Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada

The scaling out of Housing First (HF) programs was examined in six Canadian communities, in which a multi‐component HF training and technical assistance (TTA) was provided. Three research questions were addressed: (a) What were the outcomes of the TTA in terms of the development of new, sustained, or enhanced programs, and fidelity to the HF model? (b) How did the TTA contribute to implementation and fidelity? and (c) What contextual factors facilitated or challenged implementation and fidelity? A total of 14 new HF programs were created, and nine HF programs were sustained or enhanced. Fidelity assessments for 10 HF programs revealed an average score of 3.3/4, which compares favorably with other HF programs during early implementation. The TTA influenced fidelity by addressing misconceptions about the model, encouraging team‐based practice, and facilitating case‐based dialogue on site specific implementation challenges. The findings were discussed in terms of the importance of TTA for enhancing the capacities of the HF service delivery system—practitioners, teams, and communities—while respecting complex community contexts, including differences in policy climate across sites. Policy climate surrounding accessibility of housing subsidies, and use of Assertive Community Treatment teams (vs. Intensive Case Management) were two key implementation issues.     

Assessment of the Readability of Genetic Counseling Patient Letters

Patient letters are a powerful tool that genetic counselors use to communicate with their patients. Patient letters are often sent to provide information on a new diagnosis, reiterate test results, and to serve as a permanent record of the visit. Patient letters, however, are only helpful if the patients can understand them. More than 50 % of the US population reads below a 9th grade reading level and over one-third of the population has low health literacy skills. In this study we evaluate the readability of genetic counseling patient letters by assessing reading level, image use, and terminology use. One hundred forty-nine genetic counselors participated in the survey and of these, 79 submitted a sample patient letter. Analyses of the letters revealed a mean reading level of 10.93. On average, 6 genetic terms were included in each letter, and only 25 % of these terms were defined. Analyses of survey responses revealed over 75 % of the genetic counselors did not include images in their patient letters. These results indicate there is room for improvement in order to make genetic counseling patient letters more accessible to the general population.     

Empirical Adequacy and Virtue Ethics

Situationists contend that virtue ethics is empirically inadequate. However, it is my contention that there is much confusion over what “empirical adequacy” or “empirical inadequacy” actually means in this context. My aim in this paper is to clarify the meanings of empirical adequacy in order to see to what extent virtue ethics might fail to meet this standard. I argue that the situationists frequently misconstrue the empirical commitments of virtue ethics. More importantly, depending on what we mean by empirical adequacy, either virtue ethics has no need to be empirically adequate or where it does have such a need, the psychological evidence fails to show that it is empirically inadequate. An additional contribution the paper intends to make is to provide a more detailed discussion of the explanatory nature of virtue ethics.     

Behavioral Activation and Inhibition as Moderators of the Relationship Between Music Video-Viewing and Joyriding Attitudes

Recently, a growing number of studies have shown a relationship between exposure to risk-glorifying media and risky driving perceptions, attitudes, and behaviors. The present study contributes to this line of research by examining emerging adults' behavioral approach system (BAS) and behavioral inhibition system (BIS) as moderators of the relationship between music video-viewing and joyriding attitudes. A cross-sectional survey among a sample of 539 emerging adults (ages 18–24) was conducted to examine the relationships between these constructs. Advanced moderation analyses indicated that, after controlling for sensation-seeking, physical aggression, gender, BIS, and BAS, the relationship between music video-viewing and joyriding attitudes only existed for respondents with a low BIS profile. Thus, low sensitivity to punishment functioned as a condition for the relationship between music video-viewing and joyriding attitudes. Furthermore, the results provided initial evidence for the hypothesis that the relationship between sensation-seeking and joyriding attitudes is explained by respondents' BAS scores. Accordingly, it seems advisable to include BIS and BAS in future media research. The present study also has important implications for the construction and planning of prevention campaigns, which are extensively discussed.     

Experiencing versus contemplating: Language use during descriptions of awe and wonder

Awe and wonder are theorised to be distinct from other positive emotions, such as happiness. Yet little empirical or theoretical work has focused on these emotions. This investigation explored differences in language used to describe experiences of awe and wonder. Such analyses can provide insight into how people conceptualise these emotional experiences, and whether they conceptualise these emotions to be distinct from other positive emotions, and each other. Participants wrote narratives about experiences of awe, wonder and happiness. There were differences in the language used to describe these positive emotional states, consistent with the theorised functions of each emotion. Awe was related to observing the world, reflected in greater use of perception words. Wonder was related to trying to understand the world, reflected in greater use of cognitive complexity and tentative words. Language use for both emotions reflected an environmental focus, whereas language use for happiness reflected a social/relationship focus.     

Aspiration Strain and Mental Health: The Education‐Contingent Role of Religion

This study examines whether dimensions of religious involvement (i.e., perceived divine control, private religious practices, and religious social integration) buffer associations between aspiration strain and mental health outcomes (i.e., psychological distress, loneliness, and optimism). We also test three‐way interactions to determine whether the stress‐buffering effects of religious involvement are amplified among undereducated persons. We test our hypotheses with cross‐sectional survey data from Vanderbilt University's Nashville Stress and Health Study (2011–2014), a probability sample of non‐Hispanic white and black adults from Davidson County, Tennessee (n = 1,252). Results from multivariate regression models confirmed: (1) aspiration strain was positively associated with psychological distress and loneliness, and negatively associated with optimism; and (2) religious involvement attenuated these associations, but only for respondents with less than or equal to a high school education. We discuss the implications and limitations of our findings and outline avenues for future research.