Aderonke Bamgbose Pederson1*, Valerie Earnshaw2, Crystal T. Clark1*, Katelyn Zumpf1, Inger Burnett-Zeigler1
1Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, United Sates
2Department of Human Development and Family Sciences, University of Delaware, United Sates
Background: Mental health stigma results in unmet mental health needs. Research describing predictors of stigma remains limited among Black immigrants. We aim to examine stigma associated with mental illness among a group of Black immigrant women.
Methods: We examined data from 22 women from two Black immigrant community centers. We collected surveys on demographics, cultural beliefs, migration status, religiosity and mental health stigma. Simple linear regression was used to model the unadjusted association between each component variable and overall stigma scores. All analyses were conducted using R and assumed a two-sided, 5% level of significance.
Results: A linear relationship was found between author-generated scale, the Stigma and Culture Survey (SCS) and the Depression Self Stigma Scale (DSSS). Among respondents, use of religious resources was associated with less stigma (p-value: 0.04). Whereas spirituality and morality was associated with greater stigma (p-value: 0.003). United States citizenship was associated with less stigma (p-value: 0.0001).
Discussion/Conclusion: Religion and spirituality are critical to understanding mental health stigma among Black immigrants. Studies aimed at assessing and reducing stigma need to critically engage with cultural and religious factors.DOI: 10.29245/2578-2959/2021/2.1234 View / Download Pdf
A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States
Kevin J. Rivera1, Jenny Y. Zhang2, David C. Mohr3, Annie B. Wescott4, Aderonke Bamgbose Pederson2*
1Department of Psychiatry, Carver College of Medicine, University of Iowa. 200 Hawkins Dr, Iowa City, Iowa, 52242, United States
2Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University. 446 E. Ontario St, #7-200, Chicago, Illinois, 60611, United States
3Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University. 680 N. Lake Shore Dr, Suite 1400, Chicago, Illinois, 60611, United States
4Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University. 320 E Superior St, Chicago, Illinois, 60611, United States
Among African Americans, the chronicity and severity of mental illness correlates with worse health outcomes and widens health disparities. Stigma related to mental illness compounds mental health disparities by creating barriers to help-seeking behavior. We examine the current tools designed to reduce mental illness stigma and promote improved mental health outcomes among African Americans. The authors reviewed the current evidence in the literature for such stigma reduction interventions. The review team developed a focused search across four databases: PubMed, Embase, Scopus, and APA PsycINFO. Initial searches identified 120 articles, from which six studies were included as reporting on mental illness stigma reduction interventions among African Americans. We describe these four quantitative and two qualitative studies. There have been various interventions used among African Americans to reduce mental illness stigma, and the level of efficacy and effectiveness is not well studied. Our review demonstrated a need for more robust studies to yield strong evidence on effectiveness among stigma reduction interventions in this target population. The evidence does support tailoring intervention studies to this population. Effectively engaging and partnering with key stakeholders, including schools, community organizations, and faith-based institutions enhances the acceptance and delivery of stigma reduction interventions.DOI: 10.29245/2578-2959/2021/2.1235 View / Download Pdf
From Research to Practice: Designing a Treatment Program for Individuals Convicted of Child Sexual Exploitation Material
Department of Criminology, California State University, Fresno, USA
The term evidence-based is increasingly found in treatment manuals and program titles designed for individuals convicted of a sexual offense. However, whether the presented evidence truly qualifies as “evidence-based” is questionable. I will share my experience as the clinical director for a private outpatient agency where we designed a program based on the existing peer-reviewed literature on individuals convicted of Child Sexual Exploitation Material (CSEM) offenses. I will describe the steps that we followed in developing a workgroup to explore and apply the knowledge from research to our clinical practice. We adapted the term evidence-informed to acknowledge that the program relied on existing literature in combination with the experiences and expertise of our clinical team. A fictitious case that reflects an amalgamation of facts is presented to demonstrate the assessment and treatment processes. Implications for organizational consensus to conduct program evaluation and research are discussed.DOI: 10.29245/2578-2959/2021/2.1236 View / Download Pdf
Treatment with Non-invasive respiratory support in severe COVID-19: Clinical effectiveness observational study
Gonzalo Segrelles-Calvo1*, Estefanía Llopis-Pastor1, Glauber Ribeiro de Sousa Araújo2, Inés Escribano1, Esther Antón1, Laura Rey1, Nestor Rodriguez Melean1, Marta Hernández1, Javier Carrillo1, Celia Zamarro1, Mercedes García-Salmones1, Susana Frases2.
1Respiratory Intermediate Care Unit, Respiratory Department, University Rey Juan Carlos Hospital, Madrid, Spain
2Laboratorio de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brasil
Introduction: The study aimed to analyse the clinical response and short-term outcomes with the use of high-flow oxygen therapy (HFOT), non-invasive mechanical ventilation (NIMV) with bilevel positive airway pressure, or continuous positive airway pressure (CPAP) in severe COVID-19 patients.
Methods: We conducted an observational, prospective, single-center study, approved by Ethics Committee of “Instituto de Investigación Sanitaria Fundación Jiménez Díaz” (EO102-20-HRJC).
We included a total of 130 patients ≥18 years-old, with proved SARS-CoV-2 infection and secondary Acute Respiratory Failure (ARF) that required treatment with Non-invasive Respiratory Support (NIRS). We collected data about population demographic characteristics, clinical factors, and evolution during the incoming. A baseline of patients treated with HFO, CPAP and NIMV were compared with one-way ANOVA test, while categorical variables were expressed as numbers and percentages and were compared using the chi-square test or Fisher’s exact test when appropriate.
Results: The cohort was distributed as follows: CPAP 54.6% (n = 71), NIMV 30% (n = 39), HFO 15.4% (n = 20). There were no differences between NIRS subgroups regarding age, comorbidity, or functional status. At the beginning of NIRS treatment, PaO2/FiO2 value was 149.3 ± 69.7. After 24 hours, PaO2/FiO2 was significantly higher in the CPAP group (CPAPvsNIMV, p-value = 0.0042; CPAPvsHFO, p-value = 0.000169).
The overall ICU admission evaded rate was 69.1% and TF rate was 43.8%, without differences between the three therapies (p-value = 0.281). The mortality rate was 37.2%, without significant differences between subgroups.
Conclusions: Our data suggest that CPAP versus treatment with NIMV or HFO improves PaO2/FiO2 rate in severe ARF patients, significantly reducing ICU admission. No differences were observed in mortality or therapeutic failure.DOI: 10.29245/2689-999X/2021/2.1173