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OBJECTIVE: Guided by the Transactional Model of Stress and Coping, this study seeks to (1) examine the independent relationships between the level of distress among burn survivors, pre-morbid psychiatric history, and burn severity on length of hospital stay, and (2) to examine the relationship between having a premorbid psychiatric history and level of distress following a burn injury., METHODS: Data collected by the National Institute on Disability, Independent Living, Rehabilitation Research funded Burn Model System (N = 846) was used to theoretically link psychological distress with the length of hospital stay for survivors of burn injuries. Structural Equation Modeling was used to evaluate the aims of this study., RESULTS: Although counterintuitive, and while significant, burn severity was found to have a rather modest association with a burn survivor's level of distress, indicating that one's ability to cope may be a better predictor of distress rather than burn severity alone. Premorbid psychiatric history was significantly associated with increased levels of distress. While burn severity was associated with length of stay, level of distress did not act as a partial mediator. Length of stay was, however, significantly related to having a premorbid-psychiatric history. Of notable interest, a significant racial, ethnic, and gender difference exists in level of distress. Women and people of color experience higher levels of distress holding constant burn severity and psychiatric history., CONCLUSION: A need exists to assess for and address premorbid and current mental health challenges of burn survivors, specifically the ability to cope, especially among people of color and women, regardless of the burn size or severity. Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.

Screening for social determinants of health allows health care teams to assess and address social factors that influence one’s health, mental health, and access to care. These social factors include poverty, health literacy, social support, exposure to trauma, food insecurity, and housing instability. The objective of this study was to examine what screening tools for social determinants of health are being used, in what contexts, and with what populations. Findings suggest that health literacy is the most commonly screened for, followed by trauma history, social support, food insecurity and housing across diverse contexts and populations. Results from this study can be used to inform providers of available screening tools and resources that can be readily utilized in practice. © 2019, © 2019 Taylor & Francis.

Recovery of burn patients may be impeded by mental health problems. By gaining a better understanding of the impact that psychological factors may have on hospital length of stay, providers may be better informed to address the complex needs of burn survivors through effective and efficient practices. This systematic review summarizes existing data on the adverse psychological factors for the length of burn patients' hospitalization, and assesses the methodological quality of the extant literature on mental health conditions of burn survivors. A literature search was conducted in four electronic databases: PubMed, PsychINFO, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature. Results yielded reports published between 1980 and 2016. Methodological quality was assessed by using an 11-item methodological quality score system. Seventy-four studies were identified by search; 19 articles were eligible for analysis. Findings demonstrate paucity of evidence in the area. Reports indicate longer hospital stay among burn patients with mental health problems. Substance use was the most consistent mental-health predictor of longer hospital stay. Heterogeneity in data on mental health conditions rendered impossible estimation of effect sizes of individual psychological factors on length of hospitalization. Many studies over-relied on retrospective designs, and crude indicators of psychological factors. Findings indicate that mental health problems do have an impact on the trajectory of burn recovery by increasing the length of hospital stay for burn survivors. Inpatient mental health services for burn patients are critically needed. Prospective designs, and more sensitive psychological indicators are needed for future studies.

Adolescent violence is a significant public health problem. The goal of this evaluation was to determine whether communication skills, relationships with adults, and relationships with peers were enhanced through participating in an after-school program aimed at reducing violence-related behaviors among urban middle school youth. Elements that helped to foster success among our population were providing a program that enabled consistent choice in recreational activities in a safe place, and also providing busing home to increase safety. A non-experimental study was conducted with 115 students who participated in the program. Bivariate, ANOVA analysis, and Kruskal–Wallis tests were carried out. Results indicated that participating in the program significantly impacted student relationships with adults and their peers as well as positively impacted their communication skills. The program was designed with purposeful activities that would address pro-social behaviors, enhance youth interest, and increase attendance. The program specifically used recreation to help foster relationships with their peers and the adults in the program, with the intention of reducing conflict, and therefore violence among the students.

A wheelchair basketball showcase was hosted at a state university in New England. Student surveys revealed that the event had a positive effect on students’ views of both individuals with disabilities and adapted sports. Using Allport’s (1954) contact theory as a lens, the author demonstrates how the event met the four positive features that Allport believed should be present in order to reduce negative feelings toward another group: (a) equal status between the groups, (b) common goals, (c) intergroup cooperation and (d) the support of authorities. This exploratory study argues that adapted sports can be an effective method to positively impact stereotypical views of people with disabilities.Subscribe to PALAESTRA

The Affordable Care Act aims to increase affordable coverage, reduce overall costs, and improve health outcomes. To achieve these aims, new knowledge and skills must be built within the existing workforce. The purpose of this article is to examine the behavioral and organizational changes brought about by an educational program that aimed to retool the healthcare workforce for the implementation of integrated primary and behavioral healthcare models, with an added emphasis on prevention. Sixty-three participants of an Advanced Certificate Program completed 1 or more evidence-informed learning modules centered on integrated primary and behavioral health care. The vast majority of students who completed each of the 5 modules of the program reported acquiring new knowledge and skills. Student satisfaction of the program met or exceeded overall expectations. In addition, program participation has resulted in not only students’ intentions to change workplace practices but also actual implementation of workplace changes related to integrated care models. The Advanced Certificate Program appears to be a promising platform for service providers to align their knowledge and skills with the premises of current healthcare reform. © 2018, © 2018 Taylor & Francis.

The purpose of this commentary was to describe the barriers and facilitators to mental health screening efforts for children between age 5 and 18 years within three primary care clinics in poverty-impacted communities as part of an integrated care model. Three screeners, two women and one male, participated in a screening effort between September and December 2015. Screeners were interviewed about their perceptions of barriers and facilitators to screening. Organizational, family, and screener-level factors were found to influence delivery of screenings to children. Given the benefits of screening in primary care settings, identifying barriers to these initiatives and ways to address them pre-emptively could potentially alter the developmental trajectory and outcomes of children at risk for serious mental health conditions. © 2018, © 2018 Taylor & Francis.

Disproportionately high rates of caregiver stress and depression are found among poverty-impacted communities, with high levels of caregiver stress and depression putting youth at heightened risk for the onset and perpetuation of disruptive behavior disorders. The purpose of this study was to examine the effects of a behavioral parent training program called the 4Rs and 2Ss for Strengthening Families Program (4R2S) on caregiver stress and depressive symptoms among 320 youth aged 7 to 11 and their families assigned to either the 4R2S or services as usual (SAU) condition. Among caregivers with clinically significant (CS) scores at baseline, 4R2S participants manifested significantly reduced scores on the stress and depressive symptom scores to SAU participants at 6-month follow-up. Findings suggest that 4R2S may reduce caregiver stress and depressive symptoms among those caregivers initially manifesting CS levels of stress or depressive symptoms.