Gatekeeper Suicide Prevention Trainings such as Question Persuade and Refer (QPR) are used to increase suicide awareness and teach participants basic suicide intervention skills. Previous researchers showed that QPR training increases knowledge of suicide risk factors and increases participants' willingness to intervene with individuals at risk of suicide. It was hypothesized that completion of QPR would also increase positive attitudes toward the utilization of mental health services and that this outcome would be more pronounced among male participants. The examination of attitudes was rooted in the theoretical framework of Ajzen's theory of planned behavior. The Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) was the instrument used for the study. The study occurred in a rural community college in southern Oregon. Student attitudes were assessed prior to completion of a 1-hour QPR presentation followed by a 3-week post assessment. Analysis of Variance revealed significant effects of QPR training. IASMHS scores were significantly higher at post QPR training. A significant interaction between gender and QPR training showed that women scored significantly higher than men only at pre QPR training. There was no statistical gender difference in attitudes measured by the IASMHS at post QPR training. QPR increased help seeking attitudes in both men and women with the increase being more pronounced in men. Increasing positive attitudes toward help seeking can contribute to positive social change. Practitioners in the field of men's health should consider using gatekeeper suicide prevention training such as QPR as a means of increasing male help seeking.

Many adults in the United States experience posttraumatic stress disorder (PTSD) within their lifetimes. Researchers have identified compassion fatigue (CF), which debilitates mental health providers as a result of being exposed to their clients' traumatic experiences, as an occupational hazard. The purpose of this study was to examine whether a correlation exists between the presence of CF and the level of resilience. A confidential survey using the Connors-Davidson Resilience Scale, the Professional Quality of Life Scale Version 5, and a demographic questionnaire were given to graduate-level mental health clinicians who self-identified as routinely working with and/or treating trauma victims in the past 6 months. Participants were recruited from the New England Society for the Treatment of Trauma and Dissociation, the Metropolitan Atlanta Therapists Network, Dallas Chapter NASW listserv, and the Georgia Therapist Network. A multivariate analysis on the collected data was conducted to determine whether a relationship exists between the resilience scale and the subscales of CF within these population samples. According to study findings, there is a correlation between resilience and the 3 compassion fatigue subscales---CF, burnout, and compassion satisfaction. This study may lead to positive social change by helping guide clinicians to find ways to enhance resilience, and therefore, decrease risks of CF.

Thesis (Ph. D.)--University of Chicago, School of Social Service Administration, 2001. / Includes bibliographical references. Also available on the Internet.

<p>Incivility is a low-level form of violence that has been found to threaten safety and has gained increasing attention from healthcare leaders. Incivility at work causes distractions and threatens the culture of safety. Locations providing mental health services are among such high-risk areas. The purpose of this study was to evaluate the effectiveness of a nurse leader&rsquo;s educational approach to improve civility in the mental health (MH) nursing workplace using assertiveness training with role-play. </p><p> The civility score in this study was measured by staffs&rsquo; perceptions of eight items: respect; conflict resolution; cooperation; anti-discrimination; value differences; diversity acceptance; personal interest; and reliability of team members. In this study, the principal investigator (PI), a MH nurse leader, prepared and implemented a six-month plan of evidence-based actions intended to improve civility and to strengthen the sense of community. </p><p> Role-play exercises were included in assertiveness training sessions. Personalized brochures that summarized information and future direction for improving civility were prepared and distributed. </p><p> Civility awareness and assertiveness were reinforced by sharing literature, facilitating discussions, and practicing occasional role-plays to problem-solve past and current incivilities as they surfaced. Follow-up measurements showed a rapid and sharp increase in civility, with improved scores for each of the eight items. These findings support continued use of assertiveness training with role-play as an effective approach for improving civility in a culturally diverse MH nursing staff. Limitations of this study are discussed. </p>

