometimes smokers, who are much more likely to do requisite physical activity. Findings differ by age, sometimes smokers age 65 and over being less likely to do physical activity. Findings among all men are similar to the overall findings, while those among all women are similar to those for older respondents. Associations of smoking status with physical activity vary greatly by race/ethnicity. CONCLUSIONS Daily smokers may be most in need of both smoking cessation and leisure-time physical activity interventions. Smoking-cessation efforts may pay greater physical activity benefits among women and the aged, while smoking-reduction efforts may provide better outcomes among men. Smoking reduction efforts may pay more exercise benefits among African-Americans and Hispanics.
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Affiliation(s)
- J H Swan
- James H. Swan, Ph.D. Professor of Applied Gerontology, Department of Rehabilitation and Health Services, University of North Texas,, Denton, TX, USA,
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Brooks JM, Muller V, Sánchez J, Johnson ET, Chiu CY, Cotton BP, Lohman MC, Catalano D, Bartels S, Chan F. Mindfulness as a protective factor against depressive symptoms in people with fibromyalgia. J Ment Health 2017; 29:161-167. [PMID: 29271273 DOI: 10.1080/09638237.2017.1417555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Depressive symptoms complicate pain management for people with FM, with adverse consequences such as a greater need for pain medications and limited pain coping strategies. Determining risks and protective factors associated with depressive symptoms in persons with FM could inform the development and implementation of mental health interventions.Aims: To formulate and test a behavioral activation model of depression with mindfulness as a protective factor for people with FM.Methods: We conducted an online cross-sectional survey with 117 adults with FM from community and clinic networks. Path analysis was used to assess the relationships of pain intensity, perceived stress, activity interference, pain catastrophizing and mindfulness with depressive symptoms.Results: Mindfulness has a negative direct association with depressive symptoms and a negative indirect association with depressive symptoms through perceived stress, activity interference and pain catastrophizing. Perceived stress, activity interference and pain catastrophizing had direct associations with depressive symptoms. Finally, perceived stress, activity interference and pain catastrophizing had indirect associations with depressive symptoms through pain intensity.Conclusions: Mindfulness seems to play an important role as a protective factor against the negative effects of stress and depression among people with FM and should be included in mental health interventions for chronic pain.
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Affiliation(s)
- Jessica M Brooks
- Department of Psychiatry, Dartmouth College, Lebanon, NH, USA.,Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
| | - Veronica Muller
- Department of Educational Foundation and Counseling Programs, Hunter College, City University of New York, New York, NY, USA
| | - Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, IA, USA
| | - Eboneé T Johnson
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, IA, USA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, The University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | | | - Denise Catalano
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
| | - Stephen Bartels
- Department of Psychiatry, Dartmouth College, Lebanon, NH, USA
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, USA
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Affiliation(s)
- J M Brooks
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, U.K
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Abstract
Chronic pain has been linked to depression among individuals and their partners. Yet, little is known about long-term mutual influences between pain intensity and depressive symptoms within couples as they age. Using a nationally representative U.S. sample of wives and husbands aged 50 and older (mean = 64.53, SD = 7.86), this study explored the links between own and partner pain intensity and depressive symptoms across an 8-year period. A total of 963 heterosexual married couples drawn from the Health and Retirement Study completed interviews biennially from 2006 to 2014. Dyadic growth curve models examined mutual associations within couples and controlled for sociodemographic characteristics, length of marriage, and marital quality, along with self-rated health, number of chronic health conditions, and functional disability. For wives and husbands, their own greater baseline pain intensity was significantly linked to their own higher levels of depressive symptoms. Unexpectedly, wives with greater baseline pain intensity reported decreases in their depressive symptoms over time. There were also partner effects such that husbands' greater pain intensity at baseline was associated with increases in wives' depressive symptoms over time. Findings highlight the importance of considering both individual and spousal associations between pain intensity and depressive symptoms in later life. Understanding how individual and couple processes unfold may yield critical insights for the development of intervention and prevention efforts to maintain mental health among older chronic pain patients and their spouses.
