Development and Evaluation of the Sleep Treatment and Education Program for Students (STEPS)

University students report significantly worse sleep quality than the general population. Sleep problems are related to increased health concerns, irritability, depression, fatigue, and attention and concentration difficulties, along with poor academic performance. Clinical research indicates that psychoeducational interventions are among the most effective methods for improving sleep quality in the general population. Similar studies for university students are lacking. In this study, the authors describe the development of the Sleep Treatment and Education Program for Students (STEPS) and evaluate its effectiveness with a double blind, experimental design. Students in the treatment group reported significantly improved sleep quality and sleep hygiene behaviors at 6 weeks posttreatment.     

Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) Program With a Mandated Population

Abstract

Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of high-risk drinkers. Methods: Data were collected from January 2006 through December 2008. A total of 1,390 (67%) students in the intervention group and 508 (61%) students in the comparison group completed baseline and 6-month follow-up surveys. Results: Male students in the intervention group significantly decreased their drinking at follow-up, whereas those in the comparison group increased their drinking. Women in both the intervention and comparison groups decreased their drinking at 6 months. Conclusions: When implemented with fidelity, BASICS is a generally effective intervention, especially for male adjudicated college students. The intervention was most effective for moderate- and high-risk drinkers.     

Program evaluation of services for the homeless : Challenges and strategies

The rapid growth of the homeless population in North America has given rise to a sharp increase in the number of task forces and studies aimed at setting up either programs for the homeless, or policies for controlling the phenomenon. Whenever there is a need for program evaluations in this process, numerous methodological and strategic challenges have to be faced. Due to the characteristics of the clientele, evaluation studies of services for the homeless call for innovative approaches. This paper reviews the research strategies (types of evaluations, designs, and indicators) that have been developed to assess programs for chronic inebriates and mentally ill homeless. The findings from previous evaluations are then summarized and their consequences for evaluation practice are considered.     

The Program of All-Inclusive Care for the Elderly (PACE)

Summary

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.     

Evaluation of an STD-Prevention Program for Swedish University Students

Abstract

The authors evaluated a sexually transmitted disease (STD)-prevention program that combined a mass media campaign with peer education. The program was designed to increase Swedish university students' knowledge about STDs. improve attitudes toward condom use, and tell students where to get an STD checkup. Preintervention and postintervention postal questionnaires were used with an intervention group and two types of control groups. Responses ranged from 32% to 67% for the randomly selected students and from 93% to 99% for classroom and clinic participants. The intervention was noticed by a majority of the students (85–98%) and discussed by 43% to 57%; more women than men observed and discussed the campaign. Knowledge about STDs. where to turn for STD checkups, and the intention of having an STD checkup increased. Attitudes toward condom use were equally positive before and after the intervention. Although it was successful in attracting attention and leading to discussions of STD prevention, the campaign did not encourage students to have an STD checkup.     

Fitness and Mobility Exercise (FAME) Program for stroke

Given the potential of exercise to positively influence so many physical and psychosocial domains, the Fitness and Mobility Exercise (FAME) Program was developed to address the multiple impairments arising from the chronic health condition of stroke. We present the details of this exercise program and the evidence which has shown that the FAME Program can improve motor function (muscle strength, balance, walking), cardiovascular fitness, bone density, executive functions and memory. The FAME Program can help to improve the physical and cognitive abilities of people living with a stroke and reduce the risk of secondary complications such as falls, fractures and heart disease.     

Sleep Quality and Body Mass Index in College Students: The Role of Sleep Disturbances

Abstract

Objective: Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI) and sleep patterns, including duration and disturbances. Methods: A convenience sample of 515 college students completed an online survey consisting of the Pittsburgh Sleep Quality Index (PSQI), and self-reported height and weight to calculate BMI. Univariate and multivariate logistic regression analyses were performed using components of the PSQI as predictors of overweight (BMI ≥ 25). Results: One-third of the participants had BMI ≥ 25, and 51% were poor-quality sleepers (PSQI > 5). Controlling for age and sex, only sleep disturbances were associated with overweight (odds ratio = 1.66, 95% confidence interval [1.08, 2.57]). Conclusions: Sleep disturbances, rather than sleep duration, predicted overweight among young adults; this is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among students.     

