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1.
J Behav Med ; 44(3): 379-391, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33677766

RESUMO

The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives.Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1.


Assuntos
Exercício Físico , Instituições Acadêmicas , Acelerometria , Adolescente , Feminino , Promoção da Saúde , Humanos , Masculino , Motivação , Meio Social
2.
J Clin Child Adolesc Psychol ; 50(3): 385-399, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31910050

RESUMO

Objective: A population-level, randomized controlled trial was conducted to test the effectiveness of a parent recruitment package for increasing initial engagement into a school-based parenting program and to identify strategies responsible for effects.Method: Participants were caregivers of kindergarten- to third-grade students (N = 1,276) attending one of five schools serving ethnically diverse families living in mostly low-income, urban conditions. First, families were randomly assigned to be recruited for research surveys or not, and then to a parenting program recruitment condition: 1) Engagement-as-usual (EAU) informational flyer; 2) EAU + testimonial booklet; 3) EAU + teacher endorsement; 4) EAU + recruitment call; or 5) all strategies (full package). Caregivers were offered a free parenting program at their child's school. Primary dependent variables were parenting program enrollment and attending at least one session (initiation). Exploratory analyses were conducted on program completion, attendance across sessions, homework completion, and in-session participation.Results: In the population-level sample, enrollment and initiation were higher for the full package compared to all other conditions except the recruitment call condition. Enrollment, initiation, and program completion were higher for the recruitment call and full package conditions compared to the EAU condition. In the subsample of initiators, parents in the full package condition attended fewer parenting sessions than in the EAU condition. Controlling for attendance across sessions, there were no condition effects on homework completion or in-session participation.Conclusions: The recruitment call can increase the public health impact of evidence-based parenting programs by improving enrollment, initiation, and program completion.

3.
Am J Community Psychol ; 66(3-4): 267-278, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32969506

RESUMO

There is an array of youth participatory approaches relevant to health equity efforts in community psychology, adolescent health, youth development, and education. While they share some commonalities, they also reflect important distinctions regarding key processes and intended level of impact. Here, we consider the following: (a) youth-led participatory action research (YPAR), (b) youth organizing (YO), (c) youth-led planning, (d) human-centered design, (e) participatory arts, and (f) youth advisory boards. Informed by community psychology theories on empowerment and levels of change and social epidemiology frameworks that focus on the social determinants of health inequities, we aim to promote greater clarity in the conceptualization, implementation, and evaluation of youth participatory approaches; frame the "landscape" of youth participatory approaches and their similarities and differences; present an integrative review of the evidence regarding the impact of youth participatory approaches; and describe several illustrative cases so as to consider more deeply how some youth participatory approaches aim to influence the social determinants of health that lead to the physical embodiment of health inequities. We conclude by identifying areas of future policy- and practice-relevant research for advancing youth participation and health equity.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Formação de Conceito , Equidade em Saúde , Adolescente , Pesquisa sobre Serviços de Saúde , Humanos , Adulto Jovem
4.
Child Youth Serv Rev ; 1082020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32863498

RESUMO

Emerging adults (EA), individuals between the ages of 15-26, face many challenges in their transition to a new developmental stage, especially those with behavioral health concerns who do not receive the supports they need. Many EA drop out of services at 18, which is likely due in part to the need to transition to the adult service system and the lack of available transition support services in child/adolescent service systems. Though this is a clear disparity, research on EA service utilization, especially those enrolled in Medicaid and with co-occurring conditions, is rare. This paper begins to address this gap by examining variables at age 17 that predict the service utilization of continuously Medicaid enrolled EA at age 18. Data came from an administrative dataset. The sample had 4,548 EA and 53% were female, 50% identified with a minority group, and 19% were child-welfare involved. Exploratory logistic regression analyses were used. Minority EA had lower odds of utilizing services at age 18. EA involved with child welfare had greater odds of utilizing services at age 18. EA with at least one Substance Use Disorder (SUD) and at least one mental health disorder at 17 had a higher likelihood of service utilization at 18, the opposite was true for EA with only SUDs. These findings identified predictors of service utilization for an understudied sample-EA enrolled in Medicaid. Results provided preliminary evidence that EA with SUD diagnoses access behavioral health services differently than those without a SUD diagnosis, and that it is fruitful to examine subgroups of EA when seeking to understand their service utilization patterns. Identifying predictors of service utilization during the transition period from the child to the adult system can help inform systems interventions to retain EA in services.

