Melissa Dawn Pinto-Foltz

Posttest only design. Forty-nine hospitalized adults, recovering from a critical illness, received either MDS or AD educational brochure. Demographic characteristics and self-report measures of AD knowledge were captured at baseline and used as covariates. Helpfulness of the intervention (acceptability) and the outcome variable, intention to complete an AD decision, were assessed after exposure to the MDS intervention or educational brochure (information-only control condition). Conclusions: The MDS was a more acceptable form of education compared to a brochure. After adjusting for covariates, participants exposed to the MDS intervention were 24.7 times more likely to intend to complete an AD compared to those who were assigned to the information-only control condition. Implications for practice: This pilot study establishes the acceptability and initial efficacy of the MDS intervention among individuals with critical illness, who are at high risk for hospital readmission life-sustaining treatment. This study illuminates a teachable moment in which patients are more receptive to interventions to complete an AD....

The Revised Attribution Questionnaire (r-AQ) measures mental illness stigma. This study’s purpose is to evaluate the factor structure of the (r-AQ) and examine the validity of the factor structure in adolescents. A convenience sample (n = 210) of adolescents completed the r-AQ and these data were used in exploratory (EFA) and confirmatory factor analyses (CFA). The EFA established a five item single factor structure, which we called the modified r-AQ and captures the negative emotional reactions to people with mental illness, a domain of mental illness stigma. The CFA established the validity of the factor structure (χ² = 2.4, df = 4, p = .659, TLI = 1.042, CFI = 1.00, RMSEA = .000). Internal consistency reliability for the scale was acceptable (α = .70). The modified r-AQ is a reliable and valid measure of the emotional reaction to people with mental illness.

Little is known about recruiting and retaining adolescent mothers in research studies. Investigators who study adolescent mothers have been guided by trial and error, clinical experience, qualitative inquiry, literature of special populations, or the advice of stakeholders. This paper describes the challenges and lessons learned in engaging adolescent mothers in a longitudinal community-based mental health intervention study. Audio-recorded data that describes the circumstances of five adolescent mothers lost to attrition were extracted from a longitudinal mental health intervention study. Adolescent mothers described a chaotic home environment with multiple demands, family conflict, health issues, limited access to a telephone, transportation, financial, and social support. Utilizing a multidisciplinary community advisory group, dedicated telephone, and free electronic media may assist in overcoming modifiable barriers to recruitment and retention of adolescent mothers. Exploring a waiver of informed consent and the engagement of mothers of adolescents in research are indicated.

Depression is prevalent among adolescent girls, but few receive mental health treatment. Adolescent girls often forgo needed mental health treatment because they fear responses of peers about depression. Understanding the processes of how adolescent girls respond to peers with depression is an important first step to improve access to mental health treatment. This qualitative study describes the knowledge, perceptions, and behaviors of adolescent girls about depression and mental health treatment within their peer group. The investigators conducted two focus groups, with adolescent girls (n = 21), in a public high school in the southern U.S. Grounded theory methods were utilized to identify a beginning substantive theory about perceptions and behaviors of adolescent girls related to depression in their peers. Participants cognitively processed mental health concepts similarly to adults. However, their affective responses to peers with mental illness fluctuated between adult and child perspectives. Participants expressed concerns about individuals with depression that have previously been identified in adults, but expressed unique perspectives that reflect their transitional stage of development. Findings provide new information about how adolescent girls respond to peers with depression, define areas for further investigation, provide directions for constructing developmentally appropriate mental health educational interventions for adolescent girls, and elucidate the need to provide guidance to women with whom adolescent girls have sustained contact.