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Articles 61 - 90 of 676
Full-Text Articles in Mental and Social Health
Exploring Mental Health In Veterinary Students: Common Stressors And Effective Coping Strategies: A Narrative Review, Rahib K. Islam, Emily K. Cobb, Hannah K. Mccowan, Kylie Watson, Kaustuv Bhattacharya, Anjali Chandra, Warda Mohiuddin, Karen Gruszynski, Amanda H. Wilkerson, John J. Dascanio, Robert E. Davis, Vinayak K. Nahar
Exploring Mental Health In Veterinary Students: Common Stressors And Effective Coping Strategies: A Narrative Review, Rahib K. Islam, Emily K. Cobb, Hannah K. Mccowan, Kylie Watson, Kaustuv Bhattacharya, Anjali Chandra, Warda Mohiuddin, Karen Gruszynski, Amanda H. Wilkerson, John J. Dascanio, Robert E. Davis, Vinayak K. Nahar
School of Medicine Faculty Publications
INTRODUCTION: Veterinary students face significant challenges impacting their mental health and wellbeing. The rigorous academic curriculum, high expectations, and demanding clinical training create an environment of intense pressure and constant stress. This review explores the demographic and psychosocial variables influencing mental health outcomes, highlighting common stressors and coping strategies. METHODS: A systematic literature search was conducted using PubMed, CAB Abstracts, and Google Scholar. Studies published up to 2021 involving veterinary students were included. Twenty-one peer-reviewed studies met the inclusion criteria. Demographic data, stressors, mental health measures, and coping strategies were extracted and analyzed. Studies focused on various mental health aspects, …
Improving Outcomes Of Depression Through Implementation Of Depression Screenings At A College Health Center, Shelby Leigh Hanigan
Improving Outcomes Of Depression Through Implementation Of Depression Screenings At A College Health Center, Shelby Leigh Hanigan
Electronic Theses and Dissertations
Depression is a common phenomenon. Depression and suicidality are a problem on university campuses. This quality improvement Doctor of Nursing project aimed to establish the importance of routine depression screenings within a college health clinic. The purpose of this project was to determine if implementing routine depression screenings at a university health clinic will or will not increase the number of counseling referrals when compared to the absence of depression screenings in place within an identified timeframe. This protocol screened for depression in college-aged students and suggested care to those students who screened positive. It also led an interprofessional team …
Acceptance And Commitment Therapy With Huntington's Disease: A Narrative Review And Case Report Of A Caregiver-Assisted Intervention, Simone H. Schriger, Chelsi N. Nurse, C. Virginia O'Hayer
Acceptance And Commitment Therapy With Huntington's Disease: A Narrative Review And Case Report Of A Caregiver-Assisted Intervention, Simone H. Schriger, Chelsi N. Nurse, C. Virginia O'Hayer
Department of Psychiatry and Human Behavior Faculty Papers
Acceptance and commitment therapy (ACT) is an experiential, action-oriented talk therapy that emphasizes acceptance of painful inner experience through increased psychological flexibility. In this narrative review and case report, we first review the extant literature on applications of ACT to patients with a variety of mental and physical health challenges, including neurodegenerative disorders, and their caregivers. We then discuss applications of ACT to Huntington's disease (HD). We provide a case report of a 52-year-old man living with HD who, accompanied by his caregiver, received a virtually-delivered 6-session ACT intervention. We measured the patient's self-reported symptoms of depression (PHQ-9) and anxiety …
Infertility Stigma And Openness With Others Are Related To Depressive Symptoms And Meaning In Life In Men And Women Diagnosed With Infertility, Brennan Peterson, Orit Taubman‑Ben‑Ari, Bonnie Chiu, Douglas Brown, David A. Frederick
Infertility Stigma And Openness With Others Are Related To Depressive Symptoms And Meaning In Life In Men And Women Diagnosed With Infertility, Brennan Peterson, Orit Taubman‑Ben‑Ari, Bonnie Chiu, Douglas Brown, David A. Frederick
Psychology Faculty Articles and Research
Background
Stigma is the experience of feeling different from socially accepted norms which can lead to personal devaluation or fear of disapproval from others. For men and women experiencing infertility, stigma has been associated with psychological distress, feelings of otherness in relation to people with children, and selective disclosure with others about their infertility challenges. However, there are few studies which examine how infertility stigma and being open with others are related to depressive symptoms and meaning in life for men and women diagnosed with infertility.