5.
Am J Community Psychol ; 66(1-2): 81-93, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32497266

RESUMO

Youth-Led Participatory Action Research (YPAR) is a social justice-focused approach for promoting social change and positive youth development in which youth conduct systematic research and actions to improve their schools and communities. Although YPAR is oriented to generating research for action, with evidence-based recommendations often aimed at influencing adults with power over settings and systems that shape youths' lives, we have little understanding of how YPAR evidence influences the thinking and/or actions of adult policymakers or practitioners. In general, the participatory research field lacks a theoretically informed "use of research evidence" lens, while the use of evidence field lacks consideration of the special case and implications of participatory research. To start to address these gaps, this paper presents a conceptual linkage across these two fields and then provides six illustrative case examples across diverse geographic, policy, and programmatic contexts to demonstrate opportunities and challenges in the use of YPAR evidence for policy and practice. Our illustrative focus here is on U.S. K-12 educational contexts, the most-studied setting in the YPAR literature, but questions examined here are relevant to YPAR and other systems domestically and internationally, including health, educational, and legal systems. HIGHLIGHTS: The use of research evidence (URE) field identifies characteristics of research and conditions that strengthen URE. Youth-led Participatory Action Research is a special case for factors that influence research use. Six case examples across diverse K-12 contexts illustrate facilitators and barriers for YPAR use. We propose next steps for community psychology research and action to promote the study and use of YPAR evidence.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Formação de Conceito , Instituições Acadêmicas/estatística & dados numéricos , Mudança Social , Adolescente , Humanos
6.
Clin Med Insights Pediatr ; 14: 1179556520918902, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547286

RESUMO

Most interventions do not reach full implementation in real-world settings. Due to this issue, formative process evaluation during pilot programs can be especially useful to understand implementation strengths and areas for improvement so that full implementation can be reached in future iterations. This study demonstrated how a formative process evaluation of the Connect through Positive Leisure Activities for Youth (Connect) pilot informed course corrections for year 2 implementation. Connect is an intervention to promote a positive social motivational climate for physical activity (PA) in pre-existing after school programs. Connect ran 3 days a week for 8 weeks and had 2 components: a 30-minute "Get-to-Know-You" (GTKY) session and a 60-minute PA session. Formative evaluation was assessed using an observational tool and staff surveys. Changes in youth PA during program hours was assessed as a process outcome using the System for Observing Children's Activity and Relationships during Play (SOCARP). All Connect essential elements were assessed with the observational tool including (a) social goal-oriented support; (b) collaborative, cooperative play; (c) equal treatment/access; and (d) an inclusive and engaging climate. Adequate dose was achieved on all items in all sessions. Although GTKY and PA sessions both reached high fidelity in promoting equal treatment and access, success in reaching fidelity varied for the 3 remaining essential elements. Post-intervention staff surveys indicated acceptability/adoptability of the Connect program and SOCARP observations indicated significant increases in PA from baseline to post-intervention. Changes for year 2 implementation based on the findings are discussed.

