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This study supported the hypothesis that short-term shelter programs can help reduce depression in homeless parents.

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Background: Alzheimer’s disease (AD) is a type of Dementia and a neurodegenerative disease that is characterized by the gradual degrading of both memory and cognitive functions. According to the World Health Organization (WHO), the prevalence of AD is increasing globally. Currently, AD is the sixth leading cause of mortality in the United States. As the ageing population increases in the United States, it is possible that AD will move up the ladder in the top cause of mortality. Although the prevalence of AD in most urban parts of developed nations such as the United States is widely known, little is known about the prevalence and early diagnosis of the disease among the rural populations. According to a study by the Centers for Disease Control and Prevention (CDC), on deaths from AD between 1999 and 2014, most mortality are concentrated in the rural counties of the Appalachian region of the United States, where the mortality rate has increased by an alarming 75%. Our study focuses on the Northeast Tennessee region, which is a prominent part of the Appalachian region. We examine the prevalence of Alzheimer’s disease in the Northeast Tennessee region compared to other parts of the state of Tennessee. We sought to understand whether there is a likely association between the disease and the rural counties in the Northeast Tennessee region. Methods: We performed a cross-sectional study that computes and compares between the Prevalence Odds Ratio (POR) of the 2013 to 2015 Centers for Medicare and Medicaid Services Public Use Files data on rural versus urban counties in the Northeast Tennessee region followed by the Northeast Tennessee counties versus other counties in Tennessee. In addition, we collected primary data from 44 experts and professionals working in AD-related fields within the Northeast Tennessee region using an online survey that captures the perceived observation of the experts and professionals about the increasing prevalence of AD over the last five years. Results: Findings show that the rural counties within the Northeast Tennessee region had 18.3% (POR: 1.183, C.I: 1.113-1.258), 4.7% (POR: 1.047, C.I: 0.982-1.117), and 19% (POR: 1.190, C.I: 1.121-1.264) increased odds of prevalence of AD compared to the urban counties within the region in 2013, 2014, and 2015, respectively. Similarly, the Northeast Tennessee region as a whole, had increased odds of 22.7% (POR: 1.227, C.I: 1.203-1.250), 22.5% (POR: 1.225, C.I: 1.202-1.249), and 21.2% (POR: 1.212, C.I: 1.189-1.235) of AD compared to all other counties in Tennessee during the same periods. Conclusions: Statistical analysis and findings from experts and professionals working with patients with AD in the Northeast Tennessee region show that there are more cases of AD in the Northeast Tennessee region compared to the last five years. We suggest early screening strategies for possible decrease in the morbidity and mortality rates in Northeast Tennessee region.

Maternal depression during pregnancy can have a negative impact on the developing child. Numerous studies have focused on postpartum depression and the influences on infant outcomes; however, there are limited data on pregnancy-related depression. The problem addressed in this study was the inadequacy and insufficiency of depression screening during the pregnancy period and access to quality-related health services for women. The purpose of this quantitative retrospective study was to test social cognitive theory on low birth weight and prenatal care adherence to pregnancy-related depression in women residing in Colorado. This research measured an association between pregnancy-related depression and both low birth weight prevalence and prenatal care adherence. Secondary analysis of archived data included data from Colorado vital statistics and the 2016 Colorado Pregnancy Risk Assessment Monitoring System. Data were analyzed using Chi-square analysis and multiple logistic regression. The findings showed that pregnancy-related depression was statistically significant of very low birth weight. I reported a summary of findings on p. 68. Biopsychosocial variables were significant to pregnancy-related depression. Pregnancy-related depression was significant in prenatal and postpartum depression. The implications of these findings for social change include the potential to support improved depression screening strategies during pregnancy that may contribute to transformation within the community by promoting more efficient and accessible healthcare for women.

Background Youth and young adults represent a critical time for early detection and intervention of serious mental health conditions (SMHCs); however, of all age groups, health care use is lowest in young adults. Continued access to health services such as outpatient primary care and specialized mental health care, especially during the transition from pediatric to adult care, is important to improving outcomes in those with serious mental health conditions. Methods Stakeholder engagement and a mixed-method design were used. Quantitative Aims 1 and 2 used the IBM MarketScanCommercial Database. Qualitative Aim 3 used semi-structured interviews with a purposive sample of pediatricians and child/adolescent psychiatrists. Stakeholders were engaged throughout all Aims to ensure relevance of goals, real-world interpretation of results, and dissemination of key findings. Aim 1 described patterns of outpatient (e.g., primary, reproductive, mental health care) and acute (e.g., emergency room use, inpatient hospitalization) health care use by age, and serious mental health condition for youth and young adults. Aim 2 used logistic models with generalized estimating equations to identify factors associated with mental health follow-up after hospitalization and emergency room use for a serious mental health condition. Aim 3 explored pediatrician and child/adolescent psychiatrist perspectives on coordinated care for youth and young adults with serious mental health conditions, particularly as they transition to adult care. Main Results The prevalence of outpatient mental health care and primary care decreased with age, with a larger drop in primary care utilization. While 74.0-78.4% of those aged 12-17 years used both outpatient mental health care and primary care, 53.1-59.7% of those aged 18-27 years did. Differences were observed by mental health condition; those with schizophrenia and other psychotic disorders had the lowest rates of outpatient primary care use and the highest rates of acute care use. Of those hospitalized, 42.7% received follow-up within 7 days and 64.7% within 30 days. Of those with emergency room use not resulting in a hospitalization, 28.6% received follow-up within 7 days and 46.4% within 30 days. Having established mental health care strongly predicted follow-up, and more so than having established primary care. Providers described poor communication systems, no organized process for the transition from pediatric to adult care, a lack of time and reimbursement, and inadequate connection to community supports as key barriers to continuous, coordinated care for youth with serious mental health conditions. Conclusion Findings provide foundational knowledge to inform efforts to provide a comprehensive continuum of care for people with serious mental health conditions, potentially through increased access to primary care and specialized mental health care via enhanced care coordination of providers.

