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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6
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Publication Open Access Youth with chronic health problems: how do they fare in main-stream mentoring programs?(BioMed Central, 2018) Lipman, Ellen L.; Dewit, David; DuBois, David L.; Larose, Simon; Department of Psychology; Gürel, Gizem Erdem; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 222027Background: Youth with chronic physical health problems often experience social and emotional problems. We investigate the relationship between participation in the Big Brothers Big Sisters of Canada community-based mentoring programs (BBBS) and youth social and mood outcomes by youth health status. Methods: Youth newly enrolled in BBBS were classified by health status (one or more chronic physical health problems without activity limitation, n = 191; one or more chronic physical health problems with activity limitation, n = 94; no chronic health problem or activity limitation, n = 536) and mentoring status (yes/no) at 18 month follow-up. Youth outcomes measured at follow-up were social anxiety, depressed mood, and peer self-esteem. Results: Youth with chronic health problems and activity limitation were more likely to live with two biological parents, use mental health or social services, and have parents who reported difficulties with depressed mood, social anxiety, family functioning and neighbourhood problems. At 18 month follow-up, mentored youth in this health status group experienced fewer symptoms of social anxiety and higher peer self-esteem compared to non-mentored youth. Mentored youth with chronic health problems without activity limitation andmentored youth with no health problems or limitations did not show significant improvements in social anxiety and peer self-esteem. Regardless of their health status, mentored youth reported fewer symptoms of depressed mood than non-mentored youth. Conclusions: Youth with chronic health problems, particularly those with activity limitation as well, demonstrate a capacity to experience social and mood benefits associated with mentoring.Publication Open Access Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience(Wiley, 2022) Abel, T.; Tadesse, L.; Frahsa, A.; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. Methods: the MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production. Results: deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland. Conclusions: building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice. Patient and Public ContributionWomen with chronic illness and immigration experience contributed to interview-guideline development, provided PREs in interviews, identified priority areas for health-service change and actively participated in the development of practice recommendations.Publication Open Access Health system modelling research: towards a whole-health-system perspective for identifying good value for money investments in health system strengthening(BMJ Publishing Group, 2019) Verguet, Stephane; Feldhaus, Isabelle; Kwete, Xiaoxiao Jiang; Aqil, Anwer; Atun, Rifat; Bishai, David; Cecchini, Michele; Guerra Junior, Augusto Afonso; Habtemariam, Mahlet Kifle; Jbaily, Abdulrahman; Kruk, Margaret E.; Haneuse, Sebastien; Norheim, Ole Frithjof; Smith, Peter C.; Tolla, Mieraf Taddesse; Zewdu, Solomon; Bump, Jesse; Department of Business Administration; Karanfil, Özge; Department of Business Administration; College of Administrative Sciences and EconomicsGlobal health research has typically focused on single diseases, and most economic evaluation research to date has analysed technical health interventions to identify 'best buys'. New approaches in the conduct of economic evaluations are needed to help policymakers in choosing what may be good value (ie, greater health, distribution of health, or financial risk protection) for money (ie, per budget expenditure) investments for health system strengthening (HSS) that tend to be programmatic. We posit that these economic evaluations of HSS interventions will require developing new analytic models of health systems which recognise the dynamic connections between the different components of the health system, characterise the type and interlinks of the system's delivery platforms; and acknowledge the multiple constraints both within and outside the health sector which limit the system's capacity to efficiently attain its objectives. We describe priority health system modelling research areas to conduct economic evaluation of HSS interventions and ultimately identify good value for money investments in HSS.Publication Open Access Pathways towards scaling up roblem management plus in Turkey: a theory of change workshop(BioMed Central, 2020) Fuhr, D.C.; Uygun, E.; McGrath, M.; İlkkurşun, Z.; Kaykha, S.; Sondorp, E.; Sijbrandij, M.; Ventevogel, P.; Cuijpers, P.; Roberts, B.; Department of Psychology; Acartürk, Ceren; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 39271Background: a considerable evidence base has been produced in recent years highlighting the effectiveness of brief scalable psychological interventions for people living in communities exposed to adversity. However, practical guidance on how to scale up these interventions to wider populations does not exist. In this paper we report on the use of Theory of Change (ToC) to plan the scale up of the World Health Organization's flagship low intensity psychological intervention "Problem Management Plus" (PM+) for Syrian refugees in Turkey. Methods: we conducted a one-day ToC workshop in Istanbul. ToC is a participatory planning process used in the development, implementation and evaluation of projects. It is similar to driver diagrams or logic models in that it offers a