Effectiveness of the KiVa anti-bullying program in the Czech Republic: A cluster randomized control trial.

AIMS: One of the most widely used evidence-based anti-bullying programs, KiVa, originates from Finland and aims to change students' peer context, activate teachers, and inform parents with two main components (universal preventive actions and indicated actions when bullying occurs), complemented by monitoring. Because research documented somewhat varied KiVa outcomes in different countries and because there is a lack of research focusing solely on the effectiveness of the universal and indicated actions, this study aimed to evaluate the effectiveness of KiVa main components when implemented in a new country. This two-arm parallel cluster randomized control trial (RCT) evaluated the effectiveness of the KiVa anti-bullying program in elementary schools in the Czech Republic. It examined the effects of the universal and indicated actions on self-reported bullying and victimization as primary outcomes and well-being as a secondary outcome, while keeping monitoring constant across the intervention and control schools. The study also examined the role of implementation fidelity on the proposed outcomes. METHODS: Schools were allocated via stratified randomization into a KiVa intervention group (12 schools, 35 classes, N = 407 students) or a wait-list control group (12 schools, 32 classes, N = 400 students). The study employed data from baseline and post-measurement waves, which were 10 months apart. RESULTS: The data were analyzed using linear mixed effects models, which showed no significant intervention or fidelity effects for bullying, victimization, and well-being. However, promising trends (at α < .10) were revealed, such as lower levels of bullying observed in the intervention group and in schools with high implementation fidelity. Additional analysis using Bayes factors supported these promising trends and provided moderate support for lower levels of victimization in the intervention group compared to the control schools. CONCLUSIONS: Evaluation of effectiveness of anti-bullying programs could benefit from a more targeted fidelity assessment at the classroom or individual level and from distinguishing between the effects of the main components of the programs and the effects of monitoring. The promising yet non-significant intervention and fidelity effects suggest that schools may require enhanced support and longer implementation time frames than a single school year, especially when implementation faces structural obstacles, such as the Covid-19 pandemic.

Applying dynamic systems theory and complexity theory methods in psychotherapy research: A systematic literature review.

OBJECTIVE: Dynamic systems theory and complexity theory (DST/CT) is a framework explaining how complex systems change and adapt over time. In psychotherapy, DST/CT can be used to understand how a person's mental and emotional state changes during therapy incorporating higher levels of complexity. This study aimed to systematically review the variability of DST/CT methods applied in psychotherapy research. METHODS: A primary studies search was conducted in the EBSCO and Web of Knowledge databases, extracting information about the analyzed DST/CT phenomena, employed mathematical methods to investigate these phenomena, descriptions of specified dynamic models, psychotherapy phenomena, and other information regarding studies with empirical data (e.g., measurement granularity). RESULTS: After screening 38,216 abstracts and 4,194 full texts, N = 41 studies published from 1990 to 2021 were identified. The employed methods typically included measures of dynamic complexity or chaoticity. Computational and simulation studies most often employed first-order ordinary differential equations and typically focused on describing the time evolution of client-therapist dyadic influences. Eligible studies with empirical data were usually based on case studies and focused on data with high time intensity of within-session dynamics. CONCLUSION: This review provides a descriptive synthesis of the current state of the proliferation of DST/CT methods in the psychotherapy research field.

The associations between interoceptive awareness, emotion regulation, acceptance, and well-being in patients receiving multicomponent treatment: a dynamic panel network model.

Mechanisms of change represent the cornerstone of the therapeutic process. This study aimed to investigate how network models could be used to test mechanisms of change at a group level. A secondary aim was to investigate which of the several hypothesized mechanisms (emotion regulation, interoceptive awareness, and acceptance) are related to changes in psychological well-being. The sample comprised adult patients suffering from psychological disorders (N=444; 70% women) from 7 clinical sites in the Czech Republic who were undergoing groupbased multicomponent treatment composed mainly of psychodynamic psychotherapy (lasting from 4 to 12 weeks depending on the clinical site). Data were collected weekly using the multidimensional assessment of interoceptive awareness, emotion regulation skills questionnaire, chronic pain acceptance questionnaire-symptoms and outcome rating scale. A lag-1 longitudinal network model was employed for exploratory analysis of the panel data. The pruned final model demonstrated a satisfactory fit. Three networks were computed, i.e., temporal, contemporaneous, and between-person networks. The most central node was the modification of negative emotions. Mechanisms that were positively associated with well-being included modification, readiness to confront negative emotions, activity engagement, and trust in bodily signals. Acceptance of negative emotions showed a negative association with well-being. Moreover, noticing bodily sensations, not worrying, and self-regulation contributed indirectly to changes in well-being. In conclusion, the use of network methodology to model panel data helped generate novel hypotheses for future research and practice; for instance, well-being could be actively contributing to other mechanisms, not just a passive outcome.