Symptoms of mental illness such as anxiety and depression diminish functioning, cause distress, and create an economic burden to individuals and society. This meta-analysis was designed to evaluate the effectiveness of video based interventions (VBIs) for the treatment of adults in mental health settings. VBIs comprise four different ways of using video in mental health therapy, including video modeling, video exposure, video feedback, and videos used for psychoeducation. Bandura's social learning theory, Beck's cognitive theory, and Dowrick's theory of feedforward learning form the theoretical framework for understanding how VBIs work. The research questions were: (a) what is the range of effect sizes for VBI in mental health treatment of adults? (b) what is the mean standardized effect size for VBI in this context? and (c) what categorical variables, such as type of mental health issue or specific VBI application, moderate the effect of VBI? A comprehensive literature search strategy and coding plan for between-group studies was developed; the overall effect size for the 60 included studies equaled 0.34. A meta-regression was conducted; although the results were not significant, it is possible that type of VBI may be a moderator. Subgroup analyses by mental health outcome found the largest effect size, 0.48, for caregiving attitude and the smallest effect size, 0.21, for depression. Although the results of this meta-analysis were mixed, this study provides preliminary support for VBI use with adults as an evidence-based treatment. VBIs can contribute to positive social change by improving mental health treatment for the benefit of individuals, families, and society.

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses using 2 Likert-scale instruments, the Leisure Motivational Scale (LMS) and the Recovery Assessment Scale - Domains and Stages (RAS-DS). Pearson correlation coefficients indicated significant moderate positive correlations between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. These findings were used to design a professional development program on motivation to teach the staff at a Clubhouse about how to engage members in leisure activities. The study has the potential to inspire positive social change by motivating members to improve their quality of life, learn social and work skills, develop friendships and a support system, reengage with society, and to become employed.

Researchers have extensively studied the experiences and potential consequences of being a child whose parent has a mental illness (COPMI). However, there is no consensus on the best way to support these children, in general or in schools. The purpose of this quantitative study was to examine the effects of parental mental illness on children by using an ecological approach. Researchers have used ecological theory to illustrate the importance of internal characteristics, skills, and supports for children to enhance resiliency. This study looked at whether COPMI differed significantly from the children of parents of parents with no current or past mental illness (NonCOPMI) on the Developmental Assets Profile (DAP). The study also looked at whether there was a significant difference in the change in DAP scores for the COPMI compared to the NonCOPMI over time. A secondary data analysis of DAP survey results was performed and SPSS v.23.0 (IBM, 2015) software was used to complete one-way and two-way repeated measures ANOVA on DAP scores. COPMI reported lower DAP levels than NonCOPMI, and this difference was statistically significant in some areas of Internal Assets and Social and Community contexts. These findings suggest that COPMI may be challenged in these areas and are in line with previous findings regarding the challenges that COPMI may face and supports the continued use of ecological theory. By utilizing the DAP survey, specific areas where COPMI may benefit from additional supports can help professionals promote resilience among children. Proactive efforts like this, especially in schools, where increasing attention is being paid to mental health education, may contribute to positive social change.

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in the Centers for Disease Control's Youth Risk Behavioral Surveillance Survey were analyzed using complex samples binominal logistic regression. The dependent variable was suicidal ideation or suicide attempts, and the independent variable was intake of fruits and vegetables. Suicidal ideation was significantly, positively correlated with fruit and vegetable intake. Even after controlling for age, sex, race, and depression, there was a significant, positive correlation with fruit and vegetable intake. Suicide attempt was significantly, positively correlated with fruit and vegetable intake even after controlling for age, sex, race, and depression. Although the results of this study were contrary to previous findings, these results do support the claim that sugary foods and fast foods have a dopaminergic 'reward effect'. The findings may foster positive social change by identifying the relationship between fruit and vegetable intake and suicidal ideation or suicide attempts in adolescents.