Introduction to Multi-Level Community Based Culturally Situated Interventions

This introduction to a special issue of the American Journal of Community Psychiatry is the result of a symposium at the Annual Meeting of the Society for Applied Anthropology, 2006, that brought together anthropologists and psychologists involved in community based collaborative intervention studies to examine critically the assumptions, processes and results of their multilevel interventions in local communities with local partners. The papers were an effort to examine context by offering a theoretical framework for the concept of “level” in intervention science, and advocating for “multi‐level” approaches to social/behavioral change. They presented examples of ways in which interventions targeted social “levels” either simultaneously or sequentially by working together with communities across levels, and drawing on and co‐constructing elements of local culture as components of the intervention. The papers raised a number of important issues, for example: (1) How are levels defined and how should collaborators be chosen; (2) does it matter at which level multilevel interventions begin; (3) do multilevel interventions have a greater effect on desired outcomes than level‐specific interventions; (4) are multilevel interventions more sustainable; (5) are multilevel interventions cost effective to run, and evaluate; (6) how can theories of intervention be generated and adapted to each level of a multilevel intervention; (7) how should intervention activities at each level coordinate to facilitate community resident or target population empowerment? Many of these questions were only partially addressed in the papers presented at that time, and are more fully addressed in the theoretical papers, case studies and approach to evaluation included in this collection.     

Striving for a culturally responsive process in training health professionals on Asian American and Pacific Islander youth violence prevention

The quality of youth violence prevention practice is dependent on the quality of education and training of professionals who will care for disadvantaged and/or underserved youth. The authors propose that culturally responsive youth violence prevention curricula, focused on Asian Americans and Pacific Islanders, should: 1) target institutions that train health professionals likely to serve Asian Americans and Pacific Islanders; 2) promote the professional development of Asian American and Pacific Islander students and enhance all students' comfort in addressing behavioral, social, and cultural concerns; 3) cover specific issues relevant to Asian Americans and Pacific Islanders, including the role of acculturative stress, socioeconomic hardship, and other risk factors that may account for mental health disparities; and 4) continuously engage researchers, educators, and community stakeholders in cooperatively and creatively applying new knowledge to clinical challenges. The authors summarize resources for youth violence prevention education that have been used for training healthcare professionals in a multicultural context.     

Effects of attentional-focus instructions on movement kinematics

BackgroundRecent research has shown that internal (body-related) attention-focus instructions disrupt motor learning and performance, whereas paying attention to the environmental effects of movements (external focus) leads to better performance than an internal focus [see, for reviews, Wulf, G. (2007). Attentional focus and motor learning: a review of 10 years of research. E-Journal Bewegung und Training, 1, 4–14.; Wulf, G., &; Prinz, W. (2001). Directing attention to movement effects enhances learning: a review. Psychonomic Bulletin &; Review, 8, 648–660.]. However, Beilock's studies [Beilock, S. L., Bertenthal, B. I., McCoy, A. M., &; Carr, T. H. (2004). Haste does not always make waste: expertise, direction of attention, and speed versus accuracy in performing sensorimotor skills. Psychonomic Bulletin &; Review, 11, 373–379.] suggest that an internal focus is detrimental in experts but not in novices. Because detrimental effects of consciously attending to movements have generally been measured by performance scores such as accuracy scores or reaction times, it remains unclear how internal and external attentional-focus instructions influence movement kinematics when learning a new skill. To fill this gap, the present study investigated attentional-focus effects on a biomechanical level.MethodsA video of an expert juggler demonstrating a two-ball juggling task was presented to juggling novices. Experimental groups were given either body-related (internal group) or ball-related (external group) verbal instructions or no attention-guiding instructions (control group). In the retention phase without attention-guiding instructions, the body-movement and ball-flight aspects of performance focused on in the verbal instruction were subjected to biomechanical analyses.Results and ConclusionsJuggling performance improved equally in all three groups. However, internally vs. externally instructed acquisition phases had differential effects on the kinematics of the upper body as well as ball trajectories when performing the juggling task. Remarkably, ball trajectories in the control group who received no specific attentional cueing were similar to those in the externally instructed group. This suggests that task-relevant information is picked up independently of instructions, and that external instructions provide redundant information. Internal instructions for object-related tasks, however, may confront novice learners with the need to process additional information. As a result, task difficulty might be unnecessarily enhanced in an observational learning setting.     

Prevention program for disturbed eating and body dissatisfaction in a Spanish university population: a pilot study

A pilot study was carried out in university students to evaluate the effect of a health promotion program for eating disturbances and body dissatisfaction. A subgroup of 135 medical students of both sexes in their second year was selected. There were divided in three groups, high-risk students (EDI > 40) and low-risk students (EDI < 40) who participated in the program and nonparticipants as comparison group. Program had a total of 16 workshops of 90 min. A year later the different assessment measurements were compared, body image, attitudes and eating behaviours, psychopathological levels and self-esteem. Differences by gender were found on the impact of the intervention. The program presented a statistical significant improvement in body-image satisfaction, eating attitudes only in high-risk female students in the intervention group. This pilot program for eating disorder prevention in university populations can be considered effective, mainly in female populations at risk for developing an eating disorder.     

