WorldWideScience

Sample records for schoolwide programs evidence

  1. 34 CFR 200.28 - Schoolwide program components.

    Science.gov (United States)

    2010-07-01

    ... instructional program. (c) Parental involvement. (1) A schoolwide program must involve parents in the planning... 34 Education 1 2010-07-01 2010-07-01 false Schoolwide program components. 200.28 Section 200.28 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY...

  2. Schoolwide Programs: Parents' Guide & Capacity-Building Materials = Programas Schoolwide: Una Guia para Padres y Materias de Capacitacion.

    Science.gov (United States)

    WestEd, San Francisco, CA.

    The reauthorization of Title I (Improving America's Schools Act--IASA) made the Schoolwide Program (Schoolwide) a major strategy for schools with high poverty rates and stressed the importance of parent involvement. This guide was developed to provide professional development and parent education on Schoolwide implementation in California. The…

  3. A Quasi-Experimental Analysis of Schoolwide Violence Prevention Programs

    Science.gov (United States)

    Barnes, Tia Navelene; Leite, Walter; Smith, Stephen W.

    2017-01-01

    Violence prevention programs are commonplace in today's schools, though reviews of the literature reveal mixed empirical findings on their effectiveness. Often, these programs include a variety of components such as social skills training, student mentoring, and activities designed to build a sense of school community that have not been tested for…

  4. The Effects of a School-Wide Positive Behavior Intervention Support Program on the Intrinsic Motivation of Third Grade Students

    Science.gov (United States)

    Amis, Sarah Anne

    2013-01-01

    This research project sought to determine the effects of a School-Wide Positive Behavior Intervention Support program (SWPBIS) on the intrinsic motivation of third grade students in regard to student achievement, student behavior, and teacher perception. Students of two intermediate schools served as the treatment group and control group, and were…

  5. A Presidential Election Simulation: Creating a School-Wide Interdisciplinary Program

    Science.gov (United States)

    Joyce, Helen M.

    2008-01-01

    Given the low turnout among younger voters, it is important to seek innovative ways of engaging students in the electoral process, and a presidential year like this one offers exciting opportunities for doing so. In this article, the author describes her experiences with a schoolwide project designed by herself and colleagues that simulates the…

  6. School-Wide Healthy Weight Behaviors: Promoting Universal Longevity via School-Family Ecologies (PULSE)

    Science.gov (United States)

    Anderson, Laura M.; Phelps, LeAdelle

    2009-01-01

    Rates of childhood obesity have more than tripled in the last 40 years, resulting in a challenge from the public sector and various governmental institutions for the development of effective prevention/early intervention programming. Based on an extensive review of the literature, an evidence-based, school-wide curriculum is proposed. Promoting…

  7. Elementary School-Wide Implementation of a Blended Learning Program for Reading Intervention

    Science.gov (United States)

    Prescott, Jen Elise; Bundschuh, Kristine; Kazakoff, Elizabeth R.; Macaruso, Paul

    2018-01-01

    The authors examined the implementation of a blended learning program for literacy instruction across kindergarten through Grade 5 in a Title I urban elementary school, including a population of students (18%) who are English learners. Student progress in the online component of the blended learning program was a significant predictor of growth in…

  8. Exploring Barriers to Implementing a School-Wide Positive Behavioral Intervention and Support Program

    Science.gov (United States)

    Gay, Ronald Lynn

    2016-01-01

    This study examined factors related to the implementation of a School Wide Positive Behavioral Intervention and Support (SWPBIS) program at a large middle school in the United States. Parent Teacher Student Association volunteers at the school reported that teacher fidelity to implementation of SWPBIS activities was inconsistent, threatening the…

  9. 34 CFR 200.86 - Use of MEP funds in schoolwide projects.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Use of MEP funds in schoolwide projects. 200.86 Section... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Migrant Education Program § 200.86 Use of MEP funds in schoolwide projects. Funds available under part C...

  10. Yoga as a School-Wide Positive Behavior Support

    Science.gov (United States)

    Accardo, Amy L.

    2017-01-01

    A yoga-based school-wide positive behavior support (SWPBS) may provide a foundation for teaching mindfulness and self-regulation in K-12 schools. Here, the use of yoga as a SWPBS was examined through a review of existing literature and interviews of yoga program facilitators. Yoga was reported to be effective as a pedagogical approach, and found…

  11. Building school-wide capacity for improvement: the role of leadership, school organizational conditions, and teacher factors

    NARCIS (Netherlands)

    Thoonen, E.E.J.; Sleegers, P.J.C.; Oort, F.J.; Peetsma, T.T.D.

    2012-01-01

    Education policies for greater accountability of schools assume that schools are capable of building their capacity for continuous improvement. While policy-makers, scholars, and practitioners acknowledge the importance of building school-wide capacity for continuous improvement, empirical evidence

  12. Building school-wide capacity for improvement: the role of leadership, school organizational conditions and teacher factors

    NARCIS (Netherlands)

    Thoonen, E.E.J.; Thoonen, E.E.J.; Sleegers, P.J.C.; Oort, F.J.; Peetsma, T.T.D.

    2012-01-01

    Education policies for greater accountability of schools assume that schools are capable of building their capacity for continuous improvement. While policy-makers, scholars, and practitioners acknowledge the importance of building school-wide capacity for continuous improvement, empirical evidence

  13. Changing classroom practices: the role of school-wide capacity for sustainable improvement

    NARCIS (Netherlands)

    Sleegers, P.J.C.; Thoonen, E.E.J.; Oort, F.J.; Peetsma, T.T.D.

    2014-01-01

    Purpose: Elementary schools have been confronted with large-scale educational reforms as strategies to improve the educational quality. While building school-wide capacity for improvement is considered critical for changing teachers’ classroom practices, there is still little empirical evidence for

  14. Changing classroom practices: the role of school-wide capacity for sustainable improvement

    NARCIS (Netherlands)

    Sleegers, P.J.C.; Thoonen, Eric E.J.; Oort, Frans J.; Peetsma, Thea T.D.

    2015-01-01

    Purpose – Elementary schools have been confronted with large-scale educational reforms as strategies to improve the educational quality. While building school-wide capacity for improvement is considered critical for changing teachers’ classroom practices, there is still little empirical evidence for

  15. Advances in Schoolwide Inclusive School Reform

    Science.gov (United States)

    Sailor, Wayne

    2015-01-01

    This article highlights three significant advances in schoolwide inclusive school reform and suggests three next steps to improve educational outcomes for "all" students, particularly for students for whom typical instruction is not effective. Significant advances are as follows: (a) a multi-tiered system of support (MTSS) with embedded…

  16. Implementation of a School-Wide Adolescent Character Education and Prevention Program: Evaluating the Relationships between Principal Support, Faculty Implementation, and Student Outcomes

    Science.gov (United States)

    Holtzapple, Carol K.; Griswold, J. Suzy; Cirillo, Kathleen; Rosebrock, Jim; Nouza, Noreen; Berry, Cami

    2011-01-01

    School-based character education and violence prevention programs focus on improving prosocial competencies and reducing negative behaviors in students. The Capturing Kids' Hearts Campus by Design model is a school-level intervention that impacts student behavior by enhancing school climate through improved relational and conflict management…

  17. A Big Apple for Educators: New York City's Experiment with Schoolwide Performance Bonuses. Final Evaluation Report. Monograph

    Science.gov (United States)

    Marsh, Julie A.; Springer, Matthew G.; McCaffrey, Daniel F.; Yuan, Kun; Epstein, Scott; Koppich, Julia; Kalra, Nidhi; DiMartino, Catherine; Peng, Art

    2011-01-01

    In the 2007-2008 school year, the New York City Department of Education and the United Federation of Teachers jointly implemented the Schoolwide Performance Bonus Program in a random sample of the city's high-needs public schools. The program lasted for three school years, and its broad objective was to improve student performance through…

  18. Merging Empiricism and Humanism: Role of Social Validity in the School-Wide Positive Behavior Support Model

    Science.gov (United States)

    Marchant, Michelle; Heath, Melissa Allen; Miramontes, Nancy Y.

    2013-01-01

    Criteria for evaluating behavior support programs are changing. Consumer-based educational and behavioral programs, such as School-Wide Positive Behavior Support (SWPBS), are particularly influenced by consumer opinion. Unfortunately, the need for and use of social validity measures have not received adequate attention in the empirical literature…

  19. A High School Counselor's Leadership in Providing School-Wide Screenings for Depression and Enhancing Suicide Awareness

    Science.gov (United States)

    Erickson, Anne; Abel, Nicholas R.

    2013-01-01

    The prevalence of mental health issues and suicidal thoughts and actions among school-aged children and adolescents is a serious issue. This article examines the scope of the problem nationwide and provides a brief overview of the literature regarding the effectiveness of school-wide screening programs for depression and suicide risk. The authors…

  20. Effective Inclusive Schools: Designing Successful Schoolwide Programs

    Science.gov (United States)

    Hehir, Thomas; Katzman, Lauren I.

    2012-01-01

    This book presents lessons learned from in-depth case studies of some of our most effective inclusive public schools. The authors conclusively demonstrate that schools can educate students with mild and severe disabilities in general education classrooms by providing special education services that link to and bolster general education…

  1. Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

    2013-01-01

    In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

  2. Efficacy of Schoolwide Programs to Promote Social and Character Development and Reduce Problem Behavior in Elementary School Children. Report from the Social and Character Development Research Program. NCER 2011-2001

    Science.gov (United States)

    Ruby, Allen; Doolittle, Emily

    2010-01-01

    The Institute of Education Sciences (IES) and the Division of Violence Prevention in the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC) collaborated to conduct a rigorous impact evaluation of programs aimed at improving students' behavior. For this evaluation, such programs were termed Social…

  3. WWC Review of the Report "A Big Apple for Educators: New York City's Experiment with Schoolwide Performance Bonuses. Final Evaluation Report." What Works Clearinghouse Single Study Review

    Science.gov (United States)

    What Works Clearinghouse, 2013

    2013-01-01

    The study examined in this paper focuses on whether monetary bonuses for teachers improved schoolwide academic achievement in New York City public schools. Study authors analyzed data from 389 high-need elementary, middle, and high schools in New York City in the first year of the bonus program (2007-08) and from 371 of those same schools in the…

  4. Positive Behavior Support in Schools (PBSIS): An Administrative Perspective on the Implementation of a Comprehensive School-Wide Intervention in an Urban Charter School

    Science.gov (United States)

    Christofferson, Remi Dabney; Callahan, Kathe

    2015-01-01

    This research explores the implementation of a school-wide intervention program that was designed to foster and instill intrinsic values based on an external reward system. The Positive Behavior Support in Schools (PBSIS) is an intervention intended to improve the climate of schools using system-wide positive behavioral interventions to discourage…

  5. Identifying Barriers and Facilitators in Implementing Schoolwide Positive Behavior Support

    Science.gov (United States)

    Kincaid, Don; Childs, Karen; Blase, Karen A.; Wallace, Frances

    2007-01-01

    As the number of schools implementing systemic, schoolwide positive behavior support (PBS) processes expands (nationally, at least 5,000 schools are participating), increasing attention is being paid to the efficacy of implementation. This article describes a case study of the experiences of Florida's Positive Behavior Support Project, which used…

  6. Schoolwide Enrichment Model: Challenging All Children to Excel

    Science.gov (United States)

    Beecher, Margaret

    2010-01-01

    This article summarizes how the components of the Schoolwide Enrichment Model were used to dramatically reduce the achievement gap in a school with a high at-risk student population. The theories of enrichment and instructional differentiation replaced an existing remedial paradigm and a strength-based methodology was embraced by the school…

  7. The Impact of Teasing and Bullying on Schoolwide Academic Performance

    Science.gov (United States)

    Lacey, Anna; Cornell, Dewey

    2013-01-01

    Hierarchical regression analyses conducted at the school level found that the perceived prevalence of teasing and bullying was predictive of schoolwide passing rates on state-mandated achievement testing used to meet No Child Left Behind requirements. These findings could not be attributed to the proportion of minority students in the school,…

  8. Examining Barriers to Sustained Implementation of School-Wide Prevention Practices

    Science.gov (United States)

    Turri, Mary G.; Mercer, Sterett H.; McIntosh, Kent; Nese, Rhonda N. T.; Strickland-Cohen, M. Kathleen; Hoselton, Robert

    2016-01-01

    The purpose of this study was to determine if an experimental 5-item measure of barriers to implementing and sustaining school-wide prevention practices, the "Assessment of Barriers to Implementation and Sustainability in Schools" (ABISS), would relate to objective measures of school-wide positive behavioral interventions and supports…

  9. Achievement, Engagement, and Behavior Outcomes of Youth at Risk Following a Pre-Eighth-Grade Summer Academic Enrichment Program and Participation in a School-Wide, School Year Long, Ownership, Mastery, and Grading Initiative

    Science.gov (United States)

    Alati, David K.

    2011-01-01

    No significant differences in beginning eighth-grade pretest compared to ending eighth-grade posttest California Achievement Test Normal Curve Equivalent Scores were found for youth at risk who completed a pre-eighth-grade summer academic enrichment program where comparisons for reading vocabulary t(19) = 0.46, p = 0.33 (one-tailed), d = 0.107,…

  10. Evidence for transgenerational metabolic programming in Drosophila

    Directory of Open Access Journals (Sweden)

    Jessica L. Buescher

    2013-09-01

    Worldwide epidemiologic studies have repeatedly demonstrated an association between prenatal nutritional environment, birth weight and susceptibility to adult diseases including obesity, cardiovascular disease and type 2 diabetes. Despite advances in mammalian model systems, the molecular mechanisms underlying this phenomenon are unclear, but might involve programming mechanisms such as epigenetics. Here we describe a new system for evaluating metabolic programming mechanisms using a simple, genetically tractable Drosophila model. We examined the effect of maternal caloric excess on offspring and found that a high-sugar maternal diet alters body composition of larval offspring for at least two generations, augments an obese-like phenotype under suboptimal (high-calorie feeding conditions in adult offspring, and modifies expression of metabolic genes. Our data indicate that nutritional programming mechanisms could be highly conserved and support the use of Drosophila as a model for evaluating the underlying genetic and epigenetic contributions to this phenomenon.

  11. Shakespearience: A Schoolwide Celebration of the Renaissance.

    Science.gov (United States)

    Wall, Angela F.; And Others

    1997-01-01

    Describes across disciplines in the culture, literature, science, art, and music of the Renaissance. The program featured student exhibits, performances, projects, and demonstrations and a visit by a professional actor posing as William Shakespeare. (DB)

  12. An evidence-based rehabilitation program for tracheoesophageal speakers

    NARCIS (Netherlands)

    Jongmans, P.; Rossum, M.; As-Brooks, C.; Hilgers, F.; Pols, L.; Hilgers, F.J.M.; Pols, L.C.W.; van Rossum, M.; van den Brekel, M.W.M.

    2008-01-01

    Objectives: to develop an evidence-based therapy program aimed at improving tracheoesophageal speech intelligibility. The therapy program is based on particular problems found for TE speakers in a previous study as performed by the authors. Patients/Materials and Methods: 9 male laryngectomized

  13. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  14. Evidence of eligibility manipulation for conditional cash transfer programs

    Directory of Open Access Journals (Sweden)

    Sergio Firpo

    2014-09-01

    Full Text Available This paper assesses whether eligibility for conditional cash transfer programs has been manipulated, as well as the impact of this phenomenon on time allocation within households. To perform this analysis, we use data from the 2006 PNAD (Brazilian national household survey and investigate the eligibility manipulation for the Bolsa Família (Family Stipend program during this time period. The program assists families with a monthly per capita income of around R$120.00 (US$60.00. By applying the tests developed by McCrary (2008, we find suggestive evidence that individuals manipulate their income by voluntarily reducing their labor supply in order to become eligible to the program. Moreover, the reduction in labor supply is greater among women, especially single or divorced mothers. This evidence raises some concern about the unintended consequences related to the eligibility criteria utilized by Bolsa Família, as well as the program's impact on individuals living in extreme poverty.

  15. Worker programs and resource use: Evidence from better work jordan

    Science.gov (United States)

    Robins, Nathan

    This paper examines data collected for the Better Work program in Jordan which aims to protect laborers in the garment industry from poor working conditions. Data are examined to look for benefits to the factories participating in the program beyond improved compliance with labor law. In particular, potential impacts to firm energy use are examined and correlations are tested between electricity use rates and measures of worker outcomes and a number of factory traits such as size and production input costs. Evidence was found to back up work done in Vietnam with regard to resource use and distribution of electricity expenses. It was also found that the type of data being collected is not ideal for examinations of energy, and more direct methods are desirable, and that considerable production obstacles are worker skill level, electricity prices, and to a greater degree in Jordan than in previously examined countries, water prices.

  16. An Analysis of Implementation Strategies in a School-Wide Vocabulary Intervention

    Science.gov (United States)

    Roskos, Katheen A.; Moe, Jennifer Randazzo; Rosemary, Catherine

    2017-01-01

    From an improvement research perspective, this study explores strategies used to implement a school-wide vocabulary intervention into language arts instruction at an urban elementary school. Academic language time, an innovative change in the instructional delivery system, allots time and structure for deliberate teaching of cross-disciplinary…

  17. Investigating School-Wide Antecedents of Good Practice Dissemination from Individual Subject Projects

    Science.gov (United States)

    Christophersen, Knut-Andreas; Elstad, Eyvind; Turmo, Are

    2012-01-01

    Good practice dissemination is an unsolved problem in education. This article describes how clear and "soft" leadership and perceptions of social and economic exchange operate in the bottom-up processes of school reforms and examines the relative impact of these factors on school-wide good practice dissemination and discusses how…

  18. Explicitly Teaching Social Skills Schoolwide: Using a Matrix to Guide Instruction

    Science.gov (United States)

    Simonsen, Brandi; Myers, Diane; Everett, Susannah; Sugai, George; Spencer, Rebecca; LaBreck, Chris

    2012-01-01

    Socially skilled students are more successful in school. Just like academic skills, social skills need to be explicitly taught. Students, including students who display at-risk behavior, benefit when social skills instruction is delivered schoolwide as part of a comprehensive intervention approach. This article presents a seven-step action…

  19. The Schoolwide Enrichment Model: A Focus on Student Strengths and Interests

    Science.gov (United States)

    Renzulli, Joseph S.; Renzulli, Sally Reis

    2010-01-01

    This article includes an introduction to the Schoolwide Enrichment Model (SEM), with its three components: a total talent portfolio for each child, curriculum differentiation and modification, and enrichment opportunities from the Enrichment Triad Model. Also included is a brief history of the SEM and a summary of 30 years of research underlying…

  20. The Role of Leadership Capacity in Sustaining the School Improvement Initiative of Schoolwide Positive Behavior Supports

    Science.gov (United States)

    Combs, Christine; Martin, Barbara N.

    2011-01-01

    This article examines what occurred within schools successfully implementing and sustaining Schoolwide Positive Behavior Supports through the lens of leadership capacity. Leadership capacity, a broad-based, skillful participation in leadership, promotes the capabilities of many organizational members to lead. Researchers used quantitative analysis…

  1. Brief Report: Assessing Attitudes toward Culturally and Contextually Relevant Schoolwide Positive Behavior Support Strategies

    Science.gov (United States)

    Fallon, Lindsay M.; O'Keeffe, Breda V.; Gage, Nicholas A.; Sugai, George

    2015-01-01

    Given the increased interest and implementation of Schoolwide Positive Behavior Support (SWPBS) systems in schools in the United States, practitioners and researchers have become interested in how to improve implementation with students and staff from a wide range of cultural backgrounds. Fallon, O'Keeffe, and Sugai (2012) reviewed the literature…

  2. A Schoolwide Discipline Plan That Empowers Teachers and Gives Principals Time for Instructional Leadership.

    Science.gov (United States)

    Borelli, Jan

    1997-01-01

    A high school principal explains her strategy for turning around a disorderly, gang-ridden middle school. Her discipline plan's success hinged on developing schoolwide expectations for behavior, developing positive consequences, compiling a list of unacceptable behaviors, and empowering teachers to administer consequences, including contacting…

  3. Schoolwide Positive Behavior Supports and Students with Significant Disabilities: Where Are We?

    Science.gov (United States)

    Kurth, Jennifer A.; Enyart, Matt

    2016-01-01

    Although the number of schools implementing schoolwide positive behavior supports (SWPBS) has increased dramatically, the inclusion of students with severe disabilities in these efforts remains negligible. This article describes the evolution of positive behavior intervention and supports into the SWPBS approach used in many schools today,…

  4. Classified Staff Perceptions of Behavior and Discipline: Implications for Schoolwide Positive Behavior Supports

    Science.gov (United States)

    Feuerborn, Laura L.; Tyre, Ashli D.; Beaudoin, Kathleen

    2018-01-01

    Classified staff are important stakeholders in schools and commonly interact with students across grade levels, subject matter areas, and physical locations--making their involvement in the implementation of schoolwide positive behavior interventions and supports (SWPBIS) essential. However, their voice, including the intentional and systematic…

  5. How Do Staff Perceive Schoolwide Positive Behavior Supports? Implications for Teams in Planning and Implementing Schools

    Science.gov (United States)

    Feuerborn, Laura L.; Tyre, Ashli D.

    2016-01-01

    Schoolwide Positive Behavior Support (SWPBS) offers an alternative to reactive and exclusionary school discipline practices. However, the shift to SWPBS requires substantial change in the practices of staff, and many leadership teams struggle to rally staff support for implementation. With a more thorough understanding of staff perceptions, level…

  6. Staff Concerns in Schools Planning for and Implementing School-Wide Positive Behavior Interventions and Supports

    Science.gov (United States)

    Tyre, Ashli D.; Feuerborn, Laura L.; Woods, Leslie

    2018-01-01

    Understanding staff concerns about a systemic change effort allows leadership teams to better anticipate and address staff needs for professional development and support. In this study, staff concerns in nine schools planning for or implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) were explored using the…

  7. Practical Considerations in Creating School-Wide Positive Behavior Support in Public Schools

    Science.gov (United States)

    Handler, Marcie W.; Rey, Jannette; Connell, James; Thier, Kimberly; Feinberg, Adam; Putnam, Robert

    2007-01-01

    School-wide positive behavior support (SWPBS) has been identified as an effective and efficient method to teach students prosocial skills. It requires both effective behavior support practices and systems that will support these changes, including data-based decision making among the school leadership team. There are many practical and systemic…

  8. Factors Predicting Sustainability of the Schoolwide Positive Behavior Intervention Support Model

    Science.gov (United States)

    Chitiyo, Jonathan; May, Michael E.

    2018-01-01

    The Schoolwide Positive Behavior Intervention Support model (SWPBIS) continues to gain widespread use across schools in the United States and abroad. Despite its widespread implementation, little research has examined factors that influence its sustainability. Informed by Rogers's diffusion theory, this study examined school personnel's…

  9. Implementing Schoolwide Positive Behavior Support in High School Settings: Analysis of Eight High Schools

    Science.gov (United States)

    Flannery, K. Brigid; Frank, Jennifer L.; Kato, Mimi McGrath; Doren, Bonnie; Fenning, Pamela

    2013-01-01

    Schoolwide positive behavior support (SWPBS) is a systems-level intervention designed to prevent the occurrence of problem behavior and increase social competence. A growing body of research documents that SWPBS reduces problem behavior and improves academics (e.g., McIntosh, Chard, Boland, & Horner, 2006), yet documentation of the feasibility…

  10. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

    Science.gov (United States)

    McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

    2014-01-01

    Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

  11. Evidence, models, conservation programs and limits to management

    Science.gov (United States)

    Nichols, J.D.

    2012-01-01

    Walsh et al. (2012) emphasized the importance of obtaining evidence to assess the effects of management actions on state variables relevant to objectives of conservation programs. They focused on malleefowl Leipoa ocellata, ground-dwelling Australian megapodes listed as vulnerable. They noted that although fox Vulpes vulpes baiting is the main management action used in malleefowl conservation throughout southern Australia, evidence of the effectiveness of this action is limited and currently debated. Walsh et al. (2012) then used data from 64 sites monitored for malleefowl and foxes over 23 years to assess key functional relationships relevant to fox control as a conservation action for malleefowl. In one set of analyses, Walsh et al. (2012) focused on two relationships: fox baiting investment versus fox presence, and fox presence versus malleefowl population size and rate of population change. Results led to the counterintuitive conclusion that increases in investments in fox control produced slight decreases in malleefowl population size and growth. In a second set of analyses, Walsh et al. (2012) directly assessed the relationship between investment in fox baiting and malleefowl population size and rate of population change. This set of analyses showed no significant relationship between investment in fox population control and malleefowl population growth. Both sets of analyses benefited from the incorporation of key environmental covariates hypothesized to influence these management relationships. Walsh et al. (2012) concluded that "in most situations, malleefowl conservation did not effectively benefit from fox baiting at current levels of investment." In this commentary, I discuss the work of Walsh et al. (2012) using the conceptual framework of structured decision making (SDM). In doing so, I accept their analytic results and associated conclusions as accurate and discuss basic ideas about evidence, conservation and limits to management.

  12. Evidence-Based Programming within Cooperative Extension: How Can We Maintain Program Fidelity While Adapting to Meet Local Needs?

    Science.gov (United States)

    Olson, Jonathan R.; Welsh, Janet A.; Perkins, Daniel F.

    2015-01-01

    In this article, we describe how the recent movement towards evidence-based programming has impacted Extension. We review how the emphasis on implementing such programs with strict fidelity to an underlying program model may be at odds with Extension's strong history of adapting programming to meet the unique needs of children, youth, families,…

  13. Applying behavior analysis to school violence and discipline problems: Schoolwide positive behavior support

    Science.gov (United States)

    Anderson, Cynthia M.; Kincaid, Donald

    2005-01-01

    School discipline is a growing concern in the United States. Educators frequently are faced with discipline problems ranging from infrequent but extreme problems (e.g., shootings) to less severe problems that occur at high frequency (e.g., bullying, insubordination, tardiness, and fighting). Unfortunately, teachers report feeling ill prepared to deal effectively with discipline problems in schools. Further, research suggests that many commonly used strategies, such as suspension, expulsion, and other reactive strategies, are not effective for ameliorating discipline problems and may, in fact, make the situation worse. The principles and technology of behavior analysis have been demonstrated to be extremely effective for decreasing problem behavior and increasing social skills exhibited by school children. Recently, these principles and techniques have been applied at the level of the entire school, in a movement termed schoolwide positive behavior support. In this paper we review the tenets of schoolwide positive behavior support, demonstrating the relation between this technology and applied behavior analysis. PMID:22478439

  14. Informing the Implementation of School-Wide Positive Behaviour Support in Singapore Preschools

    OpenAIRE

    LILY HUI SING LAU

    2017-01-01

    This thesis sought to inform the implementation of School-Wide Positive Behaviour Support (SWPBS) in Singapore preschools. Findings indicated that SWPBS implementation is likely to be perceived as needed by teachers, and that there is a need to focus on training teachers in SWPBS primary tier classroom management practices when SWPBS is implemented. Additionally, the Classroom Check-Up consultation model was shown to be a promising coaching model to be included in SWPBS training. A major cont...

  15. Family support programs and adolescent mental health: review of evidence

    Directory of Open Access Journals (Sweden)

    Kuhn ES

    2014-07-01

    Full Text Available Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be delivered as prevention programs designed to prevent the onset or escalation of mental or behavioral health problems. This review discusses the rationale for family support programs and describes the range of services provided by family support programs. The primary focus of the review is on evaluating the effectiveness of family support programs as treatments or prevention efforts delivered by clinicians or peers. Two main themes emerged from the review. First, family support programs that included more forms of support evidenced higher levels of effectiveness than family support programs that provided fewer forms of support. Discussion of this theme focuses on individual differences in client needs and program adaptions that may facilitate meeting diverse needs. Second, family support prevention programs appear to be most effective when serving individuals more in need of mental and behavioral health services. Discussion of this theme focuses on the intensity versus breadth of the services provided in prevention programs. More rigorous evaluations of family support programs are needed, especially for peer-delivered family support treatments. Keywords: intervention, parent, mental and behavioral health

  16. Examining the Effects of Schoolwide Positive Behavioral Interventions and Supports on Student Outcomes: Results from a Randomized Controlled Effectiveness Trial in Elementary Schools

    Science.gov (United States)

    Bradshaw, Catherine P.; Mitchell, Mary M.; Leaf, Philip J.

    2010-01-01

    Schoolwide Positive Behavioral Interventions and Supports (SWPBIS) is a universal, schoolwide prevention strategy that is currently implemented in over 9,000 schools across the nation to reduce disruptive behavior problems through the application of behavioral, social learning, and organizational behavioral principles. SWPBIS aims to alter school…

  17. The Significance of Ongoing Teacher Support in Earth Science Education Programs: Evidence from the GLOBE Program

    Science.gov (United States)

    Penuel, B.; Korbak, C.; Shear, L.

    2003-12-01

    study, SRI researchers used the data on student data reporting activity from different partners to identify candidate sites for case studies, where we might investigate the nature of follow-up activities provided by successful partners more closely. We worked to select 2 regional partners that had evidence of high percentages of teachers trained that reported data and that also offered follow-up to teachers. Case study researchers conducted observations within 2-3 active GLOBE schools supported by each regional partner organization and interviewed teachers, principals, and partner staff. On the basis of our observation data and transcripts from interviews, we compiled profiles of schools' implementation and analyzed the core activities of each regional partner. Researchers found that keys to promoting successful implementation in one partnership were: one partnership were: close alignment with state mathematics and science initiatives; mentors that helped teachers by modeling inquiry in GLOBE and by assisting with equipment set-up and curriculum planning; and allowing room for schools to adopt diverse goals for GLOBE. In the second partnership, keys to success included a strategic approach to developing funding for the program; a focus on integration of culturally-relevant knowledge into teacher preparation; follow-up support for teachers; and use of GLOBE as an opportunity to investigate local evidence of climate change. Both partner organizations were challenged by funding limitations that prevented them from providing as much follow-up support as they believe is necessary.

  18. Family support programs and adolescent mental health: review of evidence

    OpenAIRE

    Laird, Robert; Kuhn,Emily

    2014-01-01

    Emily S Kuhn, Robert D Laird Department of Psychology, University of New Orleans, New Orleans, LA, USA Abstract: Family support programs aim to improve parent wellbeing and parenting as well as adolescent mental and behavioral health by addressing the needs of parents of adolescents experiencing or at risk for mental health problems. Family support programs can be part of the treatment for adolescents diagnosed with mental or behavioral health problems, or family support programs can be deli...

  19. School-wide implementation of the elements of effective classroom instruction: Lessons from a high-performing, high-poverty urban school

    Science.gov (United States)

    Dyson, Hilarie

    2008-10-01

    The purpose of the study was to identify structures and systems implemented in a high-performing high-poverty urban school to promote high academic achievement among students of color. The researcher used a sociocultural theoretical framework to examine the influence of culture on the structures and systems that increased performance by African American and Hispanic students. Four research questions guided the study: (1) What are the trends and patterns of student performance among students of color? (2) What are the organizational structures and systems that are perceived to contribute to high student performance in high-poverty urban schools with high concentrations of students of color? (3) How are the organizational structures and systems implemented to support school-wide effective classroom instruction that promotes student learning? (4) How is the construct of race reflected in the school's structures and systems? Qualitative data were collected through interviews, observations, and artifact collection. A single case study method was employed and collected data were triangulated to capture and explore the rich details of the study. The study focused on a high-performing high-poverty urban elementary school located in southern California. The school population consisted of 99% students of color and 93% were economically disadvantaged. The school was selected for making significant and consistent growth in Academic Performance Index and Adequate Yearly Progress over a 3-year period. The school-wide structures and systems studied were (a) leadership, (b) school climate and culture, (c) standards-based instruction, (d) data-driven decision making, and (e) professional development. Four common themes emerged from the findings: (a) instructional leadership that focused on teaching and learning; (b) high expectations for all students; (c) school-wide focus on student achievement using standards, data, and culturally responsive teaching; and (d) positive

  20. School-Wide PBIS: Extending the Impact of Applied Behavior Analysis. Why is This Important to Behavior Analysts?

    Science.gov (United States)

    Putnam, Robert F; Kincaid, Donald

    2015-05-01

    Horner and Sugai (2015) recently wrote a manuscript providing an overview of school-wide positive behavioral interventions and supports (PBIS) and why it is an example of applied behavior analysis at the scale of social importance. This paper will describe why school-wide PBIS is important to behavior analysts, how it helps promote applied behavior analysis in schools and other organizations, and how behavior analysts can use this framework to assist them in the promotion and implementation of applied behavior analysis at both at the school and organizational level, as well as, the classroom and individual level.

  1. Implementing an Evidence Based Preceptorship Program in a Military Center

    Science.gov (United States)

    2014-11-05

    want to act in good conscience, always trying to reach their goals without compromising their personal code of ethics . As Concrete Utilitarians ...Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training Leadership, Ethics ...management Education and training Leadership, Ethics , and Mentoring: Health policy Recruitment and retention Preparing tomorrow’s leaders Care of

  2. Independent Teacher Education Programs: Apocryphal Claims, Illusory Evidence

    Science.gov (United States)

    Zeichner, Ken

    2016-01-01

    Teacher education provided in U.S. colleges and universities has been routinely criticized since its inception in the early nineteenth century. These programs are uneven in quality and can be improved. Advocacy groups and self-proclaimed social entrepreneurs are working aggressively to deregulate the preparation of teachers and to expand…

  3. Barriers to International Student Mobility: Evidence from the Erasmus Program

    Science.gov (United States)

    Souto-Otero, Manuel; Huisman, Jeroen; Beerkens, Maarja; de Wit, Hans; Vujic, Suncica

    2013-01-01

    In this article, we look at the barriers to international student mobility, with particular reference to the European Erasmus program. Much is known about factors that support or limit student mobility, but very few studies have made comparisons between participants and nonparticipants. Making use of a large data set on Erasmus and non-Erasmus…

  4. Strengthening the evidence base for health programming in humanitarian crises.

    Science.gov (United States)

    Ager, A; Burnham, G; Checchi, F; Gayer, M; Grais, R F; Henkens, M; Massaquoi, M B F; Nandy, R; Navarro-Colorado, C; Spiegel, P

    2014-09-12

    Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial. Copyright © 2014, American Association for the Advancement of Science.

  5. Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

    Science.gov (United States)

    Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

    2015-09-01

    Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

  6. Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

    Science.gov (United States)

    Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

    2018-04-01

    The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

  7. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Manlove J

    2015-04-01

    Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should

  8. Principal Leadership and School Culture with a School-Wide Implementation of Professional Crisis Management: A Redemptive v. Punitive Model

    Science.gov (United States)

    Adams, Mark Thomas

    2013-01-01

    This qualitative study investigated the nature of the relationship between principal leadership and school culture within a school-wide implementation of Professional Crisis Management (PCM). PCM is a comprehensive and fully integrated system designed to manage crisis situations effectively, safely, and with dignity. While designed primarily to…

  9. The Impact of School-Wide Positive Behavioral Interventions and Supports (PBIS) on the Organizational Health of Elementary Schools

    Science.gov (United States)

    Bradshaw, Catherine P.; Koth, Christine W.; Bevans, Katherine B.; Ialongo, Nicholas; Leaf, Philip J.

    2008-01-01

    Positive Behavioral Interventions and Supports (PBIS) is a universal, school-wide prevention strategy that is currently implemented in over 7,500 schools across the nation to reduce disruptive behavior problems through the application of behavioral, social learning, and organizational behavioral principles. PBIS aims to alter school environments…

  10. Schoolwide Collaboration to Prevent and Address Reading Difficulties: Opportunities for School Psychologists and Speech-Language Pathologists

    Science.gov (United States)

    Nellis, Leah M.; Sickman, Linda Sue; Newman, Daniel S.; Harman, Deborah R.

    2014-01-01

    With the increase in schoolwide practices to improve reading instruction for all students and provide supplemental interventions for struggling readers, the need for collaboration among education professionals has become increasingly important. This article focuses on the expanding opportunities for collaboration between school psychologists and…

  11. The Effectiveness of Title I Schoolwide Projects: A Synthesis of Findings from the First Years of Evaluation.

    Science.gov (United States)

    Wong, Kenneth K.; Meyer, Stephen J.

    The 1988 Hawkins-Stafford Elementary and Secondary School Improvement Amendments to Chapter 1 (now Title I) have enabled broad expansion of Title I schoolwide projects. The regulatory changes provide funding to entire schools, rather than targeting services to meet the needs of the most disadvantaged subpopulations. This paper reviews what is…

  12. The Staff Perceptions of Behavior and Discipline Survey: A Tool to Help Achieve Systemic Change through Schoolwide Positive Behavior Support

    Science.gov (United States)

    Feuerborn, Laura L.; Tyre, Ashli D.; King, Joe P.

    2015-01-01

    The practices of schoolwide positive behavior support (SWPBS) are dependent on staff implementation in classroom and common areas throughout the school. Thus, gaining the support and commitment of school staff is a critical step toward reaching full implementation of SWPBS. However, achieving buildingwide support can be challenging; many schools…

  13. Tapping into the Power of School Climate to Prevent Bullying: One Application of Schoolwide Positive Behavior Interventions and Supports

    Science.gov (United States)

    Bosworth, Kris; Judkins, Maryann

    2014-01-01

    Preventing bullying requires a comprehensive approach that includes a focus on school climate. We review the climate features shown to reduce bullying, then illustrate how School-wide Positive Behavioral Interventions and Supports (SWPBIS) applies these principles in practice. SWPBIS, grounded in multiple theories--behaviorism, social learning…

  14. Case Studies of Successful Schoolwide Enrichment Model-Reading (SEM-R) Classroom Implementations. Research Monograph Series. RM10204

    Science.gov (United States)

    Reis, Sally M.; Little, Catherine A.; Fogarty, Elizabeth; Housand, Angela M.; Housand, Brian C.; Sweeny, Sheelah M.; Eckert, Rebecca D.; Muller, Lisa M.

    2010-01-01

    The purpose of this qualitative study was to examine the scaling up of the Schoolwide Enrichment Model in Reading (SEM-R) in 11 elementary and middle schools in geographically diverse sites across the country. Qualitative comparative analysis was used in this study, with multiple data sources compiled into 11 in-depth school case studies…

  15. School-wide PBIS: An Example of Applied Behavior Analysis Implemented at a Scale of Social Importance.

    Science.gov (United States)

    Horner, Robert H; Sugai, George

    2015-05-01

    School-wide Positive Behavioral Interventions and Supports (PBIS) is an example of applied behavior analysis implemented at a scale of social importance. In this paper, PBIS is defined and the contributions of behavior analysis in shaping both the content and implementation of PBIS are reviewed. Specific lessons learned from implementation of PBIS over the past 20 years are summarized.

  16. Middle School Characteristics That Predict Student Achievement, as Measured by the School-Wide California API Score

    Science.gov (United States)

    Paredes, Josie Abaroa

    2013-01-01

    The purpose of this study was to investigate, through quantitative research, effective middle school characteristics that predict student achievement, as measured by the school-wide California API score. Characteristics were determined using an instrument developed by the Office of Superintendent of Public Instruction (OSPI), which asked middle…

  17. Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program.

    Science.gov (United States)

    Cabell, A; Casteel, C; Chronister, T; Nocera, M; Vladutiu, C J; Peek-Asa, C

    2013-12-01

    Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.

  18. The Process of Adoption of Evidence-based Tobacco Use Prevention Programs in California Schools

    Science.gov (United States)

    Little, Melissa A.; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

    2014-01-01

    Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community- and organizational variables on the adoption of prevention programs via school administrators’ beliefs and the organization’s receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts’ use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools. PMID:24398826

  19. Resource List--Using Evidence-Based Programs as the Foundation of Comprehensive Sex Education

    Science.gov (United States)

    Advocates for Youth, 2015

    2015-01-01

    Decades of research have identified dozens of programs that are effective in helping young people reduce their risk for pregnancy, HIV, and STDs. These evidence-based programs utilize strategies that include the provision of accurate, honest information about abstinence as well as contraception and can serve as the foundation for comprehensive sex…

  20. A constructive Indian country response to the evidence-based program mandate.

    Science.gov (United States)

    Walker, R Dale; Bigelow, Douglas A

    2011-01-01

    Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.

  1. Evidence for developmental programming of cerebral laterality in humans.

    Directory of Open Access Journals (Sweden)

    Alexander Jones

    2011-02-01

    Full Text Available Adverse fetal environments are associated with depression, reduced cognitive ability and increased stress responsiveness in later life, but underlying mechanisms are unknown. Environmental pressures on the fetus, resulting from variations in placental function and maternal nutrition, health and stress might alter neurodevelopment, promoting the development of some brain regions over others. As asymmetry of cerebral activity, with greater right hemisphere activity, has been associated with psychopathology, we hypothesized that regional specialization during fetal life might be reflected persistently in the relative activity of the cerebral hemispheres. We tested this hypothesis in 140 healthy 8-9 year-old children, using tympanic membrane temperature to assess relative blood flow to the cerebral hemispheres at rest and following psychosocial stress (Trier Social Stress Test for Children. Their birth weight and placental weight had already been measured when their mothers took part in a previous study of pregnancy outcomes. We found that children who had a smaller weight at birth had evidence of greater blood flow to the right hemisphere than to the left hemisphere (r = -.09, P = .29 at rest; r = -.18, P = .04 following stress. This finding was strengthened if the children had a relatively low birth weight for their placental weight (r = -.17, P = .05 at rest; r = -.31, P = .0005 following stress. Our findings suggest that lateralization of cerebral activity is influenced persistently by early developmental experiences, with possible consequences for long-term neurocognitive function.

  2. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence.

    Science.gov (United States)

    Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

    2015-01-01

    US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and

  3. Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

    OpenAIRE

    Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

    2013-01-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustain...

  4. Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.

