Women’s Experience of Telehealth Cancer Genetic Counseling

Telegenetics offers an alternative model of delivering genetic counseling to rural and outreach areas; however there is a dearth of qualitative research into the patient’s experience. Twelve women who had received telemedicine genetic counseling for hereditary breast and/or ovarian cancer (HBOC) within the previous 12 months participated in a semi-structured telephone interview. The interview explored women’s experience with telegenetics, satisfaction, perceived advantages and disadvantages and quality of the interaction with their genetic professionals. Overall women were highly satisfied with telegenetics. Telegenetics offered them convenience and reduced travel and associated costs. The majority of women described feeling a high degree of social presence, or rapport, with the off-site genetic clinician. One woman with a recent cancer diagnosis, reported that telemedicine was unable to meet her needs for psychosocial support. This finding highlights the need to be mindful of the psychosocial support needs of women with a recent diagnosis being seen via telegenetics. Patients attending for HBOC genetic counseling are generally highly satisfied with the technology and the interaction. Care should be taken, however, with patients with more complex psychosocial needs.     

A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy

Project CHOICES developed an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. Settings included primary care, university-hospital based obstetrical/gynecology practices, an urban jail, substance abuse treatment settings, and a media-recruited sample in three large cities. The intervention was based on motivational interviewing and targeted both adoption of effective contraception and reduction of alcohol use. Treatment included 4 manual-guided sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. This paper describes the rationale for treatment; the use of motivational interviewing and the transtheoretical model for a dual-focused approach to behavior change; the development of the Project CHOICES intervention; development of the study protocol and treatment manual; and selection, training, supervision, and monitoring of study counselors. Implications for future applications of the intervention are discussed.     

Transfer of skill engendered by complex task training under conditions of variable priority

We explored the theoretical underpinnings of a commonly used training strategy by examining issues of training and transfer of skill in the context of a complex video game (Space Fortress, Donchin, 1989). Participants trained using one of two training regimens: Full Emphasis Training (FET) or Variable Priority Training (VPT). Transfer of training was assessed with a large battery of cognitive and psychomotor tasks ranging from basic laboratory paradigms measuring reasoning, memory, and attention to complex real-world simulations. Consistent with previous studies, VPT accelerated learning and maximized task mastery. However, the hypothesis that VPT would result in broader transfer of training received limited support. Rather, transfer was most evident in tasks that were most similar to the Space Fortress game itself. Results are discussed in terms of potential limitations of the VPT approach.     

Executive control processes of working memory predict attentional blink magnitude over and above storage capacity

When two masked, to-be-attended targets are presented within approximately half a second of each other, performance on the second target (T2) suffers, relative to when the targets are presented further apart in time or when the first target (T1) can be ignored. This phenomenon is known as the attentional blink (AB). Colzato et al. (Psychon Bull Rev 14:1051–1057, 2007) used an individual differences approach to examine whether individual AB magnitude was predicted by individual differences in working memory (WM), using the operation span paradigm (OSPAN). They found that OSPAN score was inversely related to AB magnitude even when a fluid intelligence measure (Raven’s SPM) was partialled out. However, it is not clear from this study whether it was the executive control aspect of working memory, the capacity aspect of short-term memory, (or both), that related to AB magnitude. In the present study we used a variety of WM measures that required varying degrees of executive control. OSPAN was negatively related to AB magnitude with Raven’s SPM, reading comprehension, reading rate, and digit forward and backward partialled out. Backward and forward digit span did not predict AB magnitude. These results support the conclusion that a “working” executive component of WM predicts temporal limitations of selective attention beyond static STM capacity and general cognitive ability.     

Religiosity and HIV Risk Behavior Involvement Among “At Risk” Women

During the past decade, increased attention has been payed to the role that religious and faith-based organizations can play in enhancing health behaviors. Generally, researchers have found that religious and faith-based programs can have a positive impact upon enhancing people's health and helping them to reduce risky health practices. Initial research into the impact that these programs can have on HIV-related knowledge and risk behaviors has also been promising, albeit quite limited. In this study, we examine the role that religiosity plays in women's involvement in HIV risk behaviors. Religiosity was found to be a strong predictor of women's involvement in HIV-related risky behaviors, with the greatest risk reported by women who were the least religious.     

