The DASH Pilot Project: Developing Community-Based Nutrition Education for Older Adults

ABSTRACT

Nutrition-related chronic health conditions among older adults are a growing concern. In this study, nutrition education materials were created for use in senior centers by graduate nutrition students. After the materials were presented, focus groups were conducted with participants (n = 62) to obtain feedback on the content and presentation. Findings related to the participant’s knowledge of nutrition-related information, strategies to improve future class sessions, and participant recruitment will be discussed. These findings will be useful to program administrators as they develop nutrition programs for older adults who are vulnerable to nutrition-related health problems.     

A qualitative evaluation of an innovative resilience‐building camp for young carers

Young carers are at increased risk of developing mental health and social problems. The objective was to pilot a camp‐based resilience‐building programme for young carers. Twelve young carers (12 to 14 years) recruited from Carers Queensland attended a 3‐day resilience‐building camp adapted from the Resourceful Adolescent Program. One month after the camp, carers participated in a semi‐structured telephone interview. Thematic analysis was used to analyse the data. Two key themes emerged. The first, coping self‐efficacy, included subthemes of affect regulation, interpersonal skills, and recognition of strengths and coping ability. The second key theme, social benefits, included opportunities for respite and social engagement. Overall, participants reported enjoying the camp and would recommend it to other young carers, yet they were able to provide some suggestions to improve future camps. Implementing an integrative resilience‐building program such as the Resourceful Adolescent Program in a camp format shows promise as a way of both engaging and benefiting young carers, as well as selective populations more generally.     

Interventions for families with multiple problems: Similar contents but divergent formats

For families with multiple problems (FMP), knowledge is lacking on the practice elements of interventions (the distinct techniques practitioners use to promote positive outcomes) and their program elements (intervention design and delivery systems). The aim of this study is to identify both common and specific practice and program elements so as to determine contents and overlap between interventions. For FMP, we selected interventions that had at least moderate (>0.5) effect sizes in the Dutch context (N = 8). A deductive content analysis was used to assess the manuals of these interventions with the taxonomy of interventions for FMP. We defined as common those elements found in at least five of the eight interventions and as specific those found in fewer than five. Of the practice elements, 79% were common across the interventions, and 21% were intervention specific. Interventions with the highest percentages of intervention‐specific elements derived from the taxonomy were 10 for the Future (15%), Family Central (14%), Intensive Family Therapy (14%), and Multisystemic therapy (11%). Core program elements: duration, intensity, intervision, supervision, and consultation, varied greatly between interventions. Among interventions for FMP, we found practice elements to have considerable overlap. Among program elements, we found greater variety.     

Who benefits from network intervention programs? TERGM analysis across ten Philippine low-income communities

Building social capital and strengthening social networks among members of low-income communities has been recommended as a potential pathway out of poverty. However, it is not clear how network-strengthening interventions and community-based programs interact with pre-existing networks and power structures. We examine the impact of one such intervention in ten low income communities in the Philippines. The intervention is a standardized program of a faith-based organization implemented in thousands of communities in multiple countries. It brings together low-income individuals in each community for 16 weekly sessions about health, income generation, and Christian values. An important but yet unmeasured goal of the intervention is the strengthening of social networks among the participants. We measured the social networks before and after the intervention and analysed their changes both separately and jointly for all ten communities with temporal exponential random graph models (TERGM). We modelled the post-intervention network structures conditioning on the pre-intervention networks, pre-intervention node attributes, and attribute changes through the intervention. We found social engagement (measured by social visits to others) to moderate most consistently the effects of the intervention across the ten communities. Those who were more socially engaged consistently strengthened their networks through the intervention. By contrast, some network mechanisms strongly diverged between the communities. In particular, religiosity was positively associated with gaining social links through this faith-based intervention in some communities and negatively in others. Similar communities may in some aspects react to the same intervention in opposite ways—a phenomenon that should be further explored through studies of larger numbers of comparable networks.     

Dysfunctional Career Thoughts and Perceived Quality of Parental Relationships in Adolescents With Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is known to cause significant difficulties in interpersonal relationships. Empirical research in career development has demonstrated that close, supportive relationships are associated with positive vocational behaviors (Kenny et al., 2018). We examined dysfunctional career thoughts and perceived quality of parental relationships in high school students with ADHD. One hundred two adolescents (76 boys, 26 girls) with ADHD responded to measures of career thoughts and interpersonal relationship quality. Preliminary exploratory analysis, using multiple linear regression, showed that male participants' dysfunctional career thoughts were statistically significantly related to their relationships with their mothers. For female participants, relationships with fathers represented an area for further exploration. Results suggest that career professionals can enhance positive outcomes of decision-making and problem-solving issues in adolescence with additional focus on relational interventions. Future research should incorporate the influence of gender and race/ethnicity on crucial relationships and focus on paternal relationships using cognitive information processing–based interventions with this population.     

