Youth Living with HIV as Peer Leaders

Community-based service providers often hire youth living with HIV (YLH) as peer leaders for delivering HIV education to uninfected adolescents. Life narratives were collected from 44 YLH during a hypotheses-generating two-year ethnographic study. About 30% of the youth were employed as peer educators. While 60% of the 44 youth had a lower-class background, only 23% of the peer leaders were lower class. One-fifth of the sample were female, but more than one-half of the peer leaders were female. After identifying and categorizing difficulties experienced by the peer leaders, a frequency count of each theme was conducted. Issues about professional boundaries were evident in 38.5% of the youth's narratives, indicating conflicts in their roles as peer leaders; 23% of the youth engaged in substance use and sexual behaviors that placed themselves and uninfected youth in their peer educator programs at risk; and 8% of the youth reported relapse while peer leaders. The observations suggest reconsideration or restructuring of existing peer-education models that employ YLH.     

Ecological Factors Impacting Provider Attitudes Towards Human Service Delivery Reform

Although reform efforts are substantially altering the structural operations and guiding ideological framework of the human service delivery system, little empirical work has been done to systematically examine these transformations. This study examines providers' attitudes regarding two reform elements that are being widely implemented: an increased emphasis on inter-agency collaboration and a shift from a medical model service delivery philosophy, that focuses on client deficits, to one that emphasizes consumer strengths. Through survey data collected from 186 providers from 32 human service agencies in one county, the relationship between providers' perceptions of contextual support for human service delivery reform and providers' attitudes towards these initiatives is explored. The findings from this study support the importance of attending to the ecology in which we initiate system reform efforts. For both reform elements, working within contexts that are perceived as providing ideological and functional support for change was associated with positive provider attitudes towards those changes. Staffs' perceptions of the external environment played the most critical role in shaping staff attitudes. Interestingly, unique aspects of providers' work environments were related to positive attitudes towards the two different reforms. The implications of these findings for the success of human service delivery reform are discussed.     

What Every Teacher of Science and Religion Needs to Know about Pedagogy

This essay provides practical tips for effective teaching in science-and-religion courses. It offers suggestions for dealing with difficult questions and creating a climate of shared learning. Along with pedagogical advice, it covers fundamental principles for teaching broadly integrative religion-and-science courses. Instructors are encouraged to reflect on their purpose(s) in offering their course and to formulate specific objectives using the techniques and resources outlined here.     

A Comparison of Least-to-Most Prompts and Progressive Time Delay on the Disruptive Behavior of Students with Autism

We compared the effects of two instructional strategies on the frequency of errors and episodes of disruptive behavior of 4 students with autism. In Phase I, easy and difficult tasks were presented to determine whether the tasks were associated with differential rates of disruptive behavior. Phase II compared the effects of a least-to-most prompting procedure (LTM) to a progressive time delay procedure (PTD) on errors and disruptive behavior when difficult tasks were presented. Observers sequentially recorded instructor instructions, response prompts, prompts for appropriate sitting, and feedback statements; and student disruptive, correct, error, and no responses during 1:1 sessions. Results showed PTD produced fewer errors than LTM for all 4 students, and lower rates of disruptive behavior for 2 students. When PTD was implemented as the final phase with 2 of the students, rates of disruptive behavior associated with the task previously taught with LTM immediately decreased. Conditional probability statements indicated that disruptive behavior occurred infrequently with all 4 students when effective response prompts were used.     

Marketing measurably effective instructional methods

The failure to gain wider acceptance of measurably effective teaching methods by the educational establishment may be due to resistance to behaviorism, in particular, and to a set of contingencies that resist change, in general. The promotion of effective instructional methods is presented in terms of recommended marketing principles, including identifying and solving perceived consumer needs, using plain English, segmenting the marketplace and developing specific solutions, identifying opportunities for greatest impact, creating tangible educational products, seeking new markets, planning marketing strategy and tactics, and writing for non-technical publications. Precision Teaching is presented as a case study in the promotion of effective instructional methods. Although it is a measurably superior instructional methodology, Precision Teaching has not been widely adopted. By applying basic marketing principles and strategic planning, some of its proponents have initiated an ongoing effort of outreach and promotion.     

Postpartum depression: Proposal for prevention through an integrated care and support network

Social science research and clinical literature concur with our experience as providers of psychoeducational and clinical services: Postpartum depression results from the interplay of a multitude of individual and contextual factors. In light of the extensive literature on postpartum depression, it is surprising that models for prevention have not been established. We propose a model for prevention through integrated care and support, in which a wide range of existing services are used. This model is similar to comprehensive prevention models proposed by advocates of integrated service systems, such as community mental health and family support. The article includes illustrative case material.     

Predictors of Placement Outcomes in Treatment Foster Care: Implications for Foster Parent Selection and Service Delivery

Treatment foster care (TFC) is a normalizing environment in which to treat those children whose particular needs are not addressed in traditional foster care and for whom an institutional setting is a restrictive and unnecessary alternative. However, when the foster care placements of these emotionally and behaviorally disturbed children fail, as they often do, the children are shifted from one home to another without the opportunity to experience permanence or emotional attachment, resulting in poor adjustment to foster care. Placement stability, which depends in part upon effective matching of foster children with potential foster families, is critical for achieving positive outcomes in TFC. Yet, there is a dearth of information to guide placement agencies in making decisions about matching foster children with families. Moreover, once a successful match has been made, it is equally vital that service delivery be of high quality so that permanence is maintained. We review research on the predictors of positive outcomes in foster care, focusing on studies involving emotionally or behaviorally disturbed children, and provide recommendations for selecting foster parents and for ensuring high quality foster care services and placement stability.     

Possession and Medicine in South Central India

Possession is a powerful and surprisingly prevalent belief system in many parts of the developing world. In India it is common for many reasons—isolation, illiteracy, polyglotism, lack of an adequate medical infrastructure, a need for hope. Possession, and the practice of exorcism, is more than just an explanatory system based on superstition and folk lore. It is also an important social structure and force that allows the integration of the sick into the community of the well, and facilitates a first albeit tentative step from the local community to the medical community. In many parts of India, health care delivery as well as social organization is through the practice of possession. Thus, the role and power of possession needs to be appreciated if one seeks to affect health care delivery in India, and further possession should be appreciated if one seeks to better understand how some of its forces might in fact be curative.