An ESID Case Study at the Federal Level

The D (dissemination) phase of the ESID model has been often overlooked in our efforts to create innovative and widespread social change. The process of replicating successful social innovations is both a prerequisite for dissemination (in order to assess the consistency of effects) and an obvious outcome of a successful dissemination effort. Fidelity, the extent to which a replicated program is implemented in a manner consistent with the original program model, is an important dimension of replication. This study was designed to provide empirical data related to three questions. Can complex social programs be implemented with fidelity? How much fidelity is appropriate or desired? What are the organizational dynamics of adoption with fidelity? Data were collected from grantees of a national replication initiative funded by the Center for Substance Abuse Prevention. Data suggest that high fidelity can be achieved, at least in the context in which programs are mandated to do so as part of the funding agreement and are given technical assistance in achieving fidelity. Secondly, programs perceived high fidelity as having positive effects on the program and its participants, a finding consistent with a limited assessment of the relationship of program outcomes and fidelity. Finally, much was learned about the human and organizational dynamics of replicating with fidelity. Implications for policy and direction regarding replication are discussed.     

Twelve steps to heaven: Successfully managing change through developing innovative teams

In this article we propose that work teams implement many of the innovative changes required to enable organizations to respond appropriately to the external environment. We describe how, using an input?–?process?–?output model, we can identify the key elements necessary for developing team innovation. We propose that it is the implementation of ideas rather than their development that is crucial for enabling organizational change. Drawing on theory and relevant research, 12 steps to developing innovative teams are described covering key aspects of the team task, team composition, organizational context, and team processes.     

Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada

The scaling out of Housing First (HF) programs was examined in six Canadian communities, in which a multi‐component HF training and technical assistance (TTA) was provided. Three research questions were addressed: (a) What were the outcomes of the TTA in terms of the development of new, sustained, or enhanced programs, and fidelity to the HF model? (b) How did the TTA contribute to implementation and fidelity? and (c) What contextual factors facilitated or challenged implementation and fidelity? A total of 14 new HF programs were created, and nine HF programs were sustained or enhanced. Fidelity assessments for 10 HF programs revealed an average score of 3.3/4, which compares favorably with other HF programs during early implementation. The TTA influenced fidelity by addressing misconceptions about the model, encouraging team‐based practice, and facilitating case‐based dialogue on site specific implementation challenges. The findings were discussed in terms of the importance of TTA for enhancing the capacities of the HF service delivery system—practitioners, teams, and communities—while respecting complex community contexts, including differences in policy climate across sites. Policy climate surrounding accessibility of housing subsidies, and use of Assertive Community Treatment teams (vs. Intensive Case Management) were two key implementation issues.     

Development of the HIV/AIDS Stress Scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS; hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS were interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms, reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal, and differs from controllability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.     

Stability and Change in Psychosocial Resources during Caregiving and Bereavement in Partners of Men with AIDS

ABSTRACT This study examines the effects of caregiving and bereavement on psychosocial resources in HIV + and HIV? caregivers of men with AIDS. We explored three hypotheses regarding these effects: the “wear and tear” hypothesis, which asserts that the chronic stress of caregiving and bereavement diminishes resources; the “enhancement” hypothesis, which asserts that caregiver resources may increase in response to increased demands; and the “personality” hypothesis, which asserts that psychosocial resources reflect stable personality characteristics. We addressed four questions: (a) What are the effects of caregiving on resources? (b) How do these resources vary by the imminence of the partner's death? (c) What is the effect of the partner's death on these resources? and (d) How does the caregivers' HIV serostatus influence the effects of caregiving and bereavement on resources? Support for the personality hypothesis predominated, with some support for the wear and tear hypothesis, depending on the resource in question. In general, HIV seropositivity did not put people at additional risk for resource depletion.     

Reliability and Validity of a Treatment Fidelity Assessment for Motivational Interviewing Targeting Sexual Risk Behaviors in People Living with HIV/AIDS

This study psychometrically evaluates the Motivational Interviewing Treatment Integrity Code (MITI) to assess fidelity to motivational interviewing to reduce sexual risk behaviors in people living with HIV/AIDS. 74 sessions from a pilot randomized controlled trial of motivational interviewing to reduce sexual risk behaviors in people living with HIV were coded with the MITI. Participants reported sexual behavior at baseline, 3-month, and 6-months. Regarding reliability, excellent inter-rater reliability was achieved for measures of behavior frequency across the 12 sessions coded by both coders; global scales demonstrated poor intraclass correlations, but adequate percent agreement. Regarding validity, principle components analyses indicated that a two-factor model accounted for an adequate amount of variance in the data. These factors were associated with decreases in sexual risk behaviors after treatment. The MITI is a reliable and valid measurement of treatment fidelity for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.     