<p> Human Immunodeficiency Virus (HIV) remains a serious public health issue, and many social factors are involved in virus transmission and treatment. The current conceptualization of how HIV status disclosure and perceived stigma of HIV diagnosis interact is undeveloped. This study was based on social cognitive theory and tested hypothesized positive relations between HIV serostatus disclosure, social support, and self-efficacy. In addition, self-rated HIV stigma was examined as a potential mediating variable. Participants were 109 HIV positive, mostly White gay men recruited via an online bulletin board. They completed the medical outcomes study social support survey, the general self-efficacy scale, the HIV stigma scale, a HIV serostatus disclosure questionnaire, and a demographic questionnaire. Linear regression revealed that social support significantly and positively predicted HIV serotatus disclosure. HIV stigma mediated this relation by lowering the perception of support. Sexual orientation disclosure significantly and positively predicted HIV serostatus disclosure and social support. It is recommended that future research examine the impact of HIV stigma in different groups (racial and sexual minorities, and women). Culturally-sensitive assessments may also be used to measure individual levels of perceived stigma, HIV status disclosure, and social support. Action for social change includes raising general public awareness regarding HIV misconceptions, such as transmission risk; lowering stigma and raising support through public education; and increasing sexual minority status self-identification via outreach in low self-disclosure communities.</p>

<p> The purpose of this project was to translate evidence-based literature into policy and practice guidelines in order to improve leadership standards and skills among nurse managers and improve patient outcomes and the quality of care. Guided by the American Nurses Credentialing Center Magnet Model and Lewin's change theory, which sets the framework for creating exceptional nursing leaders, a literature search was conducted from studies ranging from 2010 to 2012 from several databases. Inclusion criteria were based on the presence of one or more leadership styles discussed in the articles and the impact of leadership style on nursing satisfaction. A total of 25 articles were found during the electronic search, but only 7 articles met the inclusion criteria for analysis. The results of this review revealed that transformational leadership enhanced nursing satisfaction rates, while transactional leadership and situational leadership contributed to low levels of nursing satisfaction rates. This project contributes to positive social change for nurse managers because there is limited research available that focuses on leadership styles and its implication for practice. This project will inform the work of nurse managers by illuminating the importance of leadership styles on nursing satisfaction and work environment conditions.</p>

<p> A resource guide for mental health practitioners working with Latino victims of collective trauma was developed based on a review of the literature. The development of the resource was also informed by two structured interviews with experts in the field of collective trauma within the Latino population. Review of the literature and structured interviews were used to develop culturally sensitive treatment approaches for victims of collective trauma from Latin America. The resource guide offers clinicians culturally adapted interventions, including PTSD measures, a table to identify culture bound syndromes, PTSD psychoeducation handouts (provided in Spanish and English), relaxation skills (e.g. breathing techniques, progressive muscle relaxation, the use of music, meditation), interoceptive exposure protocols, and tools to help clients live a life of meaning as well as restore their roles in the community and within their family. An additional two experts in the field evaluated the resource guide for validity, content, and applicability to the Latino population. Feedback from the evaluators will be used for future versions of the resource guide. Results indicated that the resource guide may be advantageous for Latino victims of collective trauma and may therefore serve as an adjunct to current treatment protocols. The resource guide may assist mental health practitioners in modifying their approach to treatment as well as offer culturally appropriate interventions in order to enhance cultural sensitivity, thus leading to a stronger therapeutic alliance.</p>

<p> <b>Background:</b> Dengue prevention for U.S. travelers focuses on compliance with mosquito avoidance practices (MAP) and passive surveillance. Understanding determinants of MAP among high-risk travelers can improve Dengue prevention strategies. In travel medicine, a risk assessment framework of social determinants of health and travel purpose of visiting friends and relatives (VFR) determines risk of travel-associated diseases. This risk assessment framework is subject to bias and inaccuracy because it fails to account for factors of influence on travel behaviors from a social-ecological perspective. A mixed methods approach identified and characterized determinants of MAP in U.S. West-Indian American VFR travelers. Two pilot studies revealed travelers' decision-making processes for MAP and outlined determinants of intended MAP through a qualitative interview and cross-sectional survey. Survey analyses included an exploratory factor analysis, Chi-squared/ Fisher's exact test, logistic regression and qualitative coding for development of an `Intended MAP International Travel Behavior' (IMAP-ITB) model. </p><p> <b>Methods:</b> To expand the IMAP-ITB model and describe factors of influence on actual MAP, 2 subsequent qualitative studies were conducted. A multi-case ethnographic study of travel cohorts to Trinidad, Brazil and Thailand identified social/physical environmental influences on actual MAP in a cross-case content analysis of field observations data. An interpretive phenomenological analysis of semi-structured interviews yielded similarities and differences in MAP by revealing the meaning of `going home' in VFR travelers versus another travel destination. </p><p> <b>Results:</b> A '<i>Cultural Embeddedness and MAP</i>' model extends the IMAP-ITB, using a social-ecological perspective, including factors of influence on intended and actual MAP. MAP during international travel was associated with travel logistics, social interactions, risk perceptions and cues to action. The concept of '<i>Cultural Embeddedness</i>' may explain compliance behaviors with MAP, irrespective of VFR status. </p><p> <b>Discussion:</b> Prevention strategies at each level of influence within a social-ecological framework would address Dengue emergence because individual level prevention using MAP is capricious by individual, type of travel and social/physical environmental influences. Findings demonstrate that VFR terminology does not accurately depict high-risk travelers. Next steps should include more research on the concept of '<i>Cultural Embeddedness </i>' and CEMAP. Furthermore, improvements to current Dengue surveillance are needed to prevent to prevent and monitor imported Dengue.</p>

