Maintenance of community change: enforcing youth access to tobacco laws

Youth access to tobacco remains a significant problem for this nation. Methods have been developed to reduce youth access to commercial outlets and these involve enforcement efforts of monitoring and fining merchant offenders. In the present study, over a three year period of time, readiness to participate in these types of enforcement programs were assessed in 11 communities. Several years after the research study was completed, enforcement activities were re-assessed. Findings indicated that those communities that had made the largest changes in community readiness to enforce youth access laws during the three year intervention were the ones most likely to continue enforcement activities into the follow-up period. There is a need to better understand how youth access to tobacco community-based interventions can be maintained.     

Effective approaches to reducing adolescent unprotected sex,pregnancy, and childbearing

In the United States, there exist a multitude of different approaches to reducing adolescent sexual risk-taking, unintended pregnancy, childbearing, and sexually transmitted disease, including HIV. While many of these approaches have some positive effects upon some outcomes (such as greater knowledge), only some of these programs actually delay the initiation of sex, increase condom or contraceptive use, and reduce unprotected sex among youth. This article summarizes a review of 73 studies and their respective programs, and describes four groups of programs which have reasonably strong evidence that they delay sex, increase condom or contraceptive use, or reduce teen pregnancy or childbearing. These four groups of programs include (a) sex and HIV education curricula with specified characteristics, (b) one-on-one clinician-patient protocols in health settings with some common qualities, (c) service learning programs, and (d) a particular intensive youth development program with multiple components.     

Beyond access and supply: youth-led strategies to captivate young people's interest in and demand for youth programs and opportunities

Increasing access, even increasing supply, may not be sufficient to attract young teens who do not typically participate in youth programs. Several youth mapping projects in rural and urban communities have led to these conclusions: youth do not know what is available even in their own neighborhoods, young teens have a strong voice in how they spend their discretionary time, and we need to learn how to market youth programs much more effectively. This author reviews important findings from youth community-mapping experiences and showcases a project attempting to move beyond access and supply issues to increasing young people's interest and engagement in community youth development programs.     

Multisectoral approaches to addressing youth violence

Youth violence is a public health concern that has devastating consequences for communities and requires a collaborative community response. While public health approaches underscore the importance of collaborative efforts to address public health concerns, violence prevention programs are often siloed and lack a multisectored response that includes the education system, criminal justice system, local government, university, and service providers. This article explores the successes and lessons learned from the emergence of a multisectoral community-based initiative to address youth violence in southeastern North Carolina. The model for this initiative evolved from the Harlem Children’s Zone and includes identifying existing resources and coordinating a continuum of support and services to increase availability of after-school, summer enrichment, life-skills, and parenting programs to reduce youth violence. Implications of applying multisectoral community-based interventions are discussed in terms of capacity building, promotion of well-being, and research.     

Using civil representation to reduce delinquency among troubled youth

Team Child is designed to provide civil legal representation for very troubled delinquent youth to improve their access to needed education programs, mental health services, and family services. Better provision of these services is intended to reduce delinquency and potentially avoid the long-term incarceration of these youth. This article uses an incidental truncation model to evaluate two Team Child programs in Florida. The authors find the programs not to be effective in reducing recidivism among the youth but to be effective in reducing the arrest rate of the recidivating juveniles. The results indicate a reduction of 11% to 23% of arrests after treatment for the Team Child group.     

Clinical Social Work Practice with Former System Youth with Mental Health Needs: Perspective of Those in Need

The purpose of this study is to describe the types of programs and mental health services former system youth with mental health histories would be inclined to engage in to manage their mental health difficulties, along with the factors that might hinder them from engaging in these services. A series of closed and open-ended questions on potential programs and services were asked, as part of a larger study. Participants were former system youth; specifically 18?C30?year olds who were diagnosed with a mood disorder and were involved with public mental health and social services (e.g., public welfare, child welfare, juvenile justice) during childhood. Responses to the open-ended questions were categorized and percentages are reported from the yes/no items. Eighty-three percent and 76% reported that they would be enticed to come to a support group and panel discussion on mood disorders, respectively, while only 46% reported that they would attend a family support group. Talking with others who have had similar experiences, material possessions and creative expression were the most common responses regarding what would entice them to get involved. Further, peer disrespect, transportation, and daycare were common barriers to potential participation. As the field continues to build knowledge on system-wide strategies to improve agency-based mental health care for transitioning youth and young adults, new evidence-based approaches may benefit from listening to the specific needs, preferences, and suggestions of these youth themselves.     

