المؤلفون: Christina M Luberto PhD, Giselle K Perez PhD, Lucy Finkelstein-Fox PhD, Rachel A Millstein PhD, Lucy Fell BA, Emma Chad-Friedman MA, Elyse R Park PhD, MPH, Karen A Kuhlthau PhD

المصدر: Global Advances in Health and Medicine, Vol 10 (2021)

مصطلحات موضوعية: Medicine (General), R5-920, Public aspects of medicine, RA1-1270

الوصف: Objective Parents of children with learning/attentional disabilities (LAD) and autism spectrum disorder (ASD) are at elevated risk for chronic stress. Types of stress and treatment needs differ between these parent groups. We adapted our evidence-based mind–body intervention (SMART-3RP) for parents of children with LAD and ASD, delivered via videoconferencing. Preliminary results from our two wait-list randomized pilot trials suggest the programs were feasible and efficacious. To gain an in-depth understanding of acceptability, the purpose of this secondary analysis from the RCTs is to (1) explore feedback regarding the virtual SMART-3RP and (2) compare feedback across LAD and ASD parents. Methods Participants were randomized to immediate or delayed SMART-3RP (separate groups for LAD and ASD) and completed a feedback questionnaire post-intervention ( N = 33 LAD, N = 37 ASD; 93% female, 93% white, Mage = 45.52, SD = 6.50). Results Participants reported the intervention had the right number of sessions (69%), session duration (83%), and amount of structure (83%). They felt comfortable during sessions (89%) and found mind–body skills helpful (89%). There were no significant differences between parent groups other than a trend for more ASD parents reporting sessions were too long (22% ASD vs. 6% LAD, X 2 = 5.67, p =0.06). Qualitative themes were similar across parents and included that video delivery had some technical challenges but enabled participation; group support and mind–body skills were helpful; and further SMART-3RP sessions or therapy is needed. Conclusion LAD and ASD parents found a synchronous video-based mind–body resiliency program acceptable. Technology limitations notwithstanding, online delivery was very satisfactory and overcame obstacles to participation.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2164-9561

URL الوصول: https://doaj.org/article/971255b3819746a6b5195826f9da4d44

المؤلفون: Daniel L Hall PhD, Rachel A Millstein PhD, MHS, Christina M Luberto PhD, Giselle K Perez PhD, Elyse R Park PhD, MPH

المصدر: Global Advances in Health and Medicine, Vol 9 (2020)

مصطلحات موضوعية: Medicine (General), R5-920, Public aspects of medicine, RA1-1270

الوصف: The COVID-19 pandemic has resulted in unprecedented stress and uncertainty, particularly among vulnerable populations such as healthcare workers who are facing a multitude of current and looming economic and psychosocial stressors. As clinician-scientists delivering mind-body interventions in our hospital, we suggest applying evidence-based mind-body techniques that promote resiliency and adaptive coping during these difficult times. Interventions that package a variety of mind-body skills into one cohesive program, such as the Stress Management and Resiliency Training – Relaxation Response Resiliency Program (SMART-3RP), offer promise for meeting the variety of stress management needs (e.g., health concerns, isolation) present during the COVID-19 pandemic. From our work with frontline healthcare clinicians and other caregiver populations, we offer recommendations for adapting the delivery, modality, and content of mind-body practices during the COVID-19 pandemic and suggest key skills for promoting resiliency and buffering against the future stressors that lie ahead for everyone.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2164-9561

URL الوصول: https://doaj.org/article/5f502f2ef04f42ee91ad57136beb11dc

المؤلفون: Christina M Luberto PhD, Daniel L Hall PhD, Elyse R Park PhD, MPH, Aviad Haramati PhD, Sian Cotton PhD

المصدر: Global Advances in Health and Medicine, Vol 9 (2020)

مصطلحات موضوعية: Medicine (General), R5-920, Public aspects of medicine, RA1-1270

الوصف: Mind–body medicine is an evidence-based approach to health and healing that focuses on interactions between the mind, body, and behavior. It encompasses a wide range of interventions that are similar yet different in meaningful ways. Mindfulness and relaxation practices are 2 mind–body techniques that have similarities and differences; however, these techniques are often used or discussed interchangeably, such that the differences between them become obscured. A greater understanding of the unique facets of mindfulness and relaxation is needed for researchers and clinicians to make informed decisions when selecting an approach. The purpose of the current article is to offer an evidence-informed perspective on similarities and differences between mindfulness and relaxation. Specifically, mindfulness and relaxation practices are compared and contrasted in terms of theoretical foundation, intention, and psychological and physiological effects and mechanisms. Implications for clinical practice and suggestions for future research are discussed.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2164-9561

