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Background Identity is how we understand ourselves and others through the roles or social groups we occupy. This review focuses on lived experience researchers and providers and the impact of these roles on identity. Lived experience researchers and providers use their lived experience of mental or physical disability either as experts by experience, researchers, peer workers, or mental health professionals with lived experience. They must navigate both professional and personal aspects to their roles which can be complex. Performing roles simultaneously embodying professional and lived experiences contribute towards a lack of clarity to identity. This is not adequately explained by the theoretical evidence base for identity. Main body This systematic review and narrative synthesis aimed to provide a conceptual framework to understand how identity of lived experience researchers and providers is conceptualised. A search strategy was entered into EBSCO to access Academic search complete, CINAHL, MEDLINE, PsycINFO, Psych Articles, and Connected papers. Out of the 2049 yielded papers, thirteen qualitative papers were eligible and synthesised, resulting in a conceptual framework. Five themes explained identity positions: Professional, Service user, Integrated, Unintegrated and Liminal. The EMERGES framework, an original conception of this review, found themes of: Enablers and Empowerment, Motivation, Empathy of the self and others, Recovery model and medical model, Growth and transformation, Exclusion and Survivor roots contributed to lived experience researcher and provider identities. Conclusions The EMERGES framework offers a novel way to understand the identities of lived experience researchers and providers, helping support effective team working in mental health, education, and research settings. Plain English summary Patients now commonly help to teach healthcare professionals from their own perspective of what it is like to experience health difficulties and healthcare services. Consequently, the needs of patients are being better recognised by healthcare providers. Patients are also involved in research. These types of patient involvement lead to improved research and care. Patients included in this type of work are frequently referred to as patient providers, service user researchers, peer workers, experts by experience or lived experience researchers and providers. This might mean they are no longer viewed as people who use services but as people who provide a service. This review helps us understand how those in these roles are affected and how they understand themselves. We found they were sometimes described as either patients or professionals. Sometimes they were described as both patient and professional at the same time. Other times they were described as somewhere between a patient or professional. There were other important ideas that affected how they viewed themselves because of these experiences. These included feelings of empowerment and motivation from doing this important teaching and clinical work. The roles gave them a better understanding of their own experiences. These roles led to a personal growth and sense of achievement. The experiences of exclusion, and of being a patient affected how patient providers think of themselves. This understanding can lead to patient providers being better understood and leads to better teaching and training of healthcare professionals.

The purpose of this study was to examine how successes and difficulties with various developmental tasks of early adulthood relate to the course of well-being. Three waves of national panel data spanning ages 18–26 were drawn from the Monitoring the Future study (N = 3518). Based on self-reports, respondents were assigned scores (succeeding, maintaining, or stalling) to reflect progress in seven domains of developmental tasks: education, work, financial autonomy, romantic involvement, peer involvement, substance abuse avoidance, and citizenship. We identified trajectory groups of well-being (based on self-esteem, self-efficacy, and social support) that reflect diverging trajectories during the transition: steady–high versus high–decreasing, and low–increasing versus steady–low. Logistic regression analyses were conducted to predict membership in the diverging well-being trajectory groups as a function of developmental task domain scores. Maintaining or gaining a salutary trajectory of well-being across the transition was found to be a function of more success and less stalling across the developmental tasks, specifically in the work, romantic involvement, and citizenship domains. Compensatory effects (e.g., succeeding in education compensated for not succeeding in work) and threshold effects (e.g., succeeding in both achievement and affiliation domains was necessary for a salutary trajectory) were also found.This study was supported in part by a grant from the National Institute on Drug Abuse (DA01411). The authors thank Dante Cicchetti, Kate Fiori, Jennifer Maggs, Wayne Osgood, and Arnold Sameroff for helpful comments and suggestions and Ginny Laetz and Tanya Hart for assistance with the preparation of this article.

The current study expands upon body image research to examine how gender, self-esteem, social support, teasing, and family, friend, and media pressures relate to body image and eating-related attitudes and behaviors among male and female adolescents (N = 177). Results indicated that adolescents were dissatisfied with their current bodies: males were concerned with increasing their upper body, whereas females wanted to decrease the overall size of their body. Low self-esteem and social support, weight-related teasing, and greater pressures to lose weight were associated with adolescents' negative body esteem, body image, and eating attitudes. Females displayed more high risk eating behaviors--which were associated with more psychosocial risk factors--than males, whose high risk attitudes and behaviors were only associated with low parental support and greater pressure to be muscular. Reducing adolescents' perceptions of appearance-related pressure from family and friends may be key for enhancing body image and decreasing links between low self-esteem and negative eating behaviors and weight-related perceptions.

