The effect of self-recording and social reinforcement components of parent training programs

This investigation attempted to assess the effectiveness of two components of parent training programs: (1) the effect of a self-behavior management project prior to intervention with deviant child behaviors, and (2) that of social reinforcement from peers and the consultant. Four groups of parents were exposed to a basic training program and were measured on their success in an intervention program in the inappropriate behavior of their children (ages 7–9 years). Two groups of parents were requested to do a self-modification program prior to the intervention with deviant child behavior; two groups did a child intervention program without a self-management project. One group in the self-management and one group without self-management received verbal social reinforcement from peers and the consultant during interventions. Results obtained indicate that the parent group whose training involved a self-behavior management project prior to intervention with their child's inappropriate behavior and verbal social reinforcement achieved a significantly greater reduction of these behaviors when compared to the groups where either self-management of social reinforcement was used.     

A Self-Management Program for Adolescents and Children with Renal Transplantation

This paper describes the development and implementation of a self-management program designed to address noncompliance in adolescents with renal transplants. Transplantation provides the best treatment alternative for End-Stage Renal Disease (ESRD), but is a procedure that subsequently demands recipients follow a life-long medication regimen. Nonadherance to medical therapy is a serious problem for adolescents; it is one of the most common causes of chronic graft rejection in this population. To improve compliance rates for this population, a self-management program was designed: (1) to provide social support; (2) to review information about medications and transplant management; and (3) to both teach and provide transplantation patients the opportunity to practice self-management skills. Details about the program, including recruitment issues and session content, are provided. Evaluations by participants indicated that the program was effective in creating a supportive environment for both patients and their parents, and in addressing health-related concerns.     

A friendship intervention for children with Attention-Deficit/Hyperactivity Disorder: preliminary findings

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are known to experience difficulty in peer relationships. Neither standard interventions for ADHD nor peer acceptance-oriented interventions fully remedy this problem. We propose that interventions targeting ADHD children's dyadic friendships may be more realistic strategies for improving peer relationships. Hence, a friendship intervention, implemented within the context of an intensive behavioral treatment program with 209 ADHD children, is described. A model is proposed in which the friend's antisocial behavior relates to parental compliance with the friendship intervention, and both the friend's antisocial behavior and parental compliance predict friendship quality and treatment response. Results indicate that children paired with peers lower on antisocial behavior and children whose parents had higher levels of compliance with the friendship intervention achieved higher quality friendships and were rated by teachers as more improved.     

THE EFFECT OF THE AVAILABILITY OF A SIMILAR TOY ON COMPLIANCE WITH INSTRUCTIONS TO SURRENDER A TOY AMONG PRESCHOOL CHILDREN

We evaluated the effect of the availability of a similar toy on compliance with an instruction to surrender a toy among three preschool children. First, high‐preference and medium‐preference toys were identified for each participant. During the treatment evaluation, reversal designs were used to examine compliance with an instruction to surrender these toys when a toy similar to the target toy was added to the environment. The results indicated that, for two participants, the similar toy intervention increased compliance to moderate levels; a consequence‐based intervention was then added to the similar toy intervention and resulted in high levels of compliance. For the third participant, the similar toy intervention did not increase compliance. A separate consequence‐based intervention was necessary to increase compliance and to demonstrate experimental control. Copyright © 2011 John Wiley & Sons, Ltd.     

A parent intervention with a growth mindset approach improves children's early gesture and vocabulary development

Socioeconomic disparities in children's early vocabulary skills can be traced back to disparities in gesture use at age one and are due, in part, to the quantity and quality of communication children are exposed to by parents. Further, parents' mindsets about intelligence contribute to their interactions with their children. We implemented a parent gesture intervention with a growth mindset component with 47 parents of 10‐month‐olds to determine whether this approach would increase parents' use of the pointing gesture, infants' use of pointing, and child vocabulary growth. The intervention had an effect on parent gesture such that by child age 12‐months, parents who received the intervention increased in their pointing more than parents in the control condition. Importantly, the intervention also had a significant effect on child gesture use with parents. There was no main effect of the intervention on child vocabulary. Further, the effect of the intervention on pointing was stronger for parents who endorsed fixed mindsets at baseline, and had an added benefit of increased vocabulary growth from 10–18 months for children of those parents who endorsed fixed mindsets. Incorporating growth mindset approaches into parenting interventions is encouraged.     

