Suicide Prevention Among College Students Before and During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-analysis.

BACKGROUND: Suicide is the second leading cause of death for college-aged individuals worldwide and in the United States. Recent studies have identified preliminary evidence of widening disparities in suicidal behaviors across sex, sexual orientation, race/ethnicity, age, and socioeconomic status among college students. Few systematic reviews and meta-analyses offer a comprehensive understanding of on-campus and off-campus suicide interventions, nor is collated information available for different types of screening, assessment, treatment, and postvention plans. Further challenges have been identified since the COVID-19 pandemic, calling for cost-effective and innovative interventions to address increased rates of suicidal behaviors among college students facing unprecedented stressors. OBJECTIVE: This research protocol describes the first systematic review and meta-analysis to identify the most effective and cost-effective intervention components for universal and targeted (indicated and selected) suicide prevention among college students in a global context. Special attention will be placed on disparities in suicide prevention across sociodemographic subgroups, inclusive interventions beyond campus, global context, and intervention responses to the COVID-19 pandemic. METHODS: A sensitive search strategy will be executed across MEDLINE (Ovid), EMBASE, PsycINFO (EBSCO), ERIC (EBSCO), Cochrane Library, Dissertations and Theses Global (ProQuest), Scopus, Global Index Medicus, SciELO, African Journals Online, Global Health (CABI), and Google Scholar. Data extraction and evaluation will be conducted by three independent researchers. Risk of bias will be assessed. A multilevel meta-regression model and subgroup analysis will be used to analyze the data and estimate effect sizes. RESULTS: The initial search was completed in December 2020 and updated with additional other-language studies in March 2020. We expect the results to be submitted for publication in mid-2021. CONCLUSIONS: Despite increasing rates of suicidal behaviors among college students, few preventative efforts have targeted this population, and fewer focus on factors that might place specific demographic groups at heightened risk. The impact of COVID-19 on suicidal behaviors among college students highlights and exacerbates the urgent need for rapid and effective interventions that might differ from traditional approaches. This equity-focused study will address these gaps and provide a valuable analysis of the effectiveness of suicide prevention programs and interventions. Findings will inform clinicians, researchers, policy makers, families, and organizations about evidence-based interventions for reducing the gaps in the suicide crisis among college students from different sociodemographic groups. TRIAL REGISTRATION: PROSPERO CRD42020225429; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225429. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26948.

Health behavior change in pregnant women: a two-phase study.

BACKGROUND: Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. MATERIALS AND METHODS: Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. RESULTS: In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. CONCLUSIONS: Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.

Outcomes for aging adults following total hip arthroplasty in an acute rehabilitation facility versus a subacute rehabilitation facility: a pilot study.

PURPOSE: The purpose of our study was to determine if aging adults who received rehabilitation following total hip arthroplasty (THA) due to osteoarthritis had better short-term outcomes in an Inpatient Rehabilitation Facility (IRF) compared with those currently receiving rehabilitation in subacute rehabilitation units. METHODS: Thirty-six adults, aged 65 to 88 years, who received inpatient rehabilitation following THA secondary to osteoarthritis participated in this study. A prospective descriptive study of 4 aging adults receiving rehabilitation in 2 subacute rehabilitation facilities and a retrospective descriptive study of 32 aging adults who received rehabilitation in an IRF were conducted. Socioeconomic, medical, rehabilitative care, and demographic data were obtained by review of participants' medical charts. FIM scores of the aging adults in the IRF were obtained by chart review, while FIM scores of the aging adults in the subacute facilities were collected by one of the investigators. RESULTS: In this sample, the aging adults in the IRF appeared to have greater changes in total FIM score, motor subscale FIM score, and self-care subscale FIM score than the aging adults in the subacute facilities. In this sample, discharge setting appeared similar for the aging adults in the two rehabilitation settings. CONCLUSIONS: It is imperative that further research determine if rehabilitation provided in different settings that offer different intensities and durations of rehabilitation affects functional outcomes for aging adults following THA procedures.