Agriculture-based interventions fall under the umbrella of nature-based interventions, meaning social and care interventions such as rehabilitation, habilitation and daily activities in conjunction with animals and/or nature. The purpose of the study was to examine Grön Arena-organizers' experiences working in green care based on the questions of "what makes one choose to work in green care?" and "which factors encourage and inhibit organizer motivation in their work with green care?". During march of 2021, eight semistructured interviews were performed on the subject. The transcribed material was then analyzed with thematic analysis. A total of three themes were identified: Humanitarian action, Resistance and obstacles with the two sub-themes (Negative attitudes and experiences as well as Economics and politics), and Conviction in method. The results of the study shows the presence of both significant motivational and demotivational factors that affect the drive and motivation of the organizers. A need for the organizers to help and work with other people became clear, as did a desire to be closer to nature and animals. Furthermore, a deep-seated belief in the healing bond between humans and nature was a central and recurring motivational theme. On the other hand is a sense of external resistance springing from a lack of public knowledge about green care initiatives, as well as assumptions surrounding organizers' motives in opening green care facilities, coupled with difficulties of economic sustainability and reliability. The study shows that there is room for further research into the nature of these initiatives, as well as significant potential for these types of interventions to complement a traditional care model going forward. / Lantbruksbaserade insatser går in under paraplybegreppet naturbaserade insatser som innebär att sociala och vårdande insatser som rehabilitering, habilitering, daglig verksamhet kombineras med djur och/eller natur. Studiens syfte var att utforska anordnare inom Grön Arenas upplevelse av att arbeta med grön omsorg utifrån frågeställningarna "varför arbetar man med grön omsorg? samt "vilka faktorer främjar och hämmar anordnares motivation i arbetet med grön omsorg?". Sammanlagt genomfördes åtta semistrukturerade intervjuer i mars 2021. Transkriberat material analyserades utifrån metoden tematisk analys. Totalt tre teman identifierades: Humanitärt intresse, Motkrafter och hinder med två underteman (Negativa attityder och erfarenheter, Ekonomi och politik) och Övertygelse om metod. Resultatet visar att det förekommer både motiverande och demotiverande faktorer som påverkar anordnares drivkraft och motivation. En stark vilja att arbeta med och för människor framträdde tillsammans med en önskan om närhet till djur och natur som positiva motivationsfaktorer. Vidare beskrevs en tilltro till det band som finns mellan människa och naturen och de fördelar som kommer med detta band. Demotiverande var det upplevda yttre motstånd som låg kring en liten kännedom om fenomenet grön omsorg, negativa uppfattningar kring anordnares motivation till att starta en grön omsorgsverksamhet och en viss svårighet kring stabilitet gällande grön omsorg som inkomstkälla. Studien visar att det finns utrymme för utökad forskning kring området och en stor framtidspotential för konceptet som komplement till sedvanlig vård.

Promoting Alternative Thinking Strategies (PATHS) is an intervention program for children with behavioral and emotional deficits, designed for use, and shown to be effective when used in the classroom a minimum of 3 times per week. However, in some settings, as in the current study, PATHS is being used just once per week. The purpose of this quantitative study was to determine whether PATHS was beneficial in helping elementary school aged children improve their behavioral and emotional health when implemented once per week in a group therapy setting. PATHS was developed based on cognitive behavioral theory, which focuses on improving internalizing symptoms of mental health disorders (thoughts) as well as the externalizing symptoms (behaviors). A one-way, repeated measures ANOVA was utilized to analyze archival data of 193 scores, collected over a single school year. Results indicated that elementary school aged children who received PATHS once per week in a group setting showed a decrease in aggression and disruptive behaviors, and an increase in concentration and attention as well as social and emotional competence. Social change implications could involve the results of the study informing how we might promote overall emotional and behavioral well-being in children. At the organizational level, the expansion of the use of PATHS at reduced costs and time within other settings will extend these benefits to more children with behavioral and emotional deficits. Future studies are suggested to examine further the effectiveness of PATHS when implemented in other programs and alternative ways.

No description available.

No description available.

