Counselors' Perceptions of Their Preparedness for Telemental Health Services: A Phenomenological Examination.

Background: To examine counselors' perceptions of their formal preparation for engaging in telemental health (TMH) counseling with the intent of gaining an understanding of their lived experiences. Materials and Methods: Semistructured interviews were conducted with seven seasoned counselors who regularly engage in technology-mediated distance counseling. Results: The results highlighted themes within two emerging categories: the counselor and training/education. Themes related to motivation and specific counselor attributes emerged from the first category and themes of availability, inadequacy, and modality emerged from the second category. Discussion: The implications from this study suggest a lack of availability and standardization of effective training on TMH delivery. Conclusion: This study identifies areas of potential future research related to counselors' preparation experiences as well specific areas of need for TMH training in counseling graduate programs and other natural opportunities.

Family Structure and Child Behavior Problems in Australia, the United Kingdom, and the United States.

A large body of literature suggests that children living with two married, biological parents on average have fewer behavior problems than those who do not. What is less clear is why this occurs. Competing theories suggest that resource deficiencies and parental selectivity play a part. We suggest that examining different contexts can help adjudicate among different theoretical explanations as to how family structure relates to child behavior problems. In this paper, we use data from the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC), the UK Millennium Cohort Study (MCS), and the US Early Childhood Longitudinal Study (ECLS-K) to examine the relationship between family structure and child behavior problems. Specifically, we look at how living in several configurations of biological and social parents may relate to child behavior problems. Findings suggest both similarities and differences across the three settings, with explanations in the UK results favoring selectivity theories, US patterns suggesting that there is a unique quality to family structure that can explain outcomes, and the Australian results favoring resource theories.

Athletic Training Student Core Competency Implementation During Patient Encounters.

CONTEXT: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience. OBJECTIVE: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters. DESIGN: Cross-sectional study. SETTING: Professional athletic training program, National Collegiate Athletic Association Division I institution. PATIENTS OR OTHER PARTICIPANTS: We purposefully recruited 1 athletic training program that used E*Value software; 40 participants (31 females, 9 males) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. INTERVENTION(S): Participants viewed a 20-minute recorded CC educational module followed by educational handouts, which were also posted online for reference throughout the semester. The E*Value software was used to track PEs, including the type of encounter (ie, actual patient, practice encounter, didactic practice scenario), the type of site where the encounter occurred (university, high school), and the participant's role (observed, assisted, performed), as well as responses to an added block of questions indicating which, if any, of the CCs were implemented during the PE. MAIN OUTCOME MEASURE(S): Variables per patient were PE length (minutes), participant role, site at which the encounter occurred, and whether any of the 6 CCs were implemented ( yes/ no). Variables per participant were average encounter length (minutes), encounter frequency, modal role, clinical site assignment, and the number of times each CC was implemented. Separate 1-way analyses of variance were used to examine the relationships between role or clinical site and implementation of total number of CCs. Multiple linear regressions were used to determine how the average length and frequency of PEs were related to the average and total number of implemented CCs. Binary logistic regression models indicated how the length of each encounter, role of the participant, and type of clinical site related to the implementation of each CC. RESULTS: The roles of participants during PEs were related to their ability to implement the total number of CCs ( F = 103.48, P < .001). Those who observed were likely to implement fewer total CCs than those who assisted (M diff = -0.29, P < .001); those who assisted were likely to implement more total CCs than those who performed (M diff = 0.32, P < .001). Frequency of encounters was the only significant variable in the model examining all independent variables with CC implementation ( b4,32 = 3.34, t = 9.46, P < .001). CONCLUSIONS: The role of the student, namely assisting during PEs, and the volume of PEs should be considered priorities for students to promote greater CC implementation.

A Comparison of Screening Tools for the Early Detection of Peripheral Neuropathy in Adults with and without Type 2 Diabetes.

OBJECTIVE: Examine the effectiveness of the 128 Hz tuning fork, two monofilaments, and Norfolk Quality of Life Diabetic Neuropathy (QOL-DN) questionnaire as tools for the early detection of diabetic peripheral neuropathy (DPN) in overweight, obese, and inactive (OOI) adults or those who have prediabetes (PD) or type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: Thirty-four adults (mean age 58.4 years ± 12.1) were divided by glycemia (10 OOI normoglycemic, 13 PD, and 11 T2D). Sural nerves were tested bilaterally with the NC-stat DPNCheck to determine sural nerve amplitude potential (SNAP) and sural nerve conduction velocity (SNCV). All other testing results were compared to SNAP and SNCV. RESULTS: Total 1 g monofilament scores significantly correlated with SNAP values and yielded the highest sensitivity and specificity combinations of tested measures. Total QOL-DN scores negatively correlated with SNAP values, as did QOL-DN symptoms. QOL-DN activities of daily living correlated with the right SNAP, and the QOL-DN small fiber subscore correlated with SNCV. CONCLUSIONS: The 1 g monofilament and total QOL-DN are effective, low-cost tools for the early detection of DPN in OOI, PD, and T2D adults. The 128 Hz tuning fork and 10 g monofilament may assist DPN screening as a tandem, but not primary, early DPN detection screening tools.

Motivations and Consequences of Alcohol Use among Heavy Drinking Nonstudent Emerging Adults.

Research suggests that nonstudent emerging adults may be at elevated risk for alcohol-related problems in adulthood. The present study utilized a qualitative approach to broaden our understanding of the drinking-related perceptions and experiences of heavy drinking nonstudents, with the ultimate goal of generating meaningful knowledge that could aid intervention planning. Research aims were to identify nonstudent (1) drinking motivations and (2) drinking consequences. Eleven focus groups were conducted (n = 64 participants). Data analytic techniques were used to code transcripts and generate themes emerging from the group data. Analyses revealed three main themes emerged regarding nonstudent reasons for drinking (i.e., emotional, social, enhanced experiences). Four prominent themes were identified for drinking consequences (i.e., physical health, psychological health, risk-taking, life functioning). Our findings underscore several considerations related to intervening with this at-risk and understudied population.

Use of evidence-based practice among athletic training educators, clinicians, and students, part 1: perceived importance, knowledge, and confidence.

CONTEXT: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. OBJECTIVE: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. DESIGN: Cross-sectional study. SETTING: Online survey instrument. PATIENTS OR OTHER PARTICIPANTS: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. MAIN OUTCOME MEASURE(S): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. RESULTS: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). CONCLUSIONS: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.