Methods
Participants experiencing infertility were recruited for this cross-sectional study during November 2023-January 2024 …
Mental Health Conditions Of Adults With Chronic Obstructive Pulmonary Disease And Comorbidities, Amanda M. Hinson-Enslin, Luis E. Espinoza, Jennifer L. Talleff
Mental Health Conditions Of Adults With Chronic Obstructive Pulmonary Disease And Comorbidities, Amanda M. Hinson-Enslin, Luis E. Espinoza, Jennifer L. Talleff
Journal of Social, Behavioral, and Health Sciences
Although the association is not well understood, people with COPD are likely to suffer from mental health issues such as depression and anxiety. Due to this occurrence, the aim of the present study is to better understand the mental health experience and COPD comorbidities of U.S. adults with a COPD diagnosis. The final sample comprised 1,676 U.S. adults who were surveyed in the 2019 National Health Interview Survey adult public file. Logistic and ordinal regression were used to calculate adjusted odds ratios for comorbid conditions predicting depression, anxiety, and the number of mental health issues, respectively. Depressive symptoms were more …
Prevalence Of Depression Among Type 2 Diabetes Mellitus Patients In Urban Mysuru – A Cross-Sectional Study, Jesymol Joy, Renuka M, Chiranjeevi G S
Prevalence Of Depression Among Type 2 Diabetes Mellitus Patients In Urban Mysuru – A Cross-Sectional Study, Jesymol Joy, Renuka M, Chiranjeevi G S
Digital Journal of Clinical Medicine
Background: Depression is a significant comorbidity among individuals with Type 2 Diabetes Mellitus (T2DM) adversely affecting disease management and overall quality of life. Diabetes and depression have a bidirectional relationship, where poorly managed diabetes increases the risk of depression, and depression exacerbates diabetes-related complications. Depression contributes to poor glycemic control, decreased adherence to treatment, increased risk of diabetes-related complications, and higher healthcare utilization.
Objectives: To determine the prevalence of depression and its associated factors among Type 2 Diabetes Mellitus patients in urban Mysuru.
Methods: A community-based cross-sectional study was conducted among 300 Type 2 Diabetes mellitus patients >18 years of …
Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood
Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood
Masters Theses
Mindfulness is a practice of intentionally paying attention to the present moment in a nonjudgmental way. Being more mindful can decrease symptoms of anxiety, depression, and stress, among other mental and physical health improvements. (Donald et al., 2016; Hofmann et al., 2010; Kabat-Zinn et al.,1992). This study examined if balanced time perspective (BTP) is one of the mechanisms of action of mindfulness in its relationship with depression, anxiety, and stress. BTP refers to a person’s ability to flexibly adapt their time perspective (attention to the past, present, or future, and positive or negative attitudes toward each) to suit the current …
Hypnosis: An Evidenced Based Treatment, Gregory P. Brown
Hypnosis: An Evidenced Based Treatment, Gregory P. Brown
Psychiatry & Behavioral Health Faculty Research
Review of meta analyses and systemic review level studies of hypnosis in the treatment of anxiety, burnout, and depression.
Ministry Organization Response To The Mental Health Crisis, Bryn L. Wood
Ministry Organization Response To The Mental Health Crisis, Bryn L. Wood
Senior Honors Theses
The mental health crisis has been negatively affecting individuals across the globe for about half a century, only growing in its impact each year. However, following the Covid-19 pandemic, mental health crises skyrocketed. This is especially true for youth and young adults as physical isolation has altered many facets of their lives. This thesis will explore the mental health crisis, as well as the way it has impacted youth and young adult organizations. Specifically, it will discuss research on recommended ways for these organizations to respond to the mental health crisis through unique programming and how these practices have been …
Ketamine Infusion Treatment For Depression, Isabella Schwing
Ketamine Infusion Treatment For Depression, Isabella Schwing
Capstone Showcase
Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.
Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …
The Association Of Vitamin D Status In Us Adults With Depression: Nhanes 2011 - 2018, Joshua A. Yearout
The Association Of Vitamin D Status In Us Adults With Depression: Nhanes 2011 - 2018, Joshua A. Yearout
All Master's Theses
ABSTRACT
Background: Vitamin D (VD), essential for bone health and various physiological processes, has been increasingly associated with mental health, particularly depression. Depression is the most common and prevalent of disorders regarding mental health. It is influenced by biological, psychological, and socioeconomic factors. This study examines association and the interplay of both vitamin D deficiency (VDD) and depression among adults 18- 70+ residing in the U.S, focusing on disparities across demographic and socioeconomic groups.
Methods: Data was taken from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. The present study utilized a cross-sectional analysis included 7,981 participants aged 18 …
Social Determinants Of Mental Health Outcomes, Ariana Fein
Social Determinants Of Mental Health Outcomes, Ariana Fein
Honors Theses
Mental health disorders, particularly anxiety and depression, are a growing global concern with profound consequences on individuals' well-being and societal functioning. The burden of these disorders is not only psychological but also economic, affecting quality of life. Mental health outcomes are heavily influenced by a range of social determinants, such as financial status, education, and access to healthcare. While extensive research has focused on WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries, there remains a significant gap in understanding how these determinants affect mental health in low-resource settings or non-WEIRD countries. This study aimed to address this gap by exploring the …
Comparative Efficacy Of Hallucinogens In Treating Mood Disorders Through A Meta-Analysis Of Symptom Reduction, Dosage, And Duration, John Marco D.F. Muniz
Comparative Efficacy Of Hallucinogens In Treating Mood Disorders Through A Meta-Analysis Of Symptom Reduction, Dosage, And Duration, John Marco D.F. Muniz
Honors Undergraduate Theses
Background: Hallucinogens including psilocybin, lysergic acid diethylamide (LSD), ketamine, N,N-dimethyltryptamine (DMT) (as ayahuasca), have re-emerged as potential rapid-acting treatments for mood disorders. We conducted a meta-analysis of placebo-controlled trials evaluating their efficacy in depression and anxiety disorders. Methods: A systematic review identified 12 trials (Total ≈ 670) meeting inclusion criteria (randomized, placebo-controlled). Data on Cohen’s d and Hedges’ g effect sizes for depression- and anxiety-related outcomes were extracted. We computed pooled effect sizes (weighted by sample size and inverse variance), performed subgroup analyses by drug, diagnosis, follow-up duration, and outcome measure type, and assessed heterogeneity (I2, Q …
The Impact Of Nutrition On Depressive And Anxiety Symptoms In Adults, Joseph P. Galabit
The Impact Of Nutrition On Depressive And Anxiety Symptoms In Adults, Joseph P. Galabit
Graduate Research Projects
No abstract provided.
Nurse-Led Cbt For Depression In Heart Transplant Patients: A Feasibility Study, Matthew R. Wallace
Nurse-Led Cbt For Depression In Heart Transplant Patients: A Feasibility Study, Matthew R. Wallace
DNP Projects
Background: Heart transplant recipients are at an elevated risk of experiencing depressive symptoms compared to the general population. Those with depression post-transplant face increased complications, e.g., infection, organ rejection, prolonged hospitalization, and higher mortality rates. However, specific psychotherapeutic interventions tailored for heart transplant recipients remain limited. Nevertheless, there is substantial evidence supporting the effectiveness of various interventions for adults with heart failure, a condition frequently diagnosed in these patients. This suggests that successful strategies for managing depressive symptoms in heart failure patients could be adapted for heart transplant recipients.
