Marketing Psychology at Academic Health Centers

The administrative structure of academic health centers is reviewed, with a view to understanding the issues of marketing psychological services within that setting. The slow changes at academic health centers to new practice styles requires psychology to formulate a market strategy addressing the traditional specialist model and another plan responsive to the emerging model emphasizing primary care. Market targets for psychologists include administration, physicians, and patients. Presently, the Association of Medical School Psychologists is working with the Association of Academic Health Centers to design a marketing program targeting leaders at academic health centers.     

EVALUATION OF TWO HEALTH EDUCATION STRATEGIES FOR TESTICULAR SELF-EXAMINATION

We evaluated the effects of two health education teaching methods, a pamphlet based on a task-analyzed checklist and two professionally developed films, on the completeness, accuracy, and maintenance of testicular self-examinations (TSE). Subjects (N = 48) were videotaped while performing a TSE after training and at a follow-up visit. Direct observation of the tapes showed that checklist-based training resulted in more complete and longer TSEs (p < .05). Social validation ratings, however, suggested that physicians were unable to discriminate reliably the performances of subjects taught using the two methods. Accuracy of detection of simulated lesions on plastic models was also similar for the two groups. Adherence to TSE recommendations was high during the study, but declined across the follow-up period. Further study is needed to promote adherence to TSE and to document the effects of early detection on morbidity and mortality of testicular cancer.     

HOME ACCESS MODIFICATIONS: EFFECTS ON COMMUNITY VISITS BY PEOPLE WITH PHYSICAL DISABILITIES

We examined the effects of access modifications to home entrances of people with physical disabilities on their reported community outings. An interrupted time-series design was used, in which the introduction of ramps was staggered across the homes of 6 people with moderate to severe mobility impairments. Four participants reported increases in weekly outings following installation of ramps at their entrances, and 2 reported a small decrease. These findings suggest that reducing the response requirements of access to and from the residence of people with mobility impairments may increase community visits, but may be insufficient given other environmental barriers in the community.     

Empowerment praxis in community coalitions

Community coalitions address a wide variety of community problems, espousing a community development processes that promotes individual and collective self-determination. They offer a promising venue for the study of empowerment of individuals and organizations. This study utilizes data from members of 35 community coalitions organized for the prevention of alcohol and other drug problems to address the following questions: What individual characteristics are related to the psychological empowerment of coalition members? What organizational characteristics are related to the collective empowering of members? What organization characteristics are related to a coalition being organizationally empowered to succeed in achieving its objectives? At the individual level, psychological empowerment was most strongly related to individuals' participation levels, sense of community, and perceptions of a positive organizational climate. At the group level, the strongest predictors of collective empowering (our operationalization of the empowering organization) were net benefits of participation, commitment, and positive organization climate. Psychological empowerment and positive organizational climate were the two predictors of organizational effectiveness (the empowered organization). Implications and limitations of these findings are discussed.     

Organizational characteristics of empowering community settings: A multiple case study approach

Although empowerment is often cited as a major guiding construct for community psychology, relatively little is known about the characteristics of empowering community settings. The current paper uses a multiple case study methodology to generate a number of key organizational characteristics of empowering community settings to guide future work in the area. In-depth, multilevel, longitudinal research was conducted on three empowering community settings: a religious fellowship, a mutual help organization for persons with severe mental illness, and an educational program for African American students. The organizational features found to characterize all three settings were (a) a belief system that inspires growth is strengths-based, and is focused beyond the self; (b) an opportunity role structure that is pervasive, highly accessible, and multifunctional (c) a support system that is encompassing, peer-based, and provides a sense of community; and (d) leadership that is inspiring, talented, shared, and committed to both setting and members. Limitations of the research are discussed, and directions for future research suggested.     

Toward community: A third position

This essay addresses the insufficiency of modern science as the solution to the problems of human life. It is a critique of community theory and a constructivist proposal for a synthesis of the individuality and collectivity solutions to the Paradox of the One and the Many—designated as the Third Position. The Third Position is necessary for the postmodern period for there is a need to incorporate the goal of Equality (or Justice) into a paradigm based on Liberty and Fraternity. The Third Position is also called the Just Community. To achieve the development of the new position (paradigm), a location-specific action research center is proposed based on the Woods Hole Marine Biological Laboratory (Kelly, 1970). Two examples of action research are described: aqualitative project to develop community within a parish that has served to advance the theory of the Just Community, and aquantitative project of community-level change-monitoring of social indicators and the use of dynamic modeling as a way to understand and simulate local community processes. The Society for Community Research and Action is urged to take specific actions to explore the development of a Woods Hole community research laboratory.     

The interface between physical and mental disorders: The need to dismantle the biopsychosocialneuroimmunological model of disease

This article argues for the necessity of cognitive-behavioral assessment for a thorough understanding of how psychological factors mediate disease process across a wide range of diseases including coronary artery disease, breast cancer, and human immunodeficiency disease. Based on empirical data presented as part of the APA Presidential miniconvention, “To Your Health: Psychology through the Life Span,” the conclusion is that psychological treatment can help extend life. Stress management programs can positively influence adherence to treatment regimens and positively influence the human immune system response during the course of treatment and recovery from illness. Even in the face of life-threatening circumstances such as liver transplantation, Stage II and III breast cancer, and after HIV infection has been diagnosed, the quality of life can be remarkably improved. Physicians and psychologists must work together to produce the beneficial effects of the synergy between mind-body processes.     

Factors associated with respite care use by families with a child with disabilities

This paper reviews the literature on respite care utilization, describes a respite care program in Arkansas, and reports on a study of utilization initiated by the Arkansas Division of Mental Health Services (DMHS). Among the 89 families qualifying for respite services, 70 consented to participate, and 66 were surveyed in a phone interview. Users (n=54) and non-users (n=12) were compared relative to a variety of staff, child, geographic, and budget differences. Also, respite use was examined relative, to the aforementioned variables based on level of use, (i.e., none, low, moderate, high). There were no differences in use according to age, the number of family members, family income, or needs of the child. A larger percentage of non-use and low use of respite care was evident among those families receiving Tax Equity Fiscal Responsibility Act (TEFRA) benefits. There were no significant differences between races related to perceived barriers to care. Differences in expectations/experiences with respite care among rural and urban groups were limited with rural respondents expressing, concern about travel/distance issues. Overall, the program as a whole received positive ratings by parents, and no clear factors were found to be related to non-use in the small sample (n=12) who did not take advantage of respite services.     

The readability of educational materials written for parents of children with attention-deficit hyperactivity disorder

Health-care providers are relying increasingly on printed materials to educate patients and their families about varous aspects of their health or mental health conditions. For the target audience to be able to read and understand health brochures, they should be written at or about the 8th-grade level and incorporate variables that facilitate comprehension. The purpose of this study was to analyze brochures related to Attention-Deficit Hyperactivity Disorder to determine (a) if they were written at a level appropriate for the target audience, and (b) the extent to which they incorporated variables identified in the research literature as facilitating comprehension. The results showed that the brochures were written at a reading level beyond that of the target audience. Further, although the brochures incorporated a large number of variables which facilitate comprehension, many were not used to the extent necessary to ensure that readers would be able to understand the brochures. These results clearly indicated the need for health care materials to be written in such a way that they can be read and understood by the target audience.     

Crisis for community mental health: The use of groups in the struggle for survival

The task of community mental health is to provide quality services to clients despite funding cutbacks. This paper describes the recent evolution in conceptualization and service delivery in one center. The outcomes are a philosophy that is customer oriented, and treatment that draws upon brief techniques, in group and long term contexts.