Publications by authors named "Anao Zhang"

28 Publications

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Solution-focused brief therapy for adolescent and young adult cancer patients in China: a pilot randomized controlled trial.

J Psychosoc Oncol 2021 Jul 7:1-18. Epub 2021 Jul 7.

Department of Medicine, University of Chicago, Chicago, IL, USA.

Objective: This pilot clinical trial investigated solution-focused brief therapy (SFBT) for psychological distress among adolescent and young adult (AYA) patients with cancer in China.

Methods: Fifty Chinese AYA patients diagnosed with cancer were randomized into the treatment group (SFBT) and control group (active control). Psychological distress was measured by the brief symptom inventory and hope was measured by the Herth-Hope-Index. Treatment effects were analyzed using analysis-of-covariance and between-group small-sample-size corrected Hedges' .

Results: The results indicated that SFBT resulted in a significant reduction in the psychological distress and improvement in hope of AYA patients with cancer. Analyses of the 4-week posttreatment score suggest the short-term sustainability of SFBT for psychological distress among AYAs diagnosed with cancer.

Conclusions And Implications: This study has demonstrated that SFBT's impact is statistically significant and clinically meaningful. The inclusion of positive emotions, i.e., hope, as part of the investigation also highlighted the significance of promoting positive emotions among AYA patients with cancer.
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http://dx.doi.org/10.1080/07347332.2021.1931627DOI Listing
July 2021

The Effectiveness of Psychosocial Interventions for Elder Abuse in Community Settings: A Systematic Review and Meta-Analysis.

Front Psychol 2021 26;12:679541. Epub 2021 May 26.

Graduate School of Social Work, University of Denver, Denver, CO, United States.

As a global public health concern, elder abuse negatively affects health, psychosocial wellbeing, and mortality among elders. Research and practice efforts made to explore effective prevention and intervention strategies are growing. Despite the growing number of intervention studies on elder abuse, research synthesis on the empirical literature seems lacking. This study aims to identify the pooled effect size of prevention and interventions targeted ultimate and intermediate outcomes for elder abuse that occurred in community settings. Following the Cochrane guideline, our team searched across eight electronic databases and manually searched reference lists of eligible studies and existing systematic reviews for all potentially eligible studies. A random-effects model of 51 effect size estimates reported an overall positive and statistically significant treatment effect of psychosocial interventions for elder abuse, = 0.63, < 0.05. The overall treatment effect was approaching statistical significance at 0.1 level for ultimate outcomes, = 0.32, = 0.09, and intermediate outcomes, = 0.75, = 0.1. An overall significant effect size was found among family-based interventions, = 0.59, < 0.05, and interventions targeting older adults and their caregivers, = 0.45, < 0.05. Existing evidence supports an overall significant effect for psychosocial interventions for elder abuse. Interventions that used a family-based model, combined education and supportive services, and targeted both caregivers and elders, showed significant effect size, suggesting such features being considered in elder abuse intervention design. Future intervention research is needed to shed light on the link between intervention activities and ultimate change in elder abuse behaviors.
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http://dx.doi.org/10.3389/fpsyg.2021.679541DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187616PMC
May 2021

Technology-Assisted Psychosocial Interventions for Childhood, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis.

J Adolesc Young Adult Oncol 2021 May 6. Epub 2021 May 6.

University of Michigan School of Social Work, Ann Arbor, Michigan, USA.

Technology-assisted interventions are essential in supporting cancer survivors' psychosocial outcomes, especially for childhood, adolescent, and young adult (AYA) cancer survivors, a tech-savvy generation. This study aims to systematically evaluate review and meta-analyze technology-assisted interventions for childhood and AYA cancer survivors. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the study team used a pre-set of key words and searched studies across 11 electronic databases and 4 professional websites, and conducted a manual search of reference lists from published reviews. Meta-analysis of small sample size corrected Hedges' was conducted using meta-regression with robust variance estimation. Final analysis included a total of 28 clinical trials, including 237 effect sizes reported an overall statistically significant treatment effect of technology-assisted psychosocial interventions for childhood and AYA cancer survivors,  = 0.382, 95% confidence interval (CI) 0.243 to 0.521,  < 0.0001. Subgroup analysis revealed that distraction-based interventions and interventions for psychosocial and emotional health were overall statistically significant, whereas interventions for childhood and AYA cancer survivors' cancer knowledge outcomes and physical and functional health outcomes were statistically nonsignificant. Moderator analysis found intervention target was a significant moderator. Technology-assisted interventions for childhood and AYA cancer survivors were overall effective across domains of survivorship outcomes. Favorable evidence was found primarily for childhood cancer survivors with limited support for AYA cancer survivors. Although existing technology-assisted interventions are overall promising, research support for cancer survivors from different age groups and with different psychosocial challenges varies and should be considered individually.
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http://dx.doi.org/10.1089/jayao.2021.0012DOI Listing
May 2021

Mindfulness-based interventions for breast cancer patients in China across outcome domains: a systematic review and meta-analysis of the Chinese literature.

