A Critical Analysis of Approaches to the Development of Preventive Interventions for Subcultural Groups

The ultimate success of preventive interventions relies on their ability to engage and influence the growing presence of subcultural groups. To encourage and guide the development of effective preventive intervention for subcultural groups, four approaches are described, illustrated, and critiqued with respect to their considerations of cultural fit, reach, efficacy and adoption. Those approaches are (a) the prevention research cycle, (b) cultural adaptations of evidence-based interventions, (c) investigator-initiated culturally-grounded approaches, and (d) community-initiated indigenous approaches. Special attention is given to recent advances in the specification of stages in the cultural adaptation of interventions. The paper closes with some conclusions and topics in need of greater attention.     

Multicultural Issues in the Delivery of Group Interventions

Innovative preventive interventions are increasingly delivered in small group settings to children in school who are at risk for a variety of negative outcomes. In addition to reducing children's risk, these interventions present the possibility of enhancing students' awareness and understanding of cross-ethnic peers. To be effective with children from diverse ethnic backgrounds, these programs must examine their underlying assumptions regarding the definitions of social competence and methods of behavior change, tailor the program for each ethnic group served, and examine the impact of the interventions across different domains of the children's life.     

The Role of Hope in Preventive Interventions

Preventive interventions have historically focused on reducing risk factors for psychological difficulties. Recent research has found that prevention programs are more effective when they enhance strengths, rather than merely reduce risk factors. An increased focus on strengths is consistent with a positive psychology perspective. In fact, hope has been found to be a central human strength in the positive psychology literature. Hope is associated with better adjustment, lower anxiety, lower depression, greater academic performance, and greater athletic achievement. In addition, individuals with high hope are able to respond more adaptively after traumatic events and physical illnesses. Intervention studies have shown that hope can be increased in individuals, and hope has been shown to predict more positive outcomes in psychotherapy. Future directions for research are outlined, including investigating hope as a preventive intervention for members of stigmatized groups, including ethnic minorities and lesbian, gay, and bisexual individuals.     

Tobacco, Drug, and HIV Preventive Media Interventions

Media-based health promotion interventions can reach large segments of the population and lower barriers to participation in programs. By collaborating with media specialists, we can develop interventions that might be broader, more publicized, and ultimately more likely to change behaviors and attitudes within the community. The present paper describes a series of media interventions involving smoking cessation, drug abuse prevention, stress reduction, weight control, and HIV/AIDS prevention. The process by which I became involved in these interventions is discussed, and the implications of developing these types of large-scale behavioral interventions are discussed.     

Developing a Community Science Research Agenda for Building Community Capacity for Effective Preventive Interventions

Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available (e.g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research—one based in Community Science—is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level.     

Delivery of Psychological Interventions by Clinical Neuropsychologists: Current Practice in Australia and Implications for Training

Clinical neuropsychologists are increasingly involved in delivering psychological interventions to people with neurological conditions. This is a key competency for accredited Australian postgraduate neuropsychology courses; however it is not clear how effective courses are in preparing neuropsychologists to deliver interventions. The study aims were to (a) determine the frequency and confidence with which particular types of interventions are delivered by Australian neuropsychologists, (b) examine the availability of opportunities to deliver interventions on clinical placements, (c) identify barriers to delivering interventions in current workplaces; and (d) determine which factors influence the frequency and confidence with which neuropsychologists deliver interventions. An online survey was completed by 114 participants who had graduated from a postgraduate neuropsychology program. Results indicated that respondents delivered different intervention types with varying frequency. They reported limited opportunities to practice these interventions on placements. The majority wanted to be doing more interventions, with lack of time, resources, and adequate training being the major barriers. There were several significant relationships between the frequency and confidence with which respondents delivered interventions and the perceived quality of their postgraduate training. These results highlight the need to consider appropriate postgraduate training options in delivery of interventions, including increasing opportunities to practice interventions on placements.     

