Random-effects models for analyzing clustered data from a nutrition education intervention

When evaluating the effects of public health intervention, larger units, or clusters, of individuals are often the unit of randomization and implementation. Ignoring dependency in the data due to clustering can misrepresent intervention effects. Random-effects models (REMs) may be a useful way to analyze such data. The present study compares results of analyses of data from a nutrition intervention program using four different methods: (a) usual multiple regression analysis using individual subject data, (b) usual multiple regression analysis using the classroom cluster as the unit of analysis, (c) two-level REM model with subjects clustered within classrooms, and (d) two-level REM model with subjects clustered within sites.     

Parents' perceptions of a school-based prevention education program

There are few studies of parents' views about prevention education in general, or about specific prevention education activities. Yet, their perceptions are important because families are a primary socialization source, and because parents' opinions can either reinforce or countermand the message of prevention education programs. This article is an analysis of parents' views of the Drug Abuse Resistance Education (D.A.R.E.) program based on a statewide survey of adults from rural, suburban, and urban communities who had a child participate in the program within the past year. Parent involvement and knowledge of D.A.R.E. was high. Generally, parents were very positive about D.A.R.E., especially when they viewed the D.A.R.E. officer as an effective educator. This article suggests that much more research on parents' views and support of prevention education program needs to be conducted, especially within the context of how their perceptions may mediate the influence of the prevention effort on young people's attitudes and behaviors about substance use.     

Children of alcoholics: a school-based comparative study.

This study investigates children of alcoholics (COAs) and their cohorts who are not affected by parental alcoholism (non-COAs). Participants include fourth through sixth grade students who are identified as COAs and non-COAs. The study examines differences between COAs and non-COAs on measures of internalized shame, self-esteem, perceived support, and teacher behavior ratings. Results indicate that COAs and non-COAs demonstrate no significant differences on measures of social support and shame. In contrast, self-esteem and teacher ratings for COAs are significantly lower in comparison to ratings for non-COAs. In addition, teacher ratings of male COAs are significantly negatively affected by their COA status, whereas female COA and non-COA teacher ratings do not differ significantly.     

Intercultural education and academic achievement: a framework for school-based policies in multilingual schools

The paper reviews quantitative and qualitative research evidence regarding the relationship between intercultural education and academic achievement among students from socially marginalized communities. Intercultural education is conceptualized as including a focus both on generating understanding and respect for diverse cultural traditions and challenging inequitable distribution of resources and educational opportunities across social groups. As such, intercultural education incorporates notions such as critical literacy and culturally responsive education. By definition, socially marginalized communities have experienced social exclusion and discrimination, often over generations. Thus, educators who adopt an intercultural education orientation are also committed to challenging the operation of coercive relations of power within their school environments. The operation of societal power relations that affect marginalized group students’ academic achievement can be conceptualized along a continuum ranging from structural/societal, through structural/educational, to interpersonal. Structural/societal forms of discrimination are largely outside the scope of what educators can influence directly (e.g. housing segregation). However, the research evidence suggests that educators have considerable power to resist and challenge coercive power relations operating at both structural/educational (e.g. curriculum materials) and interpersonal (e.g. classroom interactions) dimensions of the continuum. Thus, the proposed framework represents an explanatory model to account for patterns of school success and failure among marginalized group students and a predictive model to specify educator behaviors that are likely to promote academic achievement.     

The changing nature of population education for workers

The efforts of the International Labour Office (ILO) to educate workers in developing countries about population issues and family planning are discussed. "The author traces the evolution of ILO thinking from population control to family planning to family and community welfare and discusses the rationale for concentrating on the industrial sector, the programmes' orientation, content and methods, and the need to involve personnel managers and trade union leaders in particular."     

The relationship between implementation fidelity and educational outcomes in a school-based family support program: development of a model for evaluating multidimensional full-service programs

There is increasing recognition of the need for evaluations that identify program processes or mediators and assess degree of program implementation rather than focusing solely on outcome evaluation. This paper describes the application of complementary qualitative and quantitative evaluation procedures to assess the degree of implementation of multi-component family support programs for improving educational outcomes for at risk youth, and to assess the relationship between program implementation and outcomes. The qualitative evaluation involved prolonged engagement to identify common program domains or mediators. Using a method called Innovation Configuration Analysis, levels of implementation of program domains were explicated as well as an overall Implementation Fidelity Index. Strong positive relationships were found between overall program implementation and program-level outcomes achieved by student participants.     

