Longitudinal effects of Youth Empowerment Solutions: Preventing youth aggression and increasing prosocial behavior.

Youth violence remains a significant public health problem despite efforts to address it. We describe the evaluation results of Youth Empowerment Solutions (YES), an after-school active learning program implemented by trained local teachers and designed to engage middle school youth in multi-systematic promotive behaviors at the individual-, interpersonal-, and community-level to make lasting positive changes within the context of institutional disadvantages, such as racism. First, we used a modified randomized controlled trial design to examine the direct and indirect influence of YES on prosocial and delinquent behaviors 12 months after the conclusion of the program, through youth empowerment. Next, we evaluated these models by race, to determine if the intervention equitably promotes prosocial outcomes and decreases aggressive behaviors. Among 329 middle school students, YES participation enhanced prosocial behaviors through empowerment, and directly reduced aggressive behaviors a year after the conclusion of the program. This trend was particularly pronounced for African American youth. These effects were found after controlling for age, sex, and behavioral outcomes at baseline, and across different schools and teachers, suggesting that YES can also be sustainable and readily implemented by communities. The implications of the results for youth violence prevention, empowerment theory and intervention development and practice for ethnic minority youth who face structural disenfranchisement are discussed.

Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study.

BACKGROUND: Regarding health technologies, African American young adults have low rates of uptake, ongoing usage, and engagement, which may widen sexual health inequalities. OBJECTIVE: We aimed to examine rates of uptake and ongoing usage, and factors influencing uptake, ongoing usage, and engagement for a consumer health informatics (CHI) intervention for HIV/sexually transmitted infection (STI) prevention among African American young adults, using the diffusion of innovation theory, trust-centered design framework, and O'Brien and Toms' model of engagement. METHODS: This community-based participatory mixed methods study included surveys at four time points (n=315; 280 African American participants) among young adults aged 18 to 24 years involved in a blended offline/online HIV/STI prevention intervention (HIV Outreach, Prevention, and Education [HOPE] eIntervention), which was described as a "HOPE party." Qualitative interviews were conducted with a subset of participants (n=19) after initial surveys and website server logs indicated low uptake and ongoing usage. A generalized linear mixed-effects model identified predictors of eIntervention uptake, server logs were summarized to describe use over time, and interview transcripts were coded and thematically analyzed to identify factors affecting uptake and engagement. RESULTS: Participants' initial self-reported eIntervention uptake was low, but increased significantly over time, although uptake never reached expectations. The most frequent activity was visiting the website. Demographic factors and HOPE party social network characteristics were not significantly correlated with uptake, although participant education and party network gender homophily approached significance. According to interviews, one factor driving uptake was the desire to share HIV/STI prevention information with others. Survey and interview results showed that technology access, perceived time, and institutional and technological trust were necessary conditions for uptake. Interviews revealed that factors undermining uptake were insufficient promotion and awareness building, and the platform of the intervention, with social media being less appealing due to previous negative experiences concerning discussion of sexuality on social media. During the interaction with the eIntervention, interview data showed that factors driving initial engagement were audience-targeted website esthetics and appealing visuals. Ongoing usage was impeded by insufficiently frequent updates. Similarly, lack of novelty drove disengagement, although a social media contest for sharing intervention content resulted in some re-engagement. CONCLUSIONS: To encourage uptake, CHI interventions for African American young adults can better leverage users' desires to share information about HIV/STI prevention with others. Ensuring implementation through trusted organizations is also important, though vigorous promotion is needed. Visual appeal and targeted content foster engagement at first, but ongoing usage may require continual content changes. A thorough analysis of CHI intervention use can inform the development of future interventions to promote uptake and engagement. To guide future analyses, we present an expanded uptake and engagement model for CHI interventions targeting African American young adults based on our empirical results.

Impact of embedded librarianship on undergraduate nursing students' information skills.

