Reflections from novice youth participatory action researchers: Emphasis on critical gender perspectives

Rooted in multiracial feminist theory, this research investigated the roles of adults engaged in youth participatory action research (YPAR) projects focused on developing critical perspectives of gender, power, and critical hope with the youth of color. Across 10 weeks, two novice adult facilitators documented ethnographic observations (i.e., voice memos) of their experiences collaborating with youth in YPAR. Voice memos were transcribed and coded for emergent themes. Our findings highlight how we deconstructed adultism, prioritized humanizing youth, and integrated critical gender perspectives to understand gender as a mechanism of systemic oppression. Our purpose was to capture moments of breakthroughs, realizations, and tensions as scholars contending with inexperience in YPAR and share our journey with other researchers interested in YPAR. We provide recommendations for adults to develop pathways towards humanity for the youth of color, collective resistance and take social justice action steps towards a critically hopeful future.     

Using computer-based interactive imagery strategies for designing instructional anatomy programs

In an effort to design and implement effective anatomy educational programs, this study was conducted to evaluate students' perceptions toward using two computer-based self-directed instructional modules (e.g., digestive system and canine skull) that were designed utilizing interactive imagery strategy for teaching and learning veterinary anatomy. Sixty-eight freshmen veterinary students and one graduate student participated in this study. Open-ended and close-ended questionnaires were administered to evaluate the utilization of computer-based interactive imagery strategy in developing anatomy instructional programs, and to collect data about the students' perceptions toward the use of interactive images in teaching and learning of anatomy. Means and standard deviations were calculated and analyzed for close-ended items. The open-ended questionnaire items were analyzed to identify shared patterns or themes in the students' experience after using the two instructional anatomy modules. Students reported positive attitudes toward the interactive imagery strategy used in the development of computer-based anatomy modules. Based on our findings, this study outlines the characteristics of effective instructional images that will serve as guidelines for the preparation and selection of anatomical images, as well as, how to utilize these images to develop computer-based instructional anatomy programs. Students perceived interactive imagery as an effective design strategy that helped them learn anatomical concepts.     

Evaluation of image processing programs for accurate measurement of budding and fission yeast morphology

To study the cellular functions of gene products, various yeast morphological mutants have been investigated. To describe yeast morphology objectively, we have developed image processing programs for budding and fission yeast. The programs, named CalMorph for budding yeast and F-CalMorph for fission yeast, directly process microscopic images and generate quantitative data about yeast cell shape, nuclear shape and location, and actin distribution. Using CalMorph, we can easily and quickly obtain various quantitative data reproducibly. To study the utility and reliability of CalMorph, we evaluated its data in three ways: (1) The programs extracted three-dimensional bud information from two-dimensional digital images with a low error rate (<1%). (2) The absolute values of the diameters of manufactured fluorescent beads calculated with CalMorph were very close to those given in the manufacturer’s data sheet. (3) The programs generated reproducible data consistent with that obtained by hand. Based on these results, we determined that CalMorph could monitor yeast morphological changes accompanied by the progression of the cell cycle. We discuss the potential of the CalMorph series as a novel tool for the analysis of yeast cell morphology.     

Developing a stroke intervention program: What do people at risk of stroke want?

OBJECTIVE: There is currently little research examining what individuals who are at risk of a stroke want from an invention program. In order to increase the usefulness of such programs, qualitative research methods were used explore invention design issues such as factors affecting accessibility of programs and preferred health information sources. METHODS: Thirty people, each with at least one stroke risk factor, participated in one of eight focus groups. RESULTS: Broad support was indicated for our proposed intervention. Participants perceived the value and likely success of such a program enhanced if it: (a) was integrated with, and supported by, other respected health services; (b) included social components (particularly important to women); (c) produced long-term benefits; and (d) included information that was personally relevant and practical in terms of implementing change. Three reasons emerged for continuing stroke education campaigns as a component of intervention programs; these were: (a) a lack of awareness among some participants of gaps in their stroke knowledge; (b) participants' explicit requests for specific rather than general information; and (c) the apparent failure of some participants to self-identify as at risk. CONCLUSION: This study yielded a number of important design considerations that should be taken into account when developing stroke intervention programs. PRACTICE IMPLICATIONS: We discuss ways of maximising the personal relevance of stroke prevention information along theoretically important dimensions, and consumers' recommendations for the design and delivery of stroke intervention programs.     

