Group support interventions for women with breast cancer: who benefits from what?

Research on the benefits of social support groups has been inconclusive. One reason is that individual differences in intervention responses have rarely been examined. The authors determined the extent to which individual difference variables moderated the effects of an information-based educational group and an emotion-focused peer discussion group on the mental and physical functioning of women with breast cancer (n = 230). The authors administered the SF-36 (S.E. Ware, K.K. Snow, M. Kosinski, & B. Gandek, 1993), a multidimensional quality of life instrument, pre- and postintervention. Educational groups showed greater benefits on the physical functioning of women who started the study with more difficulties compared with less difficulties (e.g., lacked support or fewer personal resources). Peer discussion groups were helpful for women who lacked support from their partners or physicians but harmful for women who had high levels of support. Implications of these results for clinical interventions are discussed.     

Moderators of the benefits of psychoeducational interventions for men with prostate cancer.

The authors examined whether 3 individual difference variables--self-esteem, self-efficacy, and depressive symptoms--interacted with psychoeducational group interventions for men with prostate cancer (n = 250) to predict general and prostate-specific quality of life. Men with nonmetastatic prostate cancer were randomly assigned to an education intervention, an education plus group discussion intervention, or usual care and followed for 12 months. Eight groups of 10 to 12 men were convened in each condition. Men who began the study with lower self-esteem, lower prostate-specific self-efficacy, and higher depressive symptoms benefited the most from the interventions. Of these 3 moderator variables, the most consistent results emerged for self-esteem. That is, the benefits of the intervention were strongest for men with low self-esteem.     

Rape: A Century of Resistance

In this paper, we offer an overview of feminist contributions to the reframing and redefinition of rape over the last century. Topics of discussion include empirical research on rape prevalence that shows a consistent 15% prevalence rate despite continuing rape prevention and education efforts. The effects of sociocultural interventions focusing on legal reforms and psychosocial interventions focusing on rape prevention and education efforts are reviewed. The paper concludes with suggestions for refocusing intervention efforts to include rape prevention training for men, rape resistance training for women, and community-based legal interventions.     

Effects of the Maytiv positive psychology school program on early adolescents' well-being,engagement, and achievement

As positive psychology is a nascent area of research, there are very few empirical studies assessing the impact and sustained effects of positive psychology school interventions. The current study presents a 2-year longitudinal evaluation of the effects of a school-based positive psychology program on students' subjective well-being, school engagement, and academic achievements. The study investigated the effectiveness of the Maytiv school program using a positive psychology-based classroom-level intervention with 2517 seventh- to ninth-grade students in 70 classrooms, from six schools in the center of Israel. The classes were randomly assigned to intervention and control conditions, which were comparable in terms of students' age, gender, and socio-economic status. Hierarchical linear regression analyses revealed positive intervention effects on positive emotions, peer relations, emotional engagement in school, cognitive engagement, and grade point average scores (Cohen's ds 0.16–0.71). In the control group, there were significant decreases in positive emotions and cognitive engagement, and no significant changes in peer relations, emotional engagement or school achievements. These findings demonstrate the significant socio-emotional and academic benefits of incorporating components of positive psychology into school curricula.     

Influence of Three Interventions on Group Participation in an Acute Psychiatric Facility

In this article the authors present a comparison of three modes of group-based intervention within an acute psychiatric facility. The group-based interventions were: (1) verbal discussion, (2) verbal discussion with a psychoeducation component, and (3) verbal discussion and psychoeducation within a therapeutically designed occupational environment. Outcome measures were group member participation, perceived social support, and perceived helpfulness of intervention. Researchers conducted retrospective analysis of group records to determine if differences existed among the three modes of interventions. Analysis revealed a significant difference in participation among the interventions. Perceived social support and helpfulness of intervention were high, but not statistically significant among the interventions.     

Comprehensive Intervention for Anxiety and Depression among the Community Elderly with Tuberculosis

Anxiety and depression are common comorbidities in the elderly who have tuberculosis. We conducted a community-based trial to explore the effect of comprehensive interventions on anxiety and depression of the elderly tuberculosis patients. The control group (n?=?122) received health education, and the intervention group (n?=?61) received health education, psychotherapy, home visit, peer support, and psycho-educational workshops. Compared with the control group, the anxiety (β_Group×Time = ?0.79) and depression (β_Group×Time = ?1.13) declined more pronounced in the intervention group. The results suggested that comprehensive interventions could alleviate the anxiety and depression of the elderly tuberculosis patients sustainably and effectively.     

Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial

Few interventions have succeeded in reducing psychosocial risk among pregnant women. The objective of this study was to determine whether an integrated group prenatal care intervention already shown to improve perinatal and sexual risk outcomes can also improve psychosocial outcomes compared to standard individual care. This randomised controlled trial included pregnant women ages 14-25 from two public hospitals (N = 1047) who were randomly assigned to standard individual care, group prenatal care or integrated group prenatal care intervention (CenteringPregnancy Plus, CP+). Timing and content of visits followed obstetrical guidelines, from 18-week gestation through birth. Each 2-h group prenatal care session included physical assessment, education/skills building and support via facilitated discussion. Using intention-to-treat models, there were no significant differences in psychosocial function; yet, women in the top tertile of psychosocial stress at study entry did benefit from integrated group care. High-stress women randomly assigned to CP+ reported significantly increased self-esteem, decreased stress and social conflict in the third trimester of pregnancy; social conflict and depression were significantly lower 1-year postpartum (all p-values < 0.02). CP+ improved psychosocial outcomes for high-stress women. This 'bundled' intervention has promise for improving psychosocial outcomes, especially for young pregnant women who are traditionally more vulnerable and underserved.     

Effects of A Parenting-Focused Mindfulness Intervention on Adolescent Substance Use and Psychopathology: A Randomized Controlled Trial

Substance use and psychopathology symptoms increase in adolescence. One key risk factor for these is high parent stress. Mindfulness interventions reduce stress in adults and may be useful to reduce parent stress and prevent substance use (SU) and psychopathology in adolescents. This study tested the feasibility and effects of a mindfulness intervention for parents on adolescent SU and psychopathology symptoms. Ninety-six mothers of 11–17 year olds were randomly assigned to a mindfulness intervention for parents (the Parenting Mindfully [PM] intervention) or a brief parent education [PE] control group. At pre-intervention, post-intervention, 6-month follow-up, and 1-year follow-up, adolescents reported on SU and mothers and adolescents reported on adolescent externalizing and internalizing symptoms. Primary intent to treat analyses found that the PM intervention prevented increases in adolescent SU over time, relative to the PE control group. The PM intervention also prevented increases in mother-reported externalizing symptoms over time relative to the PE control group. However, PM did not have a significant effect on internalizing symptoms. PM had an indirect effect on adolescent-reported externalizing symptoms through greater mother mindfulness levels at post-intervention, suggesting mother mindfulness as a potential intervention mechanism. Notably, while mothers reported high satisfaction with PM, intervention attendance was low (31% of mothers attended zero sessions). Secondary analyses with mothers who attended?>??=?50% of the interventions (n?=?48) found significant PM effects on externalizing symptoms, but not SU. Overall, findings support mindfulness training for parents as a promising intervention and future studies should work to promote accessibility for stressed parents.

Clinical Trials Identifier: NCT02038231; Date of Registration: January 13, 2014

     

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: a multilevel analysis.

The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager-peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences.     

The relation of peer social support and psychological symptomatology during the transition to junior high school: A two-year longitudinal analysis

Studied the longitudinal relation of peer social support and psychological symptomatology among a sample of 143 early adolescents during a two-year period spanning the transition from elementary school to junior high school. Correlational analyses indicated strong inverse relations between peer support and symptoms, both cross sectionally and across time. Prospective analyses investigated the degree to which prior levels of peer support were related to subsequent symptoms after controlling for initial levels of symptoms and, conversely, the degree to which prior symptoms were related to future levels of peer support after controlling for initial levels of support. A significant prospective effect for peer support was found only for the specific period encompassing the school change. Prospective effects for symptoms were more numerous and of longer duration. The discussion emphasizes how the relation among support, stress, and mental health may differ over the course of a major life transition. Implications are also considered for the timing of preventive interventions.     

Family,peer, and neighborhood influences on academic achievement among African-American adolescents: One-year prospective effects

Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American community.     