    Science.gov (United States)

    Silver, Marc T; Sterns, Laurence D; Piccini, Jonathan P; Joung, Boyoung; Ching, Chi-Keong; Pickett, Robert A; Rabinovich, Rafael; Liu, Shufeng; Peterson, Brett J; Lexcen, Daniel R

    2015-03-01

    Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. The purpose of the Shock-Less Study was to determine if providing feedback reports to physicians on their adherence to evidence-based shock reduction programming could improve their programming behavior and reduce shocks. Shock-Less enrolled primary prevention (PP) and secondary prevention (SP) ICD patients between 2009 and 2012 at 118 study centers worldwide and followed patients longitudinally after their ICD implant. Center-specific therapy programming reports (TPRs) were delivered to each center 9 to 12 months after their first enrollment. The reports detailed adherence to evidence-based programming targets: number of intervals to detect ventricular fibrillation (VF NID), longest treatment interval (LTI), supraventricular tachycardia (SVT) discriminators (Wavelet, PR Logic), SVT limit, Lead Integrity Alert (LIA), and antitachycardia pacing (ATP). Clinicians programmed ICDs at their discretion. The primary outcome measure was the change in utilization of evidence-based shock reduction programming before (phase I, n = 2694 patients) and after initiation of the TPR (phase II, n = 1438 patients). Patients implanted after feedback reports (phase II) were up to 20% more likely to have their ICDs programmed in line with evidence-based shock reduction programming (eg, VF NID in PP patients 30/40 in 33.5% vs 18.6%, P programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  5. Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

    Science.gov (United States)

    Kelsey, Meredith; Layzer, Jean

    2014-03-01

    This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  6. [Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

    Science.gov (United States)

    Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

    2016-01-01

    This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

  7. Automated Eukaryotic Gene Structure Annotation Using EVidenceModeler and the Program to Assemble Spliced Alignments

    Energy Technology Data Exchange (ETDEWEB)

    Haas, B J; Salzberg, S L; Zhu, W; Pertea, M; Allen, J E; Orvis, J; White, O; Buell, C R; Wortman, J R

    2007-12-10

    EVidenceModeler (EVM) is presented as an automated eukaryotic gene structure annotation tool that reports eukaryotic gene structures as a weighted consensus of all available evidence. EVM, when combined with the Program to Assemble Spliced Alignments (PASA), yields a comprehensive, configurable annotation system that predicts protein-coding genes and alternatively spliced isoforms. Our experiments on both rice and human genome sequences demonstrate that EVM produces automated gene structure annotation approaching the quality of manual curation.

  8. Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile.

    Science.gov (United States)

    Flores, Rodrigo; Naranjo, Carola; Hein, Andreas

    2016-01-01

    Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

  9. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  10. Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

    Science.gov (United States)

    Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

    2017-01-01

    Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

  11. Do Payments Pay Off? Evidence from Participation in Costa Rica's PES Program.

    Directory of Open Access Journals (Sweden)

    R A Arriagada

    Full Text Available Payments for environmental services (PES are often viewed as a way to simultaneously improve conservation outcomes and the wellbeing of rural households who receive the payments. However, evidence for such win-win outcomes has been elusive. We add to the growing literature on conservation program impacts by using primary household survey data to evaluate the socioeconomic impacts of participation in Costa Rica's PES program. Despite the substantial cash transfers to voluntary participants in this program, we do not detect any evidence of impacts on their wealth or self-reported well-being using a quasi-experimental design. These results are consistent with the common claim that voluntary PES do not harm participants, but they beg the question of why landowners participate if they do not benefit. Landowners in our sample voluntarily renewed their contracts after five years in the program and thus are unlikely to have underestimated their costs of participation. They apparently did not invest additional income from the program in farm inputs such as cattle or hired labor, since both decreased as a result of participation. Nor do we find evidence that participation encouraged moves off-farm. Instead, semi-structured interviews suggest that participants joined the program to secure their property rights and contribute to the public good of forest conservation. Thus, in order to understand the social impacts of PES, we need to look beyond simple economic rationales and material outcomes.

  12. Evidence-based policy versus morality policy: the case of syringe access programs.

    Science.gov (United States)

    de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

    2015-01-01

    Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

  13. The Devil Is in the Details: Examining the Evidence for "Proven" School-Based Drug Abuse Prevention Programs

    Science.gov (United States)

    Gandhi, Allison Gruner; Murphy-Graham, Erin; Petrosino, Anthony; Chrismer, Sara Schwartz; Weiss, Carol H.

    2007-01-01

    In an effort to promote evidence-based practice, government officials, researchers, and program developers have developed lists of model programs in the prevention field. This article reviews the evidence used by seven best-practice lists to select five model prevention programs. The authors' examination of this research raises questions about the…

  14. DO FAMILY PLANNING PROGRAMS DECREASE POVERTY? EVIDENCE FROM PUBLIC CENSUS DATA

    Science.gov (United States)

    Bailey, Martha J.; Malkova, Olga; Norling, Johannes

    2014-01-01

    This paper provides new evidence that family planning programs are associated with a decrease in the share of children and adults living in poverty. Our research design exploits the county roll-out of U.S. family planning programs in the late 1960s and early 1970s and examines their relationship with poverty rates in the short and longer-term in public census data. We find that cohorts born after federal family planning programs began were less likely to live in poverty in childhood and that these same cohorts were less likely to live in poverty as adults. PMID:25346655

  15. Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

    Science.gov (United States)

    Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

    2013-01-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs. PMID:24038245

  16. Building evidence for sustainability of food and nutrition intervention programs in developing countries.

    Science.gov (United States)

    Kim, Sunny S; Rogers, Beatrice L; Coates, Jennifer; Gilligan, Daniel O; Sarriot, Eric

    2013-09-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, "Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries," provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs.

  17. Effectiveness of Structured Teacher Adaptations to an Evidence-Based Summer Literacy Program

    Science.gov (United States)

    Kim, James S.; Burkhauser, Mary A.; Quinn, David M.; Guryan, Jonathan; Kingston, Helen Chen; Aleman, Kirsten

    2017-01-01

    The authors conducted a cluster-randomized trial to examine the effectiveness of structured teacher adaptations to the implementation of an evidence-based summer literacy program that provided students with (a) books matched to their reading level and interests and (b) teacher scaffolding for summer reading in the form of end-of-year comprehension…

  18. Analysis of Evidence Supporting the Educational Leadership Constituent Council 2011 Educational Leadership Program Standards

    Science.gov (United States)

    Tucker, Pamela D.; Anderson, Erin; Reynolds, Amy L.; Mawhinney, Hanne

    2016-01-01

    This document analysis provides a summary of the research from high-impact journals published between 2008 and 2013 with the explicit purpose of determining the extent to which the current empirical evidence supports the individual 2011 Educational Leadership Constituent Council Program Standards and their elements. We found that the standards are…

  19. The Behavior Intervention Support Team (BIST) Program: Underlying Theories

    Science.gov (United States)

    Boulden, Walter T.

    2010-01-01

    The Behavior Intervention Support Team (BIST) is a proactive school-wide behavior management plan for all students, emphasizing schools partnering with students and parents through caring relationships and high expectations. The BIST program is well-grounded in behavioral theory and combines strength-based and resiliency principles within the…

  20. Adapting the Behavior Education Program for Preschool Settings

    Science.gov (United States)

    Steed, Elizabeth A.

    2011-01-01

    Behavior Education Program (BEP) is the most researched targeted intervention that is used in schoolwide positive behavior intervention and supports (PBIS). It is a daily check-in and check-out system in which students receive extra attention for positive social behavior throughout their school day. This extra attention is intended to prevent…

  1. Leading by Example: Health Promotion Programs for School Staff

    Science.gov (United States)

    Herbert, Patrick C.; Lohrmann, David K.

    2011-01-01

    Health promotion programs for school staff are an overlooked and underused resource that can reduce overweight and obesity among teachers and other staff members. They can also reduce staff absenteeism, increase productivity, reduce costs associated with health care and disability, and foster a climate that promotes good health schoolwide. An…

  2. Integrating the Principles of Effective Intervention into Batterer Intervention Programming: The Case for Moving Toward More Evidence-Based Programming.

    Science.gov (United States)

    Radatz, Dana L; Wright, Emily M

    2016-01-01

    The majority of batterer intervention program (BIP) evaluations have indicated they are marginally effective in reducing domestic violence recidivism. Meanwhile, correctional programs used to treat a variety of offenders (e.g., substance users, violent offenders, and so forth) that adhere to the "principles of effective intervention" (PEI) have reported significant reductions in recidivism. This article introduces the PEI-the principles on which evidence-based practices in correctional rehabilitation are based-and identifies the degree to which they are currently integrated into BIPs. The case is made that batterer programs could be more effective if they incorporate the PEI. Recommendations for further integration of the principles into BIPs are also provided. © The Author(s) 2015.

  3. Research-Based Curriculum, Pedagogy, and Assessment in a Deaf Bilingual Program

    Science.gov (United States)

    Peterson, Laura

    2012-01-01

    The California School for the Deaf (CSD), Fremont, is a deaf-centered bilingual program. CSD's approach to curriculum development, instructional pedagogy, and assessment integrates best practices in deaf education, bilingual education, and general education. The goals of the program are outlined in the Expected School-wide Learning Results which…

  4. Promoting physical therapists’ of research evidence to inform clinical practice: part 1 - theoretical foundation, evidence, and description of the PEAK program

    Science.gov (United States)

    2014-01-01

    Background There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura’s social cognitive theory and Malcolm Knowles’s adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. Discussion The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a “Best Practices List” - a list of locally generated, evidence-based, actionable behaviors relevant to the groups’ clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. Summary This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program

  5. Promoting physical therapists' of research evidence to inform clinical practice: part 1--theoretical foundation, evidence, and description of the PEAK program.

    Science.gov (United States)

    Tilson, Julie K; Mickan, Sharon

    2014-06-25

    There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a "Best Practices List" - a list of locally generated, evidence-based, actionable behaviors relevant to the groups' clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program - an educational program designed to

  6. Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

    Science.gov (United States)

    Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

    2012-06-01

    BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government

  7. Evidence and Feasibility of Implementing an Integrated Wellness Program in Northeast Georgia.

    Science.gov (United States)

    Flanigan, Amber; Salm Ward, Trina

    2017-08-01

    Evidence for the connection between physical and mental health is growing, as is interest in providing a holistic, mind-body approach to improving mental health and wellness. A needs assessment in northeast Georgia identified several regional health priorities, including mental health and substance abuse, access to care, and cardiovascular health. The study's purpose is threefold: to (1) review evidence for integrated mind-body wellness services, (2) explore the feasibility of implementing wellness services in a small mental health agency serving northeast Georgia, and (3) conduct a brief survey assessing interest in a wellness program. The literature search identified articles within the past 10 years with these key words: "yoga," "mental health," "wellness program," "complementary alternative medicine," "tai chi," "mindfulness," "meditation," and "nutrition." The survey was distributed to the agency's affiliates. The literature review identified strong evidence for an integrated mind-body wellness program that includes yoga, tai chi, mindfulness meditation, and nutrition education. Among 73 survey respondents, 86 percent indicated interest in wellness services, and 85 percent agreed that wellness services are important to mental health and well-being. Authors suggest a model to incorporate a holistic wellness program to complement mental health services and help facilitate physical and mental health. © 2017 National Association of Social Workers.

  8. CE: Original Research: Exploring Clinicians' Perceptions About Sustaining an Evidence-Based Fall Prevention Program.

    Science.gov (United States)

    Porter, Rebecca B; Cullen, Laura; Farrington, Michele; Matthews, Grace; Tucker, Sharon

    2018-05-01

    : Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014. Audio-recorded data were transcribed and analyzed using inductive qualitative analysis. Two primary themes emerged from participants regarding the sustainability of an evidence-based fall prevention program: communication patterns within the interprofessional health care team and influences of hospital organizational practices and elements. Several subthemes also emerged. Participants gave nursing staff primary responsibility for fall risk assessment and prevention. Individual professional perceptions and practices, as well as organizational characteristics, affect the sustainability of evidence-based fall prevention practices. While all team members recognized patient falls as a significant quality and safety issue, most believed that direct care nurses hold primary responsibility for leading fall prevention efforts. The data support the importance of effective interprofessional team communication and organizational practices in sustaining an evidence-based fall prevention program across inpatient units. Furthermore, the data call into question the wisdom in labeling quality indicators as "nursing sensitive"; the evidence indicates that a team approach is best.

  9. 5-2-1-0 Activity and Nutrition Challenge for Elementary Students: New, Evidence-Based, Promising

    Science.gov (United States)

    Lovell, Cynthia Miller

    2018-01-01

    Obesity prevention in youth is a health priority, and teaching healthy habits toward this end is one of a school nurse's many responsibilities. A school nurse developed and implemented a school-wide, 2-week-long Activity and Nutrition Challenge (ANC) using the evidence-based 5-2-1-0 initiative to prevent and fight childhood obesity. Despite…

  10. 34 CFR 200.27 - Development of a schoolwide program plan.

    Science.gov (United States)

    2010-07-01

    ... school year. (2) The school must develop the comprehensive plan with the involvement of parents... comprehensive plan to improve teaching and learning throughout the school. (2) The school must develop the..., parents, and the public. (2) Information in the plan must be— (i) In an understandable and uniform format...

  11. 34 CFR 200.29 - Consolidation of funds in a schoolwide program.

    Science.gov (United States)

    2010-07-01

    ... those parents, or both, first to meet the unique educational needs of migratory students that result... AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE...; (iv) Student and parental participation and involvement; (v) Services to private school children; (vi...

  12. Perceived barriers to completing an e-learning program on evidence-based medicine.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Légaré, France; Labrecque, Michel; Frémont, Pierre; Cauchon, Michel; Desmartis, Marie

    2007-01-01

    The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

  13. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)

    DEFF Research Database (Denmark)

    Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine

    2015-01-01

    of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs......; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations......./Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible...

  14. Investigating the Utilization of Research Evidence in the 4-H Youth Development Program

    Directory of Open Access Journals (Sweden)

    Lynette H. Bikos

    2011-06-01

    Full Text Available This study investigated the acquisition, interpretation, and utilization of research evidence in the 4-H Youth Development Program from the frame of Social Cognitive Theory. Utilizing Consensual Qualitative Research, we interviewed twenty 4-H faculty, staff, and volunteers from seven states. Results indicated four domains, which covered participants’ definitions of research utilization, their experiences utilizing research, the process of acquiring and distributing research, and barriers and facilitators to research utilization. Participants described research use primarily in terms of improving 4-H programs. They discussed their level of confidence (i.e. self-efficacy in finding and applying research evidence and their beliefs about the outcomes of research utilization (i.e. outcomes expectancy. Participants mentioned such barriers as not knowing where to look for research, lack of time, lack of funding, and difficulty applying research findings to their work. The facilitators included support from other 4-H colleagues and availability of 4-H specific conferences, publications, and curriculum databases.

  15. The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development.

    Science.gov (United States)

    Chang, Amy L; Pribbenow, Christine M

    2016-05-01

    The American Society for Microbiology (ASM) established its ASM-NSF (National Science Foundation) Biology Scholars Program (BSP) to promote undergraduate education reform by 1) supporting biologists to implement evidence-based teaching practices, 2) engaging life science professional societies to facilitate biologists' leadership in scholarly teaching within the discipline, and 3) participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM) reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL) to more than 270 participants ("scholars") from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER). To identify the BSP's long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program's 2010-2014 scholars (n = 127) and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life sciences and helps

  16. A Demonstration of Evidence-Based Action Research Using Information Dashboard in Introductory Programming Education

    OpenAIRE

    Matsuzawa , Yoshiaki; Tanaka , Yoshiki; Kitani , Tomoya; Sakai , Sanshiro

    2017-01-01

    Part 3: Computer Science Education and Its Future Focus and Development; International audience; In this paper, we demonstrated an evidence-based action research in an introductory programming class with the use of an information dashboard which provides coding metrics to visualize students’ engagement of their assignments. The information dashboard was designed for teachers to improve their classroom teaching using the same coding metrics which was verified in our previous research [9]. The ...

  17. Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

    Science.gov (United States)

    Evans, Steven W; Randy Koch, J; Brady, Christine; Meszaros, Peggy; Sadler, Joanna

    2013-07-01

    Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

  18. An "Evidence-Based" Professional Development Program for Physics Teachers Focusing on Knowledge Integration

    Science.gov (United States)

    Berger, Hana

    This dissertation is concerned with the design and study of an evidence-based approach to the professional development of high-school physics teachers responding to the need to develop effective continuing professional development programs (CPD) in domains that require genuine changes in teachers' views, knowledge, and practice. The goals of the thesis were to design an evidence-based model for the CPD program, to implement it with teachers, and to study its influence on teachers' knowledge, views, and practice, as well as its impact on students' learning. The program was developed in three consecutive versions: a pilot, first, and second versions. Based on the pilot version (that was not part of this study), we developed the first version of the program in which we studied difficulties in employing the evidence-based and blended-learning approaches. According to our findings, we modified the strategies for enacting these approaches in the second version of the program. The influence of the program on the teachers and students was studied during the enactment of the second version of the program. The model implemented in the second version of the program was characterized by four main design principles: 1. The KI and evidence aspects are acquired simultaneously in an integrated manner. 2. The guidance of the teachers follows the principles of cognitive apprenticeship both in the evidence and the KI aspects. 3. The teachers experience the innovative activities as learners. 4. The program promotes continuity of teachers' learning through a structured "blended learning" approach. The results of our study show that this version of the program achieved its goals; throughout the program the teachers progressed in their knowledge, views, and practice concerning the knowledge integration, and in the evidence and learner-centered aspects. The results also indicated that students improved their knowledge of physics and knowledge integration skills that were developed

  19. Rating the strength of scientific evidence: relevance for quality improvement programs.

    Science.gov (United States)

    Lohr, Kathleen N

    2004-02-01

    To summarize an extensive review of systems for grading the quality of research articles and rating the strength of bodies of evidence, and to highlight for health professionals and decision-makers concerned with quality measurement and improvement the available "best practices" tools by which these steps can be accomplished. Drawing on an extensive review of checklists, questionnaires, and other tools in the field of evidence-based practice, this paper discusses clinical, management, and policy rationales for rating strength of evidence in a quality improvement context, and documents best practices methods for these tasks. After review of 121 systems for grading the quality of articles, 19 systems, mostly specific, met a priori scientific standards for grading systematic reviews, randomized controlled trials, observational studies, and diagnostic tests; eight systems (of 40 reviewed) met similar standards for rating the overall strength of evidence. All can be used as is or adapted for particular types of evidence reports or systematic reviews. Formally grading study quality and rating overall strength of evidence, using sound instruments and procedures, can produce reasonable levels of confidence about the science base for parts of quality improvement programs. With such information, health care professionals and administrators concerned with quality improvement can understand better the level of science (versus only clinical consensus or opinion) that supports practice guidelines, review criteria, and assessments that feed into quality assurance and improvement programs. New systems are appearing and research is needed to confirm the conceptual and practical underpinnings of these grading and rating systems, but the need for those developing systematic reviews, practice guidelines, and quality or audit criteria to understand and undertake these steps is becoming increasingly clear.

  20. Evidence in promoting positive parenting through the Program-Guide to Develop Emotional Competences

    Directory of Open Access Journals (Sweden)

    Raquel-Amaya Martínez-González

    2016-07-01

    Full Text Available This study aims at providing evidence of the effectiveness of the Program-Guide to Develop Emotional Competences in promoting positive parenting. Contextual, institutional, methodological and professional issues were taken into account to develop a social innovation experience to support parenting as a preventive measure to family conflicts. The study describes both the contents of the Program-Guide and the methodological and evaluation issues that trained professionals need to consider when delivering the Program-Guide to families in natural contexts. Information was gathered and analyzed from 259 parents with children of ages 1-18 who participated in 26 parent training groups. A pre- and post-test design showed that after finishing the sessions parents perceived themselves more competent as parents according to the five dimensions of parenting competences considered: (1 emotional self-regulation abilities; (2 self-esteem and assertiveness; (3 communication strategies; (4 strategies to solve conflicts and to negotiate; and (5 strategies to establish coherent norms, limits and consequences to promote positive discipline. The study presents a discussion on these results from evidence-based parenting programs, as well as some strengths and limitations of the study, together with some suggestions for further research.

  1. Assessing Awareness and Use of Evidence-Based Programs for Cancer Control in Puerto Rico

    Science.gov (United States)

    Calo, William A.; Fernández, María E.; Rivera, Mirza; Díaz, Elba C.; Correa-Fernández, Virmarie; Pattatucci, Angela; Wetter, David W.

    2012-01-01

    The Community Cancer Control Outreach Program (CCCOP) is a community-academic partnership aimed at developing and implementing a cancer control outreach, research, and training program in Puerto Rico. The CCCOP surveyed 56 partners to assess their awareness, training needs, and use of resources related to evidence-based programs (EBPs). Despite relatively high levels (70%) of confidence in adopting EBPs, there were low levels of awareness (37%) and use (25%) of existing EBPs resources. Respondents’ who had used EBPs resources were more likely to have positive beliefs about EBPs than nonusers (p<0.05). Training needs were high among respondents and no significant differences were found between those who had and had not used existing EBPs resources. These findings can guide the development of training tools and technical assistance to increase the use of EBPs for Latino audiences. PMID:22528632

  2. Adapting Evidence-Based Prevention Approaches for Latino Adolescents: The Familia Adelante Program - Revised

    Directory of Open Access Journals (Sweden)

    Richard C. Cervantes

    2012-12-01

    Full Text Available Behavioral health is defined as the absence of mental illness or substance use problems and the presence of positive emotional well being. Although many U.S. Hispanic youth are at increased risk for substance abuse, suicidality, teen pregnancy, unsafe sexual practices and HIV, there exists a lack of available evidence-based practices for Hispanic youth which promotes behavioral health and HIV prevention. The objective of the current research was to adapt and revise the Familia Adelante (FA Program, a behavioral health, drug intervention and prevention program to incorporate an HIV prevention component. Through qualitative community based participatory methods, including an expert panel and members of the target population, the curriculum was redesigned to integrate effective HIV risk reduction strategies. The process of adapting the intervention is described in this paper, as well as recommendations for future research in program adaptation.

  3. The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development

    Directory of Open Access Journals (Sweden)

    Amy L. Chang

    2016-05-01

    Full Text Available The American Society for Microbiology (ASM established its ASM-NSF (National Science Foundation Biology Scholars Program (BSP to promote undergraduate education reform by 1 supporting biologists to implement evidence-based teaching practices, 2 engaging life science professional societies to facilitate biologists’ leadership in scholarly teaching within the discipline, and 3 participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL to more than 270 participants (“scholars” from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER. To identify the BSP’s long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program’s 2010­–2014 scholars (n = 127 and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life

  4. Role of Information Professionals in Knowledge Management Programs: Empirical Evidence from Canada

    Directory of Open Access Journals (Sweden)

    la Ajiferuke

    2003-01-01

    Full Text Available The implementation of a knowledge management program in an organization has the potential of im-proving customer services, quickly bringing new products to market, and reducing cost of business operations. Information technologies are often used in knowledge management programs in informing clients and employees of latest innovation/development in the business sector as well as sharing knowledge among the employees. The key professionals involved in knowledge management programs are information technologists and human resource managers but the information professionals also have a role to play as they are traditionally known as good managers of explicit knowledge. Hence, the aim of this study is to provide empirical evidence of the role of information professionals in knowledge management programs. 386 information professionals working in Canadian organizations were selected from the Special Libraries Association's Who's Who in Special Libraries 2001/2002, and a questionnaire with a stamped self-addressed envelope for its return was sent to each one of them. 63 questionnaires were completed and returned, and 8 in-depth interviews conducted. About 59% of the information professionals surveyed are working in organizations that have knowledge management programs with about 86% of these professionals being involved in the programs. Factors such as gender, age, and educational background (i.e. highest educational qualifications and discipline did not seem to have any relationship with involvement in knowledge management programs. Many of those involved in the programs are playing key roles, such as the design of the information architecture, development of taxonomy, or con-tent management of the organization's intranet. Others play lesser roles, such as providing information for the intranet, gathering competitive intelligence, or providing research services as requested by the knowledge management team.

  5. Feasibility of the evidence-based cognitive telerehabilitation program Remind for patients with primary brain tumors.

    Science.gov (United States)

    van der Linden, Sophie D; Sitskoorn, Margriet M; Rutten, Geert-Jan M; Gehring, Karin

    2018-05-01

    Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation program developed by our group. We converted the program into the iPad-based cognitive rehabilitation program ReMind, to increase its accessibility. The app incorporates psychoeducation, strategy training and retraining. This pilot study in patients with primary brain tumors evaluates the feasibility of the use of the ReMind-app in a clinical (research) setting in terms of accrual, attrition, adherence and patient satisfaction. The intervention commenced 3 months after resective surgery and patients were advised to spend 3 h per week on the program for 10 weeks. Of 28 eligible patients, 15 patients with presumed low-grade glioma or meningioma provided informed consent. Most important reason for decline was that patients (7) experienced no cognitive complaints. Participants completed on average 71% of the strategy training and 76% of the retraining. Some patients evaluated the retraining as too easy. Overall, 85% of the patients evaluated the intervention as "good" or "excellent". All patients indicated that they would recommend the program to other patients with brain tumors. The ReMind-app is the first evidence-based cognitive telerehabilitation program for adult patients with brain tumors and this pilot study suggests that postoperative cognitive rehabilitation via this app is feasible. Based on patients' feedback, we have expanded the retraining with more difficult exercises. We will evaluate the efficacy of ReMind in an RCT.

  6. Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program.

    Science.gov (United States)

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2015-10-01

    Pharmacies represent a valuable opportunity to deliver weight management services, rather than just the routine supply of weight-loss products. In order to provide optimal services and translation of evidence-based weight management in community pharmacy, a best practice model program was designed and pilot tested to facilitate implementation of such services in pharmacies in Australia. To develop and pilot a pharmacist-delivered, evidence-based, non-product-centred weight management service for community pharmacy in Australia. Setting Sydney, New South Wales, Australia. A pharmacy-based weight management service called the A Healthier Life Program (AHLP), for overweight and obese individuals, was developed based on current Australian weight management guidelines and recommendations made by key stakeholders. The pharmacist undertook training to acquire specific competencies to deliver the program. The AHLP involved six individual face-to-face sessions with the pharmacist over 3 months. The intervention targeted three areas: diet, physical activity and behavioural change. Weight, BMI, waist circumference, blood pressure, dietary intake, and physical activity levels at 3 months were compared with values at baseline. Qualitative feedback on participants' satisfaction and willingness to pay were also analysed. Eight pharmacies provided the AHLP between February and December 2013. Thirty-four participants were enrolled in the AHLP; mean age 50.7 years (SD 15.7) and mean BMI 34.3 kg/m(2) (SD 5.3). Of the 22 (65%) participants who completed the program, six had achieved the target weight loss of ≥5%. The mean change in weight was -3.5 kg (95% CI -4.8, -2.2) and waist circumference -2.0 cm (95% CI -2.8, -1.3) for program completers at 3 months. Furthermore, participants reported overall positive experiences of the program, and identified accessibility of the pharmacy and high comfort level with the pharmacist, as the major advantages. The AHLP was well received and

  7. Parallel programming of saccades during natural scene viewing: evidence from eye movement positions.

    Science.gov (United States)

    Wu, Esther X W; Gilani, Syed Omer; van Boxtel, Jeroen J A; Amihai, Ido; Chua, Fook Kee; Yen, Shih-Cheng

    2013-10-24

    Previous studies have shown that saccade plans during natural scene viewing can be programmed in parallel. This evidence comes mainly from temporal indicators, i.e., fixation durations and latencies. In the current study, we asked whether eye movement positions recorded during scene viewing also reflect parallel programming of saccades. As participants viewed scenes in preparation for a memory task, their inspection of the scene was suddenly disrupted by a transition to another scene. We examined whether saccades after the transition were invariably directed immediately toward the center or were contingent on saccade onset times relative to the transition. The results, which showed a dissociation in eye movement behavior between two groups of saccades after the scene transition, supported the parallel programming account. Saccades with relatively long onset times (>100 ms) after the transition were directed immediately toward the center of the scene, probably to restart scene exploration. Saccades with short onset times (programming of saccades during scene viewing. Additionally, results from the analyses of intersaccadic intervals were also consistent with the parallel programming hypothesis.

  8. Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

    Science.gov (United States)

    Kranker, Keith

    2016-03-01

    In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Implementation and outcomes of an evidence-based precepting program for burn nurses.

    Science.gov (United States)

    Robbins, Johnnie R; Valdez-Delgado, Krystal K; Caldwell, Nicole W; Yoder, Linda H; Hayes, Elizabeth J; Barba, Michaèl G; Greeley, Hope L; Mitchell, Colleen; Mann-Salinas, Elizabeth A

    2017-11-01

    There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty. The Iowa Model of Evidence-based Practice served as the model for this project. A working group was formed consisting of nurse scientists, clinical nurse leaders, clinical nurse specialists, lead preceptors, staff nurse preceptors and wound care coordinators. A systematic review of the literature was conducted focusing on nurse transition; preceptor development and transitioning nurse training programs with competency assessment, ongoing multifaceted evaluation and retention strategies were created. The evidence-based Vermont Nurses in Partnership (VNIP) Clinical Transition Framework was selected and subsequent education was provided to all Burn Center leaders and staff. Benchmarks for basic knowledge assessment (BKAT) and burn wound care were established among current staff by work site and education level to help evaluate transitioning nurses. Policies were modified to count each preceptor/transitioning nurse dyad as half an employee on the schedule. Multiple high-fidelity simulation scenarios were created to expand hands-on opportunities. From September 2012-December 2013, 110 (57% acute care nursing) Burn Center staff attended the VNIP Clinical Coaching Course, to include 34 interdisciplinary staff (rehabilitation, education, respiratory therapy, and outpatient clinic staff) and 100% of identified preceptors (n=33). A total of 30 new nurses participated in the transition program: 26 (87%) completed, 3 (10%) did not complete

  10. Building an evidence base for community health: a review of the quality of program evaluations.

    Science.gov (United States)

    Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

    2007-11-01

    An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

  11. The fetal programming of food preferences: current clinical and experimental evidence.

    Science.gov (United States)

    Dalle Molle, R; Bischoff, A R; Portella, A K; Silveira, P P

    2015-09-28

    Increased energy consumption is one of the major factors implicated in the epidemic of obesity. There is compelling evidence, both clinical and experimental, that fetal paucity of nutrients may have programming effects on feeding preferences and behaviors that can contribute to the development of diseases. Clinical studies in different age groups show that individuals born small for their gestational age (SGA) have preferences towards highly caloric foods such as carbohydrates and fats. Some studies have also shown altered eating behaviors in SGA children. Despite an apparent discrepancy in different age groups, all studies seem to converge to an increased intake of palatable foods in SGA individuals. Small nutrient imbalances across lifespan increase the risk of noncommunicable diseases in adult life. Homeostatic factors such as altered responses to leptin and insulin and alterations in neuropeptides associated with appetite and satiety are likely involved. Imbalances between homeostatic and hedonic signaling are another proposed mechanism, with the mesocorticolimbic dopaminergic pathway having differential reward and pleasure responses when facing palatable foods. Early exposure to undernutrition also programs hypothalamic-pituitary-adrenal axis, with SGA having higher levels of cortisol in different ages, leading to chronic hyperactivity of this neuroendocrine axis. This review summarizes the clinical and experimental evidence related to fetal programming of feeding preferences by SGA.

  12. Responding to Problem Behavior in Schools: The Behavior Education Program. Second Edition

    Science.gov (United States)

    Crone, Deanne A.; Hawken, Leanne S.; Horner, Robert H.

    2010-01-01

    This bestselling book has been used in schools across the country to establish efficient and cost-effective systems of Tier II positive behavior support. The Behavior Education Program (BEP) was developed for the approximately 10-15% of students who fail to meet schoolwide disciplinary expectations but do not yet require intensive, individualized…

  13. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)12345

    Science.gov (United States)

    Raiten, Daniel J; Ashour, Fayrouz A Sakr; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben

    2015-01-01

    An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. PMID:25833893

  14. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE).

    Science.gov (United States)

    Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben

    2015-05-01

    An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. © 2015 American Society for Nutrition.

  15. Banking behavior under uncertainty: Evidence from the US Sulfur Dioxide Emissions Allowance trading program

    International Nuclear Information System (INIS)

    Rousse, Olivier; Sevi, Benoit

    2006-02-01

    The aim of this paper is to examine portfolio management of emission allowances in the US Sulfur Dioxide Emissions Allowance Trading Program, to determine whether utilities have a real motive to bank when risk increases. We test a theoretical model linking the motivation of the firm to accumulate permits in order to prepare itself to face a risky situation in the future. Empirical estimation using data for years 2001 to 2004 provides evidence of a relationship between banking behavior and uncertainty the utility is facing with. (authors)

  16. National preceptor development program (PDP): Influential evidence and theory. The first of a 3-part series.

    Science.gov (United States)

    Mulherin, Katrina; Walter, Sheila; Cox, Craig D

    2018-03-01

    Priority #3 of the Canadian Experiential Education Project for Pharmacy provided evidence-based guidance for the design and implementation of a national approach to preceptor development. In this first article (of three), findings from the project and recommendations to achieve a high-quality preceptor development program (PDP) are presented. A multi-method approach including detailed semi-structured interviews, classic literature review, and advisory committee feedback was employed. The research team performed an integrated analysis of all data to achieve the objectives of Priority #3. Fifteen formal interviews, 167 articles and two stakeholder meetings informed findings. Experiential Education programs exhibited commonality in content and usually delivered programs online using modules or live lectures. Not all programs required preceptor education despite it being mandated by academic accreditors. Academics' perceptions varied regarding pharmacists' baseline knowledge, skills and attitudes prior to engaging in the preceptor role. A national approach to a PDP was desired if jurisdictional content was accommodated. Copious interprofessional literature of generally fair quality did not identify superior preceptor development approaches although there were numerous descriptions of interventions. Only 29 articles measured educational outcomes. Outcomes included satisfaction rates, self-efficacy and perceived knowledge, skill retention, skill implementation and participation rates. Twelve recommendations were identified to guide successful development of a national PDP. In the absence of good evidence, adult educational theory provided a basis for an effective PDP. Findings from Priority #3 may be relevant not only to pharmacy in Canada but other health professions and counterparts in other western nations with similar approaches to professional education. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2009-01-01

    Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

  18. Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

    Science.gov (United States)

    Hunt, Anne W; De Feo, Luciano; Macintyre, Jennifer; Greenspoon, Dayna; Dick, Talia; Mah, Katherine; Paniccia, Melissa; Provvidenza, Christine; Reed, Nick

    2016-08-17

    Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

  19. Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

    Science.gov (United States)

    Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

    2016-08-01

    Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

  20. Do Parent Education Programs Promote Healthy Post-Divorce Parenting? Critical Distinctions and a Review of the Evidence

    Science.gov (United States)

    Sigal, Amanda; Sandler, Irwin; Wolchik, Sharlene; Braver, Sanford

    2009-01-01

    Most parent education programs are designed to improve child well-being following divorce by changing some aspect of parenting. However, there has been relatively little discussion of what aspects of parenting are most critical and the effectiveness of programs to change different aspects of parenting. This paper addresses these issues by: 1. Distinguishing three aspects of post-divorce parenting that have been targeted in parent education programs; 2. Reviewing evidence of the relations between each aspect of parenting and the well-being of children and; 3. Critically reviewing evidence that parent education programs have been successful in changing each aspect of post-divorce parenting. PMID:21552360

  1. The Impact of a Therapy Dog Program on Children's Reading: Follow-Up and Extension to ELL Students

    Science.gov (United States)

    Kirnan, Jean; Ventresco, Nina E.; Gardner, Thomas

    2018-01-01

    An initiative in which therapy dogs were integrated into a school-wide reading curriculum was analyzed to determine the effect on student reading in the program's second year. Prior research on the first year of this specific program (Kirnan et al. in "Early Child Educ J" 44(6):637-651) demonstrated improvement in reading scores only for…

  2. Primary and Secondary Prevention of Behavior Difficulties: Developing a Data-Informed Problem-Solving Model to Guide Decision Making at a School-Wide Level

    Science.gov (United States)

    Ervin, Ruth A.; Schaughency, Elizabeth; Matthews, Amy; Goodman, Steven D.; McGlinchey, Margaret T.

    2007-01-01

    This article focuses on the development and implementation of primary and secondary behavior supports at a schoolwide level. The approach described is consistent with previous efforts to address behavior at a systems level (e.g., G. Sugai, R.H. Horner, & F.M. Gresham, 2002). In this article, we illustrate this process through a school-based…

  3. Identifying Relationships between High-Risk Sexual Behaviors and Screening Positive for Chlamydia and Gonorrhea in School-Wide Screening Events

    Science.gov (United States)

    Salerno, Jennifer; Darling-Fisher, Cindy; Hawkins, Nicole M.; Fraker, Elizabeth

    2013-01-01

    Background: This article describes a school-wide sexually transmitted infection (STI) screening to identify adolescent high-risk sexual behaviors, STI history/incidence, and presence of chlamydia and gonorrhea, and examines relationships between high-risk behaviors and screening positive for chlamydia and gonorrhea in an alternative high school…

  4. Response to Intervention and Continuous School Improvement: How to Design, Implement, Monitor, and Evaluate a School-Wide Prevention System, 2nd Edition

    Science.gov (United States)

    Bernhardt, Victoria L.; Hébert, Connie L.

    2017-01-01

    Experts Bernhardt and Hébert's latest book demonstrates strategies to ensure your entire staff works together to design, implement, monitor, and evaluate a schoolwide prevention system with integrity and fidelity. Each step in this important resource is designed to help administrators, teachers, and other educators improve the learning of every…

  5. Response to Intervention and Continuous School Improvement: Using Data, Vision, and Leadership to Design, Implement, and Evaluate a Schoolwide Prevention System

    Science.gov (United States)

    Bernhardt, Victoria L.; Hebert, Connie L.

    2011-01-01

    Ensure the success of your school and improve the learning of "all" students by implementing Response-to-Intervention (RTI) as part of a continuous school improvement (CSI) process. This book shows you how to get your entire staff working together to design, implement, and evaluate a schoolwide prevention system. With specific examples, CSI expert…

  6. The Relationship Between Implementation of School-Wide Positive Behavior Intervention and Supports and Performance on State Accountability Measures

    Directory of Open Access Journals (Sweden)

    Adriana M. Marin

    2013-10-01

    Full Text Available This study examined data from 96 schools in a Southeastern U.S. state participating in training and/or coaching on School-Wide Positive Behavioral Interventions and Supports (SWPBIS provided by the State Personnel Development Grant (SPDG in their state. Schools studied either received training only (“non-intensive” sites or training and on-site coaching (“intensive” sites. Fidelity of implementation was self-evaluated by both types of schools using the Benchmarks of Quality (BOQ. Some schools were also externally evaluated using the School-Wide Evaluation Tool (SET, with those scoring 80% or higher determined “model sites.” Using an independent sample t-test, analyses revealed statistically significant differences between intensive and nonintensive schools’ Quality of Distribution Index (QDI scores and between model sites and nonmodel sites on QDI scores. Correlations were performed to determine whether the fidelity of implementation of SWPBIS as measured by the BOQ was related to any of the state’s accountability measures: performance classification, QDI, or growth.

  7. The Social Construction of "Evidence-Based" Drug Prevention Programs: A Reanalysis of Data from the Drug Abuse Resistance Education (DARE) Program

    Science.gov (United States)

    Gorman, Dennis M.; Huber, J. Charles, Jr.

    2009-01-01

    This study explores the possibility that any drug prevention program might be considered "evidence-based" given the use of data analysis procedures that optimize the chance of producing statistically significant results by reanalyzing data from a Drug Abuse Resistance Education (DARE) program evaluation. The analysis produced a number of…

  8. Patient and program factors that bridge the detoxification-treatment gap: a structured evidence review.

    Science.gov (United States)

    Timko, Christine; Below, Maureen; Schultz, Nicole R; Brief, Deborah; Cucciare, Michael A

    2015-05-01

    Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox. The purpose of this structured evidence review, summarizing data extraction on a yield of 26 articles, is to identify patient, program, and system factors associated with the outcomes of completion of alcohol detox and successful transitions from alcohol detox to SUD treatment and mutual-help group participation. The review found wide variability among studies in the rates at which patients complete a detox episode (45 to 95%) and enter SUD treatment or mutual-help groups after detox (14 to 92%). Within program factors, behavioral practices that contribute to both detox completion and transitioning to SUD care after detox entail involving the patient's family and utilizing motivational-based approaches. Such practices should be targeted at younger patients, who are less likely to complete detox. Although more studies using a randomized controlled trial design are needed, the evidence suggests that barriers to detox completion and transition to SUD care can be overcome to improve patient outcomes. Published by Elsevier Inc.

  9. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

  10. Lessons from the Social Innovation Fund: Supporting Evaluation to Assess Program Effectiveness and Build a Body of Research Evidence

    Science.gov (United States)

    Zandniapour, Lily; Deterding, Nicole M.

    2018-01-01

    Tiered evidence initiatives are an important federal strategy to incentivize and accelerate the use of rigorous evidence in planning, implementing, and assessing social service investments. The Social Innovation Fund (SIF), a program of the Corporation for National and Community Service, adopted a public-private partnership approach to tiered…

  11. Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET program: protocol for a program of research

    Directory of Open Access Journals (Sweden)

    Green Sally E

    2012-08-01

    Full Text Available Abstract The Neurotrauma Evidence Translation (NET program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys; theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.

  12. Behavioral change of pharmacists by online evidence-based medicine-style education programs.

    Science.gov (United States)

    Aoshima, Syuichi; Kuwabara, Hidenori; Yamamoto, Masahiro

    2017-12-01

    Although e-learning evidence-based medicine (EBM) courses have proven useful in improving the knowledge and skills of residents, it was still unclear for pharmacists in non-English-speaking countries. Thus, we investigated the behavioral change of Japanese pharmacists who participated in an EBM-style e-learning educational program available online. This EBM-style e-learning program, the Japanese Journal Club for Clinical Pharmacists, was operated by three pharmacists through Skype. It comprised an online questionnaire administered to the program viewers. Two frequencies, the opportunity to be aware of EBM practices and that of reading an article, were compared before and after viewing the broadcast. Frequencies were classified into five categories: "almost every day," "1-2 times a week," "1-2 times a month," "1-2 times a year," and "not at all." The changes before and after viewing the broadcast were evaluated using a Wilcoxon signed-rank test. The announcement of the questionnaire survey on the web was conducted during the journal club on August 24 and September 7, 2014. The maximum number of simultaneous audiences at the time was 113 persons. Among them, we analyzed data from 36 people who answered the questionnaire. Among these, "1-2 times a week" and "almost every day" were increased, whereas "not at all" was greatly reduced. Indeed, a significant difference was observed in overall change of each frequency before and after viewing the broadcast ( P education of pharmacists.

  13. Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence.

    Science.gov (United States)

    Brown, Sharon A; García, Alexandra A; Zuñiga, Julie A; Lewis, Kimberly A

    2018-01-05

    The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive. The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes. Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. A Standardized, Evidence-Based Massage Therapy Program for Decentralized Elite Paracyclists: Creating the Model.

    Science.gov (United States)

    Kennedy, Ann B; Trilk, Jennifer L

    2015-09-01

    Evidence suggests that para-athletes are injured more often than able-bodied athletes. The benefits of massage therapy for these disabled athletes are yet to be explored. This paper documents the process followed for creating a massage program for elite paracycling athletes with the goal to assess effects on recovery, rest, performance, and quality of life both on and off the bike. Massage therapists' private practices throughout the United States. A United States Paracycling team consisting of 9 elite athletes: 2 spinal cord injury, 2 lower limb amputation, 1 upper limb amputation, 1 transverse myelitis, 1 stroke, 1 traumatic brain injury, and 1 visually impaired. The process used to develop a massage therapy program for para-cyclists included meetings with athletes, coaching staff, team exercise physiologist, and sports massage therapists; peer-reviewed literature was also consulted to address specific health conditions of para-athletes. Team leadership and athletes identified needs for quicker recovery, better rest, and improved performance in elite paracyclists. This information was used to generate a conceptual model for massage protocols, and led to creation of the intake and exit questionnaires to assess patient health status and recovery. Forms also were created for a general health intake, therapist information, and a therapist's SOAAP notes. The conceptual model and questionnaires developed herein will help to operationalize an exploratory study investigating the feasibility of implementing a standardized massage therapy program for a decentralized elite paracycling team.

