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1.
Article in English | MEDLINE | ID: mdl-38695191

ABSTRACT

OBJECTIVES: Custodial grandparents are grandparents who raise grandchildren on a full-time basis in absence of the grandchild's birth parents. Compared to non-caregiving grandparents, custodial grandparents report poorer mental and physical health and stronger changes in daily well-being when experiencing negative and positive events. We examine whether an online social intelligence training (SIT) program improves custodial grandmothers' (CGM) daily well-being, socio-emotional skills, and changes in well-being when confronted with daily negative and positive events. METHOD: Multilevel models were applied to 200 CGM who were recruited from across the U.S. and completed a daily survey for 14 consecutive days prior to and following participation in a randomized clinical trial. Participants were randomized into the SIT program or an attention control condition focusing on healthy living habits. The outcomes of interest were daily well-being, social connectedness, emotional awareness, and perspective-taking. RESULTS: Multilevel analyses revealed that participants who participated in the SIT program, compared to the attention control condition, exhibited stronger emotional responsiveness (i.e., improvements) to daily positive events in the outcomes of positive affect, social engagement, and perspective-taking. DISCUSSION: Our findings illustrate that SIT improves key components of daily functioning in CGM, which may serve as a pathway linking the demands of custodial grandparenting to poorer mental and physical health. Our discussion focuses on the utility and accessibility of the SIT program for helping improve outcomes for this disadvantaged population.

2.
Subst Use Misuse ; 59(4): 558-566, 2024.
Article in English | MEDLINE | ID: mdl-38037904

ABSTRACT

BACKGROUND: As overdose rates increase for multiple substances, policymakers need to identify geographic patterns of substance-specific deaths. In this study, we describe county-level opioid and psychostimulant overdose patterns and how they correlate with county-level social vulnerability measures. METHODS: A cross-sectional observational study, we used nationwide 2016-2018 restricted access Centers for Disease Prevention and Control county-level mortality files for 1,024 counties. We estimated quartiles of opioid and psychostimulant overdose mortality and provided estimates of their association with county-level Social Vulnerability Index (SVI) percentile. RESULTS: There was high opioid and psychostimulant overdose mortality in the Middle Atlantic, South Atlantic, East North Central, and Mountain regions. The Central US had the lowest opioid and psychostimulant overdose mortality rates. Counties with higher SVI scores (i.e. higher social vulnerability) were significantly more likely to experience high opioid and high psychostimulant overdose (high-high) mortality. A 10-percentile increase in SVI score was associated with a 3.1 percentage point increase in the likelihood of being a high-high county (p < 0.001) in unadjusted models and a 1.5 percentage point increase (p < 0.05) in models adjusting for region. CONCLUSION: Our results illustrated the heterogenous geographic distribution of the growing concurrent opioid and psychostimulant overdose crisis. The substantial regional variation we identified highlights the need for local data to guide policymaking and treatment planning. The association of opioid-psychostimulant overdose mortality with social vulnerability demonstrates the critical need in impacted counties for tailored treatment that addresses the complex medical and social needs of people who use both opioids and psychostimulants.


Subject(s)
Central Nervous System Stimulants , Drug Overdose , Opiate Overdose , Opioid-Related Disorders , Humans , Analgesics, Opioid/therapeutic use , Opioid-Related Disorders/drug therapy , Cross-Sectional Studies , Drug Overdose/prevention & control , Central Nervous System Stimulants/therapeutic use , Opiate Overdose/drug therapy
3.
J Child Psychol Psychiatry ; 65(3): 328-339, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37257941

