Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

Depression in people with intellectual disability : an evaluation of a staff-administered treatment program

The prevalence of co-morbid depression in people with intellectual disability (ID) provides a strong rationale for the early identification and treatment of individuals at risk. The aim of this study was to evaluate a staff-administered group CBT program for the treatment of depression in people with mild ID. A sample of 13 staff employed at two community-based disability agencies were trained to deliver the program to 47 individuals with mild ID and symptoms of depression. A wait list control group comprised of 27 individuals subsequently completed the program. Compared to the control group, individuals who had participated in the treatment program showed lower depression scores, and fewer automatic negative thoughts. Furthermore, these changes were maintained at a 3-month follow-up. The results indicate that staff can be trained to deliver a CBT program within community settings that is effective in the reduction of depression symptomatology in people with mild ID.

Getting your life back on track after stroke : a phase II multi-centered, single-blind, randomized, controlled trial of the Stroke Self-Management Program vs. the Stanford Chronic Condition Self-Management Program or standard care in stroke survivors

Background Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial.
Methods Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements, Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible participants are randomized to either;
• standard care,
• standard care plus a six week generic chronic condition self-management group education program, or,
• standard care plus an eight week stroke specific self-management education group program.
Interventions are conducted after discharge from hospital. Participants are assessed at baseline, immediate post intervention and six months.
Study Outcomes The primary outcome measures determine study feasibility and safety, measuring, recruitment, participation, compliance and adverse events.
Secondary outcomes include:
• positive and active engagement in life measured by the Health Education Impact Questionnaire,
• improvements in quality of life measured by the Assessment of Quality of Life instrument,
• improvements in mood measured by the Irritability, Depression and Anxiety Scale,
• health resource utilization measured by a participant held diary and safety.

Conclusion The results of this study will determine whether a definitive Phase III efficacy trial is justified.

Triple G girls get going in tennis : resource manual

Physical activity is ranked second in importance only to tobacco control in health promotion and disease prevention in Australia. Individuals can be active in many ways every day, including –walking to and/or from school, work and other places of interest; participating in sports clubs; going to the YMCA or community leisure centre where you can be active through gyms, group fitness classes or in the swimming pool; visiting local parks and walking trails, and even at home and in the backyard. You can always find ways to be active in the community.

Promoting physical activity to young people is important for developing healthy lifestyles now and maintaining them for the future. A physically active lifestyle can be of benefit to physical, mental and social health. Despite these benefits, adolescent girls and young women are considerably less active than their male counterparts, and sport participation decreases dramatically among girls during their secondary school years. Many physical education teachers have also expressed concern about girls minimising their participation in school physical education. Consequently, it is timely that a project such as Triple G ‘Girls Get Going in Tennis, in Football, and at the YMCA’ should be developed and implemented in an effort to arrest the decline in girls’ participation in sport, physical activity and physical education.

The Triple G program aims to develop, implement and evaluate a program to promote participation in physical activity by girls in rural and regional schools and communities. The impact of the Triple G program on the mental and physical wellbeing of the girls will also be evaluated. The program specifically aims to create school and community linkages through the introduction of tennis coaches, football coaches, and YMCA instructors into the physical education class to team teach with physical education staff during the 2011 school year. As part of the school-based program, Year 7 – 9 girls will participate in a YMCA unit and one of tennis or football during their physical education classes (6 sessions x 100mins each). Each unit is then followed by an eight week afterschool program at the local tennis or football club, or YMCA centre.

Critical evaluation of a program to foster reflexive antiracism

This paper documents the evaluation of a three-day program entitled “Race, Culture, Indigeneity and the Politics of Disadvantage,” which was delivered in 2010 in Melbourne, Australia with the aim of promoting Reflexive Antiracism (RA), a novel diversity training approach. To assess the impact of the program on its participants, the Reflexive Antiracism Scale- Indigenous (RAS-I) was devised and administered before and after the program both to participants and a matched control group. The program increased Reflexive Antiracism among participants through an enhanced understanding of whiteness, racialisation and White Racial Identity. Future studies are required to advance both the concept of Reflexive Antiracism and its measurement.

Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians.

Objective: To evaluate the Arthritis Self-Management Course (ASMC) when applied in a nationwide context.

Methods: Four hundred fifty-two people who participated in the ASMC across Australian states took part in a longitudinal followup study. ASMC is a 6 week, 2 h group educational program designed to assist people with chronic illness to better manage their condition. Measures of program effectiveness included health status and service utilization. Data were collected on 3 occasions: before intervention (baseline) and 6 months and 2 years after the program.

