Search

Objective: The goal of this study was to examine the experiences of women diagnosed with ADHD in adulthood. Methods: Benefits and costs associated with obtaining the diagnosis were examined in two focus groups conducted virtually. Factors hindering and facilitating the identification, assessment, and subsequent treatment of ADHD were also explored. Focus groups were conducted virtually and together included 14 women (M[subscript age] = 39.43, SD = 6.37) who were diagnosed with ADHD in adulthood. Results: The majority of women described numerous benefits of receiving a diagnosis of ADHD, including validation/self-compassion, adaptive coping, and social support. Negative aspects of the diagnosis, including difficulties accessing care, the burden of care, limitations to existing evidence-based treatments, and stigma were also identified by some women. Furthermore, women described variable diagnostic experiences, with many indicating that they had not recognized their own symptoms of ADHD, as well as diagnostic complexity and other factors that masked identification of ADHD. Women described a range of diagnostic assessment procedures, as well as considerable self-advocacy to convince their providers to consider the diagnosis of ADHD. Conclusion: These lived experiences of women diagnosed with ADHD provide critical insight into improving clinical care for ADHD in women. Recommendations to increase accurate and timely identification of ADHD in women and advance efforts toward effective and equitable care are discussed.

Objective: Although there has been increased attention to campus interpersonal violence, there is limited information on survivor advocacy services. Participants: We recruited participants from 155 U.S. institutions of higher education responsible for advocacy services on their campus. Methods: We used a community participatory action approach in partnership with the Campus Advocacy and Prevention Professionals Association to develop and disseminate a survey regarding campus advocacy services. Results: Participants shared critical insights about (a) advocacy staffing/caseload, (b) program structure, (c) advocacy practices, and (d) connection to services for people who had caused harm. We found that advocacy programs are often providing best practice services for survivors of violence but operating with few staff and unclear privacy protections. Conclusions: This study provided crucial preliminary information about how campuses provide advocacy services, but more researcher-practitioner engagement is needed to build on this study and establish clear practice guidelines.

Objective: To optimize healthcare for gender-diverse students at a large, public university's Student Health and Wellness (SHW) Center. Methods: SHW professionals from medicine, gynecology, health promotion, counseling, psychiatry, and disability services developed a multidisciplinary gender-diverse care team (GDCT) in 2016. The GDCT's team-based design was created to support a diverse student body and provide extra resources to a vulnerable population, ensuring students engage fully in the University. Results: The GDCT has assisted approximately 93 unique students, in-person or by phone with clinical or supportive care. The number of students presenting with questions pertaining to transgender and gender-diverse health care has increased since 2016. Conclusions: Having a comprehensive, multidisciplinary GDCT available within a university SHW provides transgender and gender-diverse students with access to a safe, inclusive, and resource-rich environment to seek care and serves as a potential model for other college health centers.

School-based mental health professionals, including school psychologists, counselors, and social workers are critical to appropriate mental health services to youth in schools. However, the vast majority of states are chronically underserved by these professionals, despite policies that attempt to rectify the shortages. In this paper, we document variation in access to these professionals across the United States, assessing the school- and district-level factors associated with the presence and prevalence of these service providers using the Civil Rights Data Collection from 2017-2018. We analyze these results descriptively and with logistic regression and find evidence of varying degrees of inequity in all three positions with significant factors associated with the prevalence of these professionals. Implications for policy and future research are discussed.

The state of mental health has become increasingly concerning, particularly with the impact of the COVID-19 pandemic. Emerging adulthood is a time of adjustment and growth, and for many youths this includes attending college. The transition to college often comes with significant challenges that impact student mental health. This study uses thematic analysis to analyze qualitative responses from focus groups with college students (N = 22) following an innovative credit-bearing mental health course at a large university in the Southern U.S. Students discussed various aspects of mental health, including stressors such as academic rigor, social expectations, and challenges to seeking mental health care. In addition to stressors, students highlighted engaging in coping strategies such as physical health, positive relationships, spirituality, and more to manage stress, which suggests students applied skills garnered in the mental health course. Implications for practice and research are discussed.

