Factors associated with participation in a community senior health promotion program: a pilot study.

Factors associated with participation in a community senior health promotion program were studied in 103 participants and a population-based control group of 531 non-participants. Compared to controls, participants had similar physical health status, but lower mental and social health status. Both men and women participants reported more depressive symptoms, lower positive affect, and lower social participation. Mental and social health may be important yet under-studied factors influencing participation in community health promotion programs.     

Social support and well-being: Implications for prevention programs

A variety of prevention programs have assumed that social support has health-promotive and health-protective effects. Although numerous studies have examined the relationship between social support and well-being, the result has been a heterogeneous and complex set of findings. We seek to review and summarize this research as a data base for planning and evaluating prevention programs. To organize our review, we present a model of stress, support, and well-being which distinguishes among several mechanisms through which support may affect well-being. We consider research on each of these mechanisms: thedirect effects of support upon functioning; theindirect effects of support upon functioning through its influence on exposure to environmental stressors; and theinteractive effects of social support in buffering the individual from the maladaptive effects of stress. We then address several implications of this research that need to be considered in the process of designing and evaluating prevention programs: (a) the need to consider the varying mechanisms through which social support has its effects; (b) the need for specificity in developing preventive interventions; and (c) the need to examine relationships among stress, support, and functioning within a broader social context.The authors are affiliated with the Social Ecology Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University and Veterans Administration Medical Center, Palo Alto, California 94305. Preparation of this article was supported in part by Veterans Administration Medical Research funds, NIAAA Grant AA02863, and NIMH Grants MH09063 and MH16744.     

Stress management delivered over public television: Steps toward promoting community mental health

This study evaluated the efficacy of television as a teaching and skills-developing medium in the area of health promotion. Experimental subjects viewed a five-part stress management series aired on public television. Control subjects were not told about the series. All subjects completed a stress questionnaire battery before and after the televised series and again at a six-week follow-up. The results indicated that experimental subjects learned about stress and stress management from the program. Those experimental subjects who watched four or five segments of the series tended to score higher on stress knowledge than did subjects who viewed fewer than three segments. No significant differences were found between experimental and control subjects on other self-report measures. Theoretical and methodological issues are discussed.Laura J. Solomon is in the Department of Psychology, University of Vermont. Lee W. Frederiksen and Kathleen A. Brehony are in the Department of Psychology, Virginia Polytechnic Institute and State University. Susan E. Arnold is in the Federal Personnel and Compensation Division, Government Accounting Office.Part of this work was supported by a grant from the Corporation for Public Broadcasting. We appreciate the assistance we received from the people at WBRA—Television (PBS-Roanoke, VA): Pam Berg, John Boettcher, and Barbara Landon. We also thank Stephen Perconte for his help in data collection. Requests for reprints should be sent to Laura J. Solomon, Department of Psychology, University of Vermont, Burlington, Vermont 05405.     

Negative affective experiences in relation to stages of eating disorder recovery

The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n = 53), partially recovered (n = 15; psychological criteria not met), and fully recovered (n = 20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal functioning and social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has salutatory effects on depression, anxiety, and perceived stress.     

Social dependency and social support in bulimic and nonbulimic women

We tested the hypotheses that bulimic women would be characterized by a high degree of social dependency and low levels of social support and that bulimic and nonbulimic women would differ in the interaction of these two variables. A secondary hypothesis, derived from Boskind-White and White's feminist account of bulimia, was that bulimic women are characterized in particular by social dependency on men and a lack of social support from men. A group of 23 normal-weight bulimic women were compared with 38 control subjects and were found to differ only in that they reported more social dependency. There was no evidence that bulimics were lacking in social support, compared with controls, nor was there any relation between bulimia and the interaction of social dependency with social support. Contrary to Boskind-White and White's theory, both bulimic and nonbulimic women reported more social dependency on men than on women, and the size of this discrepancy was found to be equal for both samples.     

