Clergy Wellness: An Assessment of Perceived Barriers to Achieving Healthier Lifestyles

This study sought to obtain a better understanding of how clergy view their health and to investigate their self-reported health status. Additionally, this study sought to explore personal and professional barriers among clergy to living a healthier life. An electronic 32-item survey was sent to all practicing clergy in Kansas East and West conferences of United Methodist church by the Kansas Area Office of the United Methodist Church. Survey items included participants’ demographic information and health conditions (e.g., diabetes, heart disease, high blood pressure, high cholesterol). The self-reported general health, mental health, and physical health data were also collected to compare to the general population in Kansas. Clergy were also asked to identify perceived barriers to health. A total of 150 clergy participated in the survey. The majority (93.7 %) self-reported their health as good, very good, or excellent. Participating clergy self-reported a higher prevalence of chronic diseases (diabetes, heart disease, high blood pressure, and high cholesterol) than the Kansas general population, but those differences were not statistically significant. More than three-fourths (77.4 %) of the participating clergy reported weights and heights that classified them as either overweight or obese. Lack of family time was the most frequently reported personal barrier to achieving a healthier lifestyle. An unpredictable work schedule was reported as the most frequent professional barrier to achieving a healthier lifestyle. This study suggests that Kansas clergy generally view their overall health status favorably despite being overweight or obese. Clergy also self-reported higher prevalence of chronic diseases than the general Kansas population, though the prevalence was not statistically different. This study provides additional insight into clergy health and offers suggestions to address the barriers preventing clergy from working toward better health.     

Overcoming Barriers to HIV Treatment Adherence: A Brief Cognitive Behavioral Intervention for HIV-Positive Adults on Antiretroviral Treatment

Maximizing HIV treatment adherence is critical in efforts to optimize health outcomes and to prevent further HIV transmission. The Balance Project intervention uses cognitive behavioral approaches to improve antiretroviral medication adherence through promoting adaptive coping with medication side effect and distress related to HIV. This 5-session intervention has been documented to prevent nonadherence among persons living with HIV who experience high levels of distress associated with their antiretroviral medication side effects. We describe the theoretical underpinnings of the intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications of the intervention in both research and clinical settings.     

Parent Expectancies for Child Therapy: Assessment and Relation to Participation in Treatment

Two studies examined parents' pre-treatment expectancies for their child's psychotherapy among children (N = 405, ages 2–15) referred for oppositional, aggressive, and antisocial behavior. Study I focused on the development of a measure to assess expectancies. The results indicated that the measure was internally consistent. Moreover, socioeconomic disadvantage and ethnic minority status, severity of child dysfunction, child age, and parental stress and depression were significant predictors of lower parent expectancies for child therapy. Study II examined the relation of parent expectancies and participation in therapy. The results indicated that parent expectancies predicted subsequent barriers to treatment participation, treatment attendance, and premature termination from therapy. Overall, these findings have implications for the study of expectancies for therapy, for identifying families at risk for premature termination from treatment, and for the development of interventions designed to increase parent participation in child therapy.     

Governance Barriers to Sustainability

Humanity and water represent an intersection of two natural cycles: the human economy and the earth's hydrological system. Although water is vital for human survival and growth, the point where human endeavor intersects is the most variable and uncertain in the hydrological system. Significant spatial and temporal variation of evaporation and rainfall has led to a number of responses aimed at increasing certainty of access to water. However, many of the world's civilizations can attest that the very act of reducing water uncertainty by technical means (capture, storage, and irrigation) has ultimately led to greater uncertainty and civilization failure. This article explores the concept of living with water as a complex entity, inseparably connected with all three levels of existential complexity—individual, social, and ecological—rather than as a commodity, which has led to our current uncertain status.     

