Ejura Yetunde Salihu

Background: Antidepressant use and withdrawal are often accompanied by side effects such as dizziness, weight gain, and sexual dysfunction. Antidepressants and their associated side effects are stigmatized topics. Social media platforms such as Reddit are considered “safe spaces” by users because they can freely share their experiences and receive support. Objective: This pilot study analyzed discussions from the subreddit r/depression to examine how users discuss antidepressant side effects, withdrawal symptoms, and related experiences of depression. Methods: We scraped 10 high-engagement threads from the subreddit r/depression using the Python wrapper for the Reddit application programming interface and conducted a 2-step analysis. First, a pilot test was performed using sertraline (Zoloft) threads, followed by an analysis of all antidepressant-related threads. A subset of the data was hand-coded to create and validate regular expressions, which were then used to automatically code the remaining dataset. The resulting coded data were analyzed using epistemic network analysis and complemented with qualitative analysis and elements of semantic networks and hypergraphs. Results: We found that posts were more likely to discuss emotional flattening, sleep, and memory or cognitive issues (Mann-Whitney U =33,235.5; P =.003). Additionally, references to dizziness tended to co-occur with discussions of withdrawal and offers of empathy, while reports of dream-related side effects and requests for personal experiences also co-occurred frequently. By incorporating elements of semantic networks and hypergraphs, we deduced that offers of empathy occurred when users said they experienced dizziness caused by withdrawal, while mentions of “brain zaps” associated with withdrawal often co-occurred with offers of teaching support. Conclusions: Study findings highlight how individuals experiencing antidepressant side effects and withdrawal symptoms use online forums such as Reddit to seek validation, share coping strategies, and provide emotional support to others. The nuanced discussions observed, particularly those related to empathy, symptom management, and shared learning, underscore the role of peer-to-peer networks in normalizing stigmatized experiences and mitigating isolation associated with antidepressant use. Clinicians and digital health practitioners can leverage these insights to better understand patient language, emotional framing, and informational needs outside clinical settings.

Background: Engaging diverse populations, including Muslims, in research activities is important to support patient-centered research and improve health equity. Objectives: The research aimed to describe the community engagement steps that informed conducting research with five distinctively diverse U.S. Muslim communities. Methods: This work provides methodological reflections on engaging diverse Muslim communities in the U.S. Researchers built trust-based partnerships with community healthcare organizations and engaged with administrative leaders, advisory members, and people from five diverse communities. Strategies to support sampling, recruitment, multi-language interpretation methods, and how to engage communities and address their concerns are discussed. Results: A total of 22 participants were included in the original study. The research team successfully engaged five of the six planned communities, utilizing multiple interpretation methods and participating in community events to support recruitment and relationship-building. Direct-to-participant recruitment efforts were strengthened by personal connections with trusted community members. Conclusions: Flexibility and adaptability are integral in recruitment and data collection, as diverse communities may respond differently to methods successfully used elsewhere. Attention to gender-related cultural norms, the inclusion of language-concordant researchers, and respect for communities’ autonomy in deciding whether and how to participate collectively contributed to more effective and culturally grounded engagement with Muslim communities.

Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid analgesics to mitigate discomfort and facilitate recovery. Although opioids remain an integral part of post-traumatic injury pain management, their use exposes trauma survivors to the risk of developing persistent use, misuse, or opioid use disorder (OUD). Pre-injury health determinants, such as age, gender, psychiatric conditions, medical conditions, and substance use history, may interact with injury-related factors to acutely escalate the risk for misuse and addiction. Despite the growing recognition of these potential vulnerabilities, there remains a lack of evidence-based clinical decision support on modifiable and non-modifiable risk factors specific to post-traumatic injury opioid risk trajectories. This review summarizes the literature related to the multifactorial contributors to opioid misuse and addiction following traumatic injury such as patient-level (e.g., demographics, behavioral health), injury-related (e.g., severity, type), and system-level (e.g., prescribing patterns) characteristics. A comprehensive literature search, inclusive of the literature from 1995 to November 2025, was performed in PubMed/MEDLINE, Scopus, and Google Scholar using combinations of terms related to “opioids,” “misuse,” “addiction,” “trauma,” and “injury.” Search keywords and operators were developed in collaboration with a university librarian. Reference lists of articles were searched and synthesized. Case reports, case series, editorials, mini-reviews, letters to editor without original data, and qualitative studies were excluded. The findings of the review are expected to provide insight into clinical-decision making as it relates to the management of pain, pain-related distress and functional impact, and co-occurring conditions that may impact injury-related outcomes and the potential likelihood of substance misuse and addiction.