Healthy start program participation: the consumers' perspective

In 1991, the federal Maternal and Child Health Bureau developed the Healthy Start Initiative as a comprehensive community-based program to eliminate the high rates of poor pregnancy outcomes among women of color. To date, few studies of the programmatic outcomes of this Initiative have examined the views of Healthy Start consumers. To understand the benefits of Healthy Start from their consumers' perspective, the Pittsburgh Allegheny County Healthy Start project conducted a survey of 202 of their Healthy Start participants in 2003. The participants completing the survey reported benefits of participating in the program including stress reduction, receiving resources and referrals, and consistent social support of program staff. According to the project's annual statistics, Healthy Start has improved pregnancy outcomes among African American women participants in the Pittsburgh community. However, and according to these participants, the quality of staff and consumer connectedness, availability and consistency of material resources, and social support are as critical as more traditional health interventions to their satisfaction, motivation to participate, and willingness to refer others to the program. Women of color will often forego health services perceived as intimidating and/or culturally insensitive, but programs such as the Healthy Start Initiative offer a critical link that encourages participation and, as a result, improves maternal and child health status.     

Program evaluation in sex education: Outcome assessment of sexual awareness weekend workshops

The results of an outcome assessment of a growth-oriented sex education program are reported. The evaluation project attempted to overcome flaws of existing sex education research by explicitly delineating goals and by incorporating both a rigorous experimental control group design and quasiexperimental cohort comparisons. A Sex Questionnaire (covering sexual knowledge, attitudes, and behavior) was administered to the participants of three weekend workshops at the time of registration and 1 month later. Overflow registration for one workshop permitted the random selection of a no-program control group. Results supported inferences of workshop effectiveness in meeting program goals in the areas of attitude and behavior change, but not with regard to increasing sexual knowledge. Implications for development and evaluation of sex education programs are discussed.Requests for additional information should be sent to Jacqueline Voss, Ph.D., Counseling Center, University of California at Irvine, Irvine, California 92716. The paper is based on research taken from the senior author's dissertation. We would like to thank the staff of Human Sexuality Services and the workshop's Task Force at Southern Illinois University at Carbondale for their support and cooperation in the evaluation project.     

Effects of a worksite coping skills intervention on the stress,social support,and health outcomes of working mothers

This study examines the effectiveness of a 15-session worksite coping skills intervention aimed at modifying work- and family-related risk and protective factors and at reducing negative health outcomes among mothers employed in secretarial positions. A sample of 142 mothers employed at one of four corporate worksites was assessed at pretest, immediately following the intervention, and at 6-month follow-up using multiple self-report measures. Results showed that at immediate posttest, intervention participants reported significantly lower employee role stress, higher social support from work sources, and lower levels of alcohol and tobacco use. They also tended to report less use of avoidance coping and lower psychological symptomatology. At 6-month follow-up, intervention participants reported significantly lower work-family and work environment stress, higher social support from work sources, less avoidance coping, and lower psychological symptomatology. Attrition analyses provided support for the external and internal validity of the study findings. Results were discussed in relation to issues of longitudinal prevention research and worksite-based interventions.     

Foster Mothers' Stress, Coping, and Social Support in Parenting Drug-Exposed and Other At-Risk Toddlers

Foster mothers of drug-exposed (n = 18) and nonexposed (n = 11) toddlers ages 12 to 30 months completed standardized measures and semistructured interviews to assess differences between groups on parenting stress and satisfaction and to examine relations among stress, satisfaction, social support, and coping. Foster mothers in.both groups scored within normal ranges on parenting stress and reported high parenting satisfaction, and analyses revealed no group differences on parenting stress and satisfaction. Both parenting stress and satisfaction were significantly correlated with social support, but both significantly correlated with support seeking contrary to the expected direction. Foster mothers' low reported stress and high satisfaction are discussed relative to this group's high level of social support, and continued exploration of social support and coping as they affect foster parent outcomes is suggested. Implications for future research and interventions are discussed, and better understanding of foster family functioning is suggested.     