The Role of the Black Church in HIV Prevention: Exploring Barriers and Best Practices

Black people have the highest rate of HIV/AIDS infection in the USA, and they are less likely to access quality physical and mental healthcare. To address these disparities as outlined in the National HIV/AIDS Strategy, there is a need for culturally congruent, innovative approaches to HIV/AIDS prevention. The first multi‐denominational national study of Black faith leaders was conducted utilizing focus groups that were held in 11 US cities. The 265 participants were faith leaders who reported involvement in such prevention practices as sponsoring HIV/AIDS workshops, integrating HIV/AIDS messaging in the worship service, hosting HIV/AIDS screenings, distributing written materials about HIV/AIDS through the bulletin or flyers, pastoral counselling, advocating for policies that provide quality healthcare to the community and disseminating HIV/AIDS prevention messages through new media such as the Church website. These findings, including attention to barriers to engagement, provide insight into innovative practices that can be integrated into faith‐based HIV/AIDS prevention programming. Copyright © 2016 John Wiley & Sons, Ltd.     

Assessment of the Fiji-Based Condom Social Marketing (CSM) Program

This paper discusses the results of a systematic review of the Condom Social Marketing (CSM) program which was implemented in Fiji by a non-profit organization for a period of 5?years. The CSM program was introduced during a decade when Fiji was recording an escalating number of new Human Immunodeficiency Virus (HIV) infections. The aim of the program was to increase the awareness and utilization of safe sexual practices among the most vulnerable group??the youths??which had reported the highest incidences of sexually transmitted infections. Program assessment revealed that the CSM program had reportedly increased the acceptability, accessibility, and usage of their TRY TiME condoms in Fiji. We conducted a survey on a sample of sexually active people during January?CFebruary 2009 to examine their prevailing level of knowledge about HIV/AIDS, sexual behavior/practices, and risk perception. The results showed that, despite the high level of awareness about HIV/AIDS among survey participants, people did not consistently practice safe sexual behavior and commonly identified themselves as at low risk of acquiring HIV. This paper concludes that more extensive behavior change programs are needed in order to influence people to change their risky sexual practices and reassess their risk perceptions.     

Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions

Assessing treatment fidelity is a core methodological consideration in the study of treatment outcome; it influences both the degree to which changes can be attributed to the intervention and the ability to replicate and disseminate the intervention. Efforts to increase access to evidence-based psychological treatments are receiving unprecedented support; but pressures exist to adapt treatments to service settings, running the risk of compromising fidelity. However, little evidence is available to inform the necessary conditions for the transportation of interventions to service provision settings, and the degree to which fidelity is even evaluated or emphasized in dissemination and implementation programs varies dramatically. Moreover, adaptation is associated with several benefits for dissemination efforts and may address relevant barriers to adoption. A particularly promising strategy for maximizing the benefits of both fidelity and adaptation is the use of transdiagnostic interventions. Such treatments allow for greater flexibility of the pacing and content of treatment, while still providing structure to facilitate testing and replication. Preliminary evidence supports the efficacy of this strategy, which may be particularly conducive to dissemination into service provision settings. At this time, further research is needed to evaluate the relationships among fidelity, adaptation, and outcome, and to determine the potential for transdiagnostic treatments to facilitate dissemination.     

Saints and Sinners: Training Papua New Guinean (PNG) Christian Clergy to Respond to HIV and AIDS Using a Model of Care

Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model “Church’s Response to HIV and AIDS in a Care Continuum” was developed to assist the training. This paper discusses the model and the lessons learned.

AIDS prevention for intravenous drug users in the community: Street-based education and risk behavior

Conducted a study of behavior change associated with a street-based AIDS education project targeted to intravenous (IV) drug users in San Francisco. Two cross-sections were sampled from drug detoxification clinics and street locations in 1986 (n = 438) and 1987 (n = 623). Significant increases were reported in the percentage of IV drug users who used bleach to decontaminate syringes, who did not share needles in past year, and in condom use. A significant reduction in an index of the number of needle-sharing partners was reported. Respondents ranked treatment program as most important source of AIDS information prior to implementation of the program, and ranked outreach workers as most important after implementation. Findings suggest that this community-based outreach program had at least some impact on knowledge about AIDS and may have led to reductions in behaviors known to transmit HIV.     

“When Will Your Program Be Available in Spanish?” Adapting an Early Parenting Intervention for Latino Families

This paper describes the Spanish adaptation of PACE—Parenting Our Children to Excellence. Successfully offered in preschools and daycare centers since 2002, PACE is a research-based preventive intervention to support families in their parenting task through discussions and activities that address practical childrearing issues and promote child coping-competence. Developed in response to community calls, the new program is known as CANNE –Criando a Nuestros Niños hacia el Éxito. The paper makes the processes linking original and adapted versions explicit by accounting for the conceptual and practical decisions that were made as CANNE was being developed. We begin by summarizing the challenges of adapting and translating a behavioral intervention, and by describing the coping-competence model that informs both versions of the program. We turn then to a detailed account of the adaptation itself and of its results. Specifically, we describe: (a) the consultation process at the origin of this adaptation, (b) the adaptation of the manual and the steps taken to establish the extent to which the English and Spanish versions correspond (adaptation fidelity), and (c) the translation of the manual and the cross-language comparison of measures to demonstrate that they yield comparable data when administered in English and Spanish.     