ABSTRACT

BACKGROUND: Across several sites in the United States, we examined whether kindergarten conduct problems among mostly population-representative samples of children were associated with increased criminal and related (criminal + lost offender productivity + victim; described as criminal + victim hereafter) costs across adolescence and adulthood, as well as government and medical services costs in adulthood. METHODS: Participants (N = 1,339) were from two multisite longitudinal studies: Fast Track (n = 754) and the Child Development Project (n = 585). Parents and teachers reported on kindergarten conduct problems, administrative and national database records yielded indexes of criminal offending, and participants self-reported their government and medical service use. Outcomes were assigned costs, and significant associations were adjusted for inflation to determine USD 2020 costs. RESULTS: A 1SD increase in kindergarten conduct problems was associated with a $21,934 increase in adolescent criminal + victim costs, a $63,998 increase in adult criminal + victim costs, a $12,753 increase in medical services costs, and a $146,279 increase in total costs. In the male sample, a 1SD increase in kindergarten conduct problems was associated with a $28,530 increase in adolescent criminal + victim costs, a $58,872 increase in adult criminal + victim costs, and a $144,140 increase in total costs. In the female sample, a 1SD increase in kindergarten conduct problems was associated with a $15,481 increase in adolescent criminal + victim costs, a $62,916 increase in adult criminal + victim costs, a $24,105 increase in medical services costs, and a $144,823 increase in total costs. CONCLUSIONS: This investigation provides evidence of the long-term costs associated with early-starting conduct problems, which is important information that can be used by policymakers to support research and programs investing in a strong start for children.


Subject(s)
Conduct Disorder , Problem Behavior , Adult , Child , Humans , Male , Adolescent , Female , United States/epidemiology , Conduct Disorder/epidemiology , Longitudinal Studies , Self Report , Educational Status
4.
J Fam Psychol ; 37(8): 1148-1158, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37824255

ABSTRACT

The present study aimed to identify intergenerational patterns of attachment insecurity among grandmothers, adolescent grandchildren, and birth mothers in custodial grandfamilies and to test the relations among triadic attachment patterns and grandchild socioemotional outcomes. Prior research with custodial grandfamilies has found distinct "profiles" reflecting patterns of closeness between grandmothers, grandchildren, and birth mothers. However, no studies have tested patterns of attachment insecurity among members of the triad, despite the likelihood of attachment disruption in grandfamilies. Moreover, previous studies have only examined links between profile and grandmother outcomes or rudimentary grandchild outcomes. In a sample of 230 grandmother-grandchild dyads from a larger randomized controlled trial testing the efficacy of an online social intelligence training program for grandfamilies, latent profile analysis (LPA) was conducted to identify profiles of intergenerational attachment insecurity, using grandmother and grandchild reports. Profile differences in grandchild internalizing and externalizing problems, social skills, self-esteem, and prosocial behavior were examined. We identified three profiles: isolated mother, grandchild-linked, and disconnected. Overall, grandchildren in disconnected families (in which attachment insecurity between all three members of the triad was high) fared worst. Grandchildren in isolated mother families (in which only grandmother-grandchild attachment insecurity was low) fared best. A secure attachment relationship between grandmother and adolescent grandchild may buffer effects of attachment insecurity between the grandchild and birth mother. These findings inform intervention efforts and highlight the utility of family- and attachment-focused research for building understanding of custodial grandfamilies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Grandparents , Intergenerational Relations , Female , Adolescent , Humans , Grandparents/psychology , Mothers , Social Skills
5.
Implement Sci ; 18(1): 12, 2023 05 05.
Article in English | MEDLINE | ID: mdl-37147643

ABSTRACT

BACKGROUND: While prior work has revealed conditions that foster policymakers' use of research evidence, few studies have rigorously investigated the effectiveness of theory-based practices. Specifically, policymakers are most apt to use research evidence when it is timely, relevant, brief, and messaged appropriately, as well as when it facilitates interactive engagement. This study sought to experimentally evaluate an enhanced research dissemination intervention, known as the SciComm Optimizer for Policy Engagement (SCOPE), implemented during the COVID-19 pandemic among US state legislators. METHODS: State legislators assigned to health committees and their staff were randomized to receive the SCOPE intervention. This involved providing academic researchers with a pathway for translating and disseminating research relevant to current legislative priorities via fact sheets emailed directly to officials. The intervention occurred April 2020-March 2021. Research language was measured in state legislators' social media posts. RESULTS: Legislators randomized to receive the intervention, relative to the control group, produced 24% more social media posts containing research language related to COVID-19. Secondary analyses revealed that these findings were driven by two different types of research language. Intervention officials produced 67% more COVID-related social media posts referencing technical language (e.g., statistical methods), as well as 28% more posts that referenced research-based concepts. However, they produced 31% fewer posts that referenced creating or disseminating new knowledge. CONCLUSIONS: This study suggests that strategic, targeted science communication efforts may have the potential to change state legislators' public discourse and use of evidence. Strategic science communication efforts are particularly needed in light of the role government officials have played in communicating about the pandemic to the general public.


