Evaluating the Impact of Statewide Anti-Tobacco Campaigns: The Massachusetts andCalifornia Tobacco Control Programs

Despite more than 30 years of public health programs to reduce tobacco use, smoking is still the leading preventable cause of death in the United States. In response to this continuing epidemic, voters in California (1988), Massachusetts (1992), Arizona (1994), and Oregon (1996) approved ballot initiatives that established statewide tobacco control programs funded by cigarette excise tax revenues. Evaluating these innovative public health interventions is important, both to improve existing programs and to guide other states in developing and implementing similar interventions. In this paper we describe the methods being used to evaluate the statewide anti-tobacco campaigns in California and Massachusetts, and review the findings of process and outcome evaluations of both programs.
Our review suggests that both programs have had a substantial impact on the public's health by reducing cigarette consumption and stimulating the development of policies to reduce environmental tobacco smoke exposure. However, it does not appear that either program has reduced smoking initiation among adolescents. Our evaluation suggests three problems in program implementation that future anti-tobacco campaigns must avoid in order to produce long-term, sustained effects: (1) the gradual erosion of program funding by the state legislatures and governors; (2) the lack of a consistent, supportive constituency within state government; and (3) inconsistency in campaign themes, messages, and programs. We conclude by offering recommendations to correct these problems so that statewide cigarette-tax-funded anti-tobacco campaigns can realize their potential to become one of the most effective public health interventions available.     

Perceived benefits and psychosocial outcomes of a brief existential family intervention for cancer patients/survivors

This study assessed a range of benefits from participation in a brief existential intervention consisting of a semi-structured videotaped interview with cancer patients and their families designed to illuminate a life legacy for the family (the Life Tape Project [LTP]). Results indicated the majority reported intervention-specific benefits, especially in the areas of symbolic immortality (passing on personal values and philosophy), self-reflection and growth, and improved family cohesion and communication. Participants, particularly those who had perceived their cancer as a threat of death, serious injury, or threat to their physical integrity, and responded with intense fear or helplessness, also reported more general reductions in mood disturbance, improvements in aspects of well-being (including overall quality of life), satisfaction with the understanding they received, and enhanced cancer-related posttraumatic growth. In short, the LTP is a brief, inexpensive, existential intervention that can yield broad positive psychosocial changes for a majority of participants.     

Alternative criteria for the design of means of production

Conclusion Criteria for deciding on the means of production are not only varied in character at any one time, but show definite patterns of transformation through time. In consequence, it is to be expected that both the physical means of production and the ways of using them will be altered in a congruent fashion. This is currently visible in two interesting ways. First, human factors engineering considerations are becoming more important in the design of tools and machines. Second, methods for the social organization of work are moving away from the classic patterns of work simplification and micro-division of labor in favor of group responsibility for multiple tasks, with work performance accompanied by a measure of responsibility and authority for the finished product. These changes in the criteria applied to the design of means and methods of production are a consequence of definable social processes. There is an ongoing struggle for control in industrial decision making. The preferred design criteria for means of production, and their evolution, reflect the evolving requirements of employers (the business process) and workers (unions) in their contest for control. The employers change, not only in cost criteria, but also in forms of organization (from family firm to multinational conglomerate), and even location (from private firm to state enterprise). The union has been evolving from business unionism to a concern with virtually all aspects and effects of enterprise operation. Thereby the shaping of the means of production may be understood as the derived effect of the application of socially preferred design criteria to the properties of materials given by nature.

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In Defence of a Modern Medical Model: Purism and Eclecticism in Family Therapy*

Family therapists criticise the ‘medical model’ for relying on linear causality, focusing on pathology rather than health processes and tending to coerce the family into preconceived models. These criticisms might be legitimately levelled at 19th Century models but not at modern medical models which include the circularity of general systems theory, attention to ecological field, and understanding of reciprocal influences of many factors such as emotions, antibodies, genetic endowment, nutrition, interpersonal relations, environmental stress, and symbiotic micro-organisms. This modernised medical model is consistent with modern family therapy theory which integrates general systems theory, ecological theory, communication theory, small group process, role theory and metaphoric communications. Family therapy purists define themselves by contrasting their differences with ‘the medical model’. Eclecticists tend to be practitioners who use broad theoretical frames of reference and commonsense, straight-forward, direct intervention where it is likely to work but will resort to indirect, metaphoric or paradoxical intervention for the more complex and resistant family.     