Support Care Cancer 2021 Mar 26. Epub 2021 Mar 26.

Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine, Shanghai, China.

Objective: This study aims to evaluate the treatment effect of a mindfulness-based intervention for Chinese breast cancer patients across outcome domains, including symptom-related, psychosocial, and quality of life outcomes.

Methods: Following the Cochrane Systematic Review guideline, we searched across five electronic databases, reference lists of eligible studies, professional websites, and major academic journals in Chinese. Publication bias was assessed using funnel plot and Vevea and Woods sensitivity analysis, and risk of bias was evaluated using the revised Cochrane risk of bias tool for randomized trials and risk of bias in non-randomized studies of interventions. A meta-analysis of Hedges' g was conducted using meta-regression with robust variance estimation.

Results: Final analysis included a total of 45 controlled trials containing 286 effect size estimates. Across outcome domains, studies reported an overall large and statistically significant treatment effect, d = 0.921, 95% CI (0.805, 1.040), p < 0.001. Subgroup analyses of specific domains of outcome reported overall significant treatment effects for (1) symptom-related outcomes, d = 0.885, 95% CI (0.657, 1.110), p < 0.001; (2) psychosocial wellness outcomes, d = 0.984, 95% CI (0.879, 1.090), p < 0.001; and (3) quality of life, d = 0.990, 95% CI (0.776, 1.200), p < 0.001. Moderator analysis did not identify any significant moderator.

Conclusion: Chinese literature reported an overall statistically significant and large treatment effect of a mindfulness-based intervention for breast cancer patients in China. Except for physical symptom outcomes, e.g., nausea/vomiting and pain, a mindfulness-based intervention was effective across outcome domains among Chinese breast cancer patients.
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http://dx.doi.org/10.1007/s00520-021-06166-0DOI Listing
March 2021

A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial.

Mindfulness (N Y) 2021 Mar 18:1-11. Epub 2021 Mar 18.

Graduate School of Social Work, University of Denver, Denver, CO USA.

Objectives: The coronavirus (COVID-19) global pandemic has increased psychological distress among the general population. The objective of this study is to evaluate a mindfulness-based intervention for psychological distress among Chinese residents during COVID-19.

Methods: This study used a switching replications design to test the feasibility and efficacy of a brief online mindfulness-based intervention for Chinese residents' psychological distress. Fifty-one residents in the Hubei province were randomly allocated to two groups (experimental group and waitlist control group) with three waves of measurement at time 1, time 2, and time 3 for changes in mindfulness and psychological distress.

Results: In addition to significant within-group improvements over time for both groups, OLS linear regression with full information likelihood estimation revealed statistically significant between-group treatment effects across outcome domains, including mindfulness awareness, = 2.84, < 0.001, = 6.92, psychological distress, = -21.33, < 0.001, = 6.62, somatic symptoms, = -6.22, < 0.001, = 4.42, depressive symptoms, = -7.16, < 0.001, = 5.07, and anxiety symptoms, = -8.09, < 0.001, = 6.84.

Conclusions: Results suggest that a brief online mindfulness-based intervention can be a feasible and promising intervention for improving mindfulness and decreasing psychological distress among Chinese residents staying at home during the COVID-19 outbreak. The study used a small convenience sample which led to a concern of external generalizability and with limited evaluation of long-term change.
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http://dx.doi.org/10.1007/s12671-021-01618-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025PMC
March 2021

Psychosocial, behavioral, and supportive interventions for pediatric, adolescent, and young adult cancer survivors: A systematic review and meta-analysis.

Crit Rev Oncol Hematol 2021 Apr 3;160:103291. Epub 2021 Mar 3.

University of Michigan Medical School Department of Internal Medicine, United States.

Background: Pediatric, adolescent, and young adult (PAYA) cancer survivors suffer from multiple domains of adverse psychosocial and behavioral outcomes during and after their cancer treatment. This study conducted a systematic review and metaanalysis of psychosocial, behavioral, and supportive interventions for PAYA cancer survivors.

Methods: We searched 11 electronic databases, 4 professional websites, and manual search of reference lists in existing reviews. We selected randomized controlled trials and controlled trials without randomization focusing on PAYA cancer survivors across six outcome domains.

Results: We included 61 studies (4,402 participants) published between 1987 and 2020. Overall risk of bias across studies was low. We identified an overall moderate and statistically significant treatment effect size for PAYA cancer survivors across six outcome domains.

Conclusion: psychosocial, behavioral, and supportive interventions were overall effective for PAYA cancer survivors. However, interventions were not effective for certain outcome domains, and less effective among AYA versus pediatric cancer survivors.
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http://dx.doi.org/10.1016/j.critrevonc.2021.103291DOI Listing
April 2021

Associations of Ageism and Health: A Systematic Review of Quantitative Observational Studies.

Res Aging 2021 Aug 15;43(7-8):311-322. Epub 2020 Dec 15.

