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Full-Text Articles in Education

The College Sexual Violence Epidemic: Examining Prevention And Response Procedures, Casey Buonocore Apr 2024

The College Sexual Violence Epidemic: Examining Prevention And Response Procedures, Casey Buonocore

Antioch University Full-Text Dissertations & Theses

A 2019 survey conducted by the Association of American Universities reported the prevalence rate of college sexual violence at approximately 13%. Additional college sexual violence research has found that there is often a significant discrepancy between rates of sexual violence and usage rates of post-assault resources (Stoner & Cramer, 2019). Given previous statistics on college sexual violence and emerging statistics on intimate partner violence, the COVID-19 pandemic likely exacerbated this existing discrepancy. Prior college sexual violence research has found that students are much more likely to access sexual violence resources if they have already received comprehensive information about those resources …


The Bloodless Period: A Transfeminine Experience, Rin Nguyen Apr 2024

The Bloodless Period: A Transfeminine Experience, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

There is limited research exploring menstruation in transgender and gender diverse (TGD) populations, and studies have primarily examined the relationship between menstruation and gender congruence. Findings revealed menstruating TGD people experienced distress related to decreased gender congruence (Eisenberg et al., 2021), and 88% of TGD people expressed interest in menstrual suppression to manage the distress (Schwartz et al., 2022). By contrast, Lowik (2020) highlighted a transfeminine person who wished to menstruate to achieve womanhood and commented on the “bloodless period” (i.e., menstrual-like symptoms in the absence of bleeding) upon receiving gender-affirming hormone therapy. To the author’s knowledge, there is no …


"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk Jan 2024

"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk

Antioch University Full-Text Dissertations & Theses

This study examines the lived experience of the perinatal population to understand how they can be supported from the lens of different ecological systems and what counselors can do to better serve people with uteruses during their perinatal experience. Furthermore, this study aims to utilize an inclusive framework for capturing the perinatal experience of people with uteruses and to explore barriers and facilitators to care through an ecological systems framework. Fifteen participants who have experienced infertility, conception, pregnancy, miscarriage, childbirth, stillbirth, and postpartum were recruited through various means throughout the United States. Thematic analysis was used, with semi-structured interviews and …


Ethnic-Racial Socialization Experiences Of Mexican American Youth, Katherine J. Bingham, Elizabeth A. Cutrer-Párraga, Timothy B. Smith Jan 2024

Ethnic-Racial Socialization Experiences Of Mexican American Youth, Katherine J. Bingham, Elizabeth A. Cutrer-Párraga, Timothy B. Smith

Faculty Publications

Research has shown that ethnic–racial socialization (ERS) predicts education and mental health outcomes for adolescents. However, limited research has evaluated the ERS experiences of Latinx students. The current study examined ERS experiences of Mexican American youth in four focus group interviews that were transcribed and analyzed at both the individual and group level using interpretive phenomenological analysis. Main themes included feeling like an outsider, navigating discrimination, encountering social/emotional difficulties, and achieving a positive identity. Each theme contained two to three subcategories that provide further insight into the Mexican Americans' ERS experiences. Participants reported within-group discrimination, motivation to disprove stereotypes, and …


How Teachers Use Data: Description And Differences Across Prek Through Third Grade, Amanda Witte, Lisa Knoche, Susan Sheridan, Natalie A. Koziol Oct 2023

How Teachers Use Data: Description And Differences Across Prek Through Third Grade, Amanda Witte, Lisa Knoche, Susan Sheridan, Natalie A. Koziol

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

The use of data to inform instruction has been linked to improved student outcomes, early identification of intervention needs, and teacher decision-making and efficacy. Additionally, data are used as a means of accountability within educational settings. However, little is known about data use practices among early grades teachers. The purpose of the current study is to describe the data use of PreK to third grade teachers and to investigate differences in data use and support across grade levels. Participants were 307 early childhood teachers in PreK and early elementary school. Analysis of survey data revealed, overall, most teachers across grade …


Family Strengths Among Native American Families And Families Living In Poverty: Preventing Adverse Childhood Experiences, Natira Mullet, Emily A. Waterman, Katie Edwards, Briana Simon, Skyler Hopfauf, Ramona Herrington Jun 2023

Family Strengths Among Native American Families And Families Living In Poverty: Preventing Adverse Childhood Experiences, Natira Mullet, Emily A. Waterman, Katie Edwards, Briana Simon, Skyler Hopfauf, Ramona Herrington

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Objective: The purpose of this study was to understand how youth, caregivers, and community professionals perceive family strengths and adverse childhood experiences (ACEs) in their community. Specifically, this study was focused on the protective role of caregivers and families, positive youth development, and how Native American families and families living in poverty support adolescents’ social–emotional development and help them thrive in the face of adversity.

