Parenting adolescents from ethno-cultural backgrounds: A scan of community-based programs in Canada for the promotion of adolescent mental health

ObjectivesTo i) describe current community-based programs across Canada to support parents for the promotion of adolescent mental health, with special attention to ethno-cultural populations; and ii) identify needs, gaps, and opportunities for the development of a framework to support parents for the promotion of adolescent mental health.MethodsWe conducted an internet-based cross Canada scan of community-based parenting programs that promote adolescent mental health in ethno-culturally diverse populations, followed by structured phone interviews with program staff. Findings were categorized according to audience (ethnicity/culture and age group), geographical distribution and coverage, and program type. Barriers to access and outreach mentioned by interviewees were documented.ResultsWe found a total of 47 programs that met our search criteria. The greatest numbers were found in the provinces of Ontario, British Columbia and Alberta, particularly in the Greater Toronto and Vancouver Areas. Most programs consisted of psycho-educational, information-based workshops, support groups, or used innovative approaches (e.g., arts, alternative medicine, mentorship, and skillsdevelopment courses). Five programs (11%) had parent and youth components. From the perspective of service providers, cultural distrust, stigma, financial constraints and language barriers pose challenges to outreach. Program evaluations are limited and often not publicly available.ConclusionThere are gaps in geographic coverage and types of programs available to parents for the promotion of adolescent mental health in ethno-cultural communities. Inconsistent and insufficient funding [and other forms of institutional support] detract from the capacity of community-based organizations to adequately support families and conduct, publicize, and evaluate their programs.     

Process evaluation of a preschool physical activity intervention using web-based delivery

Background and purposePreschool/childcare settings offer a practical target for physical activity interventions. Online learning programs have the potential for greater public health reach and impact. The SHAPES-Dissemination (SHAPES-D) project adapted the original SHAPES in-person intervention for online delivery to teachers. The purpose of this paper is to describe the implementation monitoring and process evaluation for the SHAPES-D project.MethodsNine preschools with 26 classrooms participated. A total of 41 teachers were trained via online learning to implement the SHAPES-D program in their classrooms. The dose received, completeness, and fidelity of implementation were assessed through website metrics, teacher surveys and interviews, and classroom observations.ResultsDose received was adequate (73%). Observed completeness and physical activity enjoyment fidelity were high (100%), although moderate-to-vigorous physical activity fidelity and social environment fidelity were low (25% each). Overall implementation was high (91%).DiscussionResults indicate that the online method of delivery is viable for dissemination. The online delivery system provides an easy method of monitoring dose received. This may be the first structural intervention to monitor dose received through web metrics.ConclusionThe adaptation of an in-person intervention to an online delivery system increases the potential for dissemination of a successful program to increase physical activity in preschool settings.     

Meeting the Challenge of Preparing Social Workers for Integrated Health Practice: Evidence From Two MSW Cohorts

ABSTRACT

Changes in health care policy have led to an expansion of integrated care models that rely on collaboration among interprofessional health teams. Recent federal funding has encouraged the development of innovative training models to prepare social workers for integrated health practice. This article presents evidence from the first two MSW cohorts of the Integrated Mental and Behavioral Health Training Program funded by the Health Resources and Services Administration. Twelve students completing the program in 2014 (n = 5) and 2015 (n = 7) participated in evaluation activities at the time of program completion and at 1-year postgraduation. Findings highlight key components of the training program instrumental in student attainment of program goals and competencies. Implications for MSW education and training for practice in integrated care environments are discussed.     

Faith-Based Programs and the Role of Empirical Research

Abstract

After some decades of being subject to neglect or contempt, faith-based social care programs are receiving increased attention and resources enabling them to undertake a greater role in the national network of human services. Faith-based programs receiving public support can expect to be rightly scrutinized by the public, in terms of their ability to attain professed program goals. The tools of conventional empirically-oriented program evaluation research have tremendous potential to help demonstrate the effectiveness of faith-based programs, which will justify their receipt of ongoing support from public funds. Negative research findings can be properly scrutinized by the faith-based community of service providers to help make tough, data-based, decisions on funding priorities. Several examples are described, illustrating how various types of faith-based programs have profitably participated in program evaluation studies.     

