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Description
This study examined whether changes in intervention related gains from the REACH for Personal and Academic Success program, an indicated anxiety prevention school-based protocol, vary as a function of participant youth's exposure to overprotective parenting. This study also examined if ethnicity/race (Caucasian vs. Hispanic/Latino) interacts with overprotective parenting to predict program response. A total of 98 children (M age = 9.70, SD = .07; 77.60% girls; 60.20% Hispanic/Latino) received 1 of 2 protocols (REACH or academic support) and responses were measured at post-treatment and 1-year follow-up. Findings showed that child self-regulation skills improved in the school program (REACH) for children of parents with low levels of overprotection, and child self-regulation skills improved in the control program (academic support) for children of parents with high levels of overprotection. These findings were significant in the Hispanic/Latino subsample, but not in Caucasian youth.
ContributorsBromich, Bobbi Lynn (Author) / Pina, Armando (Thesis director) / Presson, Clark (Committee member) / Hahs, Adam (Committee member) / Department of Psychology (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
In the last decade, the number of people who own a mobile phone or portable electronic communication device has grown exponentially. Recent advances in smartphone technology have enabled mobile devices to provide applications (“mHealth apps”) to support delivering interventions, tracking health treatments, or involving a healthcare team into the treatment process and symptom monitoring. Although the popularity of mHealth apps is increasing, few lessons have been shared regarding user experience design and evaluation for such innovations as they relate to clinical outcomes. Studies assessing usability for mobile apps primarily rely on survey instruments. Though surveys are effective in determining user perception of usability and positive attitudes towards an app, they do not directly assess app feature usage, and whether feature usage and related aspects of app design are indicative of whether intended tasks are completed by users. This is significant in the area of mHealth apps, as proper utilization of the app determines compliance to a clinical study protocol. Therefore it is important to understand how design directly impacts compliance, specifically what design factors are prevalent in non-compliant users. This research studies the impact of usability features on clinical protocol compliance by applying a mixed methods approach to usability assessment, combining traditional surveys, log analysis, and clickstream analysis to determine the connection of design to outcomes. This research is novel in its construction of the mixed methods approach and in its attempt to tie usability results to impacts on clinical protocol compliance. The validation is a case study approach, applying the methods to an mHealth app developed for early prevention of anxiety in middle school students. The results of three empirical studies are shared that support the construction of the mixed methods approach.
ContributorsPatwardhan, Mandar (Author) / Gary, Kevin A (Thesis advisor) / Pina, Armando (Committee member) / Amresh, Ashish (Committee member) / Arizona State University (Publisher)
Created2016
Description
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017
Description
Pediatric anxiety disorders are highly prevalent and while pharmacological intervention seems to be an effective treatment, the validity of reported adverse side effects remains unclear. <br/><br/>Objective: To analyze the nature of evidence regarding adverse side effects in the pharmacological treatment of pediatric anxiety disorders. <br/><br/>Approach: A search using Google Scholar, PubMed, and PsychInfo was conducted for meta-analyses of pharmacological treatment of pediatric anxiety disorders as well as randomized controlled trials. The focus was on adverse events.<br/><br/>Results and Conclusion: Reportings of a limited number of adverse events were found among resources available to clinician and patient informed sources to inform pharmacological treatment of pediatric anxiety disorders. Only a small fraction of adverse side effects were found in the research literature. This finding raises concerns about making informed decisions to treat pediatric anxiety disorders with pharmacotherapy.
ContributorsMartin, Mark (Co-author) / Reyes, Trevin (Co-author) / Whooley, Max (Co-author) / Pina, Armando (Thesis director) / Benoit, Renee (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Mobile health (mHealth) applications (apps) hold tremendous potential for addressing chronic health conditions. Smartphones are now the most popular form of computing, and the ubiquitous “always with us, always on” nature of mobile technology makes them amenable to interventions aimed and managing chronic disease. Several challenges exist, however, such as the difficulty in determining mHealth effects due to the rapidly changing nature of the technology and the challenges presented to existing methods of evaluation, and the ability to ensure end users consistently use the technology in order to achieve the desired effects. The latter challenge is in adherence, defined as the extent to which a patient conducts the activities defined in a clinical protocol (i.e. an intervention plan). Further, higher levels of adherence should lead to greater effects of the intervention (the greater fidelity to the protocol, the more benefit one should receive from the protocol). mHealth has limitations in these areas; the ability to have patients sustainably adhere to a protocol, and the ability to drive intervention effect sizes. My research considers personalized interventions, a new approach of study in the mHealth community, as a potential remedy to these limitations. Specifically, in the context of a pediatric preventative anxiety protocol, I introduce algorithms to drive greater levels of adherence and greater effect sizes by incorporating per-patient (personalized) information. These algorithms have been implemented within an existing mHealth app for middle school that has been successfully deployed in a school in the Phoenix Arizona metropolitan area. The number of users is small (n=3) so a case-by-case analysis of app usage is presented. In addition simulated user behaviors based on models of adherence and effects sizes over time are presented as a means to demonstrate the potential impact of personalized deployments on a larger scale.
ContributorsSingal, Vishakha (Author) / Gary, Kevin (Thesis advisor) / Pina, Armando (Committee member) / Lindquist, Timothy (Committee member) / Arizona State University (Publisher)
Created2019