Background: Research documents the concerning rates and negative outcomes of ACEs. However, very little research has examined the views of families and professionals on how to prevent ACES among these populations.

Method: Participants were youth …


White Privilege And Teacher Perceptions Of Teacher-Child Relationship Quality, Kathleen Moritz Rudasill, Colin M. Mcginnis, Sheng-Lun Cheng, Dwayne Ray Cormier, Natalie A. Koziol May 2023

White Privilege And Teacher Perceptions Of Teacher-Child Relationship Quality, Kathleen Moritz Rudasill, Colin M. Mcginnis, Sheng-Lun Cheng, Dwayne Ray Cormier, Natalie A. Koziol

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

In this study, we investigated differences in teachers’ perceptions of the teacher-child relationship from kindergarten through second grade as a function of child race and gender from the perspective of critical race theory and the cultural synchrony hypothesis. Given the extensive evidence of White privilege and anti-Black racism in the US education system, we expected that teachers, particularly White teachers, would perceive their relationships with White children more positively than with Black children. Controlling for family SES and child gender, results supported this hypothesis. Black boys had the highest risk of being perceived by teachers as having poor relationships with …


College Students’ Perceptions Of Alcohol’S Role In Disclosures Of Sexual Assault And Intimate Partner Violence, Emily A. Waterman, Lindsey M. Rodriguez, Sarah E. Ullman, Emily R. Dworkin, Katie Edwards Jan 2023

College Students’ Perceptions Of Alcohol’S Role In Disclosures Of Sexual Assault And Intimate Partner Violence, Emily A. Waterman, Lindsey M. Rodriguez, Sarah E. Ullman, Emily R. Dworkin, Katie Edwards

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Objective: Much is known about how alcohol increases the risk of sexual assault or intimate partner violence victimization during college. This research qualitatively explores perceptions about how alcohol influences disclosures about these events to informal supports.

Participants: Participants included college students who received a disclosure wherein they or the survivor were drinking during the disclosure (n = 81).

Methods: Responses were coded with regard to who was drinking and whether the effect of drinking during the disclosure was perceived as positive, negative, mixed, or neutral/none.

Results: Participants perceived alcohol to have both positive (e.g., increasing the likelihood of discussing …


Appreciating And Promoting Resilience In Families, John W. Eagle, Susan M. Sheridan Jan 2023

Appreciating And Promoting Resilience In Families, John W. Eagle, Susan M. Sheridan

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Families comprise the primary context for a child’s development. As the composition of the family system continues to change, the adult caregivers’ role has become increasingly important in fostering healthy developmental trajectories for their children. Family relationships and interaction styles are central to developing competence and promoting adaptive educational, social, emotional, and behavioral functioning. Families give children an informal education (Turnbull et al., 2015), which is a prerequisite to successful experiences in the classroom (Adams & Christenson, 2000). Whereas the school environment sets up developmental tasks for students, the family serves as an important resource for the acquisition of these …


Concern, Conflict, And Chaos: Nebraska Educator Experiences During The Pandemic, Amanda Witte, Amanda Prokasky, Courtney Boise, Renata T.M. Gomes, Gwen Nugent, Susan Sheridan Jan 2023

Concern, Conflict, And Chaos: Nebraska Educator Experiences During The Pandemic, Amanda Witte, Amanda Prokasky, Courtney Boise, Renata T.M. Gomes, Gwen Nugent, Susan Sheridan

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

During the spring of 2020, Nebraska’s 983 public schools sat vacant, and Nebraska’s 329,290 Pre-Kindergarten to Grade 12 students were learning in environments other than school. Educators were expected to pivot quickly from traditional classroom instruction to remote experiences. Understanding the effects of the pandemic on educators is necessary to effectively meet their needs and the needs of students. The purpose of this study was to identify and describe the experiences of Nebraska’s urban and rural PreK–Grade 12 educators during the early stages of the COVID-19 pandemic. In surveys collected in July 2020, participants (i.e., superintendents, principals, and teachers) completed …