Background: The shortage of prescription stimulants is an ongoing issue that is impacting the ability of individuals with ADHD to access their medication. Amidst concerns that this shortage may have a substantial impact on individuals' ability to manage their symptoms effectively, this research seeks to understand the experiences and consequences for those affected. Methods: In this study, we interviewed individuals with ADHD who have been directly impacted by the stimulant shortage. Thematic analysis focused on identifying common themes related to challenges with medication access and the resulting effects on daily living. Results: The study uncovered significant difficulties in accessing ADHD medication due to current shortages, leading to disruptions in the management of ADHD symptoms and subsequent detriments to individuals' professional, educational, and personal lives. Systematic controls aimed at reducing nonmedical use were found to exacerbate these access issues, inadvertently compounding the challenges faced by those using medication for legitimate medical needs. Individuals also described ways they coped with the shortage, with some seeking ADHD medication via unofficial channels. Conclusion: Our findings highlight the urgency of addressing stimulant shortages to safeguard the wellbeing of individuals with ADHD. This study also calls for a critical review of policy measures regulating stimulant medication access, and their effectiveness at reducing non-medical use given the unintended consequences these regulations appear to have on individuals prescribed these medications for therapeutic purposes.

Online parenting interventions hold promise for increasing access to behavioral support for families with low income and who reside in rural areas. The current study evaluates the efficacy of a mobile app-based parenting support program, the Family Check-Up Online (FCU-O) with telehealth coaching support, for parents of children 1.5-5 years old at risk of experiencing parenting challenges. We tested effects of the FCU-O on parent wellbeing (parenting self-efficacy and symptoms of depression and anxiety) and parent-reported parenting skills (support for positive behavior, limit-setting, and proactive parenting) at the 3-month follow-up in a randomized controlled trial (FCU-O versus control). We also tested relationships between parents' baseline characteristics and their engagement with the app and telehealth coaching. Eligibility criteria included endorsing depressive symptoms or current or past substance misuse. Participants (N = 356) were predominantly White (72%) and low-income, with 43% of families residing in a rural area. Approximately one-third-of participants reported clinically significant symptoms of anxiety or depression and one-third-endorsed a lifetime history of opioid misuse. Intent to treat analyses tested effects of the FCU-O on parent wellbeing and parenting skills. The FCU-O was associated with improvements to parents' support for positive behavior, limit-setting, and proactive parenting skills, as well as parenting self-efficacy and depressive symptoms. Parents' initial symptoms of depression and anxiety significantly predicted greater telehealth coach engagement; low levels of initial self-reported skills positive behavior support and limit-setting significantly predicted greater app engagement. Results provide support for the FCU-O as a preventive parenting intervention for parents experiencing mental health challenges, with implications for reducing barriers to accessing parenting support for underserved families.

This study investigated vocational students' mental health by identifying the prevalence of depression, stress, anxiety, eating disorders and associated risk and protective factors among 16- to 18-year-old students attending a vocational college in Malta. Health Related Quality of Life (HRQOL) was also investigated. A sample of 422 students completed standardised self-report mental health tools and a demographic and personal variables' questionnaire. A total of 64.4% of students were found to be struggling with at least one of the mental health conditions assessed while 36.7% reported a suspected eating disorder. The prevalence rates of depression, anxiety and stress (moderate, severe or extremely severe) were 43.3%, 48.8% and 29.3% respectively. Students had a lower HRQOL than the reference population as indicated by European norm data. Only 13.5% of participants sought help from mental health services. Risk factors include female gender, poverty, being LGBTQ, not living with both parents, past negative school experiences, poor relationships and presence of suspected or diagnosed conditions or disabilities, amongst others. Having supportive relationships with family, peers and school personnel emerged as protective factors.

The U.S. healthcare system struggles to provide adequate language assistance to medical practitioners and patients. As a result, health providers and patients rely on ad hoc interpreters, including children, to communicate. Bilingual children who regularly interpret for others, whom we refer to as child language brokers, are important linguistic and cultural conduits for their communities and bridge language differences in vital contexts, such as health and medical settings. In this paper, we explore the experiences of 17 adolescent language brokers and consider the settings, tasks, and people they engage with when language brokering for health. Findings illustrate that child language brokering is a real and important component for immigrant family health, that child language brokering for health is not a uniform experience, and that language brokering for health can sometimes have severe ramifications.