Les situations de crise sont fréquentes chez les personnes ayant des troubles de santé mentale. Plusieurs interventions ont été développées pour agir en prévention, dont les plans de crise reconnus comme particulièrement efficaces pour diminuer le recours aux mesures coercitives. Dans la littérature, plusieurs modèles de plans de crise sont proposés et incluent entre autres le plan de sécurité, le plan de crise conjoint et les directives anticipées. Un examen de ces différents plans permet de constater qu’ils ont des buts et des contenus très semblables. Basé sur la méthodologie proposée par le Johanna Briggs Institute (2020), une revue de la portée a été conduite dans l’objectif de dresser l’état des connaissances sur les plans de crise en santé mentale adulte. Une stratégie de recherche documentaire a été conduite sur six bases de données (CINAHL, PubMed, Medline, EMBASE, PsychINFO, and Cochrane) et a permis d’identifier 2435 articles. Parmi ces derniers, 122 textes complets ont été évalués et 78 ont répondu aux critères d’inclusion de l’étude. Ensuite, la qualité méthodologique des articles sélectionnés a été évaluée et les données ont été extraites de façon indépendante par deux étudiantes à la maitrise. L’analyse de contenu a été réalisée, puis les résultats préliminaires ont été présentés, discutés et validés avec un patient partenaire ayant vécu des crises en santé mentale. Une typologie des plans de crise a été identifiée selon 1) les plans de crise légaux et 2) les plans de crise formels. Également, cinq modalités pour la complétion des plans de crise ont été identifiées : les sections, le moment, les étapes de complétion, les personnes impliquées et la formation des acteurs.trices clés. Les retombées de l’intervention sont concordantes avec le but principal des plans de crise, soit la prévention de la crise. Or, les retombées les plus identifiées dans la littérature sont davantage liées au rétablissement de l’usager.ère et semblent indiquer que les plans de crise pourraient représenter une intervention permettant d’opérationnaliser le rétablissement dans les soins en santé mentale. Les futures recherches empiriques devraient cibler le développement des connaissances sur les modalités à privilégier dans l’objectif de guider les milieux cliniques dans l’implantation des plans de crise. / Crisis situations are frequent among people with mental health disorders. Several interventions have been developed to act in prevention, including crisis plans, which are recognized as particularly effective in reducing coercive measures. In the literature, several types of crisis plans have been proposed, including the safety plan, the joint crisis plan and advance directives. A review of these plans suggests that they are very similar in purpose and content. Based on the methodology proposed by the Johanna Briggs Institute, a scoping review was conducted with the objective of mapping the state of knowledge on crisis plans in adult mental health services. A literature search strategy was conducted on six databases (CINAHL, PubMed, Medline, EMBASE, PsychINFO, and Cochrane) and yielded 2435 articles. Of these, 122 full text articles were assessed for eligibility, and 78 met the inclusion criteria. Studies were then critically appraised using the Johanna Briggs Institute appraisal tools, and date were extracted my two master’s students. Content analysis was performed, and preliminary results were presented, discussed, and validated with a patient partner who has experienced mental health crises. A typology of crisis plans was identified according to 1) the legal crisis plan, 2) the formal crisis plan. Five modalities were identified for its completion: sections, timing, creation steps, people involved, and training of key actors in writing a crisis plan. The outcomes of the intervention are consistent with the main objective of crisis plans, which is to prevent a crisis. However, the most identified outcomes focused on the service user’s recovery and indicated that crisis plans could provide an opportunity to operationalize recovery in mental healthcare, thus suggesting an evolution in the aim of the intervention. Future research should further focus on the modalities of crisis plans to guide the implementation in clinical practice.

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Essay #1 - Parental Social Influence in Childhood Obesity Interventions: a Systematic Review The objective of this study is to understand the pathways through which social influence at the family level moderates childhood obesity interventions. We conducted a systematic review of obesity interventions in which parents' behaviors are targeted to change children's obesity outcomes, due to the potential social and environmental influence of parents on the nutrition and physical activity behaviors of children. Results for existing mechanisms that moderate parents' influence on children's behavior are discussed and a causal pathway diagram is developed to map out social influence mechanisms that affect childhood obesity. We provide health professionals and researchers with recommendations to leverage family-based social influence mechanisms for increasing the efficacy of the obesity intervention programs. Essay #2 - Dynamics of Obesity Interventions inside Organizations: a Case Study of Food Carry-Outs in Baltimore A large number of obesity prevention interventions, from upstream (policy and environmental) to downstream (individual level), have been put forward to curb the obesity trend; however, not all those interventions have been successful. Overall effectiveness of obesity prevention interventions relies not only on the average efficacy of a generic intervention, but also on the successful Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) of that intervention. In this study, we aim to understand how effectiveness of organizational level obesity prevention interventions depends on dynamics of AIM. We focus on an obesity prevention intervention, implemented in food carry-outs in low-income urban areas of Baltimore city, which aims to improve dietary behavior for adults through better food access to healthier foods and point-of-purchase prompts. Building on data from interviews and the literature we develop a dynamic model of the key processes of AIM. We first develop a contextualized map of causal relationships integral to the dynamics of AIM, and then quantify those mechanisms using a system dynamics simulation model. With simulation analysis, we show how as a result of several reinforcing loops that span stakeholder motivation, communications, and implementation quality and costs, small changes in the process of AIM can make a big difference in impact. We present how the dynamics surrounding communication, motivation, and depreciation of interventions can create tipping dynamics in AIM. Specifically, small changes in allocation of resources to an intervention could have a disproportionate long-term impact if those additional resources can turn stakeholders into allies of the intervention, reducing the depreciation rates and enhancing sustainability. We provide researchers with a set of recommendations to increase the sustainability of the interventions. Essay #3 - Dynamics of Implementation and Maintenance of Organizational Health Interventions: Case Studies of Obesity Interventions In this study, we present case studies to explore the dynamics of implementation and maintenance of obesity interventions. We analyze how specific obesity prevention interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes. / Ph. D.

