The experience of adolescent women living with spina bifida. Part II: Peer relationships.

Relationships are much more complex for those with disabilities than for those without disabilities. This study was part of a larger mixed-method investigation that explored comprehensive aspects of adaptation in adolescents with spina bifida (SB). The purpose of this qualitative component of the study was to explore the experiences of peer relationships in 31 adolescent women with SB. The participants were interviewed, and analysis was conducted for common themes. The five major themes and one subtheme were peers without disabilities (subtheme: peers with disabilities), normalization, challenges in peer connectedness, peer connectedness with adults, and romantic connectedness. Whereas some participants voiced close connections with peers, others described prejudices, stereotyping, and limited dating experiences. Results from this study support the need for comprehensive assessment of social relationships in adolescent women with SB and active interventions to address problems identified. Rehabilitation nurses are in a key position to implement social interventions in adolescents and young women with SB.     

Finding straight answers: identifying the needs of parents and service providers of adolescents with type 1 diabetes to aid in the creation of an online support intervention

Aims and objectives. To explore the needs and preferences of parents and service providers of adolescents with type 1 diabetes in an online support intervention. Background. Parents experience stress during this time of transition as adolescent conflict is common and the consequences of risk-taking behaviour in combination with type 1 diabetes can be severe. Parents are in need of social support and desired an online intervention. Online support interventions have not been previously designed from the perspective of the users of these interventions. Methods. Participatory, qualitative design. Fourteen group interviews across Canada (n?=?60). Results. Participants identified four main themes (Finding straight answers, Making transitions, Struggling with parenting and Connecting with others) within the context of accessibility. Parents described their needs for credible Canadian information, support from other parents, fostering positive family dynamics while shifting parenting roles during adolescence. Connecting with others included finding a social support system and venue to share stories and resources. Discussion. These findings are innovative as these experienced participants desired a blend of professional information and peer informal knowledge and support in an accessible, online format. Conclusion. The results of this study will form the foundation of an online support intervention while providing unique insight into the experiences of parents of adolescents with type 1 diabetes. Relevance to clinical practice. Parents and service providers indicate the need for information that is trusted, accurate and on a wide range of topics, within a preferred online environment. Supporting parents during this difficult time includes directing them to appropriate and accessible resources, facilitating a positive, healthy process of transition to interdependence, in their parenting of adolescents with type 1 diabetes.     

Efficacy of a Peer‐Guided Exercise Programme for Adolescents with Intellectual Disability

Background Peer support is strongly associated with physical activity of adolescents. This study examined the efficacy of a YMCA‐based, peer‐guided exercise training programme for increasing health‐related physical fitness among adolescents with intellectual disabilities. Materials and Methods Adolescents with intellectual disabilities and typically developing peer partners provided reciprocal support during 1‐h exercise sessions that included aerobic exercise, weight training and stretching activities. The programme was conducted 2 days/week for 15 weeks and pre‐ and post‐test fitness testing was conducted. Results Participants demonstrated significant improvements in curl‐ups, 6‐min walk and BMI. Exercise session attendance was high and participants typically completed all of the prescribed aerobic and stretching exercises, whereas weight training exercises were completed less consistently. Conclusions This peer‐guided model integrates social and instructional support for adolescents with intellectual disabilities and may encourage exercise participation in community settings.     

Impact of online support for youth with asthma and allergies: pilot study

Youth with asthma and allergies often feel isolated and different from their peers. The objective of this study was to test the impact of online social support for these youth. Three months of support was provided using weekly synchronous chat sessions. Online sessions were facilitated by trained peer mentors (older youth with asthma and/or allergies) and health professionals. Youth could also e-mail one another between chat sessions and post messages on an electronic community bulletin board. Twenty-eight adolescents across Canada participated. Social isolation and loneliness were significantly reduced. Youth reported gaining confidence and a sense of normality.     

Group support for couples coping with a cardiac condition

BACKGROUND/RATIONALE: Support groups of peers were designed to convey support specific to stressful situations encountered by persons with a first-time myocardial infarction and by their spouse or partners. There were no previous published support intervention studies focused on the couple. Survivors and spouses (n=28) participated in a pilot study which tested the effect of a 12-week support group intervention. DESIGN: The support groups for couples were cofacilitated by a peer and professional. The facilitators recorded field notes, while participants completed weekly diaries about the intervention activities. Following the intervention, participants were interviewed individually and facilitators were interviewed jointly about the perceived effect of the intervention and influencing factors. This article focuses on the facilitators' and participants' perceptions of intervention processes and outcomes. FINDINGS: Support processes in the group included social comparison, social learning, and social exchange. Three types of support--emotional, information, and affirmation--were provided. All participants were satisfied with the support intervention and referred to the positive effect on their coping, confidence, outlook, and spousal relationship. Factors that influenced the intervention effect were participant input, cofacilitation, similarity of group members, and the provision of information and support. CONCLUSIONS: Future interventions could consider similarity of peers, leadership, and optimum timing and duration.     