School of Social Work, University of Michigan, Ann Arbor, MI, USA.

This systematic review synthesizes observational studies on the relationship between ageism and health. We searched 10 electronic databases and included 67 articles. The operationalization of ageism in these studies can be classified into three constructs: age stereotype, self-perceptions of aging, and age discrimination. Most ageism measures were used within a single study, and many lacked information about psychometric properties. Seven health domains-disease, mortality, physical/functional health, mental health, cognitive function, quality of life, and health behavior-have been used as outcomes. Evidence supports a significant association between ageism and health, particularly between self-perceptions of aging and health. Nine studies report moderators, which helps to identify those more vulnerable to negative effects of ageism and inform the development of interventions. The review suggests that the literature has examined limited dimensions of ageism, and that developing valid and reliable instruments for ageism-related concepts is a priority.
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http://dx.doi.org/10.1177/0164027520980130DOI Listing
August 2021

Associations of Ageism and Health: A Systematic Review of Quantitative Observational Studies.

Res Aging 2021 Aug 15;43(7-8):311-322. Epub 2020 Dec 15.

School of Social Work, University of Michigan, Ann Arbor, MI, USA.

This systematic review synthesizes observational studies on the relationship between ageism and health. We searched 10 electronic databases and included 67 articles. The operationalization of ageism in these studies can be classified into three constructs: age stereotype, self-perceptions of aging, and age discrimination. Most ageism measures were used within a single study, and many lacked information about psychometric properties. Seven health domains-disease, mortality, physical/functional health, mental health, cognitive function, quality of life, and health behavior-have been used as outcomes. Evidence supports a significant association between ageism and health, particularly between self-perceptions of aging and health. Nine studies report moderators, which helps to identify those more vulnerable to negative effects of ageism and inform the development of interventions. The review suggests that the literature has examined limited dimensions of ageism, and that developing valid and reliable instruments for ageism-related concepts is a priority.
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http://dx.doi.org/10.1177/0164027520980130DOI Listing
August 2021

The effectiveness of modified, group-based CBT for dementia worry among Chinese elders.

J Affect Disord 2020 09 22;274:76-84. Epub 2020 May 22.

University of Michigan, School of Social Work, Ann Arbor, MI, USA.

Objectives: Dementias are highly prevalent among Chinese elders. This study examined the effectiveness of a modified group cognitive behavioral therapy (CBT) on dementia worry among Chinese older adults.

Methods: Eighty-two older adults recruited from four elder group homes were randomly assigned to either intervention or control group. The intervention group (n= 44) received eight weekly 60-minute face-to-face CBT, while the control group (n=38) received treatment-as-usual.

Results: Outcomes indicated that the modified group CBT has significantly reduced dementia worry and culturally biased beliefs about dementia (p<.001). Study findings supported both statistically and clinically significant effect of modified group CBT on dementia worry [g=-1.52, 95% CI (-2.01, -1.03)] and biased beliefs about dementia [g=-.95, 95% CI (-1.40, -.49)].

Discussion: The culturally adapted CBT is promising in alleviating worries and anxiety over dementia among Chinese older adults. Future research needs to include larger samples and participants from different regions to replicate findings.
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http://dx.doi.org/10.1016/j.jad.2020.05.054DOI Listing
September 2020

Age moderates the association between psychological distress and engagement in mindfulness among cancer patients and survivors: A population-based study.

J Psychosoc Oncol 2020 Sep-Oct;38(5):513-526. Epub 2020 May 25.

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

Purpose: We aim to evaluate the relationship between psychological distress and engagement in mindfulness among a national representative sample of cancer survivors.

Sample And Design: Using the 2017 National Health Interview Survey, our final analytical sample included 3068 participants who reported having been diagnosed with cancer.

Methods And Analysis: We used logistic regression analysis to assess the association and to test age as a moderator. We also conducted follow-up analysis using Fisher's -to- transformation. All analyses were adjusted for complex sample weights.

Findings: Cancer survivors who had subclinical and clinical psychological distress were more likely to engage in mindfulness, OR = 1.59, 95% CI [1.24, 2.02] and OR = 1.45, 95% CI [1.02, 2.05], respectively. Age significantly moderated such association with the relationship much stronger among those who are younger (younger than 65 years old) than those who are older (65 years or older),  = 0.97, 95% CI [0.95, 0.99].

Conclusions: The relationship between psychological distress and engagement in mindfulness differs significantly by a survivor's age. Psychosocial oncological providers need to account for a survivor's age when delivering mindfulness based care to address psychological distress.

Implications: Providers should be mindful of a survivor's age when recommending mindfulness oriented practices.
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http://dx.doi.org/10.1080/07347332.2020.1764158DOI Listing
June 2021

Age moderates the association between psychological distress and engagement in mindfulness among cancer patients and survivors: A population-based study.

J Psychosoc Oncol 2020 Sep-Oct;38(5):513-526. Epub 2020 May 25.

