Transforming the Way We Live Together: A Model to Move Communities From Policy to Implementation

Most cities, counties, and neighborhoods are not designed for an aging population. By providing a range of services to all residents, Lifelong Communities allow individuals to age in place. Although the Lifelong Communities Initiative is based on established guiding principles, little information exists regarding the realities of moving from policy to implementation. The Atlanta Regional Commission conducted a case study in Mableton, Georgia, and found successful implementation requires a combination of support from local citizen groups and government. The Atlanta Regional Commission is replicating these best practices in other communities and providing support to those aspiring to launch or expand Lifelong Communities.     

Exploring the intention-behavior relationship in the prediction of sexual risk behaviors: can it be strengthened?

Many theoretical models examining health risk behaviors, such as sexual risk taking, assume intentions directly predict behavior, and intentions are sometimes measured as a proxy for behavior. Given that there is often a discrepancy between intentions and behaviors (e.g., Sheeran, 2002 ), this study addressed factors that predict intention-behavior congruence. Specifically, utilizing a prospective design, the goal of the study was to determine if characteristics of university students' last sexual encounter predicted whether those students who intended to use condoms, contraception, or dual methods did so in their last sexual encounter with both relationship and casual partners. The seven tested variables were condom planning and preparatory behaviors, mood, sexual arousal, substance use, perceived partner attractiveness, intention certainty, and intention stability. Data were collected from 520 American undergraduate students at a medium-sized university. The six discriminant function analyses examining the intention-behavior relationship were able to correctly classify between 74% and 92% of the participants concerning whether intenders engaged in safe sex behaviors. The variables that best discriminated between behavior engagement over the six analyses were intention stability, intention certainty, and engagement in condom preparatory behaviors. The implications of these results for sexual risk prevention and intervention research are discussed.     

Enclosed versus open nursing stations in adult acute care psychiatric settings: does the design affect the therapeutic milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings.     

Approaches used by employee assistance programs to address perpetration of intimate partner violence

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.     

Older adults' narratives about a flood disaster: Resilience, coherence, and personal identity

Older adults are a vulnerable group in a disaster and are more at risk of adverse effects as a result. This paper draws on the use of narrative theory in health and gerontology studies to examine how a disruptive disaster was storied. Narrative interviews were conducted with nine older adults aged over 65 years who had recently experienced a flood disaster. The participants' narratives about the disruptive event were integrated with past personal events that spanned more than seven decades. The disaster became a reference point for previous challenging experiences, which created biographical continuity, coherence and order over time. Furthermore, the disaster stories were about biography and identity, and showed how older adults made sense of the flood from a life-course perspective. The use of narrative approaches provides an insight into how the flood disaster was experienced, and reveals how four older adults storied their experiences of a significant life challenge.     

Specialisation and training for fire-fighters driving heavy rescue vehicles: consequences for the development of operators?

This work was undertaken in France at the request of a local fire and rescue school in order to conduct an analysis of driving two types of heavy rescue vehicle with a view to improving training. This study took place in a context of specialisation: the drivers of these vehicles will henceforth only perform this type of task. Consequently, specific training has been designed in advance. Our study concerns the improvement of this training, taking account of the particularities of driving these vehicles in emergency situations typical to the profession of fire-fighters. The results stress first that driving of rescue vehicles in emergency situations is a multidimensional collective activity. Driving strategies identified share certain common objectives: "optimising trajectories", warn other road users, anticipate their behaviour and leave room for manoeuvre to counter and react to any unexpected behaviour. They include risks management for the potential victims of the incident and the risk of accidents during the journey. These initial results help identify certain recommendations for the training courses dealing with driving vehicles in emergency situations. They also provide a warning concerning the possible consequences of driver specialisation.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

Nationwide Newspaper Coverage of Posttraumatic Stress: A Community Structure Approach

This study utilized the community structure approach to analyze newspaper coverage of posttraumatic stress (PTS) in veterans in 26 U.S. cities. The study examined whether media placed responsibility for PTS treatment on government or society through a review of 353 articles from March 20, 2003, to March 20, 2013. Researchers coded articles for “prominence” and “direction” to produce a “Media Vector” for each paper, ranging from 0.8403 to ?0.3592. Results showed that 25 of 26 Media Vectors (96%) supported government responsibility. Pearson correlations yielded nine significant findings. Results disconfirmed buffer hypotheses linking privilege with support for government responsibility (privilege defined by percentage of college educated, percentage of family income $100,000 or more, and percentage of professional/technical occupational status; r = ?.486, ?.524, ?.553, respectively, significant at the .006 level). Stakeholder hypotheses were also disconfirmed; greater percentages of age 65 and older correlated with more emphasis on government responsibility (r = .340, p = .048), whereas greater percentages of age 25 to 44 correlated with less emphasis (r = ?.342, p = .047). The only confirmed hypothesis linked percentage of age 45 to 64 with less emphasis on government responsibility (r = ?.559, p = .002). A regional finding was noteworthy: Media in the Midwest supported government responsibility more than other regions. Regression analysis revealed three variables influencing coverage most significantly: Family Income $100K+ (26% of variance), Percentage of Hispanic (8%), and Professional/Technical Occupational status (5%). It must be noted that nearly all newspapers yielded positive Media Vectors. This indicates that coverage in major cities generally favors government responsibility for veterans' PTS treatment, and Pearson correlation results may represent differences in the degree of support and demographic characteristics influencing this support.