Browsing by Author "Johnson, Nina"

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    Palliative Care for People With Moderate-Severe Dementia in the Community: Results of the In-Peace Trial
    (Oxford University Press, 2024-12-31) Sachs, Greg; Johnson, Nina; Gao, Sujuan; Pan, Minmin; Torke, Alexia; Hickman, Susan; Kroenke, Kurt; Medicine, School of Medicine
    Dementia care management programs in the community demonstrate some benefits. Study limitations include limited numbers of people living with dementia (PLWD) with advanced disease or from minoritized populations; lack of palliative care components; and limited success reducing health care utilization. IN-PEACE tested dementia care management integrated with palliative care for PLWD with moderate-severe disease in the community and their caregivers. 201 PLWD-caregiver dyads were randomized to either a dementia care coordinator (99) or usual care (102) and followed for 24 months. Outcomes were neuropsychiatric symptoms (NPI-Q severity) and symptom management (SM-EOLD) in PLWD; distress (NPI-Q distress) and depression symptoms (PHQ-8) in caregivers; and the combined measure of ED visits/hospitalizations. Outcomes were assessed quarterly. Separate mixed effects models were run for each symptom/distress measure and a zero-inflated Poisson model compared the mean number of ED/hospitalization events. Subgroup analyses were conducted based on baseline NPI-Q severity, sex, race, income, and health system. There were no statistically significant differences between groups in any symptoms or distress measures in PLWD or caregivers. PLWD receiving the intervention, however, had substantially fewer ED/hospitalization events (means 1.06 events versus 2.37, p < 0.007). The intervention reduced the proportion of PLWD who had one or more ED/hospitalization events (78.4% of controls vs. 50.5% of intervention, p < 0.001). The relative risk reduction was 35.6% for an event, absolute risk reduction 27.9%, and number needed to treat (NNT) of 3.6. PLWD with higher NPI-Q at baseline and Black PLWD experienced greater reductions in ED visit hospitalization events.
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    Suicide Prevention Among College Students Before and During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-analysis
    (JMIR Research Protocols, 2021-05-17) Xiao, Yunyu; Hinrichs, Rachel; Johnson, Nina; McKinley, Amanda; Carlson, Joan; Agley, Jon; Yip, Paul Siu Fai; School of Social Work
    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
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    Supports and Barriers: Social Work Educators Addressing Student Wellness Needs
    (Taylor & Francis, 2024) McCarthy, Katherine; Kondrat, David; Johnson, Nina; School of Social Work
    While the years spent in college or graduate school have traditionally been viewed as demanding, current students face financial, emotional, and mental health stressors that interfere with their success at alarming rates. Undoubtedly social issues, cultural challenges, and economic realities complicate these experiences for students. At the same time, the negative effects of stress on learning capacity can prompt a blurring of the traditional line between educator and supporter, especially for social work educators. One hundred twenty-eight social work educators responded to a survey questionnaire about what helps or hinders their efforts to support student wellness. Inductive content analyses were conducted with seven themes identified around what supports educators and five themes identified around barriers that interfere with educators in their efforts to address student wellness needs. Major factors influencing educator effects include resource availability, educator-student partnerships, wellness-centered pedagogy, environmental culture, and oppressive forces. Implications for social work educators and administrators are explored.