Patient Satisfaction with Cancer Genetic Counseling: A Psychometric Analysis of the Genetic Counseling Satisfaction Scale

Satisfaction is an important patient reported outcome of genetic counseling, as it is one of the elements used by professional organizations and healthcare accrediting bodies to determine the quality of professional work. However, empirical research on patient satisfaction with genetic counseling has been limited, partly due to the lack of standardized measures available to assess this construct. The purpose of this study was to conduct a psychometric analysis of a new satisfaction measure, the Genetic Counseling Satisfaction Scale (GCSS), within a sample of women participating in a no-cost cancer genetic counseling and testing program. The sample consisted of 61 women undergoing counseling and testing for hereditary breast-ovarian cancer risk (BRCA1/2 testing) who completed the GCSS following pretest counseling. The results suggest that the GCSS was reliable (Cronbach's coefficient alpha = 0.90) and that participants were highly satisfied with the care they received. In addition, there were no differences in satisfaction between cancer genetic counseling and prenatal counseling participants (based on preexisting norms), and satisfaction did not vary by sociodemographic characteristics. Implications and recommendations are discussed.     

Race, Culture, and Ethnicity: Implications for a Community Intervention

We present an overview of research on African American families and emphasize in this discussion limitations of approaches used in the past to study African American families. We also discuss and identify challenges for designing and implementing community, family-based programs targeting competence-promoting behaviors in African American families. In addition, we attempt to accomplish the following objectives: (1) identify themes in studies of African American families, including bias in prior research; (2) discuss ways in which prior approaches and conceptual models guiding studies of African Americans have created challenges for the development and implementation of community-based intervention and research programs; and (3) present the Parents Matter! Program as an example of a community-based prevention effort that attempted to overcome many of the challenges created by prior research efforts.     

Pain Intensity,Psychological Inflexibility,and Acceptance of Pain as Predictors of Functioning in Adolescents with Juvenile Idiopathic Arthritis: A Preliminary Investigation

Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disease associated with pain and maladjustment. This study investigated whether pain, acceptance of pain, and psychological inflexibility uniquely predicted functional disability, anxiety, general quality of life (QOL), and health-related quality of life (HQOL) among adolescents with JIA. Twenty-three adolescents with JIA and pain were recruited from a pediatric rheumatology clinic. Participants completed self-report measures pertaining to the key study variables. A series of multiple regression analyses demonstrated that higher pain uniquely predicted higher functional disability. Greater psychological inflexibility uniquely predicted higher anxiety, lower general QOL, and lower HQOL. Increases in acceptance of pain were found to be uniquely related to increases in general QOL. These data confirm prior findings that pain impacts functioning, and provide preliminary findings that psychological inflexibility and acceptance may be important targets of psychological intervention for youth with JIA and pain to improve functioning and QOL.     

Parental Strategies for Knowledge of Adolescents’ Friends: Distinct from Monitoring?

Parental monitoring is defined as a set of behaviors used to gain knowledge about an adolescent’s whereabouts, friends and associates, and activities. However, can knowledge of adolescents’ whereabouts/activities, and friends all be attained through the same strategies? Or do they require their own strategies? This study used qualitative interviews with 173 parents of older adolescents from 100 families. Emergent themes described strategies by which parents gain information about their adolescents’ friends and the substance use of those friends. The strategies included direct interaction with the friend, gaining information from the teen, using second-hand sources, and making assumptions. Some of these strategies were consistent with previous research, while others raise new questions and provide interesting new directions to pursue. Primarily, additional consideration needs to be given to assessments of parental monitoring that include strategies for gaining knowledge of adolescents’ friends and their substance use.     

Television Use,Sexual Behavior,and Relationship Status at Last Oral Sex and Vaginal Intercourse

The current longitudinal study explores the relationship between adolescent television use at time 1 and sexual experience and relationship status (i.e., committed/romantic versus casual) 1 year later. The sample (N = 824) comprised youth aged 14–18. Multinomial logistic regressions predicting group membership from television exposure variables were conducted controlling for socio-demographic characteristics and prior sexual behavior. Results indicate that sexually inexperienced youth watched more television overall than sexually experienced youth, but less adult, premium and music television on cable networks. Premium cable exposure predicted group membership among sexually active youth. Youth who watched more premium cable at time 1 were more likely to be in casual relationship at last intercourse than a committed one. A more complete understanding of media effects on adolescent sexual relationships can help guide policy development, media education/literacy efforts, and contribute to the design of interventions to reduce the negative consequences associated with adolescent sexual behavior.     