Mind Wandering In Daily Life: A National Experience Sampling Study Of Intentional And Unintentional Mind Wandering Episodes Reported By Working Adults Ages 25 – 50, Paula C. Lowe Jan 2023

Mind Wandering In Daily Life: A National Experience Sampling Study Of Intentional And Unintentional Mind Wandering Episodes Reported By Working Adults Ages 25 – 50, Paula C. Lowe

Antioch University Full-Text Dissertations & Theses

Numerous researchers have investigated thinking that drifts away from what the individual was doing, thinking that is known as mind wandering. Their inquiries were often conducted in university lab settings with student participants. To learn about mind wandering in the daily life of working adults, this experience sampling study investigated intentional and unintentional mind wandering episodes as reported by working adults, ages 25–50, living across the United States. In this age frame, work and family responsibilities have increased in complexity and overlap. Using a smartphone app, participants were randomly notified to answer experience sampling surveys six times a day for …


From A Boy To A Leader, Alejandro Zayas Jan 2023

From A Boy To A Leader, Alejandro Zayas

Antioch University Full-Text Dissertations & Theses

The following autoethnographic dissertation examines my personal experiences of trauma, abuse, and violence. Drawing on journals, memories, and artifacts from my life, I use self-reflection to illustrate the impacts of trauma on my childhood and adulthood. My traumatic experiences of sexual abuse, childhood violence, and emotional abuse are situated within broader sociocultural contexts of masculinity, Hispanic culture, and social norms. This study illuminates possibilities for healing and transformation for myself and others with shared traumatic backgrounds. It calls for trauma-informed education, masculinity, and resiliency. Evocatively sharing my traumatic life events provides an accessible window into often silenced experiences, bearing witness …


How Cultural Believes Support And Perpetuate Relational Violence: A Delphi Study For Violence Prevention, Alisha D. Guthery Jan 2023

How Cultural Believes Support And Perpetuate Relational Violence: A Delphi Study For Violence Prevention, Alisha D. Guthery

Antioch University Full-Text Dissertations & Theses

This study solicited experts in relational violence across the United States using the Delphi methodology and grounded theory. This research was conducted in two phases and designed to answer two primary questions: (1) What cultural beliefs are involved in relational violence in the United States? And (2) How are the beliefs about relational violence maintained? The findings showed agreement from the experts on the societal beliefs that hold relational violence, the specific beliefs held by the abuser, and the impacts of these beliefs on the survivor. The experts offered ideas for intervention and prevention, which are important contributions to professional …


Sexual Activity Between Victims And Perpetrators Following A Sexual Assault: A Systematic Literature Review And Critical Feminist Analysis, Katie M. Edwards, Christina M. Dardis Jul 2022

Sexual Activity Between Victims And Perpetrators Following A Sexual Assault: A Systematic Literature Review And Critical Feminist Analysis, Katie M. Edwards, Christina M. Dardis

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Rarely are perpetrators found guilty of sexual assault when the victim engaged in sex with the perpetrator following the sexual assault. Although the recent trial of Harvey Weinstein is an exception, the fact that his accusers engaged in consensual sex with him following the alleged assaults ignited debate that garnered international attention. The purpose of this paper was to conduct a systematic review to (1) document the extent to which victims engage in sex with the perpetrator following a sexual assault and (2) examine theoretical explanations for this phenomenon. Five peer-reviewed journal articles published between 1988 and 2016 were identified. …


Understanding Unwanted Sexual Experiences Of Transgender And Gender Diverse Individuals: An Interpretative Phenomenological Study, Melissa Larosa Jul 2022

Understanding Unwanted Sexual Experiences Of Transgender And Gender Diverse Individuals: An Interpretative Phenomenological Study, Melissa Larosa

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Transgender and gender diverse (TGD) people represent a small percent of the population and yet, they experience sexual violence at disproportionately high rates compared to their cisgender counterparts (Grant et al, 2011; James et al., 2016). The purpose of this interpretative phenomenological study is to gain a more nuanced understanding of the role that unwanted sexual experiences play in the lives of transgender and gender diverse people, particularly in relation to how they conceptualize their gender identity and the construct of posttraumatic growth (PTG). Semi-structured interviews were conducted with eight TGD participants who met the inclusion criteria. Two superordinate (i.e., …


Anxiety Patterns In Gifted Adolescents From Parents' Perspectives, Felicia Moreschi May 2022

Anxiety Patterns In Gifted Adolescents From Parents' Perspectives, Felicia Moreschi

Masters Theses & Specialist Projects

This study explores the connection between giftedness and anxiety. Families of gifted adolescents were invited to participate in a survey to identify themes of anxiety within the school and home settings. The Spence Children’s Anxiety Scale, parent report (Spence, 1999) was used as the survey instrument. A total of 18 participants responded. Several themes were revealed based on the responses to questions on the survey. The themes that emerged have been identified as patterns of anxiety, including separation anxiety, physical injury fears, and social anxiety.


