Mona Shattell

Peer Recovery Workers (PRWs) bring lived experience to clinical care, offering non-clinical support that enhances engagement and reduces stigma for individuals recovering from substance use disorders. Despite their growing presence, PRWs face systemic challenges that threaten the sustainability of their roles, including low wages, limited advancement, stigmatized experience, and lack of institutional understanding. These challenges differ from mental health peer support roles and reflect the unique demands of substance use recovery settings. This empirical phenomenological study explored the lived experiences of 12 PRWs in the United States through semi-structured interviews. Five key themes were identified: (1) respect in recovery - PRWs valued recognition but often encountered stigma and exclusion; (2) centering the consumer - Participants prioritized consumer needs, fostering trust and connection; (3) connection - Peer work fostered community and personal growth, though boundaries were sometimes difficult to maintain; (4) expertise - PRWs viewed experiential knowledge as complementary to clinical training; and (5) pay and benefits - Low wages, limited advancement, and inadequate benefits were major barriers to PRW retention. These themes indicate that PRWs find fulfillment but face structural barriers that threaten long-term sustainability. Healthcare systems must improve compensation, clarify roles, and provide institutional support to retain and empower PRWs.

Background: Rapid population aging poses significant challenges to health and wellness systems, necessitating innovative technological interventions. Smart home technologies, particularly voice-activated intelligent assistants (smart speakers), represent a promising avenue for supporting aging populations. Objectives: This study critically examines the empirical literature on smart speakers’ influence on older adults’ health and well-being, mapping the characteristics of existing studies, assessing the current state of this domain, and providing a comprehensive overview. Methods: A mixed-methods systematic review was conducted in accordance with published guidelines. Bibliometric data, article purposes and outcomes, keyword network analysis, and mixed-methods findings from articles retrieved from five major databases were managed through the Covidence and VosViewer applications. Results: The majority of studies were conducted in the American region. Bibliometric analysis revealed five predominant thematic clusters: health management, psychological support, social connectedness, technology adoption, and usability. Findings demonstrated multifaceted benefits across several domains. Older adults reported improvements in daily living activities, enhanced emotional well-being, strengthened social connections, and overall health benefits. Qualitative evidence particularly emphasized the advantages of medication adherence, routine maintenance, and facilitated social support. However, mixed-method synthesis revealed significant barriers to adoption and sustained use, including privacy concerns, technical difficulties, cost constraints, and limited digital literacy among older users. Conclusions: The integration of smart speakers into the homes of older adults offers considerable potential to enhance technological wellness and promote successful aging in place, underscoring the need for structured integration of smart speaker technology and human-centered designs within geriatric care systems.

Background: The global rise in the aging population presents significant challenges to healthcare systems, especially with increasing rates of chronic illnesses, mental health issues, and functional decline among older adults. In response, holistic and tech-driven approaches, such as telehealth and remote virtual interactive agents (VIAs), are potential emerging solutions to support the physical, cognitive, and emotional well-being of older adults. VIAs are multimodal digital tools that provide interactive and immersive experiences to users. Despite its promise, gaps still exist in the insights that explore ways of delivering geriatric healthcare remotely. Objective: This systematic review examines the existing literature on remote virtual interventions for older adults, focusing on bibliometrics, study purposes, outcomes, and network analysis of studies extracted from major databases using selected keywords and managed using the Covidence application. Methods and Results: Following five stages, namely, problem identification, a literature search, data evaluation, data analysis, and presentation, the review found that the studies on remote VIAs for older adults (2013–2025) were mostly from a positivist perspective, multi-authored, and U.S.-led, mainly showing positive outcomes for most studies (n = 13/15) conducted in home settings with healthy older participants. The dominance of positivist, US-led studies reflect an epistemological stance that emphasizes objectivity, quantification, and generalizability. VIAs, often pre-programmed and internet-based, supported health promotion and utilized visual humanoid avatars on personal devices. Keyword and network analysis additionally revealed four themes resulting from the review: Health and Clinical, Holistic and Cognitive, Home and Caring, and Hybrid and Connection. Conclusions: The review provides innovative insights and illustrations that may serve as a foundation for future research on VIAs and remote healthcare delivery for older adults.