Preceptorship: a shared journey between practice & education

Creative new approaches must be developed to attract new graduate and transitioning nurses to psychiatric-mental health nursing. In this article, we present a collaborative nurse preceptor program between a clinical practice agency and a university college of nursing faculty group. The preceptorship was designed to facilitate recruitment and retention of new graduate and transitioning nurses into a community-based, psychiatric-mental health agency. This process could be applied in any practice setting to address issues of recruitment and retention. Over the course of more than 2 years, the program has resulted in a 70% retention rate of new and transitioning nurses in the agency; of particular note is the 100% retention of new baccalaureate graduates. This program has positively affected the agency, the nurse preceptors, and the new graduate and transitioning nurse preceptees. We describe the collaborative development and implementation of the preceptor program designed to enhance recruitment and retention of new graduate nurses and nurses transitioning from other specialty areas into community-based psychiatric-mental health nursing practice.     

Effectiveness of a multi-faceted,school-based health intervention program with 4th graders in Alabama

Childhood obesity is considered one of the most prevalent, chronic disorders in the U.S. with Alabama among the states with the highest incidence. Schools have the opportunity to play a vital role in educating children about healthy nutritional, physical, and psychological choices. The purpose of this multi-faceted, school-based health intervention was to educate children about healthy nutrition, promote physical activity, and use avatars as an educational and motivational tool for understanding and developing healthy bodies. Six fourth-grade classrooms in rural Alabama participated. The intervention group consisted of 25 males and 26 females (43% African-American, 57% European-American; 26% obese, 14% overweight) who received a 10-week nutrition education program that incorporated classroom physical activity and exposure to avatars. The control group consisted of 30 males and 24 females (41% African-American, 59% European-American; 28% obese, 15% overweight) who received no intervention or initial avatar exposure. Repeated Measures Analysis of Variance determined that only intervention children significantly improved their healthy food choice intentions, ability to identify fatty foods, and general nutrition knowledge at posttest. Additionally, most intervention students reported that manipulating their avatar's body size helped them think about healthy weight (86%-helpful, 12%-somewhat helpful) and their own best, healthy body size (76%-yes, 22%-maybe). Intervention children picked healthier avatars as their ideal/desired body size at posttest. This intervention improved nutrition knowledge and attitudes and provided preliminary evidence that avatars can be a useful tool in childhood health interventions to help elementary school students think about healthy weight and body size.     

Assessing the effects of a school-based intervention on unscheduled school transfers during elementary school.

Raising Healthy Children is a cluster-randomized study of a school-based intervention aimed at preventing problem behaviors among children recruited into the project in the first or second grade of elementary school. Multilevel analysis was used to compare students in intervention and control schools with respect to whether they transferred out of their original schools. Students in intervention schools were less likely to transfer within the first 5 years of the project. A multilevel discrete-time survival model that included both time-varying and contextual variables revealed that the difference in hazard of transfer was greatest in the earlier years of the project.     

A concise history of school-based smoking prevention research: a pendulum effect case study

School-based cigarette smoking prevention was initiated shortly after the first Surgeon General's Report in 1964. This article highlights a sequence of events by which school-based tobacco use prevention research developed as a science, and illustrates a pendulum effect, with confidence in tobacco use prevention increasing and decreasing at/different points in time. Suggestions are offered to advance school-based smoking prevention research.     

The effect of a nutrition education programme on pregnant women attending Khartoum model clinic

A comparative study conducted in the Sudan illustrated both the potential of a nutrition education program for pregnant women and the many obstacles to creating more optimal maternal nutrition. Included in the study were 1200 women 18-34 years of age attending the Khartoum Province Model Clinic for a minimum of 5 prenatal visits. 83.3% were Muslims and 48.2% were illiterate. The 60 women who comprised the experimental group were exposed to individual nutrition counseling and home visits. Overall, 70% of subjects were anemic, 27% had malaria, and 18% were hookworm. The average weight gain during pregnancy was 4.5 kgs; 25.0% of controls and 20.0% of those in the experimental group gained 3.5-4.0 kgs, 18.3% of controls and 33.3% of experimental subjects gained 4.5-5.0 kgs, and 23.3% of controls and 30.0% of those in the experimental groups gained 5.5 kgs or more. 53.0% of controls and 61.7% of women exposed to nutrition education breastfed for at least 6 months, and 70% of women in the former group and 95% of those in the latter had enrolled their infants in an immunization program. A baseline nutrition questionnaire revealed widespread misinformation, especially a belief that pregnant women should reduce their food intake from 3 to 1-2 meals per day to prevent the fetus from growing too large and making labor difficult. Foods such as fermented sorghum products, fresh fish, and water melon were regarded as abortifacients and avoided, while hot pepper, sour milk, and cola sodas were considered nutritious. Consumption was self-reported to be poor for milk products by 25% of mothers, for meat by 16%, and for fruits and vegetables by 40% Although the educational intervention increased women's knowledge of basic nutrition, it had only a minimal effect on actual practice. This finding is assumed to reflect the widespread belief that men and their guests should be given preference in food allocation, poverty, and avoidance, on the basis of tradition, of many healthy foods. Since 72% of women reported ownership of a television, use if this medium is recommended for nutrition education.     