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Affiliation(s)
| | | | - Kira S. Birditt
- Institute for Social Research, University of Michigan. Ann Arbor MI 48104
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Iwanaga K, Blake J, Yaghmaian R, Umucu E, Chan F, Brooks JM, Rahimi M, Tansey TN. Preliminary Validation of a Short-Form Version of the Attachment Style Questionnaire for Use in Clinical Rehabilitation Counseling Research and Practice. Rehabilitation Counseling Bulletin 2017. [DOI: 10.1177/0034355217709477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The purpose of this study was to develop and validate a short-form version of the Attachment Style Questionnaire (ASQ) in people with disabilities. The construction sample consisted of 108 participants recruited from spinal cord injury (SCI) advocacy organizations. The cross-validation sample comprised 140 individuals with traumatic injuries recruited from a rehabilitation hospital. Measures administered were the ASQ, Trait Hope Scale, Sense of Coherence Scale, and Satisfaction With Life Scale. Results showed that the three subscales of secure, anxious, and avoidant attachment from the short-form ASQ had high correlations with the three subscales from the long-form ASQ. The reliability of the subscales for the short-form ASQ was adequate and similar to the long-form ASQ. Both the short- and long-form ASQ subscales were found to correlate with hope, sense of coherence, and subjective well-being in the expected theoretical directions. Confirmatory factor analysis also supported the three-factor measurement structure of the short-form ASQ. This study provides evidence to support the psychometric properties of the abbreviated ASQ in people with disabilities. The short-form version of the ASQ is a brief, reliable, and psychometrically sound measure of attachment that can be used in clinical rehabilitation counseling research and practice.
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Affiliation(s)
| | - John Blake
- West Virginia University, Morgantown, USA
| | | | | | - Fong Chan
- University of Wisconsin–Madison, USA
| | | | - Maryam Rahimi
- University of Maryland Eastern Shore, Princess Anne, USA
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Affiliation(s)
- William Culbertson Bryson
- Dr. Bryson is with the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, and the Geriatric Research Education and Clinical Centers, Veterans Affairs Puget Sound Health Care System, Seattle. Dr. Cotton and Dr. Brooks are with the Department of Psychiatry, Dartmouth College, Hanover, New Hampshire
| | - Brandi P Cotton
- Dr. Bryson is with the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, and the Geriatric Research Education and Clinical Centers, Veterans Affairs Puget Sound Health Care System, Seattle. Dr. Cotton and Dr. Brooks are with the Department of Psychiatry, Dartmouth College, Hanover, New Hampshire
| | - Jessica M Brooks
- Dr. Bryson is with the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, and the Geriatric Research Education and Clinical Centers, Veterans Affairs Puget Sound Health Care System, Seattle. Dr. Cotton and Dr. Brooks are with the Department of Psychiatry, Dartmouth College, Hanover, New Hampshire
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Brooks JM, Iwanaga K, Chiu CY, Cotton BP, Deiches J, Morrison B, Moser E, Chan F. Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain. PSYCHOL HEALTH MED 2017; 22:814-822. [PMID: 28111983 DOI: 10.1080/13548506.2017.1282161] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study examined the relationships between self-determination theory (SDT) and theory of planned behavior (TpB) applied to physical activity and exercise behavior (PA&E) in people with chronic pain. Two hundred and eleven adults with chronic musculoskeletal pain (28 males and 183 females, age range 18 to 82 years, mean age 43 years) were recruited from online support groups and clinic networks in the United States. Participants completed SDT measures relevant to PA&E on perceived autonomy support, autonomy, competence, and relatedness, as well as TpB measures relevant to PA&E on intention, attitudes, subjective norms, and perceived behavioral control. Correlational techniques and canonical correlation analysis were performed to examine the relationships and variance within and between theoretical dimensions. Overall, the SDT set accounted for 37% of the TpB variance and the TpB set accounted for 32% of the SDT set variance. The results indicate there are statistical similarities and differences between concepts in SDT and TpB models for PA&E. Using both empirical guidance and clinical expertise, researchers and practitioners should attempt to select and integrate non-redundant and complementary components from SDT, TpB, and other related health behavior theories.
