Implementation of a lifestyle intervention for people with a severe mental illness (SMILE): a process evaluation

Background Several interventions have been developed to improve physical health and lifestyle behaviour of people with a severe mental illness (SMI). Recently, we conducted a pragmatic cluster-randomised controlled trial which evaluated the effects of the one-year Severe Mental Illness Lifestyle Evaluation (SMILE) lifestyle intervention compared with usual care in clients with SMI. The SMILE intervention is a 12-month group-based lifestyle intervention with a focus on increased physical activity and healthy food intake. The aim of the current study was to explore the experiences of people with SMI and healthcare professionals (HCPs) regarding implementation feasibility of the SMILE intervention and the fidelity to the SMILE intervention. Methods A process evaluation was conducted alongside the pragmatic randomized controlled trial. The experiences of clients and HCPs in the lifestyle intervention group were studied. First, descriptive data on the implementation of the intervention were collected. Next, semi-structured interviews with clients (n = 15) and HCPs (n = 13) were performed. Interviews were audiotaped and transcribed verbatim. A thematic analysis of the interview data was performed using MAXQDA software. In addition, observations of group sessions were performed to determine the fidelity to the SMILE intervention using a standardised form. Results Ten out of 26 HCPs who conducted the group sessions discontinued their involvement with the intervention, primarily due to changing jobs. 98% of all planned group sessions were performed. Four main themes emerged from the interviews: 1) Positive appraisal of the SMILE intervention, 2) Suggestions for improvement of the SMILE intervention 3) Facilitators of implementation and 4) Barriers of implementation. Both clients and HCPs had positive experiences regarding the SMILE intervention. Clients found the intervention useful and informative. The intervention was found suitable and interesting for all people with SMI, though HCPs sometimes had to tailor the intervention to individual characteristics of patients (e.g., with respect to cognitive functioning). The handbook of the SMILE intervention was perceived as user-friendly and helpful by HCPs. Combining SMILE with daily tasks, no support from other team members, and lack of staff and time were experienced as barriers for the delivery of the intervention. Conclusion The SMILE intervention was feasible and well-perceived by clients and HCPs. However, we also identified some aspects that may have hindered effective implementation and needs to be considered when implementing the SMILE intervention in daily practice.

Social workers’ adaptation in times of pandemic crisis: A Hong Kong case

Through the lens of the theory of planned behavior, this article explores how social workers adapt to a new situation due to the outbreak of the COVID-19 pandemic. Three focus group sessions were conducted with 23 social workers from child and youth, family, and elderly services in Hong Kong. Three major themes were generated: (1) repositioning the social work profession, (2) renegotiating contracts with funders, and (3) exploring novel intervention methods. Implications of the findings are discussed. To ensure social workers can respond effectively in crises, an evolving nature of the profession is advocated to enshrine its spirit to serve.

Examining the Effects of Mindfulness–Acceptance–Commitment Training on Self-Compassion and Grit among Elite Female Athletes

Background: Mindfulness-based interventions are well-established in the field of psychotherapy, and such interventions have also gained increased attention in the field of sport psychology, either to cope with psychological pressure or to improve an athlete’s performance. The goal of the present study was to examine whether a Mindfulness–Acceptance–Commitment (MAC) program could increase self-compassion and grit among elite female athletes compared to an active control condition. To this end, we performed a randomized trial among female adult athletes. Methods: Forty female adult athletes (Mage = 22.22, SD = 2.40) were randomly assigned either to the Mindfulness–Acceptance–Commitment group (n = 20; 7 group sessions, 60 min each) or the active control group (n = 20; 7 group sessions, 60 min each). At baseline, seven weeks later at the end of the study and again four weeks later at follow-up, participants completed a series of self-rating questionnaires on mindfulness, self-compassion and grit. Results: Dimensions of mindfulness, self-compassion and grit improved over time, but more so in the Mindfulness–Acceptance–Commitment condition compared to the active control condition. Improvements remained stable from the study end to follow-up. Conclusions: While the active control condition improved dimensions of mindfulness, self-compassion and grit among female adult athletes, improvements were much stronger in the Mindfulness–Acceptance–Commitment condition. Importantly, improvements in the Mindfulness–Acceptance–Commitment condition remained stable over a time lapse of four weeks at follow-up after study completion, suggesting that the Mindfulness–Acceptance–Commitment intervention appeared to improve cognitive–emotional learning processes.

Computational Communication Science: Lessons from Working Group Sessions with Experts of an Emerging Research Field

This chapter provides an overview of computational communication science (CCS) as an emerging and exemplary subfield of computational social science. Based on lessons from working group sessions with 34 experts, we address recent challenges and desiderata of CCS research while reflecting upon its future development and expansion. Four major fields of action proved particularly relevant in these discussions: First, challenges related to a reflected but integrated CCS methodology; second, challenges related to a further elaboration on the theoretical perspectives on CCS; third, challenges related to the formation and further institutionalization of CCS as fundamental basis for further scientific exchange, progress and standardization; and fourth, implications for empirical communication research, particularly highlighting the relevance of wicked problems as research incubators driving further progress.

