Participatory Technology Development to Enhance Community Resilience

Arevian, Armen C.; O’Hora, Jennifer; Jones, Felica; Mango, Joseph; Jones, Loretta; Williams, Pluscedia; Booker‐Vaughns, Juanita; Jones, Andrea; Pulido, Esmeralda; Banner-Jackson, Denishia; Wells, Kenneth B.

doi:10.18865/ed.28.s2.493

Cited by 47 publications

(53 citation statements)

References 16 publications

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“…These outlines were traced manually onto a digital manikin by an expert tracer blinded to the diagnostic grouping [as in ( 40 )]. The digital manikin mobile application was developed and hosted on the Chorus platform ( 41 , 42 ). Before moving further a reliability check across 90 randomly selected maps, traced onto the digital manikin by a second tracer, yielded an inter-tracer Dice ( 43 ) similarity coefficient ≥ 0.77, suggesting quantitatively reliable agreement comparable to other published manual tracing approaches ( 44 ).…”

Section: Methodsmentioning

confidence: 99%

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

et al. 2018

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Individuals with anorexia nervosa (AN) typically display anxious traits prior to the onset of food avoidance and weight loss that characterize the disorder. Meal associated anxiety is an especially common clinical feature in these patients, and heightened sensitivity to sympathetically mediated interoceptive sensations has also been observed. However, it remains unclear how heightened interoceptive sensitivity relates to experiences of anxiety before and after meals. To investigate this relationship, we experimentally induced anxiety and panic symptoms with isoproterenol, a peripheral sympathetic agonist similar to adrenaline, across several different conditions: during panic provocation, during anticipation of a 1,000 Calorie meal, and after meal consumption. Fifteen AN and 15 age- and sex-matched healthy comparisons received bolus infusions of isoproterenol and saline in a double-blinded, randomized design. Participants rated anxiety symptoms after each infusion, completed panic rating scales, and traced the location of perceived palpitations on a manikin to index interoceptive “body map” representation. The AN group reported significantly elevated anxiety relative to healthy comparisons during infusions before and after the meal, but surprisingly, not during panic provocation. These symptoms were accompanied by geographical differences in patterns of perceived heartbeat sensations across each condition. In particular, the AN group localized heartbeat sensations disproportionately to the chest during meal related saline infusions, when no cardiorespiratory modulation actually occurred. The AN group also showed a trend toward higher panic attack rates during the meal anticipation period. Correcting for anxiety levels reported during saline infusions abolished group differences in anxiety change across all conditions, suggesting a significant contribution of anxious traits in AN. The observation of meal related “visceral illusions” provides further evidence that AN is associated with abnormal interoceptive representation of the heartbeat and suggests that meal consumption, particularly when anticipated, preferentially alters the processing of interoception related signals in AN.

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Section: Methodsmentioning

confidence: 99%

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

et al. 2018

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“…First, our primary clinical outcome measure was a global assessment rating as it provided a practical method to quickly assess global clinical state given time constraints of clinical staff. While it is adapted from the widely used Global Assessment of Functioning scale used in DSM-IV, it was not previously evaluated for measure constructs such as validity and reliability [37]. Because the rating was based on a clinician's assessment, there could be variability in the rating, similar to that observed with the GAF scale [52].…”

Section: Discussionmentioning

confidence: 99%

“…What do you think is good or bad about this approach?"). MCC was initially run on a Raspberry Pi server (The Raspberry Pi Foundation, Cambridge, UK) and later migrated to the Chorus mobile application platform hosted at UCLA [37].…”