The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits

Three separate studies were conducted in school, residential and after-school care settings to test the effectiveness of a music therapy-based social skills intervention program on improving social competence in children and adolescents. A total of 45 children (n = 12; n = 13; n = 20) aged 6-17 years with social skills deficits participated in a group-based five session intervention program. The same curriculum, adapted to be age appropriate, was used at all 3 sites. Specific deficits within the social skills areas of peer relations and self-management skills were targeted. Active interventions like music performance, movement to music and improvisation were used. Cognitive-behavioral techniques like modeling, feedback, transfer training and problem solving were also incorporated. Data on social functioning were collected before, during, and after the music therapy intervention from participants, appropriate adult personnel and via behavioral observations. Results indicated that significant improvements in social functioning were found in (a) school participant pre and post self-ratings, (b) researcher pre and post ratings of school participants, (c) case manager's pre and post treatment ratings for the residential participants, (d) after-school care participants' pre and post self-ratings, and (e) behavioral observations at all three settings. Additional changes, although not significant, were noted in teacher ratings, residential participant self- and peer ratings, and after-school case manager ratings. Results from these studies suggest that the music therapy intervention was effective in improving social competence in children and adolescents with social deficits. More research is warranted to provide additional guidance about the use of music therapy interventions to improve social functioning.     

Perceived Bullying and Social Support in Students Accessing Special Inclusion Programming

Perceived bullying experiences, fear of school violence, and social support were investigated in 24 students with disabilities (SWD) in self-contained special education classes and 24 peers with no known disabilities (Peers) who participated in a pilot recreation-focused inclusion program, Peer EXPRESS. Middle and high school students were invited 10 and 34 weeks after the beginning of school to complete the Reynolds’s Bully Victimization Scale (BVS) and School Violence Anxiety Scale (SVAS) and Harter’s Social Support Scale (HSS). Significantly higher rates of perceived victimization by peers and greater anxiety about multiple forms of peer victimization were noted among SWD both before and after the supplemental inclusion intervention. Although paired t-tests showed significant declines in SWD reports of victimization and anxiety over 24 weeks in Peer EXPRESS, declines were not great enough to eliminate the SWD-Peer discrepancy or substantially change perceived social support. Implications for students’ personal safety and inclusive programming are discussed. This research was made possible by a faculty research grant from The Citadel Foundation as well the Peer EXPRESS intervention grant from the South Carolina Governor’s Office Developmental Disabilities Council     

Intervening with at-risk youth: evaluation of the youth empowerment and support program

This study evaluated a community-based intervention, the Youth Empowerment and Support Program (YES-P), a theoretically-based program designed to decrease drug use and strengthen connections to school in at-risk youth living in high-risk environments. The YES-P included several interventions, such as providing mentor support and social skills training; growing a positive peer culture; and developing youth in leadership roles for community service. These interventions were delivered by 10 nursing students in a weekly, after school, 2-hour, group activity for 20 weeks for 13 inner-city youth ages 10-12 years (7 girls, 6 boys). One girl identified herself as Hispanic and the others as Caucasian. Using a pre/post one-group design, data were collected in 1999 from program participants to evaluate the YES-P. Results of a 1-year pilot study suggest that the multilevel interventions were associated with positive effects on at-risk youth. In particular, respondents at the posttest reported higher levels of self-esteem, mentor support, positive peer bonding, social skills attainment, and school attachment. Attitudes against underage drug use decreased from pre-test scores revealing areas for strengthening the program. These results lend empirical support to the positive evaluation of the YES-P with at-risk youth living in high-risk environments.     

Training to improve awareness of disabilities in clients with unilateral neglect.

