Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Point subtraction aggression paradigm: validity of a brief schedule of use

The Point Subtraction Aggression Paradigm (PSAP) is a validated behavioral measure of aggression in response to provocation. Canonically, multiple sessions continue until performance asymptotes, requiring significant time. We sought to examine whether use of the PSAP-first-session ("PSAP-FS") had acceptable construct validity for group data, potentially expanding the settings in which the PSAP may be useful. One hundred male and female young adult subjects completed the PSAP-FS and additional behavioral measures of aggression, and provided information related to risk factors. The PSAP-FS correlated significantly with known risk factors of aggression. The PSAP-FS, which measures aggression in the present, correlated well with measures of recent aggression and less strongly with life history of aggression. The PSAP-FS had satisfactory validity properties for use where group-level data are of interest.     

Effectiveness of a Web-based alcohol-misuse and harm-prevention course among high- and low-risk students

OBJECTIVE: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. PARTICIPANTS: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. METHOD SUMMARY: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. RESULTS: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. CONCLUSIONS: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff

There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.     

Staying safe while consuming alcohol: a qualitative study of the protective strategies and informational needs of college freshmen

OBJECTIVE: In this qualitative study, the authors examined how students attempt to minimize harm to themselves and others when drinking. PARTICIPANTS: The authors recruited freshmen at a large, mid-Atlantic US public university during the fall semester of 2005 to participate in 8 focus groups. METHODS: The moderator's guide was developed through an iterative process that included input from experts and pilot testing. The researchers audiotaped focus group conversations, transcribed them, and subjected them to an interrater reliability check. Analysis was based on the framework of Information-Motivation-Behavioral Skills Model and a phenomenological approach. RESULTS: College students have a repertoire of coping strategies they use in an attempt to safeguard themselves and their friends from harm when drinking. Strategies encompass planning a safe context for drinking, using safety measures to minimize harm when drinking, and taking care of someone who has consumed too much alcohol. CONCLUSIONS: A harm-reduction focus that acknowledges and builds on existing protective strategies may be a promising avenue for alcohol interventions.     

Social inequalities in intimate partner violence: a study of women in Kenya

This study examines social inequalities in intimate partner violence (IPV) among women of reproductive age in Kenya. A sample comprising 3,696 women was retrieved from the Kenyan Demographic and Health Survey of 2003. The study design was cross-sectional. Chi-square tests and logistic regression were used to analyze the data. Results indicated that while high education among women reduced the risk of IPV exposure, both being employed and having a higher education/occupational status than her partner increased a woman's vulnerability to IPV. Age differences between the partners, illiteracy, and lack of autonomy and access to information increased the likelihood of IPV. Finally, being in polygamous relationships was associated with IPV exposure. The findings indicate demographic, social, and structural differences in exposure to IPV with important implications for interventions.     

Gender differences in the relationship between intimate partner violence victimization and the perception of dating situations among college students

Although the prevalence and severity of dating violence among college students is well known, the relationship between past victimization and perceptions of future dating situations has not been examined. Using both qualitative and quantitative research methods, this study investigated gender differences in the relationship between intimate partner violence victimization and the perceptions of dating situations. The study found that the more psychological, physical, or sexual violence that was experienced by females, the more likely they perceived dating situations as inappropriate. Males, on the other hand, were more likely to report aggressive behaviors in dating situations only if victimized by sexual violence. Implications for professionals working with college students or community prevention programs are discussed.     

Barrios and burbs: residential context and health-risk behaviors among Angeleno adolescents

The increasing size of the Latino immigrant population in the United States underscores the need for a more complete understanding of the role that social context plays in influencing the health of immigrants and their children. This analysis explores the possibility that residential location influences the health-risk behaviors of Latino youth in Los Angeles County, California. The data come from the Los Angeles Family and Neighborhood Survey. We apply multivariate, multilevel Rasch models to two scales of adolescent health-risk behaviors (substance use and delinquency). The findings suggest that residence in Census tracts characterized by above-county-average levels of Latinos and above-county-average levels of poverty is associated with increased odds of health-risk behaviors for Latino adolescents, particularly for those born in the United States. The findings lend support to the contention, put forth in the segmented assimilation literature, that disadvantaged urban contexts increase the risk that U.S.-born children of immigrants will experience downward assimilation.     

Complexities in attracting and retaining direct support professionals

Recruiting and retaining direct support professionals (DSPs) remains essential to the full inclusion for persons with disabilities. Using a mixed-evaluation model, we measured DSPs' views versus those of their supervisors. DSPs expressed lower perceptions concerning their supervisors, satisfaction with their work situation, and environmental and safety factors. Focus groups provided insights into resolving issues related to compensation, work environment, and recruiting and retaining future DSPs. Motivating factors included wanting to be part of a helping community where all are valued. To improve their performance, DSPs stated their desire to understand the roles of managers and of the consumer. DSPs indicated that having career paths that provided advancement opportunities and direct contact with persons with disabilities were primary motivators.