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Jovanović V, Rudnev M, Abdelrahman M, Abdul Kadir NB, Adebayo DF, Akaliyski P, Alaseel R, Alkamali YA, Alonso Palacio LM, Amin A, Andres A, Ansari-Moghaddam A, Aruta JJB, Avanesyan HM, Ayub N, Bacikova-Sleskova M, Baikanova R, Bakkar B, Bartoluci S, Benitez D, Bodnar I, Bolatov A, Borchet J, Bosnar K, Broche-Pérez Y, Buzea C, Cassibba R, Del Pilar Grazioso M, Dhakal S, Dimitrova R, Dominguez A, Duong CD, Dutra Thome L, Estavela AJ, Fayankinnu EA, Ferenczi N, Fernández-Morales R, Friehs MT, Gaete J, Gharz Edine W, Gindi S, Giordani RCF, Gjoneska B, Godoy JC, Hancheva CD, Hapunda G, Hihara S, Islam MS, Janovská A, Javakhishvili N, Kabir RS, Kabunga A, Karakulak A, Karl JA, Katović D, Kauyzbay Z, Kaźmierczak M, Khanna R, Khosla M, Kisaakye P, Klicperova-Baker M, Kokera R, Kozina A, Krauss SE, Landabur R, Lefringhausen K, Lewandowska-Walter A, Liang YH, Lizarzaburu-Aguinaga D, López Steinmetz LC, Makashvili A, Malik S, Manrique-Millones D, Martín-Carbonell M, Mattar Yunes MA, McGrath B, Mechili EA, Mejía Alvarez M, Mhizha S, Michałek-Kwiecień J, Mishra SK, Mohammadi M, Mohsen F, Moreta-Herrera R, Muradyan MD, Musso P, Naterer A, Nemat A, Neto F, Neto J, Okati-Aliabad H, Orellana CI, Orellana L, Park J, Pavlova I, Peralta EA, Petrytsa P, Pilkauskaite Valickiene R, Et Al. The Coronavirus Anxiety Scale: Cross-national measurement invariance and convergent validity evidence. Psychol Assess 2024; 36:14-29. [PMID: 38010780 DOI: 10.1037/pas0001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirus-related anxiety. In a large-scale collaboration spanning 60 countries (Ntotal = 21,513), we examined the CAS's measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Veljko Jovanović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad
| | | | - Mohamed Abdelrahman
- School of Social Sciences and Humanities, Doha Institute for Graduate Studies
| | | | | | | | | | | | | | - Azzam Amin
- School of Social Sciences and Humanities, Doha Institute for Graduate Studies
| | - Andrii Andres
- Department of Physical Education, Lviv Polytechnic National University
| | | | | | | | - Norzihan Ayub
- Faculty of Psychology and Education, Universiti Malaysia Sabah
| | - Maria Bacikova-Sleskova
- Department of Educational Psychology and Health Psychology, Pavol Jozef Safarik University in Kosice
| | | | | | | | - David Benitez
- Department of Clinical Psychology, Albizu University
| | - Ivanna Bodnar
- Department of Theory and Methods of Physical Culture, Lviv State University of Physical Culture
| | | | | | | | | | - Carmen Buzea
- Department of Social Sciences and Communication, Transilvania University of Brasov
| | | | | | | | | | | | | | | | - Arune Joao Estavela
- Departamento de Pos-Graduacao, Instituto Superior de Ciencias de Saude, Universidade Lurio
| | | | - Nelli Ferenczi
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London
| | | | | | - Jorge Gaete
- Faculty of Education, Universidad de los Andes
| | | | | | | | | | - Juan Carlos Godoy
- Instituto de Investigaciones Psicologicas, Universidad Nacional de Cordoba, Consejo Nacional de Investigaciones Científicas y Tecnicas
| | - Camellia Doncheva Hancheva
- Department of General, Experimental, Developmental, and Health Psychology, Sofia University "St. Kliment Ohridski"
| | | | - Shogo Hihara
- Graduate School of Humanities and Social Sciences, Hiroshima University
| | - Md Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University
| | - Anna Janovská
- Department of Educational Psychology and Health Psychology, Pavol Jozef Safarik University in Kosice
| | | | | | | | | | | | | | | | | | - Richa Khanna
- School of Human Ecology, Tata Institute of Social Sciences
| | | | | | | | - Richman Kokera
- Department of Applied Psychology, University of Zimbabwe
| | - Ana Kozina
- Evaluation Studies Centre, Educational Research Institute
| | - Steven E Krauss
- Institute for Social Science Studies, Universiti Putra Malaysia
| | | | | | | | | | | | - Lorena Cecilia López Steinmetz
