Conducting Research with Stigmatized Populations: Practices, Challenges, and Lessons Learned

Conducting research with communities who are at risk of being stigmatized can be a challenging endeavor. It is often difficult to reach and recruit individuals for research purposes regarding a stigmatized condition or situation. Yet, researchers in our field have recognized the importance of work in this area and have individually developed a range of strategies to reach, recruit, and work with these populations. This workshop will invite researchers and practitioners to present, discuss, and compare strategies and experiences when working with stigmatized communities in the context of the ever-evolving nature of technology. The outcomes of the workshop will include an outline for an article that will summarize the strategies and practices discussed as well as identify the approaches that have led to the best outcomes across different populations

Qualitative study exploring the phenomenon of multiple electronic prescribing systems within single hospital organisations

BACKGROUND: A previous census of electronic prescribing (EP) systems in England showed that more than half of hospitals with EP reported more than one EP system within the same hospital. Our objectives were to describe the rationale for having multiple EP systems within a single hospital, and to explore perceptions of stakeholders about the advantages and disadvantages of multiple systems including any impact on patient safety. METHODS: Hospitals were selected from previous census respondents. A decision matrix was developed to achieve a maximum variation sample, and snowball sampling used to recruit stakeholders of different professional backgrounds. We then used an a priori framework to guide and analyse semi-structured interviews. RESULTS: Ten participants, comprising pharmacists and doctors and a nurse, were interviewed from four hospitals. The findings suggest that use of multiple EP systems was not strategically planned. Three co-existing models of EP systems adoption in hospitals were identified: organisation-led, clinician-led and clinical network-led, which may have contributed to multiple systems use. Although there were some perceived benefits of multiple EP systems, particularly in niche specialities, many disadvantages were described. These included issues related to access, staff training, workflow, work duplication, and system interfacing. Fragmentation of documentation of the patient's journey was a major safety concern. DISCUSSION: The complexity of EP systems' adoption and deficiencies in IT strategic planning may have contributed to multiple EP systems use in the NHS. In the near to mid-term, multiple EP systems may remain in place in many English hospitals, which may create challenges to quality and patient safety.Peer reviewe

Co-designing digital tools to support students' social challenges during and beyond COVID-19

The sudden emergence of the COVID-19 pandemic impacted everyone’s way of life, but it took an especially heavy toll on college and university students' mental health and well-being, in part due to the limited social interactions and increased isolation. With the evolving nature of the pandemic, students must balance social engagements with the risks to themselves and loved ones. This preliminary work focuses on understanding college students' current and desired social interactions, social challenges they have faced during COVID-19, and anticipated social challenges beyond COVID-19 and explores the potential of mobile apps to support their social needs moving forward. As a first step, we conducted two human-centered design workshops with nine students to better understand their experiences, concerns, and generate ideas for digital solutions. Participants discussed the value of social relationships, the ways they adapted during COVID-19 in order to maintain some level of social interaction, and the challenges to engaging in social interactions even as more activities move in person. Priorities for digital tools centered around assessing risk and increasing visibility about vaccination status and mask use in order to make informed decisions about their participation in social activities

A content analysis of popular diet, fitness, and weight self-tracking mobile apps on Google Play

Mobile health applications, especially diet, weight, and fitness apps, have become increasingly popular over the years. However, the content and quality of these apps is not well understood. In order to address this, we performed a preliminary content analysis of the diet, weight, and fitness mobile apps on the Google Play Store to better understand the features of such apps. We conducted a descriptive analysis of 159 relevant apps and analyzed the top free 15 for tracked indicators, goal setting, types of input, reminders and notifications, social and community features, and connecting to experts. Based on these preliminary findings, we identify gaps and discuss their importance to future research in this space

Information Presentation in Health Apps and Devices: The Effect of Color, Distance to Goal, Weight Perception, and Interest on Users' Self-Efficacy for Accomplishing Goals

Colors elicit different emotions and can impact behavior. However, few studies have examined the effects of color in health apps and devices. While these devices are becoming increasingly popular, little research has examined how the presentation of feedback within these technologies impacts users’ beliefs, such as self-efficacy. Yet understanding how information presentation affects users’ self-efficacy is important as self-efficacy is linked to successful behavior change. This study explores how manipulating the color of an exercise progress bar within a simulated health device influences users’ self-efficacy for completing today’s exercise goal and future exercise goals. This preliminary study aims to better understand how color choice, distance to goal, users’ weight perception, and interest in completing an exercise goal affect users' self-efficacy by simulating health app exercise progress bars. By understanding what influences self-efficacy, we can design better health apps and devices to increase the likelihood that users will reach their goals.ye

The inverse-trans-influence in tetravalent lanthanide and actinide bis(carbene) complexes