  15. Consumer engagement and the development, evaluation and dissemination of evidence-based parenting programs

    Science.gov (United States)

    Sanders, Matthew R.; Kirby, James N.

    2013-01-01

    A consumer perspective can contribute much to enhancing the “ecological fit” of population level parenting interventions so they meet the needs of parents. This approach involves building relationships with consumer groups and soliciting consumer input into the relevance and acceptability of interventions, clarifying the enablers and barriers to engagement and involvement of parents, and clarifying variables that influence a parent’s program completion. The adoption of a more collaborative approach to working with consumers is important if meaningful population level change in the prevalence of serious social, emotional and behavioral problems in children and young people is to be achieved. Parents seeking assistance for their children’s behavior come from a diverse range of socioeconomic backgrounds, educational levels, cultures and languages. This paper examines consumer engagement strategies that can be employed throughout the process of program development, evaluation, training and dissemination and in “scaling up” the intervention. We argue that a multi-level public health approach to parenting intervention requires a strong consumer perspective to enable interventions to be more responsive to the preferences and needs of families and to ensure improved population reach of interventions. Examples from large scale dissemination trials are used to illustrate how consumer input can result in an increasingly differentiated suite of evidence-based parenting programs. PMID:22440062

  16. Microcredit, family planning programs, and contraceptive behavior: evidence from a field experiment in Ethiopia.

    Science.gov (United States)

    Desai, Jaikishan; Tarozzi, Alessandro

    2011-05-01

    The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women's preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).

  17. A qualitative study of programs for parents with serious mental illness and their children: building practice-based evidence.

    Science.gov (United States)

    Nicholson, Joanne; Hinden, Beth R; Biebel, Kathleen; Henry, Alexis D; Katz-Leavy, Judith

    2007-10-01

    The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their children.

  18. Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature

    Directory of Open Access Journals (Sweden)

    Coretti S

    2015-04-01

    Full Text Available Silvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS, Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF, Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO, more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and $50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and $128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening

  19. Development of an evidence-based training program for laparoscopic hysterectomy on a virtual reality simulator.

    Science.gov (United States)

    Crochet, Patrice; Aggarwal, Rajesh; Knight, Sophie; Berdah, Stéphane; Boubli, Léon; Agostini, Aubert

    2017-06-01

    Substantial evidence in the scientific literature supports the use of simulation for surgical education. However, curricula lack for complex laparoscopic procedures in gynecology. The objective was to evaluate the validity of a program that reproduces key specific components of a laparoscopic hysterectomy (LH) procedure until colpotomy on a virtual reality (VR) simulator and to develop an evidence-based and stepwise training curriculum. This prospective cohort study was conducted in a Marseille teaching hospital. Forty participants were enrolled and were divided into experienced (senior surgeons who had performed more than 100 LH; n = 8), intermediate (surgical trainees who had performed 2-10 LH; n = 8) and inexperienced (n = 24) groups. Baselines were assessed on a validated basic task. Participants were tested for the LH procedure on a high-fidelity VR simulator. Validity evidence was proposed as the ability to differentiate between the three levels of experience. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on experienced surgeons' performances. Outcome measures were simulator-derived metrics and Objective Structured Assessment of Technical Skills (OSATS) scores. Quantitative analysis found significant inter-group differences between experienced intermediate and inexperienced groups for time (1369, 2385 and 3370 s; p < 0.001), number of movements (2033, 3195 and 4056; p = 0.001), path length (3390, 4526 and 5749 cm; p = 0.002), idle time (357, 654 and 747 s; p = 0.001), respect for tissue (24, 40 and 84; p = 0.01) and number of bladder injuries (0.13, 0 and 4.27; p < 0.001). Learning curves plateaued at the 2nd to 6th repetition. Further qualitative analysis found significant inter-group OSATS score differences at first repetition (22, 15 and 8, respectively; p < 0.001) and second repetition (25.5, 19.5 and 14; p < 0.001). The VR program for LH accrued validity evidence and

  20. Dietary Interventions in Multiple Sclerosis: Development and Pilot-Testing of an Evidence Based Patient Education Program.

    Science.gov (United States)

    Riemann-Lorenz, Karin; Eilers, Marlene; von Geldern, Gloria; Schulz, Karl-Heinz; Köpke, Sascha; Heesen, Christoph

    2016-01-01

    Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS). Specific diets are widely used among patients with MS. To design and pilot-test an evidence based patient education program on dietary factors in MS. We performed a systematic literature search on the effectiveness of dietary interventions in MS. A web-based survey among 337 patients with MS and 136 healthy controls assessed knowledge, dietary habits and information needs. An interactive group education program was developed and pilot-tested. Fifteen randomised-controlled trials (RCTs) were included in the systematic review. Quality of evidence was low and no clear benefit could be seen. Patients with MS significantly more often adhered to a `Mediterranean Diet`(29.7% versus 14.0%, ppilot test of our newly developed patient education program with 13 participants showed excellent comprehensibility and the MS-specific content was judged as very important. However, the poor evidence base for dietary approaches in MS was perceived disappointing. Development and pilot-testing of an evidence-based patient education program on nutrition and MS is feasible. Patient satisfaction with the program suffers from the lack of evidence. Further research should focus on generating evidence for the potential influence of lifestyle habits (diet, physical activity) on MS disease course thus meeting the needs of patients with MS.

  1. Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation.

    Science.gov (United States)

    Bobitt, Julie; Schwingel, Andiara

    2017-01-01

    While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.

  2. Evidence for a stepwise program of extrathymic T cell development within the human tonsil

    Science.gov (United States)

    McClory, Susan; Hughes, Tiffany; Freud, Aharon G.; Briercheck, Edward L.; Martin, Chelsea; Trimboli, Anthony J.; Yu, Jianhua; Zhang, Xiaoli; Leone, Gustavo; Nuovo, Gerard; Caligiuri, Michael A.

    2012-01-01

    The development of a broad repertoire of T cells, which is essential for effective immune function, occurs in the thymus. Although some data suggest that T cell development can occur extrathymically, many researchers remain skeptical that extrathymic T cell development has an important role in generating the T cell repertoire in healthy individuals. However, it may be important in the setting of poor thymic function or congenital deficit and in the context of autoimmunity, cancer, or regenerative medicine. Here, we report evidence that a stepwise program of T cell development occurs within the human tonsil. We identified 5 tonsillar T cell developmental intermediates: (a) CD34+CD38dimLin– cells, which resemble multipotent progenitors in the bone marrow and thymus; (b) more mature CD34+CD38brightLin– cells; (c) CD34+CD1a+CD11c– cells, which resemble committed T cell lineage precursors in the thymus; (d) CD34–CD1a+CD3–CD11c– cells, which resemble CD4+CD8+ double-positive T cells in the thymus; and (e) CD34–CD1a+CD3+CD11c– cells. The phenotype of each subset closely resembled that of its thymic counterpart. The last 4 populations expressed RAG1 and PTCRA, genes required for TCR rearrangement, and all 5 subsets were capable of ex vivo T cell differentiation. TdT+ cells found within the tonsillar fibrous scaffold expressed CD34 and/or CD1a, indicating that this distinct anatomic region contributes to pre–T cell development, as does the subcapsular region of the thymus. Thus, we provide evidence of a role for the human tonsil in a comprehensive program of extrathymic T cell development. PMID:22378041

  3. Nitrergic system and plasmatic methylarginines: Evidence of their role in the perinatal programming of cardiovascular diseases.

    Science.gov (United States)

    Bassareo, Pier Paolo; Mussap, Michele; Bassareo, Valentina; Flore, Giovanna; Mercuro, Giuseppe

    2015-12-07

    Atherosclerosis, in turn preceded by endothelial dysfunction, underlies a series of important cardiovascular diseases. Reduced bioavailability of endothelial nitric oxide, by increasing vascular tone and promoting platelet aggregation, leukocyte adhesion, and smooth muscle cell proliferation, plays a key role in the onset of the majority of cardiovascular diseases. In addition, high blood levels of asymmetric dimethylarginine, a potent inhibitor of nitric oxide synthesis, are associated with future development of adverse cardiovascular events and cardiac death. Recent reports have demonstrated that another methylarginine, i.e., symmetric dimethylarginine, is also involved in the onset of endothelial dysfunction and hypertension. Almost a decade ago, prematurity at birth and intrauterine growth retardation were first associated with a potential negative influence on the cardiovascular apparatus, thus constituting risk factors or leading to early onset of cardiovascular diseases. This condition is referred to as cardiovascular perinatal programming. Accordingly, cardiovascular morbidity and mortality are higher among former preterm adults than in those born at term. The aim of this paper was to undertake a comprehensive literature review focusing on cellular and biochemical mechanisms resulting in both reduced nitric oxide bioavailability and increased methylarginine levels in subjects born preterm. Evidence of the involvement of these compounds in the perinatal programming of cardiovascular risk are also discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Social media and gamification: Engaging vulnerable parents in an online evidence-based parenting program.

    Science.gov (United States)

    Love, Susan M; Sanders, Matthew R; Turner, Karen M T; Maurange, Marianne; Knott, Theresa; Prinz, Ronald; Metzler, Carol; Ainsworth, Andrew T

    2016-03-01

    The aim of this study was to examine the feasibility (accessibility, engagement and impact) of adding social media and gaming features (e.g., social sharing with anonymity, badges to incentivize skills practice, an accredited facilitator for support) and access via smartphones to an evidenced-based parenting program, Triple P Online. The highly vulnerable population included 155 disadvantaged, high-risk parents (e.g., 76% had a family annual income of less than $15,000; 41% had been incarcerated; 38% were in drug/alcohol treatment; and 24% had had a child removed due to maltreatment). The ethnic groups most commonly identified were African American (24%) and Hispanic (66%). Respondents were primarily mothers (86%) from five community programs in Los Angeles. The study used a single group repeated measures design (pre, post, 6-month follow-up). Data collected included standardized self-report measures, post-intervention focus groups and interviews, website usage reports, and Google Analytics. Significant multivariate ANOVA time effects were found, demonstrating reductions in child behavioral problems, reduced lax/permissive and over-reactive parenting, and decreased parental stress. No effects were found for parental confidence, attributions, or depression and anxiety (which were in the normal range at baseline). Positive effects were maintained or improved at 6-month follow-up. The participants engaged in the online community and valued its flexibility, anonymity, and shared learning. This foundational implementation trial provides support for future rigorous evaluation of social media and gaming features as a medium for increasing parental engagement in evidence-based parenting programs online--a public health approach to protect and improve the development of vulnerable children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Evidence for the effectiveness of a national school-based mental health program in Chile.

    Science.gov (United States)

    Guzmán, Javier; Kessler, Ronald C; Squicciarini, Ana Maria; George, Myriam; Baer, Lee; Canenguez, Katia M; Abel, Madelaine R; McCarthy, Alyssa; Jellinek, Michael S; Murphy, J Michael

    2015-10-01

    Skills for Life (SFL) is the largest school-based mental health program in the world, screening and providing services to more than 1,000,000 students in Chile over the past decade. This is the first external evaluation of the program. Of the 8,372 primary schools in Chile in 2010 that received public funding, one-fifth (1,637) elected to participate in SFL. Each year, all first- and third-grade students in these schools are screened with validated teacher- and parent-completed measures of psychosocial functioning (the Teacher Observation of Classroom Adaptation-Re-Revised [TOCA-RR] and the Pediatric Symptom Checklist-Chile [PSC-CL]). Students identified as being at risk on the TOCA-RR in first grade are referred to a standardized 10-session preventive intervention in second grade. This article explores the relationships between workshop participation and changes in TOCA-RR and PSC-CL scores, attendance, and promotion from third to fourth grades. In all, 16.4% of students were identified as being at-risk on the TOCA-RR. Statistically significant relationships were found between the number of workshop sessions attended and improvements in behavioral and academic outcomes after controlling for nonrandom selection into exposure and loss to follow-up. Effect sizes for the difference between attending most (7-10) versus fewer (0-6) sessions ranged from 0.08 to 0.16 standard deviations. This study provides empirical evidence that a large-scale mental health intervention early in schooling is significantly associated with improved behavioral and academic outcomes. Future research is needed to implement more rigorous experimental evaluation of the program, to examine longer-term effects, and to investigate possible predictors of heterogeneity of treatment response. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components.

    Science.gov (United States)

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-09-28

    Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30-70 percentage points within 1-3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning

  7. Minimalist Program and its fundamental improvements in syntactic theory: evidence from Agreement Asymmetry in Standard Arabic

    Directory of Open Access Journals (Sweden)

    Nasser Al-Horais

    2012-11-01

    Full Text Available Normal 0 21 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:auto; mso-para-margin-right:1.0cm; mso-para-margin-bottom:auto; mso-para-margin-left:2.0cm; text-align:justify; text-indent:-1.0cm; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EN-US; mso-fareast-language:EN-US;} The Minimalist Program is a major line of inquiry that has been developing inside Generative Grammar since the early nineties, when it was proposed by Chomsky  (1993, 1995. In that time, Chomsky (1998: 5 presents Minimalist Program as a program, not as a theory, but today, Minimalist Program lays out a very specific view of the basis of syntactic grammar that, when compared to other formalisms, is often taken to look very much like a theory. The prime concern of this paper, however, is  to provide a comprehensive and accessible introduction to the art of minimalist approach to the theory of grammar. In this regard, this paper discusses some new ideas articulated recently by Chomsky, and have led to several fundamental improvements in syntactic theory  such as changing the function of movement and the Extended Projection Principle (EPP feature, or proposing new theories such as Phases and Feature Inheritance. In order to evidence the significance of these fundamental improvements, the current paper provides a minimalist analysis to account for agreement and word-order asymmetry in Stranded Arabic. This fresh minimalist account meets the challenges (to the basic tenets of syntactic theory occurred

  8. Improving elementary school quality through the use of a social-emotional and character development program: a matched-pair, cluster-randomized, controlled trial in Hawai'i.

    Science.gov (United States)

    Snyder, Frank J; Vuchinich, Samuel; Acock, Alan; Washburn, Isaac J; Flay, Brian R

    2012-01-01

    School safety and quality affect student learning and success. This study examined the effects of a comprehensive elementary school-wide social-emotional and character education program, Positive Action, on teacher, parent, and student perceptions of school safety and quality utilizing a matched-pair, cluster-randomized, controlled design. The Positive Action Hawai'i trial included 20 racially/ethnically diverse schools and was conducted from 2002-2003 through 2005-2006. School-level archival data, collected by the Hawai'i Department of Education, were used to examine program effects at 1-year post-trial. Teacher, parent, and student data were analyzed to examine indicators of school quality such as student safety and well-being, involvement, and satisfaction, as well as overall school quality. Matched-paired t-tests were used for the primary analysis, and sensitivity analyses included permutation tests and random-intercept growth curve models. Analyses comparing change from baseline to 1-year post-trial revealed that intervention schools demonstrated significantly improved school quality compared to control schools, with 21%, 13%, and 16% better overall school quality scores as reported by teachers, parents, and students, respectively. Teacher, parent, and student reports on individual school-quality indicators showed improvement in student safety and well-being, involvement, satisfaction, quality student support, focused and sustained action, standards-based learning, professionalism and system capacity, and coordinated team work. Teacher reports also showed an improvement in the responsiveness of the system. School quality was substantially improved, providing evidence that a school-wide social-emotional and character education program can enhance school quality and facilitate whole-school change. © 2011, American School Health Association.

  9. Can Universal SEL Programs Benefit Universally? Effects of the Positive Action Program on Multiple Trajectories of Social-Emotional and Misconduct Behaviors.

    Science.gov (United States)

    Duncan, Robert; Washburn, Isaac J; Lewis, Kendra M; Bavarian, Niloofar; DuBois, David L; Acock, Alan C; Vuchinich, Samuel; Flay, Brian R

    2017-02-01

    Behavioral trajectories during middle childhood are predictive of consequential outcomes later in life (e.g., substance abuse, violence). Social and emotional learning (SEL) programs are designed to promote trajectories that reflect both growth in positive behaviors and inhibited development of negative behaviors. The current study used growth mixture models to examine effects of the Positive Action (PA) program on behavioral trajectories of social-emotional and character development (SECD) and misconduct using data from a cluster-randomized trial that involved 14 schools and a sample of predominately low-income, urban youth followed from 3rd through 8th grade. For SECD, findings indicated that PA was similarly effective at improving trajectories within latent classes characterized as "high/declining" and "low/stable". Favorable program effects were likewise evident to a comparable degree for misconduct across observed latent classes that reflected "low/rising" and "high/rising" trajectories. These findings suggest that PA and perhaps other school-based universal SEL programs have the potential to yield comparable benefits across subgroups of youth with differing trajectories of positive and negative behaviors, making them promising strategies for achieving the intended goal of school-wide improvements in student outcomes.

  10. Educating change agents: a qualitative descriptive study of graduates of a Master's program in evidence-based practice.

    Science.gov (United States)

    Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen

    2016-02-25

    Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.

  11. Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence.

    Science.gov (United States)

    Vaiserman, Alexander M

    2017-03-05

    Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies ('natural experiments'). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed.

  12. Adapting Evidence-Based Teen Pregnancy Programs to Be LGBT-Inclusive: Lessons Learned.

    Science.gov (United States)

    Boyce, Karen Stradford; Travers, Madeline; Rothbart, Betty; Santiago, Vivian; Bedell, Jane

    2018-05-01

    Lesbian, gay, bisexual, and transgender (LGBT) youth show higher rates of sexual risk behaviors than heterosexual and cisgender youth; yet, most school-based sexual health education is largely heteronormative and cisnormative and does not recognize the spectrum of sexual and gender identity. New York City's Departments of Health and Education collaborated to create an LGBT-inclusive supplement to the Reducing the Risk curriculum and implement it in 21 South Bronx high schools. Teachers completed an electronic survey to report the number of students reached and an online log to measure curriculum adherence. Students were administered an anonymous 74-item pre- and posttest to measure demographics, sexual health knowledge, and student satisfaction with the curriculum. Chi-square and t tests were used to assess differences in student demographics and changes in knowledge scores. Reducing the Risk was implemented in 21 schools reaching 230 classes and 5,673 students; with 161 classes receiving the supplement. Teachers reported completing an average of 70% of LGBT supplement activities. Students who received the supplement reported higher satisfaction and greater knowledge scores than students who did not. New York City experience shows that being more inclusive of LGBT teens while implementing preexisting evidence-based sexual and reproductive health programs is possible and replicable.

  13. Synthesis of evidence of diagnostic tests and preventive programs identifying pre-diabetes type

    Directory of Open Access Journals (Sweden)

    Dagmar Tučková

    2015-09-01

    Full Text Available Introduction: Type 2 diabetes mellitus (T2D has become the main type of diabetes in children and it is expected that in countries with high income diabetes it is projected to be one of the leading causes of death by 2030. Another fact is that programs and tests diagnosing pre-diabetes type 2 (T2P-DMC are missing. Methods: The aim of the paper is to present the steps for the synthesis of the evidence within the brand new type of the systematic review (SR: SR of diagnostic test accuracy (DTA. Using the acronym PIRD it was developed a review question, search strategy and inclusion and exclusion criteria. Results: The initial search was done in two databases (MedLine and Cinahl with 2 025 results. The second search after the improvement of the sensitivity and the specificity was done in 15 databases with 3 681 results. Conclusion: This methodological paper introduces how to conduct the systematic review protocols of diagnostic test accuracy on the example of T2P-DMC.

  14. Frames of scientific evidence: How journalists represent the (un)certainty of molecular medicine in science television programs.

    Science.gov (United States)

    Ruhrmann, Georg; Guenther, Lars; Kessler, Sabrina Heike; Milde, Jutta

    2015-08-01

    For laypeople, media coverage of science on television is a gateway to scientific issues. Defining scientific evidence is central to the field of science, but there are still questions if news coverage of science represents scientific research findings as certain or uncertain. The framing approach is a suitable framework to classify different media representations; it is applied here to investigate the frames of scientific evidence in film clips (n=207) taken from science television programs. Molecular medicine is the domain of interest for this analysis, due to its high proportion of uncertain and conflicting research findings and risks. The results indicate that television clips vary in their coverage of scientific evidence of molecular medicine. Four frames were found: Scientific Uncertainty and Controversy, Scientifically Certain Data, Everyday Medical Risks, and Conflicting Scientific Evidence. They differ in their way of framing scientific evidence and risks of molecular medicine. © The Author(s) 2013.

  15. An Evidence-Based Assessment of Faith-Based Programs: Do Faith-Based Programs "Work" to Reduce Recidivism?

    Science.gov (United States)

    Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.

    2011-01-01

    Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…

  16. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Review of "The Effect of Special Education Vouchers on Public School Achievement: Evidence from Florida's McKay Scholarship Program"

    Science.gov (United States)

    Yun, John T.

    2008-01-01

    A new report published by the Manhattan Institute for Education Policy, "The Effect of Special Education Vouchers on Public School Achievement: Evidence from Florida's McKay Scholarship Program," attempts to examine the complex issue of how competition introduced through school vouchers affects student outcomes in public schools. The…

  18. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

    Science.gov (United States)

    2015-03-24

    Melnyk and Eileen Fineout-Overholt, who graciously and consistently support military nursing science. Building a Unit-Level Mentored Program...Rosenberg W, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: What it is and what it isn’t. BMJ. 1996;312(7023):71-72.doi: http

  19. Implementation and Sustainability of an Evidence-Based Program: Lessons Learned from the Prism Applied to "First Step to Success"

    Science.gov (United States)

    Woodbridge, Michelle W.; Sumi, W. Carl; Yu, Jennifer; Rouspil, Kristen; Javitz, Harold S.; Seeley, John R.; Walker, Hill M.

    2014-01-01

    Although numerous studies address the efficacy of school-based interventions, fewer focus on how to support sustainability of interventions from the perspective of participants. To address this research gap, we use the Practical, Robust Implementation and Sustainability Model to examine how the characteristics of an evidence-based program interact…

  20. Translating Evidence Based Violence and Drug Use Prevention to Obesity Prevention: Development and Construction of the Pathways Program

    Science.gov (United States)

    Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

    2012-01-01

    Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health,…

  1. Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming

    Directory of Open Access Journals (Sweden)

    Kiguli Juliet

    2008-06-01

    Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation

  2. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming.

    Science.gov (United States)

    Waiswa, Peter; Kemigisa, Margaret; Kiguli, Juliet; Naikoba, Sarah; Pariyo, George W; Peterson, Stefan

    2008-06-21

    Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children). We also did 10 key informant interviews with health workers and traditional birth attendants. Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation and health systems barriers including the financial burden. Male

  3. Moving evidence-based drug abuse prevention programs from basic science to practice: "bridging the efficacy-effectiveness interface".

    Science.gov (United States)

    August, Gerald J; Winters, Ken C; Realmuto, George M; Tarter, Ralph; Perry, Cheryl; Hektner, Joel M

    2004-01-01

    This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.

  4. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  5. The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.

    Science.gov (United States)

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2013-08-01

    Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies. 2001-2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. © Health Research and Educational Trust.

  6. An evidence-based virtual reality training program for novice laparoscopic surgeons.

    Science.gov (United States)

    Aggarwal, Rajesh; Grantcharov, Teodor P; Eriksen, Jens R; Blirup, Dorthe; Kristiansen, Viggo B; Funch-Jensen, Peter; Darzi, Ara

    2006-08-01

    To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

  7. Validity evidence for the Fundamentals of Laparoscopic Surgery (FLS) program as an assessment tool: a systematic review.

    Science.gov (United States)

    Zendejas, Benjamin; Ruparel, Raaj K; Cook, David A

    2016-02-01

    The Fundamentals of Laparoscopic Surgery (FLS) program uses five simulation stations (peg transfer, precision cutting, loop ligation, and suturing with extracorporeal and intracorporeal knot tying) to teach and assess laparoscopic surgery skills. We sought to summarize evidence regarding the validity of scores from the FLS assessment. We systematically searched for studies evaluating the FLS as an assessment tool (last search update February 26, 2013). We classified validity evidence using the currently standard validity framework (content, response process, internal structure, relations with other variables, and consequences). From a pool of 11,628 studies, we identified 23 studies reporting validity evidence for FLS scores. Studies involved residents (n = 19), practicing physicians (n = 17), and medical students (n = 8), in specialties of general (n = 17), gynecologic (n = 4), urologic (n = 1), and veterinary (n = 1) surgery. Evidence was most common in the form of relations with other variables (n = 22, most often expert-novice differences). Only three studies reported internal structure evidence (inter-rater or inter-station reliability), two studies reported content evidence (i.e., derivation of assessment elements), and three studies reported consequences evidence (definition of pass/fail thresholds). Evidence nearly always supported the validity of FLS total scores. However, the loop ligation task lacks discriminatory ability. Validity evidence confirms expected relations with other variables and acceptable inter-rater reliability, but other validity evidence is sparse. Given the high-stakes use of this assessment (required for board eligibility), we suggest that more validity evidence is required, especially to support its content (selection of tasks and scoring rubric) and the consequences (favorable and unfavorable impact) of assessment.

  8. Homogeneity in Community-Based Rape Prevention Programs: Empirical Evidence of Institutional Isomorphism

    Science.gov (United States)

    Townsend, Stephanie M.; Campbell, Rebecca

    2007-01-01

    This study examined the practices of 24 community-based rape prevention programs. Although these programs were geographically dispersed throughout one state, they were remarkably similar in their approach to rape prevention programming. DiMaggio and Powell's (1991) theory of institutional isomorphism was used to explain the underlying causes of…

  9. The impact of scrappage programs on the demand for new vehicles: Evidence from Spain

    DEFF Research Database (Denmark)

    Cantos - Sánchez, Pedro; Gutiérrez-i-Puigarnau, Eva; Mulalic, Ismir

    We evaluate the impact of the Spanish car scrappage program introduced in May 2009 on short-run car purchases. The scrappage program was simultaneously discussed and implemented, and was therefore exogenous to the consumers. We analyse the effect of this program on household new car purchase deci...

  10. Program of neuropsychological stimulation of cognition in students: Emphasis on executive functions - development and evidence of content validity

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Cardoso

    Full Text Available ABSTRACT Objective: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF in Elementary School children within the school environment. Methods: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI was calculated. Results: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process Conclusion: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.

  11. The importance of using evidence-based e-health smoking cessation programs

    Directory of Open Access Journals (Sweden)

    Hein De Vries

    2016-03-01

    Full Text Available eHealth programs have become very popular to help people to quit smoking. Yet, the efficacy of eHealth programs is dependent on the health communication theories used and applied in these programs. Computer tailored technology has shown to be an effective tool to help people to quit smoking. Programs with even one session can increase the success rates significantly. During this presentation I will discuss several computer tailored eHealth programs for smoking cessation that have been developed and tested at Maastricht University. I will discuss the theoretical grounding of these programs, their effects and the cost-effectiveness. Additionally I will also outline some potential innovations for eHealth programs, and will also share the results of a test comparing eHealth and mHealth.

  12. Intervention mapping: a process for developing theory- and evidence-based health education programs.

    Science.gov (United States)

    Bartholomew, L K; Parcel, G S; Kok, G

    1998-10-01

    The practice of health education involves three major program-planning activities: needs assessment, program development, and evaluation. Over the past 20 years, significant enhancements have been made to the conceptual base and practice of health education. Models that outline explicit procedures and detailed conceptualization of community assessment and evaluation have been developed. Other advancements include the application of theory to health education and promotion program development and implementation. However, there remains a need for more explicit specification of the processes by which one uses theory and empirical findings to develop interventions. This article presents the origins, purpose, and description of Intervention Mapping, a framework for health education intervention development. Intervention Mapping is composed of five steps: (1) creating a matrix of proximal program objectives, (2) selecting theory-based intervention methods and practical strategies, (3) designing and organizing a program, (4) specifying adoption and implementation plans, and (5) generating program evaluation plans.

  13. MD/MBA programs in the United States: evidence of a change in health care leadership.

    Science.gov (United States)

    Larson, David B; Chandler, Maria; Forman, Howard P

    2003-03-01

    Managerial sciences are playing an increasingly prominent role in the organization and delivery of health care. Despite popular media reports that a rising number of physicians are acquiring a background in this discipline through MD/MBA (medical and master of business administration) programs, no recent study has verified this. This study measured changes in the number and nature of the affiliations between management and medicine in the form of MD/MBA programs in the United States. Surveys of admission officers of 125 U.S. allopathic medical schools and of the overseers of each joint MD/MBA degree program were administered in May-October 2001. Main outcome measures included program growth, curriculum and degree requirements, application and admission requirements, and program leadership and organization. The number of MD/MBA programs grew from six to 33 between 1993 and 2001, and 17 more medical schools were considering establishing the joint-degree program. Ten, 15, and 20 programs produced 27, 42, and 61 graduates in 1999, 2000, and 2001, respectively, and over 100 students were expected to graduate per year when all 33 programs matured. Program structures and oversight indicate a spectrum of philosophies regarding the appropriate level of integration of the two degrees. MD/MBA programs apparently attempt to complement medical education with management education rather than the converse. The growth in the numbers of MD/MBA programs and participants indicates rising cooperation between medical and business schools and increasing interest in management education early in the careers of graduating physicians.

  14. Do workplace wellness programs reduce medical costs? Evidence from a Fortune 500 company.

    Science.gov (United States)

    Liu, Hangsheng; Mattke, Soeren; Harris, Katherine M; Weinberger, Sarah; Serxner, Seth; Caloyeras, John P; Exum, Ellen

    2013-05-01

    The recent passage of the Affordable Care Act has heightened the importance of workplace wellness programs. This paper used administrative data from 2002 to 2007 for PepsiCo's self-insured plan members to evaluate the effect of its wellness program on medical costs and utilization. We used propensity score matching to identify a comparison group who were eligible for the program but did not participate. No significant changes were observed in inpatient admissions, emergency room visits, or per-member per-month (PMPM) costs. The discrepancy between our findings and those of prior studies may be due to the difference in intervention intensity or program implementation.

  15. Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis.

    Science.gov (United States)

    Carr, Alan; Hartnett, Dan; Brosnan, Eileen; Sharry, John

    2017-09-01

    Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front-line mental health and educational professionals. © 2016 Family Process Institute.

  16. Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana.

    Science.gov (United States)

    Rokicki, Slawa; Fink, Günther

    2017-12-20

    While mobile health (mHealth) programs are increasingly used to provide health information and deliver interventions, little is known regarding the relative reach and effectiveness of these programs across sociodemographic characteristics. We use data from a recent trial of a text-messaging intervention on adolescent sexual and reproductive health (SRH) to assess the degree to which mHealth programs reach target adolescent subpopulations who may be at higher risk of poor SRH outcomes. The study was conducted among girls aged 14-24 in 22 secondary schools in Accra, Ghana. The mHealth intervention was an interactive mobile phone quiz in which participants could win phone credit for texting correct answers to SRH questions. We use detailed data on individuals' level of engagement with the program, SRH knowledge scores, and self-reported pregnancy collected as part of the original trial to assess the extent to which engagement and program impact vary across parental education, sexual experience, SRH knowledge deficit, and parental support. Eighty-one percent of participants engaged with the mHealth program, with no evidence that the program disproportionally reached better-off groups. The program was effective at increasing knowledge of SRH across all strata. Higher levels of engagement were associated with higher knowledge scores up to year later. There was no significant impact of the program on self-reported pregnancy within subgroups. mHealth programs for adolescents have the potential to engage and increase SRH knowledge of adolescent girls across sociodemographic strata, including those who may be at higher risk of poor SRH outcomes. ClinicalTrials.gov NCT02031575 . Registered 07 Jan 2014.

  17. A systematic review of the evidence concerning the economic impact of employee-focused health promotion and wellness programs.

    Science.gov (United States)

    Lerner, Debra; Rodday, Angie Mae; Cohen, Joshua T; Rogers, William H

    2013-02-01

    To assess the evidence regarding the economic impact of worker health promotion programs. Peer-reviewed research articles were identified from a database search. Included articles were published between January 2000 and May 2010, described a study conducted in the United States that used an experimental or quasi-experimental study design and analyzed medical, pharmacy (direct), and/or work productivity (indirect) costs. A multidisciplinary review team, following specific criteria, assessed research quality. Of 2030 retrieved articles, 44 met study inclusion criteria. Of these, 10 were of sufficient quality to be considered evidentiary. Only three analyzed direct and indirect costs. Evidence regarding economic impact is limited and inconsistent. Higher-quality research is needed to demonstrate the value of specific programs.

  18. Empirical Evidence in Support of a Research-Informed Water Conservation Education Program

    Science.gov (United States)

    Thompson, Ruthanne; Serna, Victoria Faubion

    2016-01-01

    Based on results from a 2008 research study of regional citizen knowledge concerning watershed issues, a water conservation education program was designed and implemented. Findings from the initial study demonstrated program success as evidenced by knowledge gain and willingness to "commit" to water saving behaviors in 94% of students. A…

  19. An In-Depth Analysis of Learning Goals in Higher Education: Evidence from the Programming Education

    Science.gov (United States)

    Xia, Belle Selene

    2017-01-01

    Previous research has shown that, despite the importance of programming education, there is limited research done on programming education experiences from the students' point of view and the need to do so is strong. By understanding the student behaviour, their learning styles, their expectation and motivation to learn, the quality of teaching…

  20. Effectiveness of a parent training program in (pre)adolescence: Evidence from a randomized controlled trial

    NARCIS (Netherlands)

    Leijten, P.H.O.; Overbeek, G.J.; Janssens, J.M.A.M.

    2012-01-01

    The present randomized controlled trial examined the effectiveness of the parent training program Parents and Children Talking Together (PCTT) for parents with children in the preadolescent period who experience parenting difficulties. The program is focused on reducing child problem behavior by

  1. Does Competition Improve Public Schools? New Evidence from the Florida Tax-Credit Scholarship Program

    Science.gov (United States)

    Figlio, David; Hart, Cassandra M. D.

    2011-01-01

    Programs that enable students to attend private schools, including both vouchers and scholarships funded with tax credits, have become increasingly common in recent years. This study examines the impact of the nation's largest private school scholarship program on the performance of students who remain in the public schools. The Florida Tax Credit…

  2. Perceived barriers to completing an e-learning program on evidence-based medicine

    Directory of Open Access Journals (Sweden)

    Marie-Pierre Gagnon

    2007-06-01

    Conclusions This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

  3. Utilizing Secondary Agricultural Education Programs to Deliver Evidence-Based Grain Safety Training for Young and Beginning Workers.

    Science.gov (United States)

    Cheng, Yuan-Hsin; Field, William E; Tormoehlen, Roger L; French, Brian F

    2017-01-01

    Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted

  4. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

    Science.gov (United States)

    Breckenridge-Sproat, Sara T; Throop, Meryia D; Raju, Dheeraj; Murphy, Deborah A; Loan, Lori A; Patrician, Patricia A

    2015-01-01

    This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an evidence-based practice (EBP) culture among nurses in a military healthcare setting. The need to identify gaps in practice, apply principles of EBP, and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: the Organizational Readiness for System-wide Integration of Evidence-Based Practice, EBP Beliefs, and EBP Implementation scales. The study took place in 3 military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Three hundred sixty nurses (38%) completed baseline, and 325 (31%) completed follow-up surveys. Scores improved on all 3 measures following implementation of the program; however, the differences were statistically significant only for the Organizational Readiness for System-wide Integration of Evidence-Based Practice scale (70.96 vs 77.63, t = -3.95, P culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition.

  5. The criminal justice outcomes of jail diversion programs for persons with mental illness: a review of the evidence.

    Science.gov (United States)

    Sirotich, Frank

    2009-01-01

    Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement. A structured literature search identified 21 publications or research papers for review that examined the criminal justice outcomes of various diversion models. The review revealed little evidence of the effectiveness of jail diversion in reducing recidivism among persons with serious mental illness. However, evidence was found that jail diversion initiatives can reduce the amount of jail time that persons with mental illness serve. Implications for practice and research are discussed.

  6. Lessons Learned from A System-Wide Evidence-Based Practice Program Implementation

    Science.gov (United States)

    2017-04-25

    incorporating scientific evidence, clinical expertise and the patient’s values and preferences to provide quality healthcare . Despite growing...MEMORANDUM FOR ST DEPARTMENT OF THE AIR FORCE 59TH MEDICAL WING (AETC) JOINT BASE SAN ANTONIO - LACKLAND TEXAS ATTN: LT COL JACQUELINE KILLIAN...FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 14 FEB 2017 1. Your paper, entitled Lesson Learned From A System-Wide Evidence- Based

  7. Multiple impacts of an intergenerational program in Japan: Evidence from the Research on Productivity through Intergenerational Sympathy Project.

    Science.gov (United States)

    Yasunaga, Masashi; Murayama, Yoh; Takahashi, Tomoya; Ohba, Hiromi; Suzuki, Hiroyuki; Nonaka, Kumiko; Kuraoka, Masataka; Sakurai, Ryota; Nishi, Mariko; Sakuma, Naoko; Kobayashi, Erika; Shinkai, Shoji; Fujiwara, Yoshinori

    2016-03-01

    Compelling evidence supporting the benefits of social engagement in older adults has been increasingly discussed. However, knowledge regarding an intergenerational program is limited. Herein, we provide a targeted review of intergenerational programs by focusing on our novel interventional program, Research on Productivity through Intergenerational Sympathy. The Research on Productivity through Intergenerational Sympathy program is an intergenerational picture-book reading program launched in 2004. Participants were involved a 3-month intensive weekly training seminar comprising classes about book selection, reading techniques and basic knowledge of children's school life. Subsequently, they participated in group activities that involved playing a hand game, and reading picture books to children at kindergartens, elementary schools and public childcare centers, once every 1-2 weeks. The Research on Productivity through Intergenerational Sympathy program has shown improvement of physical and psychological functioning of older adults and healthy upbringing of children. Similarly, Experience Corps - designed to train and place volunteers in participating elementary schools for an academic year during which time they assist teachers - also showed positive effects for older adults' health status and the psychological/academic success of young children in the USA. Health promotion efforts for older adults must support social policy for the creation of meaningful service programs for older adults on a large social scale. As such, an intergenerational program based on the concept of social capital, defined as "features of social organization, such as trust, norms and networks, that can improve the efficacy of society by facilitating coordinated actions," is an effective and sustainable program for health promotion among older adults. © 2016 Japan Geriatrics Society.

  8. Communicating Program Outcomes to Encourage Policymaker Support for Evidence-Based State Tobacco Control

    Directory of Open Access Journals (Sweden)

    Allison M. Schmidt

    2014-12-01

    Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  9. Communicating program outcomes to encourage policymaker support for evidence-based state tobacco control.

    Science.gov (United States)

    Schmidt, Allison M; Ranney, Leah M; Goldstein, Adam O

    2014-12-04

    Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003-2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state's role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

  10. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    Science.gov (United States)

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  11. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

  12. Increasing access to evidence-based smoking cessation treatment: effectiveness of a free nicotine patch program among Chinese immigrants.

    Science.gov (United States)

    Shelley, Donna; Nguyen, Nam; Peng, Cha-Hui; Chin, Margaret; Chang, Ming-der; Fahs, Marianne

    2010-04-01

    Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

  13. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program.

    Science.gov (United States)

    Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee

    2016-01-01

    Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n  = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more

  14. Assessing parent education programs for families involved with child welfare services: evidence and implications.

    Science.gov (United States)

    Johnson, Michelle; Stone, Susan; Lou, Christine; Ling, Jennifer; Claassen, Jennette; Austin, Michael J

    2008-01-01

    Parent education programs may be offered or mandated at various stages of the child welfare services continuum. However, little is known regarding their efficacy in addressing the parenting problems that bring families to the attention of child welfare services. This article synthesizes outcome data generated from 58 parenting programs with families determined to be at-risk of child maltreatment and/or abusive or neglectful. It places parent education programs within the broader context of research on effective parenting as well as the leading etiological models of child maltreatment to assess the evaluations of these programs with regard to methodological rigor as well as theoretical salience. Practical and theoretical implications are presented along with recommendations for future research.

  15. Can Authorization Reduce Poverty among Undocumented Immigrants? Evidence from the Deferred Action for Childhood Arrivals Program

    OpenAIRE

    Amuedo-Dorantes, Catalina; Antman, Francisca M.

    2016-01-01

    We explore the impact of authorization on the poverty exposure of households headed by undocumented immigrants. The identification strategy makes use of the 2012 Deferred Action for Childhood Arrivals (DACA) program, which provided a temporary work authorization and reprieve from deportation to eligible immigrants. Using a difference-in-differences approach, we compare DACA-eligible to DACA-ineligible likely unauthorized immigrants, before and after the program implementation. We find that DA...

  16. Culture and Human Capital Investments: Evidence of an Unconditional Cash Transfer Program in Bolivia

    OpenAIRE

    Yanez-Pagans, Monica

    2008-01-01

    This paper uses a policy quasi-experiment created by the introduction of an old-age unconditional cash transfer program in Bolivia to study the intra-household income allocation process towards children's educational expenditure by ethnicity and gender of the recipient. Taking advantage of a sharp discontinuity created by the program assignment mechanism, I investigate the heterogeneity in the patterns of allocation within indigenous, multiethnic, and non-indigenous families, conditional on h...

  17. Getting Back to Living: Further Evidence for the Efficacy of an Interdisciplinary Pediatric Pain Treatment Program.

    Science.gov (United States)

    Bruce, Barbara K; Ale, Chelsea M; Harrison, Tracy E; Bee, Susan; Luedtke, Connie; Geske, Jennifer; Weiss, Karen E

    2017-06-01

    This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at 3-month follow-up. Participants included 171 adolescents (12 to 18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up. Similar to other interdisciplinary pediatric pain rehabilitation program outcome studies, significant improvements were observed at the end of the program. These improvements appeared to be maintained or further improved at 3-month follow-up. Nearly 14% of the patients were taking daily opioid medication at admission to the program. All adolescents were completely tapered off of these medications at the end of the 3-week program and remained abstinent at 3-month follow-up. This study adds to the available data supporting interdisciplinary pediatric pain rehabilitation as effective in improving functioning and psychological distress even when discontinuing opioids. Implications for future research and limitations of the study are discussed.

  18. NGO-promoted microcredit programs and women's empowerment in rural Bangladesh: quantitative and qualitative evidence.

