Journal of technology in behavioral science最新文献

COVID-19 forced college administrators to reassess how they provide students with the most effective methods of support. This project examined the first year of a novel digital peer mentoring program with the goal of connecting diverse students to campus resources they needed to navigate the transition to and through their first year of college. MentorHub, a referral and supportive accountability mobile application, was implemented with first-year undergraduates at a large, private university in the northeastern region of the USA. MentorHub tracked students' current challenges and connected them with trained peer mentors who provided students with support and referrals to campus resources (e.g., mental health, financial, academic). Analyses were not hypothesis-driven, but instead were exploratory and intended for improving the platform. In the first year of the program (August 2021 to June 2022), 47% (N = 3141) students logged onto the platform at least once. Patterns of self-reported challenges revealed that career concerns were the most challenging at the beginning of the fall semester, and that academic habits were most challenging over the course of the year. Referrals (N = 756) were made by mentors, 13% of which were for health and well-being. First-generation and underrepresented minority students showed distinct patterns in referrals. Findings revealed distinct patterns in self-reported challenges across the academic year. Students' use of MentorHub and responses to in-app questions allowed for a real-time understanding of student challenges and patterns of engagement with peer mentors. Implications for a stepped-care approach to addressing student challenges are discussed.

Supplementary information: The online version contains supplementary material available at 10.1007/s41347-023-00303-8.

Most suicides occur among adults of working age and workplace suicide prevention is a public health priority. Workplace suicide prevention efforts, however, remain limited. This paper describes and evaluates a workplace-based suicide prevention gatekeeper training delivered in-person and virtually. VitalCog is a 2-h suicide prevention program designed specifically for the workplace and based on best practices for gatekeeper training. It is designed to be practical and interactive, with four modules (why prevention matters, what to do if someone is suicidal, conversations about suicide, and postvention), each containing related video, group discussion, and role play exercise components. It was delivered live by experienced trainers either in-person or using synchronous technologies between 2018 and 2021. A mixed methods pre- and post-training design with no control group was used to evaluate in-person vs. virtual delivery to determine knowledge gain, confidence identifying warning signs, and comfort levels talking about suicide. One thousand two-hundred and forty-four (1244) pre- and post-training responses were analyzed, with no significant (p > .05) socio-economic differences between the pre-training and post-training respondent samples. Both in-person (n = 841) and virtual (n = 403) training groups demonstrated statistically significant increases in knowledge about suicide prevention and seeking help, confidence to identify suicide warning signs, and comfort levels talking to someone about getting help. Interestingly, the virtual group showed higher post-training outcome scores than the in-person group. While COVID-19 significantly reduced in-person training opportunities, these results suggest that offering VitalCog virtually is as effective as in-person, and potentially has advantages over in-person training.

Barriers to mental health care, including stigma, costs, and mental health professional shortages, have been exacerbated by the COVID-19 pandemic. Smartphone apps have the potential to increase scalability and improve access to mental health information, support, and interventions. However, evaluating these apps and selecting ones for use in care remain challenging, especially as apps are often updating and changing. Recommending apps requires knowledge of how stable apps are as the experience of one user several months ago may or may not be the same. A sample of 347 apps of the 650 apps on the M-health Index and Navigation Database (MIND) https://mindapps.org were reviewed between September 1, 2021, and January 5, 2022. Apps were selected by time since their last review, with updates occurring on average approximately 4 months from the last review. Eleven trained app evaluators reviewed apps across 105 evaluation criteria in 9 categories. Results were compared to initial ratings, identifying the changes that occurred. The average app updates every 433 days, though 19% were updated in the last 3 months and some nearly weekly. Changes in privacy and features made up the highest percentage of changes, both at 38%. The most frequently observed privacy-related change was increased privacy policy reading level. Functionality parameters changed in 28% of apps. The most common functionality change was the removal of an accessibility feature. Clinical foundations changed in 18% of apps and 9% added supporting studies. Cost structure changed in 17% of apps, with 10% adding a fee for use of the app. Engagement features changed in 17% of the apps, with additions and removals of validated assessments or screeners most common. The dynamic nature of the app stores is reflected in app privacy, features, and functionality. These changes, reflected by the increased reading levels required to understand privacy policies, the decrease in accessibility features, and the additions of fees to access mobile apps, reflect the need to constantly review apps and understand how they are evolving. Patient and clinicians should use the most recent and updated possible when evaluating apps.

