Adolescent Women's Recommendations for Enhanced Parent-Adolescent Communication About Sexual Behavior

Family communication about adolescent sexual health and behavior promotes adolescent health and family connectedness. However, few studies seek the perspective of adolescents regarding their recommended strategies for family communication. Findings of a survey of female adolescent family planning patients (n = 249) indicated adolescent recommendations for better family communication included treat teen as an equal, 63%; increase parental knowledge about lifestyle and peer pressures, 61%, and improve parental listening skills, 61%. There were no statistically significant differences according to age, pregnancy history, or school enrollment status for suggested strategies for improved communication with parents. Sexually active adolescent daughters expressed interest in maintaining family connectedness and support with increased time for family activities as well as increased quality and quantity of dialogue between the adolescent girl and her parents.     

Improving performance in a contracted physician network

Health care organizations face significant performance challenges. Achieving desired results requires the highest level of partnership with independent physicians. Tufts Health Plan invited medical directors of its affiliated groups to participate in a leadership development process to improve clinical, service, and business performance. The design included performance review, gap analysis, priority setting, improvement work plans, and defining the optimum practice culture. Medical directors practiced core leadership capabilities, including building a shared context, getting physician buy-in, and managing outliers. The peer learning environment has been sustained in redesigned medical directors' meetings. There has been significant performance improvement in several practices and enhanced relations between the health plan and medical directors.     

Alcohol and drug use of inter-city versus rural school age children

The purpose of this study of seventy-nine children was to determine: 1) the prevalence and type of substance use in inter-city and rural eight to twelve-year-old children; and 2) the relationships between child substance use, self-esteem, peer substance use, and family climate. The conceptual framework for the study was a modification of Kumpfer and Turner's Social Ecology Model (1991). Nineteen percent of the children had used alcohol or drugs. Thirty-three percent of the children acknowledged having friends who used substances. Inter-city children reported more alcohol and marijuana use, while the rural children reported more use of inhalants. The responses of both inter-city and rural children also indicated that there were problems with substance use and family violence in the home. Self-esteem and affiliation with drug using peers were significantly correlated with substance use of the child.     

Prevention training of paraprofessionals in the schools: an examination of relevancy and effectiveness

Prevention training programs for paraprofessional school personnel are examined in this article. Prevention training for the reduction of student alcohol and other drug use, incorporating a student well-being model, is described and evaluated. The prevention training, entitled "Enhancing Student Well-Being," took place in two urban school districts with over 200 paraprofessional school personnel participating. The training was evaluated using measures of knowledge gained, self-efficacy, and participant satisfaction. Pre- and post-training differences showed consistent gains in participant efficacy expectations but less consistent gains in outcome expectations and knowledge. Participant satisfaction and self-reports of knowledge enhanced and skill improvement were uniformly high across all training programs. Implications for inservice prevention training of paraprofessionals are discussed.     

Multilevel mediation modeling in group-based intervention studies

This article proposes and evaluates a method to test for mediation in multilevel data sets formed when an intervention administered to intact groups is designed to produce change in individual mediator and outcome variables. Simulated data of this form were used to compare ordinary least squares (OLS) and two multilevel estimators of the mediated effect. OLS and multilevel standard error approximations were also evaluated and recommendations given for optimal estimator choice. These methods were applied to data from an existing substance use intervention to show the impact multilevel mediation modeling can have on the conclusions drawn from real-world evaluation studies.     

Character-Based Determinants of Trust in Leaders

Trust is a prominent determinant of effective interpersonal relationships, group process, and organizational development. However, for leaders and managers, trust building is often problematic. The aim of this article is to contribute to a growing understanding of the way in which individual managers can develop trust in organizations, particularly those defined by medium to high risk. The article presents a theoretical and empirical analysis of the nature of trust at work. Building on the results of an earlier study, use is made of the facet-theoretical approach to generate a definitional framework of trust, which focuses on the characteristics of the trusted person that contribute to the development of trust. Using items developed on the basis of a mapping sentence, hypotheses regarding the relations between the definitional framework and empirical observations were tested through smallest space analysis (SSA) of data collected from a sample of 398 bank and hospital employees. The results demonstrate strong support for the definitional system and show a clear association with results of prior research that identify perceptions of ability, integrity, fairness, and openness as key determinants of trust. The empirical structure clearly reflects the attitudinal nature of interpersonal trust at work and the items empirically distinguish distinct character-based components of trust.     

Readiness for Career Choices: Planning,Exploring, and Deciding

One of Super's most important contributions has been in explicating those developmental tasks that involve planning, exploring, and deciding, processes known collectively as readiness for career choices. The authors review existing means of conceptualizing and operationalizing the various aspects of readiness, as well as innovative practice applications that have emerged from this work. Next, selected elaborations and extensions of the readiness construct are described. Finally, future directions for theory and research on readiness are presented with a particular emphasis on the promise of considering contextual issues, motivational factors, and an expanded measurement perspective in subsequent inquiry and practice.