University-based continuing education and mental health system change.

Describes how a continuing education program successfully effected a change in the organized mental health services in a large metropolitan area. The principles, goals, and outcomes of a program oriented toward mental health system change and using community organization interventions are reported and discussed. Comparisons are made with traditional individually oriented continuing education programs. Mental health professionals were trained in program consultation to community care facilities serving chronic mental patients, and attempts were made to have such consultations incorporated into the organized service delivery systems. It is concluded that university-based continuing education can be a major stimulus and have a major impact on organized mental health delivery systems. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug abuse risk and protective factors among black urban adolescent girls: A group-randomized trial of computer-delivered mother-daughter intervention.

A group-randomized design tested a mother-daughter intervention in which researchers aimed to increase protective factors in a community sample of Black urban adolescent girls. Girls and their mothers at 2 community agencies were pretested and, by agency, were randomized to either an intervention arm or a control arm. Intervention arm girls and their mothers received a program for improving mother- daughter rapport. Posttest data collected 3 weeks after program delivery revealed that intervention arm mothers and daughters improved more than did control arm mothers and daughters on measures of communication and closeness. At 3-month follow-up, intervention arm mothers, relative to control arm mothers, continued to report better communication with and closeness to their daughters. Girls and mothers in the intervention arm rated the computer program favorably on parameters of enjoyment, comfort, relevance, usefulness of information, improvements to their relationship with one another, and whether they would recommend the computer program to friends. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Partnerships for Prevention: The Story of the Highfield Community Enrichment Project.

Reviews the book, Partnerships for Prevention: The Story of the Highfield Community Enrichment Project by Geoffrey Nelson, S. Mark Pancer, Karen Hayward, and Ray Dev. Peters (see record 2006-03465-000). The authors of this text set out to tell the story of the Highfield Community Enrichment Project, which was one of eight sites for a universal, community-wide initiative in primary prevention and health promotion (Better Beginnings, Better Futures) for young children and their families living in a low-income suburb of Toronto, Ontario. This text provides the reader with a thorough and impressive evidence-base for the project as well as rich qualitative detail regarding the development, implementation, and outcome of the program. Central to the content of this work is the attention the interventions gave to involving community residents in all aspects of prevention programming, from inception through delivery. By discussing at great lengths the positive impact of the ideas and efforts of community residents within this community-wide prevention program, this text has the potential to reinforce the relations between researchers, practitioners, and community members towards similar partnerships in the future. Taken together, this text should undoubtedly serve as a road map for others interested in devising and establishing effective community-wide prevention programs focusing on enhancing the quality of life for children and families residing in low-income areas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research in the community cauldron: A case history.

This paper considers a series of natural hazards that community researchers must face, including: being a "foreign body" to the system under examination; the time-consuming, longitudinal demands of studies in this area; the dangers of program instability and change; the need for community accountability; and the pro-action, anti-research orientation of many community program personnel. These hazards lead to riskier studies and to research that falls short of traditional standards of scientific rigor. However, unless investigators are willing to gamble with less precise, less well controlled approaches, and to build knowledge through gross successive approximations, many significant, exciting problems of community psychology will not be studied. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity interventions using mass media, print media, and information technology

INTRODUCTION: Media-based physical activity interventions include a variety of print, graphic, audiovisual, and broadcast media programs intended to influence behavior change. New information technology allows print to be delivered in personalized, interactive formats that may enhance efficacy. Media-based interventions have been shaped by conceptual models from health education, Social Cognitive Theory, the Transtheoretical Model, and Social Marketing frameworks. METHODS: We reviewed 28 studies of media-based interventions of which seven were mass media campaigns at the state or national level and the remaining 21 were delivered through health care, the workplace, or in the community. RESULTS: Recall of mass-media messages generally was high, but mass-media campaigns had very little impact on physical activity behavior. Interventions using print and/or telephone were effective in changing behavior in the short term. Studies in which there were more contacts and interventions tailored to the target audience were most effective. CONCLUSION: A key issue for research on media-based physical activity interventions is reaching socially disadvantaged groups for whom access, particularly to new forms of communication technology, may be limited. There is a clear need for controlled trials comparing different forms and intensities of media-based physical activity interventions. Controlled studies of personalized print, interactive computer-mediated programs, and web-based formats for program delivery also are needed. The integration of media-based methods into public and private sector service delivery has much potential for innovation.     

Health state preferences of persons with anxiety

We have described a program that integrates clinical approaches of infant mental health to infants and toddlers in foster care. The juxtaposition of a mental health program in a forensic setting creates a number of special features that we have highlighted. Unique from the clinical perspective, the team is explicitly relationship-focused, attempting to understand all of the young child's caregiving relationships as they affect development. We strive to enhance the quality of all of relationships in which infants participate, fostering healthy attachments and development. Also unique is the emphasis on system liaison, and making programmatic efforts to affect various systems involved in making custody determinations about infants and toddlers. Unique from the forensic perspective, we offer multidisciplinary expertise about an especially high-risk population, a comprehensive service delivery system in which we provide or coordinate and monitor all intervention efforts for a given family, a prevention orientation, and clinical follow-up with infants for as long as they are in care. The goals of the program include expediting permanency planning decisions, increasing continuity in high-quality foster care placements, increasing court satisfaction with mental health consultation, decreasing the number of court-ordered evaluations for adjudicated families, and increasing CPS satisfaction with available treatment and continuity of care. We believe that this approach integrates delivery of services to the youngest and most vulnerable victims of maltreatment and expedites permanency planning.     

