“Home Practice Is the Program”: Parents’ Practice of Program Skills as Predictors of Outcomes in the New Beginnings Program Effectiveness Trial

An examination of the content and processes of evidence-based programs is critical for empirically evaluating theories about how programs work, the “action theory” of the program (West et al. in American Journal of Community Psychology, 21, 571–605, 1993). The New Beginnings Program (NBP; Wolchik et al., 2007), a parenting-after-divorce preventive intervention, theorizes that program-induced improvements in parenting across three domains: positive relationship quality, effective discipline, and protecting children from interparental conflict, will reduce the negative outcomes that are common among children from divorced families. The process theory is that home practice of program skills related to these parenting domains is the primary mechanism leading to positive change in parenting. This theory was tested using multi-rater data from 477 parents in the intervention condition of an effectiveness trial of the NBP (Sandler et al. 2016a, 2016b). Four research questions were addressed: Does home practice of skills predict change in the associated parenting outcomes targeted by the program? Is the effect above and beyond the influence of attendance at program sessions? What indicators of home practice (i.e., attempts, fidelity, efficacy, and competence) are most predictive of improvements in parenting? Do these indicators predict parenting improvements in underserved subpopulations (i.e., fathers and Latinos)? Structural Equation Modeling analyses indicated that parent-reported efficacy and provider-rated parent competence of home practice predicted improvements in the targeted parenting domains according to both parent and child reports. Moreover, indicators of home practice predicted improvements in parenting for fathers and Latinos, although patterns of effects varied by parenting outcome.     

School Coordinators’ Perceptions of Organizational Readiness Is Associated with Implementation Fidelity in a Smoking Prevention Program: Findings from the X:IT II Study

School organizational readiness to implement interventions may play an important role for the actual obtained implementation level, and knowledge about organizational readiness prior to intervention start can help pinpoint how to optimize support to the schools. In this study, we applied a novel heuristic, R?=?MC² to assess school organizational readiness prior to implementation of a multicomponent smoking prevention program. Furthermore, we examined the association to actual implementation after the first year of study. We used questionnaire data from school coordinators at 40 schools in Denmark who had accepted to implement the multi-component smoking prevention intervention—X:IT II—in the school year 2017–2018 including three main components: (1) Rules on smoke-free school time, (2) A smoke-free curriculum, and (3) Parental involvement. On behalf of the school, a school coordinator answered a baseline questionnaire about the organizational readiness and a follow-up questionnaire about implementation of the three components after first year of study. Readiness was measured by summing aspects of motivation (relative advantage, compatibility, complexity, and priority), general capacity (culture, climate, and staff capacity), and innovation-specific capacity (knowledge, skills, and abilities). Based on school coordinators’ perceptions, almost all schools had good general capacity while the other two areas of readiness varied across schools; overall, 56.8% of schools (N?=?25) had good motivation for implementing the X:IT II intervention and 61.3% (N?=?27) had high innovation-specific capacity. Half of the schools had high overall readiness defined as high motivation and high innovation-specific capacity. Schools with high overall readiness implemented the rules on smoke-free school time, smoke-free curriculum, and parental involvement to a higher degree than schools with low overall readiness. All participating schools possessed sufficient levels of general capacity, e.g., a well-functioning organizational culture and sufficient staff capacity. High levels of motivation and innovation-specific capacity were positively associated with the schools’ actual implementation of the main intervention components. This way of conceptualizing and measuring organizational readiness may be useful in future studies, i.e., in studies where enhancing readiness is a main objective.

     

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

ObjectiveTo 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.MethodFrom 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.ResultsSignificantly 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.ConclusionMeaningful 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.     

