RESUMEN

Declining student mental health is a global public health issue. Campus-based animal-assisted interventions (AAIs) are popular and effective interventions to prevent and alleviate symptoms. How to design, implement and evaluate evidence-based, student-centred interventions that enjoy sustained stakeholder buy-in and support is less known. This paper presents the procedures and results of a three-stage co-production method and the resulting curriculum of a novel AAI aimed at university students experiencing serious mental health problems. Stage 1 shaped the focus and structure of the intervention based on online student surveying (N = 204) and consultations with stakeholders (N = 10), including representatives of Student Well-being Services leadership, veterinarians, animal welfare charities and Therapets volunteers. In Stage 2, we conducted co-production workshops with post-graduate students (N = 6), developing the curriculum based on Stage 1 insights. In Stage 3, through iterative prototyping and student feedback (N = 22) the Paws on Campus programme was finalised, resulting in a series of four, one-hour themed sessions: (1) Thoughts and Feelings, (2) Well-being and Welfare, (3) Care and Compassion and (4) Problem Solving and Help Seeking. We describe the co-production method and resulting programme characteristics and provide considerations for others interested in developing effective and sustainable AAIs for their respective populations and contexts.

Asunto(s)

RESUMEN

BACKGROUND: Previous research has highlighted the role of stress in substance misuse and addiction, particularly for relapse risk. Mobile health interventions that incorporate real-time monitoring of physiological markers of stress offer promise for delivering tailored interventions to individuals during high-risk states of heightened stress to prevent alcohol relapse. Before such interventions can be developed, measurements of these processes in ambulatory, real-world settings are needed. OBJECTIVE: This research is a proof-of-concept study to establish the feasibility of using a wearable sensor device to continuously monitor stress in an ambulatory setting. Toward that end, we first aimed to examine the quality of 2 continuously monitored physiological signals-electrodermal activity (EDA) and heart rate variability (HRV)-and show that the data follow standard quality measures according to the literature. Next, we examined the associations between the statistical features extracted from the EDA and HRV signals and self-reported outcomes. METHODS: Participants (N=11; female: n=10) were asked to wear an Empatica E4 wearable sensor for continuous unobtrusive physiological signal collection for up to 14 days. During the same time frame, participants responded to a daily diary study using ecological momentary assessment of self-reported stress, emotions, alcohol-related cravings, pain, and discomfort via a web-based survey, which was conducted 4 times daily. Participants also participated in structured interviews throughout the study to assess daily alcohol use and to validate self-reported and physiological stress markers. In the analysis, we first used existing artifact detection methods and physiological signal processing approaches to assess the quality of the physiological data. Next, we examined the descriptive statistics for self-reported outcomes. Finally, we investigated the associations between the features of physiological signals and self-reported outcomes. RESULTS: We determined that 87.86% (1,032,265/1,174,898) of the EDA signals were clean. A comparison of the frequency of skin conductance responses per minute with previous research confirmed that the physiological signals collected in the ambulatory setting were successful. The results also indicated that the statistical features of the EDA and HRV measures were significantly correlated with the self-reported outcomes, including the number of stressful events marked on the sensor device, positive and negative emotions, and experienced pain and discomfort. CONCLUSIONS: The results demonstrated that the physiological data collected via an Empatica E4 wearable sensor device were consistent with previous literature in terms of the quality of the data and that features of these physiological signals were significantly associated with several self-reported outcomes among a sample of adults diagnosed with alcohol use disorder. These results suggest that ambulatory assessment of stress is feasible and can be used to develop tailored mobile health interventions to enhance sustained recovery from alcohol use disorder.

RESUMEN

Animal Visitation Programs (AVPs) targeting college students' stress and academic success have increased, despite limited research on academic outcomes. This randomized controlled trial (N = 349) examined the effects of incorporating levels of Human-animal Interaction (HAI) (0%, 50% or 100%) with therapy dogs in a four-week academic stress management program. Conditions included (1) Academic Stress Management (ASM) content only (0% HAI), (2) Human-animal Interaction only (100% HAI) and (3) equal combinations of ASM content and HAI (50% HAI). Intention-to-treat (ITT) analyses examined the effects of students' risk status (N = 146; depression, anxiety, perceived stress, worry) and treatment condition on students' learning and study strategies at posttest and follow-up. The results showed interactions between condition and risk status demonstrating higher posttest levels of WILL (i.e., anxiety, attitude, motivation) (Β = 0.582, p = 0.005) and SELFREGULATION (i.e., concentration, self-testing, study aids, time management) (Β = 0.501, p = 0.031) for at-risk students receiving equal combinations of HAI and content presentations. Moderation effects remained at follow-up (Β = 0.626, p = 0.005; Β = 0.630, p = 0.007). At-risk students receiving only HAI (100%) also showed higher levels of WILL at posttest (Β = 0.481, p = 0.021) and follow up (Β = 0.490, p = 0.038). University administrators should consider providing at-risk students with targeted programs with varying levels of HAI and ASM content, depending on the targeted academic outcome.