- Instituto de Investigaciones Psicologicas, Universidad Nacional de Cordoba, Consejo Nacional de Investigaciones Científicas y Tecnicas
| | - Ana Makashvili
- Dimitri Uznadze Institute of Psychology, Ilia State University
| | - Sadia Malik
- Department of Psychology, University of Sargodha
| | | | | | | | - Breeda McGrath
- Department of Academic Affairs, Chicago School of Professional Psychology
| | | | | | - Samson Mhizha
- Department of Applied Psychology, University of Zimbabwe
| | | | - Sushanta Kumar Mishra
- Organizational Behavior and Human Resource Management Area, Indian Institute of Management Bangalore
| | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences
| | | | | | | | - Pasquale Musso
- Department of Education, Psychology, Communication, University of Bari
| | | | - Arash Nemat
- Microbiology Department, Kabul University of Medical Sciences
| | - Félix Neto
- Department of Psychology, University of Porto
| | - Joana Neto
- Research on Economics, Management and Information Technologies, Universidade Portucalense
| | | | | | | | - Joonha Park
- Department of Management, Nagoya University of Commerce and Business
| | - Iuliia Pavlova
- Department of Theory and Methods of Physical Culture, Lviv State University of Physical Culture
| | | | - Petro Petrytsa
- Department of Physical Education and Rehabilitation, Ternopil Volodymyr Hnatiuk National Pedagogical University
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de la Garza Iga FJ, Mejía Alvarez M, Cockroft JD, Rabin J, Cordón A, Elias Rodas DM, Grazioso MDP, Espinola M, O'Dea C, Schubert C, Stryker SD. Using the project ECHO™ model to teach mental health topics in rural Guatemala: An implementation science-guided evaluation. Int J Soc Psychiatry 2023; 69:2031-2041. [PMID: 37477264 DOI: 10.1177/00207640231188038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Mental health (MH) disorders are major causes of disability in Guatemala. Unfortunately, limited academic training and funding resources make MH care inaccessible to most people in rural Guatemala. These disparities leave many indigenous populations without care. Project ECHO™ is an educational model used globally to deliver virtual training for providers in rural/ underserved communities. The aim of this project was to implement and evaluate a Project ECHO™ program bridging MH training gaps for providers who serve rural communities in Guatemala. METHODS The Project ECHO™ curriculum was implemented through a partnership between educational and nonprofit institutions in Guatemala City and the United States. Participants were primary care physicians and nurses working in rural Guatemala as well as medical/nursing/psychology students. Evaluation of its implementation was guided by a RE-AIM framework. Reach, effectiveness, adoption, fidelity, sustainability, acceptability, feasibility, and appropriateness were evaluated using a mixed-methods approach, using a pre-post survey and semi-structured focus groups. RESULTS Forty unique participants attended the five sessions. Attitudes about mental health did not change quantitatively but self-efficacy improved in four of five modules. High quality fidelity scores were noted in two of five sessions. Sustainability scores across multiple domains were highly rated. Scores on instruments measuring acceptability, feasibility, and appropriateness were high. Focus groups showed two main themes: the curriculum filled a gap in education and further adaptation of the model might help improve the experience. CONCLUSION Implementation of the Project ECHO™ educational model appeared to have good reach/adoption, showed improvements in self-efficacy, illuminated facilitators and barriers to sustainability, and was felt to be acceptable, feasible, and appropriate. Qualitative analysis supported these conclusions. Future directions would include ongoing evaluation and monitoring of further Project ECHO™ curricular experiences through this partnership and adaptation of this project to other learners and settings in Latin America.