Interest in improving roadside services for long-haul truckers’ health, safety, and well-being has led to an effort to describe the services offered at truck stop/rest areas. This study aimed to describe services offered in truck stop and rest areas and to determine, based on what was available, their implications for the health of long-haul truck drivers. A systematic and structured direct observation of thirteen truck stop and rest areas was undertaken within one state in the US on a major north–south interstate highway from October 2023 to June 2024. The categories of services observed included food, physical activity, rest, personal hygiene and health, and safety. A descriptive analysis of the data was performed. Seventeen visits were carried out in 13 truck stop and rest areas. All sites offered paved parking areas, with lighting and signage; 92% offered internet access; more than 85% offered food, safety, and personal hygiene services; 69% offered laundry services; 54% had a convenience store and hotel nearby; and 15% had green/natural areas with benches. The services offered at the truck stop and rest areas in this study meet the basic needs of food, personal hygiene, and safety of truckers and can serve as lessons for other states and countries to consider.

Objective: This paper updates the psychiatric mental health (PMH) nursing community regarding the progress of five recommendations for policy and practice to enhance workplace violence (WPV) prevention. This information should be useful to nurses in their efforts to advocate for workplace safety. Methods: A comprehensive search of current literature, organizational action, and national policy relevant to the recommendations are reviewed and discussed to enhance WPV prevention and safety. Results: Workplace safety is a critical concern for PMH nurses and has far-reaching implications in PMH nursing settings. While there has been implementation of state policy around WPV, federal legislation remains stalled. The national accreditation standards continue to provide individual institutions guidance around WPV data collection, reporting, and analysis, but these data do not inform national efforts particularly around defining requirements for mechanisms to support healthcare workplace protection. However, recent research continues to document both prevalence and associated conditions/quality metrics. While dashboards are now available for public reporting of select WPV data, nationally the public reporting standards remain the same. Organizing a nursing voice in WPV reporting resulted in interesting exemplars. Thus far, no data are available on efforts to include safety in nursing curricula. Conclusions: The safety of nurses, particularly PMH nurses, is a multi-faceted problem that will require efforts in regulatory, organizational, educational, and personal behavior change.

The health of road transport workers is affected by working conditions and life. However, there is a lack of studies on the level of stress and health of the families of these workers. This study aimed to evaluate the perceived stress level and family effectiveness of family members of road transport workers. A quantitative study was carried out with the family members of road transport workers in the southern region of Brazil. For data collection, a sociodemographic form, the Perceived Stress Scale (PSS), and the Evaluation of Family Effectiveness Strategies were used. The data were analyzed by simple frequency, Spearman correlation coefficient (ρ) (p < 0.05), and descriptive analysis from the perspective of Systemic Organization. The sample was composed of 49 family members of road transport workers. Perceived stress was higher in family members who had more than nine years of education (p = 0.0403). Family members who scored higher in Family Effectiveness scored high on the targets of Control (p = 0.0353) (Control aims to reduce anxiety and prevent and eliminate events that threaten family stability) and Growth (p = 0.0360) (represented by attitudes that promote new roles in response to critical situations experienced by families, which require re-adaptation processes and adjustments). The Control target was significant (p = 0.0353) in families that had more than three people. The Coherence dimension (concerning self-esteem, body image, personal identity, self-confidence, and sexual identity) presented positive significance (p = 0.0244) in families with health problems and whose income was less than USD 792.00 per month (p = 0.0072). The Individuation dimension (including functions and responsibilities, where talents are reinforced, as well as initiatives that allow for the incorporation of knowledge to assume behaviors against personal/family and environmental pressures), was significant (p = 0.0138) in families with incomes over USD 792.00. The Maintenance System (strategies for decision-making, problem negotiation, ritual and traditional roles, communication patterns, standards, financial management, and approaches to maintaining family harmony) presented positive significance (p = 0.0151) in families where drivers worked as intercity drivers, as did the Stability target (p = 0.0196) (concerning the continuity of routines, structure, organization, traditions, and values assumed by the family and transmitted from generation to generation, which promote unity and the development of values, attitudes, and beliefs). In conclusion, social factors, such as education, income, diseases, type of worker activity in road transport, and number of people in the family, influenced perceived stress and family effectiveness, which demonstrates the need to increase the promotion of health care for the families of road transport workers.