Well-being impact assessment of artificial intelligence - A search for causality and proposal for an open platform for well-being impact assessment of AI systems.

In recent years, the well-being impact assessment approach has been applied in the area of Artificial Intelligence (AI). Existing well-being frameworks and tools provide a relevant starting point. Taking into account its multidimensional nature, well-being assessment is well suited to assess both the expected positive effects of the technology as well as unintended negative consequences. To-date the establishment of causal links mostly stems from intuitive causal models. Such approaches neglect the fact that to prove causal links between the operation of an AI system and observed effects is difficult due to the immense complexity of the socio-technical context. This article aims at providing a framework for ascertaining the attribution of effects of observed impact of AI on well-being. An elaborated approach to impact assessment potentially enabling causal inferences is demonstrated. Furthermore, a new Open Platform for Well-Being Impact Assessment of AI systems (OPIA) is introduced, which is based on a distributed community to build reproducible evidence through effective identification, refinement, iterative testing, and cross-validation of expected causal structures.

Czech version of the Emotion Regulation Skills Questionnaire (ERSQ): Psychometric evaluation and network model in an adult clinical sample.

The Emotion Regulation Skills Questionnaire (ERSQ, 27 items) is an instrument designed to measure nine emotion regulation skills. This study examined the psychometric properties and longitudinal network structure of the Czech translation of the ERSQ in the clinical sample (primarily mood or neurotic disorders). Czech patients N = 427 completed the ERSQ weekly during treatment. The data were analyzed using confirmatory factor analysis (CFA) and network modeling. The CFA supported an eight-dimensional factor solution (with merged Acceptance and Tolerance subscales). The subscales' internal consistency ranged from ωh = .669 (Bodily sensations) to ωh = .859 (Acceptance/Tolerance). The factor structure was invariant across genders, two age groups, and seven measurement waves (invariance tested as an assumption for network analysis). The longitudinal network model indicated the existence of perceptive and modulatory clusters of emotional regulation skills and revealed the central role of Modification, Bodily sensations, and Readiness for confrontation in emotional regulation. The Czech translation of the ERSQ is a psychometrically sound instrument comparable to the original version. Despite the high internal consistency of the total score (ωtot = .910), the ERSQ is not recommended for use as a unidimensional instrument. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Feasibility of Real-time Behavior Monitoring Via Mobile Technology in Czech Adults Aged 50 Years and Above: 12-Week Study With Ecological Momentary Assessment.

BACKGROUND: Czech older adults have lower rates of physical activity than the average population and lag behind in the use of digital technologies, compared with their peers from other European countries. OBJECTIVE: This study aims to assess the feasibility of intensive behavior monitoring through technology in Czech adults aged ≥50 years. METHODS: Participants (N=30; mean age 61.2 years, SD 6.8 years, range 50-74 years; 16/30, 53% male; 7/30, 23% retired) were monitored for 12 weeks while wearing a Fitbit Charge 2 monitor and completed three 8-day bursts of intensive data collection through surveys presented on a custom-made mobile app. Web-based surveys were also completed before and at the end of the 12-week period (along with poststudy focus groups) to evaluate participants' perceptions of their experience in the study. RESULTS: All 30 participants completed the study. Across the three 8-day bursts, participants completed 1454 out of 1744 (83% compliance rate) surveys administered 3 times per day on a pseudorandom schedule, 451 out of 559 (81% compliance rate) end-of-day surveys, and 736 episodes of self-reported planned physical activity (with 29/736, 3.9% of the reports initiated but returned without data). The overall rating of using the mobile app and Fitbit was above average (74.5 out of 100 on the System Usability Scale). The majority reported that the Fitbit (27/30, 90%) and mobile app (25/30, 83%) were easy to use and rated their experience positively (25/30, 83%). Focus groups revealed that some surveys were missed owing to notifications not being noticed or that participants needed a longer time window for survey completion. Some found wearing the monitor in hot weather or at night uncomfortable, but overall, participants were highly motivated to complete the surveys and be compliant with the study procedures. CONCLUSIONS: The use of a mobile survey app coupled with a wearable device appears feasible for use among Czech older adults. Participants in this study tolerated the intensive assessment schedule well, but lower compliance may be expected in studies of more diverse groups of older adults. Some difficulties were noted with the pairing and synchronization of devices on some types of smartphones, posing challenges for large-scale studies.

Psychometric Evaluation of the Czech Version of Group Cohesiveness Scale (GCS) in a Clinical Sample: A Two-Dimensional Model.

