The Prevention Delivery System: Organizational Context and Use of Comprehensive Programming Frameworks

The purpose of this exploratory study is to investigate organizational‐level mechanisms in the Prevention Delivery System (PDS) and their influence on implementing comprehensive programming frameworks (e.g., Communities that Care‐CtC) as the innovation. The PDS is part of the Interactive Systems Framework for Dissemination and Implementation (ISF) and describes key characteristics of innovation implementation and dissemination. The study addresses two research questions: (1) What types of organizational characteristics are related to successful use of each of the programming processes (i.e., planning, implementation, evaluation, and sustainability) that are part of comprehensive programming frameworks?; and (2) What are the similarities and differences in the organizational patterns correlated with use of each of the programming processes? Surveys, interview data, and other documents designed to assess organizational characteristics and extent of use of a comprehensive programming framework over time, were collected from 8 Community boards and 23 provider agencies. These organizations were responsible for planning and delivering substance abuse prevention services as part of a statewide initiative in Ohio. Data were analyzed using Spearman rho (and rank‐biserial) correlations, with an emphasis on effect sizes. Results indicated that leadership, shared vision, process advocates, and technical assistance were common correlates of use across programming processes. However, the role played by these organizational variables differed for each programming process, pointing to complex interactions of the organizational infrastructure with other variables (i.e., characteristics of the innovation itself and external macro‐level factors). This exploratory study provides preliminary data on the organizational‐level mechanisms of the PDS and the complexity of their relationships with the other Systems in the Interactive Systems Framework.     

The Importance of Program Evaluation: How Can it be Applied to Diverse Genetics Education Settings?

The role of a genetic counselor often entails providing education to patient, community and/or health professional groups. While counseling supervision assists genetic counselors to be reflective about their clinical work and to enhance clinical skills, evaluation is a rather analogous process in the provision of education. Program evaluation of education activities can be applied to provide information about the needs of the target group (needs assessment), the delivery of the program (process evaluation) as well as determining the extent to which the education activity has met its intended aims (summative evaluation). Evaluation assists the educator to assess the impact of their program and provides an evidence base about genetics education. Although program evaluation can be a complex activity, the tools are ones that can be used by individuals to evaluate single or simple education activities. The components of evaluation are discussed with reference to genetic counseling practice and three very different examples of actual evaluations are provided to illustrate the diversity of evaluation strategy and programs to which it can be applied.     

Enhancing Therapeutic Gains: Examination of Fidelity to the Model for the Intensive Mental Health Program

Given that the development of treatment fidelity assessment protocol is an integral but too frequently ignored aspect of clinical trials for psychological treatments, the Intensive Mental Health Program (IMHP) sought to build fidelity activities into training, program evaluation, and clinical recordkeeping from the outset of a 3 year study period. We describe (a) operational definitions and measurement of the IMHP treatment model, (b) planned fidelity-promoting activities, (c) evaluation methods, and (d) fair to appreciable accomplishment of IMHP fidelity targets. Discussion of the circumstances and processes possibly hindering better fidelity for several IMHP treatment features accompanies presentation of fidelity data. We summarize pitfalls and compensatory strategies identified during IMHP program evaluation and offer practical suggestions to enhance accountability and evaluative activity in future clinical research.     

Perceptual Fluency and Judgments of Vocal Aesthetics and Stereotypicality

Research has shown that processing dynamics on the perceiver's end determine aesthetic pleasure. Specifically, typical objects, which are processed more fluently, are perceived as more attractive. We extend this notion of perceptual fluency to judgments of vocal aesthetics. Vocal attractiveness has traditionally been examined with respect to sexual dimorphism and the apparent size of a talker, as reconstructed from the acoustic signal, despite evidence that gender‐specific speech patterns are learned social behaviors. In this study, we report on a series of three experiments using 60 voices (30 females) to compare the relationship between judgments of vocal attractiveness, stereotypicality, and gender categorization fluency. Our results indicate that attractiveness and stereotypicality are highly correlated for female and male voices. Stereotypicality and categorization fluency were also correlated for male voices, but not female voices. Crucially, stereotypicality and categorization fluency interacted to predict attractiveness, suggesting the role of perceptual fluency is present, but nuanced, in judgments of human voices.     

Dilemmas of Practice: Challenges to Program Quality Encountered by Youth Program Leaders

To create and sustain high quality youth development programs it is important to understand the challenging situations and dilemmas that emerge in program leaders’ daily work with youth. In this research the experiences of leaders in 12 programs were followed over a 2–9 month period, which led to the identification of 250 dilemma situations. Qualitative analyses identified 5 categories and 12 subcategories of dilemmas that reflected distinct types of considerations (e.g., youth’s personalities, relationships with the community). The analyses also found that the experienced leaders in the study typically responded to these dilemmas in ways that were youth-centered and that balanced multiple considerations. It is argued that researchers need to go beyond identifying features of high quality programs, and more fully examine how effective leaders create and sustain high quality in response to the challenging situations of practice.     