Collective impact (CI) initiatives provide a promising collaborative community-based approach for addressing health disparities, but they are challenging to evaluate. This paper provides a detailed strategy for addressing these challenges through a case study, with the goal of not only of evaluating the CI, but also putting organizations in a position to implement and maintain sustainable self-evaluation efforts over time. A three-phase evaluation strategy was developed and implemented via a community-academic partnership to assess the impact of the CI. Process and outcome data from a CI to address health disparities in a Chicago community were collected and analyzed. The evaluation strategy, following the developmental, formative, and summative phases, helped a CI overcome barriers and build capacity for ongoing evaluative work for its members. Considering the flexible, low-technology approach, this strategy is a valuable resource in assisting individuals seeking to create a successful and sustainable CI evaluation.

Although HIV rates are statistically stable, meaning the number of new acquisitions has remained relatively flat, the impact of the epidemic is uneven. Black women between the ages of 13 and 34 are more likely to acquire HIV, suggesting intervention during college is an ideal HIV mitigation strategy. Moreover, far too few Black women who could benefit from biomedical interventions have them or know about them. In this piece, I explore the current landscape and context of HIV and the college environment for Black women, revealing the social, cultural, and epistemic need to restory and better nuance the HIV crisis. I elucidate how and why the college context is a particularly vital space for HIV-related health equity and the possibilities for transformation through teaching, research, practice, and policies around HIV and Black women.

Treatment-seeking behavior (TSB) in relation to dengue infection is a critical aspect of public health, and understanding the factors that influence it is crucial for effective disease management. This research delves into key determinants of dengue TSB by examining the perceptions and behaviors of individuals in Costa Rica, in relation to the Health Belief Model (HBM). This study utilized naturalistic inquiry and incorporated a qualitative research design involving nine students organized into four teams, with at least one student on each team with high Spanish fluency. In total, we initiated 102 semi-structured field interviews with Costa Rican residents in four communities. The interviews were recorded, transcribed verbatim, and coded in several cycles using MAXQDA 2022©. Thematic analysis was used to identify patterns and themes using an inductive approach. We found that several HBM themes influenced dengue TSB among participants. Self-treatment was the most common initial step in managing dengue. Perceived inaccessibility of health care services and perceived ineffective treatment options discouraged medical care-seeking. Ultimately, the prevalence of self-treatment practices suggests a need for interventions that emphasize the importance of timely professional medical attention, while addressing real barriers and perceptions of existing health care services as inaccessible and ineffective. These findings provide a key perspective on dengue TSB, guiding future public health strategies aimed at optimizing health-seeking behaviors and mitigating the negative impacts of dengue on population health.

Background: People with severe learning disabilities and complex needs are more likely to experience delayed discharge from hospital; however, there is little research into their experience in hospital and as they move out as part of the Transforming Care Programme. Methods: Six family members of people with complex needs who had moved out of hospital took part in four focus groups co-facilitated with an expert-by-experience consultant. Participants' relatives had hospital admissions that ranged from 6 weeks to 11 years. Transcripts were analysed using reflexive thematic analysis. Additional reflections are included from an expert-by-experience consultant to capture their unique perspective. Results: Family members reported stories of abuse in hospital and parallel experiences of institutionalisation and trauma, resulting in long-lasting impacts on themselves and their relative. Family members felt let down and undervalued by professionals. They described relief when their relatives moved out of hospital, but there were on-going difficulties accessing the right support in the community and so stability felt fragile. Conclusions: Key recommendations to support community living include respecting family members' expertise, improving partnership working and offering psychological support for family members and people with complex needs post-discharge.

Since autism diagnosis is directly linked to the availability of supportive services, identifying best practices for early diagnosis of autism has long been a concern of professionals and families. Meanwhile, studies show persistent racial disparities in autism diagnosis. Although numerous clinical diagnostic guidelines have been published, there is not enough discussion of diagnostic procedures through the lens of culturally diverse families. Purpose: This study focuses on the autism diagnostic experiences that Korean immigrant mothers had with their children. Methods: Eleven first-generation Korean-American mothers of children with autism were included in the study. The data was collected using semi-structured interviews in Korean. Results: The main five factors (i.e., cultural beliefs and values, language barriers, complex emotions, immigration and navigating systems, and facilitators and assets) that mainly influence the diagnosis process were identified through thematic analysis. Conclusion: Dynamics are interactive within and between the factors, influencing the entire diagnostic process by either delaying or facilitating the identification of a child's autism and the provision of treatment.