Maintenance of Treatment Gains: A Comparison of Enhanced,Standard, and Self-directed Triple P-Positive Parenting Program

This report describes the 3 year outcomes of three different variants of the Triple P-Positive Parenting Program, a behavioural family intervention. Families were randomly assigned to one of three intervention conditions or to a waitlist condition. At 1 year follow-up there were similar improvements on observational and self-report measures of preschooler disruptive behaviour for Enhanced, Standard and Self Directed variants of Triple P. At 3 year follow-up (completed by 139 families), each condition showed a similar level of maintenance of intervention effects. Approximately 2/3 of preschoolers who were clinically elevated on measures of disruptive behaviour at pre-intervention moved from the clinical to the non-clinical range. Across conditions, there was a comparable preventive effect for each intervention for these high risk children. The implications of the findings for the development of brief, cost effective parenting interventions within a public health framework are discussed.     

Sexual assault on college campuses: Is an ounce of prevention enough?

This article provides a construct-by-construct review of the effectiveness of sexual asault prevention programs in modifying sexual assault-related attitudes, cognitions, emotions, and behaviors. This article also discusses variables that may moderate program effectiveness, variables that may mediate program effectiveness, methodological issues, programs for special populations, and iatrogenic effects. In general, sexual assault prevention programs have been shown to be effective in producing short-term reductions in rape-supportive attitudes. There is insufficient evidence, however, to conclude that such programs are effective in reducing the incidence of sexual assault.     

Prevention, solution-focused therapy, and the illusion of mental disorders

Therapy theorists' criticism of the lack of specific mechanisms in the prevention of mental disorders is examined from the perspective of solution-focused therapy (SFT), which argues that solutions can be unrelated to problems, and that it is not even necessary to know what a problem is in order to solve it. It is suggested that the shift of attention from problems to solutions in SFT offers a conceptual framework within which the criticism is not relevant, and from which theorists of therapy and prevention can share a common outlook. This outlook involves a focus on encouraging productive, useful, positive behavior, with a corresponding deemphasis on an skepticism about current conceptualizations of mental disorders.     

Simulation-based research to improve infant health outcomes: Using the infant simulator to prevent infant shaking

Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator. Finally, we will discuss previous and future research using simulation to reduce morbidity and mortality from abusive head trauma, the most common cause of traumatic death in infancy.     

The hope of the future: The experience of pregnancy influences women’s implicit space–time mappings

It has long been observed that speakers employ spatial concepts “front” and “back” to talk about temporal concepts “past” and “future.” However, the direction of space-time mappings varies across cultures. According to Temporal Focus Hypothesis (TFH), people’s implicit associations between space and time are conditioned by their temporal focus. Here we tested whether pregnancy can affect Chinese women’s temporal focus and thereby influence their space-time mappings. One of the most striking characteristics of pregnant women noted by previous research is their future-oriented thought. Based on this, we predicted that pregnant women should be more future-focused. Consistent with this prediction, the results demonstrated that pregnant women tended to be more future-focused than non-pregnant women and demonstrated a greater tendency to conceptualize the future as in front of them, supporting the TFH. The current research offers a new perspective that culture-external factors such as pregnancy can also influence people’s spatialization of time.     

Pedestrian behaviour of 6th grade Estonian students: Implications of social factors and accident-prevention education at school

Children as pedestrians are one of the most vulnerable groups of road users. Therefore factors associated with risky pedestrian behaviour should be carefully studied. The aim of this article is to clarify how the traffic behaviour of 6th grade students as pedestrians is associated with the behaviour of their traffic companions and prevention activities at school, also taking gender into consideration. The research was conducted based on a randomly-selected sample of 1033 6th-grade students with the mean age of 12.77 ± 0.38 (SD) years. The results showed that compared to girls boys take significantly more risks as pedestrians: they rarely use reflectors during periods of darkness and often cross the road against the red light. The most important role models for adolescents in traffic behaviour are their parents. The role model behaviour with the strongest effect on adolescent high-risk behaviour in traffic is the role model not using crosswalks to cross the street. The results also showed that higher-risk traffic behaviour by adolescent pedestrians is predicted by higher-risk behaviour on the part of their companions (parents, teachers), walking alone on the street, as well as by an adolescent’s lower involvement in the less active prevention activities in the classroom. To improve adolescent pedestrians’ traffic behaviour social environment and school-based factors should be considered more thoroughly in prevention work at school.