Reasons for the adoption of celibacy among older men and women living with HIV/AIDS

The reasons for becoming celibate following diagnosis with HIV/AIDS were examined using focused interviews with 63 infected older adults (ages 50-68). Forty-eight percent reported they were currently celibate or had been celibate following diagnosis with HIV/AIDS. Women reported celibacy (78%) more than men (36%). Although men and women reported some similar reasons for celibacy, most notably fear of infecting others and fear of reinfection, we also found gender differences in the reasons for celibacy. Additional reasons offered by women included loss of interest in sex, anger and distrust of men, and desire to focus on themselves rather than men. Other reasons offered by men included fear of rejection or stigmatization, difficulty with sexual performance, and negative body image. The prevalence of celibacy and the finding that many reasons for celibacy are related to fear, anger, and distrust suggests that older adults may have difficulty resuming healthy sexual relationships following diagnosis with HIV/AIDS.     

Sexual Risk Behaviors and Perceptions of Men Who Go to Gay Sex Parties in New York City: Comparisons Between Three HIV Groups

Men who have sex with men (MSM) who attend group-sex events often engage in risky sexual behaviors that contribute to the high human immunodeficiency virus (HIV) incidence among this population. We conducted an online survey with 211 New York City MSM who attended sex parties in the prior year and asked them to describe their behaviors and perceptions of risk. We compared responses from HIV-positive-undetectable men (n = 36), HIV-negative men on pre-exposure prophylaxis (PrEP; n = 62), and HIV-negative men never on PrEP (n = 113). In bivariate analyses, undetectable and on-PrEP men had been to more sex parties in the prior six months, had more anal sex partners there, and had higher rates of sexually transmitted infection (STI) diagnoses than men never on PrEP. Although less than the other groups, 43% of the presumably HIV-negative men never on PrEP reported condomless anal sex at a party in the prior six months. About half of participants agreed that, at sex parties, they made assumptions about others’ HIV status, that they sometimes took more risks than intended, and that the atmosphere of these events was conducive to risk taking. Most disagreed that there was discussion of HIV status at sex parties. Implications for sexual health interventions are discussed.     

QUADRATIC PREFERENCES AND GOAL PROGRAMMING

One of the shortcomings of goal programming lies in its linearity, assumption, specifically in the objective function. This assumption compels one to work with constant marginal utilities and rates of substitution. In this paper a quadratic preference function, which is more consistent with economic theory and reality, is formulated and introduced into goal programming. In an effort to facilitate the understanding of the proposed procedure, two illustrative examples—one with symmetric preferences and the other with asymmetric preferences, both applied to the objective function—are solved and compared with a goal programming solution.     

A methodological assessment of the use of key informants

The key informant technique is assessed in terms of the ability of different types of informants to report on various aspects of the social system in which they perform role functions. Role theory suggests that informants occupying a specialized role within a social structure provide greater information on role-related aspects of the structure than informants occupying positions unrelated to the area being investigated. Empirical evidence in support of this assertion is presented.     

Which Models of Supervision Help Retain Staff? Findings From Australia’s Domestic and Family Violence and Sexual Assault Workforces

ABSTRACT

The contribution professional supervision makes to quality services, staff satisfaction, and retention is well recognised across social work and human service settings. Yet frequent supervision is difficult to provide where organisational resources are limited and urgent client-related tasks must take priority. In these contexts, group-based supervision may offer an alternative to traditional individual approaches, yet its impacts have been infrequently researched. Using survey data (n?=?917), we examine the prevalence of individual and group-based supervision among practitioners delivering domestic and family violence and sexual assault services (DFVSA), and associations these forms of supervision have with staff retention. While individual supervision remains most common, one in eight practitioners report that they never receive it. Multivariate analysis indicates frequent individual supervision is most effective for retaining practitioners. This provides empirical support for prioritising individual supervision within strategies for promoting workforce sustainability and service quality in DFVSA and other social service settings.

IMPLICATIONS

• Individual supervision remains more common than group-based approaches in domestic and family violence and sexual assault services.

• Workplaces should consider prioritising individual supervision over group supervision when attempting to improve practitioner retention.

• Managers should adopt a critical stance and consider evidence when assessing the implications of adopting group-based approaches to supervision.