Soldiers’ perspectives of the Married Army Couples Program: A review of perceived problems and proposed solutions

The current study investigated soldiers’ perceptions of the Married Army Couples Program (MACP) using data from focus groups conducted with Army personnel in dual-military marriages. Despite the high success rate of the program (approximately 80–83%)—success being defined as establishment of a joint domicile within a 50-mile radius of each spouse’s duty station—a variety of difficulties were reported as well as consequent negative perceptions. Problems included dissatisfaction with the parameters defining joint domicile, obstacles to career advancement, lack of quality information regarding the program, and unequal allocation depending on one’s level of leadership support. Difficulties with MACP led to negative impressions of the program and of the Army as a whole. Specifically, when asked about challenges related to the program, many participants reported perceptions of a poorly functioning program, an uncaring environment, and of the Army as a hypocritical institution. For individuals in dual-military marriages, these difficulties affect quality of life. For the institution, these negative perceptions can potentially lead to problems with retention of one or both members of a dual-military couple. We propose several strategies to improve the effectiveness of MACP and to increase positive perceptions of the program based on suggestions from the focus groups in addition to the military and work literatures.     

Predictors of Farmers’ Market Shopping among People Receiving Supplemental Nutrition Assistance Program Benefits

Promoting use of farmers’ markets (FMs) is a promising community‐level strategy to increase access to nutritious foods such as fruits and vegetables. Yet, FM shopping among people with Supplemental Nutrition Assistance Program (SNAP) benefits remains low. This research examined predictors of FM shopping among SNAP recipients living within 1 mile of a FM. A cross‐sectional survey of SNAP participants (N = 270) was conducted in 2015 in Cleveland and East Cleveland, OH, USA. Multinomial regression and zero‐truncated Poisson regression analyses were conducted to examine factors associated with FM shopping. Results indicate 48% reported shopping at a FM at least once in the past year, 26% had shopped at a FM before, but not in the last year, and 26% had never shopped at a FM. The multivariable analyses found awareness of FMs and a healthy food incentive program, and four dimensions of healthy food access are significantly associated with FM shopping among SNAP recipients. The food access dimensions included service delivery, spatial‐temporal, personal, and social access. Findings highlight modifiable leverage points for improving the reach of FMs among low‐income populations.     

A New Measure of Hallucinatory States and a Discussion of REM Sleep Dreaming as a Virtual Laboratory for the Rehearsal of Embodied Cognition

Hallucinatory states are experienced not only in connection with drugs and psychopathologies but occur naturally and spontaneously across the human circadian cycle: Our nightly dreams bring multimodal experiences in the absence of adequate external stimuli. The current study proposes a new, tighter measure of these hallucinatory states: Sleep onset, REM sleep, and non‐REM sleep are shown to differ with regard to (a) motor imagery indicating interactions with a rich imaginative world, and (b) cognitive agency that could enable sleepers to recognize their hallucinatory state. Mentation reports from the different states were analysed quantitatively with regard to two grammatical–semantic constructs, motor agency and cognitive agency. The present results support earlier physiological and psychological evidence in revealing a decline in cognitive functions and an increase in simulated interactions with a hallucinatory world, en route to normal REM sleep. This leads us to introduce the hypothesis that REM sleep, which exhibits remarkably high levels of (simulated) sensorimotor processes, may have evolved to serve as a virtual laboratory for the development and rehearsal of embodied cognition. The new measure of hallucinatory states presented here may also hold implications for the study of executive functions and (meta‐)cognitions, which might be interesting, for example, for the investigation of lucid dreaming.     

Teaching Beginning Braille Reading Using an Alphabet or Uncontracted Braille Approach

This study examined the effects of using a research based print reading program modified to accommodate beginning braille readers using an alphabet or uncontracted braille reading approach with five beginning braille readers. Four of the 5 participants displayed a clear increase in their ability to read high frequency words when they began using the Early Steps reading program modified to an Early Steps Alphabet Braille Reading Program. Study findings indicate that access to reading activities and materials afforded to sighted peers resulted in improved reading outcomes for children with visual impairments. Teachers, participants, and family members all viewed the use of the uncontracted braille reading program and materials favorably. Specialized reading instruction was also perceived as beneficial by teachers of students with visual impairments when the training addressed the specific needs of braille readers.     

Real-world inpatient programs: Shedding some light-A critique

This critique is a response to an article by Morisse, Batra, Hess, Silverman, and Corrigan (1996), in which “a token economy for the real world” is promulgated as an alternative to the comprehensive social-learning program and assessment technology presented by Paul and Lentz (1977). The article misrepresents the treatment-and-assessment procedures that have been empirically validated as the most effective and cost-efficient for inpatient programs. The article also inappropriately cites the results of prior reports as support for an oversimplified approach to the development and implementation of inpatient programs. The promoted approach is in direct opposition to the widely recognized need for empirically validated interventions and evaluations in mental health services. Not only are data lacking to support assertions of effectiveness for the resulting program but illustrative examples demonstrate technically unsound procedures as well as an ethically questionable emphasis on staff desires to the exclusion of patient needs. We attempt to correct Morisse et al.'s inaccuracies and misconceptions regarding the work of Paul and colleagues, note the major problems with their perfunctory approach, and provide recommendations for implementation and maintenance of empirically validated procedures for inpatients.