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Affiliation(s)
- Jessica M Brooks
- a Department of Psychiatry , Geisel School of Medicine, Dartmouth College , Lebanon , NH , USA.,b University of North Texas
| | | | | | - Brandi Parker Cotton
- a Department of Psychiatry , Geisel School of Medicine, Dartmouth College , Lebanon , NH , USA
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Brooks JM, Bravington A, Hardy B, Melvin J, King N. “ IT'S NOT JUST ABOUT THE PATIENT, IT'S THE FAMILIES TOO”: END-OF-LIFE CARE IN THE HOME ENVIRONMENT. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2014-000838.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Levy C, Brooks JM, Chen J, Su J, Fox MA. Cell-specific and developmental expression of lectican-cleaving proteases in mouse hippocampus and neocortex. J Comp Neurol 2014; 523:629-48. [PMID: 25349050 DOI: 10.1002/cne.23701] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 12/31/2022]
Abstract
Mounting evidence has demonstrated that a specialized extracellular matrix exists in the mammalian brain and that this glycoprotein-rich matrix contributes to many aspects of brain development and function. The most prominent supramolecular assemblies of these extracellular matrix glycoproteins are perineuronal nets, specialized lattice-like structures that surround the cell bodies and proximal neurites of select classes of interneurons. Perineuronal nets are composed of lecticans, a family of chondroitin sulfate proteoglycans that includes aggrecan, brevican, neurocan, and versican. These lattice-like structures emerge late in postnatal brain development, coinciding with the ending of critical periods of brain development. Despite our knowledge of the presence of lecticans in perineuronal nets and their importance in regulating synaptic plasticity, we know little about the development or distribution of the extracellular proteases that are responsible for their cleavage and turnover. A subset of a large family of extracellular proteases (called a disintegrin and metalloproteinase with thrombospondin motifs [ADAMTS]) is responsible for endogenously cleaving lecticans. We therefore explored the expression pattern of two aggrecan-degrading ADAMTS family members, ADAMTS15 and ADAMTS4, in the hippocampus and neocortex. Here, we show that both lectican-degrading metalloproteases are present in these brain regions and that each exhibits a distinct temporal and spatial expression pattern. Adamts15 mRNA is expressed exclusively by parvalbumin-expressing interneurons during synaptogenesis, whereas Adamts4 mRNA is exclusively generated by telencephalic oligodendrocytes during myelination. Thus, ADAMTS15 and ADAMTS4 not only exhibit unique cellular expression patterns but their developmental upregulation by these cell types coincides with critical aspects of neural development.
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Affiliation(s)
- C Levy
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, 24016; Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia, 24061
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Childress JJ, Fisher CR, Brooks JM, Kennicutt MC, Bidigare R, Anderson AE. A methanotrophic marine molluscan (bivalvia, mytilidae) symbiosis: mussels fueled by gas. Science 2010; 233:1306-8. [PMID: 17843358 DOI: 10.1126/science.233.4770.1306] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
An undescribed mussel (family Mytilidae), which lives in the vicinity of hydrocarbon seeps in the Gulf of Mexico, consumes methane (the principal component of natural gas) at a high rate. The methane consumption is limited to the gills of these animals and is apparently due to the abundant intracellular bacteria found there. This demonstrates a methane-based symbiosis between an animal and intracellular bacteria. Methane consumption is dependent on the availability of oxygen and is inhibited by acetylene. The consumption of methane by these mussels is associated with a dramatic increase in oxygen consumption and carbon dioxide production. As the methane consumption of the bivalve can exceed its carbon dioxide production, the symbiosis may be able to entirely satisfy its carbon needs from methane uptake. The very light (delta(13)C = -51 to -57 per mil) stable carbon isotope ratios found in this animal support methane (delta(13)C = -45 per mil at this site) as the primary carbon source for both the mussels and their symbionts.
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Brooks JM, Kennicutt MC, Fisher CR, Macko SA, Cole K, Childress JJ, Bidigare RR, Vetter RD. Deep-sea hydrocarbon seep communities: evidence for energy and nutritional carbon sources. Science 2010; 238:1138-42. [PMID: 17839368 DOI: 10.1126/science.238.4830.1138] [Citation(s) in RCA: 239] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Mussels, clams, and tube worms collected in the vicinity of hydrocarbon seeps on the Louisiana slope contain mostly "dead" carbon, indicating that dietary carbon is largely derived from seeping oil and gas. Enzyme assays, elemental sulfur analysis, and carbon dioxide fixation studies demonstrate that vestimentiferan tube worms and three clam species contain intracellular, autotrophic sulfur bacterial symbionts. Carbon isotopic ratios of 246 individual animal tissues were used to differentiate heterotrophic (8(13)C = -14 to -20 per mil), sulfur-based (8(13)C = -30 to -42 per mil), and methane-based (8(13)C = <-40 per mil) energy sources. Mussels with symbiotic methanotrophic bacteria reflect the carbon isotopic composition of the methane source. Isotopically light nitrogen and sulfur confirm the chemoautotrophic nature of the seep animals. Sulfur-based chemosynthetic animals contain isotopically light sulfur, whereas methane-based symbiotic mussels more closely reflect the heavier oceanic sulfate pool. The nitrogen requirement of some seep animals may be supported by nitrogen-fixing bacteria. Some grazing neogastropods have isotopic values characteristic of chemosynthetic animals, suggesting the transfer of carbon into the background deep-sea fauna.
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Abstract
Thermogenic gas hydrates were recovered from the upper few meters of bottom sediments in the northwestern Gulf of Mexico. The hydrates were associated with oil-stained cores at a water depth of 530 meters. The hydrates apparently occur sporadically in seismic "wipeout" zones of sediments in a region of the Gulf continental slope at least several hundred square kilometers in area.
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