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

Purpose: We aim to evaluate the relationship between psychological distress and engagement in mindfulness among a national representative sample of cancer survivors.

Sample And Design: Using the 2017 National Health Interview Survey, our final analytical sample included 3068 participants who reported having been diagnosed with cancer.

Methods And Analysis: We used logistic regression analysis to assess the association and to test age as a moderator. We also conducted follow-up analysis using Fisher's -to- transformation. All analyses were adjusted for complex sample weights.

Findings: Cancer survivors who had subclinical and clinical psychological distress were more likely to engage in mindfulness, OR = 1.59, 95% CI [1.24, 2.02] and OR = 1.45, 95% CI [1.02, 2.05], respectively. Age significantly moderated such association with the relationship much stronger among those who are younger (younger than 65 years old) than those who are older (65 years or older),  = 0.97, 95% CI [0.95, 0.99].

Conclusions: The relationship between psychological distress and engagement in mindfulness differs significantly by a survivor's age. Psychosocial oncological providers need to account for a survivor's age when delivering mindfulness based care to address psychological distress.

Implications: Providers should be mindful of a survivor's age when recommending mindfulness oriented practices.
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http://dx.doi.org/10.1080/07347332.2020.1764158DOI Listing
June 2021

Correction to: Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression.

J Behav Med 2020 Apr;43(2):339

Department of Sociology and Social Work, Shanghai Normal University, Shanghai, China.

The original version of this article unfortunately contained a typo in the second author surname. The author surname was incorrectly listed as Borhneimer. The correct name should be Bornheimer.
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http://dx.doi.org/10.1007/s10865-019-00132-2DOI Listing
April 2020

Self-Rated Health Among Older Chinese Americans: The Roles of Acculturation and Family Cohesion.

J Appl Gerontol 2021 04 6;40(4):387-394. Epub 2020 Jan 6.

University of Michigan, Ann Arbor, USA.

Previous research has established the influence of acculturation and family cohesion on Chinese Americans' mental health and health behavior; however, the influence of acculturation and family cohesion on self-rated health among this population has not been examined. The purpose of this study is to examine the association between family cohesion, acculturation, and self-rated health among older Chinese Americans. Data came from structured interviews with 385 Chinese Americans aged 55 and older living in a large metropolitan area in Southwest. We used logistic regression to examine the association between acculturation, family cohesion, and self-rated health. Acculturation was positively associated with self-rated health only among those with medium (odds ratio [OR] = 2.27, < .05) and high (OR = 1.93, < .05) family cohesion, but not among those with low family cohesion. Findings highlight the significance of involving family members and strengthening family support in the acculturation and supportive services provided to older Chinese Americans.
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http://dx.doi.org/10.1177/0733464819898316DOI Listing
April 2021

Perceived threat of Alzheimer's disease and related dementias in Chinese older adults: The role of knowledge and perceived stigma.

Int J Geriatr Psychiatry 2020 02 6;35(2):223-229. Epub 2019 Dec 6.

School of Social Work, University of Michigan, Ann Arbor, MI.

Objectives: This study focused on perceived threat of Alzheimer's disease and related dementias (ADRD) in Chinese older adults and investigated its associations with their perceived stigma and knowledge of ADRD.

Methods: We examined Chinese older adults' perceived threat of ADRD and its associations with perceived stigma, knowledge of ADRD, family variables and health variables. Data for this cross-sectional study were collected by student interviewers in 2016. The participants (N = 754) were recruited from two urban communities in mainland China and their ages ranged from 60 to 89 (M = 69.54, SD = 7.35).

Results: Hierarchical regression analyses indicated that those who are younger, have more depressive symptoms and lower levels of family cohesion are more likely to worry about ADRD. More ADRD knowledge and higher levels of perceived stigma are significantly associated with perceived threat of ADRD. Community site moderated the relationship between stigma and perceived threat of ADRD.

Conclusions: Intervention or service programs need to promote ADRD knowledge and awareness in a culturally sensitive way as well as address stigma and fear toward ADRD in the older population. Future studies are needed to incorporate more cultural and environmental factors to fully understand Chinese older adults' attitudes toward and literacy of ADRD.
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http://dx.doi.org/10.1002/gps.5240DOI Listing
February 2020

Perceived threat of Alzheimer's disease and related dementias in Chinese older adults: The role of knowledge and perceived stigma.

Int J Geriatr Psychiatry 2020 02 6;35(2):223-229. Epub 2019 Dec 6.

School of Social Work, University of Michigan, Ann Arbor, MI.

Objectives: This study focused on perceived threat of Alzheimer's disease and related dementias (ADRD) in Chinese older adults and investigated its associations with their perceived stigma and knowledge of ADRD.

Methods: We examined Chinese older adults' perceived threat of ADRD and its associations with perceived stigma, knowledge of ADRD, family variables and health variables. Data for this cross-sectional study were collected by student interviewers in 2016. The participants (N = 754) were recruited from two urban communities in mainland China and their ages ranged from 60 to 89 (M = 69.54, SD = 7.35).