The work and life routine of long-haul truck drivers (LHTDs) involve the use of truck stops and rest areas to meet their basic human needs. These extensions of their workspaces on the road do not always offer adequate physical structures and services that drivers need for optimal health. This study aimed to evaluate long-haul truck drivers’ perceptions of food services, safety, physical activity, rest, and personal hygiene offered at truck stops and rest areas, as well as the correlation between these perceptions and sociodemographic, health, and work conditions variables. A cross-sectional, quantitative, and descriptive study was conducted with long-haul truck drivers from the southern region of Brazil. For data collection, a sociodemographic questionnaire and a Likert scale on food, rest, personal hygiene, safety, and physical activity services offered at truck stops and rest areas along Brazilian roads from March to August 2023 were used. The data were analyzed with simple frequency descriptive statistics. The sample consisted of 175 long-haul truck drivers. Out of these, 70.29% declared that the services of the truck stops and rest areas were charged; more than half (53.59%) of the professionals evaluated the rest service as “good” or “excellent”; the food services were “good” or “excellent” for 42.24% of the drivers. The spaces for physical activities were the worst evaluated as “bad” or “terrible” by 41.61%, followed by bathroom services (28.42%) and safety (34.24%). Rest and feeding services had better evaluations, while the services of bathroom, safety, and physical activity presented worse evaluations. Variables such as nationality, weekly working days, and marital status presented positive significance and influenced drivers’ perceptions of the services offered at truck stops and rest areas. Drivers who were Brazilian and worked more than five days a week negatively evaluated the services of rest (p = 0.018), safety [0.020], physical activity (0.003), and bathrooms (0.020). In addition, the physical activity services were better evaluated by single drivers than married drivers. These findings suggest that the work conditions and nationality may influence LHTDs’ perceptions of services and structures of truck stops and rest areas. These findings may reflect a lack of investments and support efforts to improve basic services such as personal hygiene, a safe environment, and physical exercises, which are fundamental to the health of the workers and aimed at reducing vulnerability and a sedentary lifestyle and meeting the basic human needs of LHTDs.

Race-based health disparities for racially and ethnically diverse people with orthopedic-related conditions are well documented and their experiences when seeking care deserve more attention. The purpose of this study was to understand the lived experiences of racial microaggressions occurring when racially and ethnically diverse people seek health care services for orthopedic-related conditions. We used transcendental phenomenology to understand their lived experiences of racial microaggressions while receiving orthopedic-related health care services. All participants self-identified as Black, none as Hispanic. Nineteen final codes were organized into five patterns and then into five themes—two background and three figural themes. Background themes: discrimination can occur across a lifetime, and poor treatment of poor people fuels health inequity. Figural themes: racial discrimination can come at any time and in various forms; resistance is necessary in the face of racial discrimination; and despite discriminatory encounters, health care goals are achievable. Participants shared their lived experiences of racial microaggressions while seeking care for their orthopedic-related conditions (figural) through a lens shaped by their other past experiences with varied discrimination (background). Black individuals have a longstanding relationship with racial discrimination that has a negative impact on many aspects of their lives, including their health. The results highlight ways to promote equity by capitalizing on Black individuls’ goals to actively pursue health.

There is a lack of studies on the level of stress and health of families of workers in road transport. This study aimed to evaluate the perceived stress level and Family Effectiveness of family members of road transport workers. A quantitative study was carried out with family members of road transport workers in the southern region of Brazil. For the data collection, a sociodemographic form, the Perceived Stress Scale (PSS), and the Evaluation of Family Effectiveness Strategies were used. The data were analyzed by simple frequency, Spearman correlation coefficient (ρ) (p < 0.05), and descriptive analysis from the perspective of the Systemic Organization. 49 family members of road transport workers were participants. Perceived stress was higher in family members who had more than nine years of schooling, the targets of Control and Growth were higher in the evaluation of Family Effectiveness. The Control target was also higher in families with more than three people. The Coherence dimension had higher levels in families with health problems and whose income was less than $792.00 US dollars per month. In the Individuation dimension, income over $792.00 had better results. The Maintenance dimension of the system was higher in families whose drivers’ activity was as an intercity driver, as well as in the Stability target. In conclusion, the social factors such as schooling, income, diseases, type of worker activity in road transport, and number of people in the family influenced perceived stress and Family Effectiveness, which demonstrates the need to increase the promotion of health care of the families of road transport workers.