Purpose: The purpose of this project was to evaluate …
Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C
Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C
Digital Journal of Clinical Medicine
Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.
Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …
Examining The Relationship Between Bicultural Stress And Mental Well-Being Among Second-Generation Filipino Americans Living In The United States, Krista Parker
Antioch University Dissertations & Theses
Research investigating the bicultural and mental health experiences of Filipino Americans, the third largest Asian American group in the United States, are consistently overlooked, with second-generation Filipino Americans (SGFAs) facing greater risk of adverse mental health outcomes. This quantitative study addresses a critical gap in research by examining the relationship between bicultural stress and mental well-being among SGFAs living in the United States. Using a cross-sectional survey design, a multivariate regression analysis examined the relationship between bicultural stress and four mental health constructs (as measured by depression, anxiety, stress, and self-esteem) among 302 SGFA participants. Results from this study strongly …
Subthreshold Depression In The National Epidemiologic Survey On Alcohol And Related Conditions Iii (Nesarc-Iii): A Quantitative Analysis Of Prevalence, Characteristics, And Burden In A Nationally Representative Sample, Scott T. Young
Antioch University Dissertations & Theses
While subthreshold depression (subD) is relatively young for a diagnostic concept at a mere half century old, it has burdened individuals and societies for far longer. Research has established that it is a highly prevalent, clinically important entity with clear links to personal distress and impairment (including increased suicidal ideation and behavior), societal burden (e.g., increased reliance on public assistance programs), and economic costs (both personal and public). Research has also demonstrated that it represents a significant risk factor for incident major depression (MD) and that it likely represents both a prodromal and residual state in the normal course of …
The Association Between Sleep Quality, Depression, Anxiety, And Job-Related Stress Among Nurses In Saudi Arabia, Romeo Jr Patague Mostoles
The Association Between Sleep Quality, Depression, Anxiety, And Job-Related Stress Among Nurses In Saudi Arabia, Romeo Jr Patague Mostoles
Makara Journal of Health Research
Background: This study examined the mediating role of sleep quality in the relationship between depression, anxiety, and job-related stress among nurses in Saudi Arabia.
Methods: Sociodemographic information, Pittsburgh Sleep Quality Index, depression, anxiety, and work-related stress were evaluated in 851 nurses. Structural equation modeling was used to investigate the mediation effect of sleep quality on mental health and job stress in nurses.
Results: High rates of anxiety (65.9% severe, 34.1% moderate), depression (37.2% moderate to severe), and poor sleep (51.4%) were found. Sex, marital status, education, nationality, and smoking status significantly influenced mental health outcomes. For example, …
Fda Approval Of Zuranolone: A Breakthrough Treatment For Postpartum Depression, Connor Dains, Makayla Eversole, Kiley Devoll, Daniella Egbujor, Marisa Petrunich, Madilyn Paphanchith, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza
Fda Approval Of Zuranolone: A Breakthrough Treatment For Postpartum Depression, Connor Dains, Makayla Eversole, Kiley Devoll, Daniella Egbujor, Marisa Petrunich, Madilyn Paphanchith, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza
Pharmacy and Wellness Review
Postpartum depression (PPD) is a serious medical condition that increases the risk of postpartum mortality and affects the ability of a postpartum individual to take care of their newborn. Until 2023, intravenously-administered brexanolone was the only Food and Drug Administration (FDA)-approved medication for PPD. Brexanolone’s route of administration poses significant barriers to accessibility and convenience. Other treatment options, such as psychotherapy and antidepressants, often require long-term commitment and may not provide rapid relief for severe symptoms. In August 2023, the FDA approved zuranolone as an oral medication for PPD, which enhances treatment accessibility and offers patients a more flexible, outpatient …
Cognitive Behavioral Therapy (Cbt) Interventions For Group Therapy For College Students Experiencing Depression, Ty Ogren
Dissertations, Theses, and Projects
This group manual was created to support college students struggling with a depressive mood disorder such as Major Depressive Disorder. The instance of mental health concerns, including depression, have increased greatly over the last several years. Depression is the most common mental health concern for college students, and the rate at which they experience depressive symptoms has exceeded that of the general population. Depressive symptoms in college students can lead to many concerns like poor academic achievement, self-isolation, poor diet and nutrition, and suicidal ideation (Liu et al., 2022). This group manual aims to equip college students struggling with depression …
Conceptualization, Measurement, And Contributors To Participation Among People Living With Parkinson’S Disease, Moon Young Kim
Conceptualization, Measurement, And Contributors To Participation Among People Living With Parkinson’S Disease, Moon Young Kim
WUSM Theses and Dissertations – All Programs
Participation is a key outcome of rehabilitation and key to successful aging. Individuals with Parkinson’s disease (PD) often experience significant challenges in maintaining participation in meaningful activities and roles. This dissertation examines the influence of living with PD on participation by integrating findings from three studies: a systematic review, a cross-sectional study, and a longitudinal study.