Family Communication Patterns,Discourse Behavior,and Child Television Viewing

This study investigated the relationship between the Family Communication Patterns (FCP) Inventory and parent-child discourse, the effect of FCP scores on child compliance, and the effect of parent discourse strategies on child compliance. Parents and children did not appear to agree about the norms in their family and appeared to be using different instances of discourse to draw conclusions about their family. For parents, control orientation was related to controlling verbal strategies; for children, control was related to global negative affect. Communication orientation was related to information sharing for parents but to fewer parental commands for children. In addition, greater control orientation resulted in less compliance. Parent discourse strategies also were related to child compliance. Younger children were more compliant when parents used directive language coupled with positive affect, but older children were less compliant in response to this verbal strategy.     

TEACHING YOUNG CHILDREN TO USE CONTACT LENSES

Young children with surgically removed lenses and extreme nearsightedness can benefit from contact lenses, but their parents may need instruction to teach their children to accept lenses. In this study, 4 children under the age of 5 years were taught contact lens wear using a shaping procedure. Compliance was rewarded with praise and tangibles, and noncompliance was followed with brief time-out for 3 of the children and restraint for the 4th. Three children showed high compliance during an initial shaping procedure, with a decrease in compliance during initial insertion of the lenses. At 3- to 10-month follow-up, levels of compliance were high. Insertion and removal of lenses were accomplished in substantially less time, with little crying and no need for time-out. All 3 children continue to use the lenses daily, and 2 have shown improved visual acuity. The 4th child, who has Down syndrome, showed low levels of compliance with need for physical restraint throughout. Although his parents reported high compliance when he first went home, fitting difficulties and an infection resulted in plummeting of compliance, and contact lens use was discontinued. This procedure has been used successfully at the same hospital with 11 of 13 other children between the ages of 14 months and 7 years 4 months. Implications for selection of suitable candidates for this intervention and ways to decrease costs are discussed.     

Path model of multidimensional compliance with cancer therapy

Patients newly diagnosed with hematologic malignancies were followed for a 6-month treatment period to assess compliance with three regimen requirements for cancer therapy: anti-neoplastic medication self-administered intermittently, supportive medication self-administered daily, and monthly clinic appointments. The effect on compliance of three intervention "packages" (some combination of education, shaping of pill-taking behavior, and home restructuring) and the extent that patient satisfaction, knowledge, and uncertainty about illness-related events mediated the effects of the interventions were also examined. Blood levels of the drugs and self-report measures indicated that compliance with daily pill taking was higher for each intervention group compared to a control group. Similar results were obtained for compliance with clinic appointments. No improvement in intermittent self-medication was found. Although each intervention package increased patient knowledge and satisfaction, path analyses demonstrated that knowledge did not affect any aspect of compliance, whereas satisfaction was associated with increased appointment keeping only. Daily pill taking was influenced directly by the behavioral components of the interventions. Uncertainty did not influence compliance but was associated with depression, which was negatively correlated with intermittent self-medication.     

Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions.     

Do Internet‐Based Support Interventions Change Perceptions of Social Support?: An Experimental Trial of Approaches for Supporting Diabetes Self‐Management

Internet-based support groups are a rapidly growing segment of mutual aid programs for individuals with chronic illnesses and other challenges. Previous studies have informed us about the content of online exchanges between support group members, but we know little about the ability of these interventions to change participants' perceptions of support. A randomized trial of 160 adult Type 2 diabetes patients provided novice Internet users with computers and Internet access to 1 of 4 conditions: (a) diabetes information only, (b) a personal self-management coach, (c) a social support intervention, or (d) a personal self-management coach and the support intervention. After 3 months, individuals in the 2 support conditions reported significant increases in support on a diabetes-specific support measure and a general support scale. Participants' age was significantly related to change in social support, but intervention effects were still significant after accounting for this relationship. This report is a critical first step in evaluating the long-term effects of Internet-based support for diabetes self-management. The discussion identifies directions for future research.     