tool to visually present the components needed to reach a desired long-term outcome or impact. The overall aim of ToC is to understand the change process of a complex intervention and to map out causal pathways through which an intervention or strategy has an effect. Results: twenty-four stakeholders (including governmental officials, mental health providers, officials from international/national non-governmental organisations, conflict and health researchers) participated in the ToC workshop. A ToC map was produced identifying three key elements of scaling up (the resource team; the innovation and the health system; and the user organisation) which are represented in three distinct causal pathways. Context-specific barriers related to the health system and the political environment were identified, and possible strategies for overcoming these challenges were suggested. Conclusion: ToC is a valuable methodology to develop an integrated framework for scaling up. The results highlight that the scaling up of PM+ for Syrian refugees in Turkey needs careful planning and investment from different stakeholders at the national level. Our paper provides a theoretical foundation of the scaling up of PM+, and exemplifies for the first time the use of ToC in planning the scaling up of an evidence-based psychological intervention in global mental health.Publication Open Access Mentoring relationship closures in big brothers big sisters community mentoring programs: patterns and associated risk factors(Wiley, 2016) DeWit, David J.; DuBois, David; Larose, Simon; Lipman, Ellen L.; Department of Psychology; Gürel, Gizem Erdem; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 222027Previous research suggests that early mentoring relationship (MR) closures may have harmful consequences for the health and well-being of youth participating in community-based mentoring programs. However, knowledge of the factors that lead some MRs to close early has been slow to emerge. This study examined patterns and correlates of early versus on-time MR closures among 569 youth participating in Big Brothers Big Sisters community mentoring programs. Thirty-four percent of youth experienced an early MR closure prior to the end of the program's 12month period of commitment. The probability of closure was highest at 12months into the MR. Early closures were positively associated with youth gender (girls), behavioral difficulties, and match determination difficulties. Early and on-time closures were associated with youth extrinsic motives for joining the program. Early MR closures were negatively associated with youth perceptions of parent emotional support, parent social support, high quality MR, weekly contact in MR, and parent support of the MR. Implications for programming are discussed.Publication Open Access The impact of a brief RNR-based training on Turkish juvenile probation officers' punitive and rehabilitative attitudes and recidivism risk perceptions(Wiley, 2020) Ruiter, Corine; Department of Psychology; Ersayan, Ayşe Esra; Teaching Faculty; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 178452; 222027The present quasi-experimental study examined the impact of a brief training program based on the risk–need–responsivity (RNR) model on Turkish juvenile probation officers' (JPOs) punitive and rehabilitative attitudes toward justice-involved youth and recidivism risk perceptions. Fifty-nine JPOs were recruited through three probation offices in Istanbul, Turkey. Thirty-six JPOs, who received a 1-day training in the RNR model of offending behavior, were compared to JPOs in a wait-list control condition (n = 23). Participants in both conditions completed surveys at baseline and 1-week posttraining. Mixed-factorial analysis of variances revealed a significantly higher decrease in JPOs' punitive attitudes from pre- to posttest, in the training condition compared to the control group, with a medium effect size. Rehabilitative attitudes decreased in both conditions, while recidivism risk perceptions did not change from pre- to posttest in either condition. Future research could expand on these promising results using a more intensive training program and a randomized-controlled design in a larger sample of JPOs.Publication Open Access Impact of preconceptional serum thyroid stimulating hormone values ranging between 2.5 and 4.5 mIU/L on live birth rates following ovulation induction and intrauterine insemination treatment for unexplained infertility(BioMed Central, 2021) Karakış, Lale Susan; Kıyak, Hüseyin; Ökmen, Berfin; Özdemir, Çağdaş; Türkgeldi, Engin; Faculty Member; School of Medicine; Koç University Hospital; 329649Background: contrary to overt hypothyroidism, the true impact of subclinical hypothyroidism on fertility has not been well established. This study aimed to investigate whether serum thyroid stimulating hormone (TSH) values between 2.5 and 4.5 mIU/L are associated with lower pregnancy rates compared to TSH levels between 0.3 and 2.5 mIU/L in women undergoing ovulation induction with gonadotropins and intrauterine insemination (IUI) for unexplained infertility. Methods: medical records of couples with unexplained infertility who underwent IUI treatment between January 2013 and December 2018 were reviewed retrospectively. Cycle characteristics and pregnancy outcomes of patients with serum TSH levels between 0.3–2.5 mIU/L and 2.5–4.5 mIU/L were compared. Primary outcome measures were clinical pregnancy and live birth rate. Secondary outcome measures were total dose of gonadotropin administration, duration of ovulation induction and miscarriage rate. Results: a total of 726 euthyroid women who underwent 1465 cycles of ovulation induction with gonadotropins and IUI were included in the analyses. Patient and cycle characteristics of the