Background Lived experience researchers draw on their lived and living experiences to either lead on or inform research. Their personal experiences are relevant to the research topic and so they must manage the interplay of their health and healthcare experiences with the research, population, and data they work with, as well as the more general challenges of being a researcher. Lived experience researchers must navigate these dilemmas in addition to queries over their competency, due to issues relating to intersectionality and epistemic injustice. This justifies a motivation to better understand the experiences of lived experience researchers and develop appropriate and personalised supervision based on their preferences and needs. Methods Q methodology was used to identify a collection of identity-related issues that impact lived experience researchers during PhD research in the context of the UK. These issues were presented in the form of 54 statements to 18 lived experience researchers to prioritise as topics to explore in supervision. Result It was found that lived experiences researchers could be grouped into three distinct factors following an inverted factor analysis: Factor 1: Strengthening my identity, skills, growth, and empowerment; Factor 2: Exploring the emotional and relational link I have with the research and Factor 3: Navigating my lived and professional experiences practically and emotionally. The findings suggest that there may be three types of lived experience researchers, each with different needs from supervision, suggesting the population is heterogeneous. Conclusion The research identified a deeper understanding of the needs of lived experience researchers and highlights the importance of personalised supervision according to the individual needs of the researcher and their preferences for supervision. The findings reinforce the importance of integrating a clinical dimension into supervision to support the needs of all lived experience researchers. Plain English summary This research aimed to understand how to support lived experience researchers through supervision in the UK. Lived experience researchers lead and/or inform health research based on their personal experience of health and healthcare services which can lead to service provision that meets service user needs. People in these roles might be called lived experience researchers. Lived experience researchers may experience difficulties in their role as they conduct research linked to their own experiences. The research could trigger them to remember their own experiences. Other researchers might not value their knowledge and expertise as they are seen as patients and not professionals. This may be because they are viewed through their stigmatised patient identity. The support they need as lived experience researchers remains relatively unexplored. Fifty-four statements on the lived experience researcher experience were presented to 18 lived experience researchers. They were asked to prioritise these statements and arrange them on a grid according to how useful they were to them to explore in supervision. Lived experience researchers who prioritised statements similarly were grouped together. Three groups of lived experience researchers were found. The 1st group were interested in supervision that helped them develop their confidence, growth and professional skills. The 2nd group wanted to understand their personal link to the subject. The 3rd group wanted support to manage personal and professional challenges and to overcome barriers they experienced. The findings suggest different approaches are needed to personalise supervision for lived experience researchers.

Background Influenza (flu) vaccination rates in UK care home staff are extremely low. Less than 40% of staff in care homes are vaccinated for influenza (flu), presenting risks to the health of frail residents and potential staff absence from cross-infection. Staff often do not perceive a need for vaccination and are unaware they are entitled to free flu vaccination. The FluCare study, a cluster randomised control trial (RCT), uses behavioural interventions to address barriers. Videos, posters, and leaflets are intended to raise awareness of flu vaccination benefits and debunk myths. On-site staff vaccination clinics increase accessibility. Financial incentives to care homes for improved vaccination rates and regular monitoring influence the environment. This paper outlines the planned process evaluation which will describe the intervention’s mechanisms of action, explain any changes in outcomes, identify local adaptations, and inform design of the implementation phase. Methods/design A mixed method process evaluation to inform the interpretation of trial findings. Objectives • Describe the intervention as delivered in terms of dose and fidelity, including adaptations and variations across care homes. • Explore the effects of individual intervention components on primary outcomes. • Investigate the mechanisms of impact. • Describe the perceived effectiveness of relevant intervention components (including videos, leaflets, posters, and flu clinics) from participant perspectives (care home manager, care home staff, flu clinic providers). • Describe the characteristics of care homes and participants to assess reach. A purposive sample of twenty care homes (ten in the intervention arm, ten in the control arm) for inclusion in the process evaluation. Data will include (1) study records including care home site profiles, (2) responses to a mechanism of action questionnaire, and (3) semi-structured interviews with care home staff and clinic providers. Quantitative data will be descriptively reported. Interview data will be thematically analysed and then categories mapped to the Theoretical Domains Framework. Discussion Adopting this systematic and comprehensive process evaluation approach will help ensure data is captured on all aspects of the trial, enabling a full understanding of the intervention implementation and RCT findings. Trial registration ISRCTN ISRCTN22729870. Registered on 24 August 2022.

