Supporting underrepresented students in health sciences: a fuzzy cognitive mapping approach to program evaluation.

BACKGROUND: The Students Training in Academia, Health, and Research (STAHR) Program at the University of Missouri-Kansas City (UMKC) strives to help students from low-income families that have experienced educational challenges due to poverty and prepare them to enter, persist, and graduate from a health sciences degree program at UMKC. Students in the program participated in fuzzy cognitive mapping (FCM) sessions to ensure that all voices of the program were heard to improve program implementation, and student success, and contribute to an equitable educational environment. METHODS: Fuzzy Cognitive Mapping sessions for the 2020-2021 cohort of students (n = 52) were conducted to assess the strengths and weaknesses in program implementation, especially through the beginning of the COVID-19 pandemic. Students' maps were coded by a team of researchers and then confirmed using confirmatory factor analysis. RESULTS: Statistical analyses reveal that mentorship, workshops, and social support helped students to work toward their goal of obtaining a professional health sciences degree, while a lack of time, remote learning, and outside stressors inhibited their opportunities for success. CONCLUSIONS: The findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.

Development and validation of a goal attainment scale for families affected by maternal substance use.

The Team for Infants Exposed to Substance use (TIES) Program is a longstanding home-based family support program that provides a multidisciplinary, community-facing model to address the complex needs of families with young children affected by maternal substance use. The model required a comprehensive assessment tool to guide creation of individualized family goals with steps to achievement and measurement of progress on those goals. This article describes the development of a goal attainment scale and the analysis conducted to validate the scale for the service population. TIES model developers and community partners developed the goal attainment scale to assess outcomes in key domains: maternal substance use, parenting, child and maternal health, income, and housing. Data were collected from 2012 to 2019 from 220 participants and analyzed in 2020. Exploratory factor analysis (EFA) and confirmatory factor analysis were conducted. Twenty-five of the original 30 items were retained in a six-factor structure. The total percentage of variance explained was 64.44% with six factors, and Cronbach's alpha was .90. For the split-half method, the reliability of scale was .90 for unbiased conditions. Therefore, the scale reached acceptable reliability and validity. The scale provides a comprehensive approach to measure family outcomes across multiple domains addressing key risk and protective factors. This family-centered scale serves both therapeutic and evaluation purposes, acting as an intervention guide and a goal attainment measurement tool.

El Programa del Equipo para los Infantes Expuestos al Uso de Sustancias (TIES) es un programa de apoyo familiar con base en el hogar que ha existido mucho tiempo y que ofrece un multidisciplinario método de cara a la comunidad que se ocupa de las complejas necesidades de familias con niños pequeños afectados por el uso materno de sustancias. Quienes desarrollaron el modelo TIES crearon una herramienta comprensiva de evaluación para guiar la creación de metas familiares individualizadas, pasos para alcanzar y el progreso en cuanto a esas metas. Esta escala de alcance de logros evalúa los resultados en dominios claves: uso materno de sustancias, crianza, salud del niño y de la madre, entradas económicas y vivienda. Este artículo describe el desarrollo y la validez de la escala de alcance de metas. Los datos recogidos del 2012 al 2019 y de 220 participantes se analizaron en 2020. Se llevaron a cabo análisis exploratorios y confirmatorios de factores. Veinticinco de los 30 puntos originales se mantuvieron en una estructura de seis factores. El porcentaje total de variación explicado fue de 64.44% con seis factores y el factor Alpha de Cronbach fue de .90. En cuanto al método dividido en mitades, la confiabilidad de la escala fue de .90 en el caso de condiciones no prejuiciadas. Por tanto, la escala alcanzo una confiabilidad y validez aceptable. La escala ofrece un acercamiento comprensivo para medir los resultados familiares a lo largo de múltiples dominios, ocupándose de factores claves de riesgo y protección. Esta escala centrada en la familia sirve propósitos terapéuticos evaluación y actúa como una guía de intervención y medida de alcance de metas.

Le Programme de l'Equipe pour les Nourrissons Exposés à la Toxicomanie (abrégé TIES, suivant l'anglais The Team for Infants Exposed to Substance use) est un programme de soutien à la famille à domicile mis en place de longue date qui offre un modèle pluridisciplinaire et tourné vers la communauté afin de répondre aux besoins complexes des familles avec de jeunes enfants affectées par la toxicomanie maternelle. Les personnes ayant conçu et développé le modèle TIES ont créé un outil d'évaluation complet afin de guider le développement d'objectifs familiaux individualisés, d'étapes de réussite et de progrès quant à ces objectifs. L'échelle d'étape de réussite évalue les résultats dans des domaines clés: la toxicomanie maternelle, le parentage, la santé de l'enfant et la santé maternelle, les revenus, et le domicile. Cet article décrit le développement et la validation de l'échelle de réussite. Les données ont été recueillies de 2012 à 2019 de 220 participantes et elles ont été analysées en 2020. Des analyses factorielles exploratoires et des analyses factorielles confirmatoires ont été faites. Vingt-cinq des 30 éléments d'origine ont été retenus dans une structure à six facteurs. Le pourcentage total de variance expliquée était de 64,44% avec six facteurs, et l'alpha de Cronbach était de 0,90. Pour la méthode à demi-fraction la fiabilité de l'échelle était de,90 pour des conditions impartiales. L'échelle a donc atteint la fiabilité et la validité. L'échelle offre une approche complète afin de mesurer les résultats de la famille au travers de multiples domaines traitant le risque clé et les facteurs de protection. Cette échelle centrée sur la famille sert un but à la fois thérapeutique et d'évaluation, agissant comme un guide d'intervention et une mesure d'atteinte du but.

A Promising Approach in Home Visiting to Support Families Affected by Maternal Substance Use.

INTRODUCTION: Many factors influence women's use of alcohol and other drugs while pregnant and postpartum. Substance use impacts the maternal-child relationship during the critical neonatal period. The first days and months of human development lay the foundation for health and well-being across the lifespan, making this period an important window of opportunity to interrupt the transmission of trauma and stress to the next generation. Pregnant and postpartum women with a history of substance use require specialized support services. METHODS: The Team for Infants Exposed to Substance abuse (TIES) Program provides a holistic, multi-disciplinary, community-based model to address the complex needs of families with young children affected by maternal substance use. RESULTS: A multi-year implementation study of the model yielded results that indicate the effectiveness of this home-based family support intervention. The model focuses on reducing maternal alcohol and other drug use, increasing positive parenting, promoting child and maternal health, and improving family income and family housing. A key component of the model is establishing a mutual, trusting relationship between the home visiting specialists and the family. Foundational to the TIES model is a family-centered, culturally competent, trauma-informed approach that includes formal interagency community partnerships DISCUSSION: This article describes elements of the model that lead to high retention and completion rates and family goal attainment for this unique population.

Supporting Families Through the Charting the LifeCourse Framework.

Supporting families who have family members with intellectual and developmental disabilities (IDD) as they move through life is a critical need ( Reynolds, Palmer, & Gotto, 2018 ). The phrase, supporting families, juxtaposes the typical family support paradigm in response to the ongoing shrinkage of federal and state dollars and the recognition that parents and caregivers need services and supports to support their family member with IDD at home ( Amado, Stancliffe, McCarron, & McCallion, 2013 ). Within the family support movement, families are defined in the broadest terms, including those living in the same household, people who are affiliated by birth or choice, and others in the role of helping individuals with IDD succeed in life ( Reynolds et al., 2015 ; Turnbull, Turnbull, Erwin, Soodak, & Shogren, 2015 ).