Prevalence and Patterns of Child Sexual Abuse and Victim–Perpetrator Relationship Among Secondary School Students in the Northern Province (South Africa)

An investigation into the prevalence and characteristics of child sexual abuse in the Northern Province (South Africa) was conducted. A total of 414 secondary school students in standard 9 and 10 in three representative secondary schools completed a retrospective self-rating questionnaire in a classroom setting. The questionnaire asked about childhood sexual abuse and the victim-perpetrator relationship. Results shows an overall (N = 414) child sexual abuse prevalence rate of 54.2%, 60% for males (N = 193), 53.2% for females (N = 216). Among them, 86.7% were kissed sexually, 60.9% were touched sexually, 28.9% were victims of oral/anal/vaginal intercourse. "Friend" was the highest indicated perpetrator in all patterns of sexual abuse. Many victims (86.7%) perceived themselves as not sexually abused as a child, and many (50.2%) rated their childhood as "very happy." A call is made for more research, publicity, and campaigns in the area of child sexual abuse in the Province.     

Teacher: But Not Student Rating of the Pedagogic and Social Climate in School Predicts Adolescents’ Academic Aspirations

Child & Youth Care Forum - High academic aspirations relate to higher achievement and better mental health, but less is known about how these aspirations are formed in relation to the...     

Participation in “Parents Who Care”: Predicting Program Initiation and Exposure in Two Different Program Formats

Predictors of participation and exposure across two formats of a universal prevention program are examined here. Families of 225 8th-grade students, balanced by race (African American and European American) and gender, were assigned to a parent and adolescent group format (PAG) or a self-administered format (SA). Logistic regression showed greater program initiation in SA than in PAG. Hierarchical regression showed only one variable (parent high-risk behavior) to be associated with lower program exposure in the self-administered format. In contrast, demographic variables (e.g., being African American) predicted lower exposure in PAG. Overall, the findings of this study were notable in that most of the variables that have been identified in past research as lowering participation rates were not related to program initiation or level of exposure to either format of Parents Who Care. Further, the self-administered format may be particularly useful to increase program participation for families, even those who are traditionally difficult to reach. Editors' Strategic Implications: The authors make a promising contribution to the literature on program engagement by presenting experimental data highlighting different risk factors for nonparticipation across program formats. Their discussion of barriers will help program designers and practitioners decide on the most appropriate strategies for the dissemination of prevention-related materials to parents.     

Alcohol Expectancies and Risky Drinking Behaviors Among High School Athletes: “I’d Rather Keep My Head in the Game”

Research suggests that high school students who participate in sports may be at elevated risk for alcohol use compared to their non-athlete peers; however, reasons for this association are unclear. Alcohol expectancy theory posits that individuals who expect favorable outcomes to occur because of alcohol use are more likely to drink than those who do not endorse such beliefs. As such, the present study was designed to examine the associations of alcohol expectancy outcomes and valuations (i.e., beliefs about whether an outcome is good or bad), as well as alcohol expectancies related to sports functioning (e.g., alcohol’s effects on one’s ability to learn new plays and recover physically from sporting activities), with risky drinking among high school athletes. Participants were 219 in-season high school athletes (mean age = 15.6, range = 13–18) who completed anonymous self-report surveys. A structural equation model indicated that endorsement of positive alcohol expectancy outcomes and favorable evaluations of negative expectancy outcomes were associated with higher levels of risky drinking. Conversely, greater endorsement of negative athletic-functioning drinking expectancies was associated with lower levels of risky drinking. Future research considerations and implications for intervention efforts targeting high school athletes are discussed.     

Predictors of Disapproval toward “Hard Drug” Use among High School Seniors in the US

Attitudes toward drug use strongly determine whether an individual initiates use. Personal disapproval toward the use of a particular drug is strongly protective against use; however, little is known regarding how the use of one drug affects attitudes toward the use of other drugs. Since marijuana use is on the rise in the US and disapproval toward use is decreasing, research is needed to determine whether the use of marijuana or other licit or illicit drugs reduces disapproval toward the use of “harder,” more potentially dangerous drugs. The Monitoring the Future study assesses a national representative sample of high school seniors in the US each year. This study investigated predictors of disapproval toward the use of powder cocaine, crack, lysergic acid diethylamide (LSD), heroin, amphetamine, and ecstasy (“Molly”) in a weighted sample of 29,054 students from five cohorts (2007–2011). Results suggest that lifetime use of cigarettes and use of more than one hard drug consistently lowered odds of disapproval. In multivariable models, lifetime alcohol use did not affect odds of disapproval and lifetime marijuana use (without the use of any “harder” drugs) lowered odds of disapproval of LSD, amphetamine, and ecstasy, but not cocaine, crack, or heroin. In conclusion, marijuana use within itself is not a consistent risk factor for lower disapproval toward the use of harder drugs. Cigarette and hard drug use, however, are more consistent risk factors. As marijuana prevalence increases and policy becomes more lenient toward recreational and medicinal use, public health and policy experts need to ensure that attitudinal-related risk does not increase for the use of other drugs.     