    Science.gov (United States)

    Amin, R; Becker, S; Bayes, A

    1998-01-01

    Nongovernmental organizations (NGOs) in rural Bangladesh are reaching out to poor women with collateral-free credit programs aimed at both alleviating poverty and increasing women's status. The present study investigated the hypothesis that participation in credit-related activities by NGO credit members leads to greater empowerment of credit members compared to nonmembers. The sample was comprised of 1164 loanees and 1200 nonloanees from the five NGO areas in Bangladesh and of 1200 nonloanees from non-program areas of rural Bangladesh with no significant NGO presence. NGO credit members had significantly higher scores on all three indices of female empowerment: inter-spouse consultation, autonomy, and authority. Moreover, nonmembers within NGO program areas had higher autonomy and authority scores than nonmembers within the comparison areas. Even after background variables were controlled in the multivariate analysis, NGO credit membership and residence in an NGO program area remained significantly and positively associated with both the autonomy and authority indices. Other variables that exerted a significant positive effect on women's empowerment were concrete or corrugated buildings, area of residence outside the southern or eastern regions, nonagricultural occupation, respondent's education, and age. In focus group discussions, NGO credit loanees reported that the program made them more confident, assertive, intelligent, self-reliant, and aware of their rights. NGO credit programs that target poor women are likely to produce substantial improvements in women's social and economic status, without the long delays associated with education or employment opportunities in the formal sector.

  19. Teacher Research Experiences: Impacting and Benefiting Teacher Professional Development and School-wide Practices (Invited)

    Science.gov (United States)

    Manning, C. B.

    2013-12-01

    conduct research projects. Currently, I work with other science teachers creating student-driven research opportunities that involve designing and carrying out experiments, reading scientific literature, and evaluating evidence. Depending on the grade level, students also work across disciplines with teachers in English, Math, and Social Studies to develop research projects, report on results and evaluate the work of other student groups. My ARMADA experience emphasized the importance of ensuring that students understand and implement proper protocols, value academic integrity, and civic responsibility. In our program, students learn valuable teamwork and leadership skills, build on experiences from one year to the next, and develop a sense of pride in their own learning endeavors. While we do not expect every student to pursue a STEM career, we do expect our students to think critically, solve problems in a logical manner, and invest in their own creativity.

  20. Designing Incentives for Public School Teachers: Evidence from a Texas Incentive Pay Program

    Science.gov (United States)

    Springer, Matthew G.; Taylor, Lori L.

    2016-01-01

    Pay-for-performance is a popular public education reform, but there is little evidence about the characteristics of a well-designed incentive pay plan for teachers. Some of the literature suggests that effective incentive plans must offer relatively large awards to induce behavioral changes. On the other hand, the experimental economics literature…

  1. The Economic Impact of Social Media on Small Businesses: Evidence from Three Mississippi Extension Programs

    OpenAIRE

    Barnes, James N.; Hood, Ken; Gallardo, Roberto

    2014-01-01

    With many social media companies now in the marketplace, it behooves small businesses not to use these outlets to market their products, especially rural businesses. In this paper, we discuss some of the economic impacts of using online social networks and provide case study evidence from Mississippi.

  2. Videoconferencing of a national program for residents on evidence-based practice: early performance evaluation.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2010-01-01

    The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site.

  3. Primary prevention of metabolic syndrome in the community using an evidence-based exercise program.

    Science.gov (United States)

    Dalleck, Lance C; Van Guilder, Gary P; Quinn, Esther M; Bredle, Don L

    2013-10-01

    The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors. MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire. Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (pexercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Determinants of malaria program expenditures during elimination: case study evidence from select provinces in the Philippines.

    Directory of Open Access Journals (Sweden)

    Jenny X Liu

    Full Text Available ...Even though eliminating malaria from the endemic margins is a part of the Global Malaria Action Plan, little guidance exists on what resources are needed to transition from controlling malaria to eliminating it. Using Philippines as an example, this study aimed to (1 estimate the financial resources used by sub-national malaria programs in different phases during elimination and (2 understand how different environmental and organizational factors may influence expenditure levels and spending proportions. The Philippines provides an opportunity to study variations in sub-national programs because its epidemiological and ecological diversity, devolved health system, and progressive elimination strategy all allow greater flexibility for lower-level governments to direct activities, but also create challenges for coordination and resource mobilization. Through key informant interviews and archival record retrieval in four selected provinces chosen based on eco-epidemiological variation, expenditures associated with provincial malaria programs were collected for selected years (mid-1990s to 2010. Results show that expenditures per person at risk per year decrease as programs progress from a state of controlled low-endemic malaria to elimination to prevention of reintroduction regardless of whether elimination was deliberately planned. However, wide variation across provinces were found: expenditures were generally higher if mainly financed with donor grants, but were moderated by the level of economic development, the level of malaria transmission and receptivity, and the capacity of program staff. Across all provinces, strong leadership appears to be a necessary condition for maintaining progress and is vital in controlling outbreaks. While sampled provinces and years may not be representative of other sub-national malaria programs, these findings suggest that the marginal yearly cost declines with each phase during elimination.

  5. Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs.

    Science.gov (United States)

    Dietze, Paul M; Draper, Bridget; Olsen, Anna; Chronister, Karen J; van Beek, Ingrid; Lintzeris, Nicholas; Dwyer, Robyn; Nelson, Marina; Lenton, Simon

    2018-02-22

    Take-home naloxone (THN) programs have been operating in Australia since 2012 in a variety of settings. We examine whether THN programs were effective in increasing knowledge about opioid overdose and appropriate responses in program participants. Data were obtained from pre- and post-training questionnaires administered as part of the early evaluations of THN naloxone programs operated in Sydney (n = 67), Melbourne (n = 280), Perth (n = 153) and Canberra (n = 183). Pooled data from comparable items, analysed in the domains specified in previously-developed evaluation scales, were compared using repeated-measures analysis of variance and random effects logistic regression. Results pre- and post-training were compared as well as results across sites. High levels of knowledge about overdose risks and signs and appropriate actions to take were observed at baseline and this generally improved over time. No substantial differences were identified across cities. Knowledge also increased with participant age but the improvements over time were similar in each age group. There were small differences by participant gender with knowledge generally higher among females. THN programs are effective in improving knowledge related to overdose response. Major improvements in knowledge were limited to overdose recognition and effect of naloxone suggesting that education may best be focused on overdose signs and the use of naloxone among populations accessed through these programs. A focus on younger people also appears warranted. Further work is needed to understand the impact of training and knowledge on actual behaviours around overdose events. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  6. Determinants of malaria program expenditures during elimination: case study evidence from select provinces in the Philippines.

    Science.gov (United States)

    Liu, Jenny X; Newby, Gretchen; Brackery, Aprielle; Smith Gueye, Cara; Candari, Christine J; Escubil, Luz R; Vestergaard, Lasse S; Baquilod, Mario

    2013-01-01

    ...Even though eliminating malaria from the endemic margins is a part of the Global Malaria Action Plan, little guidance exists on what resources are needed to transition from controlling malaria to eliminating it. Using Philippines as an example, this study aimed to (1) estimate the financial resources used by sub-national malaria programs in different phases during elimination and (2) understand how different environmental and organizational factors may influence expenditure levels and spending proportions. The Philippines provides an opportunity to study variations in sub-national programs because its epidemiological and ecological diversity, devolved health system, and progressive elimination strategy all allow greater flexibility for lower-level governments to direct activities, but also create challenges for coordination and resource mobilization. Through key informant interviews and archival record retrieval in four selected provinces chosen based on eco-epidemiological variation, expenditures associated with provincial malaria programs were collected for selected years (mid-1990s to 2010). Results show that expenditures per person at risk per year decrease as programs progress from a state of controlled low-endemic malaria to elimination to prevention of reintroduction regardless of whether elimination was deliberately planned. However, wide variation across provinces were found: expenditures were generally higher if mainly financed with donor grants, but were moderated by the level of economic development, the level of malaria transmission and receptivity, and the capacity of program staff. Across all provinces, strong leadership appears to be a necessary condition for maintaining progress and is vital in controlling outbreaks. While sampled provinces and years may not be representative of other sub-national malaria programs, these findings suggest that the marginal yearly cost declines with each phase during elimination.

  7. Unpacking the performance of a mobile health information messaging program for mothers (MomConnect) in South Africa: evidence on program reach and messaging exposure.

    Science.gov (United States)

    LeFevre, Amnesty E; Dane, Pierre; Copley, Charles J; Pienaar, Cara; Parsons, Annie Neo; Engelhard, Matt; Woods, David; Bekker, Marcha; Benjamin, Peter; Pillay, Yogan; Barron, Peter; Seebregts, Christopher John; Mohan, Diwakar

    2018-01-01

    Despite calls to address broader evidence gaps in linking digital technologies to outcome and impact level health indicators, limited attention has been paid to measuring processes pertaining to the performance of programs. In this paper, we assess the program reach and message exposure of a mobile health information messaging program for mothers (MomConnect) in South Africa. In this descriptive study, we draw from system generated data to measure exposure to the program through registration attempts and conversions, message delivery, opt-outs and drop-outs. Using a logit model, we additionally explore determinants for early registration, opt-outs and drop-outs. From August 2014 to April 2017, 1 159 431 women were registered to MomConnect; corresponding to half of women attending antenatal care 1 (ANC1) and nearly 60% of those attending ANC1 estimated to own a mobile phone. In 2016, 26% of registrations started to get women onto MomConnect did not succeed. If registration attempts were converted to successful registrations, coverage of ANC1 attendees would have been 74% in 2016 and 86% in 2017. When considered as percentage of ANC1 attendees with access to a mobile phone, addressing conversion challenges bring registration coverage to an estimated 83%-89% in 2016 and 97%-100% in 2017. Among women registered, nearly 80% of expected short messaging service messages were received. While registration coverage and message delivery success rates exceed those observed for mobile messaging programs elsewhere, study findings highlight opportunities for program improvement and reinforce the need for rigorous and continuous monitoring of delivery systems.

  8. Evidence-Based Social Skills Training for Adolescents with Autism Spectrum Disorders: The UCLA PEERS Program

    Science.gov (United States)

    Laugeson, Elizabeth A.; Frankel, Fred; Gantman, Alexander; Dillon, Ashley R.; Mogil, Catherine

    2012-01-01

    The present study examines the efficacy and durability of the PEERS Program, a parent-assisted social skills group intervention for high-functioning adolescents with ASD. Results indicate that teens receiving PEERS significantly improved their social skills knowledge, social responsiveness, and overall social skills in the areas of social…

  9. Speech Motor Programming in Apraxia of Speech: Evidence from a Delayed Picture-Word Interference Task

    Science.gov (United States)

    Mailend, Marja-Liisa; Maas, Edwin

    2013-01-01

    Purpose: Apraxia of speech (AOS) is considered a speech motor programming impairment, but the specific nature of the impairment remains a matter of debate. This study investigated 2 hypotheses about the underlying impairment in AOS framed within the Directions Into Velocities of Articulators (DIVA; Guenther, Ghosh, & Tourville, 2006) model: The…

  10. Peer monitoring, social ties and moral hazard in group lending programs : Evidence from Eritrea

    NARCIS (Netherlands)

    Hermes, N; Lensink, R; Mehrteab, HT

    In this paper, we investigate the impact of monitoring and social ties on moral hazard behavior within group lending programs. Our study is based on data from an extensive questionnaire held in Eritrea among participants of 102 groups. We separately analyze the impact of group leaders and other

  11. The Repeated School-to-Work Transition: Evidence from a Dynamic Programming Model

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt

    by youths after high school graduation. It is assumed that the decision is taken year by year, and it is analyzed in a discrete choice dynamic programming model. In this forward-looking behavioral model, it is shown that a small bonus would remove interruptions of the educational careers just after high...

  12. Public Value Posters: Conveying Societal Benefits of Extension Programs through Evaluation Evidence

    Science.gov (United States)

    Chazdon, Scott; Meyer, Nathan; Mohr, Caryn; Troschinetz, Alexis

    2017-01-01

    The public value poster session is a new tool for effectively demonstrating and reporting the public value of Extension programming. Akin to the research posters that have long played a critical role in the sharing of findings from academic studies, the public value poster provides a consistent format for conveying the benefits to society of…

  13. The role of managerial stock option programs in governance: evidence from REIT stock repurchases

    NARCIS (Netherlands)

    Ghosh, C.; Giambona, E.; Harding, J.P.; Sezer, O.; Sirmans, C.F.

    2010-01-01

    This article examines the role of stock option programs and executive holdings of stock options in real estate investment trust (REIT) governance. We study the issue by analyzing how the market reaction to a stock repurchase announcement varies as a function of the individual REIT's governance

  14. Performance and prospects of payments for ecosystem services programs: evidence from China.

    Science.gov (United States)

    Yang, Wu; Liu, Wei; Viña, Andrés; Luo, Junyan; He, Guangming; Ouyang, Zhiyun; Zhang, Hemin; Liu, Jianguo

    2013-09-30

    Systematic evaluation of the environmental and socioeconomic effects of Payments for Ecosystem Services (PES) programs is crucial for guiding policy design and implementation. We evaluated the performance of the Natural Forest Conservation Program (NFCP), a national PES program of China, in the Wolong Nature Reserve for giant pandas. The environmental effects of the NFCP were evaluated through a historical trend (1965-2001) analysis of forest cover to estimate a counter-factual (i.e., without-PES) forest cover baseline for 2007. The socioeconomic effects of the NFCP were evaluated using data collected through household interviews carried out before and after NFCP implementation in 2001. Our results suggest that the NFCP was not only significantly associated with increases in forest cover, but also had both positive (e.g., labor reduction for fuelwood collection) and negative (e.g., economic losses due to crop raiding by wildlife) effects on local households. Results from this study emphasize the importance of integrating local conditions and understanding underlying mechanisms to enhance the performance of PES programs. Our findings are useful for the design and implementation of successful conservation policies not only in our study area but also in similar places around the world. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Marital status and HIV prevalence among women in Nigeria: Ingredients for evidence-based programming

    Directory of Open Access Journals (Sweden)

    Adeniyi Francis Fagbamigbe

    2016-07-01

    Conclusion: Being formerly married, under 15 years of age at first sex, and having engaged in transactional sex were found to be the strongest HIV risk factors among women. Besides empowering formerly married women and providing better social security, these women should be targeted in HIV programming and policies.

  16. Florida Public Health Training Center: Evidence-Based Online Mentor Program

    Science.gov (United States)

    Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

    2013-01-01

    This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

  17. Early Childhood Education Intervention Programs in the Netherlands: Still Searching for Empirical Evidence

    Science.gov (United States)

    Driessen, Geert

    2018-01-01

    Early childhood education (ECE) intervention programs nowadays are the core of the educational disadvantage policy in the Netherlands. They offer institutional compensatory activities to young children who lack educational stimulation in the home environment. Target groups mainly comprise children from deprived socioeconomic backgrounds and of…

  18. Decentralization and Educational Performance: Evidence from the PROHECO Community School Program in Rural Honduras

    Science.gov (United States)

    Di Gropello, Emanuela; Marshall, Jeffery H.

    2011-01-01

    We analyze the effectiveness of the Programa Hondureno de Educacion Comunitaria (PROHECO) community school program in rural Honduras. The data include standardized tests and extensive information on school, teacher, classroom and community features for 120 rural schools drawn from 15 states. Using academic achievement decompositions we find that…

  19. Who Carries the Burden of Reproductive Health and AIDS Programs? - Evidence from OECD Donor Countries

    NARCIS (Netherlands)

    H.P. van Dalen (Hendrik)

    2006-01-01

    textabstractThis paper tries to establish who carries the burden in supporting reproductive health and AIDS programs worldwide. The 1994 International Conference of Population and Development (ICPD) in Cairo established goals for the expansion of assistance in matters of reproductive health and

  20. Empirically Supported Psychotherapy in Social Work Training Programs: Does the Definition of Evidence Matter?

    Science.gov (United States)

    Bledsoe, Sarah E.; Weissman, Myrna M.; Mullen, Edward J.; Ponniah, Kathryn; Gameroff, Marc J.; Verdeli, Helen; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2007-01-01

    Objectives: A national survey finds that 62% of social work programs do not require didactic and clinical supervision in any empirically supported psychotherapy (EST). The authors report the results of analysis of national survey data using two alternative classifications of EST to determine if the results are because of the definition of EST used…

  1. The SOS Suicide Prevention Program: Further Evidence of Efficacy and Effectiveness.

    Science.gov (United States)

    Schilling, Elizabeth A; Aseltine, Robert H; James, Amy

    2016-02-01

    This study replicated and extended previous evaluations of the Signs of Suicide (SOS) prevention program in a high school population using a more rigorous pre-test post-test randomized control design than used in previous SOS evaluations in high schools (Aseltine and DeMartino 2004; Aseltine et al. 2007). SOS was presented to an ethnically diverse group of ninth grade students in technical high schools in Connecticut. After controlling for the pre-test reports of suicide behaviors, exposure to the SOS program was associated with significantly fewer self-reported suicide attempts in the 3 months following the program. Ninth grade students in the intervention group were approximately 64% less likely to report a suicide attempt in the past 3 months compared with students in the control group. Similarly, exposure to the SOS program resulted in greater knowledge of depression and suicide and more favorable attitudes toward (1) intervening with friends who may be exhibiting signs of suicidal intent and (2) getting help for themselves if they were depressed or suicidal. In addition, high-risk SOS participants, defined as those with a lifetime history of suicide attempt, were significantly less likely to report planning a suicide in the 3 months following the program compared to lower-risk participants. Differential attrition is the most serious limitation of the study; participants in the intervention group who reported a suicide attempt in the previous 3 months at baseline were more likely to be missing at post-test than their counterparts in the control group.

  2. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

    Science.gov (United States)

    Choma, Kim; McKeever, Amy E

    2015-02-01

    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  3. A framework for developing an evidence-based, comprehensive tobacco control program

    Directory of Open Access Journals (Sweden)

    Shacham Galia

    2010-05-01

    Full Text Available Abstract Background Tobacco control is an area where the translation of evidence into policy would seem to be straightforward, given the wealth of epidemiological, behavioural and other types of research available. Yet, even here challenges exist. These include information overload, concealment of key (industry-funded evidence, contextualization, assessment of population impact, and the changing nature of the threat. Methods In the context of Israel's health targeting initiative, Healthy Israel 2020, we describe the steps taken to develop a comprehensive tobacco control strategy. We elaborate on the following: a scientific issues influencing the choice of tobacco control strategies; b organization of existing evidence of effectiveness of interventions into a manageable form, and c consideration of relevant philosophical and political issues. We propose a framework for developing a plan and illustrate this process with a case study in Israel. Results Broad consensus exists regarding the effectiveness of most interventions, but current recommendations differ in the emphasis they place on different strategies. Scientific challenges include integration of complex and sometimes conflicting information from authoritative sources, and lack of estimates of population impact of interventions. Philosophical and political challenges include the use of evidence-based versus innovative policymaking, the importance of individual versus governmental responsibility, and whether and how interventions should be prioritized. The proposed framework includes: 1 compilation of a list of potential interventions 2 modification of that list based on local needs and political constraints; 3 streamlining the list by categorizing interventions into broad groupings of related interventions; together these groupings form the basis of a comprehensive plan; and 4 refinement of the plan by comparing it to existing comprehensive plans. Conclusions Development of a comprehensive

  4. A framework for developing an evidence-based, comprehensive tobacco control program.

    Science.gov (United States)

    Rosen, Laura; Rosenberg, Elliot; McKee, Martin; Gan-Noy, Shosh; Levin, Diane; Mayshar, Elana; Shacham, Galia; Borowski, John; Nun, Gabi Bin; Lev, Boaz

    2010-05-27

    Tobacco control is an area where the translation of evidence into policy would seem to be straightforward, given the wealth of epidemiological, behavioural and other types of research available. Yet, even here challenges exist. These include information overload, concealment of key (industry-funded) evidence, contextualization, assessment of population impact, and the changing nature of the threat. In the context of Israel's health targeting initiative, Healthy Israel 2020, we describe the steps taken to develop a comprehensive tobacco control strategy. We elaborate on the following: a) scientific issues influencing the choice of tobacco control strategies; b) organization of existing evidence of effectiveness of interventions into a manageable form, and c) consideration of relevant philosophical and political issues. We propose a framework for developing a plan and illustrate this process with a case study in Israel. Broad consensus exists regarding the effectiveness of most interventions, but current recommendations differ in the emphasis they place on different strategies. Scientific challenges include integration of complex and sometimes conflicting information from authoritative sources, and lack of estimates of population impact of interventions. Philosophical and political challenges include the use of evidence-based versus innovative policymaking, the importance of individual versus governmental responsibility, and whether and how interventions should be prioritized.The proposed framework includes: 1) compilation of a list of potential interventions 2) modification of that list based on local needs and political constraints; 3) streamlining the list by categorizing interventions into broad groupings of related interventions; together these groupings form the basis of a comprehensive plan; and 4) refinement of the plan by comparing it to existing comprehensive plans. Development of a comprehensive tobacco control plan is a complex endeavour, involving

  5. Extending the Direct Behavior Rating: An Examination of Schoolwide Behavior Ratings and Academic Engagement

    Science.gov (United States)

    Bruhn, Allison; Barron, Sheila; Fernando, Josephine; Balint-Langel, Kinga

    2018-01-01

    Direct behavior ratings have been identified as a practical and feasible alternative to direct observation of behavior for monitoring behavioral progress. Despite the evidence of usability, there have been calls for further examination of direct behavior ratings using different behaviors and scales. To this end, we examined the ratings of…

  6. A Contextual Consideration of Culture and School-Wide Positive Behavior Support

    Science.gov (United States)

    Sugai, George; O'Keeffe, Breda V.; Fallon, Lindsay M.

    2012-01-01

    Students from culturally and linguistically diverse backgrounds have historically experienced poor outcomes related to academic achievement, special education, school discipline and climate, and juvenile justice. Differences between home and school cultures likely contribute to these outcomes. Evidence-based practices in schools are promoted to…

  7. Evidence-based practice instruction by faculty members and librarians in North American optometry and ophthalmology programs.

    Science.gov (United States)

    MacDonald, Katherine A; Hrynchak, Patricia K; Spafford, Marlee M

    2014-07-01

    North American optometry and ophthalmology faculty members and vision science librarians were surveyed online (14% response rate) about teaching evidence-based practice (EBP). Similar to studies of other health care programs, all five EBP steps (Ask, Acquire, Appraise, Apply, Assess) were taught to varying degrees. Optometry and ophthalmology EBP educators may want to place further emphasis on (1) the Apply and Assess steps, (2) faculty- and student-generated questions and self-assessment in clinical settings, (3) online teaching strategies, (4) programmatic integration of EBP learning objectives, and (5) collaboration between faculty members and librarians.

  8. Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil

    Directory of Open Access Journals (Sweden)

    Simone Bohn

    2014-09-01

    Full Text Available This article examines whether the state, through conditional cash transfer programs (CCT, can reduce the poverty and extremely poverty in societies marred by high levels of income concentration. We focus on one of the most unequal countries in the globe, Brazil, and analyze the extent to which this country's CCT program - Bolsa Família (BF, Family Grant program - is able to improve the life chances of extremely poor beneficiaries, through the three major goals of PBF: First, to immediately end hunger; second, to create basic social rights related to healthcare and education; finally, considering also complementary policies, to integrate adults into the job market. The analysis relies on a quantitative survey with 4,000 beneficiaries and a qualitative survey comprised of in-depth interviews with 38 program's participants from all the regions of the country in 2008, it means that this study is about the five first years of the PBF. In order to answer the research questions, we ran four probit analyses related: a the determinants of the realization of prenatal care; b the determinants of food security among BF beneficiaries, c the determinants that adult BF recipients will return to school, d the determinants that a BF beneficiary will obtain a job. Important results from the study are: First, those who before their participation on PBF were at the margins have now been able to access healthcare services on a more regular basis. Thus, the women at the margins who were systematically excluded - black women, poorly educated and from the North - now, after their participation in the CCT program, have more access to prenatal care and can now count with more availability of public healthcare network. Second, before entering the Bolsa Família program, 50.3% of the participants faced severe food insecurity. This number went down to 36.8% in very five years. Men are more likely than women; non-blacks more likely than blacks; and South and Centre

  9. Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs.

    Science.gov (United States)

    Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M

    2018-01-01

    Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.

  10. Young driver distraction: state of the evidence and directions for behavior change programs.

    Science.gov (United States)

    Buckley, Lisa; Chapman, Rebekah L; Sheehan, Mary

    2014-05-01

    Adolescent drivers are overrepresented in distraction-related motor vehicle crashes. A number of potential reasons for such an elevated risk include driving inexperience, high adoption of communication technology, increased peer involvement, and tendency to take risks, which render young drivers particularly vulnerable. Major legislative efforts in Graduated Licensing Systems that include passenger restrictions have shown positive effects. Restrictions on cell phone use are also being introduced; however, it is challenging to enforce such regulations. This article argues that such contextual, legislative interventions are an essential prevention strategy, but there is an unfilled need to introduce behavior change programs that may target adolescents, parents, and friends. A theoretical framework is applied in which risk and protective factors are identified from research within the contexts of community and jurisdiction. In the literature on distraction, social context and normative influences are key elements used to inform program design for adolescent drivers, with parental monitoring informing interventions targeting parents. Following from this assessment of the message content assessment, the design of strategies to deliver the messages is reviewed. In the current literature, school-based programs, simulations, and Web-delivered programs have been evaluated with supplementary strategies delivered by physicians and parents. Such developments are still at an early stage of development, and ultimately will need controlled implementation and evaluation studies. Of course, there is no likely single approach to prevent adolescent driver distraction. Complementary approaches such as the further development of technological interventions to manage phone use are needed. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Consumer engagement and the development, evaluation and dissemination of evidence-based parenting programs

    OpenAIRE

    Sanders, Matthew R.; Kirby, James N.

    2011-01-01

    A consumer perspective can contribute much to enhancing the “ecological fit” of population level parenting interventions so they meet the needs of parents. This approach involves building relationships with consumer groups and soliciting consumer input into the relevance and acceptability of interventions, clarifying the enablers and barriers to engagement and involvement of parents, and clarifying variables that influence a parent’s program completion. The adoption of a more collaborative ap...

  12. Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency

    Directory of Open Access Journals (Sweden)

    James P. Wirth

    2017-02-01

    Full Text Available Vitamin A supplementation (VAS programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but amidst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD data. We found that two-thirds of the countries explored either have no VAD data or data that were >10 years old (i.e., measured before 2006, which included twenty countries with VAS coverage ≥70%. Fifty-one VAS programs were implemented in parallel with at least one other VA intervention, and of these, 27 countries either had no VAD data or data collected in 2005 or earlier. To fill these gaps in VAD data, countries implementing VAS and other VA interventions should measure VA status in children at least every 10 years. At the same time, the coverage of VA interventions can also be measured. We identified three countries that have scaled down VAS, but given the lack of VA deficiency data, this would be a premature undertaking in most countries without appropriate status assessment. While the global debate about VAS is important, more attention should be directed towards individual countries where programmatic decisions are made.

  13. FM POD: an evidence-based blended teaching skills program for rural preceptors.

    Science.gov (United States)

    Delver, Hilary; Jackson, Wesley; Lee, Sonya; Palacios, Mone

    2014-05-01

    The University of Calgary's Rural Integrated Community Clerkship anchors final-year medical student education in 9 months of family medicine. The purpose of this pilot study was to evaluate the Family Medicine Preceptor Online Development (FM POD) program, designed to meet the faculty development needs of rural preceptors facing challenges of geographical distribution and time constraints. The theoretically based program used a blended learning approach, beginning with a face-to-face workshop to strengthen participants' social presence during online interactions to follow. Asynchronous narrated presentations supplied foundational knowledge prior to facilitated synchronous web conferences, where participants shared experiences and co-constructed new knowledge. The program was evaluated using mixed methods, including surveys and focus group discussion. Evaluation tools generated data with high internal consistency reliability; focus group information substantiated and enriched the quantitative survey data. Participants enjoyed collaborating with colleagues and rated their learning experiences highly, reporting meaningful and statistically significant increases in mean comfort with all the precepting skills taught: giving effective feedback, using questions to teach, teaching communications skills, helping learners in difficulty, and making teaching time-efficient. All effect sizes were large. Increased comfort with distance learning technologies was a positive consequence. Results support the applicability of principles of social constructivism, experiential learning, and reflective learning in these participants. The program was highly rated and effectively increased participants' comfort with teaching skills, offering practical off-the-peg modular faculty development in basic teaching skills for distributed faculty. Participants appreciated the flexible delivery format, which course developers found readily adaptable for additional topics.

  14. Impact Of Microcredit Programs On Higher Income Borrowers: Evidence From Bangladesh

    OpenAIRE

    Sayma Rahman; Rafiqul Bhuyan Rafiq; Mohammad A. Momen

    2011-01-01

    In this study, we investigate the impact of microcredit on economic indicators of borrowers in Bangladesh and compare if the impact is same across borrowers having different income levels. Our estimation results show that the microcredit programs are effective in generating higher income and assets for borrowers in general. However, the impact is not found to be uniform across income levels of borrowers. Higher income borrowers seem to be better off compared to the middle and lower income bor...

  15. How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P

    Directory of Open Access Journals (Sweden)

    Wilson Philip

    2012-11-01

    Full Text Available Abstract Background Interventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal. Methods Evaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis. Results A total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79. Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87. The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest

  16. MATERNAL PERCEPTIONS OF PARENTING FOLLOWING AN EVIDENCE-BASED PARENTING PROGRAM: A QUALITATIVE STUDY OF LEGACY FOR CHILDRENTM.

    Science.gov (United States)

    Hartwig, Sophie A; Robinson, Lara R; Comeau, Dawn L; Claussen, Angelika H; Perou, Ruth

    2017-07-01

    This article presents the findings of a qualitative study of maternal perceptions of parenting following participation in Legacy for Children TM (Legacy), an evidence-based parenting program for low-income mothers of young children and infants. To further examine previous findings and better understand participant experiences, we analyzed semistructured focus-group discussions with predominantly Hispanic and Black, non-Hispanic Legacy mothers at two sites (n = 166) using thematic analysis and grounded theory techniques. The qualitative study presented here investigated how mothers view their parenting following participation in Legacy, allowing participants to describe their experience with the program in their own words, thus capturing an "insider" perspective. Mothers at both sites communicated knowledge and use of positive parenting practices targeted by the goals of Legacy; some site-specific differences emerged related to these parenting practices. These findings align with the interpretation of quantitative results from the randomized controlled trials and further demonstrate the significance of the Legacy program in promoting positive parenting for mothers living in poverty. This study emphasizes the importance of understanding real-world context regarding program efficacy and the benefit of using qualitative research to understand participant experiences. © 2017 Michigan Association for Infant Mental Health.

  17. Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach.

    Science.gov (United States)

    Leyva, Bryan; Allen, Jennifer D; Ospino, Hosffman; Tom, Laura S; Negrón, Rosalyn; Buesa, Richard; Torres, Maria Idalí

    2017-09-01

    Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.

  18. Challenges in knowledge translation: the early years of Cancer Care Ontario's Program in Evidence-Based Care.

    Science.gov (United States)

    Browman, G P

    2012-02-01

    Cancer Care Ontario's Program in Evidence-Based Care (pebc) was formalized in 1997 to produce clinical practice guidelines for cancer management for the Province of Ontario. At the time, the gap between guideline development and implementation was beginning to be acknowledged. The Program implemented strategies to promote use of guidelines. The program had to overcome numerous social challenges to survive. Prospective strategies useful to practitioners-including participation, transparent communication, a methodological vision, and methodology skills development offerings-were used to create a culture of research-informed oncology practice within a broad community of practitioners.Reactive strategies ensured the survival of the program in the early years, when some within the influential academic community and among decision-makers were skeptical about the feasibility of a rigorous methodologic approach meeting the fast turnaround times necessary for policy. The paper details the pebc strategies within the context of what was known about knowledge translation (kt) at the time, and it tries to identify key success factors. Many of the barriers faced in the implementation of kt-and the strategies for overcoming them-are unavailable in the public domain because the relevant reporting does not fit the traditional paradigm for publication. Telling the "stories behind the story" should be encouraged to enhance the practice of kt beyond the science.

  19. Fostering resilience in National Guard and Reserve families: A contextual adaptation of an evidence-based parenting program.

    Science.gov (United States)

    Pinna, Keri L M; Hanson, Sheila; Zhang, Na; Gewirtz, Abigail H

    2017-01-01

    Military deployment of a parent is a risk factor for children's internalizing and externalizing problems. This risk may be heightened in National Guard and Reserve (NG/R) families who tend to be isolated from other NG/R families and do not benefit from the centralized support system available to active duty families living on military bases. Isolation and trauma-related disorders may complicate the adjustment of military families during reintegration. An evidence-based parent training intervention was modified to meet the unique needs of recently deployed NG/R parents and their spouses, and the modified program was evaluated in a randomized controlled trial. The current study examines engagement and satisfaction with the program. Modifications such as employment of military-connected facilitators sought to maximize engagement in and satisfaction with the program. Engagement and satisfaction were examined between mothers and fathers, as well as between groups led by a military-connected facilitator and those led by civilian facilitators. Significantly greater engagement was noted for groups that were led by a military-connected facilitator (p = .01). There were no differences between genders in attendance rates, though greater positive group experiences were reported by mothers versus fathers (p = .01). Results are discussed in the context of engagement and satisfaction reported for similar programs. Implications for working with military families are also considered. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. The Irie Classroom Toolbox: developing a violence prevention, preschool teacher training program using evidence, theory, and practice.

    Science.gov (United States)

    Baker-Henningham, Helen

    2018-05-01

    In this paper, I describe the development of the Irie Classroom Toolbox, a school-based violence prevention, teacher training program for use with children aged 3-6 years. In-depth interviews were conducted with Jamaican preschool teachers, who had participated in a trial of a classroom behavior management program, at posttest (n = 35) and 5 years later (n = 20). An on-going process evaluation was also conducted. Teachers' preferred behavior management strategies and training methods were documented, and enablers and barriers to implementation were identified. Teachers were most likely to adopt strategies that they liked, found easy to use, and were effective. These included paying attention to positive behavior and explicitly teaching children the expected behavior. Teachers preferred active, hands-on training strategies based on social-cognitive theories. Enablers to intervention implementation included positive teacher-facilitator relationships, choice, collaborative problem solving, teachers recognizing benefits of the intervention, group support, and provision of materials. Barriers to intervention implementation were also identified. These data were integrated with behavior change theory (i.e., the behavior change wheel and theoretical domains framework) to develop an intervention grounded in common core elements of evidence-based programs while also utilizing teachers' perspectives. The resulting program is a low cost, adaptable intervention that should be suitable for training preschool teachers in other low-resource settings. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

  1. Choice Inconsistencies among the Elderly: Evidence from Plan Choice in the Medicare Part D Program: Comment.

    Science.gov (United States)

    Ketcham, Jonathan D; Kuminoff, Nicolai V; Powers, Christopher A

    2016-12-01

    Consumers' enrollment decisions in Medicare Part D can be explained by Abaluck and Gruber’s (2011) model of utility maximization with psychological biases or by a neoclassical version of their model that precludes such biases. We evaluate these competing hypotheses by applying nonparametric tests of utility maximization and model validation tests to administrative data. We find that 79 percent of enrollment decisions from 2006 to 2010 satisfied basic axioms of consumer theory under the assumption of full information. The validation tests provide evidence against widespread psychological biases. In particular, we find that precluding psychological biases improves the structural model's out-of-sample predictions for consumer behavior.

  2. Establishing Systemic Social and Emotional Learning Approaches in Schools: A Framework for Schoolwide Implementation

    Science.gov (United States)

    Oberle, Eva; Domitrovich, Celene E.; Meyers, Duncan C.; Weissberg, Roger P.

    2016-01-01

    Social and emotional learning (SEL) is a fundamental part of education. Incorporating high-quality SEL programming into day-to-day classroom and school practices has emerged as a main goal for many practitioners over the past decade. The present article overviews the current state of SEL research and practice, with a particular focus on the United…

  3. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders (FallPAIDD: A Modified Otago Exercise Program

    Directory of Open Access Journals (Sweden)

    Mindy Renfro

    2016-12-01

    Full Text Available INTRODUCTION: Evidence-based fall prevention (EBFP programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD such as Alzheimer’s disease and related dementias (ADRD, cerebral vascular accident (CVA, or traumatic brain injury (TBI. BACKGROUND: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers, but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to healthcare and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury are on the rise and require effective and efficient prevention. METHODS: A modified group-based version of the Otago Exercise Program (OEP was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre and post-intervention using the Center for Disease Control and Prevention’s (CDC STopping Elderly Accidents Deaths and Injuries (STEADI tool kit. Participants participated in progressive once weekly, one-hour group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. RESULTS: Despite the limited number of participants (n=15 and short length of participation, improvements were observed in the 30-Second Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. DISCUSSION: Promising results of this preliminary project underline the need for further study

  4. Poverty and perceived stress: Evidence from two unconditional cash transfer programs in Zambia.

    Science.gov (United States)

    Hjelm, Lisa; Handa, Sudhanshu; de Hoop, Jacobus; Palermo, Tia

    2017-03-01

    Poverty is a chronic stressor that can lead to poor physical and mental health. This study examines whether two similar government poverty alleviation programs reduced the levels of perceived stress and poverty among poor households in Zambia. Secondary data from two cluster randomized controlled trials were used to evaluate the impacts of two unconditional cash transfer programs in Zambia. Participants were interviewed at baseline and followed over 36 months. Perceived stress among female caregivers was assessed using the Cohen Perceived Stress Scale (PSS). Poverty indicators assessed included per capita expenditure, household food security, and (nonproductive) asset ownership. Fixed effects and ordinary least squares regressions were run, controlling for age, education, marital status, household demographics, location, and poverty status at baseline. Cash transfers did not reduce perceived stress but improved economic security (per capita consumption expenditure, food insecurity, and asset ownership). Among these poverty indicators, only food insecurity was associated with perceived stress. Age and education showed no consistent association with stress, whereas death of a household member was associated with higher stress levels. In this setting, perceived stress was not reduced by a positive income shock but was correlated with food insecurity and household deaths, suggesting that food security is an important stressor in this context. Although the program did reduce food insecurity, the size of the reduction was not enough to generate a statistically significant change in stress levels. The measure used in this study appears not to be correlated with characteristics to which it has been linked in other settings, and thus, further research is needed to examine whether this widely used perceived stress measure appropriately captures the concept of perceived stress in this population. Copyright © 2017 UNICEF. Published by Elsevier Ltd.. All rights reserved.

  5. Urban fertility responses to local government programs: Evidence from the 1923-1932 U.S.

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    Jonathan Fox

    2015-02-01

    Full Text Available Background: During the 1920s and early 1930s, U.S. fertility declined overall but with large regional variations. Changes in foreign born populations explain only part of this. Differences in public health and poverty relief programs may further help explain these declines because of their potential impact on fertility determinants, in particular on breastfeeding and child mortality. Objective: We investigate whether public health investments in child health (conservation of child life programs and poverty relief (outdoor care of poor or charity for children and mothers affected fertility for U.S. cities over 100,000 persons between 1923 and 1932. Methods: We analyze data covering 64 cities between 1923-1932 that include birth information from the U.S. Birth, Stillbirth and Infant Mortality Statistics volumes and city financial information from the Financial Statistics of Cities volumes. Time and city fixed-effects models are used to identify the impact of public investments on fertility. Results: Fixed effects estimates indicating the conservation of child life programs explain about 10 percent of the fertility change between 1923 and 1932. Outdoor care of poor did not seem to be related to fertility. Investments in charity for children and mothers were associated with fertility increases, possibly because poorer areas experienced relative increases in both higher fertility and charitable spending. Conclusions: Public spending on child health was strongly related to decreasing fertility in the U.S. during the 1920s, possibly because of increased breastfeeding and decreased child mortality. This leads to a better understanding of the 1920s fertility decline and highlights how public policy may affect fertility.

  6. Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

    Science.gov (United States)

    Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

    2012-01-01

    Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

  7. Cancer Control Programs in East Asia: Evidence From the International Literature

    Directory of Open Access Journals (Sweden)

    Malcolm A. Moore

    2014-07-01

    Full Text Available Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

  8. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

  9. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

  10. Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): an evidence-based multi-level approach.

    LENUS (Irish Health Repository)

    Hegerl, Ulrich

    2009-01-01

    BACKGROUND: Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. METHOD: The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. DISCUSSION: This multi-centre research seeks to overcome major

  11. Optimizing suicide prevention programs and their implementation in Europe (OSPI-Europe): An evidence-based multi-level approach

    LENUS (Irish Health Repository)

    Hegerl, Ulrich

    2009-11-23

    Abstract Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major

  12. Examining the Sustainability of an Evidence-Based Preschool Curriculum: The REDI Program

    Science.gov (United States)

    Sanford DeRousie, Rebecca M.; Bierman, Karen L.

    2011-01-01

    This study examined the extent to which an evidence-based preschool curriculum (Head Start REDI) was sustained by 20 teachers during the year following a randomized controlled efficacy trial, when teachers were no longer required by the research project to implement the curriculum. Two quantitative measures of sustainability (teacher ratings, REDI coach ratings) and a qualitative measure (teacher interview) were collected and compared. Sustainability varied by the specific curriculum component, with higher rates of sustainability for the social-emotional component (Preschool PATHS) than for the language and literacy components. Estimates of sustainability were affected by the method of measurement, with REDI coach ratings and qualitative teacher interviews more closely aligned than teacher ratings. Responses from qualitative interviews identified the main factors that teachers thought affected sustainability. Teacher responses suggest that efforts to promote sustainability are best targeted at reducing barriers, such as competing demands, rather than simply highlighting the benefits of the new curriculum. PMID:22408287

  13. Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis.