Across the periodic table the trans-influence operates, whereby tightly bonded ligands selectively lengthen mutually trans metal–ligand bonds. Conversely, in high oxidation state actinide complexes the inverse-trans-influence operates, where normally cis strongly donating ligands instead reside trans and actually reinforce each other. However, because the inversetrans-influence is restricted to high-valent actinyls and a few uranium(V/VI) complexes, it has had limited scope in an area with few unifying rules. Here we report tetravalent cerium, uranium and thorium bis(carbene) complexes with trans C¼M¼C cores where experimental and theoretical data suggest the presence of an inverse-trans-influence. Studies of hypothetical praseodymium(IV) and terbium(IV) analogues suggest the inverse-trans-influence may extend to these ions but it also diminishes significantly as the 4f orbitals are populated. This work suggests that the inverse-trans-influence may occur beyond high oxidation state 5f metals and hence could encompass mid-range oxidation state actinides and lanthanides. Thus, the inverse-trans-influence might be a more general f-block principle

Terminal uranium(V/VI) nitride activation of carbon dioxide and carbon disulfide: factors governing diverse and well-defined cleavage and redox reactions

The reactivity of terminal uranium(V/VI) nitrides with CE2 (E=O, S) is presented. Well-defined C=E cleavage followed by zero-, one-, and two-electron redox events is observed. The uranium(V) nitride [U(TrenTIPS)(N)][K(B15C5)2] (1, TrenTIPS=N(CH2CH2NSiiPr3)3; B15C5=benzo-15-crown-5) reacts with CO2 to give [U(TrenTIPS)(O)(NCO)][K(B15C5)2] (3), whereas the uranium(VI) nitride [U(TrenTIPS)(N)] (2) reacts with CO2 to give isolable [U(TrenTIPS)(O)(NCO)] (4); complex 4 rapidly decomposes to known [U(TrenTIPS)(O)] (5) with concomitant formation of N2 and CO proposed, with the latter trapped as a vanadocene adduct. In contrast, 1 reacts with CS2 to give [U(TrenTIPS)(κ2-CS3)][K(B15C5)2] (6), 2, and [K(B15C5)2][NCS] (7), whereas 2 reacts with CS2 to give [U(TrenTIPS)(NCS)] (8) and “S”, with the latter trapped as Ph3PS. Calculated reaction profiles reveal outer-sphere reactivity for uranium(V) but inner-sphere mechanisms for uranium(VI); despite the wide divergence of products the initial activation of CE2 follows mechanistically related pathways, providing insight into the factors of uranium oxidation state, chalcogen, and NCE groups that govern the subsequent divergent redox reactions that include common one-electron reactions and a less-common two-electron redox event. Caution, we suggest, is warranted when utilising CS2 as a reactivity surrogate for CO2

Evaluation of a pilot implementation of a digital cognitive behavioral therapy platform for isolated older adults in county mental health services.

BACKGROUND: Technology-enabled services (TESs) have the potential to increase access to mental healthcare. However, little research has focused on how TESs can be integrated into publicly funded service settings. As part of the state-wide Help@Hand project, Marin County conducted a pilot implementation of myStrength, a digital cognitive behavioral therapy platform, to explore its potential to reduce loneliness among isolated older adults. We evaluated the pilot impact using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. METHOD: A single-site 6-month pilot implementation recruited English (n = 15) and Spanish-speaking (n = 15) isolated older adults who received a digital literacy course followed by 8 weeks of myStrength access and human support. We evaluated factors related to reach, effectiveness, adoption, and implementation using the perspectives of users and County staff. Descriptive statistics were used to examine reach, adoption, and implementation. Nonparametric tests, including Friedman and Wilcoxon signed-rank, were used to examine effectiveness. RESULTS: Reach: Compared to overall county demographics, platform users were majority female (93.1% vs. 50.5%), ethnoracialized (62.1% vs. 24.2%), and of lower socioeconomic status (Mdn = $35,000 vs.$131,008). Effectiveness: Users reported a significant (z = -2.62, p < .001) decrease in loneliness. Adoption: Users logged into myStrength an average of 10 times and completed 33 activities during the 8 weeks of myStrength use. Implementation: Each pilot staff (N = 20) spent an average of 19.8 hr (SD = 16.51) supporting users use of myStrength during the pilot. Pilot staff reported several adaptations to meet the needs of users. CONCLUSIONS: Successes included reaching the target population, reducing loneliness, and user adoption. However, pilot staff invested significant time to support those with lower digital literacy skills. As such, although TESs may address unmet needs, their use with underserved populations may require upfront and ongoing support provided by the settings where they are implemented. PLAIN LANGUAGE SUMMARY TITLE: Testing a New Digital Therapy Tool for Isolated Older Adults in County Mental Health Services

Conducting Research with Stigmatized Populations: Practices, Challenges, and Lessons Learned

Conducting research with communities who are at risk of being stigmatized can be a challenging endeavor. It is often difficult to reach and recruit individuals for research purposes regarding a stigmatized condition or situation. Yet, researchers in our field have recognized the importance of work in this area and have individually developed a range of strategies to reach, recruit, and work with these populations. This workshop will invite researchers and practitioners to present, discuss, and compare strategies and experiences when working with stigmatized communities in the context of the ever-evolving nature of technology. The outcomes of the workshop will include an outline for an article that will summarize the strategies and practices discussed as well as identify the approaches that have led to the best outcomes across different populations