An evaluation of the Baltimore Community Lead Education and Reduction Corps (CLEAR Corps) program

This evaluation examines the effectiveness of the Baltimore Community Lead Education and Reduction Corps (CLEARCorps) program in reducing lead dust levels in low-income urban housing in Baltimore, Maryland, through minor lead-reduction activities and tenant lead-poisoning prevention education. Lead dust data collected before and after lead-reduction activities show statistically significant mean declines for floors, window sills, and window wells. Limited data using tests also show that follow-up lead dust levels collected 6 months after the CLEARCorps intervention were significantly lower than preintervention lead levels. Although there are many important of this analysis, the findings suggest that in-place management may be an effective method in reducing childhood lead poisoning in high-risk areas.     

Program evaluation of trauma-informed yoga for vulnerable populations

BackgroundTrauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences.MethodsTrauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing.ResultsStudents were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga.ConclusionOur findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.     

An Evening and Weekend Treatment Program for Alcoholism in the Workplace

This paper presents the findings of a demonstration Evening and Weekend treatment program for alcoholism conducted as part of the Employee Assistance Program for the U.S. Department of Health and Human Services. Forty-five persons initially entered the program. Process and outcome data based on supervisory ratings and treatment outcomes indicate such programs can be successful for alcoholism and also cost effective.     

Understanding engagement in the Program of Assertive Community Treatment (PACT) from the perspectives of individuals receiving treatment

ABSTRACT

Engagement of individuals with serious mental illnesses in community mental health services is a significant challenge. The Program of Assertive Community Treatment (PACT) is an individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with serious mental illness who have a history of or likelihood of disengagement with services. Understanding what helps and hinders consumers’ involvement in PACT services may provide information on how to tailor engagement strategies to individuals based on their treatment needs and preferences. The current study builds on existing studies by exploring factors that help and hinder engagement in PACT services from the perspectives of individuals receiving treatment. We conducted open-ended, semi-structured interviews with 17 individuals receiving PACT services. Nine themes were identified through thematic analysis: Desirable qualities of PACT, Focusing on positive outcomes, PACT as a safety net, Recovery orientation, Practical barriers, Conflictual relationships, and Medication side-effects. We conclude that the development of a trusting, therapeutic relationship that is collaborative and person-centered and that is facilitated by both practical and emotional support is critical to engaging individuals in treatment and maximizing positive outcomes.     

A Focus on the Program of All-Inclusive Care for the Elderly (PACE)

For over four decades, the Program of All-Inclusive Care for the Elderly (PACE) has been operated by nonprofit organizations. Research has demonstrated that nonprofit PACE provides quality, cost-effective community-based care to older adults who would otherwise require a nursing home level of care. Recently, the U.S. Secretary of the Department of Health and Human Services has authorized for-profit entities to operate PACE, contingent on their ability to demonstrate that they can provide care that is similar to nonprofit PACE with regard to access to care, quality of care, and cost-effectiveness. In 2013, a study was conducted to evaluate how PACE operates under for-profit versus nonprofit status. The results were presented to Congress which, in turn, authorized for-profit PACE providers. This article critiques the 2013 study, offers a comparison to for-profit hospice, and argues that at best there is not enough evidence to conclude that for-profit PACE provides the same quality of care as existing nonprofit operators.     

Getting with the (evidence-based) program: An evaluation of the Incredible Years Parenting Training Program in child welfare

This study evaluates four group sessions of the Incredible Years (IY) Parenting Training Program used for the first-time in two child welfare agencies in New York State. Few studies have examined process and evaluation outcomes of evidence-based parenting programs in child welfare. Qualitative staff interviews and surveys on parenting behaviors were used to examine program processes, improvements in parenting behaviors, and participant satisfaction. Program participation was associated with less parental distress, defensive responding, dysfunctional parent-child interactions, child difficulty, total stress, and greater empathy and social support. The effectiveness of this evidence-based, parent education program in the context of a child welfare population, as well as implementation challenges and recommendations, are discussed.     

Open systems evaluation and the logic model: Program planning and evaluation tools

This paper describes two case management projects and efforts to evaluate outcomes. Lessons learned from the first effort suggest that a tool referred to as the logic model and a particular approach to evaluation called the “open systems” model might be useful to planners and program evaluators. The logic model provides a means of presenting conditions a program is intended to address, activities that constitute a program, short term outcomes resulting from program activities and long term impacts. The open systems perspective emphasizes evaluation as a tool to be used to achieve program objectives as opposed to establishing cause and effect relationships. This paper also describes how the logic model and open systems evaluation were used to facilitate the development of an evaluation plan for a project designed to assist homeless, substance abusing, pregnant women.