BACKGROUND: One-shot library sessions have numerous drawbacks; most notably, they rarely have a long-term impact on students' research behavior or skill sets. Library literature notes that when students interact with an embedded librarian, their skills improve. While close partnerships with subject faculty are important, librarians must also assess students' skill sets to determine the impact of these teaching efforts. CASE PRESENTATION: During the course, the embedded librarian used various activities and assignments to teach information-seeking skills, with the expected outcome of increased skill sets. This IRB-approved research project focused on measuring and assessing students' information-seeking abilities before and after interacting with the embedded nursing librarian. Changes in students' information fluency skills were measured using pre- and post-tests. CONCLUSIONS: The study results provide evidence of the benefits of the embedded librarianship model. Continued measurement of students' skills acquisition is important to enable librarians and library administrators to show the positive impacts the library has on student learning and success.

INPUT: An academic-practice partnership to an underserved rural community.

The INPUT project is a model partnership that changed the way health care was offered to the underserved in rural Western North Carolina. Grant funding provided a full-time Family Nurse Practitioner (FNP) to a free clinic and created clinical placements for FNP students. Students had opportunities to learn about unique aspects of care for vulnerable, underserved populations to encourage them to consider working in rural communities. The clinic saw an increase in patient visits and offered more continuity in follow-up care. This academic-practice partnership represents a successful example of how working together can benefit the collaborators and community.

Busy Streets Theory: The Effects of Community-engaged Greening on Violence.

Lack of maintenance on vacant neighborhood lots is associated with higher levels of depression, anxiety, and stress for nearby residents. Overgrown grasses and dense brush provide hiding spots for criminals and space to conduct illicit activities. This study builds upon previous research by investigating greening programs that engage community members to conduct routine maintenance on vacant lots within their neighborhoods. The Clean & Green program is a community-based solution that facilitates resident-driven routine maintenance of vacant lots in a midsized, Midwestern city. We use mixed effects regression to compare assault and violent crime counts on streets where vacant lot(s) are maintained by community members (N = 216) versus streets where vacant lots were left alone (N = 446) over a 5-year timeframe (2009-2013). Street segments with vacant lots maintained through the Clean & Green program had nearly 40% fewer assaults and violent crimes than street segments with vacant, abandoned lots, which held across 4 years with a large sample and efforts to test counterfactual explanations. Community-engaged greening programs may not only provide a solution to vacant lot maintenance, but also work as a crime prevention or reduction strategy. Engaging the community to maintain vacant lots in their neighborhood reduces costs and may increase the sustainability of the program.

Measuring the Implementation of Youth Empowerment Solutions.

Scholars have increasingly emphasized the importance of using evidence-based programs to promote health and prevent disease. While theoretically and empirically based programs may be effective in carefully controlled conditions, many fail to achieve desired outcomes when implemented in real-world settings. Ensuring high-quality implementation of health promotion programs is critically important as variation in implementation is closely associated with program effectiveness. The purpose of this article is to present methods used to document and assess the implementation of the Youth Empowerment Solutions (YES) program. We collected process evaluation data on 25 YES groups from 12 schools over a period of 4 years. The evaluation assessed four key aspects of delivery: fidelity, dose delivered, dose received, and program quality. We found wide variations in delivery for some measures, while others were more consistent across groups. These indicators of program delivery provided a strong basis for evaluating program implementation, taking actions to improve it, and ultimately, deepening understanding of program effectiveness. The study suggests a model for using multiple methods to collect and analyze data about aspects of program delivery to guide future implementations.

Psychological Empowerment Among Urban Youth: Measurement Model and Associations with Youth Outcomes.

