This study examined the effects of the REsilient Attitudes and Living for Professionals (REAL Pro) prevention intervention on the well-being of professionals who work with children and families. The program combines mindfulness and self-compassion practices with cognitive-behavioral tools that aim to promote improved stress management, emotion regulation and well-being, and was evaluated with early childhood (n = 87) and K-12 educators (n = 40), staff serving youth in out-of-school or after-school settings (n = 31), and medical providers (n = 35). Participants completed pre- and post-test assessments, reporting on measures of stress management (perceived stress, self-compassion), emotion regulation (dysregulation, active coping, denial), and well-being (flourishing, resilience, burnout, secondary trauma symptoms). Dependent sample t-tests were conducted, showing significant improvement from pre- to post-test in self-compassion, emotion regulation, active coping, and a trend toward increased resilience. Three-month follow-up in a small subset of the sample (n = 11) suggested potential delayed reduction in burnout and secondary trauma symptoms. Satisfaction surveys and qualitative data indicated high participant satisfaction with the program and that participants made use of and perceived benefits from the skills for themselves and their clients. The preventive intervention shows promise for providing professionals with tools for stress management and emotion regulation, with the potential for reducing burnout in providers working with children and families who tend to experience substantial work-related stress.

This study examined the feasibility and accessibility of brief perinatal mindfulness-based interventions (1 prenatal, 2 postnatal) aimed at supporting the wellbeing of women and their infants living in the context of low income. First time expectant mothers (n = 202) were recruited through clinics and community-based organizations. We examined the feasibility of recruitment, research assessments and intervention implementation, and the acceptability of the intervention programs. Feasibility was assessed by recruitment and attendance numbers, and participant self-report on barriers and facilitators to participation. Intervention acceptability was assessed by class evaluation questions and qualitative interview. The study showed mixed feasibility with successful recruitment and retention in the study, attributable to incentives and strong community relationships which lead to high levels of completion of research assessments. However, there were low levels of group intervention attendance in the postpartum groups due to significant barriers to in-person program attendance. In qualitative interviews, participants indicated having an online or combined online and in-person option would address attendance challenges. Program evaluation and participant interview data show high levels of program acceptability, with over 95

This study evaluated the impact on student and staff well-being of a mindfulness-based cognitive-behavioral coping program, Be REAL (Resilient Attitudes & Living), delivered by campus staff using a task-sharing approach. The program was adapted for online delivery during COVID19. Study participants included 325 undergraduate students and 100 staff members at a large tri-campus university in the U.S. Participants completed surveys with self-report measures assessing mindfulness, perceptions of stress, emotion regulation, executive control, coping, self-compassion, anxiety, depression, and indicators of well-being including resilience and flourishing. Students also completed measures of social connectedness and happiness, while staff completed measures of work-related burnout and self-efficacy. With students we employed an assessment only control group, and with staff, a waitlist control (WLC) design was used. Feasibility and acceptability measures were obtained. Compared to students in the assessment-only group, students participating in Be REAL showed significant improvements in mindfulness, self-compassion, flourishing, resilience, happiness, emotion regulation problems, executive control, active coping, social connection, depression and anxiety symptoms. These effects were maintained at follow-up. Compared to WLC, staff participating in Be REAL reported improved self-efficacy and reduced anxiety symptoms. This study demonstrated that a mindfulness-based cognitive-behavioral coping enhancement program, Be REAL, delivered online during the pandemic, can improve the well-being and mental health of college students and staff. It further demonstrated feasibility, acceptability, and effectiveness through a task-sharing model whereby staff supporting students facilitated the groups, which presents universities with a promising model of cultivating a campus culture of well-being.

This study examined specificity in the effects of three perinatal mindfulness-based prevention programs that differed in their timing (prenatal, postpartum) and target (maternal well-being, parenting). Effects on maternal mental health (depression, anxiety, resilience), mindfulness, and observed parenting, as well as observed, physiological, and mother-report indicators of infant self-regulation, were examined. The programs were evaluated in a racially and ethnically diverse sample of first-time mothers (n = 188) living in low-income contexts using intention-to-treat analysis. Mothers were assigned to a prenatal well-being, postpartum well-being, parenting, or book control group. Multi-method assessments that included questionnaire, observational, and physiological measures were conducted at four time points: during pregnancy (T1) and when infants were 2–4 months (T2), 4–6 months (T3), and 10–12 months. Compared to the postpartum intervention and control groups, the 6-week prenatal well-being intervention was related to decreases in depressive symptoms during pregnancy but not postpartum, higher maternal baseline respiratory sinus arrhythmia (RSA), fewer intrusive control behaviors, and lower infant cortisol levels in the early postpartum period. Compared to all other groups, the postpartum parenting intervention was related to decreases in maternal anxiety and increases in responsive parenting. Some differential effects across programs might be due to differences in attendance rates in the prenatal (62

A residual mediastinal mass after completion of initial treatment for Hodgkin's disease is a frequent clinical problem. Investigators have suggested three possible approaches to this important problem: 1) observation, 2) additional diagnostic tests with subsequent action based upon test results, or 3) immediate treatment for high-risk patients. The method of decision analysis was applied to determine the optimal management for residual mediastinal abnormalities following treatment of Hodgkin's disease with combined modalities of MOPP chemotherapy and radiation therapy. The three parameters of the importance for making the best decision were: 1) the probability that the mass is truly active disease, 2) the salvage success rate using MOPP or ABVD treatment and 3) the specificity of the gallium scan. The analysis favored the gallium imaging strategy as an initial management choice when the probability was greater than 3% that the residual mass represented active disease and the specificity of gallium imaging was greater than 56%. This strategy proved to be the most cost effective, as well. Additional chemotherapy was favored only when there was a greater than 99% probability that the mass represented active disease. A nomogram has been constructed combining all three parameters of importance for graphically determining the best decision.

Stress that undergraduate students experience is a growing public health concern, and there is increasing attention to programs that promote protective factors and skills to support resilience and well-being. Be REAL (REsilient Attitudes and Living) is a program that has been shown to increase students' use of effective coping strategies, mindfulness, and sense of well-being. This study examined whether the program would be effective when delivered by university staff who mentor or advise students. Methods: Eleven university staff advising or mentoring students delivered Be REAL in a variety of campus settings to 271 students, and 116 students completed pre- and post-test assessments to evaluate potential changes in stress reduction, managing emotions, coping, social connections, well-being and mental health. Results: Students who participated in Be REAL showed significant pre to post-test improvements in perceived stress, emotion dysregulation, coping, social connection, self-compassion, and symptoms of anxiety. There was also a trend toward improvements in symptoms of depression. Conclusions: The findings suggest that training university staff who work with students to deliver well-being programs is a potential avenue for supporting college student mental health, and a more rigorous evaluation of the Be REAL program is warranted.