Finding ways to move knowledge-to-impact is a key priority for research funding agencies, universities, and academics. However, academic engagement with the broader community is not without tensions and challenges, including arriving at mutual benefit and relevance, and addressing power dynamics and often incompatible communication practices. This study used a mixed-methods approach to examine a unique event series of public dialogues that brought together diverse community and academic perspectives around health equity issues. Findings suggest the series successfully merged strategies from both the knowledge mobilization and citizen engagement/public involvement domains to spark conversations in one community regarding health equity and social justice. We provide initial descriptive evidence that the format was successful in achieving its proximate goals, and was appreciated by those who participated and attended. We position this type of activity as a promising strategy to effectively bring academic research to the broader local community.

Oman Dental College partnered with local health agencies in Zanzibar, Tanzania, for an international dental outreach project. This early-stage engagement aims to address Zanzibar's pressing dental health needs and to provide a transformative educational experience for student volunteers. Informed by the intertwined histories of Oman and Zanzibar, the project delivered preventive and curative dental services, emphasizing the need for sustained oral hygiene education. Initial impact measurements revealed the high prevalence of dental decay, highlighting a need for preventive measures. Volunteers reported educational gains and a deeper understanding of Oman-Zanzibar heritage. Challenges such as electricity, internet connectivity, and sterilization conditions were identified for future improvement. This project provides valuable lessons for community engagement, especially the importance of preparation, adaptability, and long-term community involvement for sustained impact. Future directions include training local health care workers and developing community-based oral hygiene programs.

Rural health work-integrated learning exposes students to the unique features of rural professional practice and provides opportunities to improve students' work-readiness. Service learning placements delivered in rural settings seek to address the dual goals of student learning and meeting community identified needs. This research aimed to evaluate the experiences of students and supervisors who were involved in service learning placements in various rural and regional communities across a range of educational and health settings. Thirty-eight participants completed an online survey, reporting high levels of satisfaction with this placement format. Students experienced a strong sense of belonging within the host organisation, felt welcomed, and engaged in organizational and community activities. Supervisors universally reported feeling well supported. Ongoing attention to supervisory confidence, particularly when supervisors are unfamiliar with the service learning placement format is indicated, along with the need to develop student awareness of and access to interprofessional learning opportunities.

International Students (IS) generate significant revenue in Australia, bringing diversity, but also distinctive needs and values. IS experience unique mental health challenges and their unmet support needs have recently received public and academic attention, notably during the COVID-19 pandemic. However, framing IS as homogeneous misses important variations within this population. A nuanced understanding of diverse IS subgroups with regard to mental health and help seeking is missing from current research. This study therefore explores the experiences of Queer International Students (QIS) in Victoria, and the barriers and facilitators that influence how they seek and gain mental health support. Results show that the persistent impacts of broader socio-cultural factors and systemic gaps in addressing QIS' intersectional needs act as barriers to accessing support, while awareness of intersectionality is critical in providing appropriate professional assistance to QIS. Findings suggest the need to build cultural competence and service collaborations to better support IS.

Constructs of social justice has become an increasingly prevalent area of interest in the field of Communication Sciences and Disorders (CSD). In fact, competencies related to social justice are required program content per the Council of Academic Accreditation in Speech-Language Pathology and Audiology. This study's purpose was to describe and evaluate an online, introductory course designed to address such concepts. Students' perceptions of (a) the concept of social justice, (b) program content, and (c) program usability were examined. Undergraduate students from two universities completed the program, and a sample of students provided data about their perceptions during pre-program and post-program semi-structured interviews. Using a qualitative design (i.e., thematic analysis) the authors identified themes reflected in the data. This data revealed that the students had little to no prior experience with social justice yet were motivated to learn more about the topic due to perceptions that the topic is important to the field. Analysis of the program content and usability revealed that the students perceived an increase in knowledge and self-awareness. Outcomes show that the program holds promise and supports further study to evaluate program impact on students' attitudes and beliefs.

Under-education in Cameroon significantly hampers the nation's socio-economic development. Addressing this issue is crucial for enhancing the overall quality of life and economic growth of the country. This study identifies and analyses the primary factors contributing to under-education, offering actionable solutions to improve educational outcomes and promote sustainable development. The study employed a mixed-methods approach combining quantitative and qualitative data. Surveys were conducted with 1,000 households across urban and rural regions, alongside in-depth interviews with 50 educators, policymakers, and community leaders, and field observations in 20 schools. Structured questionnaires, semi-structured interview guides, and observation checklists were used. Advanced statistical techniques, including regression and factor analysis, were applied.