    Science.gov (United States)

    Loew, Laurianne; Brosseau, Lucie; Wells, George A; Tugwell, Peter; Kenny, Glen P; Reid, Robert; Maetzel, Andreas; Huijbregts, Maria; McCullough, Carolyn; De Angelis, Gino; Coyle, Douglas

    2012-07-01

    To update the Evidence-Based Clinical Practice Guidelines (EBCPGs) on aerobic walking programs for the management of osteoarthritis (OA) of the knee. A literature search was conducted using the electronic databases MEDLINE, PubMed, and the Cochrane Library for all studies related to aerobic walking programs for OA from 1966 until February 2011. The literature search found 719 potential records, and 10 full-text articles were included according to the selection criteria. The Ottawa Methods Group established the inclusion and exclusion criteria regarding the characteristics of the population, by selecting adults of 40 years old and older who were diagnosed with OA of the knee. Two reviewers independently extracted important information from each selected study using standardized data extraction forms, such as the interventions, comparisons, outcomes, time period of the effect measured, and study design. The statistical analysis was reported using the Cochrane collaboration methods. An improvement of 15% or more relative to a control group contributes to the achievement of a statistically significant and clinically relevant progress. A specific grading system for recommendations, created by the Ottawa Panel, used a level system (level I for randomized controlled studies and level II for nonrandomized articles). The strength of the evidence of the recommendations was graded using a system with letters: A, B, C+, C, D, D+, or D-. Evidence from 7 high-quality studies demonstrated that facility, hospital, and home-based aerobic walking programs with other therapies are effective interventions in the shorter term for the management of patients with OA to improve stiffness, strength, mobility, and endurance. The greatest improvements were found in pain, quality of life, and functional status (grades A, B, or C+). A common limitation inherent to the EBCPGs is the heterogeneity of studies included with regards to the characteristics of the population, the interventions, the

  14. Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health Triangulation

    Science.gov (United States)

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L.; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Introduction Swaziland’s severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Methods Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. Results By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4<350/mm3, with progressively improving patient retention and survival. As of 2010, 88% of health facilities providing antenatal care offered comprehensive PMTCT services. The HTC program recorded a halving in the proportion of adults tested who were HIV-infected; similarly HIV infection rates among HIV-exposed babies halved from 2007 to 2010. Case fatality rates among hospital patients diagnosed with HIV/AIDS started to decrease from 2005–6 in adults and especially in children, contrasting with stable case fatality for other causes including TB. All-cause child in-patient case fatality rates started to decrease from 2005–6. TB case notifications as well as rates of HIV/TB co-infection among notified TB patients continued a steady increase through 2010, while coverage of HIV testing and CPT for co-infected patients increased to above 80%. Conclusion Against a background of high, but stable HIV prevalence and decreasing HIV incidence, we documented early evidence of a mortality decline associated with the expanded national HIV response since 2004. Attribution of impact to specific interventions (versus natural epidemic dynamics) will require additional data from future

  15. Challenges and Ideas from a Research Program on High Quality, Evidence-Based Practice in School Mental Health

    Science.gov (United States)

    Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

    2013-01-01

    Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310

  16. Programmed cell death in Leishmania: biochemical evidence and role in parasite infectivity

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    Sreenivas eGannavaram

    2012-07-01

    Full Text Available Demonstration of features of a programmed cell death (PCD pathway in protozoan parasites initiated a great deal of interest and debate in the field of molecular parasitology. Several of the markers typical of mammalian apoptosis have been shown in Leishmania which suggested the existence of an apoptosis like death in these organisms. However studies to elucidate the down stream events associated with phosphotidyl serine exposure, loss of mitochondrial membrane potential, cytochrome c release and caspase-like activities in cells undergoing such cell death remain an ongoing challenge. Recent advances in genome sequencing, chemical biology should help solve some of these challenges. Leishmania genetic mutants that lack putative regulators/effectors of PCD pathway should not only help demonstrate the mechanisms of PCD but also provide tools to better understand the putative role for this pathway in population control and in the establishment of a successful infection of the host.

  17. MECHANISMS IN ENDOCRINOLOGY: Neurodevelopmental disorders in children born to mothers with thyroid dysfunction: evidence of fetal programming?

    Science.gov (United States)

    Andersen, Stine Linding; Carlé, Allan; Karmisholt, Jesper; Pedersen, Inge Bülow; Andersen, Stig

    2017-07-01

    Fetal programming is a long-standing, but still evolving, concept that links exposures during pregnancy to the later development of disease in the offspring. A fetal programming effect has been considered within different endocrine axes and in relation to different maternal endocrine diseases. In this critical review, we describe and discuss the hypothesis of fetal programming by maternal thyroid dysfunction in the context of fetal brain development and neurodevelopmental disorders in the offspring. Thyroid hormones are important regulators of early brain development, and evidence from experimental and observational human studies have demonstrated structural and functional abnormalities in the brain caused by the lack or excess of thyroid hormone during fetal brain development. The hypothesis that such abnormalities introduced during early fetal brain development increase susceptibility for the later onset of neurodevelopmental disorders in the offspring is biologically plausible. However, epidemiological studies on the association between maternal thyroid dysfunction and long-term child outcomes are observational in design, and are challenged by important methodological aspects. © 2017 European Society of Endocrinology.

  18. Livelihoods, conflict and aid programming: is the evidence base good enough?

    Science.gov (United States)

    Mallett, Richard; Slater, Rachel

    2016-04-01

    In conflict-affected situations, aid-funded livelihood interventions are often tasked with a dual imperative: to generate material welfare benefits and to contribute to peacebuilding outcomes. There may be some logic to such a transformative agenda, but does the reality square with the rhetoric? Through a review of the effectiveness of a range of livelihood promotion interventions--from job creation to microfinance--this paper finds that high quality empirical evidence is hard to come by in conflict-affected situations. Many evaluations appear to conflate outputs with impacts and numerous studies fail to include adequate information on their methodologies and datasets, making it difficult to appraise the reliability of their conclusions. Given the primary purpose of this literature--to provide policy guidance on effective ways to promote livelihoods--this silence is particularly concerning. As such, there is a strong case to be made for a restrained and nuanced handling of such interventions in conflict-affected settings. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

  19. Peer mentorship program on HIV/AIDS knowledge, beliefs, and prevention attitudes among orphaned adolescents: an evidence based practice

    Science.gov (United States)

    Nabunya, Proscovia; Ssewamala, Fred M.; Mukasa, Miriam N.; Byansi, William; Nattabi, Jennifer

    2015-01-01

    Adolescents and young adults in sub-Saharan Africa (SSA) are particularly vulnerable to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) infection. Adolescents orphaned as a direct result of HIV/AIDS are at an elevated risk of acquiring HIV/AIDS and other sexually transmitted infections. However, limited empirical evidence exists on HIV knowledge and prevention programs, especially those designed to address HIV information gaps among adolescents. This study evaluates the effect of a peer mentorship program provided in addition to other supportive services on HIV/AIDS knowledge, beliefs, and prevention attitudes, among school-going orphaned adolescents in southern Uganda. We utilize data from the Bridges to the Future Study, a 5-year longitudinal randomized experimental study funded by the National Institute of Child Health and Human Development. Out of the 1410 adolescents enrolled in the study (average age = 12.7 at study initiation), 855 of them participated in a nine-session, curriculum based peer mentorship program. We analyzed data collected at baseline and 12-months post intervention initiation. The results from bivariate and regression analysis indicate that, controlling for socioeconomic characteristics, adolescents who participated in a peer mentorship program were more likely than non-participants to report increased scores on HIV/AIDS knowledge(b = .86, 95%CI = .47 – 1.3, p ≤ .001); better scores on desired HIV/AIDS-related beliefs (b = .29, 95%CI = .06 – .52, p ≤ .01); and better scores on HIV/AIDS prevention attitudes (b = .76, 95%CI = .16 – 1.4, p ≤ .01). Overall, the study findings point to the potential role a of peer mentorship program in promoting the much-desired HIV/AIDS knowledge, beliefs, and prevention attitudes among orphaned adolescents. Future programs and policies that support AIDS-orphaned adolescents in sub-Saharan Africa should consider incorporating peer mentoring programs that provide

  20. Human Research Program Human Health Countermeasures Element: Evidence Report - Artificial Gravity

    Science.gov (United States)

    Clement, Gilles

    2015-01-01

    The most serious risks of long-duration flight involve radiation, behavioral stresses, and physiological deconditioning. Artificial gravity (AG), by substituting for the missing gravitational cues and loading in space, has the potential to mitigate the last of these risks by preventing the adaptive responses from occurring. The rotation of a Mars-bound spacecraft or an embarked human centrifuge offers significant promise as an effective, efficient multi-system countermeasure against the physiological deconditioning associated with prolonged weightlessness. Virtually all of the identified risks associated with bone loss, muscle weakening, cardiovascular deconditioning, and sensorimotor disturbances might be alleviated by the appropriate application of AG. However, experience with AG in space has been limited and a human-rated centrifuge is currently not available on board the ISS. A complete R&D program aimed at determining the requirements for gravity level, gravity gradient, rotation rate, frequency, and duration of AG exposure is warranted before making a decision for implementing AG in a human spacecraft.

  1. How effective are energy-efficiency incentive programs? Evidence from Italian homeowners

    International Nuclear Information System (INIS)

    Alberini, Anna; Bigano, Andrea

    2015-01-01

    We evaluate incentives for residential energy upgrades in Italy using data from an original survey of Italian homeowners. In this paper, attention is restricted to heating system replacements, and to the effect of monetary and non-monetary incentives on the propensity to replace the heating equipment with a more efficient one. To get around adverse selection and free riding issues, we ask stated preference questions to those who weren't planning energy efficiency upgrades any time soon. We argue that these persons are not affected by these behaviors. We use their responses to fit an energy-efficiency renovations curve that predicts the share of the population that will undertake these improvements for any given incentive level. This curve is used to estimate the CO_2 emissions saved and their cost-effectiveness. Respondents are more likely to agree to a replacement when the savings on the energy bills are larger and experienced over a longer horizon, and when rebates are offered to them. Reminding the respondents about possible CO_2 emissions reductions (our non-monetary incentive) had little effect. Even under optimistic assumptions, monetary incentives similar to those in the Italian tax credit program are generally not cost-effective.

  2. Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans

    Science.gov (United States)

    2014-01-01

    Background Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption – the proportion and representativeness of organizations that decided to implement the program. Methods During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having ≥ 150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Results Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14 = 79%) and among organizations that were referred to us by community partners (5/10 = 50%) and lowest among new organizations (6/20 = 30%). Few organizational differences were found between adopters and non-adopters. Conclusions The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings. PMID:24618267

  3. Using Evidence-Based Interventions to Improve Cancer Screening in the National Breast and Cervical Cancer Early Detection Program.

    Science.gov (United States)

    DeGroff, Amy; Carter, Aundrea; Kenney, Kristy; Myles, Zachary; Melillo, Stephanie; Royalty, Janet; Rice, Ketra; Gressard, Lindsay; Miller, Jacqueline W

    2016-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides cancer screening to low-income, un-, and underinsured women through more than 11 000 primary care clinics. The program is well-positioned to work with health systems to implement evidence-based interventions (EBIs) to increase screening among all women. To collect baseline data on EBI use, evaluation of EBIs, and related training needs among NBCCEDP grantees. The Centers for Disease Control and Prevention conducted a Web-based survey in late 2013 among NBCCEDP grantees for the period July 2012 to June 2013. This was the first systematic assessment of EBIs among NBCCEDP grantees. The Centers for Disease Control and Prevention's NBCCEDP. Primarily program directors/coordinators for all 67 NBCCEDP grantees. Data captured were used to assess implementation of 5 EBIs, their evaluation, and related training needs. Frequencies and proportions were determined. Cluster analysis identified grantees with similar patterns of EBI use for NBCCEDP clients and providers. On average, 4.1 of 5 EBIs were implemented per grantee for NBCCEDP clients and providers. Four clusters were identified including "high overall EBI users," "high provider EBI users," "high EBI users with no provider assessment and feedback," and "high client EBI users." Only 1.8 EBIs were implemented, on average, with non-NBCCEDP clients and providers. Fewer than half (n = 32, 47.8%) of grantees conducted process or outcome evaluation of 1 or more EBIs. Overall, 47.6% of grantees reported high or medium training needs for client-oriented EBIs and 54.3% for provider-oriented EBIs. The NBCCEDP grantees are implementing EBIs extensively with clients and providers. Increased EBI use among non-NBCCEDP clients/providers is needed to extend the NBCCEDP's reach and impact. Grantee training and technical assistance is necessary across EBIs. In addition, grantees' use of process and outcome evaluation of EBI implementation must be increased

  4. UNAM Scientific Drilling Program of Chicxulub Impact Structure-Evidence for a 300 kilometer crater diameter

    Science.gov (United States)

    Urrutia-Fucugauchi, J.; Marin, L.; Trejo-Garcia, A.

    As part of the UNAM drilling program at the Chicxulub structure, two 700 m deep continuously cored boreholes were completed between April and July, 1995. The Peto UNAM-6 and Tekax UNAM-7 drilling sites are ˜150 km and 125 km, respectively, SSE of Chicxulub Puerto, near the crater's center. Core samples from both sites show a sequence of post-crater carbonates on top of a thick impact breccia pile covering the disturbed Mesozoic platform rocks. At UNAM-7, two impact breccia units were encountered: (1) an upper breccia, mean magnetic susceptibility is high (˜55 × 10-6 SI units), indicating a large component of silicate basement has been incorporated into this breccia, and (2) an evaporite-rich, low susceptibility impact breccia similar in character to the evaporite-rich breccias observed at the PEMEX drill sites further out. The upper breccia was encountered at ˜226 m below the surface and is ˜125 m thick; the lower breccia is immediately subjacent and is >240 m thick. This two-breccia sequence is typical of the suevite-Bunte breccia sequence found within other well preserved impact craters. The suevitic upper unit is not present at UNAM-6. Instead, a >240 m thick evaporite-rich breccia unit, similar to the lower breccia at UNAM-7, was encountered at a depth of ˜280 m. The absence of an upper breccia equivalent at UNAM-6 suggests some portion of the breccia sequence has been removed by erosion. This is consistent with interpretations that place the high-standing crater rim at 130-150 km from the center. Consequently, the stratigraphic observations and magnetic susceptibiity records on the upper and lower breccias (depth and thickness) support a ˜300 km diameter crater model.

  5. A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

    Science.gov (United States)

    Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

    2015-01-01

    Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

  6. Music training improves speech-in-noise perception: Longitudinal evidence from a community-based music program.

    Science.gov (United States)

    Slater, Jessica; Skoe, Erika; Strait, Dana L; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2015-09-15

    Music training may strengthen auditory skills that help children not only in musical performance but in everyday communication. Comparisons of musicians and non-musicians across the lifespan have provided some evidence for a "musician advantage" in understanding speech in noise, although reports have been mixed. Controlled longitudinal studies are essential to disentangle effects of training from pre-existing differences, and to determine how much music training is necessary to confer benefits. We followed a cohort of elementary school children for 2 years, assessing their ability to perceive speech in noise before and after musical training. After the initial assessment, participants were randomly assigned to one of two groups: one group began music training right away and completed 2 years of training, while the second group waited a year and then received 1 year of music training. Outcomes provide the first longitudinal evidence that speech-in-noise perception improves after 2 years of group music training. The children were enrolled in an established and successful community-based music program and followed the standard curriculum, therefore these findings provide an important link between laboratory-based research and real-world assessment of the impact of music training on everyday communication skills. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Challenges and ideas from a research program on high-quality, evidence-based practice in school mental health.

    Science.gov (United States)

    Weist, Mark D; Youngstrom, Eric A; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

    2014-01-01

    This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.

  8. Evidence-based intervention against bullying and cyberbullying: Evaluation of the NoTrap! program in two independent trials.

    Science.gov (United States)

    Palladino, Benedetta E; Nocentini, Annalaura; Menesini, Ersilia

    2016-01-01

    The NoTrap! (Noncadiamointrappola!) program is a school-based intervention, which utilizes a peer-led approach to prevent and combat both traditional bullying and cyberbullying. The aim of the present study was to evaluate the efficacy of the third Edition of the program in accordance with the recent criteria for evidence-based interventions. Towards this aim, two quasi-experimental trials involving adolescents (age M = 14.91, SD = .98) attending their first year at different high schools were conducted. In Trial 1 (control group, n = 171; experimental group, n = 451), latent growth curve models for data from pre-, middle- and post-tests showed that intervention significantly predicted change over time in all the target variables (victimization, bullying, cybervictimization, and cyberbullying). Specifically, target variables were stable for the control group but decreased significantly over time for the experimental group. Long-term effects at the follow up 6 months later were also found. In Trial 2 (control group, n = 227; experimental group, n = 234), the moderating effect of gender was examined and there was a reported decrease in bullying and cyberbullying over time (pre- and post-test) in the experimental group but not the control group, and this decrease was similar for boys and girls. © 2016 Wiley Periodicals, Inc.

  9. Increasing evidence for the efficacy of tobacco control mass media communication programming in low- and middle-income countries.

    Science.gov (United States)

    Mullin, Sandra; Prasad, Vinayak; Kaur, Jagdish; Turk, Tahir

    2011-08-01

    Antitobacco mass media campaigns have had good success at changing knowledge, attitudes, and behaviors with respect to smoking in high-income countries provided they are sustained. Mass media campaigns should be a critical component of tobacco control programs in low- and lower-middle-income countries. Mounting evidence shows that graphic campaigns and those that evoke negative emotions run over long periods of time have achieved the most influence. These types of campaigns are now being implemented in low- and middle-income countries. The authors provide 3 case studies of first-ever graphic warning mass media campaigns in China, India, and Russia, 3 priority high-burden countries in the global Bloomberg Initiative to Reduce Tobacco Use. In each of these countries, message testing of core messages provided confidence in messages, and evaluations demonstrated message uptake. The authors argue that given the initial success of these campaigns, governments in low- and middle-income countries should consider resourcing and sustaining these interventions as key components of their tobacco control strategies and programs.

  10. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical, and genetic association studies.

    Science.gov (United States)

    Xita, Nectaria; Tsatsoulis, Agathocles

    2006-05-01

    Polycystic ovary syndrome (PCOS) is a common endocrine disorder of premenopausal women, characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance and abdominal obesity as frequent metabolic traits. Although PCOS manifests clinically during adolescence, emerging data suggest that the natural history of PCOS may originate in intrauterine life. Evidence from experimental, clinical, and genetic research supporting the hypothesis for the fetal origins of PCOS has been analyzed. Female primates, exposed in utero to androgen excess, exhibit the phenotypic features of PCOS during adult life. Clinical observations also support a potential fetal origin of PCOS. Women with fetal androgen excess disorders, including congenital 21-hydroxylase deficiency and congenital adrenal virilizing tumors, develop features characteristic of PCOS during adulthood despite the normalization of androgen excess after birth. The potential mechanisms of fetal androgen excess leading to a PCOS phenotype in humans are not clearly understood. However, maternal and/or fetal hyperandrogenism can provide a plausible mechanism for fetal programing of PCOS, and this, in part, may be genetically determined. Thus, genetic association studies have indicated that common polymorphic variants of genes determining androgen activity or genes that influence the availability of androgens to target tissues are associated with PCOS and increased androgen levels. These genomic variants may provide the genetic link to prenatal androgenization in human PCOS. Prenatal androgenization of the female fetus induced by genetic and environmental factors, or the interaction of both, may program differentiating target tissues toward the development of PCOS phenotype in adult life.

  11. KiVa Anti-Bullying Program in Italy: Evidence of Effectiveness in a Randomized Control Trial.

    Science.gov (United States)

    Nocentini, Annalaura; Menesini, Ersilia

    2016-11-01

    The present study aims to evaluate the effectiveness of the KiVa anti-bullying program in Italy through a randomized control trial of students in grades 4 and 6. The sample involved 2042 students (51 % female; grade 4, mean age = 8.85; ds = 0.43; grade 6, mean age = 10.93; ds = 0.50); 13 comprehensive schools were randomly assigned into intervention (KiVa) or control (usual school provision) conditions. Different outcomes (bullying, victimization, pro-bullying attitudes, pro-victim attitudes, empathy toward victims), analyses (longitudinal mixed model with multiple-item scales; longitudinal prevalence of bullies and victims using Olweus' single question), and estimates of effectiveness (Cohen's d; odds ratios) were considered in order to compare the Italian results with those from other countries. Multilevel models showed that KiVa reduced bullying and victimization and increased pro-victim attitudes and empathy toward the victim in grade 4, with effect sizes from 0.24 to 0.40. In grade 6, KiVa reduced bullying, victimization, and pro-bullying attitudes; the effects were smaller as compared to grade 4, yet significant (d ≥ 0.20). Finally, using Olweus dichotomous definition of bullies and victims, results showed that the odds of being a victim were 1.93 times higher for a control student than for a KiVa student in grade 4. Overall, the findings provide evidence of the effectiveness of the program in Italy; the discussion will focus on factors that influenced successfully the transportability of the KiVa program in Italy.

  12. Hot Idea or Hot Air: A Systematic Review of Evidence for Two Widely Marketed Youth Suicide Prevention Programs and Recommendations for Implementation

    Science.gov (United States)

    Wei, Yifeng; Kutcher, Stan; LeBlanc, John C.

    2015-01-01

    Introduction: Youth suicide is highly related to mental disorders. While communities and schools are marketed to with a plethora of suicide prevention programs, they often lack the capacity to choose evidence-based programs. Methods: We conducted a systematic review of two youth suicide prevention programs to help determine if the quality of evidence available justifies their wide spread dissemination. We searched Medline, PsycINFO, EMBASE, CINAHL, the Cochrane Library, Campbell Collaboration SPECTR database, SocIndex, Sociological Abstracts, Social Services Abstracts, ERIC, Social Work Abstracts, Research Library, and Web of Science, for relevant studies. We included studies/systematic reviews/meta-analysis that evaluated the effectiveness, cost-effectiveness, and/or safety of Signs of Suicide (SOS) and Yellow Ribbon (YR) suicide prevention programs that target adolescents. We applied the Office of Justice Program What Works Repository (OJP-R) to evaluate the quality of the included studies as effective, effective with reservation, promising, inconclusive evidence, insufficient evidence, and ineffective. Two SOS studies were ranked as “inconclusive evidence” based on the OJP-R. One SOS study was ranked as having “insufficient evidence” on OJP-R. The YR study was ranked as “ineffective” using OJP-R. We only included studies in peer-reviewed journals in English and therefore may have missed reports in grey literature or non-English publications. Results: We cannot recommend that schools and communities implement either the SOS or YR suicide prevention programs. Purchasers of these programs should be aware that there is no evidence that their use prevents suicide. Conclusions: Academics and organizations should not overstate the positive impacts of suicide prevention interventions when the evidence is lacking. PMID:26336375

  13. A Program for Introducing Information Literacy to Commercial Art and Design Students

    Directory of Open Access Journals (Sweden)

    David A. Walczak

    2010-03-01

    Full Text Available This paper describes the process of developing and implementing a comprehensive, school-wide, and sustainable information literacy program at a commercial art and design school. The program requires that information literacy student learning outcomes be included in specific General Education and art and design courses across the curriculum. The results of this multi-year effort indicate that while the program is sound, teaching information literacy is an on-going effort requiring much more training of faculty and students. Best practices in information literacy in library science and art and design literature are reviewed

  14. Transfer Entails Communication: The Public Understanding of (Social) Science as a Stage and a Play for Implementing Evidence-Based Prevention Knowledge and Programs.

    Science.gov (United States)

    Bromme, Rainer; Beelmann, Andreas

    2018-04-01

    Many social science-based interventions entail the transfer of evidence-based knowledge to the "target population," because the acquisition and the acceptance of that knowledge are necessary for the intended improvement of behavior or development. Furthermore, the application of a certain prevention program is often legitimated by a reference to science-based reasons such as an evaluation according to scientific standards. Hence, any implementation of evidence-based knowledge and programs is embedded in the public understanding of (social) science. Based on recent research on such public understanding of science, we shall discuss transfer as a process of science communication.

  15. Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

    Science.gov (United States)

    Kingston, Beverly; Bacallao, Martica; Smokowski, Paul; Sullivan, Terri; Sutherland, Kevin

    2016-04-01

    This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

  16. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

    Science.gov (United States)

    Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

    2012-06-01

    Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

  17. The potential and peril of health insurance tobacco surcharge programs: evidence from Georgia's State Employees' Health Benefit Plan.

    Science.gov (United States)

    Liber, Alex C; Hockenberry, Jason M; Gaydos, Laura M; Lipscomb, Joseph

    2014-06-01

    A rapidly growing number of U.S. employers are charging health insurance surcharges for tobacco use to their employees. Despite their potential to price-discriminate, little systematic empirical evidence of the impacts of these tobacco surcharges has been published. We attempted to assess the impact of a health insurance surcharge for tobacco use on cessation among enrollees in Georgia's State Health Benefit Plan (GSHBP). We identified a group of enrollees in GSHBP who began paying the tobacco surcharge at the program's inception in July 2005. We examined the proportion of these enrollees who certified themselves and their family members as tobacco-free and no longer paid the surcharge through April 2011, and we defined this as implied cessation. We compared this proportion to a national expected annual 2.6% cessation rate. We also compared our observation group to a comparison group to assess surcharge avoidance. By April 2011, 45% of enrollees who paid a tobacco surcharge starting in July 2005 had certified themselves as tobacco-free. This proportion exceeded the expected cessation based on 3 times the national rate (p health insurance surcharges in changing behavior, are tempered by the important limitation that enrollees' certification of quitting was self-reported and not subject to additional, clinical verification.

  18. Explaining variations in state foster care maintenance rates and the implications for implementing new evidence-based programs

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D.; Babiarz, Kimberly S.; Garfield, Rachel L.; Wulczyn, Fred; Landsverk, John; Horwitz, Sarah M.

    2013-01-01

    Background U.S. Child Welfare systems are involved in the lives of millions of children, and total spending exceeds $26 billion annually. Out-of-home foster care is a critical and expensive Child Welfare service, a major component of which is the maintenance rate paid to support housing and caring for a foster child. Maintenance rates vary widely across states and over time, but reasons for this variation are not well understood. As evidence-based programs are disseminated to state Child Welfare systems, it is important to understand what may be the important drivers in the uptake of these practices including state spending on core system areas. Data and methods We assembled a unique, longitudinal, state-level panel dataset (1990–2008) for all 50 states with annual data on foster care maintenance rates and measures of child population in need, poverty, employment, urbanicity, proportion minority, political party control of the state legislature and governorship, federal funding, and lawsuits involving state foster care systems. All monetary values were expressed in per-capita terms and inflation adjusted to 2008 dollars. We used longitudinal panel regressions with robust standard errors and state and year fixed effects to estimate the relationship between state foster care maintenance rates and the other factors in our dataset, lagging all factors by one year to mitigate the possibility that maintenance rates influenced their predictors. Exploratory analyses related maintenance rates to Child Welfare outcomes. Findings State foster care maintenance rates have increased in nominal terms, but in many states, have not kept pace with inflation, leading to lower real rates in 2008 compared to those in 1991 for 54% of states for 2 year-olds, 58% for 9 year-olds, and 65% for 16 year-olds. In multivariate analyses including socioeconomic, demographic, and political factors, monthly foster care maintenance rates declined $15 for each 1% increase in state unemployment and

  19. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    Science.gov (United States)

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  20. Feasibility of the evidence-based cognitive telerehabilitation program ReMind for patients with primary brain tumors

    NARCIS (Netherlands)

    van der Linden, S.D.; Sitskoorn, M.M.; Rutten, G.J.M.; Gehring, K.

    2018-01-01

    Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation

  1. Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature.

    Science.gov (United States)

    Cancelliere, Carol; Cassidy, J David; Ammendolia, Carlo; Côté, Pierre

    2011-05-26

    Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem.Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age), and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies). These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. This review is limited to English publications. A large number of reviewed studies (70%) were inadmissible due to issues of bias, thus limiting the amount of primary evidence. The uncertainties surrounding

  2. Are workplace health promotion programs effective at improving presenteeism in workers? a systematic review and best evidence synthesis of the literature

    Directory of Open Access Journals (Sweden)

    Cassidy J David

    2011-05-01

    Full Text Available Abstract Background Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem. Workplace health promotion (WHP is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. Methods The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age, and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. Results After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies. These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. Limitations: This review is limited to English publications. A large number of reviewed studies (70% were inadmissible due to issues of bias, thus limiting

  3. The importance of socio-economic context for social marketing models for improving reproductive health: Evidence from 555 years of program experience

    Directory of Open Access Journals (Sweden)

    Rahaim Stephen

    2005-01-01

    Full Text Available Abstract Background Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. Methods This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. Results The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. Conclusions To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context.

  4. The importance of socio-economic context for social marketing models for improving reproductive health: evidence from 555 years of program experience.

    Science.gov (United States)

    Meekers, Dominique; Rahaim, Stephen

    2005-01-27

    Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context.

  5. Development, implementation and evaluation of an evidence-based program for introduction of new health technologies and clinical practices in a local healthcare setting.

    Science.gov (United States)

    Harris, Claire; Garrubba, Marie; Allen, Kelly; King, Richard; Kelly, Cate; Thiagarajan, Malar; Castleman, Beverley; Ramsey, Wayne; Farjou, Dina

    2015-12-28

    This paper reports the process of establishing a transparent, accountable, evidence-based program for introduction of new technologies and clinical practices (TCPs) in a large Australian healthcare network. Many countries have robust evidence-based processes for assessment of new TCPs at national level. However many decisions are made by local health services where the resources and expertise to undertake health technology assessment (HTA) are limited and a lack of structure, process and transparency has been reported. An evidence-based model for process change was used to establish the program. Evidence from research and local data, experience of health service staff and consumer perspectives were incorporated at each of four steps: identifying the need for change, developing a proposal, implementation and evaluation. Checklists assessing characteristics of success, factors for sustainability and barriers and enablers were applied and implementation strategies were based on these findings. Quantitative and qualitative methods were used for process and outcome evaluation. An action research approach underpinned ongoing refinement to systems, processes and resources. A Best Practice Guide developed from the literature and stakeholder consultation identified seven program components: Governance, Decision-Making, Application Process, Monitoring and Reporting, Resources, Administration, and Evaluation and Quality Improvement. The aims of transparency and accountability were achieved. The processes are explicit, decisions published, outcomes recorded and activities reported. The aim of ascertaining rigorous evidence-based information for decision-making was not achieved in all cases. Applicants proposing new TCPs provided the evidence from research literature and local data however the information was often incorrect or inadequate, overestimating benefits and underestimating costs. Due to these limitations the initial application process was replaced by an Expression of

  6. Reconciling the Multiple Objectives of Prison Diversion Programs for Drug Offenders: Evidence from Kansas' Senate Bill 123

    Science.gov (United States)

    Stemen, Don; Rengifo, Andres F.

    2011-01-01

    Background: In recent years, several states have created mandatory prison-diversion programs for felony drug possessors. These programs have both individual-level goals of reducing recidivism rates and system-level goals of reducing prison populations. Objective: This study examines the individual level and system level impact of Kansas' Senate…

  7. The effectiveness and feasibility of an online educational program for improving evidence-based practice literacy: an exploratory randomized study of US chiropractors.

    Science.gov (United States)

    Schneider, Michael; Evans, Roni; Haas, Mitchell; Leach, Matthew; Delagran, Louise; Hawk, Cheryl; Long, Cynthia; Cramer, Gregory D; Walters, Oakland; Vihstadt, Corrie; Terhorst, Lauren

    2016-01-01

    Online education programs are becoming a popular means to disseminate knowledge about evidence-based practice (EBP) among healthcare practitioners. This mode of delivery also offers a viable and potentially sustainable solution for teaching consistent EBP content to learners over time and across multiple geographical locations. We conducted a study with 3 main aims: 1) develop an online distance-learning program about the principles of evidence-based practice (EBP) for chiropractic providers; 2) test the effectiveness of the online program on the attitudes, skills, and use of EBP in a sample of chiropractors; and 3) determine the feasibility of expanding the program for broader-scale implementation. This study was conducted from January 2013 to September 2014. This was an exploratory randomized trial in which 293 chiropractors were allocated to either an online EBP education intervention or a waitlist control. The online EBP program consisted of 3 courses and 4 booster lessons, and was developed using educational resources created in previous EBP educational programs at 4 chiropractic institutions. Participants were surveyed using a validated EBP instrument (EBASE) with 3 rescaled (0 to 100) subscores: Attitudes, Skills, and Use of EBP. Multiple regression was used to compare groups, adjusting for personal and practice characteristics. Satisfaction and compliance with the program was evaluated to assess feasibility. The Training Group showed modest improvement compared to the Waitlist Group in attitudes (Δ =6.2, p < .001) and skills (Δ =10.0, p < .001) subscores, but not the use subscore (Δ = -2.3, p = .470). The majority of participants agreed that the educational program was 'relevant to their profession' (84 %) and 'was worthwhile' (82 %). Overall, engagement in the online program was less than optimal, with 48 % of the Training Group, and 42 % of the Waitlist Group completing all 3 of the program courses. Online EBP training leads to

  8. Evidence-based decision making : developing a knowledge base for successful program outcomes in transportation asset management.

    Science.gov (United States)

    2015-12-01

    MAP-21 and AASHTOs framework for transportation asset management (TAM) offer opportunities to use more : rigorous approaches to collect and apply evidence within a TAM context. This report documents the results of a study : funded by the Georgia D...

  9. ValuedCare program: a population health model for the delivery of evidence-based care across care continuum for hip fracture patients in Eastern Singapore.

    Science.gov (United States)

    Mittal, Chikul; Lee, Hsien Chieh Daniel; Goh, Kiat Sern; Lau, Cheng Kiang Adrian; Tay, Leeanna; Siau, Chuin; Loh, Yik Hin; Goh, Teck Kheng Edward; Sandi, Chit Lwin; Lee, Chien Earn

    2018-05-30

    To test a population health program which could, through the application of process redesign, implement multiple evidence-based practices across the continuum of care in a functionally integrated health delivery system and deliver highly reliable and consistent evidence-based surgical care for patients with fragility hip fractures in an acute tertiary general hospital. The ValuedCare (VC) program was developed in three distinct phases as an ongoing collaboration between the Geisinger Health System (GHS), USA, and Changi General Hospital (CGH), Singapore, modelled after the GHS ProvenCare® Fragile Hip Fracture Program. Clinical outcome data on consecutive hip fracture patients seen in 12 months pre-intervention were then compared with the post-intervention group. Both pre- and post-intervention groups were followed up across the continuum of care for a period of 12 months. VC patients showed significant improvement in median time to surgery (97 to 50.5 h), as well as proportion of patients operated within 48 h from hospital admission (48% from 18.8%) as compared to baseline pre-intervention data. These patients also had significant reduction (p value based care for hip fracture patients at Changi General Hospital. This has also reflected successful change management and interdisciplinary collaboration within the organization through the program. There is potential for testing this methodology as a quality improvement framework replicable to other disease groups in a functionally integrated healthcare system.

  10. Pilot Implementation of two evidence based programs (SafeCare and IncredibleYears in Child Protection Services in Gipuzkoa (Spain

    Directory of Open Access Journals (Sweden)

    Joaquín de Paul

    2015-08-01

    Full Text Available This paper describes the implementation process of two evidence-based programs in Gipuzko as Child Protection System (Spain: SafeCare and Incredible Years. SafeCare is a home visiting program for high-riskand neglectful families with children under 5 years. Incredible Years is a parenting skills training program for families with children between 4 to 8 years with behavior problems whose parents have significantdifficulties to manage. The paper describes the process by which public institutions responsible for child protection in Gipuzkoa decided to shift from current intervention programs towards more structured, focused, and short-term programs that have shown positive results in previous applications in other countries. Issues related to programs adaptation, selection, and training of professionals and pre- and postresults obtained in the preliminary application of SafeCare and Incredible Years to a limited set of families are presented. Finally, the next step of the implementation process (pilot implementation with a randomized control trial design is described. The paper discusses a significant number of issues that have been important throughout this process and that may be useful for administrations and institutions that wish to undertake a similar process.

  11. Programming

    International Nuclear Information System (INIS)

    Jackson, M.A.

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies. (orig.)

  12. Programming

    OpenAIRE

    Jackson, M A

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, thi...

  13. The effects of a disease management program on self-reported health behaviors and health outcomes: evidence from the "Florida: a healthy state (FAHS)" Medicaid program.

    Science.gov (United States)

    Morisky, Donald E; Kominski, Gerald F; Afifi, Abdelmonem A; Kotlerman, Jenny B

    2009-06-01

    Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.

  14. Outcomes and impact of HIV prevention, ART and TB programs in Swaziland--early evidence from public health triangulation.

    Science.gov (United States)

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Swaziland's severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4impact to specific interventions (versus natural epidemic dynamics) will require additional data from future household surveys, and improved routine (program, surveillance, and hospital) data at district level.

  15. Examining the Impact of a Highly Targeted State Administered Merit Aid Program on Brain Drain: Evidence from a Regression Discontinuity Analysis of Missouri's Bright Flight Program

    Science.gov (United States)

    Harrington, James R.; Muñoz, José; Curs, Bradley R.; Ehlert, Mark

    2016-01-01

    The adoption of state-funded merit-based aid programs has become increasingly popular among policy-makers, particularly in the southeastern part of the United States. One of the primary rationales of state-funded merit-based aid is to provide scholarships to the best and brightest students as a means to retain high quality human capital in the…

  16. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries.

    Science.gov (United States)

    Tambo, Ernest; Ugwu, Chidiebere E; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    This review paper examines the growing implications of China's engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China's significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Strengthening China-Africa health development agenda towards collective commitment and investment in quality care delivery, effective programs coverage and efficiency, preparedness and

  17. When the healthcare does not follow the evidence: The case of the lack of early intervention programs for psychosis in Spain.

    Science.gov (United States)

    Arango, Celso; Bernardo, Miguel; Bonet, Pere; Cabrera, Ana; Crespo-Facorro, Benedicto; Cuesta, Manuel J; González, Nel; Parrabera, Sílvia; Sanjuan, Julio; Serrano, Alfonso; Vieta, Eduard; Lennox, Belinda R; Melau, Marianne

    There is now sufficient evidence to support the importance of interventions in the early stages of psychosis. The delay in the detection and treatment of the first-episode psychosis is related to a lower and slower recovery, as well as a higher risk of relapse. Despite this fact, early intervention units or teams are still not regularly implemented in mental health service settings in Spain. In this opinion article, a review is presented of the main arguments for defending the need to implement these programs and strategies in order to achieve this aim. There are a number of programs for early intervention for psychosis currently working in other countries, with a therapeutic program that includes pharmacological and psychosocial interventions, together with public awareness, information dissemination, and family-professional collaboration activities. Published literature on the experience of these programs indicates that early intervention is not only effective in terms of the improvement of health status, but is also economically efficient. The main steps and recommendations needed to implement such early intervention programs in our country are described. Copyright © 2017 SEP y SEPB. All rights reserved.

  18. An Evidence-Based Education Program For Adults About Child Sexual Abuse (“Prevent It!” Significantly Improves Behaviours As Well As Attitudes And Knowledge

    Directory of Open Access Journals (Sweden)

    Erin K Martin

    2016-08-01

    Full Text Available Here we describe the development of an evidence-based education program for adults about childhood sexual abuse (CSA, called Prevent It! Uniquely, the primary goal of this program was to change the behaviour of participants, as well as to increase knowledge about CSA and positive attitudes towards it. A comprehensive review shows no previous similar approach. The program includes a detailed manual to allow standardized administration by trained facilitators, as well as multiple video segments from CSA survivors and professionals. A total of 23 program workshops were run, with 366 adults participating. Of these, 312 (85% agreed to take part in the study. All completed baseline ratings prior to the program and 195 (63% of study sample completed follow-up assessments at 3-months. There were no significant differences between the demographic make-up of the baseline group and the follow-up group. Assessments included demographic data, knowledge, attitudes, and several measures of behaviour (our primary outcome variable. Behavioural questions asked individuals to select behaviours used in the previous 3-months from a list of options. Questions also included asking how many times in the previous 3-months have you talked about healthy sexual development or child sexual abuse with a child you know; suspected a child was sexually abused; taken steps to protect a child; or reported suspected sexual abuse to police or child welfare? The majority of attendees were women, with the commonest age group being between 30 – 39 years old. Approximately 33% had experienced CSA themselves. At 3-month follow-up there were highly statistically significant improvements in several aspects of behaviour and knowledge, and attitudes regarding CSA. For example, the number of subjects actively looking for evidence of CSA increased from 46% at baseline to 81% at follow-up, while the number of subjects who actively took steps to protect children increased from 25% at baseline

  19. The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

    Science.gov (United States)

    Singleton, Perry

    2009-01-01

    I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

  20. Gifted Programs Cannot Be Successful without Gifted Research and Theory: Evidence From Practice With Gifted Students of Mathematics

    Science.gov (United States)

    Dimitriadis, Christos

    2016-01-01

    This study investigated the educational provision for mathematically gifted students offered in primary (elementary) schools in England (United Kingdom) just before the abandonment of the government's Gifted and Talented (G&T) program. Through a questionnaire within five Educational Authorities and four in-depth case studies in different…

  1. Can a Public Scholarship Program Successfully Reduce School Drop-Outs in a Time of Economic Crisis? Evidence from Indonesia

    Science.gov (United States)

    Cameron, Lisa

    2009-01-01

    This paper evaluates the role played by Indonesia's Social Safety Net Scholarships Program in reducing school drop-out rates during the Asian financial crisis. The expectation was that many families would find it difficult to keep their children in school and drop-out rates would be high. The scholarships are found to have been effective in…

  2. Mechanism of Developmental Change in the PLAY Project Home Consultation Program: Evidence from a Randomized Control Trial

    Science.gov (United States)

    Mahoney, Gerald; Solomon, Richard

    2016-01-01

    This investigation is a secondary analysis of data from a randomized control trial of the PLAY Home Consultation Intervention Program which was conducted with 112 preschool children with Autism Spectrum Disorders and their parents (Solomon et al. in "J Dev Behav Pediatr" 35:475-485, 2014). Subjects were randomly assigned to either a…

  3. Evidence-Based Sexuality Education Programs in Schools: Do They Align with the National Sexuality Education Standards?

    Science.gov (United States)

    Schmidt, Sara C.; Wandersman, Abraham; Hills, Kimberly J.

