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Caregivers are known to experience increased morbidity when compared to noncaregivers. Does an intervention targeting caregiver distress affect their health care utilization? One hundred forty-eight caregivers of allogeneic hematopoietic stem cell transplant patients were randomized to treatment as usual (TAU) or a psychoeducation, paced respiration, and relaxation (PEPRR) intervention. Assessments of caregivers' service utilization were collected at baseline and 1, 3, and 6 months post-transplant. During the first 30 days after patient transplant, caregiver medical and mental health professional service use decreased while support group attendance peaked. Mixed model regressions showed a significant decrease in mental health service use by the PEPRR group (P=0.001). At six months caregivers in TAU had predicted marginal probabilities of mental health services utilization over 10 times as high as caregivers in PEPRR (18.1% vs 1.5%). Groups failed to differ in medical service (P=0.861) or support group (P=0.067) use. We can conclude that participation in PEPRR compared to TAU was associated with reduced mental health service utilization. Caregiver psychosocial support services are critical to improve caregiver outcomes.

The purpose of this paper is to examine the prevalence of academic stress and exam anxiety among private secondary school students in India as well as the associations with socio-economic and study-related factors.

Participants were 400 adolescent students (52 percent male) from five private secondary schools in Kolkata who were studying in grades 10 and 12. Participants were selected using a multi-stage sampling technique and were assessed using a study-specific questionnaire.

Findings revealed that 35 and 37 percent reported high or very high levels of academic stress and exam anxiety respectively. All students reported high levels of academic stress, but those who had lower grades reported higher levels of stress than those with higher grades. Students who engaged in extra-curricula activities were more likely to report exam anxiety than those who did not engage in extra-curricula activities.

Private high school students in India report high levels of academic stress and exam anxiety. As such there is a need to develop effective interventions to help these students better manage their stress and anxiety.

This is the first study the authors are aware of that explores the academic stress levels of private secondary school students in India. The study identifies factors that may be associated with the experience of high levels of stress that need to be explored further in future research.