RESUMO
The current study evaluated the impact of a math tutoring program delivered in 20 schools to students in 4th through 8th grades by community members over one academic year. Students were randomly assigned to treatment and control groups. Multi-level linear and generalized linear mixed models were used to evaluate group differences in post-test scores and the probability of attaining the spring proficiency benchmark on two increasingly distal measures of math achievement. Intent-to-treat analyses identified higher achievement scores among students assigned to treatment on a measure of fact fluency and a computer adaptive measure of overall math achievement. Students assigned to treatment also had a higher probability of reaching grade-level benchmarks on the computer adaptive test. No statistically significant effects were observed on a state proficiency test. Implications for significant and null findings are discussed within the context of intervention content and delivery.
Assuntos
Logro , Apoio Comunitário , Humanos , Matemática , Instituições Acadêmicas , EstudantesRESUMO
PURPOSE OF THE REVIEW: Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. RECENT FINDINGS: Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it.
Assuntos
Procedimentos Clínicos/legislação & jurisprudência , Política de Saúde , Manejo da Obesidade/legislação & jurisprudência , Obesidade Mórbida/terapia , Programas de Redução de Peso/legislação & jurisprudência , Adulto , Inglaterra , Feminino , Humanos , Masculino , Medicina Estatal , Resultado do TratamentoRESUMO
This paper describes implementation (fidelity, perceived acceptability) and tier 1 and tier 2 outcomes of a school-wide positive behavior interventions and supports approach (PBIS) including mental health supports at tier 2 in two K-8 urban schools. Interventions for tier 2 consisted of three manualized group cognitive behavioral therapy (GCBT) protocols for externalizing behavior problems, depression and anxiety. tier 1 and tier 2 interventions were implemented with fidelity but program feasibility for tier 2 was in question because school personnel needed a great deal of external support in order to implement the interventions. tier 1 interventions were associated with a decrease in office discipline referrals. Students participating in GCBT showed a significant decrease in mental health diagnostic severity at post-treatment. A discussion of perceived and actual implementation barriers and how they were addressed is provided. Implications for practice in low-income urban schools are discussed.