Home-based early intervention: dimensions of current practice

Is home-based early intervention an invasion of the family that inadvertently undermines its self-confidence, or is it a life-saving service to families whose children are at risk of abuse and neglect?     

The nature of structure: a biosocial approach

This paper considers how developments within the neurosciences might be applied to advance sociologists’ (and other social scientists’) understanding of social selves and social processes and, importantly, why this might be a fruitful pursuit despite some residual reservations within the discipline. With respect to the latter, the argument presented is firstly approached by briefly reflecting upon sociologists’ lingering reticence with respect to engagement with biology, albeit that there has been some softening of this position over the last decade or so. This piece asserts that overcoming remaining sociological reservations regarding the biological offers considerable potential, in terms of enhancing our theoretical models and understanding of aspects of the social world, potentially offering fresh insights with respect to some perennial issues and concepts. Here, an example of this potential is offered through a neurosociological reframing of the foundations of social structure and the rationalization of conduct.     

The teaching case conference as a method of practice education and training

The teaching case conference is suggested as one means of meeting the problem of the dependency of practice training on the quality of the practice placement. Some of the learning opportunities which these conferences provide are described, including the development of a capacity for collaborative work and for a multi-factorial approach. Examples are given of different methods of organizing the conferences and providing the teaching/facilitation of learning. Collaboration between management and education is regarded as important.     

The future of clinical practice: A study

This paper presents the results of a study conducted to determine how BSW and MSW social work students differentially assess the relative prestige and effectiveness of casework, psychotherapy, and private practice in relation to thirteen other social work methods, and to ascertain what methods they would ideally like to practice upon graduation from their respective programs. The results indicate that undergraduate and graduate students view the average prestige and effectiveness of the three clinical methods quite differently. Also, the results reveal a very low correlation between what methods the students would like to practice and how they assess their prestige and effectiveness.     

The problems of project implementation:: a post-mortem study of Thika Dam project, Kenya

This paper analyses the problems of project implementation programmes. Taking a case study of Thika Dam Component of the Third Nairobi Water Supply Project, the analysis reveals that delays in land acquisition among other factors had a serious impact on the overall performance of development project. The impact of delays in acquisition resulted into cost overruns due to price variations and time overruns. In this paper, the main focus is on the impact that the delays in land acquisition had on the successful completion of a development project. It further discusses the contribution of land availability to the realisation of project planning objectives. The macro-economic instability that Kenya faced during the project implementation is also highlighted. It is hoped that the findings of this study will provide useful insights into policy matters concerning land acquisition in project implementation.     

The implementation of buprenorphine/naloxone in college health practice

Opiate abuse and dependence have become important concerns for college healthcare providers. The passage of the Drug Addiction Treatment Act of 2000 and the approval of the combination buprenorphine/naloxone for office-based treatment of opiate dependence have increased the options available for college students and their healthcare providers. The authors review the pharmacology of buprenorphine/naloxone and discuss how it can be implemented in college health practice. They also present a case report.     

The adventures of Case Connie (1975): a tool for reflecting on practice?

This was one of a number     

Dissemination and implementation of evidence-based practice in the social services: a UK survey

A cross sectional UK-wide survey assessed current levels of dissemination and implementation of evidence-based practice in social care and social work agencies. A structured questionnaire was e-mailed to 357 agencies of which 155 (43.4%) completed and returned it. Although the results show that evidence-based practice in this area is still in its early stages, most respondents reported a good knowledge of evidence-based practice as well as the view that professional decisions should be informed by-but not only-research evidence. The lack of time, resources, information, and training are identified as the main barriers to be overcome for an effective implementation of evidence-based practice in the social services.