Demographic and HIV status diversities as mechanisms of social integration and segregation among Black sexual and gender minorities enrolled in a community-based social network intervention

Drawing on a social integration and intersectionality framework, this study advances a dynamic network understanding of the mechanisms that enable differential patterns of within-group social integration and segregation among Black sexual and gender minorities (BSGM). Specifically, in a cohort of BSGM (18–35 years of age, n = 340) participating in a community-based network intervention for HIV prevention, we examine how sexual, gender, age, and HIV status diversities contribute to friendship formation and maintenance patterns over the 12-month study enrollment period. We found attenuated social integration (or social activity) among non-gay-identified and older BSGM and evidence of social segregation (or homophily) on the basis of sexual identity and age similarities. Accounting for the moderating effects of the intervention revealed that the attenuated integration of non-gay-identified and older BSGM were stronger for participants who received the peer leadership training, and integration challenges were also found for transgender BSGM who received the peer leadership training. Meanwhile, BSGM living with HIV who received the peer leadership training were significantly more integrated than their counterparts in the control arm. These findings help us understand the complicated social fabric among BSGM and the dynamics that interventions for this community may have to contend with or alter.     

Practical considerations of physical and emotional sibling violence in foster families: A summary of the current literature

This article draws upon current literature and case examples to enrich the understanding of physical and emotional sibling violence in foster families. A brief overview of physical and emotional sibling violence is presented followed by a discussion of the interventions that address sibling conflict and aggression. The lack of knowledge regarding sibling violence for different kinds of sibling combinations is highlighted. The authors stress the potential for negative interactions among children in foster families and the need to alter approaches to include all sibling combinations.     

Agency and structure in the life-world of Aboriginal children in Central Australia

This paper offers ethnographic observations on the place of “agency” in the lives of Aboriginal children in Central Australia. The focus is on children's play and adult-child interaction in the remote community of Ernabella, the oldest settlement in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, northern South Australia. The circumstance of Aboriginal children in remote areas is introduced as a contrasting picture: on the one hand, the life of Aboriginal families is shaped by their marginalised socio-economic position and dependency on the state, which has become especially evident in the recently intensified efforts by the government to “mainstream” Aboriginal communities deemed in “social chaos” in order to regulate and thereby improve children's lives; on the other there is the social fact that children enjoy a comparatively high level of autonomy within the Aboriginal domain. The much-observed “freedom” from parental discipline, however, does not simply mean that children assert their will without regard for certain social rules. Rather, it is suggested that it is precisely the relatively low level of direct instruction and reprimand by adults that fosters children's ability to pattern their behaviour in relation to one another and to structure their social world and understandings according to the meanings that they co-create. Agency of this kind often occurs through imaginative play and spontaneously. This paper does not address policy issues directly. However, it is relevant as a background paper on Aboriginal children's lives that contributes to the understanding and recognition of existing social capacities outside institutional settings.     

Usability testing,initial implementation,and formative evaluation of an evidence-based intervention: Lessons from a demonstration project to reduce long-term foster care

The field of child welfare faces an undersupply of evidence-based interventions to address long-term foster care. The Permanency Innovations Initiative is a five-year federal demonstration project intended to generate evidence to reduce long stays in foster care for those youth who encounter the most substantial barriers to permanency. This article describes a systematic and staged approach to implementation and evaluation of a PII project that included usability testing as one of its key activities. Usability testing is an industry-derived practice which analyzes early implementation processes and evaluation procedures before they are finalized. This article describes the iterative selection, testing, and analysis of nine usability metrics that were designed to assess three important constructs of the project's initial implementation and evaluation: intervening early, obtaining consent, and engaging parents. Results showed that seven of nine metrics met a predetermined target. This study demonstrates how findings from usability testing influenced the initial implementation and formative evaluation of an evidence-supported intervention. Implications are discussed for usability testing as a quality improvement cycle that may contribute to better operationalized interventions and more reliable, valid, and replicable evidence.     

Voices of 9/11 First Responders: Patterns of Collective Resilience

The aim of the ethnographic research reported here was to increase knowledge concerning the values and social and emotional characteristics of 9/11 responders in order to benefit others in subsequent manmade disasters. The research is based on a series of in-depth interviews conducted with ground zero first responders; firefighters, police officers, fire and police chaplains, and media persons. The materials that emerged from the study indicate that psychodynamic concepts, such as post-traumatic stress, may be too individualistically formulated to take into account the significant factors that acted as the basis for the resilience of these responders.