There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement.

Rates of human migration are steadily rising and have resulted in significant sociopolitical debates over how to best respond to increasing cultural diversity and changing migration patterns. Research on prejudicial attitudes toward immigrants has focused on the attitudes and beliefs that individuals in the receiving country hold about immigrants. The current study enhances this literature by examining how young adults view authorized and unauthorized immigrants and refugees. Using a between-groups design of 191 undergraduates, we found that participants consistently reported more prejudicial attitudes, greater perceived realistic threats, and greater intergroup anxiety when responding to questions about unauthorized compared with authorized immigrants. Additionally, there were differences in attitudes depending on participants' generational status, with older-generation participants reporting greater perceived realistic and symbolic threat, prejudice, and anxiety than newer-generation students. In some instances, these effects were moderated by participant race/ethnicity and whether they were evaluating authorized or unauthorized immigrants. Lastly, perceived realistic threat, symbolic threat, and intergroup anxiety were significant predictors of prejudicial attitudes. Overall, participants reported positive attitudes toward refugees and resettlement programs in the United States. These findings have implications for future research and interventions focused on immigration and prejudice toward migrant groups.

Background: Youth living with HIV (YLHIV) enrolled in HIV treatment experience higher loss to follow-up, suboptimal treatment adherence, and greater HIV-related mortality compared with younger children or adults. Despite poorer health outcomes, few interventions target youth specifically. Expanding access to mobile phone technology, in low- and middle-income countries (LMICs) in particular, has increased interest in using this technology to improve health outcomes. mHealth interventions may present innovative opportunities to improve adherence and retention among YLHIV in LMICs.Objective: This study aimed to test the effectiveness of a structured support group intervention, Social Media to promote Adherence and Retention in Treatment (SMART) Connections, delivered through a social media platform, on HIV treatment retention among YLHIV aged 15 to 24 years and on secondary outcomes of antiretroviral therapy (ART) adherence, HIV knowledge, and social support.Methods: We conducted a parallel, unblinded randomized controlled trial. YLHIV enrolled in HIV treatment for less than 12 months were randomized in a 1:1 ratio to receive SMART Connections (intervention) or standard of care alone (control). We collected data at baseline and endline through structured interviews and medical record extraction. We also conducted in-depth interviews with subsets of intervention group participants. The primary outcome was retention in HIV treatment. We conducted a time-to-event analysis examining time retained in treatment from study enrollment to the date the participant was no longer classified as active-on-treatment.Results: A total of 349 YLHIV enrolled in the study and were randomly allocated to the intervention group (n=177) or control group (n=172). Our primary analysis included data from 324 participants at endline. The probability of being retained in treatment did not differ significantly between the 2 study arms during the study. Retention was high at endline, with 75.7% (112/163) of intervention group participants and 83.4% (126/161) of control group participants active on treatment. HIV-related knowledge was significantly better in the intervention group at endline, but no statistically significant differences were found for ART adherence or social support. Intervention group participants overwhelmingly reported that the intervention was useful, that they enjoyed taking part, and that they would recommend it to other YLHIV.Conclusions: Our findings of improved HIV knowledge and high acceptability are encouraging, despite a lack of measurable effect on retention. Retention was greater than anticipated in both groups, likely a result of external efforts that began partway through the study. Qualitative data indicate that the SMART Connections intervention may have contributed to retention, adherence, and social support in ways that were not captured quantitatively. Web-based delivery of support group interventions can permit people to access information and other group members privately, when convenient, and without travel. Such digital health interventions may help fill critical gaps in services available for YLHIV.Trial Registration: ClinicalTrials.gov NCT03516318; https://clinicaltrials.gov/ct2/show/NCT03516318

Physical activity and time spent outdoors may be important non-pharmacological approaches to improve sleep quality and duration (or sleep patterns) but there is little empirical research evaluating the two simultaneously. The current study assesses the role of physical activity and time outdoors in predicting sleep health by using objective measurement of the three variables. A convenience sample of 360 adult women (mean age = 55.38 ±9.89 years; mean body mass index = 27.74 ±6.12) was recruited from different regions of the U.S. Participants wore a Global Positioning System device and ActiGraph GT3X+ accelerometers on the hip for 7 days and on the wrist for 7 days and 7 nights to assess total time and time of day spent outdoors, total minutes in moderate-to-vigorous physical activity per day, and 4 measures of sleep health, respectively. A generalized mixed-effects model was used to assess temporal associations between moderate-to-vigorous physical activity, outdoor time, and sleep at the daily level (days = 1931) within individuals. There was a significant interaction (p = 0.04) between moderate-to-vigorous physical activity and time spent outdoors in predicting total sleep time but not for predicting sleep efficiency. Increasing time outdoors in the afternoon (versus morning) predicted lower sleep efficiency, but had no effect on total sleep time. Time spent outdoors and the time of day spent outdoors may be important moderators in assessing the relation between physical activity and sleep. More research is needed in larger populations using experimental designs.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

Research has shown that taxi drivers are at risk for numerous health concerns, such as low back and leg pain, linked to their highly sedentary occupation, long work hours and stressors related to the job (e.g. low income, safety threats). The goal of this study was to explore occupational health risks and opportunities for health interventions with taxi drivers using community-based participatory research (CBPR) methods. A mixed methods approach included first a convenience sample of 19 East African taxi drivers participating in focus group discussions. Second, a convenience sample of 75 current taxi drivers (M age = 45.7 years) and 25 non-driver comparison participants (M age = 40.3 years) were recruited to complete a structured self-reported questionnaire and objective measures of health. Health education was provided alongside the research to address common health concerns and to ensure mutual benefit and an action orientation. The focus groups described numerous health concerns that drivers attributed to their occupation, including chronic pain, sleep deprivation, cardiovascular disease, diabetes, kidney disease and eye problems, as the most common. Participants offered ideas for health interventions that include workplace reform and driver education. Quantitative data indicate that 44% of drivers reported their health as ‘fair’ or ‘poor’. Drivers were more likely to report musculoskeletal pain, less sleep, more fatigue and less physical activity as compared to non-drivers. The majority of drivers reported financial and job dissatisfaction. The research provides data to inform targeted health interventions that support the health and safety of taxi drivers.