Empowerment-based strategies have become widely used method to address health inequities and promote social change. Few researchers, however, have tested theoretical models of empowerment, including multidimensional, higher-order models. We test empirically a multidimensional, higher-order model of psychological empowerment (PE), guided by Zimmerman's conceptual framework including three components of PE: intrapersonal, interactional, and behavioral. We also investigate if PE is associated with positive and negative outcomes among youth. The sample included 367 middle school youth aged 11-16 (M = 12.71; SD = 0.91); 60% female, 32% (n = 117) white youth, 46% (n = 170) African-American youth, and 22% (n = 80) identifying as mixed race, Asian-American, Latino, Native American, or other ethnic/racial group; schools reported 61-75% free/reduced lunch students. Our results indicated that each of the latent factors for the three PE components demonstrate a good fit with the data. Our results also indicated that these components loaded on to a higher-order PE factor (X2  = 32.68; df: 22; p = .07; RMSEA: 0.04; 95% CI: .00, .06; CFI: 0.99). We found that the second-order PE factor was negatively associated with aggressive behavior and positively associated with prosocial engagement. Our results suggest that empowerment-focused programs would benefit from incorporating components addressing how youth think about themselves in relation to their social contexts (intrapersonal), understanding social and material resources needed to achieve specific goals (interactional), and actions taken to influence outcomes (behavioral). Our results also suggest that integrating the three components and promoting PE may help increase likelihood of positive behaviors (e.g., prosocial involvement); we did not find an association between PE and aggressive behavior. Implications and future directions for empowerment research are discussed.

Parenting While Incarcerated: Tailoring the Strengthening Families Program for Use with Jailed Mothers.

Most incarcerated women are mothers. Parenting programs may benefit women, children and families, yet effectively intervening in correctional settings is a challenge. An evidence-based parenting intervention (the Strengthening Families Program) was tailored and implemented with women in a jail setting. Goals were to assess mothers' needs and interests regarding parenting while they were incarcerated, adapt the program to address those needs, and establish intervention delivery and evaluation methods in collaboration with a community-based agency. Women reported wanting to know more about effective communication; how children manage stress; finances; drug and alcohol use; self-care; and stress reduction. They reported high program satisfaction and reported reduced endorsement of corporal punishment after the intervention. Barriers to implementation included unpredictable attendance from session to session due to changing release dates, transfer to other facilities, and jail policies (e.g., lock-down; commissary hours). Implications for sustainable implementation of parenting programs in jail settings are discussed.

Partnering to translate evidence-based programs to community settings: bridging the gap between research and practice.

Implementing evidence-based programming in diverse community settings is an essential translational research step to make effective programs widely accepted and accessible and thereby improve public health. This process is challenging and complex, yet there are few examples to guide the efforts. The authors present their experience as an example of using a university-community partnership approach to aid in translating an evidence-based program (EBP) into a small community setting as a resource for researchers and community partners wishing to implement evidence-based programming in community settings. The authors review the steps of systematic planning and client needs assessment to decide on an EBP: adapting the EBP to appeal to the community while maintaining program fidelity, building staff and organizational capacity, arranging for implementation and family engagement, and carrying out program evaluation. The study focuses on research-to-practice links and highlights each partner's role and activities in facilitating successful translation of an EBP to this community setting. The lessons learned and recommendations are also presented. Using partnerships to prepare community-based organizations to implement EBPs is a vital mechanism for bridging the discovery-delivery gap and moving toward real-world applications of research discoveries.

Youth Empowerment Solutions for Peaceful Communities: combining theory and practice in a community-level violence prevention curriculum.

This article describes the development and evaluation of an after-school curriculum designed to prepare adolescents to prevent violence through community change. This curriculum, part of the Youth Empowerment Solutions for Peaceful Communities (YES) program, is guided by empowerment and ecological theories within a positive youth development context. YES is designed to enhance the capacity of adolescents and adults to work together to plan and implement community change projects. The youth curriculum is organized around six themed units: (a) Youth as Leaders, (b) Learning about Our Community, (c) Improving Our Community, (d) Building Intergenerational Partnerships, (e) Planning for Change, and (f) Action and Reflection. The curriculum was developed through an iterative process. Initially, program staff members documented their activities with youth. These outlines were formalized as curriculum sessions. Each session was reviewed by the program and research staff and revised based on underlying theory and practical application. The curriculum process evaluation includes staff and youth feedback. This theoretically based, field-tested curriculum is designed to be easily adapted and implemented in a diverse range of communities.

