Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety‐focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11–71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6 % of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community‐based interventions.     

Les principes d’une prévention de la récidive efficace : le modèle Risque-Besoins-Réceptivité

Recidivism prevention remains a crucial issue in France. While meta-analyses clearly indicated the effectiveness of the Risk-Need-Responsivity (R-N-R) model for assessment and rehabilitation, this model is not used in French probation services. The aim of this article is to introduce the R-N-R model, through an emphasis on its three main principles. A necessary continuity from assessment to intervention is highlighted. The article concludes by stressing the need to empirically evaluate the effectiveness of intervention to prevent recidivism.     

Parcours : développement d’une stratégie de prévention de la récidive adaptée aux milieux ouverts

Experiments show that applying RNR principles “in the real world” within the context of probation can reduce recidivism, provided that evidence-based intervention models are used. In Quebec, probation officers agreed to take part in a pilot project whereby the Parcours program (Pathways) was transposed into a series of interview outlines to be used in a community setting. The experiment took place over a one-year period, the management of convicted offenders consisting in around 10 30 to 90-minute interviews. These interviews addressed: motivation for change, beliefs, values and cognitive distortions, as well as the adoption of relapse prevention strategies. Results were positive enough to authorize the deployment of Parcours en milieu ouvert (Pathways in community settings) in all sectors. This approach could be implemented in France, where at the instigation of the Council of Europe, new European probation rules recommend the establishment of interventions based on evidence-based models.     

Measuring Sense of Community Responsibility in Community‐Based Prevention Coalitions: An Item Response Theory Analysis

Research on sense of community (SOC) has traditionally been approached from a resource perspective. Recently, however, research on the experience of SOC has evolved to include a related but distinct construct of sense of community responsibility (SOC‐R), or feelings of accountability for the well‐being of a community. This study applied item response theory to examine the psychometric properties of a SOC‐R scale used in an evaluation of community‐based substance abuse prevention coalitions. Data were collected in 2017 from coalition members (analytic sample = 309) in the northeastern United States. Findings indicate that the scale was reliable, unidimensional, and functioned well, particularly at low and moderate levels of the construct. The addition of two items intended to capture higher levels of the construct improved the scale's functioning at higher levels of SOC‐R. The adapted SOC‐R scale was also shown to have moderately strong relationships with conceptually relevant variables, including SOC, coalition participation, number of roles performed in the coalition, and engagement in community action activities. These findings provide empirical evidence to support the reliability and validity of the SOC‐R scale, and have critical implications for our conceptualization of the SOC construct, its measurement, and for the evaluation of community‐based prevention interventions.     

Exploring the acceptance of connected and automated vehicles: Focus group discussions with experts and non-experts in transport

The successful deployment of connected and automated vehicles (CAVs) will largely depend on public opinion. Expectations and concerns are essential components driving the speed of market uptake and final adoption of these technologies. We have studied user expectations and concerns, as well as their provenance, by conducting a series of Focus Group (FG) discussions with transport area experts and non-expert participants, in Italy, Germany, and Spain. Together with user acceptance, potential advantages and disadvantages that CAVs may bring at a societal level were explored. Results show that benefits like increased safety and accessibility and improved travel experience for both driver and passengers could support CAVs’ deployment. Nevertheless, a variety of concerns were raised during the discussions, related to privacy, responsibility in case of an accident, and increase in maintenance and repair costs. These aspects could significantly hamper or delay CAVs acceptability and need to be carefully considered by stakeholders. The reported insights from the FG discussions and the fact that some participants noted positive changes of their initial idea of CAVs due to their participation in the discussion, exemplify the importance of citizen engagement activities to address mobility challenges.     