Effectiveness of a Cultural Stroke Prevention Program in the United States—South Asian Health Awareness About Stroke (SAHAS)

Journal of Immigrant and Minority Health - There are few stroke education programs focused on the South Asian population in the United States. The South Asian Health Awareness about Stroke (SAHAS)...     

Experiences and Perceived Outcomes of Low-Income Adults During and After Participating in the British Columbia Farmers’ Market Nutrition Coupon Program: A Longitudinal Qualitative Study

BackgroundThe British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) is a farmers’ market food subsidy program that provides low-income households with coupons valued at $21/wk for 16 weeks to purchase healthy foods at participating BC Association of Farmers’ Markets members’ markets.ObjectiveThis study aimed to explore changes, differences, and similarities in participants’ experiences and perceived short-term outcomes during and after participating in the FMNCP.DesignA longitudinal qualitative research approach was used to conduct a recurrent cross-sectional analysis. Data generation and analysis were guided by Freedman et al’s theoretical framework of nutritious food access. Data generation occurred during 2019 FMNCP program (time 1) and 4 to 7 weeks after (time 2) the program year ended. Data at each time point were analyzed separately using directed content analysis, followed by a comparative analysis to identify changes, differences, and similarities between time points.ParticipantsTwenty-eight adult participants were interviewed during the program; 24 were re-interviewed post program.SettingThree communities in British Columbia, Canada.ResultsThree themes were generated: temporary relief and engagement; lasting experiences and outcomes; enhancing participant experiences and outcomes. The first theme related to how participants’ experiences and perceived outcomes, such as increased financial support and improved diet quality and health, were temporary. The second theme reflected positive lasting experiences and outcomes from participating in the FMNCP, including increased food and nutrition knowledge and enhanced social ties. The third theme focused on enhancing participants’ program experiences and outcomes, including increasing the duration of food subsidies.ConclusionThe FMNCP temporarily enhanced access to nutritious foods and had lasting positive effects on participants’ nutrition-related knowledge and social outcomes. Nevertheless, participants struggled to maintain healthy eating practices post program due to financial constraints. Expanding farmers’ market subsidy programs may improve access to nutritious foods; maintain positive dietary, social, and health outcomes for participants; and reach more low-income households.     

“What if You Already Know Everything About Sex?” Content Analysis of Questions From Early Adolescents in a Middle School Sex Education Program

PurposeTo assess sixth graders' knowledge and curiosity about sex-related topics that can guide the development of sexual health education and healthcare delivery.MethodsSixth graders (n = 795) in eight ethnically diverse schools participating in an evaluation of a sex education curriculum submitted 859 anonymous questions that were content analyzed. The χ² analysis examined whether the themes varied by coed/single-sex environments or by school-level sexual risk.ResultsSexual activity, female anatomy, reproduction, and puberty were the most frequently mentioned topics, whereas, questions on STIs, sexual violence, and drug/alcohol use were fewer. Questions that avoided sexual topics came from lower sexual-risk schools; students at higher-risk schools asked about sexual initiation, contraception, vaginal and anal sex, general health, and pain during sex. Single-sex classrooms elicited more direct and explicit questions about sex.ConclusionsThe results are relevant to educators and healthcare providers who ask and answer questions from early adolescents regarding sexual health.     

Promoting a Culture of Prevention in Albania: the “Si Je?” Program

Prevention Science - Albania is a small country on the Balkan Peninsula that recently implemented an innovative primary healthcare program called “Si Je?” (How are you?) which allowed...