Psychological effects of deep-breathing: the impact of expectancy-priming

Outcome expectancy could mediate the psychological effects of exercise-related interventions, which implies that part of the psychological benefits of physical activity could be ascribed to placebo effects. In this framed field-experiment, 89 healthy participants were studied in three groups, (1) breathing-primed (deep-breathing with an exercise-related expectancy), (2) breathing-unprimed (deep-breathing with no exercise-related expectancy), and (3) control (no intervention). Deep-breathing lasted for three minutes. Before and after deep-breathing, or sitting quietly in the control group, participants completed two questionnaires assessing their positive- and negative affect (NA) and subjective well-being (WB). In contrast to the control group, both the breathing-primed and breathing-unprimed groups showed decreased NA and increased subjective WB. The breathing-primed group reported larger changes in WB than the breathing-unprimed group, in addition to also exhibiting significant increases in positive affect. These findings support the hypothesis of the work that expectations mediate the psychological effects of deep-breathing beyond the intervention’s specific effects. Therefore, future research should control for expectations related to an intervention when gauging psychological changes.     

A Cost Analysis of Self-Management Programs for People with Chronic Illness

The soaring cost of health care is a national problem that needs response at multiple levels, including that of the community. Reducing or limiting health care costs through interventions that emphasize the self-management of health may promote broader health care coverage, better quality of health care, and a sense of control over one's health. Therefore, it behooves community psychologists to perform cost analyses when testing interventions for people in a community. The present study investigated the effects of social support and education interventions on psychosocial variables, health status, and health care costs in older people with osteoarthritis. Participants were 363 members of a health maintenance organization (HMO), 60 years of age and older, with osteoarthritis. Participants were randomly assigned to one of three intervention groups (social support, education, or a combination of both) or to a control group. The results indicated that feelings of helplessness decreased in the intervention groups but not in the control group. All groups showed increases in self-efficacy and overall health status. In addition, health care costs increased less in the intervention groups than in the control group. Cost analysis was used to demonstrate that the monetary savings of the intervention greatly outweighed the cost of conducting the intervention. It appears that interventions can limit health care costs while improving health and increasing feelings of control for older people with osteoarthritis. Further, this paper demonstrates how a cost-benefit focus can benefit community studies.     

Mediating effects of an indicated prevention program for reducing youth depression and suicide risk behaviors

This study explored the intervention processes of an indicated prevention program for high-risk youth. It was hypothesized that intervention effects would be influenced by the direct and mediating effects of teacher social support on both peer group support and perceived personal control. In turn, personal control was hypothesized to mediate between teacher and peer group support, contributing to reductions in depression and suicide risk behaviors. The hypotheses were tested using a three-wave, longitudinal design incorporating data from preintervention, 5-month follow-up, and 10-month follow-up assessments of 106 high-risk youth divided into three comparison groups: two experimental, one control. For the two intervention groups, there were direct and/or indirect effects of teacher and peer group support on personal control, depression, and suicide risk behaviors. The general hypothesis that personal control mediates between support resources and reductions in depression and suicide risk behaviors received partial support across the study groups.     

Teaching coping skills enhances quality of life more than peer support: results of a randomized trial with multiple sclerosis patients.

This 2-year randomized trial of multiple sclerosis patients compared a coping skills group (n = 64) with peer telephone support (n = 68). Growth curve analyses that adjusted for neurological deterioration and gender revealed that the coping skills intervention yielded gains in psychosocial role performance, coping behavior, and numerous aspects of well-being. In contrast, the peer support intervention increased external health locus of control but did not influence psychosocial role performance or well-being. Subgroup analyses revealed that patients with affective problems were more likely to benefit from the peer support intervention than the coping skills group in terms of reported depression, anxiety, use of avoidant coping, and some aspects of well-being. The coping group is discussed as a vehicle for facilitating response shift, helping patients to change their internal referents, their conceptualization of quality of life, and their priorities.     

ACADEMIC EFFECTS OF PROVIDING PEER SUPPORT IN GENERAL EDUCATION CLASSROOMS ON STUDENTS WITHOUT DISABILITIES

We studied the academic effects on peers without disabilities of serving as peer supports for students with disabilities in general education classrooms. Three peers were studied using a range of indicators, including academic engagement, coursework performance, and social validity assessments. Peers assisting a student with disabilities via curricular adaptation, assignment completion, and social facilitation constituted the multicomponent independent variable. We used withdrawal or multiple baseline designs to demonstrate positive benefits for peers for all measures used. In addition, follow-up data for 2 peers indicated that the positive changes associated with serving as a peer support were maintained for up to 2 months. Our results are discussed in relation to the possible academic and social effects of providing peer supports in general education classrooms for students with and without disabilities.     

