Browsing by Author "Wasmuth, Sally"
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Item A developmental formative evaluation of a pilot participatory music program for veterans with housing insecurity(BMC, 2023-08-19) Wasmuth, Sally; Rattray, Nicholas A.; Cheng, Phillip; Crow, Shannon; Myers, Jennifer; Burns, Debra S.; Myers, Laura J.; Hook, Brittany; Lustig, Anne; Perkins, Anthony J.; Cheatham, Ariel J.; Bravata, Dawn M.; Medicine, School of MedicineBackground: Interventions are needed to improve well-being and promote community reintegration among Veterans with housing insecurity. The objective was to conduct a developmental formative evaluation of a participatory music program. Methods: This single-site, pilot study implemented a participatory music program at a U.S. Department of Veterans Affairs (VA) Homeless Domiciliary that included one-hour sessions (group music instruction and ensemble playing), 3 times per week for 3 months. Intervention development was guided by the Model of Human Occupation (MOHO). Evaluation was guided by the MOHO and the Consolidated Framework for Implementation Evaluation (CFIR). Qualitative data were collected via semi-structured interviews from participants and non-participants, and were analyzed using an interdisciplinary, constant comparison qualitative analysis technique. Results: Sixteen program participants and 8 non-participants were enrolled, age range 26-59 (mean 41; standard deviation, 11) years; 75% were White. The sample for this study (N = 12) included five participants and seven non-participants. Semi-structured interview responses produced three salient themes illuminating Veterans' perspectives: (1) key characteristics of the intervention (the relative advantage of the participatory program over other problem-focused programs; the importance of a supportive, encouraging teaching; the group setting; the role of music); (2) the therapeutic power of the program (based on it being enjoyable; and serving as an escape from preoccupations); and (3) the context and culture (which included Veterans supporting each other and the Domiciliary setting). Conclusions: Veterans described the benefits of a participatory music intervention compared to problem-based groups, which included enjoyment, skill acquisition facilitating pride, escape, reconnecting with their identity prior to current problems, and experiencing positive aspects of Veteran culture such as mutual support and discipline. These data support ongoing research about participatory music programs to support Veterans with housing insecurity.Item Addressing Mental Health Needs of Health Care Workers through Peer Support Groups During the COVID-19 Crisis(Indiana University, 2020-12) Thornsberry, Tanner; Nault Connors, Jill; Welch, Julie; Hayden, Julie; Hartwell, Jennifer; Ober, Michael; Sotto-Santiago, Sylk; Draucker, Claire; Wasmuth, Sally; Boustani, Malaz; Overley, Ashley; Monahan, Patrick; Kroenke, KurtItem Bridging the Humanities and Health Care With Theatre: Theory and Outcomes of a Theatre-Based Model for Enhancing Psychiatric Care via Stigma Reduction(APA, 2022-12-22) Wasmuth, Sally; Pritchard, Kevin T.; Belkiewitz , Johnna; Occupational Therapy, School of Health and Human SciencesObjective: This article describes the rational, methods, implementation, and effectiveness of Identity Development Evolution and Sharing (IDEAS), an evidence-supported, narrative theater-based training that reduces stigma among health care providers to increase health care equity in psychiatric rehabilitation. Method: The IDEAS model has been used to reduce provider bias toward patients. From May 2017 to January 2020, we interviewed people from three patient groups who have been harmed by stigma, including Black women, transgender, and gender-diverse people, and people with substance use disorders. These interviews informed the creation of three theatrical scripts that were performed by professional actors for audiences of health care providers from January 2020 to May 2022. The performances aimed to raise conscious awareness of implicit provider biases and to provide a reflective opportunity to ameliorate these biases. The purpose of IDEAS is to improve experiences in health care settings such as psychiatric rehabilitation of patients from groups who have been harmed by stigma. We used paired-samples t tests to compare pre/postprovider stigma, measured via the Acceptance and Action Questionnaire-Stigma (AAQ-S). Results: Sociodemographic factors for providers who viewed IDEAS were similar across all three performances. IDEAS significantly decreased AAQ-S scores (t = 11.32, df = 50, M = 13.65, 95% confidence limit: [11.32, 15.97], p < .0001). Conclusions and implications for practice: IDEAS reduces provider stigma to support positive clinical encounters with diverse patient populations. These findings are relevant for psychiatric rehabilitation settings, which seek to establish positive rapport between providers and patients.Item A Clothing Group for Adolescents with Eating Disorders: A Role for Occupational Therapy(2023) Larson, Sydney; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Weesner, ValerieEating disorders are one of the most prevalent psychiatric conditions and can have a long-term impact, disrupting the cardiac system, gastrointestinal tract, reproductive system, cognitive functions, and many other systems of the body. In addition to the physical impacts, eating disorders effect occupational functioning, roles and routines, social participation, and often accompany other mental health conditions including anxiety and depression. Occupational therapists have a unique and valuable role in eating disorder recovery and mental health. Increased efforts of advocacy are needed to bolster the presence of occupational therapy in this area of practice. This capstone student assisted with the development of a clothing group within the adolescent intensive outpatient program at a local center for eating disorders. This group addresses the relationship with clothing and how clothes can be used to portray elements of identity, culture, and expression as opposed to this expression being controlled by negative body image or self-esteem. In addition to clothing group development, this capstone project advocated for the role of occupational therapy in eating disorder recovery.Item Community Transition: Addressing Factors that Lead to Readmission in Inpatient Psychiatric Units(2021-05-07) Chim, Chhattrah; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Button, JoPsychiatric readmission is a common problem for individuals with psychiatric illness worldwide. Approximately one in seven individuals hospitalized for psychiatric illness are readmitted within 30 days of discharge. 