The increase in the prevalence of mental illness among Black millennials has led to more awareness and advocacy within the generation. However, Black millennial men are still utilizing counseling services at significantly lower rates than millennial Black women and men of other races. Consequently, this leads to an increase in suicide completions and undiagnosed mental health issues among Black men who experience more severe and disabling symptoms of mental illness. An exploration of racism, stigma, mental health in the Black community, and Black masculinity influenced the development of this study. Based on past reported themes, Black Masculinity and Critical Race Theory are utilized as a multi-dimensional framework for this phenomenological study to provide in-depth information on the barriers to counseling experienced by millennial Black men in a metropolitan city in North Carolina. Using Interpretive Phenomenological Analysis of the semi-structured interviews of this study, results indicated the following three themes as experienced barriers: "Black Pride", "Classical Masculinity", and "Negative Perceptions of Mental Health and Counseling." Implications for improving advocacy efforts in similar metropolitan areas by mental health professionals, universities, and general social justice advocates, as well as future research, are provided.

Place-based education, grounded in collaborative learning opportunities with minoritized communities, is vitally needed to change the health crises that impact our communities. Many current learning models focus on engaging in communities by centering on the deficits of particular populations or naming issues that affect individuals' health. This approach falls short of teaching students to be inclusive of those impacted by injustices such as health inequities. Many times, these learning experiences are one-time activities that are not sustainable over time. Thus, as anchor institutions, universities are responsible for using innovative learning strategies to allow students to develop skills to take action on these issues while partnering with other organizations. This paper will present a case study using the Health Commons model as an example of how institutions of higher education work with the community to implement an anchor institution framework. Stories and lessons learned from engaging in this work over the last three decades will highlight how anchor institutions in higher education can create change at the community level through place-based education. This case study highlights the significance of place-based learning for students, educators, and community partners. The essential concepts include: (1) knowledge is dynamic, (2) humility is crucial, (3) comfort with ambiguity is necessary, (4) health is interconnected with community, (5) continuous learning is vital, (6) withholding judgment is important, and (7) making time for critical self-reflection is imperative.

Childhood maltreatment has had a damaging effect on many people in our society. The abuser strips the victim's innocence and leaves him or her to maneuver through a lifetime of harmful residue. Creating a healthy societal awareness and offering effective counselling solutions are necessary to minimize the damage of maltreatment.

In the past decade concern about the mental health of university students has been growing worldwide. Yet epidemiological data and intervention research on student mental health comes predominantly from high income western countries in the Global North, with a relative scarcity of studies from sub-Saharan Africa and other countries in the Global South. While universities in the Global North and Global South face similar challenges to provide accessible, acceptable, and effective mental health services to students, there are also important historical, cultural, economic, and political issues that make it necessary for context-sensitive research which is responsive to the needs of students in the Global South. Using South Africa (SA) as a case study, this commentary aims to explore the relevance and appropriateness of uncritically importing knowledge and "evidence-based" strategies to student mental health challenges from the Global North into sub-Saharan Africa. The article draws on research from South Africa to illustrate how distinct and varied contextual issues create unique challenges to promoting student mental health that cannot be solved with foreign knowledge. Recommendations are made for how equitable partnerships between countries in sub-Saharan Africa could support student well-being in the region. Key to creating equality in the global provision of appropriate student support services is a strategy and funding to redress global knowledge-power imbalances and set research agendas from within the Global South.

To increase community health knowledge, the El Paso Health Education and Awareness Team (EP-HEAT) was established at Paul L. Foster School of Medicine. The Medical Student Run Clinic (MSRC) emphasizes community health care access. "Promotores de salud" (community health workers) increase health care awareness and connect predominantly underserved communities with resources. Surveys were conducted to determine how EP-HEAT and MSRC patients' communication with promotores affected their access to health care and communication skills. Surveys demonstrated that 91% of EP-HEAT members agreed that working with promotores improved their communication ability. All MSRC patients surveyed stated interacting with promotores helped improve health care communication in various ways.