乳腺癌患者自我管理行为与生活质量的相关性研究

探讨乳腺癌患者自我管理行为、生活质量及两者之间的相关性.应用慢性病自我管理研究测量表中的自我管理行为量表、乳腺癌患者生活质量测定量表调查260例乳腺癌患者的自我管理行为和生活质量.乳腺癌患者自我管理行为及生活质量现状均不理想,自我管理行为与生活质量呈正相关（P＜0.05）.乳腺癌患者自我管理行为与生活质量间有密切关系,临床护理工作中可对患者进行护理干预来增强其自我管理行为,进而提高生活质量.     

Willingness to Use ADHD Self-Management: Mixed Methods Study of Perceptions by Adolescents and Parents

Little is known about perceptions surrounding self-management for attention deficit hyperactivity disorder (ADHD), although such interventions appear commonly used and are considered essential components of the chronic care model. Our research is part of a mixed methods study that followed students at high and low risk for ADHD over 11 years. During the final study years, area-representative samples of 148 adolescents (54.8 % participation; 97 ADHD high-risk group; 51 low-risk peers) and 161 parents (59.4 % participation; 108 parents of high-risk adolescent; 53 parents of low-risk peer) completed a cross-sectional survey on community-identified self-management interventions for ADHD (activity outlets, sleep regulation, dietary restriction, homework help, family rules, and prayer). Respondents also answered open-ended questions addressing undesirable self-management effects, which were analyzed using grounded theory methods. High-risk adolescents expressed significantly lower willingness towards all self-management interventions than did adult respondents, except for increased activity outlets. They also reported lower receptivity towards sleep regulation and dietary restriction than did their low-risk peer group. No gender or race differences in self-management willingness were found, except for higher receptivity to prayer in African American respondents. Cost, perceived ineffectiveness, disruptions to routines, causation of interpersonal conflicts, and reduced future self-reliance were seen as potential undesirable effects. Findings suggest that activity-based ADHD interventions appear particularly acceptable across all demographic and risk groups, unlike sleep regulation and dietary approaches. Further research on self-care effectiveness is needed to incorporate adolescents’ viewpoints about ADHD self-management, as interventions may be acceptable to adults, but resisted by adolescents.     

Self-Management Training and Medication Compliance in Children with Diabetes

Four insulin dependent diabetic boys were given training in self-management. The youngsters conducted a selfchange project designed to improve adherence to their medical regimen. Additionally, they received negotiation and contracting training and developed a contract to earn reinforcement from their parents for using their self-management skills. The procedures resulted in a large increase in adherence to the targeted component of their medical regimen. Implications of the findings are discussed.     

The Effects of a Teacher–Child Play Intervention on Classroom Compliance in Young Children in Child Care Settings

The current study evaluated the effects of a teacher-conducted play intervention on preschool-aged children’s compliance in child care settings. Study participants included 8 children ranging in age from 3 to 5 years and 5 early childhood education teachers within 5 classrooms across 5 child care centers. A combination ABAB and multiple baseline design was used to demonstrate the effects of the play intervention. Pretreatment observations revealed varying degrees of child compliance difficulties. The play intervention was associated with improved rates of compliance for each participant child. The intervention is discussed with regard to its potential as a proactive, nonintrusive strategy for improving young children’s classroom compliance.     

