Sustained Implementation of Evidence‐based Programs in Disadvantaged Communities: A Conceptual Framework of Supporting Factors

This paper presents a review of the empirical literature for studies evaluating factors that facilitate and create barriers to sustained program implementation in disadvantaged communities. It outlines study methodology and sustainment outcomes and proposes a conceptual model that involves implementation sustainment support for providers delivering evidence‐based health and family services in disadvantaged communities. Sustained program implementation in the community setting is a significant issue as only 43% of studies reported successfully sustained programs. The review identified 18 factors that facilitate success and create barriers to program sustainment. The factors are synthesized into three themes; program characteristics, workplace capacity, and process and interaction factors. The majority of factors map onto commonly cited sustainability influences in implementation science. However, there was an additional focus for studies included in this review on the importance of factors such as program burden, program familiarity and perceived competence in program skills, workplace support for the program, staff mobility and turnover, supervision and peer support, and ongoing technical assistance. The need to use a conceptual framework and develop measures to guide and evaluate capacity building in EBP implementation and sustainment in low‐resource community settings is highlighted.     

Ready for Anything the World Gives Her? : A Critical Look at Sports-Based Positive Youth Development for Girls

Girl-centered sport and physical activity programs that are grounded in a positive youth development approach have grown tremendously in the United States since the 1990s. While research on the efficacy of sports-based positive youth development is limited, recent studies conducted in the United States suggest these programs yield benefits. Our assessment of the literature and programming efforts however highlight a significant gap in the theoretical assumptions of girl-centered, sports-based positive youth development: an understanding of the complexity of sport and physical activity within a gendered context. Focusing on the U.S. context and using a feminist sociological lens, we articulate a paradox in these programs: sport participation and physical activity can improve girls’ lives along numerous psycho-social dimensions, yet in absence of attention to the social and political context of gender relations, girl-centered, sports-based positive youth development programs risk unwittingly maintaining the gender status quo. We review three specific critiques to illustrate this paradox: 1) the emphasis on the individual and the immediate context of girls’ lives masks larger systems of inequality and privilege; 2) the use of post feminist narratives, such as Girl Power, suggests girls live in a world beyond sexism; and 3) the focus on reducing the childhood “obesity epidemic” through fitness contributes to harmful fat phobic messages for girls. We offer recommendations that assist programs in leveraging their existing strengths to have a meaningful impact on girls’ lives, and that address cultural and structural factors as well as individual and interpersonal ones.     

Conceptualizing and Measuring Safe,Stable, Nurturing Relationships and Environments in Educational Settings

Most children and adolescents older than 5 years spend at least 6 h of their day in school settings. Like parents, education professionals can promote health and protect youth from harm by providing safe, stable, nurturing relationships and environments. The Centers for Disease Control and Prevention has developed a framework which posits that safe, stable, nurturing relationships and environments are Essentials for Childhood and are fundamental to promoting health and well-being; protecting youth from maltreatment and other violence and victimization; and ensuring optimal, healthy development. In this paper, the authors propose an approach to applying safe, stable, nurturing relationships and environments to the school ecology; review select survey measures to examine these constructs within educational settings; and suggest available indicators to measure safety, stability, and nurturance within the school context.     

Genetic Counselors in Startup Companies: Redefining the Genetic Counselor Role

Genetic counselors (GCs) have recently begun moving into non-clinic based roles in increasing numbers. A relatively new role for GCs is working for startup companies. Startups are newly established companies in the phase of developing and researching new scalable businesses. This article explores the experiences of four GCs working at different startup companies and aims to provide resources for GCs interested in learning more about these types of roles. The article describes startup culture, including a relatively flat organizational structure, quick product iterations, and flexibility, among other unique cultural characteristics. Financial considerations are described, including how to understand and evaluate a company’s financial status, along with a brief explanation of alternate forms of compensation including stock options and equity. Specifically, the article details the uncertainties and rewards of working in a fast-paced startup environment that affords opportunities to try new roles and use the genetic counseling skill set in new ways. This article aims to aid GCs in determining whether a startup environment would be a good fit, learning how to evaluate a specific startup, and understanding how to market themselves for positions at startups.     

Unexpected Social Benefits of Alcoholics Anonymous for Older Women

The authors interviewed older women in Alcoholics Anonymous to explore the participants' most beneficial and meaningful experiences in the program. Findings suggested that these women obtained unexpected social benefits from their participation. These benefits are examined through the framework of Carstensen's ( 1993 ) socioemotional selectivity theory.     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.