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Affiliation(s)
| | | | - Joshua D Cockroft
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Julia Rabin
- Department of Psychology, College of Arts & Sciences, University of Cincinnati, OH, USA
| | - Ana Cordón
- Wuqu' Kawoq / Maya Health Alliance, Tecpan, Guatemala
| | | | | | - Maria Espinola
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, OH, USA
| | - Christine O'Dea
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Charles Schubert
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
| | - Shanna D Stryker
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, OH, USA
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Samore T, Fessler DMT, Sparks AM, Holbrook C, Aarøe L, Baeza CG, Barbato MT, Barclay P, Berniūnas R, Contreras-Garduño J, Costa-Neves B, Del Pilar Grazioso M, Elmas P, Fedor P, Fernandez AM, Fernández-Morales R, Garcia-Marques L, Giraldo-Perez P, Gul P, Habacht F, Hasan Y, Hernandez EJ, Jarmakowski T, Kamble S, Kameda T, Kim B, Kupfer TR, Kurita M, Li NP, Lu J, Luberti FR, Maegli MA, Mejia M, Morvinski C, Naito A, Ng'ang'a A, de Oliveira AN, Posner DN, Prokop P, Shani Y, Solorzano WOP, Stieger S, Suryani AO, Tan LKL, Tybur JM, Viciana H, Visine A, Wang J, Wang XT. Greater traditionalism predicts COVID-19 precautionary behaviors across 27 societies. Sci Rep 2023; 13:4969. [PMID: 37041216 PMCID: PMC10090070 DOI: 10.1038/s41598-023-29655-0] [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] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/08/2023] [Indexed: 04/13/2023] Open
Abstract
People vary both in their embrace of their society's traditions, and in their perception of hazards as salient and necessitating a response. Over evolutionary time, traditions have offered avenues for addressing hazards, plausibly resulting in linkages between orientations toward tradition and orientations toward danger. Emerging research documents connections between traditionalism and threat responsivity, including pathogen-avoidance motivations. Additionally, because hazard-mitigating behaviors can conflict with competing priorities, associations between traditionalism and pathogen avoidance may hinge on contextually contingent tradeoffs. The COVID-19 pandemic provides a real-world test of the posited relationship between traditionalism and hazard avoidance. Across 27 societies (N = 7844), we find that, in a majority of countries, individuals' endorsement of tradition positively correlates with their adherence to costly COVID-19-avoidance behaviors; accounting for some of the conflicts that arise between public health precautions and other objectives further strengthens this evidence that traditionalism is associated with greater attention to hazards.
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Affiliation(s)
- Theodore Samore
- Department of Anthropology, Center for Behavior, Evolution, and Culture, University of California, Los Angeles, CA, 90095, USA.
| | - Daniel M T Fessler
- Department of Anthropology, Center for Behavior, Evolution, and Culture, Bedari Kindness Institute, University of California, Los Angeles, CA, 90095, USA
| | | | - Colin Holbrook
- Department of Cognitive and Information Sciences, University of California, Merced, CA, 95343, USA
| | - Lene Aarøe
- Department of Political Science, Aarhus University, 8000, Aarhus C, Denmark
| | - Carmen Gloria Baeza
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - María Teresa Barbato
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - Pat Barclay
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | | | - Jorge Contreras-Garduño
- Escuela Nacional de Estudio Superiores, Universidad Nacional Autónoma de México, Unidad Morelia, 58190, Morelia, Michoacán, Mexico
| | - Bernardo Costa-Neves
- Lisbon Medical School, University of Lisbon, 1649-028, Lisbon, Portugal
- Centro Hospitalar Psiquiátrico de Lisboa, 1749-002, Lisbon, Portugal
| | - Maria Del Pilar Grazioso
- Centro Integral de Psicología Aplicada, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
- Proyecto Aiglé Guatemala, Guatemala City, Guatemala
| | - Pınar Elmas
- Department of Psychology, Adnan Menderes University, Aydın, Turkey
| | - Peter Fedor
- Department of Environmental Ecology and Landscape Management, Faculty of Natural Sciences, Comenius University, 842 15, Bratislava, Slovakia
| | - Ana Maria Fernandez
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - Regina Fernández-Morales
- Facultad de Humanidades, Universidad Rafael Landivár, Guatemala City, 01016, Guatemala
- Departamento de Psicología, Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Leonel Garcia-Marques
- CICPsi Research Center for Psychological Science, Universidade de Lisboa, Lisbon, Portugal
- School of Psychology, Universidade de Lisboa, Lisbon, Portugal
| | - Paulina Giraldo-Perez
- The School of Biological Sciences, The University of Auckland, Auckland, 1010, New Zealand
| | - Pelin Gul
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Groningen, The Netherlands
| | - Fanny Habacht
