Demographic variables, smoking variables, and outcome across five studies.

OBJECTIVE: Intervention effectiveness can potentially be affected by membership in different demographic subgroups (race, ethnicity, gender, age, and education level) or smoking behavior variables (time to first cigarette, longest previous quit attempt, number of attempts in the past year, number of cigarettes, and stage of change). Previous research on these 2 sets of variables has produced mixed results. DESIGN: This secondary data analysis combined data from 5 effectiveness trials (a random-digit-dial sample [N=1,358], members of an HMO [N=207], parents of students recruited for a school-based study [N=347], patients from an insurance provider list [N=535], and employees [N=175]) in which smokers were all proactively recruited from a defined population and all received the same expert system intervention. The intervention produced a consistent 22% to 26% point prevalence cessation rate across the 5 studies. MAIN OUTCOME MEASURES: The main outcome measures were 24-hr point prevalence, 7-day point prevalence, 30-day prolonged abstinence, and 6-month prolonged abstinence. RESULTS: There were no significant differences in outcome across gender, race, and ethnicity subgroups. There were significant differences and small effect sizes for age and education subgroups. There were significant differences and large effect sizes for all 5 smoking behavior variables. DISCUSSION: Demographic variables are static variables, whereas the smoking variables are more dynamic, that is, open to change. Given the dynamic nature of the smoking variables and the large effect sizes, interventions tailored on the smoking variables should be more successful.     

Effects of an Antecedent Intervention on Repetitive Behaviors of a Child With Autism

Repetitive self-injurious eye poking and stereotypic hand clapping were assessed in a child with autism and hearing impairment. A functional behavioral assessment conducted to identify the variables maintaining eye-poking behaviors indicated automatic reinforcement. Choice and environmental enrichment strategies were implemented to decrease the motivating operations associated with eye poking. Providing a choice of toys to hold in his hand led to the greatest reductions in both repetitive eye poking and hand clapping. Three follow-up observations were conducted 9 months after the intervention, which indicated that eye poking was eliminated and hand clapping was greatly reduced. This antecedent intervention was simple and effective, two hallmarks of sustainable behavior interventions.     

Children's social problem-solving skills, behavioral adjustment, and interventions: A meta-analysis evaluating theory and practice

Meta-analyses were performed to examine reported relations between children's interpersonal cognitive problem-solving (ICPS) skills and adjustment, and to specify the effects of ICPS training. In general, the relation between ICPS and adjustment appears robust, and interventions yield clear increases in ICPS skills. Intervention effects on behavioral adjustment are somewhat more equivocal; meta-analytic results differ depending on whether behavioral ratings or observations are the dependent variables. Age of subject, source of publication, and expertise of investigator are boundary conditions for the meta-analysis regarding ICPS and adjustment; teacher/child dialogues on ICPS principles in real-life situations, expertise of investigator, source and quality of publication, and length of interventions mediate magnitude of certain intervention effects. Further research is needed where data were sparse, as in follow-up data and effects of intervention for various special populations.     

Psychoeducational Interventions with Pediatric Cancer Patients: Part I. Patient Information and Knowledge

We present a systematic review of published research on psychoeducational interventions for children with cancer. The current lack of an organizational model for this literature makes it difficult to form a coherent picture of the scattered literature and draw nomothetic conclusions. A model is described that is based on functional concepts from the literature on learning and instructional design. It is argued that it makes sense conceptually to analyze psychoeducational interventions in terms of psychoeducational principles, especially if the purpose is to illuminate the learning processes involved. Three categories of intervention are distinguished and the first of these, informational interventions to influence patient knowledge, is considered in this paper, and the other two categories will be reviewed in a subsequent paper. This review is organized by categories of information needs, intervention modes, and major types of independent variables. We concluded that the research supports few generalizable conclusions at this time, except that development of health-related knowledge in children is best accomplished by information transfer methods that are highly interactive and individualized. Interactive multimedia formats such as video games are seen as having the best potential, but further research is required.     

A Prospective Validation Study of Inclination,Belief, and Context Predictors of Family-Focused Prevention Involvement

Prior research by the authors tested a model of factors influencing parent inclination to participate in parenting interventions. Family context, belief, attitude, and inclination to participate variables from this model were used to predict the actual participation of 1,121 families in assessment and intervention activities of a family-focused preventive intervention research project. Invitations to the project assessment and intervention components were, respectively, about 6 months and 10 months following the initiation of a telephone survey collecting predictor variable data. Logistic regression analyses examining each predictor individually showed that a number of family context, belief, attitude, and inclination variables were predictive of project participation. Subsequently, multiple logistic regressions were conducted, entering variables by blocks corresponding to theoretical model components. These analyses showed that prospectively stated inclination to participate in a parenting intervention and level of education were consistently significant predictors of both assessment participation and intervention enrollment. Implications for both research and practice are discussed.     

