Effective targeted and community HIV/STD prevention programs

Community interventions and interventions targeting specific groups at risk of STDs/HIV have demonstrated significant impacts on sexual behavior, particularly condom use and safer sex. The scientific evidence suggests the factors that make these interventions particularly effective include the establishment of community, including business and CBO partnerships; maintainance of the intervention post-research funding; and buy-in by the community or target group. The modification of risky normative beliefs through the use of opinion leaders and role models, and through intervention delivery by peer educators, is an important facet of such interventions. Interventions delivered by health professionals, absent a community base, appear to be unsuccessful. Where cultures or subcultures are targeted, the close involvement of such groups in the design and delivery of messages is critical to their success. Diffusion of interventions through existing social networks further extends the intervention into the community and acts to reinforce and maintain changes in peer norms toward safer sexual behavior. The available data confirm that community or medical infrastructure-based interventions are effective in changing sexual behavior and can reach a wider range of the population than face-to-face programs if they incorporate peer educators as role models in modifying norms, and if diffusion of the intervention is integral to the design.     

The Impact of the Therapist's Curiosity on the Treatment Process of Children and Adolescents

Therapists bring their own initiative, interest, and wonder—their professional curiosity—into treatment sessions. Some children and adolescents pull away in reaction to this curiosity, bristling or withdrawing, if only for a moment. This can happen abruptly, even in response to the first hello, but most often it occurs subtly, over the course of treatment. These children and adolescents may be replaying the ruptures in relationships they experienced when they have expressed their own initiative and curiosity to important others in their lives. Therapists need to utilize opportunities to understand the dynamics, explore where the original ruptures may have occurred, and bring the experience into therapeutic focus. Case vignettes illustrate these dynamics.     

Perspectives on workplace disability management: a review of the literature

Work-related musculoskeletal injuries represent a major source of work disability. While many employers recognize the importance of workplace disability management approaches and are assuming greater responsibility for preventing and minimizing work-related disability, questions about the effectiveness of these interventions exist. The purposes of this article are to: 1) describe the essential components of workplace disability management programs related to musculoskeletal injuries; 2) review the literature on disability management practices based on research evidence by focussing on workplace-based interventions and the role of the workplace; and 3) provide recommendations for disability management in the prevention and reduction of disability, and the rehabilitation of injured workers with musculoskeletal work injuries. The literature suggests that employer participation, a supportive work climate and cooperation between labour and management are crucial factors in facilitating return to work. Given the complexity of the disability management process and the numbers of individuals involved, it is essential that all workplace parties work together to achieve the goal of safe and early return to work.     

Perspectives on work (re)entry for persons with disabilities: implications for clinicians

Despite the prevalence of government funding to support employment opportunities for persons with disabilities, real jobs for this population still appear to be elusive. McMaster University researchers examined how six stakeholder groups defined workplace (re)entry success for persons with disabilities. Focus groups and individual interviews were conducted with representation from employers, unions, persons with disabilities, co-workers, supervisors and human resource departments. Participants numbered 86 and the average age was 42. Participant comments provided the researchers with rich data related to the study objectives. Success was perceived as not only a match between the employee and the job but also a win-win for employer and employer, a uniquely defined set of circumstances based on the specific individual and their environment as well as respect for the individual's dignity and quality of life. This article discusses the study and its outcomes and highlights implications for clinicians.     

The Media and Genetically Modified Foods: Evidence in Support of Social Amplification of Risk

Empirical examinations of the "social amplification of risk" framework are rare, partly because of the difficulties in predicting when conditions likely to result in amplification effects will occur. This means that it is difficult to examine changes in risk perception that are contemporaneous with increases and/or decreases in social or media discussion of the risks associated with a particular risk event. However, the collection of attitude data before, during, and after the increased reporting of the risks of genetically modified food in the United Kingdom (spring 1999) has demonstrated that people's risk perceptions do increase and decrease in line with what might be expected upon examination of the amplification and attenuation mechanisms integral to the framework. Perceptions of benefit, however, appeared to be permanently depressed by negative reporting about genetically modified food. Trust in regulatory institutions with responsibility for protecting the public was not affected. It was concluded that the social amplification of risk framework is a useful framework for beginning to explain the potential impact on risk perceptions of a risk event, particularly if that risk event is presented to the public as a new hazard occurring in a crisis context.     

Predictors of substance abuse treatment outcomes in Tennessee

In planning and implementing programs to treat substance abuse, it is important to understand which factors influence post-treatment abstinence.This article identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. The data used in this study was collected from 1,350 clients treated for alcohol or drug abuse in residential, halfway house, or outpatient facilities in Tennessee. We analyzed 22 variables as possible treatment outcome predictors by using two statistical procedures: stepwise logistic regression analysis and Quick, Unbiased, Efficient, Statistical Tree (QUEST) analysis, a tree-structured classification algorithm analysis. We found one pretreatment, five in-treatment, and three post-treatment variables to be significant predictors of treatment outcome: previous treatment history, perceived helpfulness of the treatment, simultaneous treatment for mental health, number of days in treatment,completion of treatment, special skills training during treatment, obtaining healthcare services for major physical health problem after treatment, living with someone using alcohol or drugs post treatment, and arrest record since treatment.     

Optimizing out-of-school time: the role of free-choice learning

Free-choice learning, a new paradigm for the learning that youth and their families engage in outside school, can play an important role in the healthy development of youth, their families, and communities.     

Reliability of the Demand-Control Questionnaire for sewing machine operators

The Demand-Control Questionnaire (DCQ), a 20-item scale that measures psychological work demands, job control and workplace social support, has frequently been used to assess occupational stress. The purpose of this study was to determine the test-retest reliability and internal consistency of the DCQ with sewing machine operators. Forty-six sewing machine operators completed the DCQ on two occasions with an 11-week time interval. A repeated measures analysis of variance model and subsequent application of generalizability theory were used to calculate the test-retest reliability of the subjects' ratings on the DCQ. Cronbach's alpha was used to determine the internal consistency of the scale. The test-retest reliability was 0.33 (95% confidence interval = 0.05-0.61), indicating fair reliability. Good internal consistency (Cronbach's alpha = 0.70) was found. The DCQ appears to be a reliable measure for assessing occupational stress in sewing machine operators. Workplaces need to place greater emphasis on the role of occupational stress in the prevention and treatment of musculoskeletal injuries among sewing machine operators.     

Neighborhood disadvantage, stress, and drug use among adults

This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.     

Consumer Selection of Food-Safety Information Sources

The aim of this study is to examine the preferences of consumers for different information sources when they have a question about food safety. On the basis of a nationally representative survey conducted in the Netherlands, five distinct consumer groups are identified that not only differ on the reported use of information sources but also regarding several personality characteristics and sociodemographic variables. The empirical results show that two-thirds of the consumers are selective in their use of information sources and prefer either institutional or social sources. So, multiple information-acquisition patterns exist among the general public. The study illustrates how these findings can help to develop effective risk communication strategies.