Reducing attrition in physical activity programs for older adults

This study investigated attrition in a 6-month physical activity intervention for older adults. The program was based on the social-cognitive theory incorporating self-efficacy factors. Two hundred forty-eight insufficiently active 65- to 74-year-olds were recruited from the Australian federal electoral roll. The intervention comprised walking and strength and flexibility exercises and was conducted in 30 local neighborhoods where the participants resided. Characteristics of individuals lost to attrition (n = 86, 35%) were compared with those of program completers (n = 162, 65%). Logistic-regression analysis showed that those lost to attrition came from areas of lower socioeconomic status, were overweight and less physically active, and had lower walking self-efficacy scores and higher loneliness scores. The results suggest that early assessment of these characteristics should be undertaken to identify individuals at risk of attrition, to improve retention, and to avoid potential bias.     

Predictors of treatment attrition and treatment length in Parent‐Child Interaction Therapy in Taiwanese families

Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.     

Support and Profiles of Nonoffending Mothers of Sexually Abused Children

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children.     

Two-year follow-up of a social-cognitive intervention to prevent substance use.

This study presents two-year follow-up results of the Adolescent Decision-Making Program initially implemented when students were in their sixth grade. The intervention was found to maintain a positive effect on mean tobacco use, but no differences were observed for mean alcohol, marijuana, or hard drug use. In a test of the differential effectiveness of the intervention, program students living with married parents reported lower mean tobacco use than control students living with married parents and program and control students living with single parents. Logistic regression analyses examining the proportion of users at follow-up revealed a negative program effect for alcohol and no differences for the other substances. Subsequent attrition analyses strongly suggested that the positive effect for tobacco use at follow-up was most likely even stronger, and that the negative effect for alcohol was spurious. The importance of examining both program and attrition effects when evaluating the impact of longitudinal preventive interventions was emphasized, and the need to consider alternative models to guide the conceptualization and evaluation of adolescent substance use prevention programs was discussed.     

EVALUATION OF AN ACADEMIC FAMILY THERAPY TRAINING PROGRAM: CHANGES IN TRAINEES' RELATIONSHIP AND INTERVENTION SKILLS

Students in an academic training program were assessed for changes in their relationship and intervention skills following completion of the program. Positive improvements were found on some measures but not all. Additionally, trainee variables such as previous clinical experience. gender, age, marital stauts and scores on standardized admission tests were examined in relation to trainees' skills changes. Trainee characteristics were unrelated to changes in intervention skills. However, a number of relationships were found between trainee characteristics and changes in relationship skills.     

Marital Conflict Resolution and Marital Affection in Chinese Marriage: Integrating Variable-Centered and Person-Centered Approaches

Abstract

To examine how couple interactions shape changes in marital affection during the early years of marriage, we used two-wave, dyadic data from 268 Chinese couples and integrated variable-centered (i.e., the actor-partner interdependence model; APIM) and person-centered analytic approaches (i.e., the latent profile analysis; LPA). Employing variable-centered analyses, we found that husbands’ stalemate and verbal aggression as well as wives’ collaboration and avoidance were particularly predictive of changes in marital affection. Using person-centered analyses, we found that (1) three groups of couples can be identified based on husbands’ and wives’ marital conflict resolution strategies (i.e., Collaborative Couples, Aggressive Wife-Defensive Husband Couples, and Defensive Couples); and (2) the changes of marital affection varied systematically across these groups. Variable-centered and person-centered approaches each generate unique insights above and beyond each other when considering marital phenomena. Integrating the two approaches can depict a more complete and nuanced picture of the association between marital conflict resolution and marital affection.     

The influence of collaboration on program outcomes: the Colorado Nurse-Family Partnership

Though collaboration is often required in community initiatives, little evidence documents relationships between collaboration and program success. The authors contend that clarification of the construct collaboration is necessary for investigating its contribution to the success of community initiatives. After respecifying collaboration, they present a study of a multisite program that involved varying degrees of collaboration in the 16 communities adopting a nurse home visitation program. The authors employ hierarchical linear modeling (HLM) to test the predictive power of individual participant characteristics and examine the increased accuracy of predictions from a second level model of site qualities-specifically, features of the collaborative process associated with different sites. The first-level model predicted approximately 10% of the variance in attrition, or dropout, of program clients. The second-level model accounted for an additional 28% of the variance in attrition. A theory of commitment transfer is offered as a first explanation of this result.     