Maternal Depression Moderated By Family Resources When Children Have Developmental Disabilities., Timothy B. Smith, Terisa P. Gabrielsen Apr 2022

Maternal Depression Moderated By Family Resources When Children Have Developmental Disabilities., Timothy B. Smith, Terisa P. Gabrielsen

Faculty Publications

Children with developmental disabilities require extensive parental involvement in intervention, but parents with depression may be less able to intervene effectively. We examined prevalence of depression symptoms and predictors among 131 mothers of children with disabilities enrolled in early childhood special education. Participants completed several self-report measures of depression and child and family functioning. Children were directly evaluated using the Battelle Developmental Inventory. One year later, 68 mothers repeated self-report measures. Participants (30%) reported elevated depression symptoms across time. Depression scores were correlated with parental stress and family resources. An interaction between higher maternal depression and higher child functioning with …


Risk And Protective Factors For Sexual Aggression Across The Ecosystem: An Overview, Emily A. Waterman, Katie M. Edwards Jan 2022

Risk And Protective Factors For Sexual Aggression Across The Ecosystem: An Overview, Emily A. Waterman, Katie M. Edwards

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Prevention of sexual aggression (which ranges from perpetration of unwanted sexual contact to attempted/completed rape) is a complex public health and safety issue that requires attention to multiple levels of social ecology (Centers for Disease Control and Prevention, 2004). The social ecological model provides a framework for understanding how risk and protective factors for sexual aggression exist at multiple levels, with some factors being more proximal such as the individual attitudes, and other factors being more distal such as the broader culture (e.g., laws and policies) (Centers for Disease Control and Prevention, 2013). Indeed, research indicates a variety of risk …


Informal And Formal Mentoring Of Sexual And Gender Minority Youth: A Systematic Review, Katie Edwards, Jillian R. Scheer, Victoria Mauer Jan 2022

Informal And Formal Mentoring Of Sexual And Gender Minority Youth: A Systematic Review, Katie Edwards, Jillian R. Scheer, Victoria Mauer

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Research demonstrates that mentoring relationships can promote positive outcomes for youth across numerous domains, a topic of importance to school social workers. Whereas most mentoring research to date has been conducted with heterosexual cisgender youth, there is a growing body of literature that examines mentoring experiences among sexual and gender minority youth (SGMY). The purpose of this article is to conduct a systematic literature review of informal and formal mentoring experiences among SGMY. Results from twelve studies that met inclusion criteria suggested that (1) the majority of SGMY report having a mentor/role model; (2) demographics are generally unrelated to having …


Searching For Mental Health Services: Search Strings And Information Acquisition, Antover Tuliao, Natira D. Mullet, Lindsey G. Hawkins, Derek Holyoak, Marisa Weerts, Anthony Inyang Jan 2022

Searching For Mental Health Services: Search Strings And Information Acquisition, Antover Tuliao, Natira D. Mullet, Lindsey G. Hawkins, Derek Holyoak, Marisa Weerts, Anthony Inyang

Nebraska Center for Research on Children, Youth, Families, and Schools: Faculty Publications

Based on decision sciences and information processing theories, how information is acquired is the foundation of decisions and choices subsequently made. Adapting the Active Information Search methodology, the aim for this study is to examine what information potential mental health clients look for in a service provider through their use of search strings. College students (N = 519) from a large public university from the southwest USA (data collection from August to December 2018) were asked in an online survey to imagine themselves needing mental health services and list down the search string they would use in a search engine …


Feedback For Teachers: What Evidence Do Teachers Find Most Useful?, Thomas R. Guskey, Laura J. Link Jan 2022

Feedback For Teachers: What Evidence Do Teachers Find Most Useful?, Thomas R. Guskey, Laura J. Link