- Division of Psychological Methodology, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Youssef Hasan
- Psychology Program, Department of Social Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Earl John Hernandez
- College of Arts and Sciences, Partido State University, Goa, 4422, Camarines Sur, Philippines
| | - Tomasz Jarmakowski
- Institute of Psychology, Nicolaus Copernicus University in Toruń, 87-100, Toruń, Poland
| | - Shanmukh Kamble
- Department of Psychology, Karnatak University, Dharwad, Karnataka, 580003, India
| | - Tatsuya Kameda
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
- Brain Science Institute, Tamagawa University, Tokyo, 194-8610, Japan
- Center for Experimental Research in Social Sciences, Hokkaido University, Sapporo, 060-0810, Japan
| | - Bia Kim
- Department of Psychology, Pusan National University, Busan, South Korea
| | - Tom R Kupfer
- Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Maho Kurita
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Norman P Li
- School of Social Sciences, Singapore Management University, Singapore, 188065, Singapore
| | - Junsong Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
| | - Francesca R Luberti
- Department of Psychology, Nipissing University, North Bay, ON, P1B 8L7, Canada
| | - María Andrée Maegli
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
| | | | - Coby Morvinski
- Department of Management, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Aoi Naito
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
- Japan Society for the Promotion of Science, Tokyo, 102-0083, Japan
| | - Alice Ng'ang'a
- Lazaridis School of Business and Economics, Wilfrid Laurier University, Waterloo, ON, N2L 3C5, Canada
| | | | - Daniel N Posner
- Department of Political Science, University of California, Los Angeles, CA, 90095, USA
| | - Pavol Prokop
- Department of Environmental Ecology and Landscape Management, Faculty of Natural Sciences, Comenius University, 842 15, Bratislava, Slovakia
- Institute of Zoology, Slovak Academy of Sciences, 845 06, Bratislava, Slovakia
| | - Yaniv Shani
- Coller School of Management, Tel Aviv University, Tel Aviv, Israel
| | | | - Stefan Stieger
- Division of Psychological Methodology, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | | | - Lynn K L Tan
- School of Social Sciences, Singapore Management University, Singapore, 188065, Singapore
| | - Joshua M Tybur
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Hugo Viciana
- Departamento de Filosofía y Lógica y Filosofía de la Ciencia, Universidad de Sevilla, 41018, Seville, Spain
| | | | - Jin Wang
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
| | - Xiao-Tian Wang
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
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Raut A, Mustafayev R, Srinivasan R, Chary A, Ertem I, Grazioso MDP, Gupta S, Krishnamurthy V, Lu C, Maliye C, Miller AC, Wagenaar BH, Rohloff P. Hybrid type 1 effectiveness/implementation trial of the international Guide for Monitoring Child Development: protocol for a cluster-randomised controlled trial. BMJ Paediatr Open 2021; 5:e001254. [PMID: 34604546 PMCID: PMC8444252 DOI: 10.1136/bmjpo-2021-001254] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION More than 40% of children under 5 years of age in low-income and middle-income countries are at risk of not reaching their developmental potential. The international Guide for Monitoring Child Development (GMCD) early intervention package is a comprehensive programme to address developmental difficulties using an individualised intervention plan for young children and their families. We will conduct a hybrid type 1 effectiveness-implementation evaluation of the GMCD intervention in rural India and Guatemala. METHODS AND ANALYSIS Using a cluster-randomised design, 624 children aged 0-24 months in 52 clusters (26 in India, 26 in Guatemala) will be assigned to usual care or the GMCD intervention plus usual care delivered by frontline workers for 12 months. After 12 months, the usual care arm will cross over to the intervention, which will continue for 12 additional months (24 total). The intervention will be delivered using a digital mobile device interface. Effectiveness will be assessed for developmental functioning (Bayley Scales of Infant Development, 3rd edition) and nurturing care (Home Observation for Measurement of the Environment Scale) outcomes. Implementation will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. Explanatory qualitative analysis guided by the Consolidated Framework for Implementation Research will explore determinants between clusters with high versus low implementation effectiveness. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Boards of Brigham and Women's Hospital, Mahatma Gandhi Institute of Medical Sciences and Maya Health Alliance; and by the Indian Council of Medical Research/Health Ministry Screening Committee. Key study findings will be published in international open-access journals. TRIAL REGISTRATION NUMBER NCT04665297, CTRI/2020/12/029748. PROTOCOL VERSION 1.0 (12 November 2020).