7.
Am J Community Psychol ; 66(3-4): 232-243, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32589272

RESUMO

To address gaps in the youth participation and adolescent physical activity (PA) promotion literature, we examined the feasibility of youth participatory action research (YPAR) in (a) general aftercare (YPAR only) and (b) with a physical activity intervention, (YPAR + PA) to reach marginalized youth and impact individual empowerment and second-order change for equitable PA access. We intervened during middle school, a developmental stage conducive to changing health habits. We used a concurrent, mixed-method triangulation design. Participants were students (94% non-Hispanic Black/African American, 75% free/reduced lunch) in the southeastern United States. YPAR was adapted from online modules. Youth conducted photovoice, capturing and analyzing social/environmental factors contributing to inequities in their schools/programs. PA inequities emerged for girls. Findings indicated feasibility of YPAR with systems supports. Changes occurred at the individual and systems level in the YPAR + PA program. Sociopolitical skills, participatory behavior, and perceived control empowerment subdomains increased pre-post, and youth qualitative responses aligned. A follow-up interview with the director revealed all youth-proposed changes occurred. A feedback loop was developed for continued youth input. Youth-led changes to increase PA access have potential to decrease health disparities by generating unique solutions likely missed when adults intervene alone.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Empoderamento , Exercício Físico , Equidade em Saúde , Pesquisa sobre Serviços de Saúde , Instituições Acadêmicas , Adolescente , Afro-Americanos/estatística & dados numéricos , Criança , Feminino , Promoção da Saúde , Humanos , Masculino , Mudança Social , Sudeste dos Estados Unidos , Estudantes
8.
J Community Psychol ; 48(4): 1178-1193, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31951291

RESUMO

AIMS: To translate evidence-based programs (EBP) for a new setting, attention must be given to the characteristics of the intervention and the local setting, as well as evidence that is compelling to decision-makers. This paper describes the history of a partnership and stakeholder recommendations to inform the adaptation of an EBP for primary care. METHODS: We established a community advisory board (CAB) consisting of stakeholders with expertize in primary care delivery. A thematic analysis was conducted with fieldnotes and transcriptions from CAB meetings and regular meetings with participating clinics. RESULTS: We found that (a) parenting programs with a focus on behavioral and physical health are appropriate for this setting, (b) variability in the structure of primary care means implementation must be tailorable, and (c) financial and organizational outcomes are compelling for decision-makers. CONCLUSION: Factors related to the content and structure of evidence-based programs are uniquely related to distinct implementation outcomes of interest to key stakeholders.


Assuntos
Prática Clínica Baseada em Evidências/organização & administração , Poder Familiar , Atenção Primária à Saúde/métodos , Participação dos Interessados , Criança , Tomada de Decisões , Feminino , Humanos , Ciência da Implementação , Masculino , Determinação de Necessidades de Cuidados de Saúde/organização & administração , Obesidade Pediátrica/terapia , Relações Médico-Paciente
9.
Health Promot Pract ; 21(4): 573-581, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-30577698

RESUMO

Youth participatory action research (YPAR) emphasizes positive youth development by engaging young people as co-researchers and change agents on complex issues to produce solutions that are relevant to youth. YPAR has primarily been used in classroom and youth organization settings, which means there are very few examples of its usage in other community-based settings or as a health intervention approach. Additionally, there is a need for further study of YPAR implementation processes and the effect on youth development and well-being outcomes. In this article, we highlight the innovative use of YPAR as a community-based health intervention through two case studies in which the adolescent health issues of physical activity and suicide were addressed. We describe the design of each YPAR health intervention and the studies that were conducted to link participatory research processes to youth development and health outcomes. Using the lessons learned from these YPAR interventions, we propose best practices for the design, implementation, and evaluation of YPAR as a health intervention strategy in a community setting.


Assuntos
Saúde do Adolescente , Pesquisa Participativa Baseada na Comunidade , Exercício Físico , Pesquisa sobre Serviços de Saúde , Suicídio/prevenção & controle , Adolescente , Humanos
10.
Am J Community Psychol ; 65(1-2): 125-135, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31410864

RESUMO

Community-based Participatory Research (CBPR), where consumers participate in the design and execution of an evaluation, holds promise for increasing the validity and usefulness of evaluations of services. However, there is no literature comparing methods and outcomes of studies conducted by professional evaluators with those conducted through a consumer-driven evaluation process. We attempt to fill this gap by presenting the methods and results from a qualitative evaluation conducted by professional evaluators along with one conducted by a team of consumer researchers who engaged in a CBPR process. This paper includes: (a) methods, and findings that emerged from these evaluations each tasked with examining similar issues within the same community; (b) description of the process used to train the team of consumer researchers whose economic and educational backgrounds are different than most evaluators; and (c) lessons learned about how to prepare for and work with common barriers to implementing a CBPR evaluation.