Educational, School, and Counseling Psychology Faculty Publications

The purpose of this exploratory, descriptive study was to investigate teachers’ perceptions of three types of feedback on students’ performance to guide instructional improvements. These include: (1) formative assessment error analyses, (2) mastery charts of class progress on formative assessments, and (3) summative assessment results comparisons with previously taught classes. Self-report survey data from 92, K-12 teachers involved in a pilot mastery learning program revealed that analyses of students’ errors on formative assessments were consistently rated the most useful in planning corrective instruction and in making instructional improvements. Mastery charts and summative assessment results were considered more useful in evaluating …


Sexuality As A Competency: Advancing Training To Serve The Public, Debra Mollen, Dena M. Abbott Jan 2022

Sexuality As A Competency: Advancing Training To Serve The Public, Debra Mollen, Dena M. Abbott

Department of Educational Psychology: Faculty Publications

Sexual health and sexual well-being are vital components of overall physical and mental well-being yet remain largely understudied, approached mainly from disease prevention and intervention perspectives, and generally excluded from most health service psychology training programs. People of color; women; lesbian, gay, and bisexual people; trans and gender diverse; disabled; and poor people are disproportionately adversely impacted by a lack of access to suitable sexual health services and reproductive healthcare. Sex education is inadequate in the United States across the lifespan, including in health service psychology training programs. Therapy clients often have sexual concerns they want to discuss, yet because …


Attachment And Creativity Focused Counseling Intervention For Parents And Adolescents Presenting With A Trauma History, Leah Merle Batty-Hibbs Jan 2022

Attachment And Creativity Focused Counseling Intervention For Parents And Adolescents Presenting With A Trauma History, Leah Merle Batty-Hibbs

Antioch University Full-Text Dissertations & Theses

The central research question that informed this study asks: How do attachment and creativity focused counseling interventions encourage connection between an adolescent and their parent or caregiver? The research study centered on two mother and son dyads that participated in six weeks of a therapeutic intervention. The modality utilized an attachment and creativity focused approach created by the author. Data was collected through a post intervention semi-structured interview with the parent (adult). Data was transcribed and evaluated with an interpretive phenomenological approach. Six themes were identified by a team of researchers. The findings have implications for clinical practice with parents …


Imposter Phenomenon And Ces Doctoral Students, Michael Drane Jan 2022

Imposter Phenomenon And Ces Doctoral Students, Michael Drane

Antioch University Full-Text Dissertations & Theses

The aim of the study was to explore the lived experience of counselor education and supervision students who reported experiencing symptoms of imposter phenomenon (IP). The population included counselor education and supervision students in their first year of their program, with a sample of convenience (N = 4). The method used in this study was an interoperative phenomenological analysis. Data analysis revealed four major themes: (a) counselor education students express self-doubt, lack of confidence and concern about competence, (b) students rate different levels of competence in counselor education and supervision roles, (c) instructor feedback impacts student perceptions of competence, and …


Examining Face-To-Face And Online Supervisee Disclosure Within The Supervisory Alliance, Letitia D'Aria Unger Johnson Jan 2022

Examining Face-To-Face And Online Supervisee Disclosure Within The Supervisory Alliance, Letitia D'Aria Unger Johnson

Antioch University Full-Text Dissertations & Theses

The purpose of this research was to examine face-to-face and online supervisee disclosure within the supervisory alliance. Just as client care pivoted to online platforms, as a result of the COVID-19 pandemic, so did clinical supervision, which was uncharted territory for many, including those familiar with online counseling. The methodology used was consensual qualitative research (CSR). Eight participants were recruited as a sample of convenience, and semistructured interviews were conducted via Zoom. Results indicated domains such as important characteristics of the supervisory relationship, importance of communication, supervisor characteristics related to self-disclosure, positive aspects and negative aspects of online supervision, and …


The Lived Experiences Of Sports Retirement Among Elite, Action Sports Athletes, Gracie Struthers Jan 2022

The Lived Experiences Of Sports Retirement Among Elite, Action Sports Athletes, Gracie Struthers

Antioch University Full-Text Dissertations & Theses

This study explored the lived experiences of sports retirement among elite, action sport athletes. This study examined participants’ retirement experiences, their well-being post-retirement, and recommendations participants had for current athletes about retirement. Interviews were conducted remotely with four participants. Participants identified as Caucasian, in the 25–38 age range, had been involved with their sport competitively for 17.75 years, and had been retired for 3.37 years. Data was collected and analyzed utilizing Interpretive Phenomenological Analysis (IPA). Participants’ experiences during retirement illustrated a significant disruption in their lives and the way they lived. This disruption was characterized by significant grief and distress, …