Innovations in the Identification and Referral of Mothers at Risk for Depression: Development of a Peer-to-Peer Model

This paper describes a feasibility study of a peer-delivered prevention intervention to identify mothers at high risk for depression and facilitate engagement in mental health services for their emotional health. Sixteen family peer advocates and their supervisors partnered with academic researchers over a period of 6 months to develop a four-session intervention that focused on identifying symptoms of depression, providing education about depression and treatment, actively linking caregivers to treatment for their own emotional health, and assisting caregivers in becoming active participants in their mental health care. Collaborating with peers to develop the model enhanced its perceived relevance and utility, and resulted in an intervention that was complimentary to their roles and the mission of peer-delivered support services. Peer/professional partnerships may be beneficial for enhancing the feasibility and acceptability of research efforts; the impact of peers’ participation in the current project and the need for future research to develop and study peer-delivered models is discussed.     

An experimental comparison of two AIDS prevention interventions among young Zimbabweans.

In 1990, psychologists compared data on 42 student teachers at the University of Zimbabwe who underwent an information-based health education session designed to increase condom use with data on 42 other student teachers who underwent a skills-based health education session. They wanted to determine whether skills-based, participative interventions are more effective in changing attitudes toward AIDS and practices than are information interventions. Mean age for all student teachers was 23.1 years. All participants completed a questionnaire before the interventions and the same questionnaire 4 months after the interventions. The 1-hour information-based intervention included a talk about HIV transmission and prevention and a question and answer period after the talk. A condom fitting demonstration, individual practice, group formulation of behavioral self-management approaches, sketches of social and assertiveness skills used to negotiate condom use, pair role plays, group psychodrama about effects of AIDS, and a video about a popular African musician with AIDS comprised the 90-minute skills-based, participative intervention. The skills-based group exhibited more knowledge about condoms and their correct use (p.001), higher self-efficacy (p.05), fewer obstacles to condom use (p,05), and fewer acts of intercourse without condom use in the last 30 days (p.05) than the information-based group. These results were especially encouraging because risk reduction behaviors were maintained over 4 months. Thus more skills-based interventions and skilled AIDS educators are needed in Africa. The few psychologists in Africa can train educators, design training programs and manuals, and develop effective support and supervision systems.     

A narrative evaluation of a psychoeducation and a therapeutic alliance intervention for parents of persons with a severe mental illness

Most attempts to study the impact of psychosocial interventions on parents of persons with severe mental illness (SMI) are quantitative. The purpose of the present study was to investigate the subjective experience of parents of persons with SMI who participated in either a psychoeducational intervention which emphasized providing information on the illness and support, or a therapeutic alliance focused intervention (TAFI) which emphasized the alliance between the group members and group leaders. Ninety-three parents, who participated in either one of these two interventions, were interviewed using the Narrative Evaluation of Intervention Interview. Results show that participants found both interventions to be beneficial with no statistical differences in the level of perceived change. Themes describing change in relating to illness were significantly more frequently mentioned by participants in the TAFI group, whereas significantly more participants in the family psychoeducation interventions reported that implementation and information provided contributed to positive change. Also participants in the TAFI reported significantly more often that group regulation contributed to change. As both interventions were perceived as contributing, the findings support the relationship orientation to psychosocial interventions, which stresses the quality of the social support and interpersonal interaction as the source of positive outcomes of intervention.     

Peer Influence in Children and Adolescents: Crossing the Bridge from Developmental to Intervention Science

Considerable evidence supports the hypothesis that peer relationships influence the growth of problem behavior in youth. Developmental research consistently documents the high levels of covariation between peer and youth deviance, even controlling for selection effects. Ironically, the most common public interventions for deviant youth involve segregation from mainstream peers and aggregation into settings with other deviant youth. Developmental research on peer influence suggests that desired positive effects of group interventions in education, mental health, juvenile justice, and community programming may be offset by deviant peer influences in these settings. Given the public health policy issues raised by these findings, there is a need to better understand the conditions under which these peer contagion effects are most pronounced with respect to intervention foci and context, the childs developmental level, and specific strategies for managing youth behavior in groups.