Flipping to Motivate: Perceptions Among Prelicensure Nursing Students.

BACKGROUND: Research suggests flipped learning may improve student motivation to learn. PURPOSE: This study examined motivation and learning strategies among prelicensure BSN students in a course taught using the flipped learning model. The hypothesis was that flipped learning may improve motivation and learning strategies of students. METHODS: A descriptive, comparative design examined motivation and learning strategies used by students in a flipped learning course. The Motivated Strategies for Learning Questionnaire and a demographic survey were administered to 25 BSN students at a Midwestern university. RESULTS: Substantial decreases were found from pretest to posttest mean scores for the task value, control of learning beliefs, and help seeking subscales. CONCLUSION: The results did not support the hypothesis that flipped learning would improve motivation and learning strategies. Further research in larger diverse samples of students in a flipped learning course is recommended.

Comprehensive approaches to addressing mental health needs and enhancing school security: a hybrid type II cluster randomized trial.

BACKGROUND: School safety is fundamental to fostering positive outcomes for children. Violence remains a critical public health issue with 8.1% of elementary and 21.8% of middle school students reporting daily or weekly bullying in 2015-16. Similarly, over half of lifetime mental health concerns become evident before age 14. Thus, elementary school is a key time for comprehensive school safety interventions. Yet, interventions are rarely delivered with fidelity in community settings. Evidence-based interventions must be complemented by implementation strategies to achieve desired public health outcomes. METHODS: We develop and test an intervention focused on promoting a positive school climate guided by a school-based 3-person leadership team (3-PLT) using a hybrid Type II design. The 3-PLT includes a School Resource Officer, (SRO), administrator and mental health services professional as a newly appointed climate specialist (CS). The interventions to be delivered include 1) Restorative justice, 2) Mental Health First Aid and 3) Crime Prevention Through Environmental Design. The CS will lead the team and coordinate implementation through a process of interactive problem solving and supports, consistent with the implementation facilitation strategy. We will conduct a cluster randomized controlled trial with staged entry over two school years in Genesee County, Michigan (n = 20 elementary schools, with 10 participating per school year). We will use a combination of data sources including data collected by schools (e.g., discipline data), a student survey, and a teacher survey. We will also conduct a process evaluation and assess implementation and sustainability through focus groups with key stakeholders, teachers, and students. Finally, we will conduct a cost-benefit analysis. DISCUSSION: Results from both the behavioral outcome and implementation strategy evaluations are expected to have significant implications for school safety and student well-being. This study adopts a unique approach by integrating three evidence-based programs and incorporating implementation facilitation led by the CS as part of the 3-PLT to support intervention delivery and enhance public health impact among schools in disadvantaged communities with students at risk of poor health outcomes. This study aims to create a comprehensive, well-integrated model intervention that is sustainable and can be translated to similar high-risk settings. TRIAL REGISTRATION: Trial was retrospectively registered, registration ISRCTN1226421, May 16, 2019.

The Role of Present Time Perspective in Predicting Early Adolescent Violence.

This study investigated the role of present and future time perspectives, and their relationships with subjective norms and beliefs regarding violence, in predicting violent behaviors among urban middle school students in the Midwestern United States. Although present time perspective covaried with subjective norms and beliefs, each made a unique prediction of self-reported violent behaviors. Future time perspective was not a significant predictor when accounting for these relationships. In addition, present orientation moderated the relationship between subjective norms and beliefs and rates of violent behaviors; those with higher present orientations exhibited stronger associations. We replicated this pattern of results in data from new participants in a subsequent wave of the study. Interventions that explicitly address issues related to time perspective may be effective in reducing early adolescent violence.

Youth Empowerment Solutions: Evaluation of an After-School Program to Engage Middle School Students in Community Change.