Applying RE-AIM to evaluate two community-based programs designed to improve access to eye care for those at high-risk for glaucoma

IntroductionGlaucoma is a leading cause of vision loss and blindness in the U.S. Risk factors include African American race, older age, family history of glaucoma, and diabetes. This paper describes the evaluation of a mobile eye health and a telemedicine program designed to improve access to eye care among people at high-risk for glaucoma.MethodsThe RE-AIM (reach, efficacy, adoption, implementation, and maintenance) evaluation framework was used to harmonize indicators. Both programs provided community-based eye health education and eye services related to glaucoma detection and care. Each program reported data on participants and community partners. An external evaluator conducted site visit interviews with program staff and community partners. Quantitative and qualitative data were integrated and analyzed using the RE-AIM dimensions.DiscussionBy targeting high-risk populations and providing comprehensive eye exams, both programs detected a large proportion of new glaucoma-related cases (17–19%) – a much larger proportion than that found in the general population (<2%). The educational intervention increased glaucoma knowledge; evidence that it led people to seek eye care was inconclusive.ConclusionsEvaluation findings from the mobile eye health program and the telemedicine program may provide useful information for wider implementation in public health clinics and in optometrist clinics located in retail outlets.     

Aligning research and practice: The role of academic-community partnerships for improving measurement and process

ObjectiveCommunity programs addressing social determinants of health are growing in prominence and are increasingly expected to provide metrics of success. Our objective is to assess the role of an academic-community partnership for a community health worker program targeting social and medical needs, and determine factors impacting its effectiveness.MethodsWe draw on a 4.5-year partnership that includes both quantitative and qualitative data collection and analysis. Quantitative data collection mechanisms evolved as a result of the partnership. Qualitative interviews were conducted with community health workers and leadership.ResultsTo align medical and social support services in a sustainable and measurable manner, our academic-community partnership found that creating and maintaining a mutually beneficial space through small wins enabled us to then address larger problems and needs. Ongoing self-study and process evaluation allowed quick adjustments. Unique partnership elements such as having consistent funding and flexible timelines and objectives were essential.ConclusionsWhen integrating health and social services, academic-community partnerships create pathways for bidirectional learning than can quickly turn research into practice and support sustainability, especially when based on incrementally built trust and a history of small wins.     

Houston Homeless Street Outreach

Abstract

Several cities in the nation have developed innovative programs to assist the homeless who are “living on their streets.” This paper describes one such program developed in Houston, Texas. The Homeless Street Outreach was a collaborative project of several service agencies in the greater Houston area. The outcome of this outreach project indicates that a coordinated effort can bring about delivery of more comprehensive services to the homeless population. The principles that emerge from the outreach include involvement of the homeless in planning and development, service agencies taking “ownership” of the project, and agency flexibility in delivering services to the homeless.     

Abortion: A Technique for Working through Grief

Abstract

The successful implementation by a large public university health service of a satellite clinic involves a number of processes and funding issues. The authors discuss the development of such a program at a small community college in Appalachia. The first 4 years' experience in operating the satellite clinic created a number of valuable management lessons that they believe could assist others with similar goals for extending their services.     

Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

IntroductionThe Singapore Physical Activity and Nutrition Study (SPANS) aimed to improve the physical activity (PA) and nutrition behaviours of Singaporean women aged 50 years and over. The SPANS program consisted of PA classes, nutrition workshops, telephone dietary counselling, health booklets, a health calendar and program ambassadors. This study aimed to assess and understand the implementation of the program strategies and gain insight into process evaluation components to inform future programs.MethodsThe evaluation was guided by a process evaluation framework and collected data via questionnaires (n = 209), program ambassador documentation and exit interviews with program completers (n = 13) and non-completers (n = 12).ResultsIn total, 295 participants completed the program (response rate = 84 %). Participants reported high levels of satisfaction with the overall program (99.5 %) and program activities (96.7 %), and also rated program ambassadors highly. Participation rates were highest for telephone dietary counselling sessions. The main reason for not attending program activities was having a ‘busy schedule’ (n = 158). Participants cited a need for improved recreational centre facilities and increased flexibility around program delivery.ConclusionsThe process evaluation showed that the program strategies were implemented as planned and were deemed suitable for supporting behaviour change among Singaporean women aged 50 years and over. The program reached and involved the majority of participants throughout the six months. The combination of practical educational resources and supportive program ambassadors were key strategies that facilitated positive PA and dietary behaviours. However, there needs to be some flexibility in the delivery of programs. The findings of this research may inform other programs in the region.     