Self-care improves health and well-being, yet many caregivers neglect it. During COVID-19, self-care courses for caregivers of veterans transitioned from in-person to virtual videoconferencing. The format remained the same with caregiver groups and a trainer. This observational study examined in-person and virtual caregivers' satisfaction with courses. Caregivers (1120 in-person, 962 virtual) could attend five courses before and following March 2020 transition to virtual. Evaluations (N = 1665) examined demographics, satisfaction, and utility. Characteristics were compared between in-person and virtual participants using chi-squared tests. Qualitative caregiver comments were compared. Half of the caregivers were over 60 years old; 49% had been caregivers at least 6 years. Caregivers were primarily women (91%) and spouses (75%), with more spouses virtually (p = 0.006) and more men in-person (p < 0.001). Both groups endorsed learning new information, planning to use it in caregiving and for themselves, increasing knowledge and skills, and having needs met. Caregiver comments revealed six types of benefits: new information, information review, positive effects, interaction, plans to act, and instructor qualities. Caregivers in virtual groups more often mentioned learning more information, being reminded of information, and planning to take further action; in-person caregivers more often mentioned interaction as a benefit. Caregivers were satisfied with and found benefit from in-person and virtual self-care courses. Although in-person courses allow for more social connection with others, virtual courses offer decreased travel costs for instructors and increased convenience and access for caregivers.

Video telehealth experienced rapid growth throughout the COVID-19 pandemic in many healthcare sectors, including mental health. The Veterans Health Administration's video telehealth platform, VA Video Connect, has been widely used to reach veterans who may have experienced difficulty accessing care, such as those living in rural areas or other barriers (e.g., transportation). Implementing VVC requires a multifaceted approach, including training providers on technical skills, increasing access to equipment for providers and veterans, and integrating VVC within the culture and processes of the clinic unit. Prior successful VVC implementation efforts in rural areas have focused on simultaneous one-on-one provider and leadership engagement using implementation facilitation (IF). However, given the rapid need for VVC expansion in light of limits and dangers associated with in-person care during the pandemic, our team developed group facilitation to increase the reach of VVC implementation through IF. Group facilitation combined training in technical and policy elements of VVC with IF with groups of providers from clinic units. This approach was designed to rapidly disseminate the necessary knowledge to conduct VVC combined with collaborative problem solving as a team to improve the ability of the clinical team to sustain VVC. Attendees were asked for feedback on the session through multiple choice and open-ended questions. Participants (N = 26) reported being highly satisfied with the training and reported a high degree of confidence in their ability to use VVC. Based on evaluation data and interview feedback, providers and clinic leaders were satisfied with group facilitation. Group facilitation may be a helpful tool in rapidly training clinical teams to implement and sustain video telemental health.

Minimal evidence exists for suicide-specific group treatment for high-risk patients offered over telehealth. This qualitative study assessed the acceptability, feasibility, and impact of a telehealth suicide safety planning intervention (SPI) multi-session group. High-risk suicidal Veterans (n = 17) participating in "Project Life Force-telehealth" (PLF-T); a manualized, 10-session SPI video group completed semi-structured qualitative interviews including measures of acceptability, appropriateness, and feasibility. We also interviewed the PLF-T coordinator and PLF-T group facilitators to identify adaptations to deliver PLF-T and learn about barriers and facilitators to implementation. A summary template and matrix analysis approach was used to analyze qualitative data. Veteran group participants were mostly male (88%), age 50 (SD = 15.6), ethnically diverse, and either divorced or separated (54%). Suicide symptoms upon study entry included past month ideation with methods (100%); and past year aborted, interrupted, or actual suicide attempt (59%). Participant interviews revealed an overall positive endorsement of PLF-telehealth with enhanced suicidal disclosure, and improved ability to manage urges and mitigate loneliness. On scales from 1 to 20, PLF-T was rated as highly acceptable (M = 17.50; SD = 2.92), appropriate (M = 17.25; SD = 3.59), and feasible (M = 18; SD = 2.45) by participants. Adaptations to deliver PLF-T included using a communications coordinator to conduct assertive outreach and engagement, adding a telehealth orientation session, restructuring sessions to review suicide severity, and screen-sharing safety plans to maximize learning. PLF-T enhanced convenience and access without compromising safety. Concerns included privacy and technological limitations including connectivity. Project Life Force-telehealth is acceptable and feasible to deliver via telehealth. This opens the possibility of delivery to hard-to-reach high-risk populations. ClinicalTrials.gov Identifier: NCT0365363.

The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.

Despite the availability of free, evidence-informed mental health mobile applications (apps) to support Veterans and Service Members, interventions are needed to ensure patients are aware of the developed resources. A psychoeducational group was developed and evaluated by a quality improvement project in the context of a Department of Veterans Affairs residential treatment program. Four weekly group sessions introduced 82 Veterans to two similarly themed apps at each group and supported Veteran installation, introduction to the clinical subject matter, app orientation and demonstration, and device/app troubleshooting. Although 94% owned a smartphone, prior to the group, seven of eight apps introduced during the group had been used by fewer than 10% of participants. Following group participation, the proportion of participants agreeing that they were comfortable using mental health apps increased from 33% at baseline to 75%. Similarly, relative to 54% of participants at baseline who agreed that they were aware of available mental health mobile applications, the proportion rose to 89% after the group. Most participants rated three apps as "helpful" or "very helpful" (Breath2Relax, Mindfulness Coach, and PTSD Coach) and most participants reported they were likely to use these apps in the future. Results and qualitative feedback identified needed improvements to the group, including the replacement of some featured apps and the inclusion of automated app usage metrics. Well-designed implementation studies of dissemination strategies are needed to inform best practices for the adoption of these promising interventions.