    2015-01-01

    While many states mandate some type of sexuality education in schools, state legislation varies widely across the United States. Nevertheless, though much has been written about the behavioral outcomes of sexuality education programs shown to be effective at reducing one or more risky sexual behaviors in teenagers, less is known about the exact…

  4. Estimating Costs and Benefits Associated with Evidence-Based Violence Prevention: Four Case Studies Based on the Fourth R Program

    Directory of Open Access Journals (Sweden)

    Claire V. Crooks

    2017-05-01

    Full Text Available Teen violence in dating and peer relationships has huge costs to society in numerous areas including health care, social services, the workforce and the justice system. Physical, psychological, and sexual abuse have long-lasting ramifications for the perpetrators as well as the victims, and for the families involved on both sides of that equation. An effective violence prevention program that is part of a school’s curriculum is beneficial not only for teaching teenagers what is appropriate behaviour in a relationship, but also for helping them break the cycle of violence which may have begun at home with their own maltreatment as children. The Fourth R program is an efficacious violence prevention program that was developed in Ontario and has been implemented in schools throughout Canada and the U.S. Covering relationship dynamics common to dating violence as well as substance abuse, peer violence and unsafe sex, the program can be adapted to different cultures and to same-sex relationships. The program, which gets its name from the traditional 3Rs — reading, ’riting and ’rithmetic — offers schools the opportunity to provide effective programming for teens to reduce the likelihood of them using relationship for violence as they move into adulthood. The federal government has estimated that the societal costs of relationship violence amount to more than $7 billion. These costs can continue to be incurred through the legal and health-care systems as the ripple effects of violence play out over the years, even after a relationship has ended. Other types of violence are also costly to society and not just in terms of dollars, but in young lives diverted into criminal activity. Up to 15 per cent of youth who become involved with the justice system grow into serious adult offenders who develop lengthy criminal careers. Yet, research shows that if prevention programs such as the Fourth R can deter just one 14-year-old high-risk juvenile from

  5. Evidence of progress. Measurement of impacts of Australia's S and L program from 1990-2010

    Energy Technology Data Exchange (ETDEWEB)

    Lowenthal-Savy; McNeil, Michael; Harrington, Lloyd [Nicholas School of the Environment, Duke University, and Lawrence Berkeley National Lab., CA (United States)

    2013-10-15

    Australia first put categorical energy efficiency labels on residential appliances in the mid-1980s, and the first Minimum Energy Performance Standards (MEPS) for refrigerators was implemented in 1999. Updated in 2005, these MEPS were aligned with US 2001 levels. Considered together, these actions set Australia apart as having one of the most aggressive appliance efficiency programs in the world. For these reasons, together with good data on product sales over time, Australia represents a potentially fruitful case study for understanding the dynamics energy efficiency standards and labeling (EES and L) programs impacts on appliance markets. This analysis attempts to distinguish between the impacts of labeling alone as opposed to MEPS, and to probe the time-dependency of such impacts. Fortunately, in the Australian case, detailed market sales data and a comprehensive registration system provides a solid basis for the empirical evaluation of these questions. This paper analyzes Australian refrigerator efficiency data covering the years 1993-2009. Sales data was purchased from a commercial market research organization (in this case, the GfK Group) and includes sales and average price in each year for each appliance model – this can be used to understand broader trends by product class and star rating category, even where data is aggregated. Statistical regression analysis is used to model market introduction and adoption of high efficiency refrigerators according to logistic adoption model formalism, and parameterizes the way in which the Australian programs accelerated adoption of high-efficiency products and phased out others. Through this analysis, the paper presents a detailed, robust and quantitative picture of the impacts of EES and L in the Australian case, but also demonstrates a methodology of the evaluation of program impacts that could form the basis of an international evaluation framework for similar programs in other countries.

  6. School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

    Science.gov (United States)

    Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P

    2013-09-01

    Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  7. Consideration of Culture and Context in School-Wide Positive Behavior Support: A Review of Current Literature

    Science.gov (United States)

    Fallon, Lindsay M.; O'Keeffe, Breda V.; Sugai, George

    2012-01-01

    A review of the literature related to culture and student behavior reveals a number of interesting observations that are not surprising. First, culture is a difficult construct to define and has been defined variably over the years. Second, schools are becoming increasingly diverse, and evidence-based behavior management practices have been…

  8. Teaching evidence-based practice in a distance education occupational therapy doctoral program: strategies for professional growth and advancing the profession.

    Science.gov (United States)

    Reynolds, Stacey

    2010-01-01

    ABSTRACT The Centennial Vision of the American Occupational Therapy Association (AOTA) projects that by 2017 all occupational therapy (OT) practice areas will be supported by evidence. Achieving this goal requires preparing clinicians with the skills to assimilate, analyze, and apply research to their areas of practice and communicate the value of OT services to consumers and payers. These skills are at the heart of evidence-based practice (EBP). Educators must be prepared to teach EBP skills in both entry-level and postprofessional programs. This article outlines how EBP can be taught to postprofessional occupational therapy clinical doctoral students using a distance education format. Key features of a successful EBP course include having access to full-text electronic articles, opportunities for students to explore the literature in their own areas of interest, consistent and timely feedback on written work and discussion topics, and opportunities to collaborate with peers.

  9. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    Directory of Open Access Journals (Sweden)

    Lemstra ME

    2016-03-01

    Full Text Available Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL. Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 at baseline and follow-up (24 weeks. To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44–9.78; P=0.007 and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28–10.68; P=0.015. Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. Keywords: obesity, health-related quality of life, social- support, SF-36, Canada

  10. Credit supply and the rise in college tuition: evidence from the expansion in federal student aid programs

    OpenAIRE

    Lucca, David O.; Nadauld, Taylor D.; Shen, Karen

    2015-01-01

    When students fund their education through loans, changes in student borrowing and tuition are interlinked. Higher tuition costs raise loan demand, but loan supply also affects equilibrium tuition costs - for example, by relaxing students' funding constraints. To resolve this simultaneity problem, we exploit detailed student-level financial data and changes in federal student aid programs to identify the impact of increased student loan funding on tuition. We find that institutions more expos...

  11. Do vouchers lead to sorting under random private-school selection? Evidence from the Milwaukee voucher program

    OpenAIRE

    Chakrabarti, Rajashri

    2009-01-01

    This paper analyzes the effect of school vouchers on student sorting - defined as a flight to private schools by high-income and committed public-school students - and whether vouchers can be designed to reduce or eliminate it. Much of the existing literature investigates sorting in cases where private schools can screen students. However, publicly funded U.S. voucher programs require a private school to accept all students unless it is oversubscribed and to pick students randomly if it is ov...

  12. The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan.

    Science.gov (United States)

    Witvorapong, Nopphol; Foshanji, Abo Ismael

    2016-03-01

    While existing research suggests that health-related conditional cash transfer (CCT) programs have positive impacts on the utilization of CCT-targeted health services, little is known as to whether they also influence the utilization of non-targeted health services-defined as general health services for which program participants are not financially motivated. Based on a sample of 6649 households in a CCT program that took place in May 2009-June 2011 in Afghanistan, we evaluate the impact of the receipt of CCTs on the utilization of non-targeted health services both by women, who were direct beneficiaries of the program, and by members of their households. We estimate the outcomes of interest through four probit models, accounting for potential endogeneity of the CCT receipt and dealing with lack of credible exclusion restrictions in different ways. In comparison with the control group, the receipt of CCTs is found to be associated with an increase in the probability of utilizing non-targeted services among household members across regression models. The results are mixed, with regard to the utilization by women, suggesting that there exist non-economic barriers to health care, unique to women, that are not captured by the data. The results confirm the importance of accounting for direct as well as indirect effects in policy evaluation and suggest that future studies investigate more deeply the role of community health workers in removing non-economic barriers for Afghan women and the possibility of introducing an incentive structure to motivate them to contribute more actively to population health in Afghanistan. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Household income and expenditure surveys: a tool for accelerating the development of evidence-based fortification programs.

    Science.gov (United States)

    Fiedler, John L; Smitz, Marc-Francois; Dupriez, Olivier; Friedman, Jed

    2008-12-01

    One-third of the world's population suffers from micronutrient deficiencies due primarily to inadequate dietary intake. Food fortification is often touted as the most promising short- to medium-term strategy for combating these deficiencies. Despite its appealing characteristics, progress in fortification has been slow. To assess the potential of household food-purchase data to fill the food-consumption information gap, which has been an important factor contributing to the slow growth of fortification programs. Household income and expenditure survey (HIES) data about: (a) a population's distribution of apparent household consumption, which are essential to setting safe fortification levels, (b) the proportion of households purchasing "fortifiable" food, and (c) the quantity of food being purchased were used to proxy food-consumption data and develop suggested fortification levels. The usefulness of the approach in addressing several common fortification program design issues is demonstrated. HIES-based suggested fortification levels are juxtaposed with ones developed using the most common current approach, which relies upon Food and Agriculture Organization (FAO) Food Balance Sheets. Despite its limitations, the use of HIES data constitutes a generally unexploited opportunity to address the food-consumption information gap by using survey data that nearly every country of the world is already routinely collecting. HIES data enable the design of fortification programs to become more based on country-specific data and less on general rules of thumb. The more routine use of HIES data constitutes a first step in improving the precision of fortification feasibility analyses and improving estimates of the coverage, costs, and impact of fortification programs.

  14. A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

    Science.gov (United States)

    Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

    2015-05-28

    The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval

  15. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

    Science.gov (United States)

    Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

    2016-01-01

    Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an

  16. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs

    Directory of Open Access Journals (Sweden)

    Melissa F. Peskin

    2017-08-01

    Full Text Available In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular, a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS, an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  17. Are Virtual Rehabilitation Technologies Feasible Models to Scale an Evidence-Based Fall Prevention Program? A Pilot Study Using the Kinect Camera.

    Science.gov (United States)

    Shubert, Tiffany E; Basnett, Jeanna; Chokshi, Anang; Barrett, Mark; Komatireddy, Ravi

    2015-11-05

    Falls in older adults are a significant public health issue. Interventions have been developed and proven effective to reduce falls in older adults, but these programs typically last several months and can be resource intensive. Virtual rehabilitation technologies may offer a solution to bring these programs to scale. Off-the-shelf and custom exergames have demonstrated to be a feasible adjunct to rehabilitation with older adults. However, it is not known if older adults will be able or willing to use a virtual rehabilitation technology to participate in an evidence-based fall prevention program. To have the greatest impact, virtual rehabilitation technologies need to be acceptable to older adults from different backgrounds and level of fall risk. If these technologies prove to be a feasible option, they offer a new distribution channel to disseminate fall prevention programs. Stand Tall (ST) is a virtual translation of the Otago Exercise Program (OEP), an evidence-based fall prevention program. Stand Tall was developed using the Virtual Exercise Rehabilitation Assistant (VERA) software, which uses a Kinect camera and a laptop to deliver physical therapy exercise programs. Our purpose in this pilot study was to explore if ST could be a feasible platform to deliver the OEP to older adults from a variety of fall risk levels, education backgrounds, and self-described level of computer expertise. Adults age 60 and over were recruited to participate in a one-time usability study. The study included orientation to the program, navigation to exercises, and completion of a series of strength and balance exercises. Quantitative analysis described participants and the user experience. A diverse group of individuals participated in the study. Twenty-one potential participants (14 women, 7 men) met the inclusion criteria. The mean age was 69.2 (± 5.8) years, 38% had a high school education, 24% had a graduate degree, and 66% classified as "at risk for falls". Eighteen

  18. Hospital Market Structure and the Behavior of Not-for-Profit Hospitals: Evidence from Responses to California's Disproportionate Share Program

    OpenAIRE

    Mark Duggan

    2000-01-01

    I exploit a plausibly exogenous change in hospital financial incentives to examine whether the behavior of private not-for-profit hospitals varies with the share of nearby hospitals organized as for-profit firms. My results show that not-for-profit hospitals in for-profit intensive areas are significantly more responsive to an increased incentive to treat low-income patients insured by the Medicaid program than are other not-for-profit providers. The heterogeneity in behavior is not due to di...

  19. Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

    Science.gov (United States)

    White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

    2017-10-20

    To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

  20. The effect of the PROSPER partnership model on cultivating local stakeholder knowledge of evidence-based programs: a five-year longitudinal study of 28 communities.

    Science.gov (United States)

    Crowley, D Max; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L; Redmond, Cleve R

    2012-02-01

    A substantial challenge in improving public health is how to facilitate the local adoption of evidence-based interventions (EBIs). To do so, an important step is to build local stakeholders' knowledge and decision-making skills regarding the adoption and implementation of EBIs. One EBI delivery system, called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), has effectively mobilized community prevention efforts, implemented prevention programming with quality, and consequently decreased youth substance abuse. While these results are encouraging, another objective is to increase local stakeholder knowledge of best practices for adoption, implementation and evaluation of EBIs. Using a mixed methods approach, we assessed local stakeholder knowledge of these best practices over 5 years, in 28 intervention and control communities. Results indicated that the PROSPER partnership model led to significant increases in expert knowledge regarding the selection, implementation, and evaluation of evidence-based interventions. Findings illustrate the limited programming knowledge possessed by members of local prevention efforts, the difficulty of complete knowledge transfer, and highlight one method for cultivating that knowledge.

  1. The Crowding-Out Effects of Garbage Fees and Voluntary Source Separation Programs on Waste Reduction: Evidence from China

    Directory of Open Access Journals (Sweden)

    Hongyun Han

    2016-07-01

    Full Text Available This paper examines how and to what degree government policies of garbage fees and voluntary source separation programs, with free indoor containers and garbage bags, can affect the effectiveness of municipal solid waste (MSW management, in the sense of achieving a desirable reduction of per capita MSW generation. Based on city-level panel data for years 1998–2012 in China, our empirical analysis indicates that per capita MSW generated is increasing with per capita disposable income, average household size, education levels of households, and the lagged per capita MSW. While both garbage fees and source separation programs have separately led to reductions in per capita waste generation, the interaction of the two policies has resulted in an increase in per capita waste generation due to the following crowding-out effects: Firstly, the positive effect of income dominates the negative effect of the garbage fee. Secondly, there are crowding-out effects of mandatory charging system and the subsidized voluntary source separation on per capita MSW generation. Thirdly, small subsidies and tax punishments have reduced the intrinsic motivation for voluntary source separation of MSW. Thus, compatible fee charging system, higher levels of subsidies, and well-designed public information and education campaigns are required to promote household waste source separation and reduction.

  2. Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level.

    Science.gov (United States)

    Homaie Rad, Enayatollah; Yazdi-Feyzabad, Vahid; Yousefzadeh-Chabok, Shahrokh; Afkar, Abolhasan; Naghibzadeh, Ahmad

    2017-01-01

    The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program's important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis. Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated. Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%). The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

  3. Cross-country discrepancies on public understanding of stress concepts: evidence for stress-management psychoeducational programs.

    Science.gov (United States)

    Souza-Talarico, Juliana Nery; Wan, Nathalie; Santos, Sheila; Fialho, Patrícia Paes Araujo; Chaves, Eliane Corrêa; Caramelli, Paulo; Bianchi, Estela Ferraz; Santos, Aline Talita; Lupien, Sonia J

    2016-06-03

    Negative effects of stress have pose one of the major threats to the health and economic well being of individuals independently of age and cultural background. Nevertheless, the term "stress" has been globally used unlinked from scientificevidence-based meaning. The discrepancies between scientific and public stress knowledge are focus of concern and little is know about it. This is relevant since misconceptions about stress may influence the effects of stress-management psychoeducational programs and the development of best practices for interventions. The study aimed to analyze stress knowledge among the Canadian and Brazilian general public and to determine the extent to which scientific and popular views of stress differ between those countries. We evaluated 1156 healthy participants between 18 and 88 years of age recruited from Canada (n = 502) and Brazil (n = 654). To assess stress knowledge, a questionnaire composed of questions regarding stress concepts ("stress is bad" versus "stress-free life is good") and factors capable of triggering the stress response ("novelty, unpredictability, low sense of control and social evaluative threat versus "time pressure,work overload, conflict, unbalance and children") was used. Both Canadian and Brazilian participants showed misconceptions about stress and the factors capable of triggering a stress response. However, the rate of misconceptions was higher in Brazil than in Canada (p stress science and its variance according to a country's society. Psychoeducational programs and vulnerability of stress-related disorder are discussed.

  4. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

    Science.gov (United States)

    Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment

  5. The impact of state-level nutrition-education program funding on BMI: evidence from the behavioral risk factor surveillance system.

    Science.gov (United States)

    McGeary, Kerry Anne

    2013-04-01

    Currently, there is insufficient evidence regarding which policies will improve nutrition, reduce BMI levels and the prevalence of obesity and overweight nationwide. This preliminary study investigates the impact of a nutrition-education policy relative to price policy as a means to reduce BMI in the United States (US). Model estimations use pooled cross-sectional data at the individual-level from the Centers for Disease Control's (CDC), Behavioral Risk Factor Surveillance System (BRFSS), state-level food prices from the American Chamber of Commerce Research Association (ACCRA) and funding for state-specific nutrition-education programs from the United States Department of Agriculture (USDA) from 1992 to 2006. The total number of observations for the study is 2,249,713 over 15 years. During this period, federal funding for state-specific nutrition-education programs rose from approximately $660 thousand for seven states to nearly $248 million for all fifty-two states. In 2011, federal funding for nutrition-education programs reached $375 million. After controlling for state-fixed effects, year effects and state specific linear and quadratic time trends, we find that nutrition education spending has the intended effect on BMI, obese and overweight in aggregate. However, we find heterogeneity as individuals from certain, but not all, income and education levels respond to nutrition-education funding. The results regarding nutrition-education programs suggest that large scale funding of nutrition-education programs may improve BMI levels and reduce obesity and overweight. However, more study is required to determine if these funds are able make the requisite dietary improvements that may ultimately improve BMI for individuals from low income and education-levels. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

    Science.gov (United States)

    Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

    2018-01-01

    Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

  7. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

    Science.gov (United States)

    Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

    2018-01-01

    Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

  8. Nationally Certified School Psychologists' use and reported barriers to using evidence-based interventions in schools: the influence of graduate program training and education.

    Science.gov (United States)

    Hicks, Taylor B; Shahidullah, Jeffrey D; Carlson, John S; Palejwala, Mohammed H

    2014-12-01

    The purpose of this study was to empirically investigate Nationally Certified School Psychologists' (NCSP) training in and use of evidence-based interventions (EBIs) for child behavior concerns as well as their reported implementation barriers. A modified Tailored Design Method (TDM; Dillman, Smyth, & Christian, 2009) using up to four mail-based participant contacts was used to obtain survey data (72% usable response rate; n = 392) from a randomly selected national sample of 548 currently practicing NCSPs. Lack of time was rated as the most serious barrier to behavioral EBI implementation, followed by a lack of necessary resources, and financial constraints. Nearly three-quarters (71%) of respondents reported a perceived inadequacy of graduate program training in behavioral EBIs, with a statistically significant difference found between respondents who attended American Psychological Association (APA)-accredited/National Association of School Psychologists (NASP)-approved programs and those who did not. These findings highlight the significant barriers school psychologists encounter when attempting to implement behavioral EBIs within applied practice, as well as the importance of graduate program training in implementation science. Implications for training, practice, and research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico.

    Science.gov (United States)

    Garcia-Diaz, Rocio; Sosa-Rubi, Sandra G; Sosa-Rub, Sandra G

    2011-07-01

    Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. The mother or the fetus? 11beta-hydroxysteroid dehydrogenase type 2 null mice provide evidence for direct fetal programming of behavior by endogenous glucocorticoids.

    Science.gov (United States)

    Holmes, Megan C; Abrahamsen, Christian T; French, Karen L; Paterson, Janice M; Mullins, John J; Seckl, Jonathan R

    2006-04-05

    Low birth weight associates with increased susceptibility to adult cardiometabolic and affective disorders spawning the notion of fetal "programming." Prenatal exposure to excess glucocorticoids may be causal. In support, maternal stress or treatment during pregnancy with dexamethasone (which crosses the placenta) or inhibitors of fetoplacental 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2), the physiological "barrier" to maternal glucocorticoids, reduces birth weight and programs permanent offspring hypertension, hyperglycemia, and anxiety behaviors. It remains uncertain whether such effects are mediated indirectly via altered maternal function or directly on the fetus and its placenta. To dissect this critical issue, we mated 11beta-HSD2(+/-) mice such that each pregnant female produces +/+, +/-, and -/- offspring and compared them with offspring of homozygous wild-type and -/- matings. We show that 11beta-HSD2(-/-) offspring of either +/- or -/- mothers have lower birth weight and exhibit greater anxiety than 11beta-HSD2(+/+) littermates. This provides clear evidence for the key role of fetoplacental 11beta-HSD2 in prenatal glucocorticoid programming.

  11. Stability of children's insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation.

    Science.gov (United States)

    Buchmueller, Thomas; Orzol, Sean M; Shore-Sheppard, Lara

    2014-06-01

    Even as the number of children with health insurance has increased, coverage transitions--movement into and out of coverage and between public and private insurance--have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor's visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.

  12. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs.

    Science.gov (United States)

    Peskin, Melissa F; Hernandez, Belinda F; Gabay, Efrat K; Cuccaro, Paula; Li, Dennis H; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

    2017-01-01

    In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CH oosing A nd M aintaining Effective P rograms for S ex Education in S chools ( iCHAMPSS ), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

  13. Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level

    Directory of Open Access Journals (Sweden)

    Enayatollah Homaie Rad

    2017-07-01

    Full Text Available OBJECTIVES The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP payments and catastrophic health expenditures (CHE. In this study, these goals were evaluated using a before-and-after analysis. METHODS Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated. RESULTS Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%. CONCLUSIONS The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

  14. Evidence of Filamentary Switching in Oxide-based Memory Devices via Weak Programming and Retention Failure Analysis

    Science.gov (United States)

    Younis, Adnan; Chu, Dewei; Li, Sean

    2015-09-01

    Further progress in high-performance microelectronic devices relies on the development of novel materials and device architectures. However, the components and designs that are currently in use have reached their physical limits. Intensive research efforts, ranging from device fabrication to performance evaluation, are required to surmount these limitations. In this paper, we demonstrate that the superior bipolar resistive switching characteristics of a CeO2:Gd-based memory device can be manipulated by means of UV radiation, serving as a new degree of freedom. Furthermore, the metal oxide-based (CeO2:Gd) memory device was found to possess electrical and neuromorphic multifunctionalities. To investigate the underlying switching mechanism of the device, its plasticity behaviour was studied by imposing weak programming conditions. In addition, a short-term to long-term memory transition analogous to the forgetting process in the human brain, which is regarded as a key biological synaptic function for information processing and data storage, was realized. Based on a careful examination of the device’s retention behaviour at elevated temperatures, the filamentary nature of switching in such devices can be understood from a new perspective.

  15. Preparing for national implementation of an evidence-based, effective HIV prevention program among bahamian sixth-grade students.

    Science.gov (United States)

    Knowles, Valerie; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Jones, Giavana; Harris, Carole; Kaljee, Linda; Li, Xiaoming; Koci, Veronica; Chen, Xinguang; Marshall, Sharon; Stanton, Bonita

    2012-01-01

    Using data from the preparatory phase prior to national implementation of an effective HIV prevention program (Focus on Youth in the Caribbean; FOYC) in all Bahamian government sixth-grade classes, we describe (1) actual FOYC implementation, (2) factors that influenced implementation, and (3) the relationship of implementation with intervention outcome. Six elementary schools (with 17 grade six classrooms) were selected to participate in the preparatory phase. The 17 teachers were invited to attend a training workshop, coordinate administration of questionnaires to the students, teach the 10 sessions of FOYC and complete self-assessment checklists. A total of 395 students submitted baseline and 311 students submitted year-end questionnaires. Thirteen teachers initiated FOYC; five completed all 10 sessions. Implementation of FOYC was not related to teacher FOYC workshop experience but did cluster by school. There were significant positive correlations between improved student knowledge of HIV/AIDS, protective health skills, perceived parental monitoring and reduced risk behaviours with the number of FOYC sessions delivered. Implementation was impeded by logistics issues, structural issues with the measures, and comfort-level issues, most of which can be addressed for national implementation. Degree of FOYC implementation is correlated with positive student outcomes.

  16. The Melbourne Family Support Program: evidence-based strategies that prepare family caregivers for supporting palliative care patients

    Science.gov (United States)

    Hudson, Peter; Aranda, Sanchia

    2014-01-01

    Background A key component of palliative care is support for family caregivers. Although some family caregivers identify positive aspects, the impact is typically burdensome; they are prone to physical and psychological morbidity, financial disadvantage and social isolation. Outcomes of systematic reviews have highlighted the importance of investment in family caregiver intervention research. Purpose To provide an overview of the development, evaluation and outcomes arising from of a programme of research (The Melbourne Family Support Program (FSP)), which focused on reducing the psychosocial burden of family caregivers. Methods Developmental work involved a systematic literature review; focus groups with family caregivers and health professionals; and identification of a conceptual framework. Following a pilot randomised controlled trial (RCT), a programme of psychoeducational intervention studies was developed and tested; one via RCT, the others via prepost test. Results Four psychoeducational interventions, incorporating one-to-one and group format delivery, conducted in both the home and inpatient hospital/hospice were evaluated. Statistically significant outcomes included improvements in family caregivers’ preparedness, competence, positive emotions, more favourable levels of psychological wellbeing and a reduction in unmet needs. Internationally endorsed guidelines for the psychosocial support of family caregivers were produced and several resources were constructed. Fifteen publications in international peer-reviewed journals have arisen from this programme. Conclusions The interventions and resources from the Melbourne FSP provide several evidenced-based and clinically relevant approaches that focus on reducing the psychosocial burden of the caregiving role. In several instances, however, more rigorous methodological testing is advocated. PMID:24644195

  17. Evidence from the field: Findings on issues related to planning, implementing and evaluating gender-based programs.

    Science.gov (United States)

    Kowalczyk, Shelly; Randolph, Suzanne; Stokes, Shereitte; Winston, Stefanie

    2015-08-01

    An Initiative of the United States Department of Health and Human Services' Office on Women's Health (OWH), Coalition for a Healthier Community (CHC), supports ten grantees across the U.S. in the implementation of gender-based health interventions targeting women and girls. A national evaluation is assessing whether gender-focused public health systems approaches are sustainable and cost effective in addressing health disparities in women and girls. To inform the evaluation, a systematic examination was conducted of literature in both the public and private sector designed to track, assess, understand, and improve women's health, public health systems approaches, and the cost-effectiveness and sustainability of gender-based programs. A two-person team assured the quality of the results following the review of abstracts and full-text articles. Of 123 articles meeting eligibility criteria (See inclusion criteria described in Section 2.2 below), only 18 met inclusion criteria specific to a focus on a systems approach, cost-effectiveness and/or sustainability. Studies assessing systems approaches suggested their effectiveness in changing perceptions and increasing knowledge within a community; increasing involvement of local decision-makers and other community leaders in women's health issues; and increasing community capacity to address women and girls' health. Further evaluation of the cost-effectiveness and sustainability of gender-based approaches is needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. The Relationship Between Exclusions from Gambling Arcades and Accessibility: Evidence from a Newly Introduced Exclusion Program in Hesse, Germany.

    Science.gov (United States)

    Strohäker, Tanja; Becker, Tilman

    2018-02-28

    An exclusion system for gambling arcades has been introduced recently in the state of Hesse. The aim of this paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. Next to socio-demographic factors, we control for three different accessibility variables in two models: the number of electronic gambling machines (EGMs) in model I, and the number of locations and density of gambling machines at a location in model II. We disentangle the association between EGMs and exclusions of model I into a location and a clustering effect. Considering the socio-demographic variables, the explanatory power of our cross-sectional models is rather low. Only the age group of the 30-39 years old and those who are not in a partnership (in model I) yield significant results. As self-exclusion systems reduce availability for the group of vulnerable players, this analysis provides evidence for the assumption that the two groups-pathological gamblers and vulnerable players-seem to have little overlap concerning sociodemographic characteristics. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The results of model II show that the location effect is more pronounced then the clustering effect of EGMs, i.e. the effect of an additional single-licensed arcade on the number of exclusions is stronger than the increase in the number of license at one location.

  19. A nurse-facilitated depression screening program in an Army primary care clinic: an evidence-based project.

    Science.gov (United States)

    Yackel, Edward E; McKennan, Madelyn S; Fox-Deise, Adrianna

    2010-01-01

    Depression, sometimes with suicidal manifestations, is a medical condition commonly seen in primary care clinics. Routine screening for depression and suicidal ideation is recommended of all adult patients in the primary care setting because it offers depressed patients a greater chance of recovery and response to treatment, yet such screening often is overlooked or omitted. The purpose of this study was to develop, to implement, and to test the efficacy of a systematic depression screening process to increase the identification of depression in family members of active duty soldiers older than 18 years at a military family practice clinic located on an Army infantry post in the Pacific. The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to develop a practice guideline incorporating a decision algorithm for nurses to screen for depression. A pilot project to institute this change in practice was conducted, and outcomes were measured. Before implementation, approximately 100 patients were diagnosed with depression in each of the 3 months preceding the practice change. Approximately 130 patients a month were assigned a 311.0 Code 3 months after the practice change, and 140 patients per month received screenings and were assigned the correct International Classification of Diseases, Ninth Revision Code 311.0 at 1 year. The improved screening and coding for depression and suicidality added approximately 3 minutes to the patient screening process. The education of staff in the process of screening for depression and correct coding coupled with monitoring and staff feedback improved compliance with the identification and the documentation of patients with depression. Nurses were more likely than primary care providers to agree strongly that screening for depression enhances quality of care. Data gathered during this project support the integration of military and civilian nurse-facilitated screening for depression in the military primary care

  20. The Melbourne Family Support Program: evidence-based strategies that prepare family caregivers for supporting palliative care patients.

    Science.gov (United States)

    Hudson, Peter; Aranda, Sanchia

    2014-09-01

    A key component of palliative care is support for family caregivers. Although some family caregivers identify positive aspects, the impact is typically burdensome; they are prone to physical and psychological morbidity, financial disadvantage and social isolation. Outcomes of systematic reviews have highlighted the importance of investment in family caregiver intervention research. To provide an overview of the development, evaluation and outcomes arising from of a programme of research (The Melbourne Family Support Program (FSP)), which focused on reducing the psychosocial burden of family caregivers. Developmental work involved a systematic literature review; focus groups with family caregivers and health professionals; and identification of a conceptual framework. Following a pilot randomised controlled trial (RCT), a programme of psychoeducational intervention studies was developed and tested; one via RCT, the others via prepost test. Four psychoeducational interventions, incorporating one-to-one and group format delivery, conducted in both the home and inpatient hospital/hospice were evaluated. Statistically significant outcomes included improvements in family caregivers' preparedness, competence, positive emotions, more favourable levels of psychological wellbeing and a reduction in unmet needs. Internationally endorsed guidelines for the psychosocial support of family caregivers were produced and several resources were constructed. Fifteen publications in international peer-reviewed journals have arisen from this programme. The interventions and resources from the Melbourne FSP provide several evidenced-based and clinically relevant approaches that focus on reducing the psychosocial burden of the caregiving role. In several instances, however, more rigorous methodological testing is advocated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Evidence of cardiac involvement in the fetal inflammatory response syndrome: disruption of gene networks programming cardiac development in nonhuman primates.

    Science.gov (United States)

    Mitchell, Timothy; MacDonald, James W; Srinouanpranchanh, Sengkeo; Bammler, Theodor K; Merillat, Sean; Boldenow, Erica; Coleman, Michelle; Agnew, Kathy; Baldessari, Audrey; Stencel-Baerenwald, Jennifer E; Tisoncik-Go, Jennifer; Green, Richard R; Gale, Michael J; Rajagopal, Lakshmi; Adams Waldorf, Kristina M

    2018-04-01

    Most early preterm births are associated with intraamniotic infection and inflammation, which can lead to systemic inflammation in the fetus. The fetal inflammatory response syndrome describes elevations in the fetal interleukin-6 level, which is a marker for inflammation and fetal organ injury. An understanding of the effects of inflammation on fetal cardiac development may lead to insight into the fetal origins of adult cardiovascular disease. The purpose of this study was to determine whether the fetal inflammatory response syndrome is associated with disruptions in gene networks that program fetal cardiac development. We obtained fetal cardiac tissue after necropsy from a well-described pregnant nonhuman primate model (pigtail macaque, Macaca nemestrina) of intrauterine infection (n=5) and controls (n=5). Cases with the fetal inflammatory response syndrome (fetal plasma interleukin-6 >11 pg/mL) were induced by either choriodecidual inoculation of a hypervirulent group B streptococcus strain (n=4) or intraamniotic inoculation of Escherichia coli (n=1). RNA and protein were extracted from fetal hearts and profiled by microarray and Luminex (Millipore, Billerica, MA) for cytokine analysis, respectively. Results were validated by quantitative reverse transcriptase polymerase chain reaction. Statistical and bioinformatics analyses included single gene analysis, gene set analysis, Ingenuity Pathway Analysis (Qiagen, Valencia, CA), and Wilcoxon rank sum. Severe fetal inflammation developed in the context of intraamniotic infection and a disseminated bacterial infection in the fetus. Interleukin-6 and -8 in fetal cardiac tissues were elevated significantly in fetal inflammatory response syndrome cases vs controls (P1.5-fold change, P<.05) in the fetal heart (analysis of variance). Altered expression of select genes was validated by quantitative reverse transcriptase polymerase chain reaction that included several with known functions in cardiac injury, morphogenesis

  2. Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

    Science.gov (United States)

    Smith, Tamara; Clark, Judith F; Nigg, Claudio R

    2015-01-01

    Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

  3. Is Project Towards No Drug Abuse (Project TND) an evidence-based drug and violence prevention program? A review and reappraisal of the evaluation studies.

    Science.gov (United States)

    Gorman, Dennis M

    2014-08-01

    This paper critically reviews the published evidence pertaining to Project Towards No Drug Abuse (Project TND). Publications from seven evaluation studies of Project TND are reviewed, and the results from these are discussed as related to the following outcomes: main effects on the use of cigarettes, alcohol and marijuana; main effects on the use of "hard drugs," defined in the evaluations as cocaine, hallucinogens, stimulants, inhalants, ecstasy and other drugs (e.g., depressants, PCP, steroids and heroin); subgroup and interaction analyses of drug use; and violence-related behaviors. Very few main effects have been found for cigarette, alcohol and marijuana use in the Project TND evaluations. While studies do report main effects for hard drug use, these findings are subject to numerous threats to validity and may be attributable to the data analyses employed. Similarly, while isolated subgroup and interaction effects were found for alcohol use among baseline nonusers and some violence-related behaviors in the early Project TND evaluations, these findings have not been replicated in more recent studies and may result from multiple comparisons between study conditions. In conclusion, there is little evidence to support the assertion that Project TND is an effective drug or violence prevention program. The broader implications of these findings for prevention science are discussed and suggestions are made as to how the quality of research in the field might be improved.

  4. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    Science.gov (United States)

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  5. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

    Directory of Open Access Journals (Sweden)

    Jimena Fritz

    Full Text Available In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP. Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness.To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO on the performance of EBP in normal births.A pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training. Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554.Significant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p. for complete Active Management of Third Stage of Labor (AMTSL (p = 0.044, and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067; at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026 and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004; at 4 months a 30 (p = 0.001 and at 8 months a 22 (p = 0.010 p.p. decrease for Uterine Sweeping.The intervention has an impact on adopting EBP at birth, contributing to

  6. Top-down, bottom-up, and around the jungle gym: a social exchange and networks approach to engaging afterschool programs in implementing evidence-based practices.

    Science.gov (United States)

    Smith, Emilie Phillips; Wise, Eileen; Rosen, Howard; Rosen, Alison; Childs, Sharon; McManus, Margaret

    2014-06-01

    This paper uses concepts from social networks and social exchange theories to describe the implementation of evidence-based practices in afterschool programs. The members of the LEGACY Together Afterschool Project team have been involved in conducting collaborative research to migrate a behavioral strategy that has been documented to reduce disruptive behaviors in classroom settings to a new setting-that of afterschool programs. We adapted the Paxis Institute's version of the Good Behavior Game to afterschool settings which differ from in-school settings, including more fluid attendance, multiple age groupings, diverse activities that may take place simultaneously, and differences in staff training and experience (Barrish et al. in J Appl Behav Anal 2(2):119-124, 1969; Embry et al. in The Pax Good Behavior Game. Hazelden, Center City, 2003; Hynes et al. in J Child Serv 4(3):4-20, 2009; Kellam et al. in Drug Alcohol Depend 95:S5-S28, 2008; Tingstrom et al. in Behav Modif 30(2):225-253, 2006). This paper presents the experiences of the three adult groups involved in the implementation process who give first-person accounts of implementation: (1) university-based scientist-practitioners, (2) community partners who trained and provided technical assistance/coaching, and (3) an afterschool program administrator. We introduce here the AIMS model used to frame the implementation process conceptualized by this town-gown collaborative team. AIMS builds upon previous work in implementation science using four phases in which the three collaborators have overlapping roles: approach/engagement, implementation, monitoring, and sustainability. Within all four phases principles of Social Exchange Theory and Social Network Theory are highlighted.

  7. Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an 'evidence-based climatic health' transfrontier training program.

    Science.gov (United States)

    Lapaige, Véronique; Essiembre, Hélène

    2010-01-01

    It has become increasingly clear to the international scientific community that climate change is real and has important consequences for human health. To meet these new challenges, the World Health Organization recommends reinforcing the adaptive capacity of health systems. One of the possible avenues in this respect is to promote awareness and knowledge translation in climatic health, at both the local and global scales. Within such perspective, two major themes have emerged in the field of public health research: 1) the development of advanced training adapted to 'global environment' change and to the specific needs of various groups of actors (doctors, nurses, public health practitioners, health care managers, public service managers, local communities, etc) and 2) the development of strategies for implementing research results and applying various types of evidence to the management of public health issues affected by climate change. Progress on these two fronts will depend on maximum innovation in transdisciplinary and transsectoral collaborations. The general purpose of this article is to present the program of a new research and learning chair designed for this double set of developmental objectives - a chair that emphasizes 'innoversity' (the dynamic relationship between innovation and diversity) and 'transfrontier ecolearning for adaptive actions'. The Écoapprentissages, santé mentale et climat collaborative research chair (University of Montreal and Quebec National Public Health Institute) based in Montreal is a center for 'transdisciplinary research' on the transfrontier knowledge-for-action that can aid adaptation of the public health sector, the public mental health sector, and the public service sector to climate change, as well as a center for complex collaborations on evidence-based climatic health 'training'. This program-focused article comprises two main sections. The first section presents the 'general' and 'specific contexts' in which the

  8. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam's Expanded Program on Immunization.

    Science.gov (United States)

    Mvundura, Mercy; Kien, Vu Duy; Nga, Nguyen Tuyet; Robertson, Joanie; Cuong, Nguyen Van; Tung, Ho Thanh; Hong, Duong Thi; Levin, Carol

    2014-02-07

    Few studies document the costs of operating vaccine supply chains, but decision-makers need this information to inform cost projections for investments to accommodate new vaccine introduction. This paper presents empirical estimates of vaccine supply chain costs for Vietnam's Expanded Program on Immunization (EPI) for routine vaccines at each level of the supply chain, before and after the introduction of the pentavalent vaccine. We used micro-costing methods to collect resource-use data associated with storage and transportation of vaccines and immunization supplies at the national store, the four regional stores, and a sample of provinces, districts, and commune health centers. We collected stock ledger data on the total number of doses of vaccines handled by each facility during the assessment year. Total supply chain costs were estimated at approximately US$65,000 at the national store and an average of US$39,000 per region, US$5800 per province, US$2200 per district, and US$300 per commune health center. Across all levels, cold chain equipment capital costs and labor were the largest drivers of costs. The cost per dose delivered was estimated at US$0.19 before the introduction of pentavalent and US$0.24 cents after introduction. At commune health centers, supply chain costs were 104% of the value of vaccines before introduction of pentavalent vaccine and 24% after introduction, mainly due to the higher price per dose of the pentavalent vaccine. The aggregated costs at the last tier of the health system can be substantial because of the large number of facilities. Even in countries with high-functioning systems, empirical evidence on current costs from all levels of the system can help estimate resource requirements for expanding and strengthening resources to meet future immunization program needs. Other low- and middle-income countries can benefit from similar studies, in view of new vaccine introductions that will put strains on existing systems. Copyright

  9. Data and methods to characterize the role of sex work and to inform sex work programs in generalized HIV epidemics: evidence to challenge assumptions.

    Science.gov (United States)

    Mishra, Sharmistha; Boily, Marie-Claude; Schwartz, Sheree; Beyrer, Chris; Blanchard, James F; Moses, Stephen; Castor, Delivette; Phaswana-Mafuya, Nancy; Vickerman, Peter; Drame, Fatou; Alary, Michel; Baral, Stefan D

    2016-08-01

    In the context of generalized human immunodeficiency virus (HIV) epidemics, there has been limited recent investment in HIV surveillance and prevention programming for key populations including female sex workers. Often implicit in the decision to limit investment in these epidemic settings are assumptions including that commercial sex is not significant to the sustained transmission of HIV, and HIV interventions designed to reach "all segments of society" will reach female sex workers and clients. Emerging empiric and model-based evidence is challenging these assumptions. This article highlights the frameworks and estimates used to characterize the role of sex work in HIV epidemics as well as the relevant empiric data landscape on sex work in generalized HIV epidemics and their strengths and limitations. Traditional approaches to estimate the contribution of sex work to HIV epidemics do not capture the potential for upstream and downstream sexual and vertical HIV transmission. Emerging approaches such as the transmission population attributable fraction from dynamic mathematical models can address this gap. To move forward, the HIV scientific community must begin by replacing assumptions about the epidemiology of generalized HIV epidemics with data and more appropriate methods of estimating the contribution of unprotected sex in the context of sex work. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an 'evidence-based climatic health' transfrontier training program

    Directory of Open Access Journals (Sweden)

    Véronique Lapaige

    2010-12-01

    Full Text Available Véronique Lapaige1–3, Hélène Essiembre41Department of Psychiatry, University of Montreal, Montreal, QC, Canada; 2Fernand-Seguin Research Centre, Montreal, QC, Canada; 3Quebec National Public Health Institute; 4Industrial and Organizational Program, Department of Psychology, University of Montreal, Montreal, QC, CanadaAbstract: It has become increasingly clear to the international scientific community that climate change is real and has important consequences for human health. To meet these new challenges, the World Health Organization recommends reinforcing the adaptive capacity of health systems. One of the possible avenues in this respect is to promote awareness and knowledge translation in climatic health, at both the local and global scales. Within such perspective, two major themes have emerged in the field of public health research: 1 the development of advanced training adapted to 'global environment' change and to the specific needs of various groups of actors (doctors, nurses, public health practitioners, health care managers, public service managers, local communities, etc and 2 the development of strategies for implementing research results and applying various types of evidence to the management of public health issues affected by climate change. Progress on these two fronts will depend on maximum innovation in transdisciplinary and transsectoral collaborations. The general purpose of this article is to present the program of a new research and learning chair designed for this double set of developmental objectives – a chair that emphasizes 'innoversity' (the dynamic relationship between innovation and diversity and 'transfrontier ecolearning for adaptive actions'. The Écoapprentissages, santé mentale et climat collaborative research chair (University of Montreal and Quebec National Public Health Institute based in Montreal is a center for 'transdisciplinary research' on the transfrontier knowledge-for-action that can aid

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Validation Programs Accreditation, Verification, and Validation Programs Accredited Education Institutes ... Entering Resident Readiness Assessment Evidence-Based Decisions in ...

  12. Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence.

    Science.gov (United States)

    Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex

    2016-04-06

    Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given

  13. The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol.

    Science.gov (United States)

    Botha, Elmarie; Gwin, Teri; Purpora, Christina

    2015-10-01

    mindfulness meditation is to empower individuals to respond to situations consciously rather than automatically.Prior to the commencement of this systematic review, the Cochrane Library and JBI Database of Systematic Reviews and Implementation Reports were searched. No previous systematic reviews on the topic of reducing stress experienced by nurses through mindfulness programs were identified. Hence, the objective of this systematic review is to evaluate the best research evidence available pertaining to mindfulness-based programs and their effectiveness in reducing perceived stress among nurses.