Objectif: Explorer les perspectives des fournisseurs de soins sur les besoins des familles migrantes en matière de développement du langage et les stratégies qui sont utilisées ou qui pourraient être utilisées pour promouvoir le développement du langage d'une manière culturellement sécuritaire. Méthodes : L'étude s'est déroulée à La Maison Bleue (LMB), un centre offrant des services sociaux et de périnatalité aux familles vulnérables à Montréal pendant la grossesse et jusqu'à l'âge de cinq ans de l'enfant. Les données ont été recueillies par le biais d'entretiens semi-structurés avec 8 membres du personnel et analysées thématiquement. Résultats: Les problèmes de langage sont une préoccupation à LMB, et les facteurs liés à la migration (l’isolement, la santé mentale, le manque d’accès aux ressources) sont considérés comme pouvant contribuer à ces problèmes. La compréhension qu’ont les parents du développement du langage de l’enfant ajoute parfois à ce contexte difficile. Des interventions ciblées ainsi que des stratégies plus globales axées sur le renforcement de la confiance et de la réceptivité des familles aux soins en général, sont utilisées pour favoriser le développement du langage. Les participants ont recommandé d'accorder plus de temps individuel aux familles pour améliorer leur compréhension du développement de l'enfant et pour favoriser leur implication dans des activités visant à stimuler le développement langagier. Ils ont également suggéré d’avoir accès à des spécialistes sur place et plus de ressources communautaires pour mieux soutenir le développement précoce du langage dans les familles migrantes. Conclusion: À LMB, une approche interdisciplinaire et holistique, qui tient compte du contexte de migration/vulnérabilité, est utilisée pour promouvoir le développement du langage d'une manière culturellement sécuritaire. Une mise en oeuvre plus large de cette approche dans différents contextes de soins primaires pourrait être bénéfique pour aider davantage des familles migrantes ayant besoin d'un soutien au développement précoce du langage. / Objective: To explore care-providers’ perspectives on the needs of migrant families regarding early language development and the strategies that are used, or that could be used, to promote language development in a culturally safe manner among this population. Methods: This was a qualitative descriptive study conducted at La Maison Bleue (LMB). Data were collected via semi-structured interviews from eight LMB care providers and support/administrative staff and thematically analyzed. Results: Language development problems among children in migrant families are of concern at LMB, and factors related to the migration context (isolation, mental health, lack of access to resources) are believed to contribute to these problems. Parents’ understanding about children’s language development sometimes add to this challenging context. Targeted interventions as well as more global strategies that focus on building trust and increasing the family’s overall receptivity to care, are used to promote language development. Participants recommended more individual time with families to enhance understanding of child development, and to further promote parents’ engagement in language stimulating activities. On site access to specialists and more resources in the community were also suggested to further support early language development among migrant families. Conclusion: At LMB, an interdisciplinary, holistic approach, that considers the migration/vulnerability context, is used to promote early-language development in migrant families in a culturally safe manner. Broader application of this approach across different primary care settings may be beneficial for helping more migrant families in need of early-language development support.