Asunto(s)

RESUMEN

An increase in the prevalence of stress among college students is compromising their mental health and academic success. One approach to stress prevention that has seen a surge in implementation is the use of university-based Animal Visitation Programs (AVPs). Despite their popularity and promising causal findings, program evaluations on students' responsiveness (e.g., enjoyment, attendance, perceptions on usefulness and behavioral change) have yet to be conducted. Using a mixed methods approach, this study reports results of a program evaluation embedded in a randomized controlled trial examining the efficacy of incorporating various levels (0%, 50% or 100%) of Human Animal Interaction (HAI) into a four-week long university-based stress prevention program resulting in three conditions: (1) Evidence-based Academic Stress Management content only (0% HAI), (2) Human Animal Interaction with therapy dogs only (100% HAI) and (3) equal combinations of Academic Stress Management and HAI (50% HAI). Responsiveness (e.g., enjoyment, usefulness, recommendation and behavioral change) was assessed quantitatively and qualitatively using self-reported survey data collected immediately following the program and again six weeks later. The results suggest that combining evidence-based content presentations with HAI was associated with higher levels of enjoyment, perceived usefulness, and likelihood of recommendation compared to presenting content presentation or HAI alone, although doing so did not result in differences in perceived behavioral change by condition. Themes of students' perceptions on the role of HAI in shaping program enjoyment, usefulness, recommendations and behavioral change were described.

Asunto(s)

RESUMEN

There has been an increase in research concerning the quality of dyadic interactions between humans and dogs in university-based animal assisted activities (AAAs). While interactions between students and dogs are commonly an area of focus, studies examining interactions between handlers and their dogs are needed. We coded 10-min long video-recorded observations (N = 151) using a mixed methods approach to capture the duration and frequency of dog-directed handler behavior (i.e., postural state, verbal and physical contact) before and during interactions with student participants in an AAA. Analyses showed a significant decrease in the proportion of time handlers spent petting their dog, and a significant increase in the proportion of time handlers spent sitting on the floor and restraining their dog by the leash in response to student introduction. Two dimensions of handlers' dog-directed behavior emerged (e.g., warmth, control) revealing distinct handler interaction styles: Hands-off (L Warmth, L Control), permissive (H warmth, L control), authoritative (H Warmth, H Control), and authoritarian (L Warmth, H Control). Handlers' interaction styles were influenced by student presence, leading some handlers to increase warmth behaviors directed to their dogs, while others decreased such behaviors. Implications for the facilitation of university-based AAAs are discussed.

RESUMEN

This study examined associations between adolescents' (N = 59; M age = 11.63) diurnal and momentary activity of the Hypothalamic Pituitary Adrenal (HPA) axis as marked by salivary cortisol, and affective and behavioral responses to their first, mounted equine assisted learning (EAL) activity. The introduction to riding occurred during the fifth week of an 11-week EAL program for at-risk and typically developing adolescents. Before the 11-week program began, participants collected 6 salivary cortisol samples at prescribed times (wakeup, 4 p.m., bedtime) over 2 days, from which indices of diurnal cortisol activity were derived. Six weeks later, on the day of their first mounted activity in week five, participants provided three salivary cortisol samples, reflecting their basal cortisol level at the end of their regular school day, and their cortisol levels linked to the beginning and end of their first ride. Participants reported on positive and negative emotion immediately before mounting the horse, and immediately after dismounting, using an 11-item survey. Using a 43-item checklist, three independent observers rated participants' behavior throughout the 90-min session. Regression analyses showed that adolescents with higher cortisol levels immediately before mounting reported higher levels of negative emotion (B = 0.350, p = 0.041) and lower levels of positive emotion (B = -0.697, p = 0.013), while basal levels and potential dysregulation of cortisol diurnal patterns were controlled. Greater cortisol reactivity in response to 10 min of riding was linked to higher negative (B = 2.95, p = 0.001), and lower positive emotion (B = -3.73, p = 0.007) after dismounting. Higher levels of pre-ride negative emotion (B = 5.50, p = 0.046), and lower levels of post-ride positive emotion (B = -5.17, p = 0.027), and an increase in cortisol reactivity in response to riding (B = 0.242, p = 0.049), predicted higher levels of negative behavior during the 90-min session that day. These findings show that participants' HPA axis activity informs their program experience and behavior. Results suggest that EAL facilitators need to employ strategies to down regulate adolescents' physiological and affective arousal during mounted sessions to prevent and redirect negative behavior.