Results: Hierarchical regression analyses indicated that those who are younger, have more depressive symptoms and lower levels of family cohesion are more likely to worry about ADRD. More ADRD knowledge and higher levels of perceived stigma are significantly associated with perceived threat of ADRD. Community site moderated the relationship between stigma and perceived threat of ADRD.

Conclusions: Intervention or service programs need to promote ADRD knowledge and awareness in a culturally sensitive way as well as address stigma and fear toward ADRD in the older population. Future studies are needed to incorporate more cultural and environmental factors to fully understand Chinese older adults' attitudes toward and literacy of ADRD.
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http://dx.doi.org/10.1002/gps.5240DOI Listing
February 2020

The stress and coping experiences among Chinese rural older adults in welfare housing: through the lens of life review.

Aging Ment Health 2019 09 13;23(9):1086-1094. Epub 2019 May 13.

d School of Social Work , University of Michigan , Ann Arbor , MI , USA.

Responding to the growing needs of the largest aging population in the world, China has been experimenting interventions introduced from other countries to serve its older citizens. Using the life review approach, this study aimed to understand stress and coping experiences of a group of rural older adults living in public welfare housing, and to identify the effect of life review on their perceptions of quality of life. This study used an experimental research design with qualitative interviews. Analyses mainly focused on qualitative interview data of participants in the experimental group (n=24). Quantitative analyses were conducted to compare changes in the measure of quality of life between the experimental group and the control group (n=22). Qualitative analyses indicated that salient life course stressors among rural Chinese old adults included financial strains, health concerns, and loss of loved ones. Such stressors were intertwined with historical and social changes they experienced in China. Coping strategies developed to survive a harsh young adulthood were used to deal with aging challenges and adaption to the welfare housing. Quantitative analysis found those who went through life review reported significant improvement in perceived quality of life compared to the control group. Life review showed preliminary acceptability and effectiveness among the most disadvantaged and marginalized older group in China. It suggests this approach can be adapted to help understand life experience of older adults from different socioeconomic and cultural backgrounds, and to bring about positive changes in their wellbeing.
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http://dx.doi.org/10.1080/13607863.2019.1612322DOI Listing
September 2019

Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression.

J Behav Med 2019 Dec 19;42(6):1117-1141. Epub 2019 Apr 19.

Department of Sociology and Social Work, Shanghai Normal University, Shanghai, China.

Cognitive-behavioral therapy (CBT) is well supported for treating depressive and anxiety disorders. Trials of CBT for anxiety and depression in primary care have increased over the past decade, yet only one meta-analysis, published in 2015, examined this topic and the scope of that review is relatively narrow. This study conducted a systematic review and meta-analysis of primary care based CBT for depression and anxiety. A search of seven electronic databases, six professional websites, and reference lists from articles meeting inclusion criteria was conducted for studies published between 1900 and November 2018. Fifty-seven eligible studies (including 10,701 participants; 221 effect sizes) of randomized controlled trials were eligible and included for meta-analysis using robust variance estimation in meta-regression. Outcome indicators were depression and anxiety measures. An overall significant treatment effect, d = 0.400, 95% CI (0.235, 0.566), p < 0.001, of CBT for depression and anxiety disorders in primary care was identified. Subgroup analyses indicated significant treatment effect for: (1) depressive (d = 0.425, p < 0.001) and anxiety (d = 0.393, p < 0.01) outcomes, (2) studies conducted inside primary care (d = 0.412, p < 0.001), (3) studies using individual-based CBT (d = 0.412, p < 0.001), (4) studies without primary care physician involvement (d = 0.395, p < 0.001), and (5) studies using both tele-health (d = 0.563, p < 0.001) and in-person CBT (d = 0.363, p < 0.001). The percentage of White participants, treatment composition (CBT only versus CBT + other approaches), and treatment duration were significant moderators. Implications for clinical practice are discussed based on both moderator and subgroup analysis results.
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http://dx.doi.org/10.1007/s10865-019-00046-zDOI Listing
December 2019

Understanding the Effectiveness of Psychosocial Services for Anxiety and Depression in Chinese Older Adults: A Systematic Review and Meta-Analysis of Controlled Trials.

Gerontologist 2020 01;60(1):e76-e92

The University of Texas at Austin, Steve Hicks School of Social Work.

Background And Objectives: There exists an imperative need to comprehensively evaluate the effectiveness of psychosocial interventions for Chinese geriatric populations' mental wellbeing. This study conducted a systematic review and meta-analysis of psychosocial services for Chinese older adults' depression and anxiety.

Research Design And Methods: A search of nine electronic databases, five geriatric mental health journals, and reference lists was conducted for studies published between 1980 and April. 2018. Thirty-three studies (including totally 3,478 participants, 107 effect sizes) of true and quasiexperimental controlled trials were eligible and included for meta-analysis using robust variance estimation in meta-regression. Outcome indicators were geriatric depression and anxiety.

