No Easy Answers: Avoiding Potential Pitfalls of De‐implementation

In 2012, the Centers for Disease Control and Prevention (CDC) began to de‐emphasize and de‐implement multiple evidence‐based HIV prevention practices that had been around for 20 years, thus changing the scope of implementation across the globe. The authors provide evidence how existing interventions (e.g., CDC HIV interventions) may influence implementation of interventions that came after the program was discontinued. De‐implementation is an ecological event that influences, and is influenced by, many parts of a system, for instance, implementation of one type of intervention may influence the implementation of other interventions (biomedical and/or behavioral) after a long‐running program is discontinued. Researchers and policy makers ought to consider how de‐implementation of behavioral interventions is influenced by biomedical interventions mass‐produced by companies with lobbying power. The scientific study of de‐implementation will be inadequate without consideration of the political climate that surrounds de‐implementation of certain types of interventions and the promotion of more‐profitable ones.     

Navigating the Road Ahead: Public Health Challenges and the Interactive Systems Framework for Dissemination and Implementation

Public health is currently faced with an array of critical challenges and disconnects. Research and evaluation have identified a number of evidence‐based strategies for effecting behavior change at individual, group, organizational, and environmental levels, all of which hold promise for leading to substantial reductions in morbidity and mortality, and increased quality of life. Unfortunately, there is huge variability across the public health system in awareness of the value of using evidence to inform decision making, let alone in capacity to locate, assess, compare, select, justify, adapt, implement, and evaluate evidence‐based strategies, or to participate in building the evidence base for practice‐based innovations. As a result, many communities may not be benefitting from research‐tested and practice‐based strategies that could help them to meet their public health goals more efficiently and effectively. CDC's Interactive Systems Framework for Dissemination and Implementation (ISF), released in 2008, was designed to help close this gap between research and practice. This commentary identifies the ways in which the ISF framework is useful in addressing the research practice gap; revisits the elements of the framework that have continued to guide research and practice in fruitful ways; and highlights areas that need further development to meet current public health challenges. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

The Health and Social Service Needs of Transgender People in Philadelphia

SUMMARY

Two Philadelphia-based HIV service organizations and a local university collaborated on a study of health and social service needs of transgender people. Transgender people were the primary resource for the development of the needs assessment survey. In this article, the survey development process, including two discussion groups and two focus groups, are described. Findings on barriers to care, violence, perception of public safety and comfort, suicide and health and social service needs are presented. Total sample size was 81, with 49 male-to-female and 32 female-to-male transgender individuals. Most (68%) were African American. About half of the respondents had thought about attempting suicide. High levels of violence were reported, especially among male-to-females. Health and social service needs included job training/work, dental care, health care, legal services, transportation, education and housing.     

Self‐Disclosure Characteristics and Motivations in Social Media: Extending the Functional Model to Multiple Social Network Sites

The purpose of this study was to examine differences in self‐disclosure goals, privacy concerns, and self‐disclosure characteristics between Facebook and Twitter. These sites were compared in terms of audience representations, based on structural cues that suggest potential audiences for a user. We conceptualized audience representations in 2 ways: based on privacy boundaries that imply bounded versus unbounded audiences, and on network characteristics such as size and diversity for audiences within the boundary. Results revealed that self‐disclosure goals, privacy concerns, and self‐disclosure intimacy were different depending on the privacy boundary. Network characteristics were also important, but effects were moderated by the privacy boundary type, suggesting a complex interplay between the 2 types of audience representations in shaping self‐disclosure in social media.     

New Perspectives on the Child‐ and Youth‐Serving Workforce in Low‐Resource Communities: Fostering Best Practices and Professional Development

The professionals and paraprofessionals who work daily with youth in low‐resource, marginalized communities are integral to youth wellbeing; yet, their professional development, and the factors that promote it, are not well understood. In this introduction to the special issue, Understanding and Strengthening the Child‐ and Youth‐Serving Workforce in Low‐Resource Communities, we focus on understudied practitioners operating in an array of sectors and settings, such as home visitors, mental health paraprofessionals, early childhood assistant teachers, teachers in low‐income countries, school resource officers, juvenile justice staff, and after‐school and community‐based program workers. We put forward a conceptual model detailing the interactive, layered set of proximal‐to‐distal ecological factors that influence the practice and professional development of these workers, and show how papers in the current issue address these layers in their examination of workforce development. We conclude with a summary of the contributions and lessons from this work – including the value of a whole‐person approach, the importance of sharing process across research stages, and the need to build on the foundation provided by community psychology and implementation science – toward the twin goals of understanding and building the skills and strengths of the workforce, and ultimately, enhancing youth development.     