Extractive knowledge is prevalent in higher education community engagement. It is a type of epistemic injustice that is harmful to the historically and systemically minoritized communities and community nonprofits that many universities, particularly predominately white institutions, seek to engage. Extractive knowledge results from what we can think of as transactional relationships with community members or community nonprofits. These are largely superficial but impactful relationships perpetuating injustice in higher education spaces that imagine themselves working to create greater justice. In this article, we make two primary arguments: a.) Extractive knowledge is an epistemic injustice prevalent in community-engaged higher education, and b.) The Robert Wood Johnson Foundation's model for transformative community engagement and the Fitz Center for Leadership in Community's Practice Principles provide strategies and models for more epistemically just approaches to community engagement that shape knowledge in epistemically responsible ways, in partnership with communities and alignment with communities' goals and outcomes, this paper finishes with the Fitz Center's Health Equity Program and a community-led partnership as examples of these Practice Principles that lead toward reciprocal, responsible, community-driven, and transformational community engagement.

Training the next generation of public health practitioners to promote health equity requires public health graduate programs to cultivate students' skills in community partnership. The Council on Education for Public Health (CEPH) requires Master of Public Health (MPH) students to produce a high-quality written product as part of their culminating Integrative Learning Experience (ILE). Because CEPH recommends that ILE written products be useful to community partners, ILEs can draw lessons from the field of experiential education, especially the social justice aligned principles of critical service-learning (CSL). However, the current literature lacks descriptions of how to operationalize CSL's principles within graduate-level culminating experiences. To help fill this gap, we discuss a CSL ILE for MPH students, called Capstone. We describe CSL's key components and explain and assess how each is operationalized. We hope Capstone's model will help educators engage more deeply with CSL practices to advance health equity.

In this article, we draw on a narrative inquiry into the experiences of children, youth, and families waiting for mental health support during the COVID-19 pandemic in Western Canada. We foreground two youths' experiences (Gillian, who self-identifies as transgender, and Malek, who self-identifies as racialized) to highlight the complex barriers and supports each encountered while attempting to secure appropriate care as they navigated moments of crisis within their worlds of home, school, and communities. By inquiring into their mental health stories, we foreground the unique ways these youth enacted counterstories to disrupt hegemonic constructions of their identities, build agency, and support their wellbeing.

There is a growing need for pre-health professional students to understand how the social determinants of health (SDOH) affect population health. The goal of this project was to evaluate the impact of a modified "Privilege Walk" (MPW) activity on students' awareness of personal privilege as a SDOH. Undergraduate students engaged in a MPW activity received a privilege score that could total 36 points (a higher score indicates more privilege). Students also completed a pre- and post-MPW survey to evaluate the impact of the activity on privilege awareness. Nonparametric tests were used to determine the effect of the MPW assignment on privilege outcomes. Twenty-one students completed the pre- and post-surveys. The majority of respondents were White (85.7%), non-Hispanic (90.5%), or female (81.0%). Ethnicity (1.14 points, p=0.052), race (0.71 points, p=0.0078), and current housing conditions (0.70 points, p=0.0273) were the top characteristics students felt gave them significantly more privilege. We demonstrated that an interactive approach in the classroom could increase students' awareness about privilege as a SDOH. These are promising findings as academic centers seek to evaluate and develop promising and evidence-based approaches to train healthcare students about the SDOH as they treat diverse and vulnerable patients.

While prior research has examined the connection between civic engagement and collectivist views, the present study considers to what extent years of education have been associated with more collectivistic views. This study analyzed data from the 2021 United States General Social Survey. Results suggested that more years of education was associated with believing that the government should do more for Black people and that the government should do move overall (in a scaled average of individualism/collectivism). Specific demographic factors were associated with more collectivist or individualistic views. Implications for program and policy development within higher education are considered.

With increased public awareness of developmental disabilities such as Autism Spectrum Disorder, there are more and more available diagnosis and therapy options for them. It is obvious that services on improving functionality of these children are beneficial. However, there are challenges existing in diagnosis, therapy and intervention service delivery for children with Autism Spectrum Disorder from culturally, linguistically diverse backgrounds due to language barriers as well as cultural differences. In this research synthesis barriers that children from culturally linguistically diverse backgrounds with ASD experienced were examined with discussions and recommendations to combat these challenges and further improve services provision for these children and their families.