Little is known about adolescents' caffeine use, yet caffeinated soda, and more recently coffee and energy drinks, are part of youth culture. This study examines adolescents' caffeine use and, using cluster analysis, identifies three groups of caffeine users who differed in their reasons for use, expectancies, and sleep behaviors. In this high school student sample (N = 197), 95% of participants reported recent caffeine use—most often soda—where typical first use of the day was in the evening. Results reveal that adolescents in the mixed use and high soda use groups consumed similar amounts of soda, reporting significantly more use than the low caffeine use group. In contrast with high soda users, mixed users drank more coffee, expected more dependence symptoms and energy enhancement from caffeine, and were more likely to report getting up early, daytime sleepiness, and using caffeine to get through the day.

Involvement in civic and community activities is a core part of positive youth development. Adolescents involved in voluntary civic activities have greater academic engagement, enhanced well-being, less involvement in problem behaviors, and they are more likely to value connections to their community than those who are not involved. The current research examined involvement in school and community civic activities as well as religious youth groups among 8th and 9th graders ( N  = 679, 61.7% female, 85.9% White) from small, rural schools in the Midwest U.S. and linked involvement to religiosity, well-being, problem behavior, academic engagement, and perceptions of parents and peers. Half of the adolescents in the sample reported involvement in civic activities or, more commonly, in religious youth groups. Adolescents who participated in religious youth groups reported more extracurriculars, less problem behavior, higher grades and motivation, and more support from parents and friends than adolescents who did not. The most frequently reported school civic activities were student council and Future Farmers of America, and 4-H was the most popular community civic activity. Those who were involved in school- and community-based civic activities reported more religiosity, academic engagement, and positive perceptions of parents and peers than uninvolved youth. The results support and extend research on rural youth by documenting civic activities across contexts and examining how involvement is associated with positive youth development.

Relations among academic achievement, school bonding, school misbehavior, and cigarette use from 8th to 12th grade were examined in two national panel samples of youth (n = 3056). A series of competing conceptual models developed a priori was tested using structural equation modeling (SEM). The findings suggest that during middle adolescence the predominant direction of influence is from school experiences to cigarette use. School misbehavior and low academic achievement contribute to increased cigarette use over time both directly and indirectly. Two-group SEM analyses involving two cohorts-gender and ethnicity- revealed that our findings are robust. In addition, comparisons between high school dropouts and nondropouts and between eighth-grade cigarette use initiators and nonusers revealed few differences in direction or magnitude of effects. Results suggest that prevention programs that attempt to reduce school misbehavior and academic failure, as well as to help students who misbehave and have difficulty in school constructively avoid negative school- and health-related outcomes, are likely to be effective in reducing adolescent cigarette use.

Background The referral process between healthcare services can be complex, especially in psychiatry, leading to significant delays and ‘hidden waiting lists’. Digital approaches may be helpful. The CHRONOSIG (CHRONOlogical SIGnature) project aims to improve the referral and triage process by applying machine learning (ML) technology to information in electronic health records. We used a focus group methodology to ascertain the views of patients and participants on using CHRONOSIG and similar digital approaches to support decision making in triaging referrals in difficult to treat depression, and the potential benefits and disadvantages of such an approach. Methods A lived experience participant focus group ( N  = 16) was held on 25th September, 2024, with a lived experience chair. Participants were recruited by convenience sampling. Data were analysed thematically and managed using the Framework method, with double coding of transcripts, and reported using COREQ guidelines. Results Main themes from the analysis were: (i) the complexity of mental health needs assessments; (ii) challenges in the current mental health system; (iii) general challenges of using a computer/artificial intelligence based tool for risk prediction and clinical decision support; (iv) differences and similarities in using a computer-based prediction tool in mental health vs. in physical health; (v) possible benefits and harms; (vi) factors to consider in the future. Conclusions Patient engagement is a key challenge for digital tools in mental health, but previous studies in digital decision support tools have focussed on clinician feedback. In this study we ascertained the views of lived experience participants in mental healthcare triage and referral in difficult to treat depression. Participants identified delays, errors and confusion in the referral process and expressed positive views on the ability of the CHRONOSIG tool to help to improve waiting times and time spent between services, particularly when used as an addition to a high-quality clinical consultation. In many countries there are shortfalls in mental health care provision with increasing waits in both recorded and unrecorded waiting lists. This study supports a potential route to improve these processes; by more accurately and efficiently identifying the needs of patients and matching these to suitable services and research opportunities.