  14. Building the evidence base for stigma and discrimination-reduction programming in Thailand: development of tools to measure healthcare stigma and discrimination

    Directory of Open Access Journals (Sweden)

    Kriengkrai Srithanaviboonchai

    2017-03-01

    Full Text Available Abstract Background HIV-related stigma and discrimination (S&D are recognized as key impediments to controlling the HIV epidemic. S&D are particularly detrimental within health care settings because people who are at risk of HIV and people living with HIV (PLHIV must seek services from health care facilities. Standardized tools and monitoring systems are needed to inform S&D reduction efforts, measure progress, and monitor trends. This article describes the processes followed to adapt and refine a standardized global health facility staff S&D questionnaire for the context of Thailand and develop a similar questionnaire measuring health facility stigma experienced by PLHIV. Both questionnaires are currently being used for the routine monitoring of HIV-related S&D in the Thai healthcare system. Methods The questionnaires were adapted through a series of consultative meetings, pre-testing, and revision. The revised questionnaires then underwent field testing, and the data and field experiences were analyzed. Results Two brief questionnaires were finalized and are now being used by the Department of Disease Control to collect national routine data for monitoring health facility S&D: 1 a health facility staff questionnaire that collects data on key drivers of S&D in health facilities (i.e., fear of HIV infection, attitudes toward PLHIV and key populations, and health facility policy and environment and observed enacted stigma and 2 a brief PLHIV questionnaire that captures data on experienced discriminatory practices at health care facilities. Conclusions This effort provides an example of how a country can adapt global S&D measurement tools to a local context for use in national routine monitoring. Such data helps to strengthen the national response to HIV through the provision of evidence to shape S&D-reduction programming.

  15. Foods and beverages offered in US public secondary schools through the National School Lunch Program from 2011-2013: Early evidence of improved nutrition and reduced disparities.

    Science.gov (United States)

    Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D

    2015-09-01

    To present data on trends in foods and beverages offered through the National School Lunch Program (NSLP) in public middle and high schools in the years immediately preceding and following implementation of new NSLP standards. From 2011 to 2013, primary data collection through the annual Youth, Education, and Society study involved use of mailed questionnaires to obtain data on NSLP meals from schools attended by nationally representative samples of US 8(th), 10(th), and 12(th) grade students (N=792 middle schools and 751 high schools). Each school was weighted to represent the percentage of target grade students enrolled, thus allowing analyses examining changes over time in the percentage of students enrolled in (attending) schools with specified NSLP measure outcomes, as well as disparities in NSLP measures based on school characteristics. Significantly more US secondary students attended schools with specified NSLP measures in 2013 than in 2011; increases were observed at both middle and high school levels. Increase rates for some NSLP measures were moderated by school characteristics; where this was the case, moderating associations decreased prior NSLP nutrition environment disparities that were especially evident in smaller schools and schools with higher percentages of minority students. Meaningful improvements have been made in the nutritional content of NSLP meals offered to US secondary students; these improvements have reduced prior NSLP meal disparities associated with school characteristics. Schools will need continued help with implementation and compliance monitoring in order to have the best opportunity to improve the nutrition environments for US students. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. School-Based Programs Aimed at the Prevention and Treatment of Obesity: Evidence-Based Interventions for Youth in Latin America

    Science.gov (United States)

    Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K.; Nagle, Brian J.; Arredondo, Elva M.; Barquera, Simon; Elder, John P.

    2013-01-01

    Background: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be…

  17. Baseline results from the Lichen Community Indicator Program in the Pacific Northwest: Air quality patterns and evidence of a nitrogen pollution problem

    Science.gov (United States)

    Sarah Jovan

    2009-01-01

    Why Are Epiphytic Lichen Communities Important? Lichens are one of the bioindicators used by the Forest Inventory and Analysis (FIA) Program to monitor forest health. To obtain data for use in its Lichen Community Indicator Program, FIA samples a regular network of permanent field plots to determine the composition of epiphytic, i.e., tree dwelling, lichen communities...

  18. The Effect of Providing Breakfast on Student Performance: Evidence from an In-Class Breakfast Program. NBER Working Paper No. 17720

    Science.gov (United States)

    Imberman, Scott A.; Kugler, Adriana D.

    2012-01-01

    In response to low take-up, many public schools have experimented with moving breakfast from the cafeteria to the classroom. We examine whether such a program increases performance as measured by standardized test scores, grades and attendance rates. We exploit quasi-random timing of program implementation that allows for a…

  19. Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

    Science.gov (United States)

    Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

    2015-01-01

    An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

  20. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

    Science.gov (United States)

    Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

    2016-06-01

    Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

  1. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

    Directory of Open Access Journals (Sweden)

    Mercy Abbey

    2017-01-01

    Full Text Available Abstract Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. Results The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. Conclusion We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  2. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach.

    Science.gov (United States)

    Abbey, Mercy; Bartholomew, L Kay; Chinbuah, Margaret A; Gyapong, Margaret; Gyapong, John O; van den Borne, Bart

    2017-01-25

    This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  3. A Reply to the Commentaries on "School-wide PBIS: An Example of Applied Behavior Analysis Implemented at a Scale of Social Importance" by Horner and Sugai (2015): PBIS is Function over Form: The Clear Behavioral Roots and Opportunities the PBIS Framework presents to the Field of Behavior Analysis Moving Forward.

    Science.gov (United States)

    Putnam, Robert F; Knoster, Tim

    2016-03-01

    In the previous issue of Behavior Analysis in Practice (May 2015), a special section of the journal was devoted to positive behavior intervention and support (PBIS). Horner and Sugai (2015) published a manuscript providing an overview of school-wide PBIS describing how PBIS is an example of applied behavior analysis at a scale of social importance. A number of manuscripts providing commentary on the Horner and Sugai manuscript were also published in this special section of the journal. This paper will review this PBIS manuscript along with the associated commentaries published in the May 2015 special section.

  4. Efficacy and safety of human papillomavirus vaccine for primary prevention of cervical cancer: A review of evidence from phase III trials and national programs

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    Partha Basu

    2013-01-01

    Full Text Available The Human Papillomavirus (HPV vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways - it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention programs. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of the clinical trial results convincingly and consistently proving their efficacy and safety. Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost-effective approach to reduce the burden of cervical cancer. The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries.

  5. Can chronic disease management programs for patients with type 2 diabetes reduce productivity-related indirect costs of the disease? Evidence from a randomized controlled trial.

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    Adepoju, Omolola E; Bolin, Jane N; Ohsfeldt, Robert L; Phillips, Charles D; Zhao, Hongwei; Ory, Marcia G; Forjuoh, Samuel N

    2014-04-01

    The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; Pmanagement programs examined in this trial affect indirect productivity losses.

  6. An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial.

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    Loew, Laurianne; Brosseau, Lucie; Kenny, Glen P; Durand-Bush, Natalie; Poitras, Stéphane; De Angelis, Gino; Wells, George A

    2017-07-01

    Knee osteoarthritis is a common joint problem leading to an increase of pain and a loss of function in older individuals. The main objective of this study was to evaluate if a participant who was randomly assigned to his preferred group improved his adherence to an effective walking program compared to a participant who did not receive his preferred group. This was a 9-month pilot randomized clinical trial, based on a patient treatment preferences design. The 69 eligible participants had a diagnosis of knee osteoarthritis. Participants were randomized to one of two groups: a supervised community-based or unsupervised walking program, based on the Ottawa Panel guidelines. At 6 months, participants who expressed a preference, either for the supervised or unsupervised program, and who were assigned to their preferred choice of program showed significantly higher adherence to walking sessions (supervised 60.7 ± 12.3%, P walking program, while ensuring the maintenance of clinical benefits of walking, among older adults susceptible to avoid or not properly engage in physical activity.

  7. Performance Information and Retrospective Voting: Evidence from a School Accountability Regime. Program on Education Policy and Governance Working Paper Series. PEPG 15-03

    Science.gov (United States)

    Barrows, Samuel

    2015-01-01

    Governments are increasingly publishing information about the performance of the services they provide, in part to help citizens hold their elected representatives accountable for government service outcomes. Yet there is little evidence concerning the influence of information about government service performance on voter behavior. This paper…

  8. The Walking Classroom: Active Learning Is Just Steps Away!

    Science.gov (United States)

    Becker, Kelly Mancini

    2016-01-01

    Walking is a viable and valuable form of exercise for young children that has both physical and mental health benefits. There is much evidence showing that school-age children are not getting the recommended 60 minutes of daily exercise. A school-wide walking program can be a great way to encourage walking in and out of school, can be aligned with…

  9. The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

    Science.gov (United States)

    McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

    2014-01-01

    This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.

  10. Can Low-Cost Online Summer Math Programs Improve Student Preparation for College-Level Math? Evidence from Randomized Experiments at Three Universities

    Science.gov (United States)

    Chingos, Matthew M.; Griffiths, Rebecca J.; Mulhern, Christine

    2017-01-01

    Every year many students enter college without the math preparation needed to succeed in their desired programs of study. Many of these students struggle to catch up, especially those who are required to take remedial math courses before entering college-level math. Increasing the number of students who begin at the appropriate level of math has…

  11. Evidence of the Adoption and Implementation of a Statewide Childhood Obesity Prevention Initiative in the New York State WIC Program: The "NY Fit WIC" Process Evaluation

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    Sekhobo, Jackson P.; Egglefield, Katherine; Edmunds, Lynn S.; Shackman, Gene

    2012-01-01

    Process evaluations are critical in determining whether outcome evaluations are warranted. This study assessed the extent to which a childhood obesity prevention initiative, "NY Fit WIC", was adopted and implemented by the New York State Supplemental Nutrition Program for Women, Infants and Children (WIC). Process data came from…

  12. An In-Depth Analysis of Teaching Themes and the Quality of Teaching in Higher Education: Evidence from the Programming Education Environments

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    Xia, Belle Selene

    2017-01-01

    Education research in computer science has emphasized the research of web-based learning environments as a result of the latest technological advancement in higher education. Our research aim is to offer new insights on the different teaching strategies in programming education both from a theoretical and empirical point of view as a response to…

  13. Will the beneficiaries of the “Minha Casa, Minha Vida” program be satisfied? Empirical evidence in the state of Minas Gerais [doi: 10.21529/RECADM.2017008

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    Vinicius Souza Moreira

    2017-10-01

    Full Text Available The “Minha Casa, Minha Vida” Program (PMCMV is the main Brazilian government initiative to remedy the country's housing deficit, which, due to its reality, requires adequate management, avoiding detours that could make it unfeasible. In this sense, the objective was to evaluate the PMCMV results based on the perception of the beneficiary families. The theoretical framework was based on the concepts of evaluation of social programs and their application to the housing context. The investigation occurred in Minas Gerais, considering a sample of 110 families distributed in eight municipalities. We adopted three categories: housing unit, housing complex and environment. In relation to the housing unit, beneficiaries of horizontal housing were more satisfied; large families showed lower satisfaction and the second phase of the Program was better evaluated. On the housing set, beneficiaries of the vertical groups, with less members and of enterprises of the second phase were more satisfied. As for the environment, there was a decrease in satisfaction with infrastructure and access to the city as family size increased. From the contact with the beneficiaries was clear the social importance of the PMCMV and the modification promoted in their lives. It is considered necessary, based on the critical points raised, to continue making corrections in the Program so that the promoted improvements can solve the social inequalities.   Keywords Housing; Evaluation; Public policy; Satisfaction.

  14. The Role of Practitioner Self-Efficacy, Training, Program and Workplace Factors on the Implementation of an Evidence-Based Parenting Intervention in Primary Care

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    Turner, Karen M. T.; Nicholson, Jan M.; Sanders, Matthew R.

    2011-01-01

    This study examines factors affecting the implementation by primary care practitioners (nursing, education, allied health, and medical) of a brief parenting and family support intervention (the Primary Care Triple P--Positive Parenting Program) following professional training. It assesses the impact of prior experience, self-efficacy, program…

  15. Do open youth unemployment and youth programs leave the same mental health scars?--Evidence from a Swedish 27-year cohort study.

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    Strandh, Mattias; Nilsson, Karina; Nordlund, Madelene; Hammarström, Anne

    2015-11-20

    Recent findings suggest that the mental health costs of unemployment are related to both short- and long-term mental health scars. The main policy tools for dealing with young people at risk of labor market exclusion are Active Labor Market Policy programs for youths (youth programs). There has been little research on the potential effects of participation in youth programs on mental health and even less on whether participation in such programs alleviates the long-term mental health scarring caused by unemployment. This study compares exposure to open youth unemployment and exposure to youth program participation between ages 18 and 21 in relation to adult internalized mental health immediately after the end of the exposure period at age 21 and two decades later at age 43. The study uses a five wave Swedish 27-year prospective cohort study consisting of all graduates from compulsory school in an industrial town in Sweden initiated in 1981. Of the original 1083 participants 94.3% of those alive were still participating at the 27-year follow up. Exposure to open unemployment and youth programs were measured between ages 18-21. Mental health, indicated through an ordinal level three item composite index of internalized mental health symptoms (IMHS), was measured pre-exposure at age 16 and post exposure at ages 21 and 42. Ordinal regressions of internalized mental health at ages 21 and 43 were performed using the Polytomous Universal Model (PLUM). Models were controlled for pre-exposure internalized mental health as well as other available confounders. Results show strong and significant relationships between exposure to open youth unemployment and IMHS at age 21 (OR = 2.48, CI = 1.57-3.60) as well as at age 43 (OR = 1.71, CI = 1.20-2.43). No such significant relationship is observed for exposure to youth programs at age 21 (OR = 0.95, CI = 0.72-1.26) or at age 43 (OR = 1.23, CI = 0.93-1.63). A considered and consistent active labor

  16. Can a cognitive-behavioral group-therapy training program for the treatment of child sexual abuse reduce levels of burnout and job-strain in trainees? initial evidence of a brazilian model

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    Bruno Figueiredo Damásio

    2014-05-01

    Full Text Available This study evaluated the extent to which a professional training program of an evidence-based intervention for the treatment of child and adolescent victims of sexual abuse could reduce strain and burnout levels in trainees. Participants were 30 psychologists, 19 of whom composed the experimental group (G1 and 11 the comparison group (G2. Data collection occurred before and after the training. The results showed that the ‘work demand’ increased for G1 and remained stable for G2, whereas the ‘control at work’ remained stable for G1 while decreasing for G2. Regarding burnout levels, there was a decrease in depersonalization and stabilization in the levels of emotional exhaustion and reduced professional efficacy for G1, whereas for G2, all the burnout indicators significantly increased. These results partially support the perspective that the training program would have an indirect protective effect on the occupational psychopathology levels of the trainees.

  17. Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X†

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    Bailey, Martha J.

    2012-01-01

    Almost 50 years after domestic US family planning programs began, their effects on childbearing remain controversial. Using the county-level roll-out of these programs from 1964 to 1973, this paper reevaluates their shorter and longer term effects on US fertility rates. I find that the introduction of family planning is associated with significant and persistent reductions in fertility driven both by falling completed childbearing and childbearing delay. Although federally funded family planning accounted for a small portion of the post-baby boom US fertility decline, my estimates imply that they reduced childbearing among poor women by 19 to 30 percent. (JEL I38, J12, J13, J18) PMID:22582135

  18. A window into a public program for prevention of mother to child transmission of HIV: Evidence from a prospective clinical trial

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    M Cotton

    2009-12-01

    Full Text Available Objectives To evaluate efficacy of the antenatal, intra-partum and post-natal antiretroviral components of a public service Prevention of Mother to Child (MTCT program in infants. Design Analysis of prospectively collected screening data of demographic and MTCT-related interventions and HIV-infection status of infants identified through HIV-specific DNA polymerase chain reaction. Setting Tygerberg Children’s Hospital, Western Cape Province, South Africa. Subjects HIV-infected women and their infants identified through participation in a public service MTCT program were referred for possible participation in a prospective study of isoniazid prophylaxis. Interventions Key components of the Program include voluntary counselling and testing, zidovudine to the mother from between 28 and 34 weeks gestation and to the newborn infant for the first week, single dose nevirapine to the mother in labour and the newborn shortly after birth and free formula for 6 months. Main Outcome Measures Number and percentage of HIV-infected infants and extent of exposure to antenatal, intrapartum and post-natal antiretrovirals. Results Of 656 infants with a median age of 12.6 weeks, screened between April 1st 2005 through May 2006, 39 were HIV-infected giving a transmission rate of 5.9% (95% CI: 4.4% - 8.0%. Antenatal prophylaxis was significantly associated with reduced transmission (OR: 0.43 (95% CI: 0.21 - 0.94 as opposed to intrapartum and postpartum components (p=0.85 and p=0.84, respectively. In multivariable analysis the antenatal component remained significant (OR=0.40 (95% CI 0.19 - 0.90. Conclusions The antenatal phase is the most important antiretroviral component of the MTCT program, allowing most opportunity for intervention.

  19. Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations.

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    Perraton, L; Machotka, Z; Grimmer, K; Gibbs, C; Mahar, C; Kennedy, K

    2017-04-01

    Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing

  20. Can colorectal cancer mass-screening organization be evidence-based? Lessons from failures: The experimental and pilot phases of the Lazio program

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    Valle Sabrina

    2008-09-01

    Full Text Available Abstract Background Screening programmes should be organized to translate theoretical efficacy into effectiveness. An evidence-based organizational model of colorectal cancer screening (CRCS should assure feasibility and high compliance. Methods A multidisciplinary Working Group (WG, reviewed literature and guidelines to define evidence-based recommendations. The WG identified the need for further local studies: physicians' CRCS attitudes, the effect of test type and provider on compliance, and individual reasons for non-compliance. A survey of digestive endoscopy services was conducted. A feasibility study on a target population of 300.000 has begun. Results Based on the results of population trials and on literature review the screening strategy adopted was Faecal Occult Blood Test (FOBT every two years for 50–74 year olds and, for positives, colonoscopy. The immunochemical test was chosen because it has 20% higher compliance than the Guaiac. GPs were chosen as the preferred provider also for higher compliance. Since we observed that distance is the major determinant of non-compliance, we choose GPs because they are the closest providers, both geographically and emotionally, to the public. The feasibility study showed several barriers: GP participation was low, there were administrative problems to involve GPs; opportunistic testing by the GPs; difficulties in access to Gastroenterology centres; difficulties in gathering colonoscopy results; little time given to screening activity by the gastroenterology centre. Conclusion The feasibility study highlighted several limits of the model. Most of the barriers that emerged were consequences of organisational choices not supported by evidence. The principal limit was a lack of accountability by the participating centres.

  1. Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

    Science.gov (United States)

    Fox, Annie B; Hamilton, Alison B; Frayne, Susan M; Wiltsey-Stirman, Shannon; Bean-Mayberry, Bevanne; Carney, Diane; Di Leone, Brooke A L; Gierisch, Jennifer M; Goldstein, Karen M; Romodan, Yasmin; Sadler, Anne G; Yano, Elizabeth M; Yee, Ellen F; Vogt, Dawne

    2016-01-01

    Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training. To evaluate whether EBQI could enhance the impact of an evidence-based training intended to improve veterans affairs health care staff gender sensitivity and knowledge (Caring for Women Veterans; CWV), we compared the reach and effectiveness of EBQI delivery versus standard web-based implementation strategies of CWV and assessed barriers and facilitators to EBQI implementation. Workgroups at four diverse veterans affairs health care sites were randomized to either an EBQI or standard web-based implementation condition (SI). All EBQI sites selected a group-based implementation strategy. Employees (N = 84) completed pretraining and posttraining assessments of gender sensitivity and knowledge, and focus groups/interviews were conducted with leadership and staff before and after implementation. Reach of CWV was greater in the EBQI condition versus the SI condition. Whereas both gender sensitivity and knowledge improved in the EBQI condition, only gender sensitivity improved in the SI condition. Qualitative analyses revealed that the EBQI approach was well received, although a number of barriers were identified. Findings suggest that EBQI can enhance the uptake and effectiveness of employee trainings. However, the decision to pursue EBQI must be informed by a consideration of available resources.

  2. Sexual dimorphism in activation of placental autophagy in obese women with evidence for fetal programming from a placenta-specific mouse model.

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    Muralimanoharan, Sribalasubashini; Gao, Xiaoli; Weintraub, Susan; Myatt, Leslie; Maloyan, Alina

    2016-05-03

    The incidence of maternal obesity and its co-morbidities (diabetes, cardiovascular disease) continues to increase at an alarming rate, with major public health implications. In utero exposure to maternal obesity has been associated with development of cardiovascular and metabolic diseases in the offspring as a result of developmental programming. The placenta regulates maternal-fetal metabolism and shows significant changes in its function with maternal obesity. Autophagy is a cell-survival process, which is responsible for the degradation of damaged organelles and misfolded proteins. Here we show an activation of autophagosomal formation and autophagosome-lysosome fusion in placentas of males but not females from overweight (OW) and obese (OB) women vs. normal weight (NW) women. However, total autophagic activity in these placentas appeared to be decreased as it showed an increase in SQSTM1/p62 and a decrease in lysosomal biogenesis. A mouse model with a targeted deletion of the essential autophagy gene Atg7 in placental tissue showed significant placental abnormalities comparable to those seen in human placenta with maternal obesity. These included a decrease in expression of mitochondrial genes and antioxidants, and decreased lysosomal biogenesis. Strikingly, the knockout mice were developmentally programmed as they showed an increased sensitivity to high-fat diet-induced obesity, hyperglycemia, hyperinsulinemia, increased adiposity, and cardiac remodeling. In summary, our results indicate a sexual dimorphism in placental autophagy in response to maternal obesity. We also show that autophagy plays an important role in placental function and that inhibition of placental autophagy programs the offspring to obesity, and to metabolic and cardiovascular diseases.

  3. Economic analysis for evidence-based policy-making on a national immunization program: a case of rotavirus vaccine in Thailand.

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    Muangchana, Charung; Riewpaiboon, Arthorn; Jiamsiri, Suchada; Thamapornpilas, Piyanit; Warinsatian, Porpit

    2012-04-16

    Severe diarrhea caused by rotavirus is a health problem worldwide, including Thailand. The World Health Organization has recommended incorporating rotavirus vaccination into national immunization programs. This policy has been implemented in several countries, but not in Thailand where the mortality rate is not high. This leads to the question of whether it would be cost-effective to implement such a policy. The Thai National Vaccine Committee, through the Immunization Practice Subcommittee, has conducted an economic analysis. Their study aimed to estimate the costs of rotavirus diarrhea and of a rotavirus vaccination program, and the cost-effectiveness of such a program including budget impact analysis. The study was designed as an economic evaluation, employing modeling technique in both provider and societal perspectives. A birth cohort of Thai children in 2009 was used in the analysis, with a 5-year time horizon. Costs were composed of cost of the illness and the vaccination program. Outcomes were measured in the form of lives saved and DALYs averted. Both costs and outcomes were discounted at 3%. The study found the discounted number of deaths to be 7.02 and 20.52 for vaccinated and unvaccinated cohorts, respectively (13.5 deaths averted). Discounted DALYs were 263.33 and 826.57 for vaccinated and unvaccinated cohorts, respectively (563.24 DALYs averted). Costs of rotavirus diarrhea in a societal perspective were US$6.6 million and US$21.0 million for vaccinated and unvaccinated cohorts, respectively. At base case, the costs per additional death averted were US$5.1 million and US$5.7 for 2-dose and 3-dose vaccines, respectively, in a societal perspective. Costs per additional DALYs averted were US$128,063 and US$142,144, respectively. In a societal perspective, with a cost-effectiveness threshold at 1 GDP per capita per DALYs averted, vaccine prices per dose were US$4.98 and US$3.32 for 2-dose and 3-dose vaccines, respectively; in a provider perspective, they

  4. Barriers and facilitators to evidence based care of type 2 diabetes patients: experiences of general practitioners participating to a quality improvement program

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    Hannes Karen

    2009-07-01

    Full Text Available Abstract Objective To evaluate the barriers and facilitators to high-quality diabetes care as experienced by general practitioners (GPs who participated in an 18-month quality improvement program (QIP. This QIP was implemented to promote compliance with international guidelines. Methods Twenty out of the 120 participating GPs in the QIP underwent semi-structured interviews that focused on three questions: 'Which changes did you implement or did you observe in the quality of diabetes care during your participation in the QIP?' 'According to your experience, what induced these changes?' and 'What difficulties did you experience in making the changes?' Results Most GPs reported that enhanced knowledge, improved motivation, and a greater sense of responsibility were the key factors that led to greater compliance with diabetes care guidelines and consequent improvements in diabetes care. Other factors were improved communication with patients and consulting specialists and reliance on diabetes nurse educators. Some GPs were reluctant to collaborate with specialists, and especially with diabetes educators and dieticians. Others blamed poor compliance with the guidelines on lack of time. Most interviewees reported that a considerable minority of patients were unwilling to change their lifestyles. Conclusion Qualitative research nested in an experimental trial may clarify the improvements that a QIP may bring about in a general practice, provide insight into GPs' approach to diabetes care and reveal the program's limits. Implementation of a QIP encounters an array of cognitive, motivational, and relational obstacles that are embedded in a patient-healthcare provider relationship.

  5. Evaluating evidence-based health care teaching and learning in the undergraduate human nutrition; occupational therapy; physiotherapy; and speech, language and hearing therapy programs at a sub-Saharan African academic institution.

    Science.gov (United States)

    Schoonees, Anel; Rohwer, Anke; Young, Taryn

    2017-01-01

    It is important that all undergraduate healthcare students are equipped with evidence-based health care (EBHC) knowledge and skills to encourage evidence-informed decision-making after graduation. We assessed EBHC teaching and learning in undergraduate human nutrition (HN); occupational therapy (OT); physiotherapy (PT); and speech, language and hearing therapy (SPLH) programs at a sub-Saharan African university. We used methodological triangulation to obtain a comprehensive understanding of EBHC teaching and learning: (1) through a document review of module guides, we identified learning outcomes related to pre-specified EBHC competencies; we conducted (2) focus group discussions and interviews of lecturers to obtain their perspectives on EBHC and on EBHC teaching and learning; and we (3) invited final year students (2013) and 2012 graduates to complete an online survey on EBHC attitudes, self-perceived EBHC competence, and their experience of EBHC teaching and learning. We reviewed all module outlines (n = 89) from HN, PT and SLHT. The OT curriculum was being revised at that time and could not be included. Six lecturers each from HN and OT, and five lecturers each from PT and SLHT participated in the focus groups. Thirty percent (53/176) of invited students responded to the survey. EBHC competencies were addressed to varying degrees in the four programs, although EBHC teaching and learning mostly occurred implicitly. Learning outcomes referring to EBHC focused on enabling competencies (e.g., critical thinking, biostatistics, epidemiology) and were concentrated in theoretical modules. Key competencies (e.g., asking questions, searching databases, critical appraisal) were rarely addressed explicitly. Students felt that EBHC learning should be integrated throughout the four year study period to allow for repetition, consolidation and application of knowledge and skills. Lecturers highlighted several challenges to teaching and practising EBHC, including lack of

  6. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  7. The design of the SAFE or SORRY? study: a cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events

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    Koopmans Raymond TCM

    2009-04-01

    Full Text Available Abstract Background Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs, which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides general barriers that inhibit implementation, this non-compliance is associated with the large number of guidelines competing for attention. As implementation of a guideline is time-consuming, it is difficult for organisations to implement all available guidelines. Another problem is lack of feedback about performance using quality indicators of guideline based care and lack of a recognisable, unambiguous system for implementation. A program that allows organisations to implement multiple guidelines simultaneously may facilitate guideline use and thus improve patient safety. The aim of this study is to develop and test such an integral patient safety program that addresses several AEs simultaneously in hospitals and nursing homes. This paper reports the design of this study. Methods and design The patient safety program addresses three AEs: pressure ulcers, falls and urinary tract infections. It consists of bundles and outcome and process indicators based on the existing evidence based guidelines. In addition it includes a multifaceted tailored implementation strategy: education, patient involvement, and a computerized registration and feedback system. The patient safety program was tested in a cluster randomised trial on ten hospital wards and ten nursing home wards. The baseline period was three months followed by the implementation of the patient safety program for fourteen months. Subsequently the follow-up period was nine months. Primary outcome measure was the incidence of AEs on every ward. Secondary outcome measures were the utilization of preventive interventions and the knowledge of nurses regarding the three topics. Randomisation took

  8. Mid-Upper Arm Circumference Based Nutrition Programming: Evidence for a New Approach in Regions with High Burden of Acute Malnutrition

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    Goossens, Sylvie; Bekele, Yodit; Yun, Oliver; Harczi, Géza; Ouannes, Marie; Shepherd, Susan

    2012-01-01

    Background In therapeutic feeding programs (TFP), mid-upper arm circumference (MUAC) shows advantages over weight-for-height Z score (WHZ) and is recommended by the World Health Organization (WHO) as an independent criterion for screening children 6–59 months old. Here we report outcomes and treatment response from a TFP using MUAC ≤118 mm or oedema as sole admission criteria for severe acute malnutrition (SAM). Methods Patient data from September 2007 to March 2009 for children admitted by MUAC ≤118 mm or oedema to a Médecins Sans Frontières (MSF) TFP in Burkina Faso were retrospectively analyzed. Analysis included anthropometric measurements at admission and discharge, program outcomes and treatment response. Results Of 24,792 patient outcomes analyzed, nearly half (48.8%; n = 12,090) were admitted with MUAC 116–118 mm. Most patients (88.7%; n = 21,983) were 6–24 months old. At admission, 52.7% (n = 5,041) of those with MUAC 116–118 mm had a WHZ <−3 SD. At discharge, 89.1% (n = 22,094) recovered (15% weight gain or oedema resolution), 7.9% (n = 1,961) defaulted, 1.5% (n = 384) failed to respond to treatment, and 1.0% (n = 260) died. Average weight gain was 5.4 g/kg/day, and average MUAC gain was 0.42 mm/day. Patients with MUAC ≤114 mm at admission had higher average daily weight and MUAC gains at discharge compared to those admitted with MUAC 116–118 mm, but those in the latter category required longer lengths of stay to achieve recovery (P<0.001). Conclusion This analysis suggests that MUAC ≤118 mm as TFP admission criterion is a useful alternative to WHZ. Regarding treatment response, rates of weight and MUAC gain were acceptable. Applying 15% weight gain as discharge criterion resulted in longer lengths of stay for less malnourished children. Since MUAC gain parallels weight gain, it may be feasible to use MUAC as both an admission and discharge criterion. PMID:23189140

  9. Why is intracellular ice lethal? A microscopical study showing evidence of programmed cell death in cryo-exposed embryonic axes of recalcitrant seeds of Acer saccharinum.

    Science.gov (United States)

    Wesley-Smith, James; Walters, Christina; Pammenter, N W; Berjak, Patricia

    2015-05-01

    Conservation of the genetic diversity afforded by recalcitrant seeds is achieved by cryopreservation, in which excised embryonic axes (or, where possible, embryos) are treated and stored at temperatures lower than -180 °C using liquid nitrogen. It has previously been shown that intracellular ice forms in rapidly cooled embryonic axes of Acer saccharinum (silver maple) but this is not necessarily lethal when ice crystals are small. This study seeks to understand the nature and extent of damage from intracellular ice, and the course of recovery and regrowth in surviving tissues. Embryonic axes of A. saccharinum, not subjected to dehydration or cryoprotection treatments (water content was 1·9 g H2O g(-1) dry mass), were cooled to liquid nitrogen temperatures using two methods: plunging into nitrogen slush to achieve a cooling rate of 97 °C s(-1) or programmed cooling at 3·3 °C s(-1). Samples were thawed rapidly (177 °C s(-1)) and cell structure was examined microscopically immediately, and at intervals up to 72 h in vitro. Survival was assessed after 4 weeks in vitro. Axes were processed conventionally for optical microscopy and ultrastructural examination. Immediately following thaw after cryogenic exposure, cells from axes did not show signs of damage at an ultrastructural level. Signs that cells had been damaged were apparent after several hours of in vitro culture and appeared as autophagic decomposition. In surviving tissues, dead cells were sloughed off and pockets of living cells were the origin of regrowth. In roots, regrowth occurred from the ground meristem and procambium, not the distal meristem, which became lethally damaged. Regrowth of shoots occurred from isolated pockets of surviving cells of peripheral and pith meristems. The size of these pockets may determine the possibility for, the extent of and the vigour of regrowth. Autophagic degradation and ultimately autolysis of cells following cryo-exposure and formation of small

  10. Medical nutrition therapy is the essential cornerstone for effective treatment of "refractory" severe hypertriglyceridemia regardless of pharmaceutical treatment: Evidence from a Lipid Management Program.

    Science.gov (United States)

    Rhodes, Katherine S; Weintraub, Martha; Marchlewicz, Elizabeth H; Rubenfire, Melvyn; Brook, Robert D

    2015-01-01

    Patients with refractory severe hypertriglyceridemia are at risk of pancreatitis and cardiovascular disease. The role of individualized nutrition therapy in these patients independent of pharmaceutical treatment has not been documented. To document the effect of nutrition intervention on severe hypertriglyceridemia regardless of medication status or prior nutrition counseling. Outcomes of new patients with triglycerides ≥ 500 mg/dL presenting to a Lipid Management Program over a 6-year period were tracked. Patients received comprehensive laboratory assessment, nutrition assessment, and initiation of an individualized diet intervention before seeing the lipidologist. Clinical and behavioral outcomes were recorded. In all, 168 patients (117 men; mean age, 49.03 ± 11.22 years; body mass index, 32.61 ± 5.85 kg/m(2); 110 (65.5%) on lipid-lowering medications) returned for assessment of nutrition intervention. Triglycerides were reduced from median (interquartile range) 961.5 (611.5-1785.3) to 493.0 (337-736.3) mg/dL (P severe hypertriglyceridemia independent of lipid-lowering medication(s) and prior nutrition counseling. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  11. Brain cancer associated with environmental lead exposure: evidence from implementation of a National Petrol-Lead Phase-Out Program (PLPOP) in Taiwan between 1979 and 2007.

    Science.gov (United States)

    Wu, Wei-Te; Lin, Yu-Jen; Liou, Saou-Hsing; Yang, Chun-Yuh; Cheng, Kuang-Fu; Tsai, Perng-Jy; Wu, Trong-Neng

    2012-04-01

    In 1981, a Petrol-Lead Phase-Out Program (PLPOP) was launched in Taiwan for the abatement of environmental lead emissions. The present study was intended to examine whether the high Petrol-Lead Emission Areas (PLEA) would result in an increase in the incidence rate of brain cancer based on a national data bank. The national brain cancer incidence data was obtained from the Taiwan National Cancer Registry. Age standardized incidence rates were calculated based on the 2000 WHO world standard population, and gasoline consumption data was obtained from the Bureau of Energy. The differences in the trend tests for age-standardized incidence rates of brain cancer between high, median, low, and small PLEA were analyzed. A significant increase was found from small to high PLEA in age-standardized incidence rates of brain cancer. By taking six possible confounders into account, the age-standardized incidence rates for brain cancer were highly correlated with the median and high PLEA by reference to the small PLEA. After being adjusted for a number of relevant confounders, it could be concluded that high PLEA might result in an increase in the incidence rate of brain cancer resulting from high lead exposures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  13. No Evidence That Short-Term Cognitive or Physical Training Programs or Lifestyles Are Related to Changes in White Matter Integrity in Older Adults at Risk of Dementia.

    Science.gov (United States)

    Fissler, Patrick; Müller, Hans-Peter; Küster, Olivia C; Laptinskaya, Daria; Thurm, Franka; Woll, Alexander; Elbert, Thomas; Kassubek, Jan; von Arnim, Christine A F; Kolassa, Iris-Tatjana

    2017-01-01

    related to FA scores at baseline (cognitive training skills and FA composite score, r s = 0.68, p = 0.05; functional physical fitness and fornix FA, r = 0.35, p = 0.03). Overall, we found no evidence of a link between short-term physical or cognitive activities and WMI changes, despite activity-related cognitive changes in older adults at risk of dementia. However, we found positive associations between the two targeted training outcomes and WMI, hinting at a potential of long-term activities to affect WMI.

  14. A Web-Based Training Resource for Therapists to Deliver an Evidence-Based Exercise Program for Rheumatoid Arthritis of the Hand (iSARAH): Design, Development, and Usability Testing.

    Science.gov (United States)

    Srikesavan, Cynthia Swarnalatha; Williamson, Esther; Eldridge, Lucy; Heine, Peter; Adams, Jo; Cranston, Tim; Lamb, Sarah E

    2017-12-13

    The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) is a tailored, progressive exercise program for people having difficulties with wrist and hand function due to rheumatoid arthritis (RA). The program was evaluated in a large-scale clinical trial and was found to improve hand function, was safe to deliver, and was cost-effective. These findings led to the SARAH program being recommended in the UK National Institute for Health and Care Excellence guidelines for the management of adults with RA. To facilitate the uptake of this evidence-based program by clinicians, we proposed a Web-based training program for SARAH (iSARAH) to educate and train physiotherapists and occupational therapists on delivering the SARAH program in their practice. The overall iSARAH implementation project was guided by the 5 phases of the analysis, design, development, implementation, and evaluation (ADDIE) system design model. The objective of our study was to conduct the first 3 phases of the model in the development of the iSARAH project. Following publication of the trial, the SARAH program materials were made available to therapists to download from the trial website for use in clinical practice. A total of 35 therapists who downloaded these materials completed an online survey to provide feedback on practice trends in prescribing hand exercises for people with RA, perceived barriers and facilitators to using the SARAH program in clinical practice, and their preferences for the content and Web features of iSARAH. The development and design of iSARAH were further guided by a team of multidisciplinary health professionals (n=17) who took part in a half-day development meeting. We developed the preliminary version of iSARAH and tested it among therapists (n=10) to identify and rectify usability issues and to produce the final version. The major recommendations made by therapists and the multidisciplinary team were having a simple Web design and layout, clear

  15. Selection and Interpretation of Scientific Evidence in Preparation for Policy Decisions: A Case Study Regarding Introduction of Rotavirus Vaccine Into National Immunization Programs in Sweden, Norway, Finland, and Denmark

    Directory of Open Access Journals (Sweden)

    Gry St-Martin

    2018-05-01

    Full Text Available The World Health Organization recommends inclusion of rotavirus vaccines in national immunization programs (NIPs worldwide. Nordic countries are usually considered comparable in terms of demographics and health-care services and have comparable rotavirus disease burden. Nevertheless, the countries have reached different decisions regarding rotavirus vaccine: Norway and Finland have already introduced rotavirus vaccines into their NIPs and Sweden is currently changing its recommendation and vaccines will now be introduced on a national scale while Denmark has decided against it. This study focuses on the selection and interpretation of medical and epidemiological evidence used during the decision-making processes in Sweden, Norway, Finland, and Denmark. The so-called “severity criteria” is identified as one of the main reasons for the different policy decisions reached across the Nordic countries.

  16. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

    Science.gov (United States)

    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Evidências da contribuição dos programas de assistência ao idoso na promoção do envelhecimento saudável no Brasil Evidence of the contribution of elderly support programs to healthy aging in Brazil

    Directory of Open Access Journals (Sweden)

    Larissa Fortunato Araújo

    2011-07-01

    Full Text Available OBJETIVO: Buscar na literatura evidências relativas à contribuição dos programas de promoção da saúde no processo de envelhecimento saudável no Brasil. MÉTODOS: Pesquisaram-se as bases de dados Science Direct, SciELO, LILACS, IBECS, Biblioteca Cochrane e MEDLINE em busca de artigos que enfocassem iniciativas voltadas para a população idosa e o envelhecimento saudável, que avaliassem multidimensionalmente a qualidade de vida do idoso e que tratassem de aspectos relativos às práticas profissionais específicas em promoção da saúde. Para definir a eficácia das iniciativas, adotaram-se os seguintes critérios: ter metas que incluíssem a melhoria da saúde e do bem-estar; ter foco na saúde holística; usar o empoderamento como mecanismo central; atender os pré-requisitos da saúde e realizar ações nas áreas prioritárias da Carta de Ottawa. RESULTADOS: Foram identificados 10 artigos que se referiam a cinco programas de promoção da saúde do idoso no Brasil. Pode-se afirmar que todos os programas apresentados demonstraram elementos que vão ao encontro da promoção da saúde no envelhecimento por abranger características que permitem a inserção dos idosos na sociedade por meio da criação do ambiente de suporte para prevenção de agravos, aumento da capacidade funcional e melhoria da qualidade de vida, tendo sido atendidos os critérios de eficácia. CONCLUSÕES: É preciso produzir evidências científicas acerca da efetividade, eficiência e eficácia dos programas para a terceira idade para que se possa avaliar o valor dessas ações na promoção da saúde no envelhecimento.OBJECTIVE: To search the literature for evidence of the contribution of elderly health programs to the process of healthy aging in Brazil. METHODS: The databases Science Direct, SciELO, LILACS, IBECS, the Cochrane Library, and MEDLINE were searched to find articles focusing on initiatives developed for the elderly population and to promote

  18. What is Evidence? (editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-06-01

    Full Text Available Lately, I have been pondering what we really mean when we say “evidence based practice”? In LIS, we all know the definitions that have been proposed (Booth 2000, Eldredge 2000, Crumley and Koufogiannakis 2002, and which have not ever really been challenged. But have we ever said explicitly what qualifies as evidence in this model? The underlying assumption seems to be that evidence is research, hence, we are really talking about research-based practice, but we don’t actually use that term.Higgs and Jones (2000 note that evidence is “knowledge derived from a variety of sources that has been subjected to testing and has found to be credible.” The Oxford English Dictionary states that evidence is “something serving as a proof” (OED, 2011. Neither of these definitions of evidence notes that evidence equals research; research is only one form of evidence. It certainly isn’t the only form of evidence – so what, then, constitutes evidence?Rycroff-Malone et al. (2004 state that that in order for evidence based practice to create a broader evidence base in nursing, “the external, scientific and the internal, intuitive” need to be brought together. The external, scientific is what evidence based practice has been focused on, in the form of scientific research, but Rycroff-Malone et al. note that other elements such as clinical experience, patient experience, and information from the local context also need to be considered.In library and information practice, what are the other forms of evidence we need to consider? I propose that while research evidence is of high importance to our profession and knowledge, LIS practitioners need to first of all consider local evidence. Local evidence is found in our working environment and specific to the context in which we carry out our work. It includes such things as our experiences with patrons in particular contexts, and what we observe to work in such situations, assessment of programs

  19. Are Stabilization Programs Expansionary?

    OpenAIRE

    Federico Echenique; Alvaro Forteza

    1997-01-01

    The empirical evidence presented in this paper casts serious doubts on the by now widely accepted "stylized facts" of the exchange rate based stabilization programs (ERBS) as they are stated in Kiguel and Liviatan (1992) and in Végh (1992). Even though the ERBS programs were associated with output booms, no evidence of booms provoked by the stabilization programs is found. Rather, exogenous capital inflows to Latin America seem to have caused both the output booms and the stabilization progra...