Results: An overall significant treatment effect was identified for geriatric depression and anxiety (d = 0.577, 95% confidence interval [CI]: 0.288, 0.867, p < .001). Outcomes, geographic area, participants' marriage, service setting, and types of control group were moderators for treatment effects. Subgroup analysis observed statistically significant effect size among studies in Taiwan, used innovative service methods and small group interventions. Both in-person, home-based interventions and interventions provided by nurse practitioners and specially trained providers were statistically significant.

Discussion And Implications: Psychosocial services can benefit Chinese geriatric populations. Innovative and culturally relevant programs received strongest research supports. Future research should incorporate social interaction as an important component for serving Chinese older adults' mental wellbeing.
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http://dx.doi.org/10.1093/geront/gny185DOI Listing
January 2020

The effectiveness of four empirically supported psychotherapies for primary care depression and anxiety: A systematic review and meta-analysis.

J Affect Disord 2019 02 11;245:1168-1186. Epub 2018 Dec 11.

Shanghai Children's Medical Center, China.

Background: Depressive and anxiety disorders are highly prevalent and detrimental in primary care settings. However, there are gaps in the literature concerning effectiveness and generalizability of empirically supported interventions and treatment of both depression and anxiety in primary care settings. The aim of this review is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care.

Methods: Seven electronic databases, five professional websites and manual search of reference lists were searched through April 2017 for randomized controlled trials (RCTs) of four psychotherapies treating primary care depression and anxiety: cognitive-behavior therapy (CBT), problem-solving therapy (PST), motivational interviewing (MI), and solution-focused brief therapy (SFBT).

Results: From an initial pool of 1140 articles, 179 articles were eligible for full-text review and 65 articles were included for final analysis. Sixty-five articles containing 198 effect sizes reported an overall treatment effect size of d = 0.462, p < 0.001. Single-predictor meta-regression indicated that marital status, treatment modality (individual versus group), and treatment composition were significant moderators. Multiple-predictor meta-regression discovered treatment setting (inside versus outside primary care) significantly moderated treatment effect, b = -0.863, p = 0.039 after controlling for other intervention characteristics.

Conclusion: Treatment effects were found for CBT and PST, both for depressive and anxiety disorders. Interventions delivered outside primary care settings were more effective than those within, individual treatment had greater treatment effects compared to group treatment, and both technology-assisted and in-person treatments were found to be effective.
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http://dx.doi.org/10.1016/j.jad.2018.12.008DOI Listing
February 2019

The effectiveness of solution-focused brief therapy for psychological distress among Chinese parents of children with a cancer diagnosis: a pilot randomized controlled trial.

Support Care Cancer 2018 Aug 15;26(8):2901-2910. Epub 2018 Mar 15.

The University of Texas at Austin, Steve Hicks School of Social Work, Austin, TX, USA.

Purpose: Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents' level of hope was also assessed.

Methods: Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope.

Results: Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group.

Conclusions: Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions.

Relevance: SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children's well-being during cancer treatment and recovery.
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http://dx.doi.org/10.1007/s00520-018-4141-1DOI Listing
August 2018

The Effectiveness of Problem-Solving Therapy for Primary Care Patients' Depressive and/or Anxiety Disorders: A Systematic Review and Meta-Analysis.

J Am Board Fam Med 2018 Jan-Feb;31(1):139-150

From the Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX (AZ, JES); Quantitative Methods Program, College of Education, The University of Texas at Austin, Austin, TX (SP); School of Social Development, East China University of Political Science and Law, Shanghai, China (SJ).

Background: There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients.

Methods: We conducted a systematic review and meta-analysis of clinical trials examining PST for patients with depression and/or anxiety in primary care as identified by searches for published literature across 6 databases and manual searching. A weighted average of treatment effect size estimates per study was used for meta-analysis and moderator analysis.

Results: From an initial pool of 153 primary studies, 11 studies (with 2072 participants) met inclusion criteria for synthesis. PST reported an overall significant treatment effect for primary care depression and/or anxiety ( = 0.673; < .001). Participants' age and sex moderated treatment effects. Physician-involved PST in primary care, despite a significantly smaller treatment effect size than mental health provider only PST, reported an overall statistically significant effect ( = 0.35; = .029).

Conclusions: Results from the study supported PST's effectiveness for primary care depression and/or anxiety. Our preliminary results also indicated that physician-involved PST offers meaningful improvements for primary care patients' depression and/or anxiety.
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http://dx.doi.org/10.3122/jabfm.2018.01.170270DOI Listing
August 2019

Efficacy of Solution-Focused Brief Therapy for Distress among Parents of Children with Congenital Heart Disease in China.