A Balancing Act: Integrating Evidence‐Based Knowledge and Cultural Relevance in a Program of Prevention Parenting Research with Latino/a Immigrants

Family therapists have a unique opportunity to contribute toward the reduction of widespread mental health disparities impacting diverse populations by developing applied lines of research focused on cultural adaptation. For example, although evidence‐based prevention parent training (PT) interventions have been found to be efficacious with various Euro‐American populations, there is a pressing need to understand which specific components of PT interventions are perceived by ethnic minority parents as having the highest impact on their parenting practices. Equally important is to examine the perceived cultural relevance of adapted PT interventions. This qualitative investigation had the primary objective of comparing and contrasting the perceived relevance of two culturally adapted versions of the efficacious parenting intervention known as Parent Management Training, the Oregon Model (PMTO). According to feasibility indicators provided by 112 Latino/a immigrant parents, as well as findings from a qualitative thematic analysis, the core parenting components across both adapted interventions were identified by the majority of research participants as relevant to their parenting practices. Participants exposed to the culturally enhanced intervention, which included culture‐specific sessions, also reported high satisfaction with components exclusively focused on cultural issues that directly impact their parenting practices (e.g., immigration challenges, biculturalism). This investigation illustrates the relevant contributions that family therapy scholars can offer toward addressing mental health disparities, particularly as it refers to developing community‐based prevention interventions that achieve a balance between evidence‐based knowledge and cultural relevance.     

Testing the long-term efficacy of a prevention program for improving marital conflict in community families

Family-focused prevention programs for community samples have potentially broad, clinically relevant implications but few studies have examined whether any program benefits continue to be observed over the long term. Although benefits of a marital conflict focused parent education program, the Happy Couples and Happy Kids (i.e., HCHK) program, were supported in a study based on pre-test, post-test, 6-month follow-up, and 1-year follow-up assessments, the longer-term stability of treatment effects has not been established. Couples with children between 4 and 8 years of age who had previously participated in the HCHK study completed a two-year follow-up, including a parent-only group (PO, n = 12); parent-child group (PC, n = 15); and a self-study group (SS, n = 12). Greater knowledge about the effects of marital conflict on families and behavioral improvements in constructive conflict, and specifically in problem-solving behaviors, were observed at the two-year follow-up for couples who received the HCHK program. Reflecting an innovative analysis of mediating mechanisms, change-to-change analyses showed that these changes were linked with improvements in other family processes over time, including marital satisfaction, parenting and child adjustment. The findings support the relatively long-term efficacy of brief, psychoeducational programs for educating community samples about marital conflict and family processes.     

Parenting as relationship: a framework for assessment and practice

Parenting tends to be framed as a set of actions directed toward the child rather than as a relationship. This article helps therapists, parent-educators, and researchers conceptualize parenting as a socioculturally embedded relationship. The authors apply the relational orientations typology (Silverstein, Bass, Tuttle, Knudson-Martin, & Huenergardt, 2006) to parent-child relationships. The typology addresses two dimensions: whether the focus is on the child's meeting parental expectations or on expectations of mutuality and whether power between parent and child is expected to be symmetrical or asymmetrical. Four relational orientations are described: (1) rule directed, (2) position directed, (3) independence directed, and (4) relationship directed. These relational orientations describe the nature of the reciprocal relationship between parent and child and offer a framework from which to address parenting issues. A case illustration shows how the relational orientations framework helps therapists incorporate a larger systems/relational perspective into what was originally framed primarily as a child behavior problem.     

Can we reduce eating disorder risk factors in female college athletes? A randomized exploratory investigation of two peer-led interventions

Female athletes are at least as at risk as other women for eating disorders (EDs) and at risk for the female athlete triad (i.e., inadequate energy availability, menstrual disorders, and osteoporosis). This study investigated whether two evidence-based programs appear promising for future study if modified to address the unique needs of female athletes. Athletes were randomly assigned to athlete-modified dissonance prevention or healthy weight intervention (AM-HWI). ED risk factors were assessed pre/post-treatment, and 6-week and 1-year follow-up. Results (analyzed sample, N = 157) indicated that both interventions reduced thin-ideal internalization, dietary restraint, bulimic pathology, shape and weight concern, and negative affect at 6 weeks, and bulimic pathology, shape concern, and negative affect at 1 year. Unexpectedly we observed an increase in students spontaneously seeking medical consultation for the triad. Qualitative results suggested that AM-HWI may be more preferred by athletes.