Spiritual Integration Predicts Self-Reported Mental and Physical Health

Data from 167 participants were used to establish the psychometric properties of the Reidhead spiritual integration scale, 31-item version (SI-31). Structural equation modeling was used to empirically evaluate influences on perceived health functioning, while accounting for possible confounds. The analyses showed that SI-31 predicted perceived mental and physical health while controlling for life satisfaction, religious variables, mood patterns, depression symptoms, and demographics. The importance of SI as a predictor of health-related outcomes is supported, as is the usefulness of the SI-31 in predicting these outcomes.     

EFFECTS OF A SIGNALED DELAY TO REINFORCEMENT IN THE PREVIOUS AND UPCOMING RATIOS ON BETWEEN-RATIO PAUSING IN FIXED-RATIO SCHEDULES

Domestic hens responded under multiple fixed‐ratio fixed‐ratio schedules with equal fixed ratios. One component provided immediate reinforcement and the other provided reinforcement after a delay, signaled by the offset of the key light. The components were presented quasirandomly so that all four possible transitions occurred in each session. The delay was varied over 0, 4, 8, 16, and 32 s with fixed‐ratio 5 schedules, and over 0, 8 and 32 s with fixed‐ratio 1, 15 and 40 schedules. Main effects of fixed‐ratio value and delay duration were detected on between‐ratio pauses. Pauses were longer when the multiple‐schedule stimulus correlated with a delayed‐reinforcer component was presented, with the longest pauses occurring at the transition from a component with an immediate reinforcer to one with a delayed reinforcer. Pause durations were shortest during immediate components. Overall, both the presence or absence of a delay in the upcoming component, and the presence or absence of a delay in the preceding component affected pause length, but the upcoming delay had the larger effect. Thus changes in delay had similar effects to past reports of the effects of changes in response force, response requirement, and reinforcer magnitude in multiple fixed‐ratio fixed‐ratio schedules.     

Using a Training-of-Trainers Approach and Proactive Technical Assistance to Bring Evidence Based Programs to Scale: An Operationalization of the Interactive Systems Framework’s Support System

Bringing evidence based programs to scale was a major initial impetus for the development of the Interactive Systems Framework for Dissemination and Implementation (ISF). The ISF demonstrates the importance of the Support System in facilitating the uptake of innovations in the community (the Delivery System). Two strategies that members of the Support System commonly use are training‐of‐trainers (TOT) models and technical assistance (TA). In this article, we focus on the role of the Support System in bringing evidence‐based programs (EBPs) to scale in the Delivery System using a case example, with special attention on two strategies employed by Support Systems—training‐of‐trainers (TOT) and proactive technical assistance. We then report on findings from a case example from the Promoting Science Based Approaches to Teen Pregnancy Prevention project that furthers our conceptualization of these strategies and the evidence base for them. We also report on the limitations in the literature regarding research on TOTs and proactive TA and provide suggestions for future research on TOTs and proactive TA that will enhance the science and practice of support in the ISF. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

A Business Model for Managing System Change Through Strategic Financing and Performance Indicators: A Case Study

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.     

Person and environmental factors associated with well-being in medical students

Medical students are exposed to demanding academic workloads and are often under considerable psychological strain. This study examined important person and environmental variables that might predict their psychological well-being. Participants were 755 students in years 2-6 from 11 Australian medical schools. A web-based survey assessed well-being, personality, professional expectations, lifestyle expectations, barriers, academic stress, and debt. A hierarchical regression analysis demonstrated that extraversion, conscientiousness, professional expectations, and lifestyle expectations were positively associated with well-being, while academic stress, which was the strongest predictor, neuroticism, and concern about debt were negatively associated. Medical students who displayed a disposition that was outgoing, conscientious, and stable, who were less stressed about their academic workload and their level of debt, and who held higher expectations for their future professional career, and expectations of a balanced lifestyle, had better well-being. Medical educators should be aware of these factors and provide support and strategies that promote well-being to students during medical training.