Working environmental conditions as experienced by women working despite pain

OBJECTIVE: This study looked at female hospital cleaners and home help personnel who continued working despite problems or pain in their musculoskeletal system and where there was a risk of increase in sickness absence. The aim was to determine whether supportive intervention for these personnel at the workplace had an effect on the way that they experienced the physical and psychosocial aspects of their working environments. METHODS: The design was prospective with non-rando-mised intervention and reference groups. A selection of 55 questions about physical and psychosocial working environment from a national survey were used. Comparisons were made between intervention and reference groups and with data on a selection of the Swedish population of people in these professions. RESULTS: The results showed that in the hospital cleaners' intervention group the introduction of new cleaning materials and new cleaning methods seemed to contribute to a reduction in workload during the intervention period, which in turn gave them a better chance of taking rest breaks during working time. In the home helps' intervention group the results showed that the group had had a reduction both in workload and in more responsible tasks, and at the same time the psychosomatic stress reactions reduced after the intervention. CONCLUSIONS: The results indicate that effects on the working environmental conditions as experienced could be obtained by a general multi-component support program at the workplace, but the number of variables influenced by the program was very small. The relatively limited effects may be explained by the fact that the impact of a support program depends on how well the remedial measures fulfil the need for such measures either at the workplace, in a work group or among the individual people at the workplace. This emphasises the importance of designing effective analysis tools for judging what remedial measures are needed before the measures themselves are tried out.     

Side-by-side: An evaluation of Connecticut’s police and youth interaction model

This study evaluated a community-based intervention program designed to promote positive youth development and to create positive interactions between police and youth in a non-enforcement environment. A pre–post-design was used to compare the results of the program for participating youth and police officers, particularly changes in each group’s attitudes toward the other. The results showed that participation in the program improved police officers’ and youths’ attitudes toward each other. For youth, the rate of change in attitudes was greatest for minority youth and for youth who had prior negative experience with the police. That is, youth who had negative prior experiences with police and began with negative attitudes toward police developed more positive attitudes toward police as a result of participating in the program. Furthermore, having opportunities for positive interactions between police and youth played an important role in decreasing negative perceptions of police for ethnic minority youth. This study suggests that community-based programs that involve police with youth can improve participants’ attitude toward each other, which might impact future interactions.     

The effects of propensity score weighting on attrition biases in attitudinal,behavioral, and socio-demographic variables in a short-term web-based panel survey

Propensity score weighting often is used to correct for attrition biases in panel surveys. While methodological literature exists on the logic of propensity score weighting and its practical applications, an in-depth discussion is lacking on the effects of using this weighting to correct for attrition biases in attitudinal, behavioral, and socio-demographic variables. By applying a split panel design, we assessed the effects of weighting on attrition biases in 48 attitudinal, 38 behavioral, and 27 socio-demographic variables. Our findings suggest – while acknowledging the estimate-specific nature of bias – first, that biases vary across these types of variables and second, that the effects of propensity score weighting are not homogeneous across the types. Accordingly, a sole reliance on socio-demographics to evaluate attrition in the present panel survey would have resulted in an underestimation of the biases of attitudinal variables and an overestimation of the ability of weighting to cure the negative effects of attrition in behavioral variables.     

ENRICHMENT OUTCOME RESEARCH:A META-ANALYSIS OF PREMARITAL, MARITAL AND FAMILY INTERVENTIONS

The findings from a meta-analysis of 85 studies of premarital, marital, and family enrichment, representing 3,886 couples or families are presented. Metaanalysis is a method for statistically aggregating and evaluating empirical findings. Findings from the study are discussed in terms of overall enrichment effectiveness as well as salient program, subject, design, measurement, and analysis characteristics. The enrichment studies yielded an average effect size of .44, which indicates that the average person who participates in enrichment is better off following intervention than 67% of those who do not. The most powerful factors related to outcome were measurement variables rather than those related to program content, structure, leadership, or participant characteristics. Implications of these findings are discussed.     