30-day readmission is a common outcome measure to indicate quality of patient care. Frequent readmission for patients decreases their quality of life, disrupts their recovery, and fosters dependence on psychiatric services. The purpose of this doctoral capstone experience is to develop a clinically useful screening tool used to identify at-risk patients for readmission to improve transition into the community. In doing so, effective patient-centered interventions focused on individualized needs can be provided to possibly decrease the risk of readmission. The screening tool was developed using retrospective clinical data collected from electronic medical records of all patients readmitted to SEMHRC within 30 days of discharge in 2020. The screening tool examines 5 domains which include previous admissions, risk of harm to self and others, individual factors, community barriers, and engagement in treatment. In 2020, Sandra Eskenazi Mental Health Recovery Center discharged 1,119 patients. Of those patients discharged, 10.3% readmitted within 30 days at least one or more times. A bivariate analysis was done using the developed screening tool on 19 patients that were first time users of the psychiatric unit comparing their hospital index admission to following hospital readmissions. These patients averaged a score of seven on the screening tool for risk of readmission. Individuals with 3+ readmissions within 30 days of prior hospitalization had an average score of 12.7 upon assessment. The study showed that the higher score on the screening tool increased the probability of readmission. The study shows the use of a screening tool to assess patients' risk of readmission on a psychiatric unit has the potential to improve delivery of mental health services.Item Comparing Narrative-Informed Occupational Therapy in Adult Outpatient Mental Health to Treatment as Usual: A Quasi-Experimental Feasibility Study with Preliminary Treatment Outcomes(Taylor & Francis, 2021) Wasmuth, Sally; Wilburn, Victoria G.; Hamm, Jay A.; Chase, Anthony; Occupational Therapy, School of Health and Human SciencesThis paper describes implementation of narrative-informed occupation-based service delivery in outpatient community mental health that addresses (1) the need for outcome data on occupational therapy in this setting, (2) an ongoing mental health provider shortage, and (3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation. Dose of occupational therapy was significantly related to improvements in roles, habits, values, long-term goals, social environment, and readiness for change. This study supports future, larger effectiveness studies of narrative-informed occupation-based intervention delivered by occupational therapists in outpatient community mental health.Item Development of an Occupational Therapy Health Promotion Group Protocol in a Gender Diverse Population(2024-05-06) Schrader, Kate; DeRolf, Annie; Wasmuth, Sally; DeRolf, Annie; Department of Occupational Therapy, School of Health and Human Sciences; Wasmuth, SallyThe transgender and gender diverse (TGD) population faces systemic and individual discrimination, high rates of poverty and houselessness, and a frequent lack of social support. TGD patients also have higher instances of mental illness and neurodiversity which can be a barrier to accessing healthcare and establishing health behaviors. Considering these disparities and the complex medical needs of TGD patients, it is imperative to increase equitable access to affirming healthcare. Introducing an occupational therapy (OT) health promotion group in the safe and affirming environment of a gender health program within a public hospital addresses this need. To inform the development of a group that addressed the needs of both the patient population and implementation site, interview questions were created using the Consolidated Framework for Implementation Research, staff within the gender health program were interviewed, and data was analyzed and applied to create a group protocol and implementation plan. Content analysis produced the following themes: 1) valuing an interdisciplinary approach; 2) establishing an affirming environment; 3) increasing accessibility; 4) existing lack of patient resources; 5) emphasizing patient feedback, 6) developing life skills; 7) challenging beauracratic red tape; and 8) fostering community to improve health and wellbeing in the TGD community. These themes were used to develop a group protocol and delivery plan that would maximize implementation success within the site. This capstone is important for OTs seeking to integrate gender affirming health promotion groups within hospital settings and can provide insight for all OTs on factors that support affirming and equitable care.Item The Efficacy and Feasibility of Occupational Therapy Programming Focused on Health and Wellness within a Homeless Shelter(2021-04) Munson, Victoria; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Hoffman, LisaHomelessness is a serious problem and can have many negative effects, including poor health (Hodge et al., 2017). Homelessness is closely tied to occupational deprivation