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Affiliation(s)
- Abhishek Raut
- Department of Community Medicine, Dr. Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Revan Mustafayev
- Department of Pediatrics, Acibadem Maslak Private Hospital, Istanbul, Turkey
| | | | - Anita Chary
- Center for Indigenous Health Research, Wuqu' Kawoq
- Maya Health Alliance, Tecpán, Chimaltenango, Guatemala
| | - Ilgi Ertem
- Developmental-Behavioral Pediatrics Division, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Subodh Gupta
- Department of Community Medicine, Dr. Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | | | - Chunling Lu
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Chetna Maliye
- Department of Community Medicine, Dr. Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Ann C Miller
- Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Bradley H Wagenaar
- Department of Global Health, University of Washington, Seattle, Washington, USA.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Peter Rohloff
- Center for Indigenous Health Research, Wuqu' Kawoq
- Maya Health Alliance, Tecpán, Chimaltenango, Guatemala.,Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Fernández Álvarez H, Del Pilar Grazioso M, Kirszman D. Distance supervision in the Aiglé Foundation's Latin American Psychotherapy Training Program. J Clin Psychol 2018; 75:282-291. [PMID: 30590869 DOI: 10.1002/jclp.22721] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Latin American literature on clinical supervision is limited and literature concerning technology-assisted supervision is virtually nonexistent. We address this gap, providing our perspective on the use of technology in distance supervision within Argentina and Guatemala. Despite important differences, these two countries share many sociocultural features. We contextualize these perspectives, describing therapist training according to the Integrative Model of Fundación Aiglé. Through the use of vignettes, we illustrate contextualized training experiences, concluding with a synthesis of strengths and weaknesses encountered when implementing the use of technology in distance supervision.
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Martinez B, Webb MF, Gonzalez A, Douglas K, Grazioso MDP, Rohloff P. Complementary feeding intervention on stunted Guatemalan children: a randomised controlled trial. BMJ Paediatr Open 2018; 2:e000213. [PMID: 29719876 PMCID: PMC5926563 DOI: 10.1136/bmjpo-2017-000213] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/22/2018] [Accepted: 03/15/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE/BACKGROUND Guatemala's indigenous Maya population has one of the highest rates of childhood stunting in the world. The goal of this study was to examine the impact of an intensive, individualised approach to complementary feeding education for caregivers on feeding practices and growth over usual care. DESIGN An individually randomised (1:1 allocation ratio), parallel-group superiority trial, with blinding of study staff collecting outcome data. SETTING Rural Maya communities in Guatemala. PARTICIPANTS 324 children aged 6-24 months with a height-for-age Z score of less than or equal to -2.5 SD were randomised, 161 to the intervention and 163 to usual care. INTERVENTIONS Community health workers conducted home visits for 6 months, providing usual care or usual care plus individualised caregiver education. MAIN OUTCOMES MEASURES The main outcome was change in length/height-for-age Z score. Secondary outcomes were changes in complementary feeding indicators. RESULTS Data were analysed for 296 subjects (intervention 145, usual care 151). There was a non-significant trend to improved growth in the intervention arm (length/height-for-age Z score change difference 0.07(95% CI -0.04 to 0.18)). The intervention led to a 22% improvement in minimum dietary diversity (RR 1.22, 95% CI 1.11 to 1.35) and a 23% improvement in minimal acceptable diet (RR 1.23, 95% CI 1.08 to 1.40) over usual care. CONCLUSIONS Complementary feeding outcomes improved in the intervention arm, and a non-significant trend towards improved linear growth was observed. Community health workers in a low-resource rural environment can implement individualised caregiver complementary feeding education with significant improvements in child dietary quality over standard approaches. CLINICAL TRIAL REGISTRATION NUMBER NCT02509936. Stage: Results.