Approximately forty percent of youths’ waking hours are unrestricted and not committed to activities such as eating, sleeping or going to school. Many of this free time is spent without companionship or supervision from adults, which puts them at risk of spending their time out on the streets, where the risk of succumbing to peer pressure and becoming involved in inappropriate or illegal activities is increased. The absence of structured activities, stimulation and support can lead to youth becoming involved in rebellious and unwanted behaviour, partly due to their continuous search for adventure and excitement. Learners with Mentally Mild Learning Disabilities (MMLD) can be seen as youth at risk because of their academic and behavioural problems. Learning disabilities can increase the risk factors for delinquency and substance dependence. Previous research suggests that adventure-based experiential programmes (AEPs), which are highly structured, can thus be a very powerful intervention or prevention medium to empower youth at risk to overcome obstacles through the acquisition and practise of skills. The purpose of the study was firstly to determine what the personal functioning profile of MMLD youth looks like, which was done in order to gain insight into the different aspects of the personal functioning, which were focused on when developing the AEP. The study was secondly done to determine what the role of an AEP is on the personal functioning of learners with MMLD. Books, journals, dissertations, theses and internet sources were used to do a thorough literature review. The literature review was done in order for readers to understand the link between MMLD youth and an AEP. The literature review gave an introduction to the phenomenon of MMLD youth and also explained how an AEP could be beneficial towards them. A qualitative research design was used by the researcher in the form of an instrumental case study. Case studies make it possible for the researcher to use qualitative as well as quantitative constructs for data gathering purposes. Sampling of participants was done in two steps. A school for Learners with Special Education Needs (LSEN) (Die Wilge High School) was sampled through purposeful sampling by means of criterion-based sampling techniques. The second step was to sample fourteen male learners from Die Wilge High School through purposive sampling. The personal functioning was determined by using the Youth at Risk Assessment Scale (YAR3) Questionnaire 3. The researcher made use of semi-structured, one-on-one interviews and field notes in order to gather data. The field notes and transcribed interviews were analysed in order to obtain a clear picture of the content, which was then used to identify the codes. After the data was analysed four main themes, each with its own categories, were identified. The themes related to the personal functioning of the youth and consisted of interpersonal relationships, trust, self-worth and perseverance. The learners had positive feedback regarding their interpersonal relationships, trust, self-worth and perseverance before participation in the AEP. This was attributed to the Strengths-based Approach which the researcher followed in the development of the AEP. Despite this positive feedback, the learners still felt that there was an improvement after the AEP in all of the areas. Most of the learners attributed the improvement to learning more about each other, learning to work together and building friendships among each other. These new found friendships made it easier to trust each other and believe in themselves. The learners also realised that they experienced more positive feelings from persevering than when they quit. The results were used to discuss the objective of the study and to determine if the researcher met the objective. / MA (Recreational Science), North-West University, Potchefstroom Campus, 2015

Approximately forty percent of youths’ waking hours are unrestricted and not committed to activities such as eating, sleeping or going to school. Many of this free time is spent without companionship or supervision from adults, which puts them at risk of spending their time out on the streets, where the risk of succumbing to peer pressure and becoming involved in inappropriate or illegal activities is increased. The absence of structured activities, stimulation and support can lead to youth becoming involved in rebellious and unwanted behaviour, partly due to their continuous search for adventure and excitement. Learners with Mentally Mild Learning Disabilities (MMLD) can be seen as youth at risk because of their academic and behavioural problems. Learning disabilities can increase the risk factors for delinquency and substance dependence. Previous research suggests that adventure-based experiential programmes (AEPs), which are highly structured, can thus be a very powerful intervention or prevention medium to empower youth at risk to overcome obstacles through the acquisition and practise of skills. The purpose of the study was firstly to determine what the personal functioning profile of MMLD youth looks like, which was done in order to gain insight into the different aspects of the personal functioning, which were focused on when developing the AEP. The study was secondly done to determine what the role of an AEP is on the personal functioning of learners with MMLD. Books, journals, dissertations, theses and internet sources were used to do a thorough literature review. The literature review was done in order for readers to understand the link between MMLD youth and an AEP. The literature review gave an introduction to the phenomenon of MMLD youth and also explained how an AEP could be beneficial towards them. A qualitative research design was used by the researcher in the form of an instrumental case study. Case studies make it possible for the researcher to use qualitative as well as quantitative constructs for data gathering purposes. Sampling of participants was done in two steps. A school for Learners with Special Education Needs (LSEN) (Die Wilge High School) was sampled through purposeful sampling by means of criterion-based sampling techniques. The second step was to sample fourteen male learners from Die Wilge High School through purposive sampling. The personal functioning was determined by using the Youth at Risk Assessment Scale (YAR3) Questionnaire 3. The researcher made use of semi-structured, one-on-one interviews and field notes in order to gather data. The field notes and transcribed interviews were analysed in order to obtain a clear picture of the content, which was then used to identify the codes. After the data was analysed four main themes, each with its own categories, were identified. The themes related to the personal functioning of the youth and consisted of interpersonal relationships, trust, self-worth and perseverance. The learners had positive feedback regarding their interpersonal relationships, trust, self-worth and perseverance before participation in the AEP. This was attributed to the Strengths-based Approach which the researcher followed in the development of the AEP. Despite this positive feedback, the learners still felt that there was an improvement after the AEP in all of the areas. Most of the learners attributed the improvement to learning more about each other, learning to work together and building friendships among each other. These new found friendships made it easier to trust each other and believe in themselves. The learners also realised that they experienced more positive feelings from persevering than when they quit. The results were used to discuss the objective of the study and to determine if the researcher met the objective. / MA (Recreational Science), North-West University, Potchefstroom Campus, 2015