Collaboration and resource exchange between professionals and natural support systems.

A number of social researchers have documented how extensively Americans utilize informal helping resources in dealing with personal problems, and interest in the preventative potential of informal social support has been spurred by concurrent research in epidemiology. A definition and preliminary typology of natural support systems are offered as a basis for discussion of their role in the delivery of human services. Opportunities for collaboration and an exchange of resources between professionals and members of informal helping networks are explored, and several ways in which professionals can identify and help to create natural support systems in the community are indicated. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contextual community prevention theory: Building interventions with community agency collaboration.

Translation from research to practice faces numerous problems that include replicating effectiveness, fidelity to the protocol and processes, and adaptations to different types of target populations. Working collaboratively with existing service providers can speed up the time for development and can ease the implementation of empirical randomized trials. Contextual community prevention theory is an innovative approach that focuses on changing behaviors of community members by creating a visible institutional presence that draws and pulls the targeted population into the organization’s activities and interventions. The result is an institution or organization within the community that provides a new active and dynamic context, engaging its community members into its activities, interventions, and functions. An HIV prevention program developed collaboratively from the ground up for Latino gay/bisexual men is presented. Results from the program evaluation efforts across the years suggest promise for testing its efficacy through a randomized trial. HIV prevention efforts need to develop dynamic support systems within communities where these men have ownership, have control, and feel safe; otherwise HIV infection rates in this population will increase. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Meta-Analysis of Smoking Cessation Interventions With Individuals in Substance Abuse Treatment or Recovery.

This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (≥ 6 months) were summarized with random effects models. Intervention effects for smoking cessation were significant at posttreatment and comparable for participants in addictions treatment and recovery; however, intervention effects for smoking cessation were nonsignificant at long-term follow-up. Smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Short-term smoking cessation effects look promising, but innovative strategies are needed for long-term cessation. Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward effective community-based interventions in child abuse.

Argues that traditional individual and family-oriented clinical and educational approaches to treating child-abusing parents seem to have limited effectiveness. Within an ecological framework, causal factors bearing on the problem of child abuse can be amenable to community intervention through the use of such concepts as natural support systems and community development activities. An example of community development intervention is described, and guidelines for community-level interventions are suggested. The consultation and education program of the community mental health center is cited as one such approach to this problem. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit and explicit attitudes predict smoking cessation: Moderating effects of experienced failure to control smoking and plans to quit.

The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characterization of the cyclin-dependent kinase inhibitory domain of the INK4 family as a model for a synthetic tumour suppressor molecule

Few studies have addressed recruitment and retention of participants in preventive interventions directed at human immunodeficiency virus (HIV), and these generally have not focused on women. In this study, part of the Women in Group Support (WINGS) project, we examine the experience of three sites in recruiting 444 high-risk women for a small group intervention to reduce risky sexual behavior. The intervention included six structured sessions, followed by a continuing series of client-focused, drop-in sessions. Incentives for participants included child care, food, and transportation tokens. Attendees at each structured session also received a cash incentive of $10-$20. Forty-six percent of the women were recruited from community sources, 35% from clinics, and 19% from drug programs. Across all recruitment sources, almost a third of the women reported having had a sexually transmitted disease (STD) in the past year, 88%-94% reported a risky male partner (who, they believed, had sex with other partners or with sex workers, was an injecting drug user, or was HIV positive), and 10%-36% reported trading sex for money or drugs. During 18 months of recruitment, each site averaged 34 screening interviews monthly to secure 8 eligible women a month who completed baseline interviews and reported for randomization. The average number of paid sessions attended by participants was five of six (83%). Average attendance at unpaid sessions was 1 of 12 (8%). Key facilitators to recruitment and retention included linkages with community agencies and monetary incentives. Our findings suggest that researchers and community service providers need to explore alternative strategies to paying women for attending group sessions (e.g., incorporating group interventions into existing program requirements) and balance these against the costs and recruitment effectiveness.     

Randomized trial of social rehabilitation and integrated health care for older people with severe mental illness.

Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase. Method: To evaluate effects of HOPES on social skills and psychosocial functioning, we conducted a randomized controlled trial with 183 older adults with SMI (58% schizophrenia spectrum) age 50 and older at 3 sites who were assigned to HOPES or treatment as usual with blinded follow-up assessments at baseline and 1- and 2-year follow-up. Results: Retention in the HOPES program was high (80%). Intent-to-treat analyses showed significant improvements for older adults assigned to HOPES compared to treatment as usual in performance measures of social skill, psychosocial and community functioning, negative symptoms, and self-efficacy, with effect sizes in the moderate (.37–.63) range. Exploratory analyses indicated that men improved more than women in the HOPES program, whereas benefit from the program was not related to psychiatric diagnosis, age, or baseline levels of cognitive functioning, psychosocial functioning, or social skill. Conclusions: The results support the feasibility of engaging older adults with SMI in the HOPES program, an intensive psychiatric rehabilitation intervention that incorporates skills training and medical case management, and improves psychosocial functioning in this population. Further research is needed to better understand gender differences in benefit from the HOPES program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation of resources in mental health delivery: Implications for training.

