Evaluation of a system designed to link people living with HIV/AIDS with mental health services at an AIDS-service organization

This study evaluated the Rapid Response System, an initiative designed to link people living with HIV/AIDS with mental health services at an AIDS service organization. Data were extracted from agency records for 314 clients who had contact with the Rapid Response System over a 6-month period. Of the 281 clients who scheduled an appointment for an evaluation to initiate mental health services, 64% completed the evaluation. In the multivariate analysis, Latinos were significantly less likely than whites to complete the mental health evaluation. Further, there was a significant decrease in the likelihood of completing the mental health evaluation as the number of days between the Rapid Response System contact and the date of the evaluation appointment increased.Strategies that reduce the period of time between the initial referral and initiation of services may facilitate linkage with mental health treatment, particularly in the context of larger multi-service organizations.     

“We don't want to talk about that”: Overcoming barriers to rural aging research and interventions on sensitive topics

Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach, describes the natural history of a project, the Mental Health and Aging Initiative (MHAI) to enhance awareness of mental health issues in rural Kentucky-Appalachian communities and overcome the reluctance of individuals in these communities to seek assistance. Funded by the United States Department of Agriculture (USDA), MHAI involved an educational intervention to improve knowledge about mental health and aging in rural Appalachian counties. The need to overcome significant community reluctance to engage in discussion of mental health resulted in significant modification of the protocol. The intervention was grounded in recognition of four key aspects of the local situation: (1) the need to understand the sensitivity of mental health as an element of rural culture; (2) the critical role of local community leaders as points of entry, acceptance, and action; (3) the need to overcome social stigma and reframe the topic of mental health in a more positive light; and (4) the need for methodological innovation in developing an empowering educational action plan oriented toward community-wide long-term impact. The intervention model that emerged from these considerations was based on engaging community leaders, providing educational and technical resources, and nurturing the acceptance by individual rural residents of responsibility for monitoring community mental health. This motif became a central theme in a strategy designed to facilitate culture change and acceptance of mental health as a community concern. It involved active engagement of community representatives in defining and implementing an intervention consistent with participatory action research as a means of empowering rural residents in monitoring and addressing sensitive health care issues. Given that many issues in rural health are difficult to address because of such sensitivity, the approach described is considered to have application in other contexts.     

论国家对未成年人监护的公权干预——以保障留守儿童的合法权益为视角

加强国家对未成年人监护的干预力度,是有效保障留守儿童合法权益的需要。在当前国际社会呈现未成年人监护公法化的发展趋势下,考察国家对未成年人监护公权干预的理论基础和社会基础,分析我国现行立法对未成年人监护公权干预之不足有重要意义。同时,可以借鉴法国、德国、日本、瑞士四国未成年人监护公权干预立法情况,提出区分亲权和监护、设立国家公权监护主体、设立未成年人监护监督机构等建议,以期完善我国未成年人监护的公权干预制度。     

学校欺负相关研究的回顾与社会学反思

对学校欺负相关研究的回顾发现,当前研究仍处于探索阶段,对于学校欺负核心概念仍然没有达成共识;理论研究处于"松散状态";现状研究对核心问题尚未探讨;研究方法与研究视角单一;干预策略本土化研究尚少。透过社会学视角,未来学校欺负研究应转向欺负行为背后,探讨谁在欺负与受欺负;明确学校欺负核心概念的内涵与外延;建立学术共同体提升理论研究与现状研究,尤其是对个案研究,在此基础上开展社会支持系统下的学校欺负干预实验,提升本土化研究水平。     

Parent adoption and implementation of obesity prevention practices through building children's asking skills at family child care homes

BackgroundEarly childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP’N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children’s asking skills for healthful home environmental change through curricular activities.ObjectiveTo evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH.MethodsFCCHs (n = 5 settings) and children (n = 25; aged 3−5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities.ResultsFCCH providers implemented 83%–100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06).ConclusionsIt is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.     

宁夏生态移民社会关系重构影响因素与干预策略研究

宁夏生态移民搬迁后,与他人生活空间上的接近和心理上的互相接纳为移民社会关系的重构提供了必要条件,移民逐渐拓展自己的社会关系网络。但在原居民主动排斥和生态移民自我封闭的双重因素影响下,移民社会关系重构仍面临着一定困难,需要通过强化移民心理干预、借助媒体争取社会支持、缓解公共资源竞争、改善移民生计资本等措施实施干预,帮助移民尽快重构社会关系网络,推动和谐移民社会的构建与发展。     

Mental health service navigation: a scoping review of programmatic features and research evidence

ABSTRACT

Service navigation is a care coordination approach that is designed to resolve barriers and facilitate access to needed services. Originating within primary and specialty health care sectors, navigation models have recently emerged to support engagement with mental health services. Presently little is known about the nature, extent, and research evidence for mental health service navigation programs. To address this gap in knowledge, this study undertook a scoping review to identify, describe, and appraise current models of mental health service navigation. Data sources included PsychINFO, Medline, CINAHL, and Google Scholar. Inclusion eligibility required studies to describe a study design, recruitment strategy, navigation approach, sample characteristics, and study outcomes. Searches were constrained to English language and published after January 1, 2000. Twenty-five studies met the inclusion criteria. Navigation programs targeted diverse populations and were delivered in-person, by telephone, and online. Navigators included peers, paraprofessionals, clinicians, teams, and web applications. Eleven studies reported results from randomized trials, remaining programs employed program evaluation, qualitative, or CBPR methodologies. Common features of navigation programs included engagement, assessment, service identification, referral, and monitoring/follow-up. Current evidence for mental health service navigation is promising, although additional rigorous randomized controlled trials are needed.     

残疾污名的研究进展与展望

残疾污名是针对残疾人负面的刻板印象而引发的偏见和歧视,其消极影响渗透残疾人个人生活和社会参与的诸多方面。现有研究对其成因的解释越来越注重社会文化背景因素。公众污名和自我感知污名是污名测量的主要内容,使用的方法以外显态度测量和内隐社会认知方法为主。当下残疾污名干预的研究主要围绕增加群际接触来改变公众对残疾群体的偏见,采用积极心理干预改变个体自我认知,通过融合教育塑造包容、共享的社会文化三个方面来进行。未来研究可以围绕污名影响的保护机制、残疾人内化污名的差异、残疾污名测量的优化、污名干预效果的评估及干预方式的改进等方面进行。     

Systematic dissemination of a preschool physical activity intervention to the control preschools

For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools that participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.