Public Health Asks of Community Psychology…

As the field of public health has increasingly recognized the social and behavioral aspects of the changing epidemiology of diseases and injuries, it has added social and behavioral scientists to the faculties of schools of public health and most federal and state public health agencies. Community psychology can play a crucial role in helping to bridge the dominant psychological theories with the family and community contexts in which individuals are conditioned and reinforced in their tendencies toward violent behavior. Public health asks of community psychology a helping hand in bridging the clinical endpoints of most NIH-sponsored behavioral research with the community endpoints of most CDC-sponsored programs such as injury control.     

Primary prevention of acculturative stress among refugees. Application of psychological theory and practice

Primary prevention in refugee mental health requires information from clinical, health, and cross-cultural psychology. Primary prevention's roots are in public health, which is distinguished by a communitywide perspective for addressing mental health concerns. This article summarizes research suggesting that refugees are an at-risk population, making them especially suitable for public health interventions. Research on stress and acculturation is highlighted, given its importance to prevention in refugee mental health. The opportunities for primary prevention programs and policies at 3 levels (i.e., local community, national, and international) are illustrated with case examples from both the United States and Canada. Prevention at the international level is highlighted by a World Health Organization Mental Health Mission to camps on the Thai-Cambodian border.     

What works in secondary schools? A systematic review of classroom-based body image programs

Governments, schools, and curriculum authorities are increasingly recognizing that body image during adolescence is a public health issue that warrants attention in the school setting. After 30 years of eating disorder prevention research, and given the current interest in this area, it seems timely to review the research on interventions to improve body image in schools. We reviewed universal-selective, classroom-based programs that have been conducted since the year 2000, among adolescents, and found 16 eligible intervention programs. Seven of these programs were effective in improving body image on at least one measure, from pre to post test, though effect sizes were small (d = 0.22–0.48). These effective programs were conducted among younger adolescents 12.33–13.62 years, and included activities focusing on media literacy, self esteem, and the influence of peers. Implications for school personnel and curriculum authorities are discussed, and we provide recommendations for a strategic approach to future research in this area.     

Before they're victims: Rethinking youth‐targeted relationship abuse prevention in Australia

Intimate partner abuse (or relationship abuse) against women is recognised as a major public health issue. A number of relationship abuse prevention programs targeted at youth have been developed in Australia. These programs are generally aimed at changing attitudes, and take the stance that girls should not be viewed as being responsible for protecting themselves against violence. In this paper it is argued that the current, dominant focus on physical violence, over other forms of relationship abuse, limits the potential effectiveness of programs that might otherwise help young people to resist the development of abusive dynamics. It is also argued that programs that presume a victim status for girls and a perpetrator status for boys are both inconsistent with contemporary evidence and unlikely to empower young people at risk of chronic perpetration and/or victimisation to avoid such outcomes. A dyadic slippery slope model of chronic relationship abuse is proposed and new directions for prevention research in this area are suggested.     

The Diffusion of Youth-Led Participatory Research in Urban Schools: The Role of the Prevention Support System in Implementation and Sustainability

This article discusses the dissemination of a process of youth-led participatory research in urban secondary schools within the Interactive Systems Framework for Dissemination and Implementation (ISF) developed in collaboration with the CDC and its university partners (Wandersman et al. American Journal of Community Psychology, 41(3-4) 2008). The focus here is on the development of the Prevention Support System with respect to general and innovation-specific capacity building. The specific process under study involves youth-led needs assessment and research to inform the planning of prevention programs and policies to address students' health and developmental needs. The article first briefly describes the youth-led research process, its potential benefits, and a case example in two urban secondary schools. It then describes challenges and responses in providing support for the diffusion of this model in 6 secondary schools. The settings are urban public schools with a majority of students of color from diverse ethnic groups: Asian-American, Latino, and African-American. This project constitutes a collaborative partnership with a university school of public health and community-based organizations (CBOs) to build capacity for long-term, sustainable implementation of this innovative process within the local school system. The perspectives of the university-based researcher and the CBO partners on the development and effectiveness of the Prevention Support System are presented.     

School Climate and Implementation of a Preventive Intervention

Although there has been wide dissemination of research-based psychosocial prevention programs, a similarly strong research base to guide program implementation has been lacking. Program implementation has been particularly difficult for schools, due partly to insufficient understanding of how school ecologies interact with these programs. This study examined the effects of multiple dimensions of school climate on level and rate of change in implementation of a violence prevention intervention across three school years. Using multi-level modeling, the study found that teacher-reported support between staff and among teachers and students predicted higher average levels of implementation. Teacher-reported administrative leadership predicted greater growth in implementation across 3 years. Findings offer implications for an ecological model of program implementation that considers school-level contextual effects on adoption and sustainability of new programs in schools. The Metropolitan Area Child Study Research Group is a collaboration of (in alphabetical order) Leonard Eron, University of Michigan; Nancy Guerra, University of California, Riverside; David Henry, University of Illinois at Chicago; L. Rowell Huesmann, University of Michigan; Patrick Tolan, University of Illinois at Chicago; and Richard VanAcker, University of Illinois at Chicago.     