Stress management in medical education: a review of the literature.

PURPOSE: To review systematically clinical studies providing empirical data on stress-management programs in medical training. METHOD: The authors searched Medline and PSYCHINFO from 1966 to 1999. Studies were included if they evaluated stress-management programs for medical trainees (medical students, interns, or residents); reported empirical data; and had been conducted at allopathic medical schools. RESULTS: Although the search yielded over 600 articles discussing the importance of addressing the stress of medical education, only 24 studies reported intervention programs, and only six of those used rigorous scientific method. Results revealed that medical trainees participating in stress-management programs demonstrated (1) improved immunologic functioning, (2) decreases in depression and anxiety, (3) increased spirituality and empathy, (4) enhanced knowledge of alternative therapies for future referrals, (5) improved knowledge of the effects of stress, (6) greater use of positive coping skills, and (7) the ability to resolve role conflicts. Despite these promising results, the studies had many limitations. CONCLUSION: The following considerations should be incorporated into future research: (1) rigorous study design, including randomization and control (comparison) groups, (2) measurement of moderator variables to determine which intervention works best for whom, (3) specificity of outcome measures, and (4) follow-up assessment, including effectiveness of future patient care.     

Blended face-to-face and online/computer-based education approaches in chronic disease self-management: A critical interpretive synthesis

ObjectiveTo review the literature on chronic disease self-management programs that blend face-to-face and online/computer-based education design and delivery.MethodsA critical interpretive synthesis was conducted. Studies that described blended chronic disease self-management programs were reviewed. Two reviewers performed independent database searches, eligibility screening, and data extraction. Findings were synthesized using a conceptual mapping process.ResultsTwelve articles were included in the final review. Studies focused on patients with diagnoses of diabetes, asthma, and chronic obstructive pulmonary disorder. Factors influencing the design and delivery of programs focused on patient characteristics (such as disease prognosis, time since diagnosis, social determinants of health, health literacy, and proficiency with online/computer-based technologies).ConclusionsBlended learning self-management programs should consider the suitability of programs in light of health conditions and patient characteristics. Individual patient needs can be identified through clinician-driven assessments, including collaborative goal setting and the selection of pertinent educational tools.Practice ImplicationsWhen considering the design and delivery of chronic disease self-management education programs, healthcare providers should consider three factors: 1) patient characteristics, 2) learning perspectives, and 3) design technology options that best meet patient abilities, clinician expertise, and administrative capacity.     

Using the desk top computer in cellular toxicity and mutagenesis

A series of programs applicable to in vitro test symptoms in environmental toxicology are described for the Tektronix 4050 series graphic system computer. The file structure, experimental design and identification, the program library, data entry program, and programs to compile data from separate experiments are presented. Experimental design information and test data are stored on magnetic tape. The programs are designed to compute cell number and viability, adenosine triphosphate level, and protein and DNA synthetic activity from raw data obtained from cellular toxicity experiments; and cloning efficiency, mutation yield, mutation frequency, and other parameters for mutagenicity. A set of subprograms can be used for statistical analysis of the data and for construction of frequency distributions. The applicability of the programs is illustrated by data obtained from exposure of Chinese hamster ovary cells to cadmium chloride or N-methyl-N′-nitro-N-nitroso-guanidine.     

