Navigating the Road Ahead: Public Health Challenges and the Interactive Systems Framework for Dissemination and Implementation

Public health is currently faced with an array of critical challenges and disconnects. Research and evaluation have identified a number of evidence‐based strategies for effecting behavior change at individual, group, organizational, and environmental levels, all of which hold promise for leading to substantial reductions in morbidity and mortality, and increased quality of life. Unfortunately, there is huge variability across the public health system in awareness of the value of using evidence to inform decision making, let alone in capacity to locate, assess, compare, select, justify, adapt, implement, and evaluate evidence‐based strategies, or to participate in building the evidence base for practice‐based innovations. As a result, many communities may not be benefitting from research‐tested and practice‐based strategies that could help them to meet their public health goals more efficiently and effectively. CDC's Interactive Systems Framework for Dissemination and Implementation (ISF), released in 2008, was designed to help close this gap between research and practice. This commentary identifies the ways in which the ISF framework is useful in addressing the research practice gap; revisits the elements of the framework that have continued to guide research and practice in fruitful ways; and highlights areas that need further development to meet current public health challenges. 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     

The Test of Time in School-Based Mentoring: The Role of Relationship Duration and Re-Matching on Academic Outcomes

The influence of match length and re-matching on the effectiveness of school-based mentoring was studied in the context of a national, randomized study of 1,139 youth in Big Brothers Big Sisters programs. The sample included youth in grades four through nine from diverse racial and ethnic backgrounds. At the end of the year, youth in intact relationships showed significant academic improvement, while youth in matches that terminated prematurely showed no impact. Those who were re-matched after terminations showed negative impacts. Youth, mentor, and program characteristics associated with having an intact match were examined. Youth with high levels of baseline stress and those matched with college student mentors were likely to be in matches that terminated prematurely, while rejection-sensitive youth and mentors who had previous mentoring experience were more likely to be in intact relationships. Implications for research and practice are discussed.     

Difficulty processing temporary syntactic ambiguities in Lewy body spectrum disorder

While grammatical aspects of language are preserved, executive deficits are prominent in Lewy body spectrum disorder (LBSD), including Parkinson’s disease (PD), Parkinson’s dementia (PDD) and dementia with Lewy bodies (DLB). We examined executive control during sentence processing in LBSD by assessing temporary structural ambiguities. Using an on-line word detection procedure, patients heard sentences with a syntactic structure that has high-compatibility or low-compatibility with the main verb’s statistically preferred syntactic structure, and half of the sentences were lengthened strategically between the onset of the ambiguity and its resolution. We found selectively slowed processing of lengthened ambiguous sentences in the PDD/DLB subgroup. This correlated with impairments on measures of executive control. Regression analyses related the working memory deficit during ambiguous sentence processing to significant cortical thinning in frontal and parietal regions. These findings emphasize the role of prefrontal disease in the executive limitations that interfere with processing ambiguous sentences in LBSD.     

Habit strength moderates the strength of within-person relations between weekly self-reported and objectively-assessed physical activity

ObjectivesPhysical activity (PA) habit strength influences how people control their PA and may also influence how people encode, store, or recall their PA. This study evaluated whether individual differences in PA habit strength moderated the magnitude of within-person associations between weekly self-reported PA and step counts.DesignLongitudinal.MethodAfter an initial assessment of PA habit strength, university students wore pedometers for four weeks and completed four self-reports of weekly mild, moderate, and strenuous PA.ResultsOn average, people's weekly step counts and self-reported PA across time were weakly-to-moderately associated, but there was substantial variability in the magnitude of these associations across people. People with strong PA habits had weaker within-person associations between deviations from their average self-reported PA and step counts than those with weak PA habits.ConclusionsThese results may indicate that PA habit strength influences the sensitivity of self-report PA measures to change in objectively-measured PA.     