OBJECTIVE: Awareness of disabilities is known to be a central problem of rehabilitation among clients with large right cerebrovascular lesions and unilateral neglect. The aim of this study was to evaluate the effect of an intervention program focused on improving the awareness of disabilities in four participants with unilateral neglect. The intervention program developed for this study was based on the assumption that awareness of disabilities is a prerequisite for being able to learn and use compensatory techniques in the performance of activities of daily living (ADL). METHOD: The study followed a single-case experimental ABA design. The Assessment of Awareness of Disability was used to measure awareness of disabilities; the Assessment of Motor and Process Skills was used to measure ADL ability; and neuropsychological tests were used to assess unilateral neglect and sustained attention. The intervention program used meaningful and purposeful occupations as therapeutic change agents to improve awareness of disabilities. RESULTS: Awareness of disabilities and ADL ability improved in all four participants; unilateral neglect decreased in three participants; and sustained attention improved in two participants. CONCLUSION: The preliminary findings indicate that training to improve awareness of disabilities might improve the ability to learn the use of compensatory techniques in the performance of ADL in clients with unilateral neglect. The effects of the intervention strategy need to be evaluated further in future research.     

Social and Vocational Skills Training Reduces Self-reported Anxiety and Depression Among Young Adults on the Autism Spectrum

Those with autism spectrum disorders (ASD) frequently experience high levels of anxiety and depression. These psychological factors may be related to some of the core challenges seen among those with ASD, including social difficulties. We examined whether a social and vocational skills intervention program for adolescents and young adults on the autism spectrum would yield a broader impact that partially alleviated these psychological factors. Following the intervention program participants reported significantly lower depression and anxiety. Responses on a measure of peer relationships were also improved post-intervention, although this did not reach significance. Although preliminary, our findings demonstrate the broader, positive impact that such programs may have.     

College students as facilitators in reducing adolescent obesity disparity in Southern Appalachia: Team Up for Healthy Living

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Through funding from the National Institute on Minority Health and Health Disparities — National Institutes of Health, the Team Up for Healthy Living project was a cluster-randomized trial targeting obesity prevention in adolescents through a cross-peer intervention. The specific aims of the project were to: 1) develop a peer-based health education program focusing on establishing positive peer norms towards healthy eating and physical activity (PA) among high school students, 2) test program efficacy, and 3) explore mechanisms underlying the program. The study was guided by the Theory of Planned Behavior, which presupposes that human behavior is primarily driven by attitude, subjective norms, perceived behavioral control, and social support. To deliver the intervention, undergraduate students from the disciplines of public health, nutrition, and kinesiology were hired as peer facilitators. Ten area high schools were invited to participate, were matched on demographics and then randomized to intervention or control. The primary outcomes of the study included body mass status, dietary behaviors, PA, and sedentary behaviors which were assessed at baseline and at three and twelve months post baseline. Intervention schools received Team Up for Healthy Living curriculum, which consists of eight 40-minute sessions. The curriculum focused on improving nutrition awareness, PA, leadership and communication. Control schools received their regularly scheduled Lifetime Wellness curriculum. The long-term goal of the study was to establish an effective academia–community partnership program to address adolescent obesity disparity in Southern Appalachia.     

Lab mentors in a two-plus-two nursing program: A retrospective evaluation

Peer mentorships improve learning outcomes, student satisfaction, and confidence levels in undergraduate nursing students. In addition, volunteering as a mentor supports leadership development and proficiency in nursing skills. This article retrospectively evaluates an educational intervention using peer mentors in a 2-plus-2 undergraduate nursing program. Students enrolled in this program take prerequisite classes at a community college, then enter the baccalaureate program at the junior level and begin their nursing courses, completing all course work on the community college campus. Senior nursing students mentored the incoming junior students during their first semester as they practiced essential nursing skills in the clinical learning lab. Junior nursing students participating in this mentorship program expressed increased confidence and decreased anxiety levels while practicing clinical skills with mentors. Senior lab mentors valued the opportunity to support junior students in skills practice, and believed participation in the mentorship program improved their own nursing skills. There are several potential benefits of extending peer mentorships to the clinical lab setting for this unique student population as they transition to a baccalaureate nursing program.     

Stress,perceived support,resourcefulness and depressive symptoms in Taiwanese adolescents