Integrating Spirituality Into Counselor Preparation: A Developmental,Wellness Approach

Recent surveys of the general public and of counseling professionals suggest the pervasive importance of spirituality in the lives of all individuals. Yet, the infusion of spirituality in counselor preparation programs continues to be a concern. Incorporating spirituality within a wellness paradigm can help counselors and counselor educators value and address spirituality as an integral component of optimum human functioning. By distinguishing between religiosity and spirituality and operationally conceptualizing spirituality as a life span developmental phenomenon that is essential for achieving wellness, counselor educators can more readily incorporate spiritual issues within the philosophy of the counseling profession.     

Treatment Implications for Young Adult Users of MDMA

Young adults' 3,4‐methylenedyoxymethamphetamine (MDMA) use is a national public health concern. Although research on the epidemiology of MDMA use has increased, inquiry into intervention and treatment is needed. The authors examine results from an epidemiological investigation from a clinical perspective and provide suggestions for clinicians working with MDMA users.     

Does Motivation Impact OCD Symptom Severity? An Exploration of Longitudinal Effects

Understanding the role of patient motivation in OCD treatment is of clinical importance given the requisite autonomous role of patients in Exposure and Response Prevention. The present study investigated state- and trait-like relations between three variables: two previously established motivational constructs, readiness to change (RTC) and committed action (CA), derived from the University of Rhode Island Change Assessment, and OCD symptom severity as measured by the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR). Utilizing a random-intercept cross-lagged panel model (RI-CLPM) design, we assessed autoregressive, within-time correlations, and cross-lagged effects of RTC, CA, and Y-BOCS-SR scores at admission, month 1 of treatment, and discharge from an intensive/residential treatment program for OCD. Results revealed significant autoregressive (i.e., state-like) effects for CA and Y-BOCS-SR, negative within-time correlations between state CA and Y-BOCS-SR across all time points, a positive within-time correlation between state CA and RTC at admission, and a cross-lagged effect between state Y-BOCS-SR at month 1 of treatment and state RTC at discharge. Results also demonstrated that the stability of the RTC variable was attributable to trait-like factors in the present sample. This study is novel in its use of RI-CLPM in an OCD sample and represents an important addition to the literature on the longitudinal impacts of dynamic constructs of motivation. Our findings may provide future researchers with strategies to supplement ERP with CA-driven motivational interviewing.     

Waimānalo Pono Research Hui: A Community–Academic Partnership to Promote Native Hawaiian Wellness through Culturally Grounded and Community‐Driven Research and Programming

Although Hawai‘i is often portrayed as an idyllic paradise and is recognized as one of the healthiest States in the United States, pervasive health disparities exist among Native Hawaiians. Similar to other indigenous populations across the globe, these disparities are linked to unjust social and economic policies rooted in colonization and historical trauma. Western‐centric efforts to address these disparities have yielded limited results. Consequently, indigenous frameworks to decolonize western‐centric research processes have emerged. The Waimānalo Pono Research Hui is an example of a community–academic partnership that uses indigenous methodologies and principles of community‐based participatory research as the foundation to engage Native Hawaiian community members in research. Monthly gatherings are held where community members and academic researchers share a meal and discuss community priorities with the goal of shaping research and programming that are rooted in Native Hawaiian values. A mission for the group has been created as well as protocols for community engagement to ensure all projects that work with the Waimānalo Pono Research Hui are ethically sound and grounded in the community's preferences, cultural knowledge, and lived experiences. Our community members continually report that the Waimānalo Pono Research Hui has positively transformed their perception of and willingness to engage in research. Similarly, university students and academic researchers express how much their knowledge about working with communities has grown and inspired them. Creating spaces for communities and researchers to build authentic relationships and engage in ongoing conversations can promote culturally grounded and community‐driven research and programming.