Health Soc Work 2018 Feb;43(1):30-40

Yaxi Li, MSW, RSW, is pediatric medical/clinical social worker, Shanghai Children's Medical Center, Shanghai, China. Phyllis Solomon, PhD, is professor and associate dean for research, School of Social Policy & Practice, University of Pennsylvania, Philadelphia. Anao Zhang, LCSW, ACSW, ACT, is research consultant, Shanghai Children's Medical Center, Shanghai, China, and doctoral candidate, Steve Hicks School of Social Work, University of Texas at Austin. Cynthia Franklin, PhD, LCSW, LMFT, is associate dean for doctoral education and Stiernberg/Spencer family professor in mental health, Steve Hicks School of Social Work, University of Texas at Austin. Qingying Ji, MD, MSW, is vice president and Yuting Chen, MSW, RSW, is director of medical social work, Shanghai Children's Medical Center, Shanghai, China.

Chinese parents of children with congenital heart disease (CHD) experience significant psychological distress due to the child's illness and hospitalization. Unfortunately, there are few psychosocial interventions for parental distress in China. This pilot study aimed to examine the efficacy of solution-focused brief therapy (SFBT) in a Chinese hospital for parental distress using a randomized controlled trial design. The participants included 40 Chinese parents of a currently hospitalized child diagnosed with CHD who were assessed to have psychological distress. Parents were randomized into either the intervention (n = 25) or the hospital medical social work treatment as usual (TAU) (n = 28) group. The Chinese Brief Symptom Inventory-18 and Chinese version of Herth Hope Index were administered before and after the interventions. Results of the intent-to-treat analysis indicated a significant decrease in parental distress and increase in parents' levels of hope in the intervention group compared with the TAU group. This study supported SFBT administered in a hospital setting as a promising intervention for reducing distress among Chinese parents with children diagnosed with CHD.
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http://dx.doi.org/10.1093/hsw/hlx045DOI Listing
February 2018

The effectiveness of strength-based, solution-focused brief therapy in medical settings: a systematic review and meta-analysis of randomized controlled trials.

J Behav Med 2018 04 3;41(2):139-151. Epub 2017 Oct 3.

University of Denver, Denver, CO, USA.

This meta-analysis synthesized randomized controlled trials of solution focused brief therapy (SFBT) in medical settings for patients' health-related psychosocial (e.g., depression, psychosocial adjustment to illness), behavioral (e.g., physical activity, nutrition score), and functional health (e.g., BMI, individual strength) outcomes. Medical setting is defined in this study as any healthcare setting that primarily focuses on patients' physical wellbeing. A comprehensive search strategy across five electronic databases, four academic journals, three professional websites, and reference lists of included articles resulted in a final sample of nine studies for meta-analytic synthesis. Combining outcomes indicated an overall significant effect of SFBT for health-related psychosocial outcomes (d = 0.34, p < .05.) and a nearly significant outcome for health-related behavioral outcomes (d = 0.28, p = .06), but not for functional health outcomes. Results indicated SFBT being an effective intervention for psychosocial outcomes and a promising approach for behavioral outcomes in medical settings.
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http://dx.doi.org/10.1007/s10865-017-9888-1DOI Listing
April 2018

Assessing the Needs of Parents of Children Diagnosed With Cancer in China: A Psychometric Study Developing a Needs Assessment Tool.

J Pediatr Oncol Nurs 2018 Jan/Feb;35(1):6-15. Epub 2017 Aug 29.

1 Shanghai Children's Medical Center, Shanghai, China.

The psychosocial well-being of parents remains integral to the treatment and recovery of children diagnosed with cancer. However, limited research addresses the unique needs of this population. To better understand the supportive care needs of parents of children with cancer, this study tested the reliability and stability of the factorial structure of a revised version of the Cancer Patient Needs Questionnaire (rCPNQ) with Chinese parents of children who have cancer. Analysis of the generalizability of the rCPNQ with this population was determined through principle components analysis with varimax rotation. Reliability coefficient and split sample analyses were performed to determine reliability and stability of the resulting factors. The principal components analysis resulted in a 6-dimension, 8-factor, 29-item survey. Each of the factors had Cronbach's α ≥ .74, indicating satisfactory internal consistency and reliability of the survey with the Chinese population. Similar loadings on splitting of the samples reflects the stability of the factors. Study results provided a preliminary understanding of the needs of Chinese parents of children with cancer and demonstrated that the rCPNQ offers a reliable measure for nurses and other health care providers to partner with Chinese parents throughout their children's treatment and survivorship to determine areas for support.
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http://dx.doi.org/10.1177/1043454217723862DOI Listing
June 2018

How Early do Social Determinants of Health Begin to Operate? Results From the Fragile Families and Child Wellbeing Study.

J Pediatr Nurs 2017 Nov - Dec;37:42-50. Epub 2017 Jul 10.

The University of Texas at Austin, United States.

Purpose: From a life course perspective, important insights about how social determinants of health operate can be gained by analyzing the various forms that social climate can take in different life periods. For children, a critical aspect of social climate is exposure to bullying. Bullying can serve as a proxy for power imbalance and social exclusion analogous to adult social climate of discrimination and racism.

