Article for “Diversity Stories in Community Research and Action” Facing Resistance in Waking Up to Privilege

This article identifies a challenge brought to us while facilitating a diversity workshop with adults in a school work setting. Our program involved using the video The Color of Fear as a centerpiece of a training to school district staff where the goals were to raise awareness and understanding of race, gender and class issues, increase understanding of power and privilege, and build alliances between people from diverse backgrounds. The challenge came from a white, male participant and involved issues of privilege, the intersections of race, class, and gender, and resistance to addressing diversity matters. Reflections of what worked and didn't work are offered as well as recommendations to other facilitators who will face similar challenges.     

Implications of evidence-based practice for community health

Evidence-based practice, developed in clinical medicine, is being applied to community health programs. Barriers to implementation of evidence-based practice noted in clinical medicine are likely to exist in community health settings and may be complicated by the nature of community health programs. These barriers include accessibility and availability of relevant data, social and political considerations of program decision-making, and conflicting expectations for evaluation research. This paper discusses barriers to both amassing evidence for practice and using evidence for decision-making in community health. The potential for conflict between practice goals set by evidence-based thinking and those set by community health organizations is also discussed. Implications for evaluations of community health programs are raised and recommendations for improving access to and use of evaluation information are made.     

不同阶层心理健康观念及需求状况的调查研究

运用开放式和封闭式问卷调查法 ,对不同阶层共 483人的心理健康观念及心理健康需求状况进行了调查研究。结果表明 :( 1 )不同阶层、不同年龄段的人关于心理健康标准的观念具有显著差异。 ( 2 )人们认为 ,心理健康的人应具有的最典型特征是“处世乐观、热情、诚恳”和“心平气和、与世无争、乐于助人”。 ( 3 )心理不健康的人或心理变态的人所表现的最典型特征是“性格孤僻、与人不合群”和“对生活失去信心、悲观”。 ( 4)虽然不少人认为心理健康与咨询工作者当前最急需开展的工作是“宣传心理健康知识、开展心理卫生服务” ,但只有极少的人能够正视自己的心理健康需求 ,提出自己需要心理健康服务或咨询。     

A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: reliability and validity data from the Australian National General Practice Youth Suicide Prevention Project

Using data from a nationwide project on young people in Australia aimed at assessing suicidality in general health settings, we present a brief screening tool for suicidality (the depressive symptom index suicidality subscale). Two thousand eight hundred and fifty-one (15-24 year old) patients presenting to 247 Australian general practitioners between 1996 and 1998 were assessed. In addition to the suicide screen, patients completed the general health questionnaire-12 and the Center for Epidemiological Studies depression scale. Patients' chief complaints were taken from the summary sheets completed by their general practitioners. Using inter-item correlational and factor-analytic techniques, as well as a general approach to construct validity, we show that the measure has favorable reliability and validity characteristics. We also provide results on cut-points that may facilitate its use in clinical and research settings. Because the screen is brief, easy to use, reliable, and valid, we encourage its use to combat the vexing international health problem of suicide.     

Work attitudes, employment barriers, and mental health symptoms in a sample of rural welfare recipients

Most of the extant research on welfare reform has neglected to consider the experiences of families in rural settings. Fifty women receiving welfare for their dependent children in a rural community were interviewed about their work experiences and aspirations, barriers to employment and service use, as well as mental health and social support. The findings indicate that the majority of participants were connected to the labor force and expressed positive attitudes about work. Barriers to employment (lack of available jobs, child care) and service use (transportation, inconvenient office hours) were endorsed. Perceived social support was negatively related to depression symptoms and positively related to self-efficacy and self-esteem. The importance of understanding the life experiences of welfare recipients in different contexts is discussed.     

Male Mental Health Problems, Psychopathy, and Personality Traits: Key Findings from the First 14 Years of the Pittsburgh Youth Study

This paper reviews key findings on juvenile mental health problems in boys, psychopathy, and personality traits, obtained in the first 14 years of studies using data from the Pittsburgh Youth Study. This is a study of 3 samples, each of about 500 boys initially randomly drawn from boys in the 1st, 4th, and 7th grades of public schools in Pittsburgh. The boys have been followed regularly, initially each half year, and later at yearly intervals. Currently, the oldest boys are about 25 years old, whereas the youngest boys are about 19. Findings are presented on the prevalence and interrelation of disruptive behaviors, ADHD, and depressed mood. Results concerning risk factors for these outcomes are reviewed. Psychological factors such as psychopathy, impulsivity, and personality are described. The paper closes with findings on service delivery of boys with mental health problems.     

转型期初中生心理健康与父母养育方式的研究

本研究采用《心理健康诊断量表》和《父母养育方式问卷》对196名初中生进行测量,探讨初中生心理健康与父母养育方式的影响因素及其相互之间的关系。结果表明,初中生的心理健康问题的检出率依次是自责倾向、恐怖倾向、冲动倾向和对人焦虑;性别因素只在心理健康的学习焦虑、养育方式上的父亲的惩罚、严厉、母亲的过干涉、过保护、父母的拒绝、否认等因素上表现出了显著差异;独生子女与非独生子女子女比较,在恐怖倾向以及惩罚、严厉的养育方式上存在显著差异;父母的文化程度、职业状况、离异、下岗等因素,只有母亲的职业状况因素对心理健康构成了影响;父母消极的教养方式将使学生的焦虑增加,母亲积极的教养方式将使学生的焦虑减少。     

Improving subjective health and reducing absenteeism in a natural work life-intervention

A natural one-year work-life intervention to improve occupational health and reduce absenteeism was designed as a field experiment. The intervention allowed the employees in the health care sector of a municipality to take up to five days of self-administered sick leave with full financial compensation up to four times a year. 165 employees in the intervention group and 100 employees in the control group filled out a questionnaire before and after the intervention. The result showed no evidence of misuse of this sick-leave option and some positive subjective health effects were found among those who used the option. Slight improvements were found in musculoskeletal problems and for cold/influenza. There were no effects on overall absenteeism. The question of the impact of local cultures on interventions to improve occupational health is also discussed.     

发展健康研究

试图讲座在健康研究中,如何适时、恰当并有效地把性别融合于其中,第一,我们应更注意健康研究的结果;第二,在健康研究中注重性别差异的意义;第三,分行性别健康的可持续性研究环境。     

20世纪全球卫生发展的回顾与展望

20世纪人类的健康状况发生了革命性的转变,同时也面临着前所未有的挑战。疾病谱的改变及人口寿命的延长以及医疗费用的上涨仍然是困扰各国决策者的难题,卫生发展与改革任重道远。完善健康保障体系最理想的选择方案是政府为居民“购买”基本卫生服务,由国家财政和居民共同承担保险基金,普及初级卫生保健,鼓励多种形式办医,WHO确定的卫生工作目标是各成员国卫生系统改革与发展的指导方针。