Happy thoughts: Enhancing well-being in the classroom with a positive events diary

Positive psychology interventions (PPIs) are effective in increasing well-being across the population. Whilst educators are recognising the importance of well-being in the classroom and of its long-term impact on life trajectory, the transformative potential of PPIs in educational settings is yet to be fully realised. This study investigates, for the first time, the effects of a PPI in school children by means of a daily dairy. Self-report questionnaires were used to measure well-being in school children aged 8–11 years. Across two studies, children kept a positive events diary, recording three experiences every day for a week. The intervention led to an increase in happiness and a decrease in depressive symptoms immediately following the intervention and at a three-month follow-up. Children who had unhappier baseline scores benefitted more from the intervention. This study demonstrates significant scope, in school settings, for targeted light-touch interventions to promote well-being in those with the greatest need.     

National Ambulatory Medical Care Survey: Tobacco intervention practices in outpatient clinics

Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Secondary smoking prevention in a university setting: a randomized comparison of an experiential, theory-based intervention and a standard didactic intervention for increasing cessation motivation.

OBJECTIVE: College may represent an untapped opportunity to reach the growing number of student smokers who are at risk of progressing toward regular smoking. The aim of this study was to test the efficacy of a theory-based experiential intervention for increasing motivation to quit smoking and reducing smoking behavior. DESIGN: This study used a 3-arm, randomized design to examine the efficacy of an experiential secondary prevention intervention. The control groups included a traditional didactic smoking intervention and an experiential intervention on nutrition. MAIN OUTCOME MEASURES: The 2 primary dependent variables were change in self-reported intention to quit smoking, measured pre- and postintervention, and change in smoking behavior over the month following the intervention. RESULTS: As hypothesized, the experiential smoking intervention was more effective than either control group in increasing immediate motivation to quit, but the effect was found only among female participants. At 1-month follow-up, both smoking interventions produced higher rates of smoking cessation and reduction than did the nutrition control condition. CONCLUSION: Findings support the potential efficacy of an intensive experiential intervention for female smokers.     

Getting it right generally,but not precisely: learning the relation between multiple inputs and outputs

In real-world situations, people are often faced with the complex task of deciding which of many potential variables are affecting their own or others’ behavior, as well as noting which specific aspects of behavior are being affected. Although it is common for professionals who encounter such conditions to claim that they acquire accurate and specific knowledge from their experience, it is unclear that such confidence is justified. Using a managerial task, we examined participants’ ability to learn how various interventions affect various aspects of their employees’ performance. The results of three experiments reveal that although participants appear to avoid prescribing an intervention that has a positive effect on a primary performance measure and a negative side effect on a secondary measure, when asked directly about the impact of the intervention, they respond by reducing their judgments of its positive impact. This was true regardless of whether participants indicated clear knowledge of its negative side effect (Experiment 3) or did not (Experiments 1 and 2). Thus, participants appear to be automatically integrating across the effects on different outcome measures.     

Consumer engagement and the development, evaluation, and dissemination of evidence-based parenting programs

A consumer perspective can contribute much to enhancing the "ecological fit" of population-level parenting interventions so they meet the needs of parents. This approach involves building relationships with consumer groups and soliciting consumer input into the relevance and acceptability of interventions, clarifying the enablers and barriers to engagement and involvement of parents, and clarifying variables that influence a parent's program completion. The adoption of a more collaborative approach to working with consumers is important if meaningful population-level change in the prevalence of serious social, emotional, and behavioral problems in children and young people is to be achieved. Parents seeking assistance for their children's behavior come from a diverse range of socioeconomic backgrounds, educational levels, cultures, and languages. This paper examines consumer engagement strategies that can be employed throughout the process of program development, evaluation, training, and dissemination, and in "scaling up" the intervention. We argue that a multilevel public health approach to parenting intervention requires a strong consumer perspective to enable interventions to be more responsive to the preferences and needs of families and to ensure improved population reach of interventions. Examples from large-scale dissemination trials are used to illustrate how consumer input can result in an increasingly differentiated suite of evidence-based parenting programs.     