The quality of life for a child with a chronic illness depends on various factors, including the illness's severity, medical treatments, psychosocial and educational support, resource availability, and community involvement. These biopsychosocial factors become significant when the child receives care at home. This article presents and evaluates a highly personalized support project offered to 40 Sicilian families, consisting of educational, social, and psychological services delivered at the families homes and in their communities. Guided by the Psychosocial Assessment Tool (PAT) and the Functional Psychology framework, the project employed a family-focused approach to healthcare and was based on a continuous dialogue between all stakeholders. The project was evaluated through a qualitative interview with eight families in the Palermo area, which was analyzed using consensual qualitative research. Results revealed families' appreciation of the project and the importance of a professional who listened to their needs, provided a connection with the medical team, and tailored activities inside and outside the home. The ability of professionals to listen and adapt activities to different contexts and needs was crucial for the project's success. We conclude that creating tailored family-level interventions with an educator acting as a liaison with the medical team is a widely acceptable strategy that should be further developed and investigated.

We investigate the contrasting realities of the pandemic on psychosocial experiences and ways of coping among American Voices Project respondent surveys (N = 720) and interviews (N = 172). Despite similar levels of distress early in the pandemic, by late 2020 clear differences across education, race and ethnicity, and gender emerged, both quantitatively and qualitatively. Those with structural advantages reported greater gains from the pandemic, including self-improvement opportunities like therapy and time outdoors. In contrast, respondents without college degrees, Black and Hispanic individuals, and women reported experiencing greater psychosocial shocks into the later months of 2020 and feeling disproportionately undervalued, socially disconnected, and stressed, respectively. The former two groups also systematically differed in their coping strategies, which included hard work, emotion suppression, and faith.

Background: People with communication disability after stroke experience low rates of return to vocational roles. Vocational rehabilitation is recommended; however, there are no clear guidelines informing vocational rehabilitation for people with communication disability. Understanding the needs and experiences of this population is critical to improving vocational stroke rehabilitation outcomes. Aims: This study aimed to--(1) investigate the experience of vocational rehabilitation for people with communication disability after stroke, (2) identify gaps and, (3) provide preliminary recommendations for tailored service delivery. Methods: Seven participants with an identified communication impairment following stroke were recruited from a larger clinical trial of early vocational rehabilitation (20% of total sample, n = 34). To address the study aims, a qualitative design was employed. Semi-structured, in-depth interviews were conducted and analysed using thematic analysis. Data were integrated with demographic and intervention audit data to contextualise participant experiences, identify vocational rehabilitation gaps and inform preliminary recommendations. Results: Participants were five men and two women aged 24-69 years whose communication profiles included difficulties with auditory comprehension and information processing, reading comprehension, thinking, executive function and self-regulation, as well as difficulties with verbal and written expression. Vocational rehabilitation was perceived as beneficial but participants identified gaps including limited access to psychological and peer-based support during early rehabilitation, limitations to accessing specialist vocational rehabilitation programs, barriers to accessing ongoing rehabilitation after resumption of vocational activity, and limited preparedness for the degree of impact that their communication changes had on execution of vocational roles and responsibilities. Conclusion: Vocational environments are communicatively demanding and people living with acquired communication difficulties face a range of vocation-related participation barriers even when communication difficulties are mild. Greater emphasis on evaluating the vocational communication environment and targeted communication training and preparation for colleagues within the workplace is recommended to reduce barriers faced. Interdisciplinary rehabilitation, inclusive of psychological care, may support working-age stroke survivors to recognise and acknowledge changes in their communication function, lead to improved engagement in the rehabilitation process, and ensure early identification of factors likely to influence successful return-to-vocational activity.

This study explored how speech-language pathologists (SLPs) in Jordan perceived and implemented telepractice at the beginning of the COVID-19 pandemic, from April to June 2020. Eighty-five SLPs who provided telepractice and 57 SLPs, who did not, completed an online survey sharing their perceptions related to the delivery and barriers of telepractice. The results showed a significant increase of telepractice use in response to the pandemic. However, the SLPs identified several barriers to telepractice, including environmental distractions at the client's end, limited computer knowledge, technological issues, internet connectivity problems, and platform availability. There was general agreement among the SLPs regarding the need for professional training and governmental guidelines to regulate the use of telepractice. The study's findings demonstrate how SLPs in Jordan adapted to the sudden shift toward telepractice, and identify potential implementation obstacles, which could assist in establishing telepractice as a reliable model for speech-language therapy services in the future.