Family life education in Chicago schools: a study of programs implemented by nonschool agencies

Although nonschool agencies provide important complementary courses on family life education (FLE) in public and private schools, little is known about the scope and content of such curricula. This paper describes a study documenting the types of school-based family life education programs implemented by nonschool agencies in Chicago. Semistructured telephone interviews were conducted with professionals from 26 health care and social service agencies, identified as offering FLE courses in the metropolitan area. The surveyed organizations provided FLE programs in almost 100 public and private schools in Chicago during the 1982-83 and 1983-84 school years. Most programs were relatively short, utilized few interactive teaching techniques (e.g., role-playing, exercises), covered a wide variety of topics, and were integrated into other curricula units rather than implemented as separate courses. Agency personnel covered topics viewed as important by school administrators and teachers, most notably information on contraception and sexual decision making.     

Adolescent pregnancy: implications for prevention strategies in educational settings

Over 1 million teenagers become pregnant each year in the U.S. The most alarming increases have occurred among adolescents who are younger than 15 years of age. Variables strongly associated with teen pregnancy include minority status, low socioeconomic status, low academic achievement and occupational aspirations, and growing up in a single- parent household. A majority of teenage pregnancies are unintended, and pregnancy is the largest contributor to school dropout rate for U.S. adolescent females. During pregnancy, adolescent mothers suffer higher rates of health complications, and after childbirth they receive less education, have more children, and are more likely to be dependent on welfare. Psychologists employed in educational settings are in a unique position to be involved in adolescent pregnancy prevention efforts, and schools are increasingly considered to be appropriate environments for this purpose. Progressive school-based family planning programs have been established by the St. Paul/Ramsey Medical Center in St. Paul, Minnesota, and by the Johns Hopkins University Medical Center in Baltimore, Maryland. Both programs emphasize the distribution of contraceptives. An increasing number of school programs focus their efforts on helping adolescents become more responsible in their approach to sexual relationships, though they do not distribute contraceptives. A number of innovative community-based programs have also been formed that utilize multiple strategies to provide positive alternatives to pregnancy. Before setting up teen pregnancy prevention programs, school psychologists should try to learn from the lessons offered by established programs. They should also consult with teachers, administrators, students, and parents, and they should decide what instructional approaches are appropriate for their own situations.     

The relationship between research and design of AIDS prevention program

The global threat of AIDS requires massive public educational campaigns that employ social and behavioral sciences such as psychology, sociology, and anthropology because sexual behavior possesses a social dimension. Research is concerned with what stimulates behavioral change, what are the prerequisites of learned behavior, and what enables personal control over the environment and future. Educational programs designing strategies for AIDS prevention require social and behavioral science content and input. Interdisciplinary provides general principles with psychological, social, and cultural aspects of human behavior. Without knowledge about psychological processes (thinking, perception, speech, aspects of personality, and interactive behavior) and social processes (economic conditions, social networks, and resources) which are implicated in health problems and also in AIDS, these educational programs cannot produce credible results. These programs and their subsequent implementation require their application in practice in a systemic and consistent fashion. Evaluations are also needed to make sure that the applied processes for behavioral change conform to methodological criteria that ensure their effectiveness. These types of studies are more complex than pure AIDS research which is aimed at finding a cure.     

Inaccuracy of family health information: implications for prevention

There is a conflict between the rest of the family's right to medical confidentiality and the individual's need to know about health risks for which she or he may show increased susceptibility. Research has shown increased risk in the development of a variety of disorders for those with a positive family history. In many cases the familial predisposition appears to interact with alterable environmental factors (e.g., diet). This suggests a need for targeting of preventive efforts at those at highest risk. As success of early detection and prevention programs increase, there will appear an increased need for accurate family health history information as an aid in early identification. Research on accuracy of family health information (Hastrup, Hotchkiss & Johnson, this issue) shows extensive inaccuracy. Implications of inaccurate information for self-directed and public health prevention are described. Research and progress in prevention will likely accelerate, continuing to alter the traditional view from one of the individual with a personal health history to one in which individuals share a familial (genetic + shared environment + similar behavior patterns) risk with others, who may also benefit from preventive programs.     

Development of Family Therapy in Ireland

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.     