The Links Among Perceived Adherence to the System of Care Philosophy,Consumer Satisfaction,and Improvements in Child Functioning

The present study investigated the associations among perceived adherence to the system of care philosophy, changes in internalizing and externalizing behaviors, and consumer satisfaction with services. Participants included 98 families, interviewed at two time points across a one-year period. Hierarchical multiple regressions indicated that the more a child and family perceived services to be consistent with the system of care philosophy, the greater their level of satisfaction with services and the fewer internalizing and externalizing behaviors they reported one year after receiving services (controlling for initial levels of problem behaviors). Implications for children’s mental health service delivery are offered.     

Using Adult Learning Theory Concepts to Address Barriers to Cancer Genetic Risk Assessment in the African American Community

Utilization of cancer genetic risk assessment can be profoundly influenced by an individuals’ knowledge of risk assessment, attitudes regarding illness and healthcare, and affective reactions derived from social norms. Race and ethnicity play a powerful role in the development of an individual's attitudes and should be considered when attempting to understand a person's openness to cancer genetic risk assessment (Lannin et al., 1998). Until recently, however, cancer screening and prevention programs have been primarily based on data from studies conducted with the Caucasian population, yielding data that are not fully applicable to the African American community. In the last several years, research findings regarding African American's knowledge, attitudes, and feelings about genetic counseling and testing have grown (Matthews et al., 2000; Singer et al., 2004; Thompson et al., 2003). However, to the authors’ knowledge, these data have yet to be presented in a manner that both summarizes the barriers that African Americans have reported regarding cancer genetic risk assessment, while at the same time suggesting methods individual genetic counselors can utilize during community presentations to help address these barriers. This article will first summarize previous empirical findings regarding African Americans’ knowledge, attitudes, and feelings about cancer genetic risk assessment. The article will then apply adult learning theory to those findings to provide genetic counselors with practical, theory based techniques to apply toward community based educational programs with African American groups.     

Critical Issues in the Assessment of Child Sexual Abuse

This article explores the feasibility of using standardized psychometric methods in the initial stages of an investigation of child sexual abuse; methods that are less intrusive and therefore less damaging to children and their families. We review the complex conceptual and research issues that arise from attempts to assess the many-sided aspects of child sexual maltreatment. Among those considered in both the clinical and research spheres are problems of definition and diagnosis; limitations of clinical interviews, and a variety of direct and indirect psychological instruments used for investigating sexual maltreatment and risk assessment; the inadequacies of experimental designs; and also the political, practical, and ethical restraints that hinder research in this area. It is argued that there is insufficient evidence based on controlled studies or standardized normative tests to advocate any simple, unidimensional methodology for the screening task. However, recommendations are put forward for the cautious, conjoint use of several procedures in a multidimensional approach to assessing child sexual abuse. Suggestions are also made for future research and development.     

Patterns of Parental Adherence and the Association to Child and Parenting Outcomes Following a Multicomponent School-Home Intervention for Youth With ADHD

The goal of the present study was to evaluate the role of parent adherence in the Collaborative Life Skills (CLS) program, a multicomponent school-home intervention, for predicting child and parenting outcomes. A sample of 129 children (63% male; M age = 8.22, SD = 1.10; grades 2–5) with attention-deficit/hyperactivity disorder (ADHD) and their parents participated in CLS, which included 10 weekly behavioral parent training group sessions. Each week, parents provided information on their CLS skill use between sessions (at home) as part of the intervention. Outcome measures included parent and teacher ratings of child behavior and parenting at post-intervention and 6 months follow-up. Growth mixture models examining weekly parent skill use trajectories throughout the intervention significantly predicted parent- and teacher-reported outcomes including parent-rated child behavior, teacher-rated academic competence, and positive parenting behaviors. Fifty-two percent of parents displayed moderate skill use throughout the intervention, whereas the remaining parents had either low (20%) or high (28%) initial levels of use but demonstrated high skill utilization by the middle of the intervention. Results highlight the importance of examining individual differences in parents between session strategy use for behavioral parent training interventions targeting child and parenting outcomes.     

