Interdisciplinary knowledge translation: lessons learned from a mental health: fire service collaboration.

Collaborative approaches are being increasingly advocated for addressing a variety of health, mental health and social needs for children, youth and families. Factors important for effective knowledge translation of collaborative approaches of service delivery across disciplines, however, have not been rigorously examined. TAPP-C: The Arson Prevention Program for Children is an intervention program for child and adolescent firesetters provided collaboratively by fire service and mental health professionals. The present study examined the adopter, innovation, and dissemination characteristics associated with TAPP-C implementation, protocol adherence and extent of collaboration by 241 community-based fire service professionals from communities across Ontario. Results revealed that dissemination factors are particularly important for understanding program implementation, adherence and cross-discipline collaboration. Moreover, the findings of this study show significant benefits to both within discipline (intra-disciplinary) and across discipline (interdisciplinary) knowledge translation strategies.

Epidemiology of firesetting in adolescents: mental health and substance use correlates.

OBJECTIVE: Despite high rates of firesetting among community adolescents, little is known about its correlates. This study identifies the mental health and substance use correlates of four firesetting levels in an epidemiological sample of adolescents. METHODS: Three thousand, nine hundred and sixty-five (3,965) students in grades 7 to 12 were surveyed. Multinomial analyses were used to compare non-firesetters; desisters (lifetime, but no past-year firesetting); low frequency firesetters (once or twice in the past 12 months); and high frequency firesetters (3 + times) on measures of mental health and substance use. RESULTS: Twenty-seven percent of youth reported firesetting during the past year. Of these, 13.7% reported one or two episodes, and 13.5% reported 3 or more episodes. Firesetting was more prevalent among males and among those in high school. Youth who began firesetting before age 10 were more likely to report frequent firesetting during the past year. Compared to non-firesetters, the firesetting groups had elevated risk profiles. Desisters and low frequency firesetters were more likely to report psychological distress, binge drinking, frequent cannabis use, and sensation seeking. Low frequency firesetters also reported higher rates of delinquent behavior, suicidal intent, and low parental monitoring than non-firesetters. High frequency firesetters reported elevated risk ratios for all of these risk indicators plus other illicit drug use. The cumulative number of risk indicators was positively associated with firesetting severity. CONCLUSIONS: Firesetting is associated with psychopathology and substance use during adolescence. Findings highlight the need for programs to address the mental health and substance use problems that co-occur with firesetting.

Fire interest and antisociality as risk factors in the severity and persistence of juvenile firesetting.

OBJECTIVE: In the DSM-IV-TR, firesetting is included as a criterion for the diagnoses of conduct disorder and pyromania. The link between firesetting and antisocial behavior is well established in the empirical literature. Although theoretical models of firesetting often include fire interest as a putative risk factor, there is little research on the role of fire interest in firesetting or on the construct of pyromania. METHOD: The present study evaluated a sample of children and adolescents referred to an outpatient specialty program for juvenile firesetters with firesetting as the primary presenting problem. By assessing fire interest and antisocial behavior concurrently, the contribution of fire interest to firesetting after controlling for the role of conduct problems was evaluated. RESULTS: Results revealed that fire interest and antisocial behavior were significantly and positively correlated. Moreover, variations in fire interest added to the prediction of firesetting severity at assessment and firesetting recidivism at 18-month follow-up above and beyond what was predicted by antisociality alone. CONCLUSIONS: These findings have implications for an empirically derived taxonomy of pathological firesetting.

Exposure to fire setting behavior on YouTube.

PURPOSE: This study is a preliminary examination of fire setting behaviors on YouTube. METHODS: Data are based on a 1 day search of YouTube. RESULTS: Results indicate YouTube is replete with inappropriate models of fire setting. CONCLUSION: The findings have potential implications for intervention with fire setting youth.

The Pictorial Fire Stroop: a measure of processing bias for fire-related stimuli.

Fire interest is a risk factor for firesetting. This study tested whether a fire-specific emotional Stroop task can effectively measure an information-processing bias for fire-related stimuli. Clinic-referred and nonreferred adolescents (aged 13-16 years) completed a pictorial "Fire Stroop," as well as a self-report fire interest questionnaire and several control tasks. Results showed (a) comparatively greater fire-specific attentional bias among referred adolescent firesetters, (b) a negative relationship between Fire Stroop attentional bias and self-reported fire interest, and (c) positive correspondence between Fire Stroop attentional bias and self-reported firesetting frequency. These findings suggest that instruments that measure an automatic bias for fire-specific stimuli may usefully supplement self-report measures in the assessment and understanding of firesetting behavior.

Closing the research-practice gap: factors affecting adoption and implementation of a children's mental health program.

Despite the availability of effective interventions, they are not widely used in community mental health centers. This study examined the adoption and implementation of The Arson Prevention Program for Children (TAPP-C), a program for juvenile firesetters developed at a teaching hospital and disseminated to community settings. Questionnaire data from mental health professionals were used to evaluate the roles of adopter, innovation, and dissemination characteristics in TAPP-C adoption and implementation. Results indicate that different factors are important at different diffusion stages. Moreover, they suggest that innovation characteristics may be particularly important to adoption, whereas adopter and dissemination characteristics may be more influential in implementation.

Hearing mothers and their deaf children: the relationship between early, ongoing mode match and subsequent mental health functioning in adolescence.

In the few studies that have been conducted, researchers have typically found that deaf adolescents have more mental health difficulties than their hearing peers and that, within the deaf groups, those who use spoken language have better mental health functioning than those who use sign language. This study investigated the hypotheses that mental health functioning in adolescence is related to an early and consistent mode match between mother and child rather than to the child's use of speech or sign itself. Using a large existing 15-year longitudinal database on children and adolescents with severe and profound deafness, 57 adolescents of hearing parents were identified for whom data on language experience (the child's and the mother's) and mental health functioning (from a culturally and linguistically adapted form of the Achenbach Youth Self Report) was available. Three groups were identified: auditory/oral (A/O), sign match (SM), and sign mismatch (SMM). As hypothesized, no significant difference in mental health functioning was found between the A/O and SM groups, but a significant difference was found favoring a combined A/O and SM group over the SMM group. These results support the notion of the importance of an early and consistent mode match between deaf children and hearing mothers, regardless of communication modality.

Adolescent standardized patients: method of selection and assessment of benefits and risks.

BACKGROUND: Our psychiatric Objective Structured Clinical Examination (OSCE) group wishes to develop adolescent psychiatry OSCE stations. The literature regarding adolescent standardized patient (SP) selection methods and simulation effects, however, offered limited assurance that such adolescents would not experience adverse simulation effects. PURPOSE: Evaluation of adolescent SP selection methods and simulation effects for low- and high-stress roles. METHOD: A two-component (employment-psychological) SP selection method was used. Carefully selected SPs were assigned across three conditions: low-stress medical role, high-stress psychosocial role, and wait list control. Qualitative and quantitative measures were used to assess simulation effects. RESULTS: Our selection method excluded 21% (7% employment and 14% psychological) of SP applicants. For SP participants, beneficial effects included acquisition of job skills and satisfaction in making an important contribution to society. SP reactions of discomfort to roles were reported. Long-term adverse effects were not identified. CONCLUSIONS: A two-component adolescent SP selection method is recommended. Adolescent SP benefits outweigh risks.