The implementation of routine outcome measures in a Tier 3 Psychological Therapies Service: The process of enhancing data quality and reflections of implementation challenges

Background: The Newham Psychological Therapies Service (PTS) has been using the CORE System of evaluation to demonstrate effectiveness since 2004. More recently there has been the national and local drive to improve outcomes as outlined by a number of Department of Health policies and the Improving Access to Psychological Therapies (IAPT) initiative. Aims: This paper describes how, as a secondary care complex mental health service, we have engaged with the process of outcome measurement through complementing the usage of the CORE System with additional measures forming the service pilot minimum dataset. The process of implementation is outlined along with reflections on the challenges which the service faced in introducing outcome measurement. Findings: Engagement with outcome measurement by a service requires attention to be paid to the organisational and professional aspects and personal resonances for clinicians if it is to become established as a meaningful enterprise within secondary care services. Despite success at this task, challenges remain to the further development of this area of work.     

The Association Between Life Satisfaction and Self‐Reported Health Status in Europe

Previous research has shown that life satisfaction (LS) and self‐reported health status are strongly related to each other. However, it is not clear whether this association holds across different nations or whether certain country‐level indicators significantly affect this association. The study was based on nationally representative samples of 32 countries from the first six rounds of the European Social Survey (N = 291 686). Results from hierarchical multilevel modelling indicated that there was a positive association between LS and self‐reported health status across countries, but this association was slightly stronger in countries where governments spent less on the health care of their residents. Self‐reported health ratings were also more strongly tied to LS judgements in countries where variability in LS ratings was larger. These results suggest that, especially in less wealthy European countries, policies should target reducing overall social inequality and the negative impact of governments' underinvestment in health care on LS. Copyright © 2015 European Association of Personality Psychology     

Cooperation in Mixed‐Motive Games: The Role of Individual Differences in Selfish and Social Orientation

In mixed‐motive games, people must choose between acting upon selfish interests and concerns for others. Yet, the consistency of people's behaviour across these various games is still unclear. If the same conflict between self and others is at the core of all mixed‐motive situations, three hypotheses can be stated: (1) behaviours in different mixed‐motive games should be substantially related; (2) all these games should substantially appeal to dispositional variables that probe in the psychological conflict between self and others; and (3) these dispositional variables should explain the shared variance among various games. These hypotheses were tested among undergraduate students (N = 219) who played seven different single‐shot mixed‐motive games and one sequential game. Social Value Orientation and the ideological attitudes Social Dominance Orientation and Right‐Wing Authoritarianism were included as dispositions. Our findings, however, showed evidence that did not fully substantiate our hypotheses, which calls into question the general idea that all mixed‐motive games render the conflict between selfish interests and concern for others salient. In the discussion, we focus on implications for research on mixed‐motive situations and elaborate on the role of ideology in this domain. Copyright © 2015 European Association of Personality Psychology     

Cultural and Institutional Determinants of Social Dominance Orientation: A Cross‐Cultural Meta‐Analysis of 27 Societies

We investigate macrocontextual antecedents of national levels of Social Dominance Orientation (SDO). The majority of previous research, in contrast, has tended to focus on individual‐level correlates of SDO. We extend research on Social Dominance Theory by modelling national‐level differences in institutional discrimination, macroeconomic development, and value ideologies as broad situational factors affecting SDO mean levels in previous studies. Our hypotheses were tested in a three‐level meta‐analysis of aggregate data from 50,971 individuals in 95 samples from 27 different societies. Strong effects for hierarchy‐attenuating legitimizing ideologies and gender empowerment were found. Aggregate discrimination against arbitrary‐set groups was less consistently linked to SDO, suggesting that these hierarchies are context‐specific. Using mixed‐effects three‐level modelling, the patterns can be generalized to new contexts and suggest a particular institutional and social climate that fosters high SDO.     

Social relationships and social support among post‐war youth in Northern Uganda

Although social relationships and social support are salient factors for post‐war adolescents' psychosocial coping and adjustment, there is only limited information regarding war‐affected adolescents' views on social support and the relationships within which social support is provided. This study therefore explored both elements among a clinical sample of 20 adolescents living in post‐war Northern Uganda. Following Braun and Clarke's thematic analysis, we found a prominent role of the biological mother and other primary biological family members in the upbringing of our participants. Spiritual and material support were perceived to be the most important type of support, respectively, while the adolescents were growing up and in their current lives. These findings provide support for the perception that caregiving systems are adaptable to particular sociocultural contexts. Further, the importance of particular functions of social support could signify a potentially selective buffering effect of these functions in adverse contexts. Because of the importance of the primary biological family and the salient role of parent–child relationships in the face of adversity, future research needs to focus on this particular kind of social relationship in contexts of prolonged collective violence.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Global identification,xenophobia and globalisation: A cross‐national exploration

This paper explores the ways in which globalisation influences social identity. Combining a psychological social‐identity framework with sociological considerations regarding the contextual impact of globalisation, it tests whether global identification—that is, people's identification as global citizens—constitutes an inclusive category, negatively linked to xenophobic attitudes towards immigrants across countries and whether the actual country level of globalisation moderates the relationship between global identification and xenophobia. Unlike most psychological studies of globalisation, it draws its data from 124 national samples across 86 countries, with 154,760 respondents overall, using three different cross‐national surveys. Study 1 (International Social Survey Program National Identity Module III 2013; N = 39,426, countries = 32) evinces that while global identification is in fact negatively linked to xenophobia, the correlation is moderated by the country level of globalisation, countries marked by higher levels of globalisation exhibiting a stronger negative relation between global identification and xenophobia than those characterised by a lower level of globalisation. Study 2 (European Values Study 2008; N = 53,083, countries = 44) and Study 3 (World Values Survey 6; N = 65,251, countries = 48) replicated these results across other countries employing dissimilar scales for global identification and xenophobia.     