Subject(s)
COVID-19 , Humans , Pandemics , Communication , Policy , Research
6.
Child Psychiatry Hum Dev ; 54(5): 1321-1335, 2023 10.
Article in English | MEDLINE | ID: mdl-35262849

ABSTRACT

Current understanding of the predictive validity of callous-unemotional (CU) traits is limited by (a) the focus on externalizing psychopathology and antisocial behaviors, (b) a lack of long-term prospective longitudinal data, (c) samples comprised of high-risk or low-risk individuals. We tested whether adolescent CU traits and conduct problems were associated with theoretically relevant adult outcomes 12-18 years later. Participants were drawn from two studies: higher-risk Fast Track (FT; n = 754) and lower-risk Child Development Project (CDP; n = 585). FT: conduct problems positively predicted externalizing and internalizing psychopathology and partner violence, and negatively predicted health, wellbeing, and education. Three conduct problems × CU traits interaction effects were also found. CDP: CU traits positively predicted depression and negatively predicted health and education; conduct problems positively predicted externalizing and internalizing psychopathology and substance use, and negatively predicted wellbeing. CU traits did not provide incremental predictive validity for multiple adult outcomes relative to conduct problems.


Subject(s)
Conduct Disorder , Problem Behavior , Child , Humans , Adult , Adolescent , Conduct Disorder/diagnosis , Conduct Disorder/psychology , Prospective Studies , Antisocial Personality Disorder/diagnosis , Antisocial Personality Disorder/psychology , Risk , Emotions
7.
Prev Sci ; 23(8): 1394-1403, 2022 11.
Article in English | MEDLINE | ID: mdl-35867317

ABSTRACT

Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.


Subject(s)
Child Abuse, Sexual , Child , Male , Female , Humans , Aged , Adolescent , Child Abuse, Sexual/prevention & control , School Health Services , Costs and Cost Analysis , Schools , Students
9.
Prev Sci ; 23(2): 181-191, 2022 02.
Article in English | MEDLINE | ID: mdl-34599473

ABSTRACT

Since the landmark study of Adverse Childhood Experiences (ACEs; Felitti et al., American Journal of Preventive Medicine, 14(4):245-258, 1998), there has been a significant growth in efforts to address ACEs and their impact on individual health and well-being. Despite this growing awareness, there has been little systematic review of state legislative action regarding variation in focus or scope or of the broader context impacting the introduction and enactment of ACE-related policy efforts. To inform the role of psychologists and related professionals to contribute to these legislative efforts, we conduct a comprehensive mixed-method analysis of all state bills introduced over the past two decades to investigate the use and impact of ACE research in introduced and enacted state legislative language (51 states, NTotal Bills = 1,212,048, NACE Bills = 425). In addition, these analyses examine congressional office communications (N = 14,916,546 public statements) and voting records (N = 1,163,463 votes) to understand the relationship between legislative members' public discussion of ACEs and their voting behavior on these bills. We find that legislators' public discourse is significantly related to ACE-related policymaking above and beyond political affiliation or demographic characteristics. Furthermore, key legislative language related to domestic violence, evidence-based practice, and prevention were significant predictors of whether an ACE-related bill becomes law-above and beyond the political party in power. These analyses highlight the ways in which ACE-related research has informed state policy. Based upon this work, we offer recommendations for researchers and policymakers.


Subject(s)
Domestic Violence , Policy Making , Humans , Politics , United States
10.
Am J Public Health ; 111(10): 1768-1771, 2021 10.
Article in English | MEDLINE | ID: mdl-34499535

ABSTRACT

Racial disparities and racism are pervasive public health threats that have been exacerbated by the COVID-19 pandemic. Thus, it is critical and timely for researchers to communicate with policymakers about strategies for reducing disparities. From April through July 2020, across four rapid-cycle trials disseminating scientific products with evidence-based policy recommendations for addressing disparities, we tested strategies for optimizing the reach of scientific messages to policymakers. By getting such research into the hands of policymakers who can act on it, this work can help combat racial health disparities.(Am J Public Health. 2021;111(10):1768-1771. https://doi.org/10.2105/AJPH.2021.306404).