Mediators of physical activity behavior change: a multivariate approach

OBJECTIVE: Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (M age = 47.5; 82% women). DESIGN: Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control. MAIN OUTCOME MEASURES: Psychosocial variables, including self-efficacy, decisional balance, and processes of change. RESULTS: All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI = 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI = 0.29, 0.80) being attenuated by decreases due to cognitive processes (-0.17, 95%CI = 0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI = 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI = 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI = -0.27, -0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance. CONCLUSIONS: These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost.     

A psychological intervention reduces doping likelihood in British and Greek athletes: A cluster randomized controlled trial

BackgroundCurrent attempts to prevent doping through deterrence and education have had limited success and have been constrained to one country. Targeting psychological variables that have been empirically associated with doping likelihood, intention, or behaviour may help in developing interventions that are effective in preventing doping in sport.ObjectivesGuided by social cognitive theory and empirical research, the main purpose of this research was to develop an anti-doping intervention that targets three psychological variables (i.e., anticipated guilt, moral disengagement, and self-regulatory efficacy) and determine whether it is more effective than an educational intervention in reducing doping likelihood in British and Greek athletes.MethodEligible participants were identified via a screening survey administered to 934 athletes in the United Kingdom and Greece. A total of 19 sport clubs (208 athletes) across the two countries were randomly assigned to either the psychological or the educational intervention. Each intervention consisted of six 1-h sessions delivered to small groups of athletes over 6–8 weeks. Athletes completed measures of doping likelihood, anticipated guilt, moral disengagement, and self-regulatory efficacy pre and postintervention and at a 2-month follow-up.ResultsA multilevel piecewise growth model was used to examine changes in study outcomes. Analysis showed that the psychological intervention was more effective than the educational intervention in reducing doping likelihood from pre to post, but the effects of the two interventions were similar at follow-up. These effects were not affected by country. Both interventions reduced moral disengagement from pre to post, and these effects were maintained at follow-up. The psychological intervention was also more effective than the educational intervention in increasing anticipated guilt from pre to follow-up.ConclusionsTargeting psychological variables in anti-doping interventions should aid our efforts to prevent doping in sport.     

Let's hang up and try again: Lessons learned from a social support intervention

Conclusion Theorists and researchers have spent some 15 years trying to better understand social support. A great deal of progress has been made in the assessment of support resources, behavior, and appraisals, in conceptualizing the support process, and in understanding how support might influence well-being. Community psychologists, in particular, have sought this knowledge as a basis for social intervention. The point has been reached where research and theory, though still incomplete, can inform intervention. Indeed, intervention programs are likely to make a unique contribution to our understanding.Yet, if anything has been learned, it is that the social support process is far more complex than initially thought, as is its relationship to well-being. It is essential that support interventions reflect that complexity. The greatest threat is not that powerful and effective support interventions will prove impossible to develop and implement, but that we may become disillusioned by misunderstanding our failures.     

Moderators of the benefits of psychoeducational interventions for men with prostate cancer.

The authors examined whether 3 individual difference variables--self-esteem, self-efficacy, and depressive symptoms--interacted with psychoeducational group interventions for men with prostate cancer (n = 250) to predict general and prostate-specific quality of life. Men with nonmetastatic prostate cancer were randomly assigned to an education intervention, an education plus group discussion intervention, or usual care and followed for 12 months. Eight groups of 10 to 12 men were convened in each condition. Men who began the study with lower self-esteem, lower prostate-specific self-efficacy, and higher depressive symptoms benefited the most from the interventions. Of these 3 moderator variables, the most consistent results emerged for self-esteem. That is, the benefits of the intervention were strongest for men with low self-esteem.     

Psychological characteristics of people with Parkinson's disease who prematurely drop out of professionally led Internet chat support groups.

Researchers of Internet health interventions have begun to address the problems of high attrition rates. Attrition has been a problem for psychosocial interventions for nearly 50 years. It is ubiquitous no matter what the type of intervention or the modality of delivery. Consistent are the repeated findings that demographic characteristics are the most robust variables. We tested the hypothesis that the greater the fear and apprehension experienced in professionally led Internet support groups, the more likely the participants would not complete the 25-week intervention. The sample consisted of 66 people with Parkinson's disease; each participant was assigned to one of six chat groups. To assess psychological states, we used PCAD, a text analysis program analyzing each person's postings during each chat room session. There was a statistically significant difference between those who terminated the group early and those who completed the intervention on the Anxiety-Fear dimension, F=2.35, (6,63), p=0.03. People who dropped out demonstrated higher death and shame anxiety. A number of possible designs for online groups that may reduce premature attrition are discussed.     