Sit Down and Play: A Preventive Primary Care-Based Program to Enhance Parenting Practices

The primary care office offers an ideal setting to encourage parenting behaviors that promote early childhood development. We conducted a pilot study to establish feasibility and acceptability of Sit Down and Play (SDP), a brief primary care-based program to facilitate positive parenting behaviors through take-home play activities. A prospective 1-month study was conducted in an urban primary care clinic. SDP was administered to 30 caregivers of 6–12 month-old children while they waited for their well-child appointment. Caregivers completed baseline and 4-week follow-up surveys. Open-ended interview questions regarding acceptability and usefulness of SDP were administered and analyzed using content analysis. Parenting practices related to child development were measured with standardized measures and changes analyzed using paired t-test and linear mixed effects models. Most caregivers were mothers (90?%) and non-white (97?%); the majority of children received Medicaid (87?%). There were significant increases in parental reports of practices related to child development (p?<?0.001), including families who reported low incomes (i.e. <$25,000) and received a high-school education or less (p?=?0.001). Four main themes emerged from the open-ended interview data: (1) importance of play, (2) noticing a change in their child, (3) reinforcing existing positive parenting behaviors, and (4) satisfaction with the program. This preliminary study suggests that SDP is a feasible and potentially beneficial program that can be delivered during pediatric well-child visits. Further studies are needed to determine the effectiveness of SDP on parenting behaviors and developmental outcomes.     

Using Qualitative Methods to Develop Contextually Relevant Measures and Preventive Interventions: An Illustration

Qualitative methods were used to develop a contextually relevant quantitative measure of parenting stress and inform the design of family-focused interventions aimed at preventing adolescent mental and behavioral health problems. The study focused on the experiences of low-income one- and two-parent families representing three ethnic groups (Mexican, African, and European Americans) living in low-income neighborhoods in a large Southwestern city. This report describes the place of this study in a broader program of prevention research, the qualitative methods and data analysis procedures employed, and how the results were used to develop a new measure of parenting stress and inform future program design. The report also includes reflective comments on the methods used and lessons gained.     

Military and Veteran Family-Centered Preventive Interventions and Care: Making Meaning of Experiences Over Time

This commentary discusses key themes in four conceptually related papers in this special issue on military families. Individually, the papers highlight the importance of the experiences of young children, the vital role of family narratives, the need for effective communication in families with a combat-injured member, and the need to understand the many dimensions of grieving and loss. Taken together, they compellingly make the case for family-centered care approaches and interventions. They also emphasize the need for families to understand and make meaning together of the experiences they have undergone and that this is a long-term, ongoing, dynamic, and interactive process.     

Non-pharmacologic Interventions for CFS: A Randomized Trial

Non-pharmacological behavioral treatments for CFS have been suggested as promising. These trials have tested protocols composed of behavioral, cognitive and cognitive–behavioral interventions but there have been few efforts to differentially evaluate their outcomes. The primary purpose of the current study was to evaluate the effectiveness of nurse delivered non-pharmacologic interventions. In the present study, 114 participants diagnosed with CFS were randomly assigned to four 6-month interventions. The interventions were: cognitive–behavior therapy, cognitive therapy, anaerobic activity, and a relaxation control group. The study found that these interventions led to increases in several areas of functioning, with more consistent changes occurring among those participants in the cognitive condition. For the 25 variables in this study, significant change occurred for 28%, 20%, 16%, and 12% of the variables for the cognitive, cognitive behavior therapy, anaerobic activity, and relaxation conditions, respectively. However, the majority of participants continued to be diagnosed with CFS following the treatment trial. Implications of these findings are discussed.     

五种干预措施对癌症儿童主要照顾者心理韧性影响的网状Meta分析

采用网状Meta分析评价不同干预措施对癌症儿童主要照顾者心理韧性的影响。检索国内外数据库自建库至2021年8月公开发表的癌症儿童主要照顾者心理韧性干预的相关文献,共纳入6项研究,涉及5种干预措施,合计327例癌症儿童主要照顾者。研究结果表明,自我表露干预（MD=29.08,95%CI：16.35～41.24）、同伴教育干预（MD=23.58,95%CI：9.80～37.43）与常规护理相比有统计学意义（P＜0.05）,其排序的优劣顺序为：自我表露干预、同伴教育干预、同伴支持干预、自我同情训练、常规护理、压力管理干预。目前证据表明,自我表露干预可能是提高癌症儿童主要照顾者心理韧性的最优干预措施,但还需大样本临床研究证实。

     