Subject(s)
COVID-19/ethnology , Health Policy , Healthcare Disparities , Public Health Administration , Racism , Scholarly Communication , COVID-19/epidemiology , Humans , Pandemics , Policy Making , SARS-CoV-2 , United States/epidemiology
11.
Proc Natl Acad Sci U S A ; 118(9)2021 03 02.
Article in English | MEDLINE | ID: mdl-33593938

ABSTRACT

Core to the goal of scientific exploration is the opportunity to guide future decision-making. Yet, elected officials often miss opportunities to use science in their policymaking. This work reports on an experiment with the US Congress-evaluating the effects of a randomized, dual-population (i.e., researchers and congressional offices) outreach model for supporting legislative use of research evidence regarding child and family policy issues. In this experiment, we found that congressional offices randomized to the intervention reported greater value of research for understanding issues than the control group following implementation. More research use was also observed in legislation introduced by the intervention group. Further, we found that researchers randomized to the intervention advanced their own policy knowledge and engagement as well as reported benefits for their research following implementation.


Subject(s)
Policy Making , Science/legislation & jurisprudence , Decision Making , Evidence-Based Medicine/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Humans , Randomized Controlled Trials as Topic/legislation & jurisprudence
12.
Am Psychol ; 76(8): 1307-1322, 2021 11.
Article in English | MEDLINE | ID: mdl-35113595

ABSTRACT

Key to bringing psychological science to bear on public policy is developing scholars' engagement and rapport with policymakers. Scholars benefit from support navigating the policy arena in ways that strengthen their independent policy engagement. This study presents findings from a randomized controlled trial of the Research-to-Policy Collaboration (RPC) model, which develops and trains a rapid response network of researchers to respond to legislative requests for scientific evidence. Researchers were surveyed on their concerns about how policymakers support or use scientific research, how they engaged with policymakers, and perceived benefits to their research. Researchers randomized to the RPC reported fewer concerns about policymakers' support and use of research, greater involvement in supporting policymakers' understanding of problems (i.e., conceptual use), and more responses to external prompts for their involvement. Subgroup analyses examined how experiences differed for those identifying as Black, Indigenous, or Person of Color (BIPOC). At baseline, BIPOC-identifying researchers perceived greater costs of policy engagement and reported less involvement in supporting conceptual or instrumental uses of research than White-identifying researchers. Subsequent to the RPC, BIPOC-identifying researchers in the intervention group were reportedly less concerned about federal support of science, more engaged in supporting conceptual uses of research, and perceived greater benefits of policy engagement for their research than BIPOC-identifying researchers in the control group. These differences were not observed among White-identifying researchers. Findings are discussed in light of disparities experienced by marginalized scholars, the ways in which resources and supports may counteract these challenges, and possible strategies to strengthen public psychology overall. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Administrative Personnel , Research Personnel , Humans , Public Policy
13.
Prev Sci ; 21(2): 256-267, 2020 02.
Article in English | MEDLINE | ID: mdl-31902038

ABSTRACT

High-quality evidence about the costs of effective interventions for children can provide a foundation for fiscally responsible policy capable of achieving impact. This study estimated the costs to society of the Family Check-up, an evidence-based brief home-visiting intervention for high-risk families implemented in the Early Steps multisite efficacy trial. Intervention arm families in three sites were offered 4 consecutive years of intervention, when target children were ages 2 through 5. Data for estimating total, average, and marginal costs and family burden (means and standard deviations, 2015 USD, discounted at 3% per year) came from a detailed database that prospectively documented resource use at the family level and a supplemental interview with trial leaders. Secondary analyses evaluated differences in costs among higher and lower risk families using repeated measures analysis of variance. Results indicated annual average costs of $1066 per family (SD = $400), with time spent by families valued at an additional $84 (SD = $99) on average. Costs declined significantly from ages 2 through 5. Once training and oversight patterns were established, additional families could be served at half the cost, $501 (SD = $404). On the margin, higher risk families cost more, $583 (SD = $444) compared to $463 (SD = $380) for lower risk families, but prior analyses showed they also benefited more. Sensitivity analyses indicated potential for wage-related cost savings in real-world implementation compared to the university-based trial. This study illustrates the dynamics of Family Check-up resource use over time and across families differing in risk.