Access to Philanthropic and Commercial Income Among Nonprofit Community Service Organisations

Governments depend on nonprofit, voluntary sector organisations to deliver social and community services, and public funding is the sector’s most important income source. However, in many countries, public funding for social services is becoming more limited, conditional and precarious, and governments are encouraging nonprofits to diversify their funding base, and shift their reliance to income from market activity and private donations. This article is concerned with access to philanthropic and commercial funding among nonprofits, and the factors affecting it. It firstly discusses an emerging policy agenda to promote private funding among nonprofit community service providers. Then, multivariate analysis of survey data from 521 Australian nonprofits shows which organisations access income from client fees, business activities, community fundraising, and philanthropic foundations. By exploring inequalities in the distribution of these main sources of private funding, the article helps identify the types of organisations that face challenges in establishing and sustaining streams of private income, and which are likely to require ongoing public support.     

Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

The American Stop Smoking Intervention Study. Conceptual framework and evaluation design.

Reducing tobacco use, especially cigarette smoking, is a public health priority. The American Stop Smoking Intervention Study (ASSIST) was initiated in 1991 to prevent and reduce tobacco use primarily through policy-based approaches to alter the social-political environment. This article describes the conceptual design, research framework, evaluation components, and analytic strategies that are guiding the evaluation of this demonstration research endeavor. The ASSIST evaluation is a unique analysis of the complex relationships between the social context, public health activity at the state level, tobacco use, and individual behavior. The measures of tobacco control activity developed for this evaluation may be useful in ongoing national cancer control surveillance efforts, and the lessons learned will enhance the development of tobacco control programs.     

An evaluation of retail outlets as part of a community prevention trial to reduce sales of harmful legal products to youth

Communities across the nation have become increasingly concerned about inhalant use and use of harmful legal products among youth because of increasing prevalence rates and deleterious health consequences from abusing these products. The increasing concern of communities about inhaling and ingesting legal products has been coupled with increasing awareness and concern about ability of youth to access and abuse a variety of other legal retail products. There are few examples of scientifically designed community prevention projects that seek to reduce youth abuse of such legal products. This article describes a community prevention trial that is designed to reduce sales of inhalants and other harmful legal products to youth and demonstrates how the retailer component of the trial can be rigorously evaluated. It also shows how data from youth purchase attempts can complement survey data from retailers.     

A Model for Change: Legislative Advocacy to Improving Access for the Uninsured and Underinsured in New York State 1

Advocates can successfully improve access to health care for people without health insurance. This article demonstrates the success of what began as a local advocacy effort to improve access to health care on Long Island, which later grew to become a major statewide advocacy movement. It explores the process taken by local coalition members to successfully fight for monumental public health legislation—first locally then statewide—to improve access to hospital care for the medically indigent. Using New York State as a model, it includes several approaches that could facilitate the enactment of legislation in other states. The experiences of New York advocates suggest that with focused collaborative efforts it is feasible to promote significant changes to public health laws to benefit the uninsured and underinsured.     

AN ASSESSMENT OF CAUSAL INFERENCE IN SMOKING INITIATION RESEARCH AND A FRAMEWORK FOR FUTURE RESEARCH

Reliably identifying the causal factors underlying youth smoking initiation is an important part of developing effective smoking prevention programs and shaping other types of smoking-related policies. The establishment of reliable scientific evidence in support of a causal link between cigarette advertising and youth smoking initiation depends on both rich longitudinal data as well as careful empirical applications. We examine basic principles of empirical scientific investigation of potential causal relationships, discuss findings of recent research on causal factors of youth smoking, and evaluate evidence from the public health literature regarding the effects of cigarette advertising on youth smoking . ( JEL I18, C5)     

Provision of basic services in slums: A review of the evidence on top‐down and bottom‐up approaches

This article synthesizes the evidence on the effectiveness of top‐down and bottom‐up approaches in providing basic services in slums in developing countries. The findings indicate that: (1) government‐led top‐down approaches focus predominantly on connectivity, but approaches led by community‐based organizations (CBOs) and non‐government organizations (NGOs) improve many additional dimensions of access; (2) legal recognition of slums improves access to services in both approaches; and (3) NGO and CBO involvement results in the right balance between the technical, social and financial resources required for effective service delivery.     