Aims and objective. This study investigated (1) the prevalence of self‐reported depressive symptoms among first‐year students at an Institute of Technology in southern Taiwan; (2) whether perceived support and resourcefulness were associated with these adolescents’ depressive symptoms and (3) the moderating and mediating effects of learned resourcefulness on the relationship between stressors and the adolescents’ depressive symptoms. Background. An individual with adequate social support or resourcefulness may see stressors as less threatening or be more resilient in dealing with stressors compared with depressed individuals. The prevalence of depression in the global population increased rapidly during this past decade and consequently may have had a negative impact on population health outcomes. Among adolescents there has recently been an increased incidence of depression‐related suicide reports. Design. A cross‐sectional, correlational design. Method. Adolescents (n = 913) were recruited to complete the following: the SDI in Chinese, the Inventory of Social Supportive Behaviours Scale – Modified and the Self‐Control Schedule. Data analysis consisted of Pearson correlation and multiple regression analysis. Results. The prevalence of depression among participants was 13·4%. Participants who were younger, expressed lower satisfaction with their grades, perceived their health as worse, described peer relationship problems and exhibited smoking behaviour were more likely to have depressive symptoms. We observed five partially mediating effects of resourcefulness on stressors (age, perceived health, peer relationships, grades satisfaction and smoking behaviour) and depressive symptoms and one moderating effect of resourcefulness on the relationship between peer and depressive symptoms. Conclusions. Learned resourcefulness may play a critical role in decreasing depressive symptoms. Relevance to clinical practice. These findings offer healthcare providers and educators information about the need for possible cognitive–behavioural interventions that could improve adolescents’ relationships with their peers, enhance their satisfaction of grades and moderate or prevent depressive symptoms among this population. Moreover, it might decrease the prevalence of adolescent suicide.     

Using the Picture Exchange Communication System to Increase the Social Communication of Two Individuals with Severe Developmental Disabilities

The purpose of this study was to examine the effectiveness of the PECS with Peers protocol developed by Garfinkle and Schwartz (1994), which uses The Picture Exchange Communication System (PECS) as a means of increasing social communication between individuals with disabilities and their peers. Two females with severe communication delays and developmental disabilities served as participants and one male with developmental disabilities and one female without disabilities acted as their peers. A multiple baseline across behaviors (i.e., greetings, requests, and responses) design was used to assess the effectiveness of PECS on social communication as well as to examine whether using PECS led to increases in the participants’ verbal communication. Both participants increased their social interactions using PECS with their peer and also demonstrated a general preference for verbal communication. Social validity questionnaires indicated that teachers and parents found the social communication skills to be important and that this intervention was helpful.     

Evaluating a Bereavement Follow-Up Intervention for Grieving Fathers and Their Experiences of Support After the Death of a Child—A Pilot Study

This article describes a study designed to evaluate the effectiveness of an intervention program for bereaved fathers and their experiences of it in a sample of intervention (n = 62) and control (n = 41) fathers. Data were collected by 3 scales: the Hogan Grief Reactions Checklist, a scale for measuring received social support, and a scale for measuring fathers' experiences of the intervention program. Assessment at 6 months after leaving the hospital showed that intervention fathers reported lower grief reaction scores and stronger personal growth. Intervention fathers reported the most emotional support from both health care personnel and peer supporters. The support received was perceived as helpful in coping, and fathers rated the intervention favorably. The findings support the continuation of the intervention.     

Effect of a computer-based intervention on social support for chronically ill rural women.

Social support is a key factor in illness management. Despite the positive effects of support groups, there are barriers to participation by rural dwellers in face-to-face groups. To address these barriers, a computer-based support group intervention, the Women to Women Project, was designed to provide peer support and health information through a computer-based intervention. Data from three groups (intervention, information, comparison) of woman who participated in the program were analyzed. The pattern of improvement in social support was in the anticipated direction, but not significant in the main analysis. Exploratory analysis was conducted on a vulnerable subsample of women reporting low social support and high psychosocial distress. Results suggest that improvement in social support, based on the intervention, was greater for the vulnerable subsample as compared with the sample as a whole. An effective and efficient means of providing social support and facilitating the mobilization of this support is through self-help groups; this study demonstrates that virtual support groups can increase perceived social support.     

Impact of the Caring for Aging Relatives Group program: an evaluation

Caregiver support programs have been developed with the goal of alleviating the stress associated with the demanding role of caring for an older person. The majority of these programs, however, have not been formally evaluated. This study is a formal program evaluation which assessed the impact of a caregiver support program on its participants. Both the intervention and matched comparison groups included a convenience sample of 23 female caregivers. A quasi-experimental pretest-posttest design was used to measure morale, social support, and information. Findings showed there was a positive relationship between morale and social support. In the comparison group only, there was a positive relationship between morale and information in both the pretest and posttest. Within the intervention group, there was a significant increase (t = 2.79, p = 0.01) in the information scores between the pretest and posttest. Caregivers in the intervention group reported that the Caring for Aging Relatives Group (CARG) provided them with social support. The results of this study partially supported the usefulness of a caregiver support program; that is, information was gained, morale was maintained, and caregivers perceived the support program as helpful. Future research is needed to address what factors lead caregivers to attend a support program and what type of social support they receive from attending such a program.