Barriers to Adult Career Change

Adults have unique problems in making career changes. They face crucial economic, educational, and psychological barriers that require special guidance services. In this article, barriers to adult career change are identified and a five-county regional learning service using paraprofessionals is described. Results in working with more than 200 adults making career changes is reported. Suggestions for overcoming some of the problems adults face in making career changes are explained.     

Adherence to sport injury rehabilitation programs

Abstract

Adherence to sport injury rehabilitation prognms has emerged as a prime area of interest in the psychology of sport injury. In this article, behaviors typically involved in sport injury rehabilitation adherence are described. research findings on sport injury rehabilitation adherence are reviewed. and theoretical, methodological. and practical issues associated with sport injury rehabilitation research are identified and discussed. Primary recommendations resulting from the literature reviewed include use of conceptual models to guide research efforts, use of prospective resexch designs and standardized, psychometrically-sound measures of key constructs. and resolution of the question of whether enhancing adherence actually improves rehabilitation outcomes before interventions targeted at adherence behavior are developed, implemented, and evaluated.     

Correlates of Rorschach Reality Adherence in the Assessment of Murderers who Plead Insanity

Reality adherence measured by Mayman's system of Rorschach form level scoring was applied to the protocols of 43 individuals all of whom were pleading insanity to a charge of murder. Reality adherence level correlated significantly with judgment of legal sanity, contributed importantly to a factor analysis dimension of reality functioning, and was extensively related to measures of primary process thought and impulse. Reality adherence further was related to intellectual functioning and areas of past history. These results suggest that Mayman's reality adherence measure has substantial validity and is importantly related to other personality variables.     

Child and adolescent psychopathy: Assessment issues and treatment needs

The identification of psychopathic traits in childhood and adolescence is a topic of growing interest for scientific research. The development of models to predict violent behavior, together with efficient preventive and therapeutic programs, is a major goal when assessing youths with psychopathic traits. This paper focuses on the construct of child and adolescent psychopathy, while approaching historical and conceptual issues. By discussing the “state of the art” of the construct, we will analyze different instruments to assess psychopathy in children and adolescents, as well as the available treatment modalities. Finally, we will present possible lines for research and clinical intervention according to an evolutionary approach to anger and antisocial behavior.     

Parent Management of Attendance and Adherence in Child and Adolescent Therapy: A Conceptual and Empirical Review

There have been impressive, recent advances in the development of efficacious treatments for child and adolescent behavior problems. However, specific methods for delivering these treatments in a way that amplifies their efficacy have not been well articulated. Although many factors may be involved, attendance and adherence to treatment are arguably the most basic necessities for effective treatment delivery. We provide a conceptual and empirical review of past research on attendance and adherence to child and adolescent therapy, with a special focus on the importance of parents/guardians in managing treatment participation. Our review demonstrates that attendance and adherence are associated with a range of significant methodological, clinical, and financial outcomes. Several pretreatment predictors of attendance and adherence have been identified; however, to date only 12 controlled, clinical trials have evaluated strategies for enhancing attendance and adherence to child therapy. We conclude with an agenda for advancing research on the prediction and enhancement of attendance and adherence to child therapy as a means of improving the efficiency and effectiveness of child treatments.     

Test Adaptation and Cross-Cultural Assessment From a Business Perspective: Issues and Recommendations

Test adaptation and cross-cultural assessment activities are skyrocketing as the demand for educational opportunities and personnel selection grow both within the United States and across the industrializing world. We chose a qualitative, case study approach to identify central themes encountered by ACT, a not-for-profit organization that has accumulated considerable experience in cross-cultural assessment and test adaptation. Based on 16 projects and 28 interviews, we present a cross-cultural assessment guide within the context of how business administration, marketing, and research and technical issues interplay. It is apparent that business expectations and cultural differences in client groups have an important influence on technical and research decisions during the test adaptation and validation processes of testing institutions. Recommendations for future research regarding this interplay of issues are discussed.