Using relaxation strategies in child and youth care practice

Competent child and youth care counselors, given adequate support and consultation, can successfully, integrate relaxation training into their repertoire of skills and strategies. This paper is intended to provide a practical guide for those who wish to use relaxation strategies in a thoughtful and informed manner. Relaxation strategies are defined and described, the findings of research into relaxation training are examined, and important procedural variables associated with successful outcomes are listed. Two case examples that suggest possible application in child care settings are provided. Finally, some readily available resource materials are described.I would like to thank Bryan Hiebert, Department of Educational Psychology, University of Calgary; Betty Reiter, Calgary Board of Education; and Sandra Snape, Wood's Homes, Calgary, for their helpful feedback on an earlier version of this article.     

Attributions for Discriminatory Events and Satisfaction with Social Support in Gay Men

Attributions modulate the impact of stressful events on mental health. However, little is known about attributions for discriminatory events and their relationship to psychosocial outcomes in sexual minority individuals. Relationships were examined between gay men’s attributions for discrimination and their satisfaction with social support, a variable critical to mental health in this population. Gay men (N = 307) completed online measures of satisfaction with social support, attributions for discriminatory events, and key minority stress constructs. Self blaming attributions for discrimination were associated with decreased satisfaction with social support, independent of the frequency with which participants reported experiencing discrimination. The link between self blaming and satisfaction with social support was partially mediated by a latent affective construct comprised of anxiety, depression, and low positive affect. A moderation effect was also found, such that the relationship between frequency of perceived discriminatory events and dissatisfaction with social support was amplified for men reporting more blame toward perpetrators of discrimination. Results support attributions for discrimination as valuable additions to minority stress models. Assessing self and other blame for these discriminatory events may help to clarify pathways by which discrimination can undermine gay men’s satisfaction with their social support networks.     

Didgeridoo Playing and Singing to Support Asthma Management in Aboriginal Australians

Context: Asthma affects over 15% of Australian Aboriginal people. Compliance in asthma management is poor. Interventions that will increase compliance are required.
Purpose: The purpose of the study was to determine whether Aboriginal children, adolescents and adults would engage in music lessons to increase their knowledge of asthma and support management of their asthma.
Methods: Participants were recruited from schools and through the local Aboriginal Medical Service. All participants identified as Aborigines and were diagnosed as being asthmatic. The intervention was a 6-month program of once weekly music lessons using a culturally significant wind instrument, the didgeridoo, for males and singing lessons for females.
Findings: High school students enthusiastically engaged and had excellent retention in what they considered to be a most enjoyable program. Respiratory function improved significantly in both junior and senior boys who also reported a noticeable improvement in their health. Similar but less significant improvement was seen in the high school girls, although like the boys, they too perceived an improvement in their asthma.
Conclusions: The project demonstrated that music has great potential for engaging and thus supporting asthma. Furthermore, cultural awareness was increased by those playing the didgeridoo and social skills were noticeably improved in the girls. Similar culturally appropriate activities have applications far beyond Aboriginal communities in Australia.     

A neonatal preventive intervention study: Issues of recruitment and retention

Intervention to prevent negative mental health outcomes in families of ill and premature newborns is an important part of neonatal care. This study addresses the factors which influence participation in a parent support group for parents of ill and premature newborns. Demographic, social support, and infant health data were examined to determine how support group participants and nonparticipants differed. In addition, efforts at enhancing recruitment and retention into support groups were examined. Results showed participants in the support group to have less healthy infants with longer hospital stays than nonparticipants. Participants reported more favorable financial situations, slightly higher incomes and less social support as measured by fewer contacts with family and friends than nonparticipants. Recommendations for future intervention research are discussed.The authors acknowledge the help of the group leaders who volunteered to participate in the study, as well as the exceptional efforts of Susan Grossbard in recruitment of subjects. In addition, the support and assistance of Drs. Ruth Stein, Henry Ireys and Dorothy Jessop throughout the research project is greatly appreciated.The authors are affiliated with the Preventive Intervention Research Center for Child Health, the Division of Neonatology, and the Low Birthweight Infant Follow-up & Evaluation Program of the Department of Pediatrics, Albert Einstein College of Medicine—Montefiore Medical Center (supported in part by Grant #P50-MH38280 from the Branch for Prevention Research of the National Institute of Mental Health).     