The systematic review synthesized the existing quantitative research on participation in people with PD, revealing inconsistencies in the conceptualization of participation. While the evaluation tools aimed at assessing participation in PD showed acceptable coverage of domains of participation, the assessment of the aspects of …
The Relationships Between Binge-Watching Behavior, Content Familiarity, Depression, And Anxiety, Emma Miller
The Relationships Between Binge-Watching Behavior, Content Familiarity, Depression, And Anxiety, Emma Miller
Master's Theses & Other Graduate Student Works
This December 2024 Master of Science in Psychology thesis at Lipscomb University analyzes how binge-watching has become a dominant media consumption behavior, yet its psychological impacts remain understudied. This thesis examines the relationships between binge-watching behavior, content familiarity, depression, and anxiety, with a focus on whether familiarity moderates mental health outcomes. A sample of 94 participants completed surveys measuring binge-watching habits, content familiarity, and mental health indicators using the CES-D and SCAARED scales. Results from multiple regression analyses indicated that age, content familiarity, and viewing context significantly predicted depression, while only age predicted anxiety. Notably, participants who binge-watched familiar content …
Effect Of Pilot Mental Health On Passenger Willingness To Fly, Isabella L. Deloach, Sara E. Bergamini, Dowon Choi, Brooke Wheeler, Vivek Sharma
Effect Of Pilot Mental Health On Passenger Willingness To Fly, Isabella L. Deloach, Sara E. Bergamini, Dowon Choi, Brooke Wheeler, Vivek Sharma
Aeronautics Student Publications
This study explored how passengers' willingness to fly is affected by the mental health condition of pilots, providing insight into public perception of the mental health condition of pilots. Results showed significant differences between all scenarios except the medication scenario vs. therapy scenario.
Family Members’ Experiences With Depression Through The Lens Of Frank's Illness Narratives, Amanda Cole, Julie Ann Pooley, Lisa Whitehead
Family Members’ Experiences With Depression Through The Lens Of Frank's Illness Narratives, Amanda Cole, Julie Ann Pooley, Lisa Whitehead
Research outputs 2022 to 2026
Background: Depression impacts around 300 million people worldwide and places significant strain on families who care for relatives with chronic mental health conditions. This strain can lead to substantial burdens and affect the mental health and well-being of family members. Aim: This study explores family members’ experiences with depression through the lens of Frank's illness narratives. Methods: Employing a narrative inquiry approach, interviews were conducted with eight family members of adults diagnosed with major depressive disorder. The data were analysed through the lens of Frank's illness narratives. Findings: Family members’ experiences revealed a complex interplay of narratives that reflected the …
Psychological Distress Among Family Caregivers Of Persons With Alzheimer’S Disease And Related Dementias In Uganda, Martha Sajatovic
Psychological Distress Among Family Caregivers Of Persons With Alzheimer’S Disease And Related Dementias In Uganda, Martha Sajatovic
Faculty Scholarship
Background: Alzheimer's disease and related dementias (ADRD) present growing global health challenges, especially in aging populations, such as Uganda. In Uganda, familial caregiving, predominantly undertaken by female relatives, is the primary form of support provided to patients with ADRD. Cultural stigma around dementia and limited access to support services amplify caregivers' challenges. This study examined psychological distress, depression, and quality of life (QoL) among family caregivers of patients with ADRD in Wakiso District, Uganda. Methods: This cross-sectional study involved 90 caregivers from three sub-counties in Wakiso, selected through purposive sampling to capture diverse experiences. Participants included caregivers aged 18 years …