two study groups were similar. No statistically significant differences could be detected in the clinical pregnancy (p = 0.74) and live birth rates (p = 0.38) between the two groups. Duration of ovulation induction, total gonadotropin dosage, number of follicles > 17 mm on the trigger day and the miscarriage rates were similar in the two groups. Conclusion: in euthyroid women undergoing ovulation induction with gonadotropins and IUI for unexplained infertility, the range of preconceptional serum TSH values between 2.5 and 4.5 mIU/L is not associated with lower pregnancy rates when compared to TSH levels between 0.3 and 2.5 mIU/L.Publication Open Access A risk assessment comparison of breast cancer and factors affected to risk perception of women in Turkey: a cross-sectional study(Tehran University of Medical Sciences, 2017) Yüksel, Serpil; Uğraş, Gülay Altun; Çavdar, İkbal; Bozdoğan, Atilla; Gürdal, Sibel Özkan; Akyolcu, Neriman; Saraçoğlu, Gamze Varol; Özmen, Vahit; Esencan, Ecem; School of MedicineBackground: The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk. Methods: This cross-sectional study was carried out among 346 women whose score in the Gail Risk Model (GRM) was >= 1.67% and/or had a 1(st) degree relative with breast cancer in Bahçeşehir town in Istanbul, Turkey between Jul 2012 and Dec 2012. Data were collected through face-to-face interviews. The level of risk for breast cancer has been calculated using GRM and the Breast Cancer Risk Assessment Form (BCRAF). Breast cancer risk perception (BCRP), has been evaluated by visual analogue 100-cm-long scale. Results: Even though 39.6% of the women considered themselves as high-risk carriers, according to the GRM and the BCRAF, only 11.6% and 9.8% of women were in the "high risk" category, respectively. There was a positive significant correlation between the GRM and the BCRAF scores (P<0.001), and the BCRAF and BCRP scores (P<0.001). Factors related to high-risk perception were age (40-59 yr), post-menopausal phase, high-very high economic income level, existence of breast cancer in the family, having regular breast self-examination and clinical breast examination (P<0.05). Conclusion: In women with high risk of breast, cancer there is a significant difference between the women's risk perception and their absolute risk level. Screen reader support enabled.Publication Open Access Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe(BioMed Central, 2021) Drescher, A.; Kiselev, N.; Akhtar, A.; Bryant, R. A.; von Känel, R.; Miller, K. E.; Pfaltz, M. C.; Schick, M.; Schnyder, U.; Sijbrandij, M.; Spaaij, J.; Morina, N.; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Faculty Member; Master Student; Department of Psychology; College of Social Sciences and Humanities; 39271; N/ABackground: Syrian refugees and asylum seekers (SRAs) face multiple stressors after flight, which may vary due to different geographic, economic, cultural and socio-political contexts in the host countries. Past research has recognised the importance of participants’ own perspectives. The aims of this multi-country study were to identify and compare self-reported problems of SRAs between various settings. Methods: a semi-structured client-generated outcome measurement was used to collect data among adult SRAs in Jordan (N = 61), Turkey (N = 46) and Switzerland (N = 57) between September 2018 and November 2019. Answers were analysed following thematic analysis. Results: over half of the participants reported practical problems with an emphasis on camp-related problems (Jordan), finances (Turkey), employment (Jordan and Switzerland) and government regulations (Switzerland), followed by psychological, and social issues. Conclusion: this study highlights the impact of local contextual factors on wellbeing. The findings emphasise that planning preventative procedures and mental health care services for SRAs need to consider local challenges affecting the population in specific countries.Publication Open Access The role of program-supported mentoring relationships in promoting youth mental health, behavioral and developmental outcomes(Springer, 2016) DeWit, David J.; DuBois, David; Larose, Simon; Lipman, Ellen L.; Department of Psychology; Gürel, Gizem Erdem; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 222027This study examined the relationship between youth mentoring status and behavioral, developmental, and emotional outcomes for 859 youths aged 6-17 participating in a national survey of Big Brothers Big Sisters community mentoring relationships (MRs). Youth self-reported behaviors and mental health occurred at the baseline assessment (before being paired to a mentor) and at 18 months follow-up. Youth mentoring status was categorized as follows: (1) continuous MR less than 12 months (n = 131); (2) continuous MR 12 or more months (n = 253); (3) dissolved MR less than 12 months (n = 110); (4) dissolved MR 12 or more months (n = 70); 5) MR with a second mentor (re-matched; n = 83); and (6); never mentored (n = 212). Structural equation model results at 18 months revealed that mentored youths, especially those in MR lasting 12 or more months (continuous or dissolved), reported significantly fewer behavioral problems and fewer symptoms of depression and social anxiety than did non-mentored youths. They also reported stronger coping skills and emotional support from parents. Mentored girls and boys in long-term relationships experienced positive outcomes. Re-matched girls displayed better outcomes than did never-mentored girls while there was some evidence of harmful outcomes for re-matched boys. Threats to internal validity are examined including the possibility of pre-existing baseline differences between mentored and non-mentored youths. Implications for mentoring programs are discussed.