Subject(s)
Child Behavior , House Calls/economics , Problem Behavior , Child, Preschool , Costs and Cost Analysis , Databases, Factual , Evidence-Based Practice , Female , Humans , Interviews as Topic , Male , Mental Health , Qualitative Research , United States
14.
Child Youth Serv Rev ; 1072019 Dec.
Article in English | MEDLINE | ID: mdl-31866702

ABSTRACT

Early childhood education (ECE) interventions hold great promise for not only improving lives but also for potentially producing an economic return on investment linked to key outcomes from program effectiveness. Assessment of economic impact relies on accurate estimates of program costs that should be derived consistently to enable program comparability across the field. This is challenged by a lack of understanding of the best approach to determine program costs that represent how they will occur in the real world and how they may vary across differing circumstances. Thorough and accurate cost analyses are vital for providing important information toward future implementations and for enabling analysis of potential return on investment. In this paper, we present five key issues most relevant to cost analysis for ECE programs that interventionists should acknowledge when estimating their programs' costs. Attention to these issues more broadly can lead to comprehensive and thorough cost estimates and potentially increase consistency in cost analyses. These issues are illustrated within the cost analysis of REDI (Research-based, Developmentally Informed), an enrichment program that seeks to extend the benefits of preschool through enhanced classroom and home visiting services. Implications for practice and policy are discussed.

15.
Am J Community Psychol ; 64(3-4): 348-358, 2019 12.
Article in English | MEDLINE | ID: mdl-31593298

ABSTRACT

Human trafficking is a critical social issue characterized by chronic trauma among victims, and frequently preceded by traumatic experiences that contribute to risk of victimization. Therefore, the research-based practice of trauma-informed care is a highly appropriate lens for both prevention and intervention. This work examines federal legislation in the United States related to human trafficking for references to trauma, as well as how the use of research could implicitly direct public policy responses toward trauma-informed approaches. Legislation on human trafficking has risen substantially since 1989, and the use of research and trauma language within these policies has also observed substantial increases. While the use of trauma language was associated with limited progression in the policy process, legislation using research language was more likely to pass out of Committee and become enacted. Moreover, legislation may leverage research in ways that have the potential to bolster trauma-informed practice among human trafficking victims. Specifically, research can be used to describe the problem and causal mechanisms (e.g., impact of trauma), guide "best practice" for service delivery, and generate knowledge through studies and evaluations that guide future policy. Therefore, human trafficking legislation that implicitly guides trauma-informed practice via the use of research may be particularly promising for the field.


Subject(s)
Crime Victims/psychology , Human Trafficking , Public Policy , Wounds and Injuries/psychology , Human Trafficking/legislation & jurisprudence , Humans , Policy Making , United States
16.
Am J Orthopsychiatry ; 89(4): 434-441, 2019.
Article in English | MEDLINE | ID: mdl-31305112

ABSTRACT

Researchers generally engage in few interactions with policymakers, which limits the extent to which empirical evidence is used to guide public policy and, consequently, the potential effectiveness of public policies in improving societal wellbeing. Although many researchers wish to see their work used for social impact, several factors contribute to researchers' limited policy engagement, including a lack of opportunities for developing policy competencies (i.e., knowledge, skills, and self-efficacy that support effective policy engagement) and limited support or incentives from research, training, and philanthropic institutions. Moreover, despite work that shows that researchers are more likely to engage in policy when they report greater policy competencies, little descriptive or evaluative research has explored the effectiveness of policy training. The current work seeks to expand the limited empirical base by drawing connections between training approaches and conditions that support policymakers' use of research evidence. Policy training approaches that combine direct instruction (i.e., information-based, often didactic teaching via classes) and experiential learning (i.e., skills and knowledge obtained through active engagement, hands-on application) appear most promising. Various pathways for policy training are described, and one specific policy training and engagement strategy is further described alongside evaluation data regarding benefits associated with direct instruction and experiential learning approaches. We conclude with recommendations to strengthen researchers' policy competency development and engagement. These recommendations range from increasing access to training opportunities to adjusting institutional incentive systems that currently hinder researchers' policy engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Subject(s)
Administrative Personnel/education , Health Policy , Research Personnel/education , Health Knowledge, Attitudes, Practice , Humans , Staff Development
17.
Prev Sci ; 19(3): 366-390, 2018 04.
Article in English | MEDLINE | ID: mdl-29435786