The efficacy of postdivorce intervention programs for children: A meta-analytical review

Preventive postdivorce interventions aim to help children cope with divorce and promote their adjustment. Nevertheless, questions remain regarding the concrete outcomes of these interventions and the intervention characteristics that influence them. This meta-analysis of 30 studies analyzes the efficacy of postdivorce interventions on children's symptomatology, personal resources, and adaptation to divorce. Likewise, it explores whether the intervention impacts the putative mediators from the family context and whether the characteristics of the studies themselves also influence the results. Using a data set of N = 4344 individuals, 258 effect sizes were calculated. Random effects analyses evidenced the impact of the interventions on specific variables instead of on children's global adjustment. There were no significant effects on children's mental health outcomes, and none of these effects were qualified by the moderators that were examined. Preventive postdivorce interventions had significant effects, specifically on children's divorce adjustment and self-esteem. The study of the moderators found that the interventions were generally homogeneous, and only one of the 20 moderators examined had a significant effect. Based on children's age, the interventions had an impact on family functioning only when they involved younger children, but this result should be interpreted with caution due to the small sample of studies. This meta-analysis provides evidence of the relevance of postdivorce interventions to critical variables as well as information about the role of the intervention characteristics in the effects and makes suggestions for future research on divorce interventions that encompass both practical and empirical developments.     

Fluent Reading as the Improvement of Stimulus Control: Additive Effects of Performance-Based Interventions to Repeated Reading on Students' Reading and Error Rates

The impact of adding performance-based interventions to a skill-based intervention on oral reading fluency was examined with 3 elementary students identified as having difficulty with reading. Two performance-based interventions were combined with the skill-based intervention Repeated Reading (RR) to create the three instructional packages investigated. The packages included Repeated Readings (RR), Repeated Readings with Performance Feedback (RR/FB), and Repeated Readings with Performance Feedback and Contingent Reward (RR/FB/REW). Results suggested that Repeated Reading (RR) alone led to the greatest increase in reading fluency for participants with the highest reading rates and lowest error rates at baseline. In contrast, the participant who exhibited the lowest reading rate and highest error rate benefited the most when Repeated Readings was offered in conjunction with Performance Feedback (RR/FB) or Performance Feedback plus Contingent Reward (RR/FB/RW). Implications for blending skill- and performance-based interventions to develop stimulus control over fluent reading and future research directions are discussed.     

Conditional effects of interventions in note-taking procedures on learning: A meta-analysis

Abstract:  A meta-analysis was conducted on 17 studies (27 separate samples and 73 effect sizes) examining the effects of interventions in the note-taking procedures on learning from lectures or texts. The overall mean weighted effect size ( d ) for the intervention groups versus the no intervention groups was 0.02. To explore what factors influence the intervention effects, moderator analyses were conducted separately for intervention type, schooling level, presentation method, publication source, and publication year. The results indicated that students at a lower schooling level gained some benefits from the interventions, whereas students at a higher schooling level did not. Also, the intervention effects were greater for journal articles than for doctoral dissertations and Education Resources Information Center reports. Other variables did not significantly account for the variance in effect sizes.     

A Review of Technology-Based Youth and Family-Focused Interventions

In the past 10 years, mental and behavioral health has seen a proliferation of technology-based interventions in the form of online and other computer-delivered programs. This paper focuses on technology-based treatment and preventive interventions aimed at benefitting children and adolescents via either involving the parents and families, or only the youth. The review considered only technology-based interventions that had at least one published study with a randomized controlled trial design. Questions being addressed included: (1) What are the technology-based interventions in the mental/behavioral health area that have been systematically evaluated in published studies? (2) What are the common and unique characteristics of these interventions and their application with respect to sample characteristics, target problems, and technology characteristics (platforms, structures, elements, and communication formats)? and (3) Which intervention approaches and strategies have accrued the greatest evidence? The review identified 30 technology-based psychosocial interventions for children and families, 19 of which were parent or family-focused (32 studies) and 11 of which were youth-focused (in 13 studies). For the parent/family-focused interventions, greatest promise was found in those that addressed either youth behavioral problems or depressive/anxious symptoms, as well as more general bolstering of parenting efficacy. The youth-focused interventions showed some promise in reducing depressive/anxious symptoms. Advantages and disadvantages of the technology-based approaches were considered, and areas for future research and development were discussed.