Design And Methods: We used the Year 9 follow-up data of the Fragile Families and Child Wellbeing Study (N=3301) that, for the first time included interviews with the children. We drew on a national sample of children and their families, which allowed us to account for broader contextual variables and represented a broad range of geographic areas and schools. Multinomial logistic regression was used to estimate the effects of exposure to bullying on self-rated health among primarily 9- to 10-year-old children while controlling for socio-demographic and diagnosed health-conditions.

Results: Both frequency and forms of bullying were positively associated with lower odds of reporting excellent, very good or good health. The effect of forms of bullying on children's self-rated health fell on a gradient. Subgroup analysis indicated a significant effect on self-rated health for children who experienced peer rejection but not for those who experienced physical aggression.

Conclusions: The results of the study provide new evidence that the harmful health consequences of power imbalance and discriminatory practices may extend to children in early development. It also accentuates the need to study social determinants of health from both an ecological/contextual and a developmental angle.

Practice Implications: Echoing a plethora of nursing literature on the critical role of psycho-social pediatric care, this study further encourages pediatric nurses to expand their assessment and intervention priorities beyond a familial and developmental perspective, and to consider the evident physical health consequence of a child's overall social climate determinants.
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http://dx.doi.org/10.1016/j.pedn.2017.06.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567992PMC
July 2018

The Effectiveness of Psychosocial Interventions Delivered by Teachers in Schools: A Systematic Review and Meta-Analysis.

Clin Child Fam Psychol Rev 2017 09;20(3):333-350

School of Social Work, Saint Louis University, St. Louis, MO, USA.

The growing mental health needs of students within schools have resulted in teachers increasing their involvement in the delivery of school-based, psychosocial interventions. Current research reports mixed findings concerning the effectiveness of psychosocial interventions delivered by teachers for mental health outcomes. This article presents a systematic review and meta-analysis that examined the effectiveness of school-based psychosocial interventions delivered by teachers on internalizing and externalizing outcomes and the moderating factors that influence treatment effects on these outcomes. Nine electronic databases, major journals, and gray literature (e.g., websites, conference abstract) were searched and field experts were contacted to locate additional studies. Twenty-four studies that met the study inclusion criteria were coded into internalizing or externalizing outcomes and further analyzed using robust variance estimation in meta-regression. Both publication and risk of bias of studies were further assessed. The results showed statistically significant reductions in students' internalizing outcomes (d = .133, 95% CI [.002, .263]) and no statistical significant effect for externalizing outcomes (d = .15, 95% CI [-.037, .066]). Moderator analysis with meta-regression revealed that gender (%male, b = -.017, p < .05), race (% Caucasian, b = .002, p < .05), and the tier of intervention (b = .299, p = .06) affected intervention effectiveness. This study builds on existing literature that shows that teacher-delivered Tier 1 interventions are effective interventions but also adds to this literature by showing that interventions are more effective with internalizing outcomes than on the externalizing outcomes. Moderator analysis also revealed treatments were more effective with female students for internalizing outcomes and more effective with Caucasian students for externalizing outcomes.
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http://dx.doi.org/10.1007/s10567-017-0235-4DOI Listing
September 2017

The Role of Internal Health Locus of Control in Relation to Self-Rated Health in Older Adults.

J Gerontol Soc Work 2017 Jan 12;60(1):68-78. Epub 2016 Dec 12.

a School of Social Work , The University of Texas at Austin , Austin , Texas , USA.

The present study examined how internal health locus of control is associated with older adults' self-rated health. Multivariate analyses with older participants (aged ≥ 60) in the MIDUS II (n = 1,533) showed that internal health locus of control was not only directly associated with positive ratings of health but also interacted with gender and race. The positive impact of internal health locus of control on self-rated health was particularly greater in females and Whites than their counterparts. Findings highlight the important role of internal health locus of control in the psychological mechanism of health and call attention to group-specific strategies for health promotion.
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http://dx.doi.org/10.1080/01634372.2016.1267672DOI Listing
January 2017

Solution Focused Brief Therapy: A Systematic Review and Meta-Summary of Process Research.

J Marital Fam Ther 2017 Jan 19;43(1):16-30. Epub 2016 Oct 19.

The Catholic University of America.

This article presents a systematic review of the process research on solution-focused brief therapy (SFBT). We searched published and unpublished studies in English across five databases, five major journals, two book chapters, and four websites to locate studies that investigate why and how SFBT works. Thirty-three studies that used various research methods were located and included for further analysis using a meta-summary approach. The findings supported the significance of the co-construction process within SFBT and the effects of specific types of SFBT techniques. The most empirical support was found for the strength-oriented techniques in comparison to the other techniques and for the co-construction of meaning. Current studies require replications with larger samples and experimental designs that study SFBT process in relationship to outcomes.
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http://dx.doi.org/10.1111/jmft.12193DOI Listing
January 2017
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