and occupational injustice (Cunningham & Slade, 2019). The purpose of this doctoral capstone project was to address the occupational needs of individuals experiencing homelessness. By working with the Wheeler Mission Center for Women and Children, this project aimed to decrease occupational deprivation and increase overall wellness through the implementation of occupation-based programming. Occupation-based programing was introduced over the course of 14 weeks, in combination with ongoing program evaluation. Success of the program was evaluated in a number of different ways, including distributing pre- and post-program surveys, evaluating results from the Canadian Occupational Performance Measure and by receiving verbal feedback from staff members. Participants were recruited from the Foundations of Wellness program at the Wheeler Mission and included individuals with a wide range of health concerns. Results indicated that participants had statistically significant increases in satisfaction with programming following the implementation of occupation-based programming, as well as significant increases in self-perceived occupational performance and satisfaction. These results can be used to advocate for the role of occupational therapists within homeless shelters, as they can increase occupational engagement and participant satisfaction. Additional research is needed to further define the role of occupational therapists within homeless shelters and to further investigate the impact occupational therapists can have on homeless populations.Item Feasibility and Acceptability of Music Imagery and Listening Interventions for Analgesia: Protocol for a Randomized Controlled Trial(JMIR Publications, 2022-09-22) Story, Kristin M.; Bravata, Dawn M.; Robb, Sheri L.; Wasmuth, Sally; Slaven, James E.; Whitmire, Leah; Barker, Barry; Menen, Tetla; Bair, Matthew J.; Medicine, School of MedicineBackground: Chronic pain and access to care are identified as critical needs of the Veterans Health Administration. Music imagery and music listening interventions have shown promise as effective nonpharmacological options for pain management. However, most studies have focused on acute pain, passive music experiences, and in-person delivery. Objective: In this study, we aimed to examine the feasibility and acceptability of 2 music interventions delivered through telehealth for chronic musculoskeletal pain, trial design, and theoretical model before conducting a fully powered efficacy or comparative effectiveness trial. Methods: FAMILIA (Feasibility and Acceptability of Music Imagery and Listening Interventions for Analgesia) is a 3-arm, parallel group, pilot trial. A total of 60 veterans will be randomized to one of the three conditions: music imagery, music listening, or usual care. Aim 1 is to test the feasibility and acceptability of a multicomponent, interactive music imagery intervention (8-weekly, individual sessions) and a single-component, minimally interactive music learning intervention (independent music listening). Feasibility metrics related to recruitment, retention, engagement, and completion of the treatment protocol and questionnaires will be assessed. Up to 20 qualitative interviews will be conducted to assess veteran experiences with both interventions, including perceived benefits, acceptability, barriers, and facilitators. Interview transcripts will be coded and analyzed for emergent themes. Aim 2 is to explore the effects of music imagery and music listening versus usual care on pain and associated patient-centered outcomes. These outcomes and potential mediators will be explored through changes from baseline to follow-up assessments at 1, 3, and 4 months. Descriptive statistics will be used to describe outcomes; this pilot study is not powered to detect differences in outcomes. Results: Recruitment for FAMILIA began in March 2022, and as of July 2022, 16 participants have been enrolled. We anticipate that enrollment will be completed by May 2023. We expect that music imagery and music listening will prove acceptable to veterans and that feasibility benchmarks will be reached. We hypothesize that music imagery and music listening will be more effective than usual care on pain and related outcomes. Conclusions: FAMILIA addresses four limitations in music intervention research for chronic pain: limited studies in veterans, evaluation of a multicomponent music intervention, methodological rigor, and internet-based delivery. Findings from FAMILIA will inform a fully powered trial to identify putative mechanisms and test efficacy.Item Girl Power: A Girls Empowerment and Social-Emotional Skills Program at the Boys and Girls Club(2024) Kelly, Chandler; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Harris, LeeAnnDue to the circumstances of the home environment or living conditions, many of the students attending the Boys and Girls Club have experienced trauma and thus have high adverse childhood experience (ACE) scores. According to research, emotional regulation and coping skills can contribute to minimizing racial trauma and preventing adverse childhood experiences (ACEs). Additionally, the program director of the Boys and Girls Club identified that many of the members have difficulty with emotional regulation, coping skills, and self-esteem. The purpose of this capstone project was to address and meet these needs by developing and implementing a girls empowerment, social-emotional skills program. Intervention activities focused on emotional regulation, coping skills, interoception, and self-esteem. The girls demonstrated satisfaction with their participation in the program by stating that they enjoyed the activities, reporting something they learned, and recommending the program to other girls. A digital and physical program handbook was created to improve sustainability and increase likelihood of continuation of program implementation after the conclusion of the capstone.