The Making of a Sexual Being in Ghana: The State,Religion and the Influence of Society as Agents of Sexual Socialization

With the aim of generating in-depth information on society’s expectations and views on sexual expression in Ghana, we present findings on what was expected of the state, religion, and the influence of society on sexual socialization in Ghana. As a society, our need to break the culture of silence about sex cannot be overemphasized. Our study is important against a background that in Sub-Saharan African, HIV and AIDS is mostly spread through sexual intercourse, and that the region bears a disproportionate large percentage of the world’s HIV and AIDS burden. Although Ghana has a 2009 adult (15+ years) prevalence rate of 1.6% and a prevalence rate of 1.9% for persons 15–49 years old, some regions and sentinel sites show rather high rates, making HIV and AIDS issues of high concern nationally. Respondents from the general public, key informants and special groups across all three ecological zones of Ghana were purposively selected. All the interviewees agreed that in Ghana fidelity in all sexual relationships is highly valued and expected. However, there is gender discrimination in the application of such social norms of fidelity, in favor of males. Amongst the three agents of socialization studied, religion seemed to exert the most influence. Modernity interwoven with Christianity seem to have taken a great toll on such norms of sexual socialization.     

Job demands,job resources and innovative work behaviour: a European Union study

This study aims to investigate the relationship between several job design variables and innovative work behaviour (IWB). Guided by the Job Demands Resources model, the aim was to evaluate the relationship between work demands (time constraints), resources (autonomy and social support), and other work factors (task monotony, complexity, and dealing with unforeseen circumstances) with idea generation and idea implementation behaviours in a sample of 12,924 participants from the 27 European Union member states in 2010. We also wished to investigate if individual IWB, at the country level, is associated with country innovative performance (an aggregate of process/product and marketing/organizational innovation). We employed a multilevel generalized structural equation model to test our hypotheses. In our final model autonomy, manager encouragement and dealing with unforeseen problems showed the highest positive relationship with idea generation and idea implementation. Conversely, monotonous tasks and working at high speed were negatively related to IWB. Furthermore, we have found strong indications that country-level IWB positively relates to the odds of a country scoring higher on the aforementioned innovation indicators. Between-country unexplained variance in IWB was reduced from 17.1% in our initial model, to 1.9% in our final iteration. Limitations, implications and suggestions for future research are discussed.     

Responsibility judgments and responses to people living with AIDS in China: testing an attributional perspective

With one in five individuals in the world living in China, there is an urgent need for HIV prevention and understanding HIV/AIDS stigma in China. This study applies an attributional analysis to Chinese students' responses to AIDS, examining effects of attributions of causal controllability for HIV infection on reactions to people living with HIV/AIDS. Students (n = 309) read one of two scenarios describing an AIDS patient and manipulating controllability of AIDS onset. Controllability of AIDS onset contributed to responsibility judgments, less positive affect, and lower desires to personally interact with the patient. Responsibility judgments predicted interaction wishes directly and indirectly through positive affect. Results provide support for Weiner's interpersonal attributional model. Implications for responses to AIDS in China are discussed.     

Mapping an HIV/STD prevention curriculum for Zambian in-school settings

HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.     

论艾滋病人及艾滋病毒感染者权利与义务的平衡

《艾滋病防治条例》,对于艾滋病病毒感染者和艾滋病人的权利和义务进行了精巧的设计。本着保护人权和预防疾病的需要,对艾滋病病毒感染者和艾滋病人在医疗活动、人身权益和社会经济各方面的权利与义务都进行了很好的平衡。     

Preschool children's development in classic Montessori, supplemented Montessori, and conventional programs

Research on the outcomes of Montessori education is scarce and results are inconsistent. One possible reason for the inconsistency is variations in Montessori implementation fidelity. To test whether outcomes vary according to implementation fidelity, we examined preschool children enrolled in high fidelity classic Montessori programs, lower fidelity Montessori programs that supplemented the program with conventional school activities, and, for comparison, conventional programs. Children were tested at the start and end of the school year on a range of social and academic skills. Although they performed no better in the fall, children in Classic Montessori programs, as compared with children in Supplemented Montessori and Conventional programs, showed significantly greater school-year gains on outcome measures of executive function, reading, math, vocabulary, and social problem-solving, suggesting that high fidelity Montessori implementation is associated with better outcomes than lower fidelity Montessori programs or conventional programs.     

Optimizing Contingency Management With Methamphetamine-Using Men Who Have Sex With Men

Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011–October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10–34) that were nonreactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.