干预对社区原发性高血压患者依从行为和自我功效影响的研究

干预前采用问卷法对90名研究对象的依从行为和自我功效水平进行调查,了解其基线水平的基础上修改干预方案,干预后再次采用问卷法评价干预效果。干预后,研究对象的自我功效水平由低水平提高到中等水平,依从行为水平由中低水平提高到高水平,强化了社区原发性高血压患者自我护理能力。     

CAREER SELF-MANAGEMENT: A QUASI-EXPERIMENTAL ASSESSMENT OF THE EFFECTS OF A TRAINING INTERVENTION

A growing trend is to encourage employees to become actively involved in the management of their own careers. Career self-management, the degree to which one regularly gathers information and plans for career problem solving and decision making, includes two main behaviors: developmental feedback seeking and job mobility preparedness. Although career self-management training is a commonly used employer intervention to re-socialize individuals to increase their own career management activity, it is rarely rigorously evaluated. Relying on an expectancy theory framework, the goal of this study was to evaluate the general effects of career self-management training using a quasi-experimental design. Based on data from several hundred professionals at a major U.S. employer, the results showed formal training efforts were generally not successful in resocializing people to engage in career self-management activities, and when done as an isolated human resource strategy, decreased trainees' likelihood of engaging in career self-management behaviors. To the extent that Time 2 expectancy perceptions got worse, the results showed that an individual's attitudes toward feedback seeking mediated the relationship between the training intervention and the level of preparation for job mobility conducted 6-8 months following the training.     

Process Evaluation of A Physical Activity Self-Management Program For Children: Spark

Abstract

SPARK is a controlled field study of a multi-component elementary school program to promote physical activity. One component is a weekly classroom-based self-management program, with the goal of increasing physical activity outside of school. The curriculum included goal setting, behavioral skills training, a reward system, and parent involvement. An evaluation of curriculum implementation and association between process and outcome was conducted using direct observation of lessons, subjective ratings by 24 teachers and 391 parents, and participation records of 549 students. Teachers viewed the self-management curriculum less positively than the physical education curriculum. Teachers were observed implementing an average of 65% of curriculum elements, which may have contributed to the limited effects of the self-management program. Student participation in the program, measured by points earned for doing out of school physical activity, was correlated significantly with changes in body mass index and multiple psychosocial variables among boys but not girls. Barriers to full program implementation were identified, and a remaining challenge is to improve self-management curriculum implementation by teachers.     

An Evaluation of a Classwide Intervention Package Involving Self-Management and a Group Contingency on Classroom Behavior of Middle School Students

The effectiveness of an intervention package involving self-management and a group contingency at increasing appropriate classroom behaviors was evaluated in a sample of middle school students. Participants included all students in each of the 3 eighth-grade general education classrooms and their teachers. The intervention package included strategies recommended as part of best practice in classroom management to involve both building skill (self-management) and reinforcing appropriate behavior (group contingency). Data sources involved assessment of targeted behaviors using Direct Behavior Rating—single item scales completed by students and systematic direct observations completed by external observers. Outcomes suggested that, on average, student behavior moderately improved during intervention as compared to baseline when examining observational data for off-task behavior. Results for Direct Behavior Rating data were not as pronounced across all targets and classrooms in suggesting improvement for students. Limitations and future directions, along with implications for school-based practitioners working in middle school general education settings, are discussed.     

An evaluation of a behavioural parenting intervention for parents of gifted children

Parents of gifted children identify a need for tailored parenting support, and gifted children have unique requirements and vulnerabilities. The aim of this study was to assess the efficacy of a tailored behavioural parenting intervention, for enhancing the parenting skills of parents of gifted children and to assess the effect of these changes on the behavioural and emotional adjustment of their gifted child. A randomised controlled trial of tailored Group Triple P – Positive Parenting Program was conducted with 75 parents of children identified as gifted. Results indicated significant intervention effects for the number and frequency of parent reported child behaviour problems, as well as hyperactivity in the intervention group, relative to a waitlist control. Parents also reported significant improvements in their own parenting style, including less permissiveness, harshness, and verbosity when disciplining their child. No intervention effects were evident for teacher reports, except for a trend in relation to hyperactivity. This study demonstrated that a tailored behavioural parenting intervention is effective and acceptable for parents of gifted children, and thus has clinical implications for the delivery of parenting interventions for this population.