URL الوصول: https://doaj.org/article/207686612a4b4147aa62ef2882dfd39d

المؤلفون: Giselle K. Perez PhD, Anjali R. Oberoi MD, MPH, Lucy Finkelstein-Fox PhD, Elyse R. Park PhD, MPH, Ryan D. Nipp MD, MPH, Beverly Moy MD, MPH

المصدر: Cancer Control, Vol 30 (2023)

مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Introduction Cancer clinical trials represent the “gold standard” for advancing novel cancer therapies. Optimizing trial participation is critical to ensuring the generalizability of findings across patients, yet trial enrollment rates, particularly among minority and socioeconomically disadvantaged populations, remain suboptimal. Methods We conducted in-depth interviews with oncologists at a large academic medical center to explore their (1) attitudes and perceived barriers to offering clinical trials to minority and socioeconomically disadvantaged patients, and (2) recommendations for improving the enrollment of minority and socioeconomically disadvantaged patients in cancer clinical trials. Results Of 23 medical oncologists approached, 17 enrolled (74% response rate; mean age = 47; female = 42%; White = 67%). Content analysis revealed several barriers to enrollment: (1) ethical dilemmas; (2) ambivalence about trial risks and benefits; and (3) concern about patient well-being. Concerns about the legitimacy of informed consent, perceived lack of equipoise, and fear of personal bias influenced clinicians’ decisions to recommend trials during treatment discussions. Concerns about creating an imbalance between trial risks and benefits among patients with high-level needs, including patients with literacy, psychiatric, and other socioeconomic vulnerabilities, impacted clinicians’ enthusiasm to engage in trial discussions. Clinicians identified patient, provider, and system-level solutions to address challenges, including increasing patient and clinician support as well as involving external personnel to support trial enrollment. Conclusion Findings reveal multi-level barriers to offering cancer clinical trials to underrepresented patients. Targeted solutions, including system level changes to support clinicians, patient financial support, and implementation of clinical trial navigation programs were recommended to help reduce access barriers and increase enrollment of underrepresented patients into cancer clinical trials.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/1526-2359

URL الوصول: https://doaj.org/article/db89dd2bf72146e59c6b7908834de829

المؤلفون: Daniel L. Hall PhD, Gloria Y. Yeh MD, MPH, Conall O'Cleirigh PhD, Jeffrey Peppercorn MD, MPH, Lynne I. Wagner PhD, John Denninger MD, PhD, Andrea J. Bullock MD, Helen R. Mizrach BS, Brett Goshe PhD, Tina Cheung BS, Raissa Li BS, Alexandros Markowitz BS, Elyse R. Park PhD, MPH

المصدر: Global Advances in Health and Medicine, Vol 11 (2022)

مصطلحات موضوعية: Medicine (General), R5-920, Public aspects of medicine, RA1-1270

الوصف: Background For cancer survivors, there is a paucity of fear of recurrence (FOR) interventions that integrate empirically supported mind-body and psychological skills for managing FOR and are delivered in scalable formats. Objective To adapt an evidence-based resiliency intervention to address FOR among cancer survivors. Methods A multidisciplinary team of researchers, clinicians, and patient stakeholders followed an iterative intervention adaptation process (ORBIT). In Step 1, we sought to define key FOR management skills through a literature review and feedback from stakeholders. In Step 2, we integrated findings into a treatment manual and refined procedures for in-person delivery to groups of cancer survivors, defined as adults who had completed primary cancer treatment for non-metastatic cancer. In Step 3, we conducted a single arm trial to assess initial acceptability and change in FOR severity with 23 cancer survivors (N=4 intervention groups). In Step 4, we conducted additional qualitative interviews with 28 cancer survivors (N=6 focus groups stratified by FOR severity, N=15 individual interviews) to define adaptive and maladaptive strategies for coping with FOR and to identify preferences for delivery. In Step 5, we refined the treatment manual and procedures for testing in a future pilot randomized feasibility trial. Results We identified critical feedback using a combination of qualitative and quantitative methods. The single arm trial suggested preliminary feasibility and sustained reductions in FOR severity, yet need for refinement (i.e., eligibility, delivery modality), prompting additional qualitative interviews for further targeting. The resulting intervention (IN FOCUS) is comprised of virtual, synchronous, group-delivered sessions that offer an integrated approach to FOR management by teaching cognitive-behavioral techniques, meditation, relaxation training, adaptive health behaviors, and positive psychology skills. Sessions are targeted by applying skills to FOR and associated healthcare engagement. Conclusions IN FOCUS is a targeted intervention for teaching mind-body resiliency skills to groups of cancer survivors with elevated FOR. Next steps are testing feasibility in a pilot randomized trial.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2164-9561