Breastfeeding interventions in Kansas: A qualitative process evaluation of program goals and objectives

Across the state of Kansas, eighteen public health departments received funding through the 2011 Breastfeeding Grant Initiative to start a breastfeeding intervention. The main objective of this study was to evaluate the progress toward program goals and objectives. This study was a process evaluation. Qualitative data were collected from recipient health departments at two time-points during the program year. Structured, open-ended questions were asked through telephone interviews. This study examined: (1) progress toward program goals and objectives, (2) problems encountered during implementation, and (3) evaluation measures employed to assess program impact. All health departments reported making significant progress toward program goals and objectives and reported successful collaboration with other healthcare providers. The use of breast pumps, educational classes, and professional training of staff were reported as providing the best outcome in the promotion of breastfeeding. The majority of respondents did not measure program impact. From a public health perspective, it is important that infants receive breast milk for the first six months of life. It appears that goals and objectives set a priori guided health departments with the administration of their breastfeeding program. Results may be used to enhance and sustain delivery of breastfeeding support programs in Kansas communities.     

The Relationship Between the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and Innovative Welfare Practices on a Local Level

SUMMARY

Part of the intention of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) was to encourage the development of innovative welfare programs on a state and local level. The Act removed stringent federal regulations regarding the design and implementation of cash welfare programs. The freer programmatic environment was to assist local offices in addressing the unique needs of their particular clients as they moved from welfare to work within a time limited setting. In an attempt to examine if this intended piece of the policy was implemented, qualitative data were collected from a statewide sample of local Division of Family and Children Services (DFCS) offices in Georgia. The findings indicate that a minority of local offices engaged in innovative behaviors that were significantly different from their pre-PRWORA behaviors. Implications for welfare policy implementation and program development are discussed.     

Campus-Based College Health Services Before the Amherst Program (1860): Military Academies Lead the Way

Abstract

Over the past 70 years a legend has evolved that the first college health program in the United States was established at Amherst College in 1861. Although the program at Amherst was innovative in its day and served as a model for the field of college health, several other institutions prior to 1860 appropriated funds, hired staff, and established on-campus programs to improve the health of their students. The military academies led the way, and the first of these early programs to become operational was located at the US Military Academy at West Point, New York, in 1830.     

Conducting a Hispanic Health Needs Assessment in rural Kansas: Building the foundation for community action

Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity.MethodsThe assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment.ConclusionThis process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives.     

The current state of truancy reduction programs and opportunities for enhancement in Los Angeles County

School truancy, defined as any intentional unauthorized or illegal absence from school, influences, and is influenced by, multiple academic, health, and social factors. This project sought to describe how truancy-reduction systems are operating in Los Angeles County and identify the highest priority policy and program options to effectively address truancy. The Department of Public Health convened an expert panel and collected data through literature review, key informant interviews, focus groups, and surveys. Results describe the interconnected players that are working to address truancy. Recommendations focus on increasing school-based efforts, identifying innovative ways to address students' and families' physical and mental health needs, enhancing coordination across partners and elevating their commitment, expanding evidence-based programs, and enhancing data collection efforts to better identify additional effective strategies. Other jurisdictions can build off our prioritization framework to describe the current state of their systems and identify promising programs to augment system functioning.     

UPSTREAM! Together evaluation results from community efforts to prevent mental,emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Multigenerational Practice and Curricular Infusion

Abstract

To date most practice methods, programs and disciplines in the health and human services are explicitly organized by age. Yet, there are a greater number of concurrent generations within families and four or even five generations are increasingly common. This article will discuss findings from a multigenerational curricular infusion project and examine key components of an innovative multigenerational practice framework that breaks downtraditional practice paradigms by cutting across age groups, populations and academic disciplines. Such an approach provides rich opportunities for multigenerational reciprocityand collaboration, and the development of important new educational models.     

An analysis of the sexual health and safety information study abroad directors present their students prior to departure

Abstract

Objective: Study abroad students engage in problematic alcohol use, risky sexual activity, and maintain high risk for sexual assault; however, there is a lack of information about relevant prevention practices in study abroad programs. The purpose of this project was to understand the health and safety behaviors (HSBs) discussed with students prior to departure. Method: A total of 143 study abroad program directors from the U.S. completed an online survey, including demographics of the program director and institution, and questions about the HSBs discussed with students. Results: Chi-square analyses revealed that discussions of HSBs rarely differed by institution size or location; however, all HSBs were more likely to be discussed by directors administering programs with higher enrollment. Conclusion: Study abroad directors provide some basic information on sexual health to their students; however, more work is needed to ensure students are informed and attending to information about potential health risks prior to traveling abroad.