Indian immigrant parents of children with developmental disabilities: stressors and support systems

Although Asian Indians constitute one of the largest immigrant groups in the USA, research examining wellbeing among Indian immigrant families caring for a child with a developmental disability is relatively scarce. In response, this study examined the stressors and perceived quality of social support among Indian immigrant families of children and adolescents with a developmental disability in the USA. Thirty-three Indian immigrant parents of a child or an adolescent with a developmental disability participated in an online study. The participants reported a moderate level of stress overall, but over 54% participants considered long-term planning for accommodation, finding opportunities for child to make friends, child's diagnosis, and planning for socioemotional support as extremely stressful. Spouse and support groups were the most positively rated sources of support. Participant stress was negatively linked to perceived quality of formal support. This paper discusses the findings in the context of practice and research implications.     

Peer Reviewed: Predictors of Increased Physical Activity in the Active for Life Program

Introduction

Targeting of evidence-based programs can be improved by knowing who benefits least and most. We examined pretest predictors of increased physical activity among participants enrolled in Active for Life.

Methods

Participants (N = 1,963) from 9 community-based organizations took part in a 6-month telephone-based or a 20-week group-based behavioral physical activity program and completed a pretest survey; 1,335 participants returned posttest surveys. Interactions tested whether increases in physical activity differed over time, according to baseline characteristics.

Results

In the telephone-based program, participants who were younger and less active at pretest and those who had higher pretest social support showed greater intervention effects. In the group-based program, younger participants, those less active at pretest, women, Hispanics/Latinos, heavier participants, and those who reported more health conditions and osteoporosis showed greater intervention effects.

Conclusion

Participant response to the 2 programs varied by age, baseline activity level, and other factors. For 6 of the 8 variables associated with differential outcomes, the least active group improved the most, which suggests that the programs worked especially well for participants most in need. Participants who were older than 75 years (both groups) and those who reported lower physical activity social support (in the telephone-based program) on entry did not respond as well and may require alternative or more intensive intervention strategies.     

Spirituality, Coping, and HIV Risk and Prevention in a Sample of Severely Mentally Ill Puerto Rican Women

Hispanics have been disproportionately impacted by HIV/AIDS. Although HIV risk is significantly elevated among severely mentally ill persons (SMI), the risk of infection appears to be even greater among those SMI who are Hispanic, reflecting the increased risk of HIV among Hispanics. We report on findings from the first 41 participants in a qualitative study examining the context of HIV risk and risk reduction strategies among severely mentally ill Puerto Rican women residents in northeastern Ohio. Individuals participated in a baseline interview, two follow-up interviews, and up to 100 hours of shadowing. Interviews and shadowing activities were recorded and analyzed using a grounded theory. The majority of individuals reported using identification with a religious faith. A large proportion of the participants reported that their religious or spiritual beliefs were critical to their coping, had influenced them to reduce risk, and/or provided them with needed social support. Several participants also reported having experienced rejection from their faith communities. The emphasis on spirituality among Puerto Rican SMI is consistent with previous research demonstrating the importance of spirituality in the Hispanic culture and reliance on spiritual beliefs as a mean of coping among SMI. Our results support the incorporation of spiritual beliefs into secular HIV prevention efforts. Loue is with the Department of Epidemiology and Biostatistics, Center for Minority Public Health, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; Sajatovic is with the Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.     