You,me, and meaning: an integrative review of connections between relationships and meaning in life

Social relationships are seen to be vital to human functioning, both in terms of psychological functioning and physical health. Relationships are a cornerstone of well-being. For instance, having positive relationships has been linked to greater happiness, life satisfaction and physical health outcomes. Meaning in life, or the perception that one's life is significant and has a purpose, is another prominent cornerstone of well-being. As such, social relationships and meaning in life should have reciprocal associations. In this paper, cross-cultural theory and empirical research will be reviewed to explore the role of family, romantic and friendship relationships in supporting meaning in life. Further, we will discuss the implications of the current research and propose new directions for future research.     

Evolution of the Millon Clinical Multiaxial Inventory

Dr. Theodore Millon (1928–2014) was a primary architect for the personality disorders in the DSM–III, a structure that has endured into the DSM–5. His 1969 book, Modern Psychopathology, created an elegant framework into which the well-known personality prototypes could be fitted and understood. His theoretical work soon led into the creation of several psychological inventories, most notably the Millon Clinical Multiaxial Inventory (MCMI). The MCMI, now in preparation for its 4th major edition, has been a very popular instrument among clinicians. This article explores the history of the MCMI's development from its origins, through 2 distinct theoretical phases, and to its current status as the MCMI–IV is finalized.     

Reading Proficiency and Comparability of Mathematics and Science Scores for Students From English and Non-English Backgrounds: An International Perspective

The purpose of this research is to examine the comparability of mathematics and science scores for students from English language backgrounds (ELB) and non-English language backgrounds (NELB). We examine the relationship between English reading proficiency and performance on mathematics and science assessments in Australia, Canada, the United Kingdom, and the United States. The findings indicate a strong relationship with reading proficiency accounting for up to 43% of the variance in mathematics and up to 79% in science. In all comparisons, ELB students either outperformed NELB students or performed at the same level. However, when statistical adjustments were made for reading proficiency, in both mathematics and science, the score gap between the groups became statistically non-significant in three out of the four countries. These findings point to differences in score meaning in mathematics and science assessments and limitations in comparing performances of ELB and NELB.     

The cognitive specificity of learned helplessness and depression deficits: The role of self-focused cognitions

Abstract

Four experiments assessed similarities and differences in learned helplessness and depression-related deficits in cognitive performance and self-focused cognitions. Subjects answered the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), were exposed to no-feedback or failure in unsolvable problems, and their response time in a digit comparison task (with or without a memory component, with different number of digits, and different number of mental transformations) and self-focused cognitions were assessed. Learned helplessness and depression deficits were found in a memory task, and the deficits increased with the number of digits. Depression deficits also increased with the number of transformations, and were also found in the no-memory/two transformation condition. Finally, task-related worries were related to learned helplessness deficits, and task-irrelevant thoughts were related to depression deficits. Findings were discussed in terms of the cognitive specificity of learned helplessness and depression deficits.     

Differential activation patterns of occipital and prefrontal cortices during motion processing: Evidence from normal and schizophrenic brains

Visual motion perception is normally mediated by neural processing in the posterior cortex. Focal damage to the middle temporal area (MT), a posterior extrastriate region, induces motion perception impairment. It is unclear, however, how more broadly distributed cortical dysfunction affects this visual behavior and its neural substrates. Schizophrenia manifests itself in a variety of behavioral and perceptual abnormalities that have proved difficult to understand through a dysfunction of any single brain system. One of these perceptual abnormalities involves impaired motion perception. Motion processing provides an opportunity to clarify the roles of multiple cortical networks in both healthy and schizophrenic brains. Using fMRI, we measured cortical activation while participants performed two visual motion tasks (direction discrimination and speed discrimination) and one nonmotion task (contrast discrimination). Normal controls showed robust cortical activation (BOLD signal changes) in MT during the direction and speed discrimination tasks, documenting primary processing of sensory input in this posterior region. In patients with schizophrenia, cortical activation was significantly reduced in MT and significantly increased in the inferior convexity of the prefrontal cortex, an area that is normally involved in higher level cognitive processing. This shift in cortical responses from posterior to prefrontal regions suggests that motion perception in schizophrenia is associated with both deficient sensory processing and compensatory cognitive processing. Furthermore, this result provides evidence that in the context of broadly distributed cortical dysfunction, the usual functional specificity of the cortex becomes modified, even across the domains of sensory and cognitive processing.