Section: Mycoachconnect Telephone Tool and Mobile Appmentioning

confidence: 99%

Clinical state tracking in serious mental illness through computational analysis of speech

et al. 2020

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Individuals with serious mental illness experience changes in their clinical states over time that are difficult to assess and that result in increased disease burden and care utilization. It is not known if features derived from speech can serve as a transdiagnostic marker of these clinical states. This study evaluates the feasibility of collecting speech samples from people with serious mental illness and explores the potential utility for tracking changes in clinical state over time. Patients (n = 47) were recruited from a community-based mental health clinic with diagnoses of bipolar disorder, major depressive disorder, schizophrenia or schizoaffective disorder. Patients used an interactive voice response system for at least 4 months to provide speech samples. Clinic providers (n = 13) reviewed responses and provided global assessment ratings. We computed features of speech and used machine learning to create models of outcome measures trained using either population data or an individual's own data over time. The system was feasible to use, recording 1101 phone calls and 117 hours of speech. Most (92%) of the patients agreed that it was easy to use. The individually-trained models demonstrated the highest correlation with provider ratings (rho = 0.78, p<0.001). Population-level models demonstrated statistically significant correlations with provider global assessment ratings (rho = 0.44, p<0.001), future provider ratings (rho = 0.33, p<0.05), BASIS-24 summary score, depression sub score, and self-harm sub score (rho = 0.25,0.25, and 0.28 respectively; p<0.05), and the SF-12 mental health sub score (rho = 0.25, p<0.05), but not with other BASIS-24 or SF-12 sub scores. This study brings together longitudinal collection of objective behavioral markers along with a transdiagnostic, personalized approach for tracking of mental health clinical state in a community-based clinical setting.

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“…Classes are supplemented with optional automated mobile text reminders about basic concepts and follow-up for care (eg, appointment reminders). Text messages are delivered by an electronic platform known as CHORUS,62 the content of which was created through a series of participatory workshops with community stakeholders and designed to provide basic and quick tips for coping support and resources. Community partners identified priorities for coping support and resources, and they adapted content from an existing CBT-based manual to support resiliency.…”

Section: Methodsmentioning

confidence: 99%

Resilience Against Depression Disparities (RADD): a protocol for a randomised comparative effectiveness trial for depression among predominantly low-income, racial/ethnic, sexual and gender minorities

Vargas

Wennerstrom

Alfaro³

et al. 2019

BMJ Open

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IntroductionDepression is the leading cause of adult disability and common among sexual and gender minority (SGM) adults. The current study builds on findings showing the effectiveness of depression quality improvement (QI) and delivery of cognitive behavioural therapy (CBT) skills provided by community health workers in reducing depression. Depression QI approaches across healthcare and social/community services in safety-net settings have shown improvements in mental wellness, mental health quality of life and depression over 12 months. Further, a randomised study showed improved depression among low-income racial/ethnic minorities enrolled in a CBT-informed resiliency class (Building Resilience and Increasing Community Hope (B-RICH)). The current protocol describes a comparativeness effectiveness study to evaluate whether predominantly low-income, SGM racial/ethnic minority adults randomised to a CBT-informed resiliency class have improvements in depressive symptoms over and above community-engaged QI resources and training only.Methods and analysisThe study approached three clusters of four to five programs serving predominantly SGM and racial/ethnic minority communities in the USA: two clusters in Los Angeles, California, and one in New Orleans, Louisiana. Clusters are comprised of one primary care, one mental health and two to three community agencies (eg, faith-based, social services/support, advocacy). All programs received depression QI training. The current study employed a community-partnered participatory research model to adapt the CBT-informed resiliency class, B-RICH+, to SGM communities. Study participants were screened and recruited in person from participating programs, and will complete baseline, 6- and 12-month survey follow-ups. Participants were depressed adults (8-item Patient Health Questionnaire ≥10; ≥18 years of age) who provided contact information. Enrolled participants were individually randomised to B-RICH+ or depression QI alone. Primary outcomes are depressive symptoms; secondary outcomes are mental health quality of life, mental wellness and physical health quality of life. Data collection for this study is ongoing.Ethics and disseminationThe current study was approved by the UCLA Institutional Review Board. Study findings will be disseminated through scientific publications and community conferences.Trial registration number https://clinicaltrials.gov/ct2/show/NCT02986126

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Participatory Technology Development to Enhance Community Resilience

Cited by 47 publications

References 16 publications

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

Clinical state tracking in serious mental illness through computational analysis of speech

Resilience Against Depression Disparities (RADD): a protocol for a randomised comparative effectiveness trial for depression among predominantly low-income, racial/ethnic, sexual and gender minorities

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