Proximal Impact of Two First-Grade Preventive Interventions on the Early Risk Behaviors for Later Substance Abuse, Depression, and Antisocial Behavior

We assessed the immediate effects of two universal, first-grade preventive interventions on the proximal targets of poor achievement, concentration problems, aggression, and shy behaviors, known early risk behaviors for later substance use/abuse, affective disorder, and conduct disorder. The classroom-centered (CC) intervention was designed to reduce these early risk behaviors by enhancing teachers' behavior management and instructional skills, whereas the family-school partnership (FSP) intervention was aimed at improving parent-teacher communication and parental teaching and child behavior management strategies. Over the course of first and second grades, the CC intervention yielded the greatest degree of impact on its proximal targets, whereas the FSP's impact was somewhat less. The effects were influenced by gender and by preintervention levels of risk. Analyses of implementation measures demonstrated that greater fidelity to the intervention protocols was associated with greater impact on behavior ratings and on achievement scores, thus providing some evidence of specificity in the effect of the interventions.     

Behavioral Health Interventions Being Implemented in a VA Primary Care System

The integration of behavioral health and primary care has received much attention in the literature. Behavioral health providers (BHPs) in integrated settings are faced with different treatment constraints than those who work in specialty mental health. The existing literature focuses on what BHPs should do in primary care settings; however, little research exists specifying what BHPs are actually doing. This study provides a glimpse into what types of interventions BHPs are using, and what types of patients they are seeing, in primary care. A chart review was conducted of patients (N?=?180) seen by BHPs in five Veterans Affairs primary care clinics. Depression was the most common diagnosis, while less common presenting problems included substance abuse/dependence, psychosis, and bipolar disorder. Common interventions used were medical management, psycho-education, elements of cognitive-behavioral therapy (CBT), and supportive psychotherapy. Future research should examine the efficacy of brief interventions in primary care settings.     

Interventions for Midlife Smoking Cessation: A Literature Review

Midlife smoking continues to be a problem in Australia, with substantial personal, social, and financial costs. Yet the specific characteristics and needs of this group have been largely overlooked. Here we review the literature for the purposes of (1) profiling the characteristics of midlife smokers and (2) assessing the effectiveness of interventions for this group. This review shows midlife smokers differ from younger smokers in important ways: they underestimate the costs of smoking and overestimate the benefits, and are less confident in their ability to quit. The few studies investigating age‐tailored interventions have shown these to be effective in reducing midlife smoking. Still, research in this area is limited, with only one study conducted during the past decade that investigated smoking interventions for those in midlife. Clearly there is a need for smoking cessation interventions for midlife smokers that are tailored to the specific beliefs and needs of this unique group. Future research should focus on establishing the best methods for interventions for those individuals who are resistant to earlier interventions and still continue smoking into midlife. Interventions may benefit from incorporating recent evidence about the less obvious costs associated with midlife smoking, including later‐life neurological disease.     

Implementing Family-Centered Interventions Within the Public Middle School: Linking Service Delivery to Change in Student Problem Behavior

The Adolescent Transitions Program is a family-centered intervention strategy designed to reduce problem behavior and prevent drug use within a public school environment. A parent consultant within a Family Resource Center (FRC) provided universal, selected, and indicated interventions that enhanced and supported positive parenting practices known to serve as protective factors. Implementation of the 3-year FRC model involved 584 students and their families in 4 middle schools. Analyses focused on the dynamics and effects of parent consultant activities and services. Differences in school “adoption” of the FRC services were found to be a function of both passage of time and school environment. Despite significant variation in implementation across schools, FRC services significantly reduced the growth in problem behavior over the course of the middle-school years. The implications of these findings for dissemination of empirically supported, school-based, family-centered interventions are discussed.     

A Systematic Framework for Integrating Psychological Evaluations and Interventions

A systematic framework for an integrative approach to psychological evaluations and interventions is proposed based on the executive system model of intelligence, the transactional processes of stress and coping, and the field properties of the personal domain. The executive system of intelligence is a comprehensive model that helps to explain the active components of various types of psychotherapies. We are proposing that psychotherapies facilitate clients' uses of their executive functions to develop coping strategies in their transactions with the environment and the events in their life space. A clinical case is presented to illustrate our systematic approach to psychological evaluation and intervention.