URL الوصول: https://doaj.org/article/f75961cbce5c4b31a3cdb2adf6de4204

المؤلفون: Raggio GA; Greer A. Raggio, PhD, MPH, is a Psychologist, National Center for Weight and Wellness, Washington, DC, USA. Sara E. Looby, PhD, ANP-BC, FAAN, is an Assistant Professor of Medicine, Harvard Medical School, and Assistant Professor in Nutrition, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. Gregory K. Robbins, MD, MPH, is an Associate Professor of Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. Elyse R. Park, PhD, MPH, is an Associate Professor of Psychiatry, Harvard Medical School, Director of Behavioral Services, Massachusetts General Hospital, Tobacco Treatment and Research Center, and the Director of Behavioral Research, Massachusetts General Hospital, Benson-Henry Institute for Mind Body Medicine, Boston, Massachusetts, USA. Elsa W. Sweek, MS, is a Clinical Research Coordinator, Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. Steven A. Safren, PhD, is a Professor of Psychology, Department of Psychology, University of Miami, Coral Gables, Florida, USA. Christina Psaros, PhD, is an Assistant Professor in Psychology, Harvard Medical School, and Associate Director, Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Looby SE, Robbins GK, Park ER, Sweek EW, Safren SA, Psaros C

المصدر: The Journal of the Association of Nurses in AIDS Care : JANAC [J Assoc Nurses AIDS Care] 2020 Mar-Apr; Vol. 31 (2), pp. 157-166.

نوع المنشور: Journal Article; Research Support, N.I.H., Extramural

بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 9111870 Publication Model: Print Cited Medium: Internet ISSN: 1552-6917 (Electronic) Linking ISSN: 10553290 NLM ISO Abbreviation: J Assoc Nurses AIDS Care Subsets: MEDLINE

مواضيع طبية MeSH: Aging*/physiology , Aging*/psychology, Body Image/*psychology , HIV Infections/*complications , HIV-Associated Lipodystrophy Syndrome/*psychology , Quality of Life/*psychology, Adipose Tissue/physiopathology ; Aged ; Anti-HIV Agents/adverse effects ; Anti-HIV Agents/therapeutic use ; Anxiety/epidemiology ; Anxiety/psychology ; Depression/epidemiology ; Depression/psychology ; Female ; HIV Infections/drug therapy ; HIV Infections/psychology ; HIV-Associated Lipodystrophy Syndrome/epidemiology ; HIV-Associated Lipodystrophy Syndrome/physiopathology ; Humans ; Male ; Menopause ; Middle Aged ; Prevalence ; Sickness Impact Profile ; Social Support

مستخلص: Body image disturbance is increasingly relevant as women living with HIV (WLWH) live longer. We explored body image disturbance and changes in fat distribution (lipodystrophy) in 63 WLWH (mean age = 51 years) and evaluated associations among lipodystrophy, body image, and psychosocial variables. Eighty-one percent of participants reported one or more body parts (of six assessed) demonstrating lipodystrophy, and more than one third reported three or more affected body parts. Increased belt/waist (58%) and increased chest/breast (39%) sizes were most common. More diffuse lipodystrophy was significantly associated with poorer body image (F[2,54] = 11.86, p < .001, partial η = .313) and anxiety (F[2,52] = 3.82, p = .029, partial η = .133) after controlling for age and duration of infection. Lipodystrophy was prevalent in our sample; more diffuse lipodystrophy was associated with anxiety and poor body image. Providers should assess lipodystrophy in older WLWH and provide referrals for mental health services.