Background: Engaging diverse populations including Muslims in research activities is important to support patient-centered research and improve health equity. Objectives: To describe the community engagement steps that informed conducting research with five distinctively diverse U.S. Muslim communities. Methods: Researchers engaged with leaders, advisory members, and people from five diverse communities. Strategies to support sampling, recruitment, multi-language interpretation methods, and how to support closed communities and address their concerns are discussed. Lessons Learned: Researchers interested in working with Muslim communities should be aware of principles of seclusion when interacting with sex-discordant participants. Including language concordant researchers demonstrated effectiveness and efficiency in the process. Researchers should be open to rejections from communities and accept stepping back to give community members the space needed to decide whether to participate in research. Conclusion: Flexibility and adaptability are integral in recruitment and data collection as diverse communities may respond differently to methods successfully used elsewhere.

Background: Community-Based Participatory Research (CBPR) has proven effective in promoting health research in hard-to-recruit and underserved populations. Tai Chi Prime is a National Council on Aging-certified fall prevention program. However, it has not been widely disseminated in African American (AA)/Black and Latinx communities. Guided by the Consolidated Framework for Implementation Research (CFIR), this study examined the process of working with a community advisory board (CAB) to adapt and disseminate Tai Chi Prime within these communities, as well as facilitators and barriers to CAB success. Methods: Eight CAB members met with researchers monthly virtually over a two-year period. Meetings focused on reviewing Tai Chi Prime materials, discussing cultural adaptations, and identifying dissemination strategies relevant to AA/Black and Latinx communities. Detailed notes from 24 meetings were compiled. In addition, semi-structured interviews were conducted with five CAB members and two researchers to capture individual reflections on their experiences, roles, and perceived impact. Data was analyzed using directed content analysis. Results: CFIR constructs helped illuminate how CAB members’ embedded community expertise, organizational partnerships, available resources, shared vision and transparent communication influenced the cultural adaptation and dissemination of Tai Chi Prime. Study findings also highlight important areas that extend beyond CFIR, particularly the cultural knowledge and power-sharing responsibilities undertaken by CAB members as co-researchers. These insights underscore the need to integrate equity-focused and community-engaged research principles into implementation frameworks when working with communities of color. Conclusions: Findings highlight the value of leveraging existing academic–community partnerships. Community-engaged researchers can use the lessons learned from this CAB to build a replicable model of sustainable partnerships with their AA/Black and Latinx community partners, as can others involved in health services research and policy.

Using the Herzberg’s Two-Factor Theory, this study explored factors influencing job satisfaction among nurses in a private hospital in Nigeria. Ten nurses were recruited through purposive sampling to participate in interviews. Data was analyzed in MAXQDA using a thematic analysis approach. Extrinsic (hygiene) factors (i.e., high workload, low salary, limited opportunities for career advancement) were noted by respondents as significant sources of dissatisfaction, while intrinsic (motivational) factors (i.e., autonomy, peer support, and recognition) enhanced job satisfaction. Findings offer insights into how systemic and interpersonal factors influence nurse satisfaction and provide evidence-based strategies for enhancing retention in low-resource, profit-driven healthcare environments.