Preventing Depression In Grandparents Raising Grandchildren: An Educational Video Series, Sabrina Casares, Steven Gerardi, Meghan Skidmore
Preventing Depression In Grandparents Raising Grandchildren: An Educational Video Series, Sabrina Casares, Steven Gerardi, Meghan Skidmore
Fall 2024 OTD Capstone Symposium
Grandparent caregivers often face increased risk for depression, yet access to mental health resources—particularly self-help approaches—is limited. Texas Grandparents Raising Grandchildren (TXGRG), a non-profit organization supporting grandparent caregivers, lacked a specific mental health resource to address this need. This capstone project developed and implemented a self-help, occupation-based educational video series to provide practical strategies for preventing and managing depression. Designed for accessibility and ease of use, the video series offers tools grounded in daily occupations to promote mental well-being. This project fills a critical gap by equipping TXGRG and its caregivers with a proactive, occupation-focused mental health resource to support …
Mortality Risks Associated With Depression In Men With Prostate Cancer, Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Weiva Sieh
Mortality Risks Associated With Depression In Men With Prostate Cancer, Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Weiva Sieh
Faculty, Staff and Student Publications
Background: Men diagnosed with prostate cancer (PC) have an increased risk of depression; however, it is unclear to what extent depression affects long-term survival. A better understanding of such effects is needed to improve long-term care and outcomes for men with PC.
Objective: To determine the associations between major depression and mortality in a national cohort of men with PC.
Design, setting, and participants: A national cohort study was conducted of all 180 189 men diagnosed with PC in Sweden during 1998-2017. Subsequent diagnoses of major depression were ascertained from nationwide outpatient and inpatient records through 2018.
Outcome measurements and …
Study Abroad Angst: A Literature Review On The Mental Health Of International Students During Covid-19, Daisuke Akiba, Michael Perrone, Caterina Almendral
Study Abroad Angst: A Literature Review On The Mental Health Of International Students During Covid-19, Daisuke Akiba, Michael Perrone, Caterina Almendral
Publications and Research
Background: The COVID-19 pandemic presented unique and unprecedented challenges for international students, those studying at institutions of higher education outside of their home countries, due to their distinct circumstances and vulnerabilities. This literature review examines the multifaceted mental health burdens they experienced and highlights the need for targeted support and interventions. Methods: A rigorous search across three databases (i.e., PubMed, PsycINFO, and ERIC) yielded 50 empirical studies for inclusion in this literature review. A six-phase thematic analysis framework was employed to identify and synthesize key themes. Results: Seven prominent themes emerged: (1) academic and professional disruptions; (2) challenges navigating international …
Building Resilience: A Specialty Clinic Tailored To Older Adults At Risk For Violence And Abuse, Jason Burnett
Building Resilience: A Specialty Clinic Tailored To Older Adults At Risk For Violence And Abuse, Jason Burnett
Faculty, Staff and Student Publications
Objective: Both structural (e.g., ageism) and personal (e.g., stigma) barriers hinder older adults' access to and engagement with mental health care. These barriers are particularly problematic for those vulnerable to interpersonal violence and abuse (e.g., due to social isolation). This study presents a quality improvement program aimed at older adults who have experienced significant stressful events, particularly elder mistreatment, within a larger trauma specialty clinic. Leveraging home-based telemedicine, the clinic provides evidence-based psychotherapy tailored to the needs of older adults.
Methods: From 2021 through 2023, the authors retrospectively examined treatment initiation, engagement, completion, and clinical outcomes among 231 older adults …