Drop-out rates from evidence-based interventions for people with a diagnosis of personality disorder (PD) are high. The COVID-19 pandemic has likely exacerbated barriers to engagement with the introduction of virtual working. Virtual therapy has a good evidence-base for Axis I disorders, but limited research for Axis II disorders.

To investigate facilitators and barriers to engagement in a Tier 3 PD service virtual group programme.

A virtual group programme was developed in collaboration with service members, and analysed members’ attendance rates over a 5-month period pre- and post-COVID-19. Thematic analysis of semi-structured telephone interviews with 38 members is reported, describing their experience of the virtual group programme.

Attendance rates were significantly higher pre-COVID (72%) than post-COVID (50%). Thematic analysis highlighted key barriers to attendance were: practical issues, low motivation, challenges of working in a group online and feeling triggered at home. Main promoters of engagement were: feeling valued, continued sense of connection and maintaining focus on recovery.

The results suggest that the pandemic has exacerbated relational and practical barriers to engagement in a Tier 3 PD service. Ways of enhancing engagement are discussed, as well as preliminary recommendation for services offering virtual therapy to people with a diagnosis of PD.

Evidence supports the use of group therapy for symptom reduction and improving functioning in people with psychosis. However, research guidelines highlight the importance of establishing the feasibility of interventions. Adherence is an important indicator of feasibility and an essential step in supporting the development of the evidence base for group interventions. This review aims to estimate adherence, and possible barriers and facilitators, to psychotherapeutic groups in people with psychosis.

Embase, Ovid MEDLINE and PsycINFO databases were searched for cross-referencing terms related to group therapy and psychosis. Studies were assessed against inclusion criteria and methodological quality was evaluated. Data wasextracted from each paper including the average session attendance, demographic, clinical, study and therapy-related characteristics and the impact of these on adherence levels evaluated.

Fifty-nine original research papers were included, reporting on 52 independent studies which consisted of 66 therapy groups comprised of 2109 participants. Average adherence was 76.4% (s.d. = 17.4). Adherence was improved by receiving incentives and was higher in participants of older age. Study sample size was inversely associated with adherence levels. Study quality was variable with approximately 61.5% found to be at risk of bias. The results support the feasibility of group therapy and suggest that adherence in people with psychosis is not dissimilar to those for people experiencing common mental health difficulties. These findings, alongside efficacy evidence, support the use of group interventions in people with psychosis but also highlight the need for further high-quality research on the efficacy for these approaches.

Cognitive-behavioral therapy (CBT) for tobacco cessation is an evidence-based, yet underutilized intervention. More research is needed to understand why some treatment-seekers are ‘no-shows’ for the initial visit.

Examine factors associated with participant no-shows among smokers scheduled for group CBT.

Tobacco smokers (N = 115) were recruited from the community, screened, and if eligible, scheduled to begin group-based CBT plus nicotine replacement therapy. At the screening, participants reported their recruitment source, demographics, smoking history, and contact information. We computed the distance to the study site using the address provided. Regression analyses tested predictors of participant no-shows for the initial visit.

Eligible participants were mostly recruited via flyers (56%), female (58%), African American (61%), middle-aged (Mage = 49 years), averaged 16 cigarettes per day, and resided 8 miles away from the study site. The overall initial visit no-show rate was 56%. Bivariate analyses indicated that respondents who were recruited online, younger, and lived further away from the site were more likely to be no-shows. Younger age significantly predicted failure to attend in the multivariable model.

Findings highlight potential barriers to participation in a group-based intervention, and have implications for pre-intervention engagement strategies and modifications that may increase reach and uptake.

To describe public health nurses’ (PHN) experiences of referring to, and families’ experiences of being referred to, a multicomponent, community-based, childhood weight management programme and to provide insight into families’ motivation to participate in and complete treatment.

Qualitative study using semi-structured interviews and the draw-and-write technique.

Two geographical regions in the south and west of Ireland.

Nine PHN involved in the referral process, as well as ten parents and nine children who were referred to and completed the programme, participated in the present study.

PHN were afraid of misclassifying children as obese and of approaching the subject of excess weight with parents. Peer support from other PHN as well as training in how best to talk about weight with parents were potential strategies suggested to alleviate these fears. Parents recalled the anxiety provoked by the ‘medical terminology’ used during referral and their difficulty interpreting what it meant for the health of their child. Despite initial fears, concern for their children’s future health was a major driver behind their participation. Children’s enjoyment, the social support experienced by parents as well as staff enthusiasm were key to programme completion.

The present study identifies the difficulties of referring families to community weight management programmes and provides practical suggestions on how to support practitioners in making referrals. It also identifies key positive factors influencing parents’ decisions to enrol in community weight management programmes. These should be maximised by staff and policy makers when developing similar programmes.

To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes.

An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors.

The Hague, the Netherlands.

Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18–60 years from a lifestyle-versus-control intervention for the prevention of diabetes.

In total, 68·2 % attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2 % of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant.

Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.

Mass gatherings create difficult environments for which to plan emergency medical responses. The purpose of this study was to identify those variables that are associated with increased medical usage rates (MURs) and certain injury patterns that can be used to facilitate the planning process.

Patient information collected at three types of mass gatherings (professional American football and baseball games and rock concerts) over a three-year period was reviewed retrospectively. Specific variables were abstracted: (1) event type; (2) gender; (3) age; (4) weather; and (5) attendance. All 216 events (total attendance9,708,567) studied were held in the same metropolitan region. All MURs are reported as patients per 10,000 (PPTT).

The 5,899 patient encounters yielded a MUR of 6.1 PPTT. Patient encounters totaled 3,659 for baseball games (4.85 PPTT), 1,204 for football games (6.75 PPTT), and 1,036 for rock concerts (30 PPTT). The MUR for Location A concerts (no mosh pits) was 7.49 PPTT, whereas the MUR for the one Location B concert (with mosh pits) was110 PPTT. The MUR for Location A concerts was higher than for baseball, but not football games (p = 0.005). Gender distribution was equal among patrons seeking medical care. The mean values for patient ages were 29 years at baseball games, 33 years at football games, and 20 years at concerts. The MUR at events held when the apparent temperature was £80°F significantly lower statistically than that at events conducted at temperatures <80°F were (18°C) (4.90 vs. 8.10 PPTT (p = 0.005)). The occurrence of precipitation and increased attendance did not predict an increased MUR. Medical care was sought mostly for minor/basic-level care (84%) and less so for advanced-level care (16%). Medical cases occurred more often atsporting events (69%), and were more common than were cases with traumatic injuries (31%). Concerts with precipitation and rock concerts had a positive association withthe incidence of trauma and the incidence of injuries; whereas age and gender were not associated with medical or traumatic diagnoses.

Event type and apparent temperature were the variables that best predicted MUR as well as specific injury patterns and levels of care.