We report on an effectiveness evaluation of the Youth Empowerment Solutions (YES) program. YES applies empowerment theory to an after-school program for middle school students. YES is an active learning curriculum designed to help youth gain confidence in themselves, think critically about their community, and work with adults to create positive community change. We employed a modified randomized control group design to test the hypothesis that the curriculum would enhance youth empowerment, increase positive developmental outcomes, and decrease problem behaviors. Our sample included 367 youth from 13 urban and suburban middle schools. Controlling for demographic characteristics and pretest outcome measures, we found that youth who received more components of the curriculum reported more psychological empowerment and prosocial outcomes and less antisocial outcomes than youth who received fewer of the intervention components. The results support both empowerment theory and program effectiveness.

Strengthening Incarcerated Families: Evaluating a Pilot Program for Children of Incarcerated Parents and Their Caregivers.

Parental incarceration can be devastating for families. Children may experience difficulties, and the stress on caregivers who take on unexpected childrearing is high. We implemented and evaluated a family-level intervention with caregivers and children experiencing parental (typically maternal) incarceration, in a community setting. We partnered with a community-based organization serving families with an incarcerated parent to conduct a pilot trial of the Strengthening Families Program (SFP). Process evaluation indicated high implementation fidelity, satisfaction, engagement, and attendance. Outcome evaluation results indicated positive changes in family-level functioning, caregivers' positive parenting, and caregiver depression symptoms from pre- to post-intervention, with some changes retained at follow-up 4 months later. Implications for preventive interventions with children of incarcerated parents, and their caregivers, are discussed.

Drama and danger: the opportunities and challenges of promoting youth sexual health through online social networks.

Social networks affect both exposure to sexually transmitted infections (STIs) and associated risk behavior. Networks may also play a role in disparities in STI/HIV rates among African American youth. Accordingly, there is growing interest in the potential of social network-based interventions to reduce STI/HIV incidence in this group. However, any youth-focused network intervention must grapple with the role of technologies in the social lives of young people. We report results of 12 focus groups with 94 youth from one economically depressed city with a high STI/HIV prevalence. We examined how youth use information and communication technologies (ICTs) in order to socialize with others, and how this aligns with their communication about sexuality and HIV/STIs. The study resulted in the generation of five themes: distraction, diversification, dramatization, danger management and dialogue. We consider implications of these findings for future development of online, social network-based HIV/STI prevention interventions for youth.

Youth empowerment solutions for violence prevention.

The limited success of youth violence prevention interventions suggests that effective prevention needs to address causes at multiple levels of analysis and empower youth in developing and implementing prevention programs. In this article, we review published studies of youth violence prevention efforts that engage youth in developing or implementing violence prevention activities. The reviewed studies suggest the promise of youth empowerment strategies and the need for systematic outcome studies of empowerment programs. After reviewing empowerment theory applied to youth violence prevention programs, we present a case study of the Youth Empowerment Solutions (YES) for Peaceful Communities program. YES engages middle-school youth in an after-school and summer program that includes a culturally tailored character development curriculum and empowers the youth to plan and implement community improvement projects with assistance from adult neighborhood advocates. The case study focuses on outcome evaluation results and presents evidence of the YES program effects on community-level outcomes (eg, property improvements, violent crime incidents) and on individual-level outcomes (eg, conflict avoidance, victimization). The literature review and the case study suggest the promise of engaging and empowering youth to plan and implement youth violence prevention programs.

Using process evaluation to strengthen intergenerational partnerships in the Youth Empowerment Solutions program.

This study illustrates the utility of process evaluation methods for improving a new violence prevention program, Youth Empowerment Solutions for Peaceful Communities (YES). The YES program empowered young adolescents to plan and complete community improvement projects with neighborhood adult advocates. The process evaluation methods included questionnaires and focus groups with students and interviews with neighborhood advocates. Process evaluation results guided program improvements for the second year. The process evaluation results after the second program year suggested that the program improvements were associated with higher student ratings of program staff and neighborhood advocates. The students and neighborhood advocates reported increased positive experiences after the second program year, but continued to note the challenges of working inter-generationally on community improvement projects.