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Affiliation(s)
- Boris Martinez
- Wuqu' Kawoq
- Maya Health Alliance, Santiago Sacatepéquez, Guatemala
| | | | - Ana Gonzalez
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Kate Douglas
- Wuqu' Kawoq
- Maya Health Alliance, Santiago Sacatepéquez, Guatemala.,School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Peter Rohloff
- Wuqu' Kawoq
- Maya Health Alliance, Santiago Sacatepéquez, Guatemala.,Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Martinez B, Cardona S, Rodas P, Lubina M, Gonzalez A, Farley Webb M, Grazioso MDP, Rohloff P. Developmental outcomes of an individualised complementary feeding intervention for stunted children: a substudy from a larger randomised controlled trial in Guatemala. BMJ Paediatr Open 2018; 2:e000314. [PMID: 30306144 PMCID: PMC6173251 DOI: 10.1136/bmjpo-2018-000314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/16/2018] [Accepted: 07/28/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Stunting is a common cause of early child developmental delay; Guatemala has the fourth highest rate of stunting globally. The goal of this study was to examine the impact of an intensive community health worker-led complementary feeding intervention on early child development in Guatemala. We hypothesised that the intervention would improve child development over usual care. DESIGN A substudy from a larger individually randomised (1:1 allocation ratio), parallel-group superiority trial, with blinding of study staff collecting outcomes data. SETTING Rural, indigenous Maya communities in Guatemala. PARTICIPANTS 210 stunted children (height-for-age z-score ≤-2.5) aged 6-24 months, previously randomised to usual care (106) or an intensive complementary feeding intervention (104). 84 in the intervention and 91 in the usual care arm agreed to participate. INTERVENTIONS Community health workers conducted monthly home visits for 6 months, providing usual care or individualised complementary feeding education. MAIN OUTCOME MEASURES The primary outcomes were change in z-scores for the subscales of the Bayley Scales of Infant Development (BSID), Third Edition. RESULTS 100 individuals were included in the final analysis, 47 in the intervention and 53 in the usual care arm. No statistically significant differences in age-adjusted scores between the arms were observed for any subscale. However, improvements within-subjects in both arms were observed (median duration between measurements 189 days (IQR 182-189)). Mean change for subscales was 0.45 (95% CI 0.23 to 0.67) z-scores in the intervention, and 0.43 (95% CI 0.25 to 0.61) in the usual care arm. CONCLUSIONS An intensive complementary feeding intervention did not significantly improve developmental outcomes more than usual care in stunted, indigenous Guatemalan children. However, both interventions had significant positive impacts on developmental outcomes. TRIAL REGISTRATION NUMBER NCT02509936. STAGE Results.
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Affiliation(s)
- Boris Martinez
- Wuqu' Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala.,Department of Medicine, Saint Peter's University Hospital, New Brunswick, New Jersey, USA
| | - Sayra Cardona
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Patricia Rodas
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Meri Lubina
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Ana Gonzalez
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Meghan Farley Webb
- Wuqu' Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala.,Department of Anthropology and Sociology, Albion College, Albion, Michigan, USA
| | | | - Peter Rohloff
- Wuqu' Kawoq, Maya Health Alliance, Santiago Sacatepéquez, Guatemala.,Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
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