Local and Regional Governments and Age-Friendly Communities: A Case Study of the San Francisco Bay Area

The purpose of this study was to assess the extent to which cities, county departments of adult and aging services, county transportation authorities, and public transit agencies in the San Francisco Bay Area have in place age-friendly policies, programs, and infrastructure in the areas of community design, housing, transportation, health care and supportive services, and opportunities for community engagement. The most common age-friendly features include those that target alternative forms of mobility (for example, incentives for mixed-use neighborhoods and changes to improve the accessibility of public transit), while the least common policies and programs are those that aim to help older adults continue driving, such as driver education programs, driver assessment programs, and slow-moving vehicle ordinances. The article concludes with policy and research implications of these findings.     

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown.Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.     

The Impact of Neighborhood Factors on Mental Health and Academic Outcomes for Adolescents Participating in the Prodigy Program

The Prodigy Cultural Arts program provides art classes embedded with three types of self-regulation skills (problem solving, social skills, and anger management) in an after school community setting to at-risk youths. Empirical evidence supports the effectiveness of self-regulation skills programs and the arts in programs for at-risk youths, yet the impact of the environment on the youth participants is often ignored. This study examines neighborhood structural characteristics along with previously identified individual, mental health variables in school outcomes for adolescents attending the Prodigy Program. Findings suggest that neighborhood structural characteristics have some influence in program outcomes. Limitations of the study and future research are discussed.     

Recreation as a component of the community youth development system

In an era of fragmented school systems and budget cuts, many educators and youth leaders seeking to solve the problems that youth face are turning to out-of-school-time programs. In many communities, these programs are seen as essential in the development of youth into fully functioning adults. One such area of the out-of-school-time sector is the provision of recreation services. Recreational services have a vital role in connecting youth to their communities, as well as enabling youth and adult allies to improve challenging conditions. This chapter outlines the historical role that recreation has played in community youth development programs and shows how community youth development has evolved. It then looks at how organizations in three communities--the Youthline Outreach Mentorship program in Minneapolis, a 4-H initiative in Parker City, Texas, and the Hockey Is for Everyone program--have successfully applied the theoretical knowledge. Best practices from these programs illustrate that the role of recreation in community youth development is changing. No longer are recreation programs about providing just "fun and games." Recreation organizations are now placing more value on the development of the community as a whole, in addition to the individual well-being of young people.     

Monitoring antitobacco sentiment among community leaders

Two public health objectives, one methodological and the other substantive, are realized in the present study. First, average survey ratings are replaced by negated mean cumulative logits (MCLs), which have the advantage of interitem commensuration. Second, these negated MCLs improve the analysis of two Florida tobacco control surveys of community leaders. Because of their common logit metric, negated MCLs for different item types are compared on their expressed antitobacco sentiment. They are also averaged to construct a precise indicator of overall sentiment. These results show that in 1998 and 1999, community leaders were most averse to selling to minors, kids buying cigarettes, and restaurant and workplace smoking. The latter aversion anticipated voters' overwhelming support of the 2002 Florida constitutional amendment prohibiting smoking in restaurants and workplaces. The authors hope that this analysis for antitobacco programs will improve other substance-abuse monitoring with surveys whose items are yet unwritten.     

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.     

Adult Literacy Education and Community Development

SUMMARY

This article responds to the concern that low-literate community residents often are marginalized in community development processes. They are unable to give voice to their concerns, interests and their vision for their community. Perspectives and approaches in the fields of adult literacy education and community development are explored to determine how adult literacy education might be used to further the goals of community development. While there are parallels between these two disciplines, there are also barriers to overcome if an integrated approach to dealing with community issues is realized. This article reflects an interest in advancing a comprehensive approach to community development in communities with limited economic resources, low-level literacy and limited access. It seeks to address the issue of whether adult literacy education programs have a meaningful role to play in community development. The strengths of participatory approaches such as community-based literacy, and community development principles such as collective action, shared values, participation, social justice, political awareness and action, comprehensiveness, empowerment, and learning and reflection, facilitate an interdisciplinary approach.