The Group Cohesiveness Scale (GCS, 7 items) measures patient-rated group cohesiveness. The English version of the scale has demonstrated good psychometric properties. This study describes the validation of the Czech version of the GCS. A total of 369 patients participated in the study. Unlike the original study, the ordinal confirmatory factor analysis (CFA) supported a two-dimensional solution (RMSEA = 0.075; TLI = 0.986). The analysis demonstrated the existence of two moderately to highly associated (r = 0.79) domains of group cohesiveness-affective and behavioral. The two-dimensional model was invariant across genders, age, education, and time (retest after 6 weeks) up to factor means level. Internal consistency reached satisfactory values for both domains (affective, ω = 0.86; behavioral, ω = 0.81). In terms of convergent validity, only weak association was found between the GCS domains and the group working alliance measured by the Group Outcome Rating Scale (GSRS). This is the first revision of the factor structure of the GCS in the European context. The scale showed that the Czech version of the GCS is a valid and reliable brief tool for measuring both aspects of group cohesiveness.

The Role of Psychological Factors in Older Adults' Readiness to Use eHealth Technology: Cross-Sectional Questionnaire Study.

BACKGROUND: Information and communication technology (ICT) use among older adults has been on the rise in recent years. However, the predictors and mechanisms behind older adults' acceptance and use of ICT are not clear. OBJECTIVE: This study aimed to systematically describe ICT usage among Czech older adults and to evaluate the factors influencing their ICT use and readiness to use digital technology to promote health (eHealth readiness). The primary focus was on psychological factors and the role of persons close to older adults. METHODS: The research utilized cross-sectional survey data from a quota-based sample of Czech older adults (>50 years) and persons close to them further referred to as close persons (N=250 dyads). A structural equation modeling framework was used to evaluate relationships between psychological factors, ICT use, and eHealth readiness. RESULTS: Czech older adults' use of ICT is low with the exception of cell phone usage (cell phone usage by 173/250, 69.2%; other devices used by 50/250, 20.0% of older adults or less). Apart from age (ß=-.21; P<.001), eHealth readiness was predicted by ICT use (ß=.65; P<.001). eHealth readiness was also indirectly affected by the need for cognitive closure (NFCC): individuals with a high need for closure perceived more barriers to ICT (ß=.23; P=.01) and more reported barriers were linked to lower ICT usage (ß=-.21; P=.001). The expected positive relationships between eHealth readiness of persons close to older adults and ICT use and eHealth readiness of older adults were not significant, but the total effect of eHealth readiness of persons close to older adults on eHealth readiness of older adults was positive and significant (ß=.18; P=.01), indicating some level of influence of persons close to them on older adults' attitudes and behaviors. CONCLUSIONS: This study provided the first systematic examination of Czech older adults' ICT usage and eHealth readiness. Novel predictors (NFCC and close persons' variables) were evaluated and yielded actionable results. More research is needed to clarify the role of persons close to older adults.

Therapeutic change mechanisms in adults with medically unexplained physical symptoms: A systematic review.

OBJECTIVE: Although psychological treatments for patients suffering from medically unexplained physical symptoms (MUPS) show promising results, evidence for their effectiveness is still limited. The aim of this study was to review the existing empirical support for change mechanisms that explain treatment effect in terms of symptom intensity and symptom interference in the daily lives of patients. METHODS: A systematic database search was conducted. Sixty-seven eligible studies were found, and change mechanism effects were extracted from them. The data were subjected to a systematic review. RESULTS: Fifteen change mechanisms were identified. Those receiving the most consistent support included Increasing symptom acceptance, Development of coping strategies, and Positive treatment expectations, although the last mechanism was investigated in only two studies. Almost all mechanisms received support for at least one type of outcome, either at post-treatment or at follow-up. CONCLUSIONS: Although some empirical support exists for many mechanisms, some of them have received only marginal attention in empirical studies. These limitations prevented us from deriving more definite conclusions.

GPs' perspectives on eHealth use in the Czech Republic: a cross-sectional mixed-design survey study.

BACKGROUND: Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others. AIM: The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies. DESIGN & SETTING: A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey. METHOD: Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used. RESULTS: Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time). CONCLUSION: In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient-provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic.

Mobile Health Interventions for Physical Activity, Sedentary Behavior, and Sleep in Adults Aged 50 Years and Older: A Systematic Literature Review.

We provide a systematic review of interventions utilizing mobile technology to alter physical activity, sedentary behavior, and sleep among adults aged 50 years and older. A systematic search identified 52 relevant articles (randomized control trial [RCT], quasi-experimental, pre/post single-group design). Of 50 trials assessing physical activity, 17 out of 29 RCTs and 13 out of 21 trials assessed for pre/post changes only supported the effectiveness of mobile interventions to improve physical activity, and 9 studies (five out of 10 RCTs and all four pre/post studies) out of 14 reduced sedentary behavior. Only two of five interventions improved sleep (one out of two RCTs and one out of three pre/post studies). Text messaging was the most frequently used intervention (60% of all studies) but was usually used in combination with other components (79% of hybrid interventions included SMS, plus either web or app components). Although more high-quality RCTs are needed, there is evidence supporting the effectiveness of mHealth approaches in those aged 50 years and older.