Is There Life After DEBI? Examining Health Behavior Maintenance in the Diffusion of Effective Behavioral Interventions Initiative

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative—commonly referred to the "DEBIs"—currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.     

Peer relationships in counseling psychology training

Twelve students from APA-accredited counseling psychology doctoral programs were interviewed about their experiences with peers in their program, and about their values and beliefs about peer relationships in graduate school. Interview data were analyzed using consensual qualitative research. Participants reported a wide range of positive (e.g. collaborative and supportive) and negative (e.g. competitive and hostile) interactions with peers inside and outside of the classroom, in research, and in clinical work. Compared to advisory and supervisory relationships, peer relationships were typically less formal and more open. The sharing of common training experiences generally facilitated mutual understanding among trainees. In addition, a visual analog scale, the peer relationship scale (PRS), was used to measure participants’ closeness with peers. Results from the PRS appeared to be useful in distinguishing participants with the most positive and negative peer relationships, warranting further investigation of its psychometric properties and application in program evaluation and research on training. Implications for training are discussed.     

Examining Adolescent Cocaine Use with Social Learning and Self-Control Theories

An estimated 1.6 million adolescents use cocaine on a regular basis. Social learning theory and self-control theory are regularly used to explain adolescent substance use, but few studies have examined Hirschi’s (2004) revised self-control theory. This study examines the efficacy of these three theories in explaining adolescent cocaine use using data from the 2011 Monitoring the Future survey. The study finds that Hirschi’s (2004) revised theory and peer hard drug use predicted the probability of adolescent cocaine use in the previous 30 days. When examining cocaine use in the prior year, all three theoretical perspectives were significant predictor of cocaine use. The implications of the findings are discussed.     

ANDREW DICKSON WHITE AND THE HISTORY OF A RELIGIOUS FUTURE

Andrew Dickson White played a pivotal role in constructing the image of a necessary, and even violent, confrontation between religion and science that persists to this day. Though scholars have long acknowledged that his position is more complex, given that White claimed to be saving religion from theology, there has been no attempt to explore what this means in light of his overwhelming attack on existing religions. This essay draws attention to how White's role as a historian was decisive in allowing him to posit a future for religion purified of dogma by science. It argues, furthermore, that this effort is better understood as religious innovation, rather than a plea for strictly secular science. In so doing it hopes to lay the foundation for a more fruitful historical treatment of White, and a range of other figures whose devotion to science has otherwise been difficult to grasp.     

Gender differences in the family-relatedness of relocation decisions

Using a dyadic study design, the present study draws on research into the family-relatedness of work decisions to examine the impact of the spouse's characteristics on an employee's willingness to engage in job-related relocation. With a sample of 1234 employees, the results show that spousal willingness to relocate mediates (a) the negative effect of the spouse's community ties and (b) the positive effect of the spouse's job alternatives on an employee's willingness to relocate. The indirect effect of the spouse's job alternatives was stronger among female than among male employees. To validate employees' perceptions, this study uses matched data from a subsample of 207 employees and their spouses to test a multi-source model, which revealed several notable inconsistencies. Our exploration of discrepancies between employee and spousal ratings helps explain these differences between single-source and multi-source models. Overall, findings suggest that employees consider various spousal factors in their career decision-making, and the family-relatedness of relocation decisions is particularly strong among female employees.     

Experiences of Women Who Underwent Predictive BRCA 1/2 Mutation Testing Before the Age of 30

This qualitative interview study focuses on the experiences of a sample of British female BRCA 1/2 carriers who had predictive testing before the age of 30, which is the minimum age for breast screening in the UK. Following appropriate informed consent procedures participants were recruited through the Cancer Genetics Service for Wales. Semi-structured interviews were conducted face-to-face with seven participants, transcribed in full and analyzed using thematic analysis. The motives for testing and perceived advantages described by participants were similar to those identified in previous studies with older participants, such as increased awareness and knowledge and feeling more in control. However some of the perceived disadvantages were specific to younger women, including feeling pressured to make important life decisions earlier than they would have liked, such as about family planning and risk reducing surgery. Participants also reported feeling abandoned or forgotten because of lack of ongoing clinical contact, or feeling “stuck waiting” for screening to begin. However, none felt that these disadvantages were a reason to regret having testing. Findings in this small study suggest that having BRCA 1/2 predictive testing can have positive outcomes for young women even though they may be unable to access interventions such as breast screening. However it may be helpful to encourage young women during pre-test counseling to explore the decisions and choices they may face. These young women could benefit from ongoing support and follow up and increased interaction with healthcare professionals.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.