  20. No evidence-based restoration without a sound evidence base: a reply to Guldemond et al.

    CSIR Research Space (South Africa)

    Ntshotsho, P

    2012-03-01

    Full Text Available Evidence-based practice is not possible without an evidence base. Guldemond et al. confuse our attempt at assessing the status of the evidence base of restoration programs in South Africa with attempting to assess whether restoration is evidence...

  1. Supporting graduation programs through empirical evidence and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Chiffrer le travail des femmes - économie sexiste sur le marché et au foyer. Les femmes ont accompli de grands progrès dans les sphères de l'économie et de la politique, mais elles n'ont pas encore rejoint les hommes. Voir davantageChiffrer le travail des femmes - économie sexiste sur le marché et au foyer ...

  2. Supporting graduation programs through empirical evidence and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... girls, migrant workers, and the ultra-poor (people who live on less than 60 cents a day). ... Call for new OWSD Fellowships for Early Career Women Scientists now open ... Eleven world-class research teams set to improve livestock vaccine ...

  3. Analysis of the evidence on the efficacy and safety of CYD-TDV dengue vaccine and its potential licensing and implementation through Mexico´s Universal Vaccination Program

    Directory of Open Access Journals (Sweden)

    Mauricio Hernández-Ávila

    2016-01-01

    Full Text Available Dengue is a major global public health problem affecting Latin America and Mexico Prevention and control measures, focusing on epidemiological surveillance and vector control, have been partially effective and costly, thus, the development of a vaccine against dengue has created great expectations among health authorities and scientific communities worldwide. The CYD-TDV dengue vaccine produced by Sanofi-Pasteur is the only dengue vaccine evaluated in phase 3 controlled clinical trials. Notwithstanding the significant contribution to the development of a vaccine against dengue, the three phase 3 clinical studies of CYD-TDV and the meta-analysis of the long-term follow up of those studies, have provided evidence that this vaccine exhibited partial vaccine efficacy to protect against virologically confirmed dengue and lead to four considerations: a adequate vaccine efficacy against dengue virus (DENV infections 3 and 4, less vaccine efficacy against DENV 1 and no protection against infection by DENV 2; b decreased vaccine efficacy in dengue seronegative individuals at the beginning of the vaccination; c 83% and 90% protection against hospitalizations and severe forms of dengue, respectively, at 25 months follow-up; and d increased hospitalization for dengue in the vaccinated group, in children under nine years of age at the time of vaccination, detected since the third year of follow-up. The benefit of the CYD-TDV vaccine can be summarized in the protection against infection by DENV 3 and 4, as well as protection for hospitalizations and severe cases in people over nine years, who have had previous dengue infection, working mainly as a booster. In this review we identified elements on efficacy and safety of this vaccine that must be taken into account in the licensing process and potential inclusion in the national vaccination program of Mexico. The available scientific evidence on the CYD-TDV vaccine shows merits, but also leads to relevant

  4. A Hybrid III stepped wedge cluster randomized trial testing an implementation strategy to facilitate the use of an evidence-based practice in VA Homeless Primary Care Treatment Programs.

    Science.gov (United States)

    Simmons, Molly M; Gabrielian, Sonya; Byrne, Thomas; McCullough, Megan B; Smith, Jeffery L; Taylor, Thom J; O'Toole, Tom P; Kane, Vincent; Yakovchenko, Vera; McInnes, D Keith; Smelson, David A

    2017-04-04

    Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, "one-stop program" to address housing and health care needs of homeless veterans. However, while 70% of HPACT's veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation. One wraparound intervention designed to address the needs of homeless veterans with co-occurring mental health and substance use disorders which is suitable to be integrated into HPACT clinic sites is the evidence-based practice called Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Veterans Edition, or MISSION-Vet. Despite the promise of MISSION-Vet within HPACT clinics, implementation of an evidence-based intervention within a busy program like HPACT can be difficult. The current study is being undertaken to identify an appropriate implementation strategy for MISSION-Vet within HPACT. The study will test the implementation platform called Facilitation and compared to implementation as usual (IU). The aims of this study are as follows: (1) Compare the extent to which IU or Facilitation strategies achieve fidelity to the MISSION-Vet intervention as delivered by HPACT homeless provider staff. (2) Compare the effects of Facilitation and IU strategies on the National HPACT Performance Measures. (3) Compare the effects of IU and Facilitation on the permanent housing status. (4) Identify and describe key stakeholders' (patients, providers, staff) experiences with, and perspectives on, the barriers to, and facilitators of implementing MISSION. Type III Hybrid modified stepped wedge implementation comparing IU to Facilitation

  5. 75 FR 28789 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants...

    Science.gov (United States)

    2010-05-24

    ... disadvantaged students, served by charter schools operated or managed by the applicant. For a definition of...: (1) Performance (school-wide and by subgroup) on statewide tests of all charter schools operated or..., and ensuring the quality and [[Page 28795

  6. Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

    Directory of Open Access Journals (Sweden)

    Nina Rydland Olsen

    Full Text Available Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs, are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1 The Adapted Fresno test (AFT, 2 the EBP Belief Scale and 3 the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1, p < 0.001 and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2, p = 0.002, but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1, p = 0.574. Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

  7. 6 CFR 13.34 - Evidence.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Evidence. 13.34 Section 13.34 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.34 Evidence. (a) The ALJ will determine the admissibility of evidence. (b) Except as provided in this part, the ALJ...

  8. A Schoolwide Endeavor: Our Exquisite Snake

    Science.gov (United States)

    Hoffman, Anne Marie

    2009-01-01

    The author was originally inspired by "The Exquisite Snake" exhibit she saw at a local museum. Two hundred contemporary artists contributed to this exhibit, which was an adaptation of the old parlor game called "The Exquisite Corpse" that Surrealist artists used to play in the late 1920s and '30s. The author just loved this idea and decided to…

  9. Teach Students about Civics through Schoolwide Governance

    Science.gov (United States)

    Brasof, Marc; Spector, Anne

    2016-01-01

    Building democracies in K-8 schools is a promising approach to increasing young people and educators' civic knowledge, skills and dispositions. The Rendell Center for Civics and Civics Engagement leveraged strategies and concepts from the fields of civic education, student voice, and distributed leadership to build a youth-adult school governance…

  10. Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

    Science.gov (United States)

    Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

    2015-01-01

    Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p students.

  11. Examining Associations between Self-Rated Health and Proficiency in Literacy and Numeracy among Immigrants and U.S.-Born Adults: Evidence from the Program for the International Assessment of Adult Competencies (PIAAC).

    Science.gov (United States)

    Prins, Esther; Monnat, Shannon

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between self-reported health (SRH) and literacy and numeracy proficiency for immigrants compared to U.S.-born respondents and for Hispanic versus Asian immigrants. The research questions were: (1) Are literacy and numeracy scores associated with adults' SRH? (2) Are associations between SRH and literacy and numeracy proficiency moderated by immigrant status? (3) Among immigrants, are literacy and numeracy scores more strongly associated with SRH for Hispanics versus Asians? Immigrants had significantly lower literacy and numeracy scores, yet reported better health than U.S.-born respondents. Ordinal logistic regression analyses showed that literacy and numeracy were both positively related to SRH for immigrants and U.S.-born adults, and should therefore be viewed as part of the growing evidence that literacy is an independent and significant social determinant of health. Second, U.S.-born and immigrant adults accrued similarly positive health benefits from stronger literacy and numeracy skills. Third, although Hispanic immigrants were more disadvantaged than Asian immigrants on almost all socioeconomic characteristics and had significantly lower literacy and numeracy scores and worse SRH than Asian immigrants, both Hispanic and Asian immigrants experienced similar positive health returns from literacy and numeracy proficiency. These findings underscore the potential health benefits of providing adult basic education instruction, particularly for immigrants with the least formal schooling and fewest socioeconomic resources.

  12. Lessons learned from a data-driven college access program: The National College Advising Corps.

    Science.gov (United States)

    Horng, Eileen L; Evans, Brent J; Antonio, Anthony L; Foster, Jesse D; Kalamkarian, Hoori S; Hurd, Nicole F; Bettinger, Eric P

    2013-01-01

    This chapter discusses the collaboration between a national college access program, the National College Advising Corps (NCAC), and its research and evaluation team at Stanford University. NCAC is currently active in almost four hundred high schools and through the placement of a recent college graduate to serve as a college adviser provides necessary information and support for students who may find it difficult to navigate the complex college admission process. The advisers also conduct outreach to underclassmen in an effort to improve the school-wide college-going culture. Analyses include examination of both quantitative and qualitative data from numerous sources and partners with every level of the organization from the national office to individual high schools. The authors discuss balancing the pursuit of evaluation goals with academic scholarship. In an effort to benefit other programs seeking to form successful data-driven interventions, the authors provide explicit examples of the partnership and present several examples of how the program has benefited from the data gathered by the evaluation team. © WILEY PERIODICALS, INC.

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Program About ACS NSQIP Join ACS NSQIP Now Collaboratives Hospital Compare Quality and Safety Conference Participant Use ... Asked Questions Resources Educational Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in Surgery Medical Student Resources ... checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS Ostomy Home ...

  15. Design of smartphone evidence awareness (SEAWARE) training

    CSIR Research Space (South Africa)

    Dlamini, Zama I

    2016-01-01

    Full Text Available be good sources of digital evidence, which might be inadmissible in a court of law if it is not handled properly. This paper presents the design of the smartphone evidence awareness (SEAware) training program for smartphone users. This training program... aware that their devices could be good sources of digital evidence, which might be inadmissible in a court of law if it is not handled properly Objective - To test smartphone evidence awareness skills before and after the training - To train a...

  16. Training Out-of-School Time Staff. Part 2 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Frontline Staff. Research-to-Results Brief. Publication #2009-05

    Science.gov (United States)

    Metz, Allison J. R.; Burkhauser; Mary; Bowie, Lillian

    2009-01-01

    A skilled and sustainable workforce is one of the most important markers of high-quality out-of-school time programs. Given the links between skilled staff, high-quality programs, and better youth outcomes, staff training has become an essential part of program implementation. To expand what is known about staff training, Child Trends recently…

  17. Longitudinal behavioral effects of a school-based fruit and vegetable promotion program.

    Science.gov (United States)

    Hoffman, Jessica A; Franko, Debra L; Thompson, Douglas R; Power, Thomas J; Stallings, Virginia A

    2010-01-01

    This study examined the longitudinal effects of a school-based program on kindergarten and first grade children's fruit and vegetable (F&V) consumption. The program included lunchroom, classroom, school-wide, and family components. The primary dependent variable, F&V consumed at lunch, was assessed using weighed plate waste. Hierarchical linear models were used to analyze the differences between intervention and control groups and to account for repeated measurements. Children in the experimental group consumed more F&V (F = 29 g; V = 6 g; 0.43 portions/lunch; 0.28 servings/lunch) at the end of Year 1 compared with children in the control group. At the end of Year 2, children in the experimental group consumed more fruit (21 g; 0.23 portions/lunch; 0.15 servings/lunch), but not more vegetables compared with children in the control group. The intervention resulted in increased F&V consumption, with more pronounced and enduring effects for fruits than vegetables.

  18. Data-Driven Decision Making in Out-of-School Time Programs. Part 6 in a Series on Implementing Evidence-Based Practices in Out-of-School Time Programs: The Role of Organization-Level Activities. Research-to-Results Brief. Publication #2009-34

    Science.gov (United States)

    Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.

    2009-01-01

    Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…

  19. Probabilistic Programming (Invited Talk)

    OpenAIRE

    Yang, Hongseok

    2017-01-01

    Probabilistic programming refers to the idea of using standard programming constructs for specifying probabilistic models from machine learning and statistics, and employing generic inference algorithms for answering various queries on these models, such as posterior inference and estimation of model evidence. Although this idea itself is not new and was, in fact, explored by several programming-language and statistics researchers in the early 2000, it is only in the last few years that proba...

  20. Transgenerational developmental programming.

    Science.gov (United States)

    Aiken, Catherine E; Ozanne, Susan E

    2014-01-01

    The concept of developmental programming suggests that the early life environment influences offspring characteristics in later life, including the propensity to develop diseases such as the metabolic syndrome. There is now growing evidence that the effects of developmental programming may also manifest in further generations without further suboptimal exposure. This review considers the evidence, primarily from rodent models, for effects persisting to subsequent generations, and evaluates the mechanisms by which developmental programming may be transmitted to further generations. In particular, we focus on the potential role of the intrauterine environment in contributing to a developmentally programmed phenotype in subsequent generations. The literature was systematically searched at http://pubmed.org and http://scholar.google.com to identify published findings regarding transgenerational (F2 and beyond) developmental programming effects in human populations and animal models. Transmission of programming effects is often viewed as a form of epigenetic inheritance, either via the maternal or paternal line. Evidence exists for both germline and somatic inheritance of epigenetic modifications which may be responsible for phenotypic changes in further generations. However, there is increasing evidence for the role of both extra-genomic components of the zygote and the interaction of the developing conceptus with the intrauterine environment in propagating programming effects. The contribution of a suboptimal reproductive tract environment or maternal adaptations to pregnancy may be critical to inheritance of programming effects via the maternal line. As the effects of age exacerbate the programmed metabolic phenotype, advancing maternal age may increase the likelihood of developmental programming effects being transmitted to further generations. We suggest that developmental programming effects could be propagated through the maternal line de novo in generations

  1. Quality of evidence-based pediatric guidelines

    NARCIS (Netherlands)

    Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

    2005-01-01

    Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

  2. Case Study in Evidence-Based Practice in Clinical Child and Adolescent Psychology: The Use of the Coping Power Program to Treat a 10-Year-Old Girl with Disruptive Behaviors

    Science.gov (United States)

    Lochman, John E.; Boxmeyer, Caroline; Powell, Nicole; Wojnaroski, Mary; Yaros, Anna

    2007-01-01

    This article describes the successful application of the Coping Power program by school-based clinicians to address a 10-year-old girl's disruptive behavior symptoms. Coping Power is an empirically supported cognitive-behavioral program for children at risk for serious conduct problems and their parents. The following case study illustrates the…

  3. Functional Programming

    OpenAIRE

    Chitil, Olaf

    2009-01-01

    Functional programming is a programming paradigm like object-oriented programming and logic programming. Functional programming comprises both a specific programming style and a class of programming languages that encourage and support this programming style. Functional programming enables the programmer to describe an algorithm on a high-level, in terms of the problem domain, without having to deal with machine-related details. A program is constructed from functions that only map inputs to ...

  4. Teachers' Perceptions of School Organizational Climate as Predictors of Dosage and Quality of Implementation of a Social-Emotional and Character Development Program.

    Science.gov (United States)

    Malloy, Margaret; Acock, Alan; DuBois, David L; Vuchinich, Samuel; Silverthorn, Naida; Ji, Peter; Flay, Brian R

    2015-11-01

    Organizational climate has been proposed as a factor that might influence a school's readiness to successfully implement school-wide prevention programs. The aim of this study was to evaluate the influence of teachers' perceptions of three dimensions of school organizational climate on the dosage and quality of teacher implementation of Positive Action, a social-emotional and character development (SECD) program. The dimensions measured were teachers' perceptions of (a) the school's openness to innovation, (b) the extent to which schools utilize participatory decision-making practices, and (c) the existence of supportive relationships among teachers (teacher-teacher affiliation). Data from 46 teachers in seven schools enrolled in the treatment arm of a longitudinal, cluster-randomized, controlled trial were analyzed. Teacher perceptions of a school's tendency to be innovative was associated with a greater number of lessons taught and self-reported quality of delivery, and teacher-teacher affiliation was associated with a higher use of supplementary activities. The findings suggest that perceptions of a school's organizational climate impact teachers' implementation of SECD programs and have implications for school administrators and technical assistance providers as they work to implement and sustain prevention programs in schools.

  5. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

    OpenAIRE

    Abbey, Mercy; Bartholomew, L. Kay; Chinbuah, Margaret A.; Gyapong, Margaret; Gyapong, John O.; van den Borne, Bart

    2017-01-01

    Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakehold...

  6. Programming in biomolecular computation

    DEFF Research Database (Denmark)

    Hartmann, Lars Røeboe; Jones, Neil; Simonsen, Jakob Grue

    2011-01-01

    Our goal is to provide a top-down approach to biomolecular computation. In spite of widespread discussion about connections between biology and computation, one question seems notable by its absence: Where are the programs? We identify a number of common features in programming that seem...... conspicuously absent from the literature on biomolecular computing; to partially redress this absence, we introduce a model of computation that is evidently programmable, by programs reminiscent of low-level computer machine code; and at the same time biologically plausible: its functioning is defined...... by a single and relatively small set of chemical-like reaction rules. Further properties: the model is stored-program: programs are the same as data, so programs are not only executable, but are also compilable and interpretable. It is universal: all computable functions can be computed (in natural ways...

  7. How Is Health Related to Literacy, Numeracy, and Technological Problem-Solving Skills among U.S. Adults? Evidence from the Program for the International Assessment of Adult Competencies (PIAAC)

    Science.gov (United States)

    Prins, Esther; Monnat, Shannon; Clymer, Carol; Toso, Blaire Wilson

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between U.S. adults' self-reported health and proficiencies in literacy, numeracy, and technological problem solving. Ordinal logistic regression analyses showed that scores on all three scales were positively and…

  8. 7 CFR 1493.470 - Evidence of export.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Evidence of export. 1493.470 Section 1493.470... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Supplier Credit Guarantee Program Operations § 1493.470 Evidence of export. (a) Report of export. The...

  9. 7 CFR 1493.280 - Evidence of export report.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Evidence of export report. 1493.280 Section 1493.280... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Facility Guarantee Program (FGP) Operations § 1493.280 Evidence of export report. (a) Report of export. The...

  10. A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: the core components of effective programs, child-focused interventions and comprehensive treatment models.

    Science.gov (United States)

    Tonge, Bruce J; Bull, Kerry; Brereton, Avril; Wilson, Rebecca

    2014-03-01

    This article reviews recent evidence and other earlier relevant articles regarding early intervention studies for children with autism spectrum disorder (ASD). There is a well-established body of empirical evidence for the effectiveness of Early Intensive Behavioural Intervention (EIBI) with young children with ASD. The importance of parent skills training, education and positive behaviour support is also a key factor in influencing outcomes. Drug treatment is of short-term benefit for disruptive behaviour but long-term outcome and metabolic side-effects have not been studied. Few studies have measured the long-term value and effectiveness of early intervention treatments, and currently there are no articles published on effects into adulthood of such treatments. Such research would indicate whether early intervention results in reduced reliance on health services into adulthood.

  11. Employment specialist competencies for supported employment programs

    NARCIS (Netherlands)

    Corbière, M.; Brouwers, E.P.M.; Lanctôt, N.; van Weeghel, J.

    2014-01-01

    Purpose Supported employment (SE) programs are evidence-based programs offered to people with severe mental illness to facilitate obtaining and keeping competitive work. However, significant variations in individuals’ vocational success may be partly explained by differences in their employment

  12. Evidence and evidence gaps in tinnitus therapy

    Science.gov (United States)

    Hesse, Gerhard

    2016-01-01

    A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient’s needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies). PMID:28025604

  13. Contribution of community-based newborn health promotion to reducing inequities in healthy newborn care practices and knowledge: evidence of improvement from a three-district pilot program in Malawi.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Nonyane, Bareng A S; Guenther, Tanya; Sitrin, Deborah; Ligowe, Reuben; Chimbalanga, Emmanuel; Zimba, Evelyn; Kachale, Fannie; Shah, Rashed; Baqui, Abdullah H

    2013-11-07

    Inequities in both health status and coverage of health services are considered important barriers to achieving Millennium Development Goal 4. Community-based health promotion is a strategy that is believed to reduce inequities in rural low-income settings. This paper examines the contributions of community-based programming to improving the equity of newborn health in three districts in Malawi. This study is a before-and-after evaluation of Malawi's Community-Based Maternal and Newborn Care (CBMNC) program, a package of facility and community-based interventions to improve newborn health. Health Surveillance Assistants (HSAs) within the catchment area of 14 health facilities were trained to make pregnancy and postnatal home visits to promote healthy behaviors and assess women and newborns for danger signs requiring referral to a facility. "Core groups" of community volunteers were also trained to raise awareness about recommended newborn care practices. Baseline and endline household surveys measured the coverage of the intervention and targeted health behaviors for this before-and-after evaluation. Wealth indices were constructed using household asset data and concentration indices were compared between baseline and endline for each indicator. The HSAs trained in the intervention reached 36.7% of women with a pregnancy home visit and 10.9% of women with a postnatal home visit within three days of delivery. Coverage of the intervention was slightly inequitable, with richer households more likely to receive one or two pregnancy home visits (concentration indices (CI) of 0.0786 and 0.0960), but not significantly more likely to receive a postnatal visit or know of a core group. Despite modest coverage levels for the intervention, health equity improved significantly over the study period for several indicators. Greater improvements in inequities were observed for knowledge indicators than for coverage of routine health services. At endline, a greater proportion of

  14. Evidence and evidence gaps - an introduction.

    Science.gov (United States)

    Dreier, Gabriele; Löhler, Jan

    2016-01-01

    Background: Medical treatment requires the implementation of existing evidence in the decision making process in order to be able to find the best possible diagnostic, therapeutic or prognostic measure for the individual patient based on the physician's own expertise. Clinical trials form the evidence base and ideally, their results are assembled, analyzed, summarized, and made available in systematic review articles. Beside planning, conducting, and evaluating clinical trials in conformity with GCP (good clinical practice), it is essential that all results of conducted studies are publicly available in order to avoid publication bias. This includes also the public registration of planned and cancelled trials. History: During the last 25 years, evidence-based medicine became increasingly important in medical care and research. It is closely associated with the names of Archibald Cochrane and David Sackett. About 15 years ago, the Deutsche Cochrane Zentrum (Cochrane Germany) and the Deutsche Netzwerk Evidenzbasierte Medizin e.V. (German Network for Evidence-based Medicine, DNEbM) were founded in Germany. In the International Cochrane Collaboration, clinicians and methodologists come together on an interdisciplinary level to further develop methods of evidence-based medicine and to discuss the topics of evidence generation and processing as well as knowledge transfer. Problem: Evidence is particularly important for physicians in the process of decision making, however, at the same time it is the base of a scientific proof of benefit for the patient and finally for the payers in health care. The closure of evidence gaps requires enormously high staff and financial resources, significant organizational efforts, and it is only successful when clinical and methodical expertise as well as specific knowledge in the field of clinical research are included. On the other hand, the knowledge has to be transferred into practice. For this purpose, practice guidelines, meetings

  15. [Evidence and Evidence Gaps - an Introduction].

    Science.gov (United States)

    Dreier, G; Löhler, J

    2016-04-01

    Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

  16. Program specialization

    CERN Document Server

    Marlet, Renaud

    2013-01-01

    This book presents the principles and techniques of program specialization - a general method to make programs faster (and possibly smaller) when some inputs can be known in advance. As an illustration, it describes the architecture of Tempo, an offline program specializer for C that can also specialize code at runtime, and provides figures for concrete applications in various domains. Technical details address issues related to program analysis precision, value reification, incomplete program specialization, strategies to exploit specialized program, incremental specialization, and data speci

  17. Hard evidence on soft skills.

    Science.gov (United States)

    Heckman, James J; Kautz, Tim

    2012-08-01

    This paper summarizes recent evidence on what achievement tests measure; how achievement tests relate to other measures of "cognitive ability" like IQ and grades; the important skills that achievement tests miss or mismeasure, and how much these skills matter in life. Achievement tests miss, or perhaps more accurately, do not adequately capture, soft skills -personality traits, goals, motivations, and preferences that are valued in the labor market, in school, and in many other domains. The larger message of this paper is that soft skills predict success in life, that they causally produce that success, and that programs that enhance soft skills have an important place in an effective portfolio of public policies.

  18. 7 CFR 1493.80 - Evidence of export.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Evidence of export. 1493.80 Section 1493.80... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103...

  19. Lifting and transport by sea of great stone columns: evidence of traditional methods used in 18th and 19th century building programs as a clue to reconstructing Roman marble transport processes

    Directory of Open Access Journals (Sweden)

    Paolo Barresi

    2017-01-01

    Full Text Available Aim of this paper is to investigate the traditional technologies of lifting and sea transport of large stone blocks (time spent for sea transport, ways of charging and stewing large stone pieces, number of people engaged with evidence from 18th and 19th century Italy, as a key to understand ancient Roman practices. I shall use data from reconstruction of the 5th century Christian basilica of St. Paul at Rome, burnt in 1823, where new granite shafts, mainly from Italian quarries, replaced the Roman ones. Other documentary sources help to understand some details related to heavy transport, otherwise unknown for Roman period. It should be obviously dangerous to induce directly that the same technologies used for lifting and transport of columns in 18th or 19th century were in use also in Roman Imperial age, but the study of such processes can help us to put in the right view our reconstruction of ancient reality.

  20. Evidence-based management - healthcare manager viewpoints.

    Science.gov (United States)

    Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

    2018-06-11

    Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

  1. More evidence on the impact of India's conditional cash transfer program, Janani Suraksha Yojana: quasi-experimental evaluation of the effects on childhood immunization and other reproductive and child health outcomes.

    Directory of Open Access Journals (Sweden)

    Natalie Carvalho

    Full Text Available In 2005, India established a conditional cash transfer program called Janani Suraksha Yojana (JSY, to increase institutional delivery and encourage the use of reproductive and child health-related services.To assess the effect of maternal receipt of financial assistance from JSY on childhood immunizations, post-partum care, breastfeeding practices, and care-seeking behaviors.We use data from the latest district-level household survey (2007-2008 to conduct a propensity score matching analysis with logistic regression. We conduct the analyses at the national level as well as separately across groups of states classified as high-focus and non-high-focus. We carry out several sensitivity analyses including a subgroup analysis stratified by possession of an immunization card.Receipt of financial assistance from JSY led to an increase in immunization rates ranging from 3.1 (95%CI 2.2-4.0 percentage points for one dose of polio vaccine to 9.1 (95%CI 7.5-10.7 percentage points in the proportion of fully vaccinated children. Our findings also indicate JSY led to increased post-partum check-up rates and healthy early breastfeeding practices around the time of childbirth. No effect of JSY was found on exclusive breastfeeding practices and care-seeking behaviors. Effect sizes were consistently larger in states identified as being a key focus for the program. In an analysis stratified by possession of an immunization card, there was little to no effect of JSY among those with vaccination cards, while the effect size was much larger than the base case results for those missing vaccination cards, across nearly all immunization outcomes.Early results suggest the JSY program led to a significant increase in childhood immunization rates and some healthy reproductive health behaviors, but the structuring of financial incentives to pregnant women and health workers warrants further review. Causal interpretation of our results relies on the assumption that

  2. Evidencias de un programa educativo sobre el uso de inhaladores antiasmáticos por adolescentes Evidences of an educational program on the use of asthma inhalers by adolescents

    Directory of Open Access Journals (Sweden)

    Elizabeth María de la Paz Reyes

    Full Text Available Se efectuó una intervención educativa en 41 adolescentes que padecían asma bronquial, pertenecientes al Policlínico Docente "Carlos Juan Finlay" de Santiago de Cuba, con el objetivo de aumentar el nivel de conocimientos sobre el uso de los inhaladores en ese grupo poblacional. Con esta intervención se mejoró considerablemente el conocimiento de los integrantes de la serie, lo cual mostró la efectividad del programa aplicado al lograr su propósito inicial.Educational intervention was performed in 41 adolescents who suffered from bronchial asthma, belonging to "Carlos Juan Finlay" Teaching Polyclinic of Santiago de Cuba, with the purpose of increasing the knowledge of the inhalers use in that population group. With this intervention the knowledge of patients of the series improved significantly, showing the effectiveness of the program implemented when achieving its initial purpose.

  3. Teachers' Attitudes towards Reflective Teaching: Evidences in a Professional Development Program (PDP Actitudes de los profesores hacia la enseñanza reflexiva: evidencias en un programa de desarrollo profesional (PDP

    Directory of Open Access Journals (Sweden)

    Sonia Jerez Rodríguez

    2008-12-01

    Full Text Available Reflective teaching is a paradigm that dominates teacher education around the world and most professional development programs include it as a way to improve teachers' practice. As a teacher educator I am aware of the importance reflective teaching (RT has on teachers' professional development. This article reports a research experience with two in-service teachers of English enrolled in a professional development program at a public university in Bogotá who initiated a reflective teaching process through the development of reflective thinking skills. Data were gathered through interviews, observation, videotaping, questionnaires and a diary. Findings showed some teachers' attitudes towards RT, the possible factors that might have stimulated and lessened reflection, and some of the changes observed in their teaching practice.La enseñanza reflexiva es un paradigma que domina la educación de docentes en el mundo y la mayoría de programas de desarrollo profesional (PDP la incluyen como una manera de mejorar la práctica de los docentes. Como docente educadora, soy consciente de su importancia en el desarrollo profesional. Este artículo describe una experiencia investigativa con dos profesores de inglés participantes en un PDP en una universidad pública en Bogotá, quienes iniciaron un proceso de reflexión sobre su práctica docente mediante el desarrollo de habilidades de pensamiento reflexivo. Los datos se recolectaron mediante entrevistas, observación, video grabación, cuestionarios y un diario. Los resultados mostraron algunas actitudes de los docentes hacia la enseñanza reflexiva, los posibles factores que pudieron estimular e inhibir la reflexión y algunos cambios en su práctica docente.

  4. LTDNA evidence on trial

    OpenAIRE

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) discip...

  5. Getting to Scale: Evidence, Professionalism, and Community

    Science.gov (United States)

    Slavin, Robert E.

    2016-01-01

    Evidence-based reform, in which proven programs are scaled up to reach many students, is playing an increasing role in American education. This article summarizes articles in this issue to explain how Reading Recovery has managed to sustain itself and go to scale over more than 30 years. It argues that Reading Recovery has succeeded due to a focus…

  6. Modeling and evaluating evidence-based continuing education program in nursing home dementia care (MEDCED)--training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial.

    Science.gov (United States)

    Testad, Ingelin; Mekki, Tone Elin; Førland, Oddvar; Øye, Christine; Tveit, Eva Marie; Jacobsen, Frode; Kirkevold, Øyvind

    2016-01-01

    The aim of this study was to evaluate the effectiveness of a tailored 7-month training intervention "Trust Before Restraint," in reducing use of restraint, agitation, and antipsychotic medications in care home residents with dementia. This is a single-blind cluster randomized controlled trial in 24 care homes within the Western Norway Regional Health Authority 2011-2013. From 24 care homes, 274 residents were included in the study, with 118 in the intervention group and 156 in the control group. Use of restraint was significantly reduced in both the intervention group and the control group despite unexpected low baseline, with a tendency to a greater reduction in the control group. There was a significant reduction in Cohen-Mansfield Agitation Inventory score in both the intervention group and the follow-up group with a slightly higher reduction in the control group, although this did not reach significance and a small nonsignificant increase in use of antipsychotics (14.1-17.7%) and antidepressants (35.9-38.4%) in both groups. This study reports on the statistically significant reduction in use of restraint in care homes, both prior and during the 7-month intervention periods, in both intervention and control groups. When interpreted within the context of the current climate of educational initiatives to reduce restraint and a greater focus on the importance of person-centered care, the study also highlights the potential success achieved with national training programs for care staff and should be further evaluated to inform future training initiatives both in Norway and internationally. Copyright © 2015 John Wiley & Sons, Ltd.

  7. Hermeneutics, evidence ad judgment

    Directory of Open Access Journals (Sweden)

    Michele Taruffo

    2018-03-01

    Full Text Available The text analyzes several topics of the judicial process from the point of view of the important contributions offered by the hermeneutical philosophy. It deals mainly with the construction of factual narratives, the presentation of evidence and the discovery of truth made by the judge in his final judgment based upon the evidence.

  8. The Evidence Movement

    DEFF Research Database (Denmark)

    Hansen, Hanne Foss; Rieper, Olaf

    2009-01-01

    The evidence movement and the idea of systematic reviews, defined as summaries of the results of already existing evaluation and research projects, have gained considerable support in recent years as many international as well as national evidence-producing organizations have been established...

  9. Teaching with Evidence

    Science.gov (United States)

    Crocco, Margaret; Halvorsen, Anne-Lise; Jacobsen, Rebecca; Segall, Avner

    2017-01-01

    In this age of real and fake news, students need to be able to assess the trustworthiness of evidence. The authors' current research examines students' use of evidence in secondary social studies classrooms as students deliberate contemporary public policy issues. The authors found that students shifted their evaluations of the trustworthiness of…

  10. Observational Evidence for Atoms.

    Science.gov (United States)

    Jones, Edwin R., Jr.; Childers, Richard L.

    1984-01-01

    Discusses the development of the concept of atomicity and some of the many which can be used to establish its validity. Chemical evidence, evidence from crystals, Faraday's law of electrolysis, and Avogadro's number are among the areas which show how the concept originally developed from a purely philosophical idea. (JN)

  11. Evidence-based radiography

    International Nuclear Information System (INIS)

    Hafslund, Bjorg; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica

    2008-01-01

    Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain

  12. Program History

    Science.gov (United States)

    Learn how the National Cancer Institute transitioned the former Cooperative Groups Program to the National Clinical Trials Network (NCTN) program. The NCTN gives funds and other support to cancer research organizations to conduct cancer clinical trials.

  13. Program auto

    International Nuclear Information System (INIS)

    Rawool-Sullivan, M.W.; Plagnol, E.

    1990-01-01

    The program AUTO was developed to be used in the analysis of dE vs E type spectra. This program is written in FORTRAN and calculates dE vs E lines in MeV. The provision is also made in the program to convert these lines from MeV to ADC channel numbers to facilitate the comparison with the raw data from the experiments. Currently the output of this program can be plotted with the display program, called VISU, but it can also be used independent of the program VISU, with little or no modification in the actual fortran code. The program AUTO has many useful applications. In this article the program AUTO is described along with its applications

  14. Student Leadership Distribution: Effects of a Student-Led Leadership Program on School Climate and Community

    Science.gov (United States)

    Pedersen, Jeff; Yager, Stuart; Yager, Robert

    2012-01-01

    This study focuses on the understandings educators developed from two schools concerning how distributed leadership involving a select group of students affected the climate and community of their schools. Findings suggest that student-led leadership roles within the school community have an impact on creating a positive school-wide climate; a…

  15. Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

    Science.gov (United States)

    Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Stevenson, Jennifer; Gaarder, Marie

    2016-11-01

    A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Evidence: Study Guide. Revision

    National Research Council Canada - National Science Library

    1997-01-01

    ...) correct application of principles of military rules of evidence. This study guide is also intended to be a convenient reference for use by Navy and Marine Corps judge advocates and Coast Guard law...

  17. LTDNA Evidence on Trial

    OpenAIRE

    Paul Roberts; Paul Roberts; Paul Roberts

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. Section 1 addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materia...

  18. Empirical Evidence for Niss' "Implemented Anticipation" in Mathematising Realistic Situations

    Science.gov (United States)

    Stillman, Gloria; Brown, Jill P.

    2012-01-01

    Mathematisation of realistic situations is an on-going focus of research. Classroom data from a Year 9 class participating in a program of structured modelling of real situations was analysed for evidence of Niss's theoretical construct, implemented anticipation, during mathematisation. Evidence was found for two of three proposed aspects. In…

  19. 7 CFR 1488.9 - Evidence of export.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Evidence of export. 1488.9 Section 1488.9 Agriculture... Export Sales of Agricultural Commodities From Private Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.9 Evidence of export. (a) If the commodity is exported by rail or...

  20. Material Programming

    DEFF Research Database (Denmark)

    Vallgårda, Anna; Boer, Laurens; Tsaknaki, Vasiliki

    2017-01-01

    . Consequently we ask what the practice of programming and giving form to such materials would be like? How would we be able to familiarize ourselves with the dynamics of these materials and their different combinations of cause and effect? Which tools would we need and what would they look like? Will we program......, and color, but additionally being capable of sensing, actuating, and computing. Indeed, computers will not be things in and by themselves, but embedded into the materials that make up our surroundings. This also means that the way we interact with computers and the way we program them, will change...... these computational composites through external computers and then transfer the code them, or will the programming happen closer to the materials? In this feature we outline a new research program that floats between imagined futures and the development of a material programming practice....

  1. LTDNA Evidence on Trial

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  2. LTDNA Evidence on Trial.

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  3. Effective Programming

    DEFF Research Database (Denmark)

    Frost, Jacob

    To investigate the use of VTLoE as a basis for formal derivation of functional programs with effects. As a part of the process, a number of issues central to effective formal programming are considered. In particular it is considered how to develop a proof system suitable for pratical reasoning......, how to implement this system in the generic proof assistant Isabelle and finally how to apply the logic and the implementation to programming....

  4. Program Fullerene

    DEFF Research Database (Denmark)

    Wirz, Lukas; Peter, Schwerdtfeger,; Avery, James Emil

    2013-01-01

    Fullerene (Version 4.4), is a general purpose open-source program that can generate any fullerene isomer, perform topological and graph theoretical analysis, as well as calculate a number of physical and chemical properties. The program creates symmetric planar drawings of the fullerene graph, an......-Fowler, and Brinkmann-Fowler vertex insertions. The program is written in standard Fortran and C++, and can easily be installed on a Linux or UNIX environment....

  5. Programming F#

    CERN Document Server

    Smith, Chris

    2009-01-01

    Why learn F#? This multi-paradigm language not only offers you an enormous productivity boost through functional programming, it also lets you develop applications using your existing object-oriented and imperative programming skills. With Programming F#, you'll quickly discover the many advantages of Microsoft's new language, which includes access to all the great tools and libraries of the .NET platform. Learn how to reap the benefits of functional programming for your next project -- whether it's quantitative computing, large-scale data exploration, or even a pursuit of your own. With th

  6. PLC Programming

    International Nuclear Information System (INIS)

    Lee, Seong Jae; Wi, Seong Dong; Yoo, Jong Seon; Kim, Se Chan

    2001-02-01

    This book tells of PLC programming for KGL-WIN with summary of PLC, performance and function of PLC like characteristic of KGL-WIN, connection method with PLC, basic performance of K200S/K300S/K1000S, diagram of input and output H/W, writing project, staring the program, editing of program, on-line function, debugging and instructions like control, timer and counter, data transmission, comparison, rotation and moving, system, data operating data conversion and application program.

  7. Programming Interactivity

    CERN Document Server

    Noble, Joshua

    2009-01-01

    Make cool stuff. If you're a designer or artist without a lot of programming experience, this book will teach you to work with 2D and 3D graphics, sound, physical interaction, and electronic circuitry to create all sorts of interesting and compelling experiences -- online and off. Programming Interactivity explains programming and electrical engineering basics, and introduces three freely available tools created specifically for artists and designers: Processing, a Java-based programming language and environment for building projects on the desktop, Web, or mobile phonesArduino, a system t

  8. Evidence-based dentistry.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  9. Evidence-Based Toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

    Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

  10. 42 CFR 405.809 - Opportunity to submit evidence.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Opportunity to submit evidence. 405.809 Section 405.809 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Appeals Under the Medicare Part B Program § 405.809 Opportunity to submit...

  11. 7 CFR 205.504 - Evidence of expertise and ability.

    Science.gov (United States)

    2010-01-01

    ... handling techniques; its ability to fully comply with and implement the organic certification program... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Accreditation of Certifying Agents § 205.504 Evidence of...

  12. Comparing Public, Private, and Market Schools: The International Evidence

    Science.gov (United States)

    Coulson, Andrew J.

    2009-01-01

    Would large-scale, free-market reforms improve educational outcomes for American children? This question cannot be reliably answered by looking exclusively at domestic evidence, much less by looking exclusively at existing "school choice" programs. Though many such programs have been implemented around the United States, none has created…

  13. Inter- and transgenerational epigenetic inheritance : Evidence in asthma and COPD?

    NARCIS (Netherlands)

    Krauss-Etschmann, Susanne; Meyer, Karolin F.; Dehmel, Stefan; Hylkema, Machteld N.

    2015-01-01

    Evidence is now emerging that early life environment can have lifelong effects on metabolic, cardiovascular, and pulmonary function in offspring, a concept also known as fetal or developmental programming. In mammals, developmental programming is thought to occur mainly via epigenetic mechanisms,

  14. Evidence-Based Practices Project for Suicide Prevention

    Science.gov (United States)

    Rodgers, Philip L.; Sudak, Howard S.; Silverman, Morton M.; Litts, David A.

    2007-01-01

    Suicide continues to be a serious public health problem. In response to this problem, a myriad of suicide prevention programs have been developed and employed across the United States. Unfortunately, the effectiveness of many of these programs is unknown because they have not been evaluated using rigorous methods. The Evidence-Based Practices…

  15. Computer Programs.

    Science.gov (United States)

    Anderson, Tiffoni

    This module provides information on development and use of a Material Safety Data Sheet (MSDS) software program that seeks to link literacy skills education, safety training, and human-centered design. Section 1 discusses the development of the software program that helps workers understand the MSDSs that accompany the chemicals with which they…

  16. BASIC Programming.

    Science.gov (United States)

    Jennings, Carol Ann

    Designed for use by both secondary- and postsecondary-level business teachers, this curriculum guide consists of 10 units of instructional materials dealing with Beginners All-Purpose Symbol Instruction Code (BASIC) programing. Topics of the individual lessons are numbering BASIC programs and using the PRINT, END, and REM statements; system…

  17. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  18. Choreographic Programming

    DEFF Research Database (Denmark)

    Montesi, Fabrizio

    , as they offer a concise view of the message flows enacted by a system. For this reason, in the last decade choreographies have been used in the development of programming languages, giving rise to a programming paradigm that in this dissertation we refer to as Choreographic Programming. Recent studies show...... endpoint described in a choreography can then be automatically generated, ensuring that such implementations are safe by construction. However, current formal models for choreographies do not deal with critical aspects of distributed programming, such as asynchrony, mobility, modularity, and multiparty...... sessions; it remains thus unclear whether choreographies can still guarantee safety when dealing with such nontrivial features. This PhD dissertation argues for the suitability of choreographic programming as a paradigm for the development of safe distributed systems. We proceed by investigating its...

  19. Effective Programs for Elementary Science: A Best-Evidence Synthesis

    Science.gov (United States)

    Slavin, Robert E.; Lake, Cynthia; Hanley, Pam; Thurston, Allen

    2012-01-01

    This article presents a systematic review of research on the achievement outcomes of all types of approaches to teaching science in elementary schools. Study inclusion criteria included use of randomized or matched control groups, a study duration of at least 4 weeks, and use of achievement measures independent of the experimental treatment. A…

  20. Evidence to Support Peer Tutoring Programs at the Undergraduate Level

    Science.gov (United States)

    Colver, Mitchell; Fry, Trevor

    2016-01-01

    The present study examined undergraduate peer tutoring in three phases. Phase I qualitatively surveyed students' perceptions about the effectiveness of tutoring. Phase II examined the usefulness of promoting regular use of services through a tutoring contract. Phase III utilized an archival, quasi-experimental approach to estimate the effect of…