How concerned significant others experience Community Reinforcement and Family Training (CRAFT) – a qualitative study

Introduction Heavy drinking causes serious harm, not only to the drinker but also to relationships and concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) is an intervention developed to help the CSOs of substance users. The aim of this study was to investigate the drivers and aims underlying CSO participation in CRAFT, as well as their experience of the intervention itself and their module preferences. Method This is a qualitative study based on data from semi-structured interviews with 11 female help-seeking CSOs of individuals with alcohol problems. The participants were recruited from an RCT study of a variety of CRAFT delivery formats (group sessions + written material, individual sessions + written material or self-delivered CRAFT with written material only). The interviews were audio-recorded, transcribed, and analyzed by Interpretative Phenomenological Analysis. Results CSOs reported CRAFT helpful when both delivered by means of individual sessions or group sessions. The “Communication Element” in CRAFT, the module focusing on positive reinforcement and acquiring a clearer understanding of AUD, appeared to be particularly helpful elements of CRAFT. Furthermore, being met with acceptance and non-judgmental attitudes seemed to count highly for the CSOs. The written material a helpful supplement to the face-to-face interventions. The written material a helpful supplement to the face-to-face interventions. Conclusion CSOs who participated in the CRAFT intervention felt helped by its components, irrespective of delivery format.

P-OGC76 A patient engagement event to assess feasibility of preoperative enhanced recovery groups in patients with oesophagogastric cancer undergoing surgery

Background Enhanced recovery (ER) includes pre-operative counselling during individual patient consultations with multidisciplinary team (MDT) members. Patients can experience lengthy appointments seeing multiple professionals. This negatively impacts on their ability to retain and process information, and results in long, overrunning clinics. Separate, virtual ER group sessions have been proposed to deliver aspects of the pre-operative appointment which are common to all patients undergoing oesophagogastric (OG) cancer surgery. The aim is to improve patient engagement and experience, and improve efficiency of clinics. A patient engagement event was undertaken to gain feedback from patients about the existing service and the proposed virtual group. Methods A semi-structured telephone interview was developed with the support of a Patient & Public Engagement Team. The 30 minute interview covered aspects such as patient experience of ER information delivery, the quality of the information they received and their thoughts on attending virtual group sessions. Seventy patients, who had undergone surgery for OG cancer in the previous 14 months were invited to take part. A Health Informatics Team screened the patient list prior to invitation letters being sent. The telephone interviews took place in November 2020. Results Twenty-seven patients responded (37%). Of these, 89% felt they received all information required for surgery preparation. Over 50% reported receiving adequate information to support with common post-operative issues (dietary - 81%; physical activity - 55%) but would like more on others (psychological impact - 26%). Patients highlighted that the MDT clinic took many hours and information delivery was overwhelming. The internet was accessible to 85% and 56% thought the information provided prior to surgery could have been delivered in a virtual group. Patient perceived advantages to virtual groups included: peer support; reduced travel; and avoidance of information repetition and overload. Conclusions Patient preference, perspective and needs are paramount when designing healthcare services. Results from this patient engagement event suggest that the delivery of preoperative information and counselling as part of ER could be improved through the implementation of virtual ER groups. They also suggest that most patients perceive benefits to such a model, including the addition of peer support. The next steps in the proof of concept are to develop the virtual groups MDT content and pilot in a cohort of patients, evaluating patient related outcome measures and impact on service efficiency.

Development of an Animal-Assisted Activity/Therapy Dog Checklist for Long-Term Care Facilities

Animal-assisted activities (AAA) and therapy standards of practice have been published to protect the well-being of animals, animal handlers, and the special populations of patients that benefit from this mode of treatment. Inconsistencies among practice standards with concerns surrounding the topics of dog welfare, human well-being, and zoonotic transmission have been reported. The purpose of this qualitative research study was to review published AAA and therapy standards with older adult populations for best practices, conduct focus group sessions with caregivers from long-term care facilities that allow therapy dog visitation, and synthesize findings into an AAA checklist to be used by long-term care facility decision-makers when interviewing or bringing in therapy dog teams. Comparative analyses utilizing a systematic and sequential approach was used to analyze the data from the focus group sessions. Due to the COVID-19 pandemic, only two focus group sessions at one long-term care facility were conducted resulting in a total of 15 caregivers. Four themes emerged from the data: promotes positive mood, essential resident screenings, caregiver roles, and memory aides. Relevant themes and AAA and therapy standards and guidelines were then combined in the development of the AAA/Therapy Dog Checklist. Administrators may find having a user-friendly AAA/therapy dog checklist a useful tool that can be used when interviewing therapy dog teams to ensure future dog therapy experiences will be positive and safe. The safety and well-being of residents in long-term care facilities and animals are essential to promote positive health outcomes for both populations.