A Comparison of Patient Satisfaction with Telehealth and On-Site Consultations: A Pilot Study for Prenatal Genetic Counseling

Many different fields of medicine are now utilizing video conferencing as a means to offer consultations to individuals in rural communities. However, there is a lack of published literature regarding the use of telehealth in clinical genetics and, specifically, in genetic counseling. Those experiences that have been reported mostly centered on cancer genetic counseling, sickle cell anemia consultation and care, or pediatric/adult genetic assessment. In these studies, the patients reported an overall satisfaction with telehealth, signifying that this type of communication may play an important role in the future of medicine. This pilot study compared patient satisfaction with prenatal genetic counseling performed via video conferencing versus that performed on-site. The results show that there was a high level of patient satisfaction when video conferencing was used to conduct prenatal genetic counseling consultations, suggesting that telehealth can be utilized as a means to offer this service to underserved populations. Telehealth refers to any type of communication technology in health care, distance education, transmission of radiological images, etc. The actual screening, diagnosis, treatment, management, etc., using distance technology is referred to as telemedicine.The term on-site indicates that genetic counseling was performed in person, rather than using telehealth.     

Mindfulness and Acceptance in the Treatment of Disordered Eating

Mindfulness and acceptance-based approaches to the treatment of clinical problems are accruing substantial empirical support. This article examines the application of these approaches to disordered eating. Theoretical bases for the importance of mindfulness and acceptance in the treatment of eating problems are reviewed, and interventions for eating problems that incorporate mindfulness and acceptance skills are briefly described. Empirical data are presented from a pilot study of mindfulness-based cognitive therapy adapted for treatment of binge eating.     

Training Community Members to Serve as Paraprofessionals in an Evidence-Based,Prevention Program for Parents of Preschoolers

Widespread dissemination of evidence-based programs for underserved populations may require non-traditional means of service provision. Collaboration with paraprofessionals from communities that are targeted for intervention holds promise as a delivery strategy that may make programs more accessible and acceptable, especially to parents living in low-income, urban neighborhoods. We describe a paraprofessional training program for individuals living in a community targeted for preventive intervention based on high levels of poverty and community violence. The design and implementation of the training program are described in the context of issues related to the use of paraprofessionals in community-based, preventive interventions with parents of young children. We also provide insight into lessons learned from a feasibility study as well as general guidelines for the development of paraprofessional training programs for delivery of evidence-based programs.     

Community Involvement in Adapting and Testing a Prevention Program for Preschoolers Living in Urban Communities: ParentCorps

We describe a university-community collaborative effort to tailor and deliver a prevention program for families of preschoolers living in low-income, urban communities. ParentCorps, which builds on efficacious interventions with parents and young children, aims to promote child social competence and prevent conduct problems by strengthening parenting skills, enhancing support for parents, and empowering parents to access resources in their communities. Active community engagement and collaboration were viewed as critical to the development of the program and its feasibility testing. We present an overview of community involvement in the development of ParentCorps and approaches taken to involve community members during a feasibility study. Areas of success and lessons learned are discussed.     

Programmatic staff care in an outpatient setting

Traditionally, chaplains have provided care for staff through consultation, informal conversation, grief work, and more formal counsel and ritual. This article discusses four programmatic approaches to staff care created in response to particular assessed needs: "Finding Soul" addresses staff care needs to find meaning and joy in their work and to contribute to the "soul" of the institution. "Existential Expedition" helps staff both deal with their accumulated grief and provide better direct care around existential issues being faced by their patients. "After Book" provides a way for staff to have closure with parents/families and to provide holistic care to families after discharge from the system. "The Labyrinth Program" provides staff with an opportunity to de-stress and to attend to their emotional and spiritual well-being. Focused upon staff care, these programs also secondarily benefit both patients/families and the vision and mission of the institution.     

Gender differences in social support for socially anxious individuals

Given that social anxiety disorder is a common, chronic, debilitating disorder and socially anxious women appear to have different experiences related to social development and social support than men, it is essential that the gender differences in social anxiety and social support be understood. The present study examined perceived social support quantity and satisfaction in 23 women and 28 men seeking treatment for social anxiety disorder. Contrary to expectations, men and women did not differ on measures of social support. However, younger, unmarried women reported having smaller social support networks and less satisfaction with their social support networks than older, married women. Analyses of socially anxious men did not reveal such a pattern. The current study provides preliminary evidence that younger, single women have social support networks that are less satisfying than the social support networks of older, married women. Inclusion of social support modules within a cognitive behavioral treatment approach for social anxiety disorder may be warranted, particularly for young, unmarried women.     

Selective target processing: perceptual load or distractor salience?

Perceptual load theory (Lavie, 1995) states that participants cannot engage in focused attention when shown displays containing a low perceptual load, because attentional resources are not exhausted, whereas in high-load displays attention is always focused, because attentional resources are exhausted. An alternative "salience" hypothesis holds that the salience of distractors and not perceptual load per se determines selective attention. Three experiments were conducted to investigate the influence that target and distractor onsets and offsets have on selective processing in a standard interference task. Perceptual load theory predicts that, regardless of target or distractor presentation (onset or offset), interference from ignored distractors should occur in low-load displays only. In contrast, the salience hypothesis predicts that interference should occur when the distractor appears as an onset and would occur for distractor offsets only when the target was also an offset. Interference may even occur in highload displays if the distractor is more salient. The results supported the salience hypothesis.     

The theory of "truth": how counterindustry campaigns affect smoking behavior among teens.

This study used structural equation modeling to test a theory-based model of the pathways by which exposure to the "truth" counterindustry media campaign influenced beliefs, attitudes, and smoking behavior in national random-digit-dial telephone surveys of 16,000 12- to 17-year-olds before, 8 months after, and 15 months after campaign launch. Consistent with concepts from the theory of reasoned action, youth in markets with higher levels of campaign exposure had more negative beliefs about tobacco industry practices and more negative attitudes toward the tobacco industry. Models also provided support for a social inoculation effect, because negative industry attitudes were associated with lower receptivity to protobacco advertising and with less progression along a continuum of smoking intentions and behavior.     

The cognitive failures questionnaire revisited: dimensions and correlates

The authors reexamined the factor structure of the Cognitive Failures Questionnaire (D. E. Broadbent, P. F. Cooper, P. Fitzgerald, & K. R. Parkes, 1982) and its correlates. The Cognitive Failures Questionnaire was designed to assess a person's likelihood of committing an error in the completion of an everyday task. A principal components factor analysis with varimax rotation yielded 4 internally consistent, interpretable factors. These factors were labeled Memory, Distractibility, Blunders, and (memory for) Names. This study lends partial support for the factor analytic solution proposed by L. K. Pollina, A. L. Greene, R. H. Tunick, and J. M. Puckett (1992). In addition, it extends previous findings by providing initial evidence for the construct validity of the factors established by correlating factor scores with measures of other related constructs (i.e., boredom proneness, attention deficit/hyperactivity disorder, Type A behavior pattern).     

Concurrent reinforcement schedules: behavior change and maintenance without extinction

We evaluated the effects of concurrent schedules of reinforcement on negatively reinforced problem behavior and task completion with 3 children with autism. Results indicated that problem behavior occurred at high levels and relatively few tasks were completed when problem behavior produced a break (from tasks) and task completion produced either no consequence or a break. By contrast, problem behavior was eliminated and tasks were completed when problem behavior produced a break and task completion produced a break with access to preferred activities. Treatment gains were maintained without the use of extinction when the response requirement was increased and the schedule of reinforcement was thinned.