Religious Service Attendance Aids Coping by Providing a Sense of Continuity: A Test of the Stress‐Support Matching Hypothesis Using Mental Health Outcome Measures

We propose that religious service attendance (RSA) serves as a coping resource by providing a sense of continuity. As a source of continuity, and per the stress‐support matching hypothesis, RSA should consistently buffer the negative mental well‐being impacts of stressors related to discontinuity—the disruption of regular routines and relationships. Most, but not all, of the relevant previous studies we reviewed found that RSA served as an effective buffer for the negative mental health impacts of discontinuity stressors (such as unemployment, terminated relationships, etc.). This variability in previous findings warranted a formal exploration of the relationship between RSA and specific stressors. To that end, we conducted a series of OLS regression path analyses on a sample of Americans age 40 and older (N = 2,579). RSA was found to consistently buffer the negative impact of discontinuity stressors on mental well‐being but failed to do so for other stressors. Overall, our observations are (a) consistent with the stress‐support matching hypothesis, (b) suggest that RSA is particularly effective for reducing the negative impacts of discontinuity stressors, and (c) found no instance in which RSA exacerbated (i.e., made more severe) the effects of life event stressors on mental well‐being.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

The Role for Public Funding of Faith-Based Organizations Delivering Behavioral Health Services: Guideposts for Monitoring and Evaluation

The paper reviews policies promoting faith-based organizations' (FBO) participation in publicly-funded programs since the Charitable Choice statute was enacted during the Clinton administration and then additional faith-based initiatives were implemented by the Bush administration. The paper focuses on research findings on FBO participation in publicly-funded human service programs under these policies. It then proposes a framework for evaluation to assess the appropriateness of public funding for behavioral health services delivered by FBOs, in order to address: (1) the programmatic and systemic effects resulting from the infusion of new players from the faith community, and the consequences to the profile of services and who gets served; and (2) the content and effectiveness of faith-infused services as a basis for identifying interventions appropriate for public funding. The analysis considers classification issues, theoretical bases of measured effects of faith-infused services, and the transferability of faith-based interventions across religious and secular applications in order to satisfy constitutional issues and client choice.     

Social problem‐solving,perceived stress,depression and life‐satisfaction in patients suffering from tension type and migraine headaches

This study aimed at investigating social problem solving, perceived stress, depression, and life‐satisfaction in patients with tension type and migraine headaches. Forty‐nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self‐report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T‐tests, chi‐square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life‐satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life‐satisfaction in patients suffering from primary headache.     

Transforming Social Regularities in a Multicomponent Community‐Based Intervention: A Case Study of Professionals’ Adaptability to Better Support Parents to Meet Their Children's Needs

This paper presents an in‐depth case study of the dynamic processes of mutual adjustment that occurred between two professional teams participating in a multicomponent community‐based intervention (CBI). Drawing on the concept of social regularities, we focus on patterns of social interaction within and across the two microsystems involved in delivering the intervention. Two research strategies, narrative analysis and structural network analysis, were used to reveal the social regularities linking the two microsystems. Results document strategies and actions undertaken by the professionals responsible for the intervention to modify intersetting social regularities to deal with a problem situation that arose during the course of one intervention cycle. The results illustrate how key social regularities were modified in order to resolve the problem situation and allow the intervention to continue to function smoothly. We propose that these changes represent a transition to a new state of the ecological intervention system. This transformation appeared to be the result of certain key intervening mechanisms: changing key role relationships, boundary spanning, and synergy. The transformation also appeared to be linked to positive setting‐level and individual‐level outcomes: confidence of key team members, joint planning, decision‐making and intervention activities, and the achievement of desired intervention objectives.     

Creative Self‐Efficacy and Innovative Behavior in a Service Setting: Optimism as a Moderator

Creativity research on the personality approach has focused on the relationship between individual attributes and innovative behavior. However, few studies have empirically examined the effects of positive psychological traits on innovative behavior in an organizational setting. This study examines the relationships among creative self‐efficacy, optimism, and innovative behavior as well as the moderating effect of optimism. Longitudinal data across two periods were collected from 120 spa employees of a diet and beauty salon company in Taiwan. After controlling for the effects of job tenure and the Big Five personality traits, this study found that employees with a high level of creative self‐efficacy demonstrate a high level of innovative behavior at work, and optimism does not have a direct effect on employees' innovative behavior, but it does play a moderating role. When employees' creative self‐efficacy is high, those with greater optimism exhibit greater innovative behavior at work. Toward the end, this paper offers suggestions for future research and discusses the practical implications of this study.