An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

ABSTRACT

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11–16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.     

Predicted outcomes in a national sample: A source of comparison for program evaluation

The lack of comparison groups is a common problem for researchers conducting evaluations of small, specialized programs. When conventional comparison groups are not available, the authors suggest a possible alternative approach which involves: (a) locating a sub-group in a national study for whom relevant variables have been measured; (b) generating a statistical model which predicts the outcome of interest in the national data; and (c) applying the predictive model to program data, in order to estimate outcomes in the absence of progam intervention. The authors illustrate this new application by presenting the results of an analysis of data from Project Talent, a national manpower study, and discuss its application to the evaluation of a medical training program in New York City.     

Health Promotion using Tablet Technology with Older Adult African American Methadone Clients: A Case Study

This exploratory study examined three single case studies to investigate the feasibility of handheld tablet computers for older adult methadone clients. The intervention targeted African American adults (N = 3) over the age of 50 who were in substance abuse treatment. Subjects participated, via a face-to-face video program, in 12 educational sessions focused on healthy living. Both the feasibility of teaching older adult subjects to use tablet computers and their levels of engagement in the intervention were assessed. In addition, completion of participants’ goals and their ability to remember those goals were tracked weekly. Findings revealed that participants were able to learn how to operate the tablets and enjoyed using the technology. Frequent interactions between the counselors and the participants, using face-to-face video, facilitated success in achieving program goals.     

Risk factors for attrition from an evidence-based parenting program: Findings from the Netherlands

Parent management training programs for the treatment of childhood conduct problems are increasingly being transported from their country of origin to international settings. Family interactions, however, may be influenced by different cultural expectations and children's mental health problems may be addressed within different systems. Demonstrating reductions in symptoms within the new population is insufficient to support the wide-scale transport of a treatment model. Implementation outcomes such as the rates of treatment retention and factors related to treatment attrition must also be considered. We explored predictors of attrition in families from the Netherlands referred to the evidence-based parenting program Parent–Child Interaction Therapy (PCIT). Participants included 40 children with conduct problems (2–7 years; 68% boys) and their caregivers. Attrition (40%) was somewhat lower than findings with similar community samples in the US. Significant predictors of attrition were child age and maternal levels of internalizing symptoms. Low parental demandingness and high child compliance before start of treatment were related to early attrition within twelve treatment sessions. Meeting the needs of families at risk for attrition is an important goal for parent management training programs within and outside the US if families in need of services are to benefit from them.     

Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers.     

A multi-site study of the ACT Raising Safe Kids program: Predictors of outcomes and attrition

The present study examined the factors related to attrition and treatment outcomes in the ACT-Raising Safe Kids (ACT-RSK) program. ACT-RSK is a family violence and child abuse prevention program for parents and caregivers of young children. Sixty parents or caregivers of children aged 9 years or younger completed the ACT-RSK group program and the research measures. The study took place at 7 community-based sites in the midwestern United States. Program completers were significantly older than noncompleters, suggesting that parent age relates to attrition from this program. Pre/post comparisons indicated increased nurturing behavior, decreased harsh parenting, and decreased negative discipline, as well as decreased child behavior problems following completion of the ACT-RSK program. Parent age predicted children's outcomes, indicating better results for the children of older parents/caregivers. In addition, pre-test harsh parenting scores predicted children's outcomes, suggesting that families with relatively higher initial levels of parental psychological aggression and corporal punishment had more robust child outcomes following completion of the program.     

In a different mindset: Critical youth work with marginalized youth

Critical youth work is based on a dual focus, on individual psychosocial development on the one hand, and collective critical consciousness and the promotion of social justice on the other. Although in practice, critical youth work is gaining popularity as an alternative to person-centered youth work, the theoretical and empirical literature has not kept pace. This paper proposes a theory based practice model that expands the vocabulary of critical youth work. The model is grounded in the work of an innovative Israeli intervention program for marginalized youth and in poststructuralist theories. The model comprised of a three dimensions: the streets as a physical and political place, the use of counter narrative, and the role the youth workers take as social capital agents.     

Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.