Content-specific auditing of a large scale anatomy ontology

Biomedical ontologies are envisioned to be useable in a range of research and clinical applications. The requirements for such uses include formal consistency, adequacy of coverage, and possibly other domain specific constraints. In this report we describe a case study that illustrates how application specific requirements may be used to identify modeling problems as well as data entry errors in ontology building and evolution. We have begun a project to use the UW Foundational Model of Anatomy (FMA) in a clinical application in radiation therapy planning. This application focuses mainly (but not exclusively) on the representation of the lymphatic system in the FMA, in order to predict the spread of tumor cells to regional metastatic sites. This application requires that the downstream relations associated with lymphatic system components must only be to other lymphatic chains or vessels, must be at the appropriate level of granularity, and that every path through the lymphatic system must terminate at one of the two well known trunks of the lymphatic system. It is possible through a programmable query interface to the FMA to write small programs that systematically audit the FMA for compliance with these constraints. We report on the design of some of these programs, and the results we obtained by applying them to the lymphatic system. The algorithms and approach are generalizable to other network organ systems in the FMA such as arteries and veins. In addition to illustrating exact constraint checking methods, this work illustrates how the details of an application may reflect back a requirement to revise the design of the ontology itself.     

Upscaling communication skills training – lessons learned from international initiatives

ObjectiveTo collect experiences and to identify the main facilitators and barriers for the implementation process of large scale communication training programs.MethodsUsing a multiple case study design, data was collected from leaders of the individual programs in Australia, Ireland, Austria and Denmark. The RE-AIM framework was used to evaluate the components: Reach, Effectiveness, Adoption, Implementation, and Maintenance of the programs.ResultsThe programs, all based on the Calgary-Cambridge Guide, succeeded in reaching the intended target groups corresponding to between 446 and 3000 healthcare workers. New courses are planned and so far the outcome of the intervention has been investigated in two countries. The fact that implementation, including educating trainers, relies on a few individuals was identified as the main challenge.ConclusionLarge scale communication training programs based on the Calgary-Cambridge Guide can be implemented and adopted in multiple different healthcare settings across a national health system culture. The importance of standardized trainer education and adaption of the programs to clinical practice was highlighted.Practice ImplicationsIn order to address the sustainability of the programs and to allow the intervention to scale up, it is important to prioritise and allocate resources at the political and organizational level.     

Informing the next generation of prevention programs: CSAP's cross-site evaluation of the 1994–95 high-risk youth grantees

With more than 400 projects funded since its initiation, the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention (CSAP) High-Risk Youth Demonstration Program (HRY) is a prime example of federally sponsored demonstrations for generating and disseminating policy and program lessons in the area of substance abuse prevention. The HRY demonstration has provided strong support for both local and cross-site evaluation, and incorporated evaluation results into demonstration policy to (a) encourage stronger local evaluation, (b) encourage more coherent program planning and management, (c) encourage use of the risk and resiliency approach(es) to designing programs, and (d) encourage more comprehensive program purposes and activities. In April 1995, the Division of Knowledge Development and Evaluation within CSAP initiated the third cross-site evaluation of HRY programs which utilizes a clear conceptual framework emphasizing the risk and resiliency approach utilized by HRY grantees funded in 1994 and 95. The study implements a common quasi-experimental design across 48 selected sites, and will involve approximately 6,000 treatment and 4,000 comparison subjects. A common questionnaire will be used in all sites, generating data that will support a flexible, regression-based analysis plan. In addition to contributing to the systematic development of substance abuse prevention knowledge, the CSAP National Cross-Site Evaluation of HRY Programs will advance understanding of the design, implementation, and utilization of large, multi-site evaluations as sources of policy learning. © 1997 John Wiley & Sons, Inc.     

The National Institutes of Health’s Biomedical Translational Research Information System (BTRIS): Design,contents, functionality and experience to date

The US National Institutes of Health (NIH) has developed the Biomedical Translational Research Information System (BTRIS) to support researchers’ access to translational and clinical data. BTRIS includes a data repository, a set of programs for loading data from NIH electronic health records and research data management systems, an ontology for coding the disparate data with a single terminology, and a set of user interface tools that provide access to identified data from individual research studies and data across all studies from which individually identifiable data have been removed. This paper reports on unique design elements of the system, progress to date and user experience after five years of development and operation.     

Delivery and interactive processing of visual data for a cooperative telemedicine environment.