Assuntos
Participação da Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Serviços de Saúde Comunitária , Connecticut , Violência Doméstica/prevenção & controle , Feminino , Grupos Focais , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pais/psicologia , Pesquisa Qualitativa , Pesquisadores/psicologia
11.
Health Educ Behav ; 46(1_suppl): 100S-109S, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30982339

RESUMO

Spreading Community Accelerators Through Learning and Evaluation (SCALE) was a Robert Wood Johnson Foundation-funded initiative from 2015 to 2017 to build capability of 24 community coalitions to advance health, well-being, and equity. The SCALE theory of change had three components: develop leadership capability, build relationships within and between communities, and create an intercommunity system to spread promising ideas. The theory was operationalized through training academies, coaching, and peer-to-peer learning that explicitly addressed equity and systems change. In this article, we describe how SCALE facilitated community transformation related to Collaborating for Equity and Justice Principles 1, 3, 4, and 6. We conducted a multiple-case study approach with two community coalitions including site visits, interviews, and observation to illuminate underlying mechanisms of change by exploring how and why change occurs. Skid Row Women worked with women experiencing homelessness in Los Angeles to address diabetes and food systems. Healthy Livable Communities of Cattaraugus County used a portfolio of projects in order to create system changes to improve population health and increase access to services for people with disabilities in rural New York State. Through our analysis, we describe how two coalitions used SCALE tools for collaborative coalition processes such as aim setting, relationship building, and shared decision making with community residents. Our findings suggest that advancing Collaborating for Equity and Justice principles requires self-reflection and courage; new ways of being in relationship; learning from failure; productive conflict to explicitly address power, racism, and other forms of oppression; and methods to test systems improvement ideas.


Assuntos
Participação da Comunidade/métodos , Coalizão em Cuidados de Saúde/organização & administração , Equidade em Saúde/organização & administração , Saúde Pública , Humanos , Los Angeles
12.
Appl Dev Sci ; 22(1): 58-73, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30147291

RESUMO

Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. Using Self-Determination Theory (SDT) as a framework, this study examined staff perspectives on the strengths and barriers within under-resourced ASPs for establishing a social-motivational climate for encouraging and supporting youth PA. Analysis of semi-structured staff interviews (28 staff; 7 ASPs) indicated that staff had knowledge and value for establishing a PA-supportive motivational climate. However, the feasibility of implementing PA curricula was identified as challenging across programs. Findings suggest increased need for staff training and supports to provide a PA climate that meets the developmental needs/interests of all youth, with particular attention toward increasing the PA of girls and older program youth. Furthermore, striking an appropriate balance between PA and other competing program demands (e.g., academics) will be required to optimize on the effectiveness of PA program components.

13.
Eval Program Plann ; 58: 199-207, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27454882

RESUMO

This article describes how we used a formative multi-method evaluation approach to gather real-time information about the processes of a complex, multi-day training with 24 community coalitions in the United States. The evaluation team used seven distinct, evaluation strategies to obtain evaluation data from the first Community Health Improvement Leadership Academy (CHILA) within a three-prong framework (inquiry, observation, and reflection). These methods included: comprehensive survey, rapid feedback form, learning wall, observational form, team debrief, social network analysis and critical moments reflection. The seven distinct methods allowed for both real time quality improvement during the CHILA and long term planning for the next CHILA. The methods also gave a comprehensive picture of the CHILA, which when synthesized allowed the evaluation team to assess the effectiveness of a training designed to tap into natural community strengths and accelerate health improvement. We hope that these formative evaluation methods can continue to be refined and used by others to evaluate training.