The Essential Nature of Sharing in Science

Advances in science are the combined result of the efforts of a great many scientists, and in many cases, their willingness to share the products of their research. These products include data sets, both small and large, and unique research resources not commercially available, such as cell lines and software programs. The sharing of these resources enhances both the scope and the depth of research, while making more efficient use of time and money. However, sharing is not without costs, many of which are borne by the individual who develops the research resource. Sharing, for example, reduces the uniqueness of the resources available to a scientist, potentially influencing the originator’s perceived productivity and ultimately his or her competitiveness for jobs, promotions, and grants. Nevertheless, for most researchers—particularly those using public funds—sharing is no longer optional but must be considered an obligation to science, the funding agency, and ultimately society at large. Most funding agencies, journals, and professional societies now require a researcher who has published work involving a unique resource to make that resource available to other investigators. Changes could be implemented to mitigate some of the costs. The creator of the resource could explore the possibility of collaborating with those who request it. In addition, institutions that employ and fund researchers could change their policies and practices to make sharing a more attractive and viable option. For example, when evaluating an individual’s productivity, institutions could provide credit for the impact a researcher has had on their field through the provision of their unique resources to other investigators, regardless of whether that impact is reflected in the researcher’s list of publications. In addition, increased funding for the development and maintenance of user-friendly public repositories for data and research resources would also help to reduce barriers to sharing by minimizing the time, effort, and funding needed by individual investigators to comply with requests for their unique resource. Indeed, sharing is an imperative, but it is also essential to find ways to protect for both the original owner of the resource and those wishing to share it.     

Evolutionary perspective on indirect victimization in adolescence: the role of attractiveness, dating and sexual behavior

We studied indirect victimization from an evolutionary perspective by examining links between this type of victimization and several indicators of attractiveness (past sexual behavior, dating frequency and physical appearance). Two thousand three hundred and nineteen (56% female) students (ages 13-18) from a region of southern Ontario, Canada, completed self-report measures of indirect victimization, physical appearance, dating frequency, recent sexual behavior (number of partners in previous month) and past sexual behavior (number of lifetime partners minus number of partners in previous month) as well as indexes of depression, aggression and attachment security, which were used to control for psychosocial maladjustment. Consistent with an evolutionary framework, physical appearance interacted significantly with gender, wherein attractive females were at greater risk for indirect victimization, whereas for males physical attractiveness was a protective factor, reducing risk of victimization. Physical appearance also interacted with grade, being inversely related to indirect victimization for younger adolescents and having a nonsignificant association with victimization for older youth. Finally, recent sexual behavior was associated with increased risk of indirect victimization for older adolescents only, which we discussed with regard to peer perceptions of promiscuity and short-term mating strategies. These findings have important implications for the development of interventions designed to reduce peer victimization, in that victims of indirect aggression may represent a rather broad, heterogeneous group, including attractive individuals with no obvious signs of maladjustment.     

Bridging Science and Practice in Violence Prevention: Addressing Ten Key Challenges

This article illustrates ideas for bridging science and practice generated during the Division of Violence Prevention's (DVP) dissemination/implementation planning process. The difficulty of moving what is known about what works into broader use is near universal, and this planning process pushed us to look beyond the common explanations (e.g., providers were resistant/unwilling to change practice) and think about the multiple layers and systems involved. As part of this planning process, the Interactive Systems Framework for Dissemination and Implementation (ISF) was developed and then applied to the fields of child maltreatment and youth violence prevention. Challenges for each of the three systems in the ISF are discussed as well as and action and research ideas to address the challenges. Also described are actions taken by DVP in response to the planning process to illustrate how a funder can use the ISF to bridge science and practice.     

A Randomized Trial of a Mental Health Consumer-Managed Alternative to Civil Commitment for Acute Psychiatric Crisis

This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.