Background: African American (AA)/Black and Latinx communities have limited access to evidence-based fall prevention programs such as Tai Chi Prime (TCP). Community-led interventions that incorporate peer support are cost-effective and sustainable. Using the Treatment Fidelity Framework (TFF) and a mixed-methods research approach, we evaluated the training and support given to trainees during the TCP leader training pathway process and their subsequent fidelity in delivering six culturally tailored community courses. Methods: Trainees completed feedback forms after each TCP leader training pathway course. Using a fidelity checklist, a TCP master trainer rated six community TCP classes led by race- and language-concordant leaders. Trainees were invited to participate in virtual one-on-one semi-structured interviews to share their perspectives on the appropriateness and relevance of the TCP leader training pathway and their experience leading community TCP classes. Quantitative data was analyzed using descriptive statistics on Microsoft Excel. Three study team members coded qualitative data using directed content analysis approach. Results: Twenty-five candidates enrolled in the TCP leader training. Forty-eight percent identified as AA/Black while 52% identified as Latinx. Eleven trainees (six AA/Black and five Latinx) completed the entire TCP leader training pathway to become certified TCP leaders. Trainees rated the training process as highly satisfactory and appropriate. Leaders from both communities received high fidelity scores for community course delivery. Conclusions: Findings contribute to the existing literature, particularly regarding how to effectively disseminate and evaluate a culturally tailored TCP leader training and certification process for culturally diverse communities while maintaining fidelity to the curriculum.

UNSTRUCTURED Antidepressant use and withdrawal are often accompanied by side effects such as dizziness, weight gain, and sexual dysfunction. Antidepressants and associated side effects are stigmatized topics. Social media platforms like Reddit are considered "safe spaces" by users because they can freely share their experiences and receive support. This study analyzes discussions from the subreddit, r/depression, to examine how users talk about antidepressant side effects, withdrawal symptoms, and related experiences of depression. We scraped ten high-engagement threads from the subreddit r/depression using the Python wrapper for the Reddit API and conducted a two-step analysis. First, a pilot test was performed using Sertraline/Zoloft threads, followed by analysis of all antidepressant threads. A subset of data was hand-coded to create and validate regular expressions, which were then used to automatically code the remaining dataset. The resulting coded data were analyzed using Epistemic Network Analysis (ENA) and complemented with qualitative analysis, elements of semantic networks, and hypergraphs. We found that posts are more likely to discuss emotional flattening, sleep, and memory or brain issues. Additionally, references to dizziness tended to occur with discussions of withdrawal and offers of empathy, while reports of dream-related side effects and requests for personal experiences co-occurred frequently. With the additions of elements of semantic networks and hypergraphs, we deduced that offers of empathy occurred when users said they experienced dizziness caused by withdrawal, while mentions of brain zaps from withdrawals received teaching support. Study findings highlight how individuals experiencing antidepressant side effects and withdrawal symptoms use online forums like Reddit to seek validation, share coping strategies, and provide emotional support to others. The nuanced discussions observed, particularly around empathy, symptom management, and shared learning, underscore the role of peer-to-peer networks in normalizing stigmatized experiences and mitigating isolation associated with antidepressant use. Clinicians and digital health practitioners can leverage these insights to better understand patient language, emotional framing, and informational needs outside clinical settings.

Objectives: This study sought to understand dietary behaviors among US Muslim people with Type 2 diabetes while managing diabetes and fasting during Ramadan, identify key psychosocial factors influencing behaviors, and examine how identified factors influence diet behaviors and health outcomes from the patient’s perspective. Methods: The study employed community-engaged research principles and qualitative research design. Twenty-two adult Muslim adults living with Type 2 diabetes for over 6 months participated in semi-structured one-on-one interviews. Participants were recruited from five US communities using purposive sampling. Three trained researchers used abductive coding, combining deductive and inductive approaches, to analyze the data. Results: Six main themes emerged from the data: (1) changes in dietary habits during Ramadan; (2) strong influence of religious, cultural and social practices on dietary behaviors; (3) variable self-efficacy in managing dietary behaviors; (4) impact of prior habits and current blood glucose status; (5) decision-making based on diabetes-related health outcomes (e.g., experiencing low blood sugar); (6) participants’ perception of Ramadan as an opportunity for sustainable behavioral changes. Conclusions: This study is among the first to document the dietary behaviors and key psychosocial factors influencing dietary behaviors and health outcomes for US Muslim people with Type 2 diabetes during Ramadan. The study suggests that interventions to improve diabetes control and promote diabetes remission among Muslims can benefit from cultural tailoring that draws on Ramadan religious, cultural and social practices to encourage sustainable behavioral change.