Quasi-experimentation - design and analysis issues for field settings - cook,td, campbell,dt

Stigma associated with mental illness has malignant effects on the lives of people with serious mental illnesses. Many strategies have been used to combat public stigma—the prejudice and discrimination endorsed by the general population. To identify the most effective approaches, researchers conducted a meta-analysis of data from 72 outcome studies in 14 countries. Overall, strategies that include education about mental illness and contact with people who have mental illness are effective. For adults, contact appears to be more effective, whereas education seems to work best among adolescents.

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201100529

Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies

Purpose and Scope. This article reviews the health and social science research relevant to both the role of powerlessness as a risk factor for disease, and the role of empowerment as a health-enhancing strategy. The research literature surveyed includes studies that address these key concepts from the fields of social epidemiology, occupational health, stress research, social psychology, community psychology, social support and networks, community competence and community organizing. Definitions are provided to operationalize these sometimes loosely-applied terms. Important Findings. Powerlessness, or lack of control over destiny, emerges as a broad-based risk factor for disease. Empowerment, though more difficult to evaluate, can also be demonstrated as an important promoter of health. Major Conclusions. Given the importance and currency of these concepts of powerlessness and empowerment, a model of empowerment education is proposed for health-promotion practitioners. Measurement of empowerment ...

Powerlessness, Empowerment, and Health: Implications for Health Promotion Programs

Social programs need to identify catalysts for action which can be targeted in order to effectively and efficiently meet their goals. A model illustrates how a sense of community can have a catalytic effect on local action (i.e., participation in a block association) by affecting the perception of the environment, social relations, and one’s perceived control and empowerment The model is tested and confirmed through path-analytic and longitudinal techniques.

Sense of community in the urban environment: A catalyst for participation and community development

The authors summarize the dementia caregiving literature and provide recommendations regarding practice guidelines for health professionals working with caregivers. Family caregiving of older persons with disability has become commonplace in the United States because of increases in life expectancy and the aging of the population, with resulting higher prevalence of chronic diseases and associated disabilities, increased constraints in healthcare reimbursement, and advances in medical technology. As a result, family members are increasingly being asked to perform complex tasks similar to those carried out by paid health or social service providers, often at great cost to their own well-being and great benefit to their relatives and society as a whole. The public health significance of caregiving has spawned an extensive literature in this area, much of it focused on dementia caregiving because of the unique and extreme challenges associated with caring for someone with cognitive impairment. This article summarizes the literature on dementia caregiving, identifies key issues and major findings regarding the definition and prevalence of caregiving, describes the psychiatric and physical health effects of caregiving, and reviews various intervention approaches to improving caregiver burden, depression, and quality of life. Authors review practice guidelines and recommendations for healthcare providers in light of the empirical literature on family caregiving.

Family Caregiving of Persons with Dementia: Prevalence, Health Effects, and Support Strategies

Family Caregiving in Chronic Illness

Overview of Family Caregiving Theoretical Perspectives on Caregiving Caregiving in Cancer Caregiving in Heart Disease Caregiving in Stroke Caregiving in Alzheimer's Disease Caregiving in Chronic Mental Illness Common Factors Affecting Family Caregivers of the Chronically Ill A Research Synthesis Caregiver Intervention Outcome Studies Future Directions Research and Policy

Family caregiving in chronic illness: Alzheimer's disease, cancer, heart disease, mental illness, and stroke.

This study uses a stress-coping-support framework to examine the predictors of caregiver burden with a sample of 103 lower social class family caregivers of persons with chronic mental illness. Results of multiple regression analyses show that the greater the frequency of client behavioral symptoms and the lower the amount of perceived support from family members, the higher the level of overall caregiver burden. Examination of the predictors of specific types of burden-family disruption, stigma, strain, and dependency-reveal that different constellations of variables predict different types of burden. The need for mental health agencies to address caregiver and client concerns is addressed. Implications are presented for practice and future research.

Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness

This review of Ule research litcrature on family adjustmenl to canccr idcntifics thc factors that consistently predict the extent of psychosocial problems experienced by family members. A conceptual model was applied that viewed the degree of family strain as being determined by two sets of variables: the objective factors of the illness itself and family context variables. With regard to objective factors, Ule degree of family strain is affected primarily by the severity of the illness as well as by the suddenness of its onset and the patient's own level of distress. In addition, such contextual variables as thc age, gender, and health of family members. Their other life stressors and previous psychological problems, family stage and relational bonds, and social supports of family members also conlribute to the psychosocial impact of illness on the family.

Predictors of Strain in Families of Cancer Patients

This study examined the predictors of depressive symptomatology among caregivers of persons with chronic mental illness. Data were collected through in-person interviews with family caregivers of 103 adults with chronic mental illness who were served by mental health case management agencies. The results indicated that insufficiency of overall social support was the most powerful predictor of caregiver depressive symptomatology. In addition, caregiver burden had a significant unique contribution to caregiver depressive symptomatology, with higher levels of burden associated with greater levels of caregiver depressive symptomatology. Higher levels of client behavioral problems and insufficient support from family members and mental health professionals related to the caregiving role were associated with higher levels of caregiver depressive symptomatology through their associations with caregiver burden. Caregiver race was not significantly related to caregiver burden or to caregiver depressive symptomatology after controlling for other variables. Over two-fifth of White caregivers and over one-quarter of Black caregivers were at risk for clinical depression. Implications for practice and research are discussed.

David E. Biegel

Papers

Family Caregiving in Chronic Illness

Family caregiving in chronic illness: Alzheimer's disease, cancer, heart disease, mental illness, and stroke.

Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness

Predictors of Strain in Families of Cancer Patients

Predictors of Depressive Symptomatology Among Lower Social Class Caregivers of Persons with Chronic Mental Illness