Cooperative telemedicine environments are required for many situations such as consultations between residents and senior doctors, case correlations, and for teaching and research purposes. The mode of collaboration may vary with different situations, in terms of the synchronisation of tasks, the sharing of data and the extent of collaboration among participants. It is essential for participants to be able to remotely view and manipulate visual data (images, two-dimensional and three-dimensional graphics, animation, and video) as well as interactively run application programs that involve visual data in real-time. However, this is not possible with current network bandwidth limitations when large amount of visual data are involved. In this article, we first provide an analysis of functional requirements by participants in cooperative diagnosis in different types of situations, before discussing technical requirements, which form the basis for our system architecture design. A new approach is also presented for efficient handling of programs, which involve visual data in real time. This is achieved via the construction and transmission of small messages that encapsulate the operations in a pipelined or hierarchical fashion.     

Observations on Training Clinical Psychology Faculty

The rank ordering of psychology programs based on the number of "core" clinical program faculty they produce is interesting and valuable. It is important to emphasize, as the Hard! et al. (this issue) did, that this is only one measure of program quality. The study was based only on faculty of university doctoral training programs, and there are other programs and locations in which faculty are involved in training future clinical psychology program faculty. It is most interesting that even the best programs train very few future clinical program faculty per year. Because of temporal shifts in program quality, when making evaluative decisions, it is essential for consumers of rank-ordered lists to obtain the most recent and direct information regarding programs. I also discuss some future implications of these and other data for future directions in training clinical psychology program faculty.     

‘CTRL’: an online,Dynamic Consent and participant engagement platform working towards solving the complexities of consent in genomic research

The complexities of the informed consent process for participating in research in genomic medicine are well-documented. Inspired by the potential for Dynamic Consent to increase participant choice and autonomy in decision-making, as well as the opportunities for ongoing participant engagement it affords, we wanted to trial Dynamic Consent and to do so developed our own web-based application (web app) called CTRL (control). This paper documents the design and development of CTRL, for use in the Australian Genomics study: a health services research project building evidence to inform the integration of genomic medicine into mainstream healthcare. Australian Genomics brought together a multi-disciplinary team to develop CTRL. The design and development process considered user experience; security and privacy; the application of international standards in data sharing; IT, operational and ethical issues. The CTRL tool is now being offered to participants in the study, who can use CTRL to keep personal and contact details up to date; make consent choices (including indicate preferences for return of results and future research use of biological samples, genomic and health data); follow their progress through the study; complete surveys, contact the researchers and access study news and information. While there are remaining challenges to implementing Dynamic Consent in genomic research, this study demonstrates the feasibility of building such a tool, and its ongoing use will provide evidence about the value of Dynamic Consent in large-scale genomic research programs.Subject terms: Genetics research, Patient education     

Multicomponent programs for reducing peer victimization in early elementary school: a longitudinal evaluation of the WITS Primary Program

Past research demonstrates the promise of multicomponent programs in reducing peer victimization and bullying in older elementary and middle school children, however little research focuses on young children. The current study examines the effectiveness of the WITS Primary program on trajectories of victimization and social responsibility in children in Grades 1 to 3 (n=830). A quasi‐experimental design is used to compare schools with well‐established programs to nonprogram control schools, using three waves of data collected over 18 months. Children in the WITS program (n=422) showed more rapid declines in peer victimization over time compared with children in control schools (n=418). In addition, teachers of children in program schools reported higher average levels of social responsibility at each time point, compared with control schools. This study adds to support for the multicomponent program in reducing peer victimization among young children. Teachers' important roles in monitoring program implementation are discussed. © 2011 Wiley Periodicals, Inc.     

Mentoring relationships for youth: Investigation of a process‐oriented model

We investigated a process‐oriented model of mentoring using data on 50 relationships in a Big Brothers/Big Sisters program. Data were collected on a monthly basis from both mentors and youth over a one‐year period; relationship benefits for youth were assessed at the end of the year by each type of informant. The degree to which relationships were continued throughout the one‐year period also was assessed. Path analyses using both youth and mentor report data revealed relations among study variables consistent with the proposed model. Mentors' ratings of their efficacy, obtained prior to the start of relationships, predicted greater amounts of mentor/youth contact as well as more positive experiences in relationships (e.g., fewer obstacles). Feelings of closeness between mentors and youth, in turn, were a final common component in model pathways that linked mentor/youth contact and most other measures to greater perceived benefits and relationship continuation. Implications for the design and evaluation of mentoring programs for youth are discussed. © 2002 Wiley Periodicals, Inc.     