Assuntos
Participação da Comunidade/métodos , Nível de Saúde , Capacitação em Serviço/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Humanos , Liderança , Fatores de Tempo , Estados Unidos
14.
Am J Community Psychol ; 57(3-4): 308-19, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27216561

RESUMO

Although extracurricular participation has been linked to positive youth outcomes in the general population, no research to date has examined benefits for youth diagnosed with mental health challenges. Youth in systems of care (SOCs) receive a variety of services and supports that could help them capitalize on this potential for positive development, such as access to flexible funding to support recreational interests. However, research has not examined the degree to which the increased community involvement (e.g., extracurricular participation) sought in SOCs contributes to improved outcomes. This study addresses these gaps by investigating the relationships between both average and increased extracurricular participation frequency and breadth and internalizing problems and intrapersonal strengths among SOC youth. Findings revealed that, on average, higher frequency of youth participation was associated with higher intrapersonal strengths and lower internalizing problems. Increases in participation frequency were also associated with increased strengths and decreased internalizing problems. These findings suggest that efforts to implement supports for increasing extracurricular participation of SOC youth could improve their psychosocial outcomes beyond the benefits yielded via formal services. Taken together, these results provide support for advocacy efforts to integrate youth with mental health challenges into existing extracurriculars and to create new extracurricular opportunities.


Assuntos
Deficiência Intelectual/psicologia , Controle Interno-Externo , Atividades de Lazer , Resiliência Psicológica , Participação Social , Apoio Social , Populações Vulneráveis/psicologia , Adolescente , Criança , Feminino , Humanos , Deficiência Intelectual/reabilitação , Estudos Longitudinais , Masculino , Sudeste dos Estados Unidos , Inquéritos e Questionários
15.
Prog Community Health Partnersh ; 8(2): 187-95, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25152100

RESUMO

BACKGROUND: Children involved in child welfare services are at high risk for emotional and behavioral problems that are not adequately identified and treated. As part of a federal review, Youth and Family Services (YFS), child protective services in Charlotte, North Carolina, was informed that they must improve their response to youth needs, particularly regarding mental health, or face losing millions of dollars in federal funding. OBJECTIVES: We have described herein an effort to build agency capacity for identifying mental health needs through a community-university partnership and share lessons learned about implementing the new process. METHODS: Community and university partners came together to develop a mental health screening pilot for one Youth and Family Services (YFS) district. LESSONS LEARNED: Community-university partners across all levels of a hierarchically structured agency must work together to align implementation of partner activities with system-level goals. Recommendations for collaboration, from a stakeholder perspective, are also described.


Assuntos
Fortalecimento Institucional/organização & administração , Transtornos do Comportamento Infantil/diagnóstico , Proteção da Criança , Saúde Mental , Transtornos do Humor/diagnóstico , Adolescente , Criança , Participação da Comunidade , Pesquisa Participativa Baseada na Comunidade , Relações Comunidade-Instituição , Feminino , Humanos , Masculino , Programas de Rastreamento , North Carolina/epidemiologia , Encaminhamento e Consulta/organização & administração , Universidades/organização & administração
16.
Body Image ; 9(1): 93-100, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22104125

RESUMO

The purpose of the current study is to create a comprehensive composite measure of parental influence based on previously developed measures to clarify the underlying dimensions of parental influence and to determine the degree to which parental influence relates to body image and dysfunctional weight concerns. Previously published literature was reviewed for measures of parental influence, and items from 22 measures were condensed and combined into a single questionnaire, which was completed by 367 female undergraduate psychology students. Two dimensions emerged from a principle components analysis: Direct Influence, which includes weight and eating related comments, and Modeling, which includes parental modeling of dieting and related behavior. Direct Influence and Modeling were significantly related to eating disturbance, such as drive for thinness and bulimic symptomatology. Overall, the results integrate the previous literature and clarify the underlying dimensions of parental influence. Further, this study provides directions for future research related to the development and maintenance of body image and eating disturbance.


Assuntos
Imagem Corporal , Dieta Redutora/psicologia , Comportamento Alimentar , Comportamento Imitativo , Poder Familiar/psicologia , Socialização , Adolescente , Adulto , Bulimia/diagnóstico , Bulimia/psicologia , Feminino , Humanos , Sobrepeso/psicologia , Inventário de Personalidade/estatística & dados numéricos , Psicometria , Valores Sociais , Inquéritos e Questionários , Magreza/psicologia , Adulto Jovem
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