Results: Several indicators of health status showed improvement at 6 months following the ASMC. These included reduction in pain (4%; p < 0.001), fatigue (3%; p < 0.01), and health distress (12%; p < 0.001) as well as increase in self-efficacy (6%; p < 0.001). Increased self-efficacy was a significant predictor of positive change in health status. Health-related behaviors such as aerobic exercise also increased, with the proportion of people who did little or no exercise decreasing by up to 8%. These changes were sustained at 2 years. There was an increase in use of analgesics at 6 months and an increase in use of nonsteroidal antiinflammatory drugs at 2 years. No changes in healthcare utilization (physician visits, allied health visits, and hospitalizations) were observed.

Conclusion: The ASMC is a widely applied program in which participants benefit through a reduction in pain, fatigue, and health distress. Although the absolute changes in health status are small, the low cost and wide application of the intervention suggests the program may have a substantial public health effect.

New work ethics? The corporate athlete's back end index and organisational performance

Drawing on Michel Foucault’s later genealogies of the Self the paper will illustrate particular dimensions of the increasingly powerful individualizing and normalizing processes shaping the lifeworlds of worker-citizens in a globalizing risk society. Processes that require those who wish to be positively identified as professional, entrepreneurial, resilient, effective, athletic to do particular sorts of work on themselves. Here the paper argues that we can identify the emergence of what we call New Work Ethics. We illustrate this more general argument via an analysis of the ways in which a large Information Technology (IT) organization seeks to produce—via a workplace health and fitness program—employees who imagine themselves as embodying the behaviours and dispositions that mark the person as a corporate athlete. Knowledge of the Self in these terms can, it is promised, enhance the performance of the Self, and the organization.

Optimising care for people with chronic disease : foreword

Chronic disease self-management emerged as an organised, formal entity in Australia in the 1980s, when a specific group-based program was introduced from the United States. This program, the Stanford Arthritis Self-Management Course, was promulgated in Australia and other countries by its creator, Professor Kate Lorig of Stanford University. The program showed much early promise, particularly with its dissemination and uptake by an enthusiastic non-government sector. Over subsequent years it has matured, and many other programs endeavouring to support patients to engage in self-management have been developed. In some ways, chronic disease self-management has become mainstream.1-3

Community nutrition : providing for older citizens

Diet quality is a contributing factor to the health of the increasing number of aged. A fortnightly small group meal program focusing on social interaction was trialled. It was concluded that the program had strong support from participants and that there is scope for expansions of existing food service programs to include alternative styles of presentations; and that the principle of the Community Meals Program should be continued and endorsed.

Preventing mental health problems in children : the families in mind population-based cluster randomised controlled trial.

Background

Externalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care).
Design

Three armed, population-level cluster randomised trial (2010-2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants: Families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. Intervention: (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Analysis: Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective.
Discussion

This trial will inform public health policy by making recommendations about the effectiveness and cost-effectiveness of these early prevention programs. If effective prevention programs can be implemented at the population level, the growing burden of mental health problems could be curbed.

The effects of a simplified tai-chi exercise program (STEP) on the physical health of older adults living in long-term care facilities : a single group design with multiple time points

Background
Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred.
Objective
To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities.
Design
A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started.
Settings
Two 300–400 bed veteran homes in Taiwan.
Participants
The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded.
Methods
The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization.
Results
A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038).
Conclusions
Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.

Influence of an adventure learning program, using group adventure initiative tasks, on participant self-esteem

The purpose of this study was to assess the influence of an adventure learning program, based on participation in group adventure initiative tasks (GAITs), on participant self-esteem and, further, to examine any associated gender differences in the dependent variable. The study took place within the framework of the 'Group Dynamics in Action' unit offered at the University of South Australia, Underdale Campus, in semester 2, 1994. The course included participation in group adventure initiative tasks, the identification and examination of group dynamic processes, the investigation of individual roles within the small group and the review of these processes in the group setting. The program also included an experience on a high ropes course. Both quantitative and qualitative data was gathered to gain insight into gender differences and their relationship to the dependent variable and also to provide insight into any discrepancy in outcomes between males and females with regard to participation in group adventure initiative tasks. The sample set of participants was drawn from undergraduate students studying at the University of South Australia in the Bachelor of Teaching (Primary), Bachelor of Education (Secondary Physical Education Teaching) and Bachelor of Applied Science (Exercise and Sport Science) courses. Subjects were assigned to either experimental or control conditions and the experimental group were then randomly assigned to one of three treatment groups. Sixty one (N = 61) male and female subjects were tested pre and post-treatment period. Psychological tests included the Coopersmith Self Esteem Inventory (Coopersmith 1981) and an adaptation of Coopersmith's Behaviour Rating Form (Coopersmith 1967). Qualitative data was gathered using Kuhn's Twenty Statements Test (Kuhn and McPartland 1954), a self-esteem questionnaire, observations made by the researcher and other staff about subjects interactions and from weekly journals kept by subjects throughout the treatment. The duration of the treatment period was 14 weeks consisting of 14, 2 hour seminars.