Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N = 1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low‐resource urban community settings.     

Likening stairs in buildings to climbing a mountain: Self-reports of expected effects on stair climbing and objective measures of effectiveness

Objectives

Health promotion agencies advocate use of mountain climbing goals to encourage regular stair climbing, a current public health target. This paper tests effects of a mountain climbing campaign on objective measures of stair use for the first time.

Design

Field interview and quasi-experimental, interrupted time-series study.

Method

In field interviews, a convenience sample (n = 1350) responded to questions about different goals, i.e., heights of climb, to encourage stair use in buildings. Subsequently, a point-of-choice intervention with the main message ‘Take the stairs to the top of this building once a day and in a year, you would have climbed Mount Everest almost twice’ was tested in a 12-floor worksite. A no-message baseline was followed by installation of the intervention.

Results

Stair ascent (n = 62,716) and descent (n = 61,218) at the ground floor was measured with automated counters at baseline (11 days) and during the intervention (18 days). The majority of interviewees (60%) chose a message based on climbing Mt. Everest as the most motivating, with only 5% of interviewees not motivated by any climbing goal. Nonetheless, the subsequent intervention using the mountain climbing goal had no effect on stair climbing (OR = 0.96). As the campaign specifically targeted stair ascent, it failed to influence the behaviour with the greater public health dividend.

Conclusion

The discrepancy between pre-testing and the campaign may reflect the fact that performance goals can only be achieved at the end of the task and may not be continually rewarded during accumulation of behaviour towards the goal.     

Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicenter study

Objective

There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in standard psychiatric settings in industrialized countries. In this study, Narrative Exposure Therapy (NET) was compared to Treatment As Usual (TAU) in 11 general psychiatric health care units in Norway. The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression.

Method

Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD (N = 81) were randomized with an a-priori probability of 2:1 to either NET (N = 51) or TAU (N = 30). The patients were assessed with Clinician Administered PTSD Scale, Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment, and again at one and six months after the completion.

Results

Both NET and TAU gave clinically relevant symptom reduction both in PTSD and in depression. NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses. No difference in treatment efficacy was found between refugees and asylum seekers.

Conclusions

The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system; NET appeared to be a promising treatment for both groups.

ClinicalTrials.gov registry number

NCT00218959.     

Recognition rights,mental health consumers and reconstructive cultural semantics

Introduction  

Those in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.     

Fitness correlates of obligatory versus health motives for exercise: An examination of men in the military

Objectives

To examine quantity of exercise and motives for exercise as predictors of men in the military’s health and fitness level.

Design

Participants completed a survey to address research questions of interest.

Methods

One-hundred and fourteen men who were active duty Air Force members, with a mean age of 31.43 years (SD = 7.43) and an average military time in service of 10.66 years (SD = 7.75), completed a modified version of the Reasons for Exercise Inventory, a survey assessing their quantity of exercise, and reported their most recent score on their Air Force Fitness Test.

Results

Correlational analyses indicated a relation between quantity of exercise and men’s score on the Air Force Fitness Test and a relation between intrinsic motives for exercise and quantity of exercise. Intrinsic motivation was found to moderate the relation between quantity of exercise and men’s health and fitness score.

Conclusions

Men in the military who exercise because of their military obligation are less likely to score high on the Air Force Fitness Test than are men who are motivated to exercise for health benefits.     

Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya

Background  

Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context.     

Addressing social determinants of mental health in therapy: A thematic synthesis

Background

The importance of addressing social determinants of mental health in therapy is well-documented. However, there appears to be limited research on what this actually involves in practice and how best to prepare therapists to work with individuals experiencing adverse social determinants.

Aims

The aim of this review was to draw implications for practice and training from reviewing research on addressing social determinants of mental health in therapy.

Methodology

A qualitative systematic review of the research on addressing social determinants of mental health in therapy was conducted, extracting papers from eight databases: Cochrane Library, ASSIA, CINAHL Plus, PsycInfo, Psychoanalytic Electronic Publishing, Science Direct, Scopus and Web of Science. Out of 127 papers found, five met the eligibility criteria and were quality-assessed and analysed thematically.

Findings

The thematic synthesis generated three main themes: “the therapeutic relationship,” “adapting to client context” and “community as a resource,” with eight subthemes.

Conclusion

This thematic synthesis highlights the importance of the therapeutic relationship and adapting mental health support to client frame of reference and context to address social determinants of mental health in therapy. It emphasises community as a helpful resource for informing training and therapeutic interventions, as well as a significant resource for people experiencing adverse social determinants.     