ABSTRACT

Over a decade ago, the Society for Prevention Research endorsed the first standards of evidence for research in preventive interventions. The growing recognition of the need to use limited resources to make sound investments in prevention led the Board of Directors to charge a new task force to set standards for research in analysis of the economic impact of preventive interventions. This article reports the findings of this group's deliberations, proposes standards for economic analyses, and identifies opportunities for future prevention science. Through examples, policymakers' need and use of economic analysis are described. Standards are proposed for framing economic analysis, estimating costs of prevention programs, estimating benefits of prevention programs, implementing summary metrics, handling uncertainty in estimates, and reporting findings. Topics for research in economic analysis are identified. The SPR Board of Directors endorses the "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science."


Subject(s)
Cost-Benefit Analysis , Preventive Medicine/economics , Research Report/standards , Consensus , Evidence-Based Practice , Policy Making
18.
Transl Behav Med ; 6(1): 145-52, 2016 Mar.
Article in English | MEDLINE | ID: mdl-27012262

ABSTRACT

Prevention advocates often make the case that preventive intervention not only improves public health and welfare but also can save public resources. Increasingly, evidence-based policy efforts considering prevention are focusing on how programs can save taxpayer resources from reduced burden on health, criminal justice, and social service systems. Evidence of prevention's return has begun to draw substantial investments from the public and private sector. Yet, translating prevention effectiveness into economic impact requires specific economic analyses to be employed across the stages of translational research. This work discusses the role of economic analysis in prevention science and presents key translational research opportunities to meet growing demand for estimates of prevention's economic and fiscal impact.


Subject(s)
Preventive Health Services/economics , Preventive Health Services/methods , Translational Research, Biomedical/economics , Translational Research, Biomedical/methods , Evidence-Based Medicine/economics , Evidence-Based Medicine/methods , Humans
19.
Eval Program Plann ; 54: 19-29, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26476860

ABSTRACT

BACKGROUND: Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. METHODS: Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. RESULTS: Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. CONCLUSIONS: Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation.


Subject(s)
Community-Institutional Relations , Cooperative Behavior , Preventive Health Services/organization & administration , Program Evaluation/methods , Group Processes , Health Education/organization & administration , Humans , Leadership , Longitudinal Studies , School Health Services/organization & administration
20.
J Policy Anal Manage ; 34(3): 497-518, 2015.
Article in English | MEDLINE | ID: mdl-26106668

ABSTRACT

Early interventions are a preferred method for addressing behavioral problems in high-risk children, but often have only modest effects. Identifying sources of variation in intervention effects can suggest means to improve efficiency. One potential source of such variation is the genome. We conducted a genetic analysis of the Fast Track randomized control trial, a 10-year-long intervention to prevent high-risk kindergarteners from developing adult externalizing problems including substance abuse and antisocial behavior. We tested whether variants of the glucocorticoid receptor gene NR3C1 were associated with differences in response to the Fast Track intervention. We found that in European-American children, a variant of NR3C1 identified by the single-nucleotide polymorphism rs10482672 was associated with increased risk for externalizing psychopathology in control group children and decreased risk for externalizing psychopathology in intervention group children. Variation in NR3C1 measured in this study was not associated with differential intervention response in African-American children. We discuss implications for efforts to prevent externalizing problems in high-risk children and for public policy in the genomic era.


Subject(s)
Behavior Therapy/methods , Early Medical Intervention/methods , Genetic Variation/genetics , Genome, Human/genetics , Internal-External Control , Randomized Controlled Trials as Topic , Receptors, Glucocorticoid/genetics , Adult , Antisocial Personality Disorder/genetics , Child , Child Behavior Disorders/psychology , Humans , Polymorphism, Single Nucleotide , Psychopathology , Substance-Related Disorders/genetics
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