Components of risk factor change in a CHD intervention program

Carried out a study on a sample of men (N = 652) at high risk or coronary heart disease (CHD) in order to note the dimensions of change for the risk factors of smoking blood pressure, cholesterol, selected intervention and psychosocial variables. The principal components analyses revealed a multi-dimensional structure with some bipolar change factors. Implications for the design and implementation of behaviorally oriented risk factor programs were discussed.     

Foundation of the Newborn Screening Translational Research Network and its tools for research

In the past 20 years, several policy activities were undertaken that shaped today’s newborn screening (NBS) programs and their associated NBS research activities: the Newborn Screening Task Force Report; the Child Health Act of 2000, Screening for Heritable Disorders; the American College of Medical Genetics and Genomics’ (ACMG’s) Newborn Screening Uniform Panel; and the ACMG expert panel to examine the development of a national collaborative study system for rare genetic diseases. These activities helped conceptualize the Newborn Screening Translational Research Network (NBSTRN) infrastructure and lay the foundation for its current activities. After 10 years, NBSTRN has grown into an organization that provides tools and resources for researchers to conduct research relevant to NBS programs for rare diseases for which data has been siloed locally. Infrastructure includes tools for the analytical and clinical validation of screening tests; the collection, analysis, sharing, and reporting of longitudinal laboratory and clinical data on newborn-screened individuals; and a web-based tool that allows researchers to acquire dried blood spots available for use in research from state NBS programs. NBSTRN also provides tools for researchers such as informed consent templates, disease registries, state NBS profiles, and consultation on planning pilot studies. In time, the growing data will become a resource itself.     

The effects of AIDS prevention programs by lay health advisors for migrants in The Netherlands

Two studies describe the effectiveness of acquired immunodeficiency syndrome (AIDS) prevention programs by lay health advisors (LHAs) for migrants in The Netherlands. The effects of such AIDS programs were evaluated (Study 1) and compared with the effects of professional health advisors (PHAs, i.e. medical doctors or nurses) (Study 2). The first study concerned Turkish and Moroccan migrants and showed positive effects on knowledge, behavioral control, and social norm towards condom use. Iraqi refugees participated in the second study that concerned a direct comparison of LHA- and PHA-based programs. Both programs result in positive effects in terms of attitude change and knowledge, but the LHA program resulted in a stronger intention to discuss AIDS with children. Analyses predicting intention to use condoms provide evidence that LHA programs lead to a stronger relation between attitudes and intention. This suggests that LHA-based AIDS programs are more successful in inducing internally motivated intentions to safe sex practices, such as condom use.     

Considering a multisite study? How to take the leap and have a soft landing

Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community‐based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using the same instruments and time frame. The proposition of introducing the same study design in different settings and programs is deceptively straightforward. The difficulty is not in the conceptualization but in the implementation. This article examines the factors that act as implementation barriers, how are they magnified in a multisite study design, and how they can be successfully addressed. In discussing the issue of study design, this article considers processes used to address six major types of barriers to conducting collaborative studies identified by Lancaster or Lancaster's six Cs—contribution, communication, compatibility, consensus, credit, and commitment. A case study approach is used to examine implementation of a multisite community mental health evaluation of services and supports (case management, self‐help initiatives, crisis interventions) represented by six independent evaluations of 15 community health programs. A principal finding was that one of the main vehicles to a successful multisite project is participation. It is only through participation that Lancaster's six Cs can be addressed. Key factors in large, geographically dispersed, and diverse groups include the use of advisory committees, explicit criteria and opportunities for participation, reliance on all modes of communication, and valuing informal interactions. The article concludes that whereas modern technology has assisted in making complicated research designs feasible, the operationalization of timeless virtues such as mutual respect and trust, flexibility, and commitment make them successful. © 2002 John Wiley & Sons, Inc.