Building Meaningful Community Advocacy for Ethnic-based Health Equity: The RoAd4Health Experience

The pervasive failure of policies aimed at overcoming health inequities suffered by European Roma reflects the oppressive and impoverished living conditions of many ethnic minorities in the Western world. The multiple social inequities that Roma experience and the cumulative effect on their health prove that the failure of health policies that impact Roma must be attributed to their ameliorative nature. These policies legitimize the mechanisms of oppression that sustain inequities, fueling fatalistic attitudes toward minorities, while these minorities internalize the stigma and attempt to survive on the margins of society. This paper presents the RoAd4Health project, a community initiative in which academic researchers partnered with Roma communities to overcome health inequities. We present the multiple methods utilized for building meaningful advocacy, such as photovoice and asset mapping led by Roma agents of change. These methods provided the capacity to develop a local narrative of disparities, build alliances to gain capacity to respond to injustices, and take actions to promote social change. The results of effectively involving all significant stakeholders (i.e., community agents of change, residents, health and social care providers, Roma community grassroots organizations, and institutional actors) are discussed along with lessons learned.     

An effectiveness trial of a new enhanced dissonance eating disorder prevention program among female college students

Objective

Efficacy trials indicate that a dissonance-based prevention program in which female high school and college students with body image concerns critique the thin-ideal reduced risk factors, eating disorder symptoms, and future eating disorder onset, but weaker effects emerged from an effectiveness trial wherein high school clinicians recruited students and delivered the program under real-world conditions. The present effectiveness trial tested whether a new enhanced dissonance version of this program produced larger effects when college clinicians recruited students and delivered the intervention using improved procedures to select, train, and supervise clinicians.

Method

Young women recruited from seven universities across the US (N = 408, M age = 21.6, SD = 5.64) were randomized to the dissonance intervention or an educational brochure control condition.

Results

Dissonance participants showed significantly greater decreases in risk factors (thin-ideal internalization, body dissatisfaction, dieting, negative affect) and eating disorder symptoms versus controls at posttest and 1-year follow-up, resulting in medium average effect size (d = .60). Dissonance participants also reported significant improvements in psychosocial functioning, but not reduced health care utilization or unhealthy weight gain.

Conclusions

This novel multisite effectiveness trial with college clinicians found that the enhanced dissonance version of this program and the improved facilitator selection/training procedures produced average effects that were 83% larger than effects observed in the high school effectiveness trial.     

A General Structure of Job Performance: Evidence from Two Studies

Purpose  

The purpose of this study is to test alternative models of job performance based on competing categorization criteria.     

How Benefit Information and Demographics Influence Employee Recruiting in Mexico

Purpose  

To examine the impact of benefit information in recruitment advertisements on job pursuit intentions.     

The Romance of Learning from Disagreement. The Effect of Cohesiveness and Disagreement on Knowledge Sharing Behavior and Individual Performance Within Teams

Purpose  

The purpose of this study was to explore the effects of disagreement and cohesiveness on knowledge sharing in teams, and on the performance of individual team members.     

Effects of Retail Store Image Attractiveness and Self-Evaluated Job Performance on Employee Retention

Purpose  

The purpose of this research was to investigate the effects of store image attractiveness and self-evaluated job performance on internal job satisfaction and organizational commitment.     

Workplace Romance: A Justice Analysis

Purpose  

The purpose of this study was to investigate the impact of several variables on coworker perceptions of fairness regarding workplace romance (WR) management practices.     

Millennials’ Career Perspective and Psychological Contract Expectations: Does the Recession Lead to Lowered Expectations?

Purpose  

The purpose of this study was to investigate the effect of generational, contextual, and individual influences on Millennials’ career expectations.     

Applying Recommendations from the Literature on Stereotype Threat: Two Field Studies

Purpose  

The objective of these two studies was to apply recommendations from the literature on stereotype threat to reduce the magnitude of subgroup differences in an employment context.     

No conflict control in the absence of awareness

Introduction  

In the present study we tested whether control over the impact of potentially conflicting information depends on awareness of that conflicting information.     

Examining the influence of group diversity on the functioning of community-based participatory research partnerships: A mixed methods study

Public health has endorsed the use of community-based participatory research (CBPR) to address health inequities involving diverse and marginalized communities. However, few studies have examined how group diversity among members of CBPR partnerships influenced how well the partnerships achieve their goals of addressing health inequities through equitable collaboration. We conducted secondary, convergent, mixed methods analysis to (1) evaluate the association between group diversity and participatory decision-making within CBPR partnerships, and (2) identify the perceived characteristics, benefits, and challenges of group diversity within CBPR partnerships. Using data from a cross-site study of federally funded CBPR partnerships, we analyzed and integrated data from surveys of 163 partnerships (n = 448 partners) and seven in-depth case study interviews (n = 55 partners). Quantitatively, none of the measured characteristics of group diversity was associated with participatory decision-making within the partnerships. Qualitatively, we found that partnerships mainly benefited from membership differences in functional characteristics (e.g., skillset) but faced challenges from membership differences in sociocultural characteristics (e.g., gender and race). The integrated findings suggest the need to further understand how emergent group characteristics and how practices that engage in group diversity contribute to collective functioning of the partnerships. Attention to this area can help promote health equity achievements of CBPR partnerships.     

Emotional Exhaustion Among Employees Without Social or Client Contact: The Key Role of Nonstandard Work Schedules

Purpose  

The current study examines emotional exhaustion and its predictors among employees without social or client contact on multiple nonstandard shifts.