Adolescent Perspectives on Social Support Received in the Aftermath of Sexual Abuse: A Qualitative Study

The extent and quality of social support provided to young survivors of sexual abuse (SA) have only rarely been examined. This qualitative study aimed to investigate adolescent perspectives on social support received in the aftermath of SA. A total of 26 sexually victimized adolescents (15–18 years old) participated in a qualitative face-to-face, in-depth interview that focused on perceived social support. Qualitative content analysis was conducted as per Mayring (2008) using the qualitative data analysis program ATLAS.ti. In addition, quantitative correlational analyses were conducted to identify characteristics of SA and their associations with perceived social support. Although participants perceived parental support as the most necessary type of support, they were much more satisfied with support from peers. In particular, adolescents stated that they wished they had received more emotional support from their parents in order to better cope with the abuse. About half of participants reported having received counseling, and counseling was seen as very helpful in dealing with the consequences of SA. Only a few adolescents mentioned their school as a source of support. Intra-familial abuse, younger victim age at the time of abuse, an adult perpetrator, and severe abuse were all negatively associated with satisfaction with perceived support. Our results suggest that support for young survivors of SA needs to be improved. Prevention of SA needs particular focus on improving parental reactions to SA, facilitating access to professional support, and raising teacher awareness of the importance of their role in the provision of support for sexually victimized children.     

Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses.

We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardless of whether they had participated in the screening program, believed that women are justified in having an abortion in the face of fetal abnormality. There was a sharp increase in the number of screening program participants who said they would have an abortion when the probability of the fetus being affected with a neural tube defect rose from 95 per cent to 100 per cent.     

Effects of an exercise intervention on participation reported by people with disabilities: A mixed methods randomized trial

BackgroundDespite a long history of research on the benefits of exercise for people with mobility impairments, little is known about how exercise affects participation in their daily activities.ObjectiveThis randomized mixed-methods study examined the effects of participating in a structured community-based exercise program on pain, depression, fatigue, exertion and participation in daily activities.MethodStudy participants were recruited from a population-based sample of people who returned a survey (n = 800) and indicated they would be willing to participate in another study. The intervention group was randomly assigned to participate in a physical therapy evaluation and 30 exercise sessions within four months and the control group completed measures only. Ecological momentary assessment and a daily diary was used to evaluate treatment outcomes for the intervention relative to the control group on pain, depression, fatigue, exertion and participation in high exertion activities. We also interviewed a subset of intervention participants to solicit their lived experience from engaging in the exercise intervention.ResultsExercise intervention participants reported 28% less pain and 19% less fatigue than control participants. They also reported engaging in 11% more bathing and grooming, 22% more household chores, and left their homes 13% more than control participants. These results were mirrored in qualitative interview results.ConclusionsParticipating in an exercise program leads to less pain and fatigue and more participation in activities that require relatively high levels of exertion like bathing and leaving home.     

Relationships between family background problems and social problem solving skills of young normal children

Relationships between family background problems and social problem solving (SPS) skills were studied in normal third grade children. Twelve urban and suburban classroom teachers provided information about the presence of six family background problems for 243 children. Three problem solving skills were assessed: 1) alternative solution thinking, means-end thinking, and 3) social role taking. Overall, children with, one or more family problems, compared to those with no problems, generated fewer effective solutions and were less able to carry out a stepwise plan or to take the point of view of another. Differential reltionships were found between specific family background problems and specific problem solving skill deficiencies. Implications of the findings for school-based preventive programming were considered.This study was done with grant support from the N.Y.S. Education Department and the NIMH Experimental and Special Training Branch MH 14547-02. The authors acknowledge that support with gratitude. Reprint requests to the 3rd author, Department of Psychology, University of Rochester, Rochester, N.Y. 14627. Viviane Perez is now at the Jerusalem Psychoeducational Clinic, Jerusalem, Israel. Ellis L. Gesten is presently at the University of South Florida, Tampa, Florida. Bruce Rapkin is now at the Department of Psychology, University of Illinois, Champaign, Illinois.