Feasibility and acceptability of a brief intervention to improve mild traumatic brain injury recovery: Problem-solving training-concussion.

OBJECTIVE: Mild traumatic brain injuries (mTBIs) are common among Veterans. Although the majority of neurobehavioral symptoms resolve following mTBI, studies with Veteran samples demonstrate a high frequency and chronicity of neurobehavioral complaints (e.g., difficulties with attention, frustration tolerance) often attributed to mTBI. Recent opinions suggest the primacy of mental health treatment, and existing mTBI practice guidelines promote patient-centered intervention beginning in primary care (PC). However, trial evidence regarding effective clinical management in PC is lacking. This study evaluated the feasibility and acceptability of a brief, PC-based problem-solving intervention to reduce psychological distress and neurobehavioral complaints. RESEARCH METHOD/DESIGN: Mixed method open clinical trial of 12 combat Veterans with a history of mTBI, chronic neurobehavioral complaints, and psychological distress. Measures included qualitative and quantitative indicators of feasibility (recruitment and retention metrics, interview feedback), patient acceptability (treatment satisfaction, perceived effectiveness), and change in psychological distress as measured by the Brief Symptom Inventory-18. RESULTS: The protocol was successfully delivered via in-person and telehealth treatment modalities (4.3 sessions attended on average; 58% completed the full protocol). Patient interview data suggested that treatment content was personally relevant, and patients were satisfied with their experience. Treatment completers described the intervention as helpful and reported corresponding reductions in psychological distress (ES = 1.8). Dropout was influenced by the onset of the COVID-19 pandemic. CONCLUSIONS/IMPLICATIONS: Further study with a more diverse, randomized sample is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Web-Based Problem-solving Training With and Without Peer Support in Veterans With Unmet Mental Health Needs: Pilot Study of Feasibility, User Acceptability, and Participant Engagement.

BACKGROUND: eHealth tools have the potential to meet the mental health needs of individuals who experience barriers to accessing in-person treatment. However, most users have less than optimal engagement with eHealth tools. Coaching from peer specialists may increase their engagement with eHealth. OBJECTIVE: This pilot study aims to test the feasibility and acceptability of a novel, completely automated web-based system to recruit, screen, enroll, assess, randomize, and then deliver an intervention to a national sample of military veterans with unmet mental health needs; investigate whether phone-based peer support increases the use of web-based problem-solving training compared with self-directed use; and generate hypotheses about potential mechanisms of action for problem-solving and peer support for future full-scale research. METHODS: Veterans (N=81) with unmet mental health needs were recruited via social media advertising and enrolled and randomized to the self-directed use of a web-based problem-solving training called Moving Forward (28/81, 35%), peer-supported Moving Forward (27/81, 33%), or waitlist control (26/81, 32%). The objective use of Moving Forward was measured with the number of log-ins. Participants completed pre- and poststudy measures of mental health symptoms and problem-solving confidence. Satisfaction was also assessed post treatment. RESULTS: Automated recruitment, enrollment, and initial assessment methods were feasible and resulted in a diverse sample of veterans with unmet mental health needs from 38 states. Automated follow-up methods resulted in 46% (37/81) of participants completing follow-up assessments. Peer support was delivered with high fidelity and was associated with favorable participant satisfaction. Participants randomized to receive peer support had significantly more Moving Forward log-ins than those of self-directed Moving Forward participants, and those who received peer support had a greater decrease in depression. Problem-solving confidence was associated with greater Moving Forward use and improvements in mental health symptoms among participants both with and without peer support. CONCLUSIONS: Enrolling and assessing individuals in eHealth studies without human contact is feasible; however, different methods or designs are necessary to achieve acceptable participant engagement and follow-up rates. Peer support shows potential for increasing engagement in web-based interventions and reducing symptoms. Future research should investigate when and for whom peer support for eHealth is helpful. Problem-solving confidence should be further investigated as a mechanism of action for web-based problem-solving training. TRIAL REGISTRATION: ClinicalTrials.gov NCT03555435; http://clinicaltrials.gov/ct2/show/NCT03555435.

Lifting the lid on disruption fever

PurposeThis paper provides evidence based quantification of both “actual” disruption of industries as well as a measure of disruption “hype”. The data cover a seven-year period from 2012 to 2018 across 12 industries. The authors’ complemented the research with a survey of 2000 business executives. Whereas there has been some measures of disruption in the past, no research to the authors’ knowledge has been conducted that measure both actual disruption and disruption hype.Design/methodology/approachThe current fascination with disruption hides an awkward truth, we assume it is happening, but do we really know for sure? Disruption is rarely defined and almost never measured. Equally, the influence of the hype around disruption is hard to gauge. The authors do not know to what extent hype is driving management action. This is worrisome as the disruption “noise level” can lead to unhealthy collective thinking and bad business decision-making. Some rigour is required. To craft winning strategies, executives should take a more evidence-based approach for managing disruption.FindingsThe authors’ failed to find evidence of any correlation between the hype around an industry disruption and actual disruption within that industry. So the important conclusion for executives is “do not believe the hype”. We found some surprising differences by industry between actual disruption and the hype by industry.Research limitations/implicationsDisruption is one of the most talked about subject in the field of strategy, yet there is little quantification. With this research, the authors’ aim is to advance the fact-based understanding of disruption. Disruption hype is never measured but has a strong influence on executives. The authors have quantified hype using online, search, social media and survey sources. Much more is needed to be able to measure hype more accurately.Practical implicationsThe authors’ recommend a set of practical guidelines for executives to support fact-based strategy formulation: analysis of actual disruption, scenario planning and strategic responses.Social implicationsThe “noise” around industry disruption is so high that it is assumed to happen. Much of what is written is quasi-fake news. The authors need to rebalance the debate with fact-based analysis.Originality/valueTo authors’ knowledge, there has never been any fact-based analysis of both actual and hype disruption levels.