Staff resistance to restraint reduction: identifying & overcoming barriers

Professional organizations, regulating agencies, and hospital administrators have taken a strong stance on restraint reduction policies. When implementing a restraint reduction initiative, it is important to identify the barriers to restraint reduction, such as concern for personal safety, lack of knowledge about and practice using alternate de-escalation skills, and fear of disrupting the therapeutic milieu by using a variety of de-escalation methods. Education aimed to reduce the use of restraints needs to do more than simply provide information. It is important to acknowledge the emotional response of the nursing staff and the culture of the current practice. A variety of educational strategies, including role-playing, and case studies will help identify attitudes, beliefs, and behaviors that are congruent with reducing the use of restraints. If the ultimate goal of restraint reduction is philosophical change, it will eventually lead to a new culture of practice.     

Development of the MyPlan Safety Decision App with Friends of College Women in Abusive Dating Relationships

Dating violence (DV) from an intimate partner/expartner is common on college campuses, but young college women are far more likely to disclose DV to a peer than to seek formal services. Therefore, our team developed a prototype smartphone application (app) aimed at DV survivors’ peers. Through focus groups/interviews, 31 college students who self-identified as friends of DV survivors reviewed and provided feedback on the app's usefulness, understandability, appropriateness, and comprehensiveness. These findings support the acceptability and usefulness of an app to support peers of DV survivors on campus and thereby also strengthen the safety net for DV survivors.     

Individuals' beliefs about the etiology of same-sex sexual orientation

We examined the relationships between beliefs about the etiology of having a same-sex sexual orientation, sexual prejudice, and support for gay-relevant legislation using the justification-suppression model of prejudice as our theoretical foundation. Results indicated that more belief that a same-sex sexual orientation was due to nurture factors predicted less support for gay-relevant legislation, and that this relationship was mediated by levels of sexual prejudice. The opposite pattern was found for belief that a same-sex sexual orientation was due to nature factors. This suggests that beliefs about the etiology of sexual orientation may serve as justification (or suppression) factors in the expression of prejudice toward gay men and lesbians.     

Black Mothers' Perceptions of the Role of Race in Children's Education

Many Black parents consider racial climate and academic quality when thinking and making decisions about their children's schooling experiences. However, few studies have directly asked Black parents about the role they believe race will play in their children's schooling, if any. The authors interviewed 76 Black mothers (M_age = 34; SD_age = 6.67) of children entering first grade (M_age = 6.13; SD_age = 0.36), asking what role they believed race would play in their children's schooling. The authors found that mothers considered the racial composition of the school and the perspectives and behaviors of teachers and the administration to be important factors when assessing the role of race in their children's education. Mothers were also particularly concerned about the discrimination their sons may face because of their position as Black boys. Given these contextual factors, mothers considered themselves to be protective agents through their involvement in their children's academic lives.     

The Effects of Electronic Data Collection on the Percentage of Current Clinician Graphs and Organizational Return on Investment

Behavior analysts rely on frequent access to graphed data to facilitate clinical decision making and enhance their programming. Several new electronic data collection (EDC) products have recently been developed and marketed to behavior analysts. We evaluated the effects of an EDC software system on the percentage of current graphs. We also evaluated the potential return on investment (ROI) of the tool for a large human services agency. During baseline, graphs were seldom updated at the designated time the supervisor examined the file. When the EDC software was implemented, 100% of graphs were updated at all checks for all consumers with minimal or no corresponding increase in clinician hours. A comprehensive index of ROI was calculated using various costs of implementation and observed and estimated savings. Implementing the EDC software across the human services agency resulted in a projected cumulative positive average ROI of 59% over five years. These results are discussed in terms of strategies for systematically evaluating the costs and benefits of organizational efforts to use technology to enhance staff performance in human service settings.     

Fat talk: A citizen sociolinguistic approach

Fat talk, or self‐disparaging talk about the body, is common among US women and increasingly reported for men. Despite its commonality, this unique genre of talk is difficult to access using traditional sociolinguistic methods both because it is brief and because it arises spontaneously in casual conversation. Here we present a new method of data collection accomplished by collaborating with citizen sociolinguists to collect spontaneous fat talk in public spaces. We compare fat talk exchanges captured by citizen sociolinguists against those collected in a vignette‐based discourse completion task. Our results show redundancy both in how fat talk is initiated and in the manner of the reply across both forms of data collection. However, the citizen sociolinguistic method produced greater variety in fat talk utterances, was less methodologically taxing, and revealed that fat talk occurs differently in same‐sex interactions than mixed‐sex ones.     

Adolescent Work Experiences and Family Formation Behavior

A long-standing critique of adolescent employment is that it engenders a precocious maturity of more adult-like roles and behaviors, including school disengagement, substance use, sexual activity, inadequate sleep and exercise, and work-related stress. Though negative effects of high-intensity work on adolescent adjustment have been found, little research has addressed whether such work experiences are associated with precocious family formation behaviors in adolescence, such as sexual intercourse, pregnancy, residential independence, and union formation. Using data from the National Longitudinal Study of Adolescent Health, we find that teenagers who spend long hours on the job during the school year are more likely to experience these family formation behaviors earlier than youth who work moderately or not at all.     

Measuring Attitudes Toward Empirically Supported Treatment in Real-World Addiction Services

Mental health workers with favorable attitudes toward empirically supported treatments (ESTs) are more likely to break through implementation barriers. The Evidence-Based Practice Attitude Scale has been shown to be reliable for mental health workers, but it has not been validated with addiction workers. This study investigates the use of the scale with a convenience sample of addiction workers from 4 agencies in 1 city. Results show that compared to mental health providers, addiction workers were more likely to view ESTs favorably if they were mandated and intuitively appealing. They also tended to rely more heavily on practical experience in forming attitudes toward treatment options. These results might help addiction agencies understand which types of workers are more likely to implement ESTs and inform effective engagement approaches specific to addiction workers.     

MIXING OF MARKOV PROCESSES*

This paper considers a Markov process in which there are rewards associated with state transitions. Two or more actions are available to the decision maker, and the transition probabilitities and the rewards are influenced by the actions selected. A key assumption is that control cannot be a function of the current state of the process. In other words, the decision maker is assumed to have no knowledge of the current state of the process (or to ignore such knowledge if it exists). Within this context the problem of determining the best randomized policy, the best in the sense of maximizing the expected reward per transition in the steady state, is discussed. Analytic results are developed for the simplest case of a two state process with two possible actions.