The Impact Of Creative Arts On Meaning Reconstruction And Loss Adaptation In Widowed Adults, Dani Baker-Cole Jan 2022

The Impact Of Creative Arts On Meaning Reconstruction And Loss Adaptation In Widowed Adults, Dani Baker-Cole

Antioch University Full-Text Dissertations & Theses

In counseling, helping grieving clients find meaning after significant loss is a unique, multidimensional, and lengthy process. This is particularly true in Western societies, where antithetical linear grief models, supported by hegemonic expectations to move on after loss, add exhausting pressure to speed up an individual’s natural grieving process. For that reason, this study examined how creative arts interventions such as using traditional art media and expressive writing, combined with postmodern, nonlinear, culturally sensitive bereavement models, help individuals explore their loss narrative to make meaning and adapt to loss. Specifically, this study examined the impact of a switch from traditional …


The Challenges Faced By University Educators In Singapore When Referring Students To Counsellors: An Instrumental Case Study, Poh Yaip, Steven Ng, Yee Lin Chung Nov 2021

The Challenges Faced By University Educators In Singapore When Referring Students To Counsellors: An Instrumental Case Study, Poh Yaip, Steven Ng, Yee Lin Chung

Research Collection School of Social Sciences

This study examines the difficulties faced by two university professors working in a public, autonomous university in Singapore, when referring students to counselling services. Educators typically observe how students interact and behave in class, and may refer students to counselling services. However, there is little research into how educators experience and view this role, particularly in higher education in Asia. Two university professors who had referred students to their university’s counselling centre took part in semi-structured interviews for the study. From these interviews, the study revealed educators can face a range of challenges in their referral role, such as lack …


Divining Structural Factors Related To Intervention Success Or Failure: Cultural Sexism Versus Other Macro-Level Factors, Blair T. Johnson, Christine M. Curley May 2021

Divining Structural Factors Related To Intervention Success Or Failure: Cultural Sexism Versus Other Macro-Level Factors, Blair T. Johnson, Christine M. Curley

CHIP Documents

This article provides commentary on a spatial meta-analysis published by Price and colleagues (2021); it provides valuable preliminary evidence that a dimension of cultural sexism can countervail efforts for psychotherapy to succeed in samples that focus on girls aged four to 18. Our own study reveals cultural sexism to be markedly associated with at least three macro-level factors: cultural tightness, historical slaveholding (and by implication racism), and sex education inclusiveness. The fact that cultural sexism can be so well predicted by these factors is additional evidence that cultural sexism is real, yet it also suggests caution in interpreting these effects …


Effects Of Psychosocial Support Interventions On Survival In Inpatient And Outpatient Healthcare Settings: A Meta-Analysis Of 106 Randomized Controlled Trials, Timothy B. Smith, Julianne Holt-Lunstad May 2021

Effects Of Psychosocial Support Interventions On Survival In Inpatient And Outpatient Healthcare Settings: A Meta-Analysis Of 106 Randomized Controlled Trials, Timothy B. Smith, Julianne Holt-Lunstad

Faculty Publications

We evaluated randomized controlled trials (RCTs) of psychosocial support interventions in inpatient and outpatient healthcare settings reporting survival data, including studies reporting disease-related or all-cause mortality. LOdds ratio (OR) and hazard ratio (HR) data were analyzed separately using random effects weighted models. Of 42,054 studies searched, 106 RCTs including 40,280 patients met inclusion criteria. Across 87 RCTs reporting data for discrete time periods, the average was OR = 1.20 (95% CI = 1.09 to 1.31, p < 0.001), indicating a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors yielded improved likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, the average was HR = 1.29 (95% CI = 1.12 to 1.49, p < 0.001), indicating a 29% increased probability of survival over time among intervention recipients compared to controls. Among those studies, meta-regressions identified 3 moderating variables: control group type, patient disease severity, and risk of research bias. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. In this meta-analysis, OR data indicated that psychosocial behavioral support interventions promoting patient motivation/coping to engage in health behaviors improved patient survival, but interventions focusing primarily on patients’ social or emotional outcomes did not prolong life. HR data indicated that psychosocial interventions, predominantly focused on social or emotional outcomes, improved survival but yielded similar effects to health information/classes and were less effective among patients with apparently greater disease severity.