RESUMEN

There is growing evidence that promoting social competence in youth is an effective strategy to prevent mental, emotional, and behavioral disorders in adulthood. Research suggests that programs delivered in collaboration with schools are particularly effective when they target social and emotional skill building, utilize an interactive instructional style, provide opportunities for youth participation and self-direction, and include explicit attempts to enhance youth social competence. A relatively new but popular approach that incorporates these characteristics is human animal interaction, which can be implemented in educational settings. We report the results from a randomized clinical trial examining the effects of an 11-week equine facilitated learning (EFL) program on the social competence and behavior of 5th-8th grade children. Children (N = 131) were recruited through referral by school counselors and school-based recruitment and then screened for low social competence. Researchers randomly assigned children to an experimental (n = 53) or waitlisted control group (n = 60). Children in the experimental group participated in an 11-week EFL program consisting of once-weekly, 90-min sessions of individual and team-focused activities, whereas children in the control group served as a wait-listed control and participated 16 weeks later. Parents of children in both groups rated child social competence at pretest and posttest. Three independent raters observed and reported children's positive and negative behavior using a validated checklist during each weekly session. Results indicated that program participation had a moderate treatment effect (d = .55) on social competence (p = .02) that was independent of pretest levels, age, gender, and referral status. Results showed that higher levels of program attendance predicted children's trajectories of observed positive (ß = .500; p = .003) and negative behavior (ß = -.062; p < .001) over the 11-week program.

Asunto(s)

RESUMEN

In this study, associations were examined between cortisol levels of wives and husbands in 47 heterosexual married couples. Both partners' salivary cortisol levels were measured at the same moments seven times a day on 2 typical weekdays. After accounting for the effects of the diurnal rhythm of cortisol and relevant control variables, dyadic hierarchical linear modeling indicated significant positive linkages between partners' cortisol levels, consistent with the hypothesized within-couple physiological synchrony. Variables reflecting more (spousal presence) or less connectedness (loneliness, being alone) were also collected at the time of each cortisol sample. Results indicated that husbands' cortisol levels were higher at moments they reported feeling lonelier and lower at moments they were in the presence of their spouse. Wives' cortisol levels were higher at moments they were alone. In addition, wife-husband cortisol synchrony was stronger for husbands who spent relatively more time with their spouse across the study period-even after accounting for time spent with others in general. These findings suggest that marital partners evidence positive within-couple cortisol associations, and that connectedness (particularly physical closeness) may underpin spouses' physiological synchrony.

Asunto(s)

RESUMEN

In this study, the authors examined parent-adolescent cortisol associations in 45 families with adolescent children (24 girls; M age = 15.78 years, SD = 1.44 years). Family members' salivary cortisol levels were measured seven times a day on 2 typical weekdays. Family members provided reports of demographic and health variables, and adolescents rated parent-child relationship characteristics. After accounting for the effects of time of day and relevant demographic and health control variables on cortisol levels, hierarchical linear models indicated the presence of significant covariation over time in mother-adolescent cortisol (i.e., physiological synchrony). Furthermore, moderating tests revealed that mother-adolescent cortisol synchrony was strengthened among dyads characterized by mothers and adolescents spending more time together, and in families rated higher on levels of parent-youth shared activities and parental monitoring or supervision. Analysis of momentary characteristics indicated that maternal presence at the time of cortisol sampling lowered adolescent cortisol levels but did not account for mother-adolescent cortisol synchrony. Within-family physiological synchrony was amplified in momentary contexts of elevated maternal negative affect and elevated adolescent negative affect.

Asunto(s)

RESUMEN

Faced with the challenges in today's acute care environment, 15% of the nurses in one study reported resigning a position due to experiencing moral distress. Moral distress is the physical or emotional suffering that is experienced when constraints (internal or external) prevent one from following the course of action that one believes is right. With more responsibility than authority, nurses often lack the autonomy to do what they feel should be done. Nurses often seem unaware of moral distress experience in themselves. Feelings labeled as stress, burnout, emotional exhaustion, and job dissatisfaction may actually be symptomatic of moral distress. An organizational commitment to addressing the issue of moral distress could reap benefits with greater employee job satisfaction, decreased turnover, and ultimately improved patient care.

Asunto(s)

RESUMEN

Associations between demographic characteristics, school schedules, activity choices, family functioning, and sleep behaviors were estimated using nationally representative time-diary data from 2,454 children (ages 5.5 to 11.9 years) and adolescents (ages 12.0 to 19.1 years). For weekdays, African American adolescents, Asian children, and those with earlier school start times and longer travel times to school reported fewer sleep hours. More time spent watching television (for children), doing homework (for adolescents), and engaging in religious activities predicted fewer hours, whereas a longer time spent on meals predicted greater hours of weekday sleep. For younger children, greater parental warmth predicted more hours of weekday sleep, whereas for adolescents, stricter household rules were protective. On weekends, African American adolescents and Hispanic children slept less, and there were strong effects of activity choices including time spent on television, computer and videogames, sports, religious activities, socializing, and employment. In accounting for age-related decreases in sleep hours from childhood to adolescence, earlier school start times, greater hours of homework, greater paid employment, less time spent on meals, and fewer household rules were all significant mediators.

Asunto(s)