Introduction to the special section on dissemination: dissemination research and research dissemination: how can we close the gap?

One of the greatest challenges facing health promotion and disease prevention is translating research findings into evidence-based public health and clinical practices that are actively disseminated and widely adopted. Despite the tremendous strides made in developing effective disease prevention and control programs, there has been little study of effective dissemination of evidence-based programs to and adoption by community, public health, and clinical practice settings. This special section provides a venue in which to highlight exemplary dissemination research efforts while also identifying limitations in research to date and framing important future research questions. This issue establishes a resource for investigators interested in dissemination research, with relevance to health psychology. In this sense, it can serve as a benchmark by which to examine subsequent progress. The 6 articles reflect the state of the science in dissemination research for the promotion and adoption of health behavior change interventions.     

The future of genetics in public health

During the 1980s, we have witnessed an erosion in federal and state funding for the coordination of genetic services in state health departments. As this decade begins, the federal budget for the support of the national genetics program is less than half of the total available in 1980. In addition, priorities in state maternal and child health programs have changed, and genetic services have often received lower rankings aside of programs to improve prenatal care and to address problems such as teenage pregnancy. Clearly we are at a critical point for the future of genetics programs in the public health arena. Fortunately, despite the problems with funding and priority setting, important coalitions have been built during the past decade and continued advances in medical genetics have made it difficult for public health officials to ignore the potential impact of genetic services. Council of Regional Networks for Genetic Services (CORN) and the regional genetic services networks have provided opportunities for interaction and coordination between genetic services providers and public health officials that had not been available to any significant extent. The full potential of these coalitions has yet to be realized, but efforts in data collection, development of national guidelines and standards, and information sharing and networking have already had an influence on state genetic services programs. Continuing research on the genetics of chronic diseases and the influence of discoveries in molecular genetics will undoubtedly broaden the current scope of state public health programs in genetics, which all too often have been limited to newborn screening and administration of grants for genetic services. The regional and national genetic services programs should be strengthened and appropriate training programs should be developed in Schools of Public Health to provide the expertise and leadership that will be needed to guide the future of genetics in public health.     

Evidence-based practices project for suicide prevention

Suicide continues to be a serious public health problem. In response to this problem, a myriad of suicide prevention programs have been developed and employed across the United States. Unfortunately, the effectiveness of many of these programs is unknown because they have not been evaluated using rigorous methods. The Evidence-Based Practices Project (EBPP) for suicide prevention was created in 2002 to identify and promote evidence-based suicide prevention programs. In this paper the process and outcomes of the initial EBPP project within the context of the broader evidence-based movement are described, and the EBPPs creation of a best practice registry for suicide prevention is previewed.     

Expand Positive Learning Opportunities and Results

Students with emotional disturbance (ED) experience the worst outcomes of any group of pupils in the public schools. We suggest that at least part of the reason is that the services they receive while in school are inadequate to meet their needs. Although applied research has resulted in a number of effective practices, they are not used in the majority of America's schools. Barriers to the implementation of such practices are described, and recommendations for improving programs and outcomes for these students are offered.     

Genetics,Faith, and Responsibility

The Battle of Dover is now concluded; and Charles Darwin's theory of evolution has won the legal day. The Theory of Evolution in the Darwainian and neo-Darwinian form is a very fertile theory; it generates hypotheses and research programs that lead to new knowledge. Even as a secular pursuit of knowledge, Christians appreciate science.

What the Christian community cannot tolerate is second-rate science; and it especially eschews pseudo-science. We ask for a general commitment; support the best science in our schools and laboratories as an expression of our Christian faith. In light of the public controversy regarding alternatives to teaching Darwinian science in our public schools, we offer six recommendations.     

A framework for assessing program institutionalization

This article presents a framework for assessing the institutionalization of programmatic innovations in nonprofit community agencies and in schools. Institutionalization is the attainment of long-term viability and integration of innovations in organizations. Institutionalization is often characterized as the final stage in an innovation diffusion process. The framework was derived from a qualitative study of ten health promotion programs that were innovations in their host organizations. The framework is a two dimensional matrix: one dimension consists of organizational subsystems; the other consists of levels of institutionalization termed passages, routines, and niche saturation. The cells of the matrix are the basis for assessing program institutionalization. Robert M. Goodman is a research assistant professor in the Department of Health Behavior and Health Education at the University of North Carolina's School of Public Health. Currently, Dr. Goodman directs a four-year intervention study on the dissemination of tobacco prevention curricular funded by the National Cancer Institute. Allan Steckler is an associate professor in the Department of Health Behavior and Health Education at the University of North Carolina's School of Public Health. Dr. Steckler is also the principal investigator of the National Cancer Institute tobacco prevention study.     

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.