<p> Meta-cognitive reactions to emotions involve the manner in which individuals cognitively appraise and emotionally respond to the provocation of their feelings (e.g., viewing sadness as weakness, becoming embarrassed that one is sad). The manner in which an individual meta-cognitively responds to his or her emotions may be an important consideration in disorders characterized by emotional pathology, such as mood and anxiety disorders. Previous research has linked negative beliefs regarding emotions and discomfort with one's feelings to anxiety and depressive pathology. The current study examined meta-cognitive reactions to sadness, anger, and anxiety, as assessed by self-report and structured interview, in relation to self-reported symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in college students. Study findings indicated that individuals with higher levels of symptoms of psychopathology (i.e., individuals in the MDD and GAD analogue groups) were less comfortable with their negative emotions, viewed their negative emotions as more problematic, were more fearful of the provocation of their negative emotions, and viewed themselves as less able to effectively cope with their negative emotions, as compared to relatively healthy individuals. Additionally, an exploratory analysis found a trend for individuals in the GAD analogue group to be more fearful of anxiety than individuals in the MDD analogue group. Finally, fear of negative emotions was found to moderate the relationship between worry and GAD symptoms, as well as the relationship between brooding and MDD symptoms, such that higher levels of fear of negative emotions strengthened these relationships. The manner in which individuals cognitively appraise and emotionally respond to their feelings is a relatively understudied area of research that has meaningful implications for the understanding and treatment of MDD and GAD. Further research is needed to elucidate distinctive emotional processes in MDD and GAD, including meta-cognitive reactions to emotions, in order to refine our understanding of the nature of these two disorders and inform cognitive-behavioral interventions that can specifically target important areas of emotional dysfunction and distress.</p>

<p> People living with HIV (PLWH) display disproportionally high levels of psychopathology (i.e., posttraumatic stress disorder symptoms [PTSS] and depressive symptoms) that may interfere with optimal medication adherence and health-related quality of life (HR-QOL). The adverse consequences of non-adherence and diminished HR-QOL, including reduced length of survival, highlight the need for intervention in PLWH. Though recent research suggests that the removal of psychological barriers (i.e., PTSS and depressive symptoms) may result in improvements in adherence and HR-QOL, this has never been directly tested in PLWH. We previously demonstrated the success of prolonged exposure (PE) therapy at improving PTSS and depressive symptoms in PLWH. The proposed study extends these findings by determining whether PE also impacted self-reported and electronically monitored medication adherence, and self-reported adherence self-efficacy, physical health symptoms, and HR-QOL in 65 PLWH. Participants were randomly assigned to either the PE (n = 40) or weekly monitoring/wait-list control group (n = 25), and completed assessments at baseline, post-treatment, and 3-months post-treatment. Following the 3-month assessment, control group participants were offered the intervention, and all PE recipients completed the 6-month assessment. Multilevel growth curve models were conducted on the completer and intent-to-treat samples using the HLM software, and exploratory mediation analyses were conducted in SPSS. Compared to the controls, PE recipients did not experience direct benefits in self-reported or electronically monitored medication adherence or HR-QOL throughout 3-months post-intervention; however, physical health symptoms improved for participants in both groups, and PE recipients reported increased adherence self-efficacy throughout 3 months. Mediation analyses further demonstrated that the removal of psychological barriers led to better short-term adherence and health.</p>