The following mental health delivery systems, which include a variety of "movements" or approaches, are briefly differentiated and reviewed: prevention, self-help groups, social-skills training problems, psychotherapeutic interventions, environmental modification, and community resources. The implications of this differentiation for training in clinical psychology are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction: Methodological issues in school-based mental health services research.

New research directions on the effectiveness of mental health services for children and adolescents offer the opportunity for school psychology to apply its knowledge base to the systemic juncture between mental health and school systems. Models of service delivery to children, adolescents, and their families that integrate school, mental health, and other service sectors are being actively studied to answer questions about the outcomes of these services for children with mental health problems. The papers in this journal were first presented at the 6th Annual Research Conference of the Florida Mental Health Institute on "A System of Care for Children's Mental Health: Expanding the Research Base." The papers describe state-of-the art studies of school-based mental health interventions for children, adolescents, and their families. In each of the papers, particular attention is paid to the salient methodological issues researchers face in conducting these studies within school settings. It is hoped that these articles will foreground the healthy and creative tensions that exist between different research paradigms and multiple service communities, especially mental health and school systems, by encouraging new research on important and as yet unanswered questions about the effectiveness of school-based service delivery to children and adolescents with mental health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementing the Put Prevention into Practice program

Put Prevention into Practice (PPIP) is a national program designed to improve the delivery of preventive care to patients by all primary care clinicians. It covers the full range of clinical preventive services, including immunizations, screening tests, chemoprophylaxis, and counseling interventions. The materials that comprise this program involve patients, office/clinic systems and staff, and clinicians, including nurse practitioners. The need for preventive care, the barriers to be overcome, the PPIP program, and a strategy for its implementation are delineated. Principles for successful implementation include: high level administrative support, ownership by all the players in the implementation process, a person designated to manage implementation, and an ongoing evaluation/auditing process that provides feedback to clinicians and others participating in the program.     

Contributions of Canadian community psychology.

The contributions of Canadian community psychologists to ethics, theory, methodology, research, and practise are highlighted in this article. Important debates about ethical issues in psychological research and practise have been advanced by Canadian community psychologists. Canadian community psychologists have also introduced theoretical perspectives (e.g., cognitive community psychology) that have provided an impetus for research and practise, and they have broadened the focus of research in community settings with contributions to participatory action research, program evaluation, and qualitative methods. A variety of substantive contributions have been made to the research literature, especially in the areas of community mental health, prevention, and social inclusion. Finally, Canadian community psychologists have contributed to practise in terms of policy, programs, and social interventions. The article concludes with a discussion of future potential areas of contribution for Canadian community psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-help interventions for smoking cessation.

Self-help interventions for smoking cessation are an important bridge between the clinical and public health approaches to smoking cessation. The current literature on self-help interventions is encouraging but incomplete. Although their quit rates are lower than those of more intensive programs, self-help interventions could have a large public health impact because of their potential for widespread distribution. Studies comparing self-help to more intensive treatment suggest that long-term cessation rates for self-help programs are potentially as high as rates for face-to-face interventions, with lower quit rates for self-help programs that are likely due to differences in program adherence. Tailored materials and personalized adjuncts (e.g., written feedback or telephone counseling) that promote program adherence may increase cessation rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions

Researchers have examined numerous psychosocial and behavioral interventions intended to alleviate distress among family caregivers of persons with dementia. Many of these interventions are complex, combining numerous treatment components. Although some multicomponent interventions have been successful in reducing caregiver distress, the impact of specific elements of these interventions on outcomes is not known. The article presents results of an analytic approach that allows researchers to describe the individual elements of multicomponent interventions and to examine the relationships between those components and outcomes. This approach is successfully applied to interventions being evaluated in the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program. The results indicate that actively targeting caregiver behavior is effective in achieving positive outcomes with respect to caregiver depression.     

Innovative service redesign and resource reallocation: responding to political realities, mental health reform and community mental health needs

General hospital mental health programs in large inner city communities face challenges in developing responsive services for populations facing high rates of serious mental illness, substance abuse, homelessness, and poverty. In addition provincial political pressures such as Mental Health Reform and hospital restructuring have caused general hospital mental health programs to reevaluate how services are delivered and resources are allocated. This paper describes how one inner city mental health service in a university teaching setting developed successful strategies to respond to these pressures. Strategies included: (a) merging two general hospital mental health services to pool resources; (b) allocating resources to innovative care delivery models consistent with provincial reforms and community needs; (c) fostering staff role changes, job transitions, and the development of new professional competencies to complement the innovative care delivery models; and (d) developing processes to evaluate the effects of these changes on client.