Preparing Teens to Stay Safe and Healthy on the Job: a Multilevel Evaluation of the Talking Safety Curriculum for Middle Schools and High Schools.

US adolescents experience a higher rate of largely preventable job-related injuries compared with adults. Safety education is considered critical to the prevention of these incidents. This study evaluates the effectiveness of a foundational curriculum from the National Institute for Occupational Safety and Health (NIOSH), Talking Safety, to change adolescents' workplace safety and health knowledge, attitude, subjective norm, self-efficacy, and behavioral intention to engage in workplace safety actions. The study also examines the impact of teacher fidelity of curriculum implementation on student outcomes. A multilevel evaluation, based on a modified theory of planned behavior, was conducted in 2016 with 1748 eighth-graders in Miami-Dade, Florida. Post-intervention, students had statistically significant increases (p < .05) in mean scores across outcomes: workplace safety knowledge (34%), attitude (5%), subjective norm (7%), self-efficacy (7%), and behavioral intention (7%). Consistent with theory, gains in attitude (b = 0.25, p < .001), subjective norm (b = 0.07, p < .01), and self-efficacy (b = 0.55, p < .001) were associated with gains in behavioral intention. Higher levels of implementation fidelity were associated with significant gains across outcome measures: knowledge (b = 0.60, p < .001), attitude (b = 0.08, p < .01), subjective norm (b = 0.04, p < .001), self-efficacy (b = 0.07, p < .01) and behavioral intention (b = 0.07, p < .01). Findings demonstrate the effectiveness of Talking Safety, delivered with fidelity, at positively changing measured outcomes, and provide support for using this curriculum as an essential component of any school-based, injury prevention program for young workers.

Mortality risk in a sample of emergency department patients who use cocaine with alcohol and/or cannabis.

BACKGROUND: Illicit drug use is common among emergency department (ED) patients, yet the association between drug use and subsequent mortality is not well understood. This study examines 36-month mortality rates for a sample of ED patients based on reported use of alcohol, cannabis, and cocaine, both individually and in combination. METHODS: Patients (N = 1669) from 2 urban EDs were surveyed at the time of the visit. The patient survey included the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) and information on physical and mental health, health care utilization, and risk factors associated with substance use. ASSIST scores were used to categorize patients into drug risk groups. Mortality information from the National Death Index was used to calculate mortality rates from 2009 to 2012. A Cox regression model identified associations between drug risk groups and mortality while controlling for patient demographics. RESULTS: The use of cocaine and cannabis both individually and in combination was associated with significantly higher mortality risk compared with other ED patients. CONCLUSIONS: ED patients who use cannabis and cocaine have higher mortality risks than other patients. Further research is necessary to determine whether this result is stable across racial/ethnic groups.

Testing effects of community collaboration on rates of low infant birthweight at the county level.

Interorganizational collaboration has become a popular strategy for addressing population health and well-being. However, evidence for its effectiveness in achieving outcomes at the population level is limited, at least in part due to a variety of methodological challenges such as reduced sample size at the population level, the availability of suitable comparison groups of communities, and study durations that are too short to detect slowly emerging outcomes. The present study addresses these challenges by retrospectively examining the effectiveness of a mature network of community collaboratives, using latent growth modeling of longitudinal change in an archival community-level outcome, low infant birthweight, and propensity score matching of comparison communities. A group of 25 Georgia counties with collaboratives targeting low infant birthweight was compared to a weighted comparison group of counties from other southeastern states, using propensity score matching. We report results of full matching methods and outcome analyses examining differences in change in county rates of low infant birthweight from 1997 to 2004 between intervention and comparison counties. Results indicated significantly smaller increases in low weight birth rates in intervention counties than in comparison counties.

Evaluation of the public health achievements made by projects supported by a federal contract mechanism at the Centers for Disease Control and Prevention (CDC), USA.

In 2012, the Centers for Disease Control and Prevention (CDC) established the Achieving Public Health Impact through Research (APHIR) contract mechanism. APHIR provides CDC's Centers, Institute, and Offices (CIOs) a mechanism that supports multiyear, high impact public health research. Awarded projects supported research on a wide range of topics (e.g., cancer surveillance, HIV education programs, development of biological assays, and evaluation of traumatic brain injury prevention programs) and achieved diverse outcomes (e.g., contribution to the body of knowledge in their field, changes in practice and health service delivery, and capacity building). This article describes how existing impact frameworks and a variety of methods and tools (key informant interviews, online survey, bibliometric analysis, Altmetric and document reviews) were used to identify the outcomes achieved by awarded projects. The approach discussed in this paper can be used to evaluate projects that involve a diversity of activities and outcomes.

Adoption, adaptation, and fidelity of implementation of sexual violence prevention programs.

Little research examines the organizational and contextual dynamics that affect decisions to adopt evidence-based programs as well as the feasibility of implementation with fidelity to the original model when new users adopt established programs. To understand how promising strategies can be disseminated widely, this study examines the adoption and implementation of two sexual violence prevention programs in new settings. Interviews were conducted with stake-holders to investigate the factors and dynamics related to the adoption and implementation of these programs. Additionally, the research team worked with the program developers to create measures of the fidelity of implementation, which were then administered at each site. The findings suggest that adoption decisions were based on perceived fit between the program and the adopting organization's values, goals, and local setting. After adoption, new sites were able to implement the program with fairly high levels of fidelity, given moderate investments in training and technical assistance.

Researchers, practitioners, and funders: using the framework to get us on the same page.

The worlds of prevention research and practice are largely disconnected. The growing body of scientific knowledge regarding effects of prevention programs is not often disseminated and translated in a manner that leads to wide scale changes in practice. The Centers for Disease Control and Prevention, in collaboration with a team of academic researchers, has developed the Interactive Systems Framework for Dissemination and Implementation to help us understand the roles and interactions of those associated with developing knowledge, those associated with using the knowledge in practice settings, and those acting in the roles of bridge, support, and broker between the research and practice communities. This special issue on the Framework presents a variety of theoretical, practical and empirical issues related to this framework and its subsystems. This compilation of articles discuss the capacity of the Framework's subsystems, provide examples of the generally under-developed prevention support system, describe the additional challenges involved in disseminating a change in culture, discuss the delicate balance and interaction of fidelity and adaptation, present a meta-analysis of the relationships between program implementation and program outcomes, and include examples of how the Framework has been used to guide action. The present commentary on this special issue provides a critical examination of the contributions, implications, and challenges raised by each of these articles. It also includes a discussion of how the Framework relates to the basic values and practice of community psychology and concludes with some suggested future directions and challenges for the continued development and use of the Framework.

Factors associated with incarceration history among HIV-positive persons experiencing homelessness or imminent risk of homelessness.

Among persons living with HIV/AIDS (PLWHA) experiencing homelessness or imminent risk of homelessness, a history of incarceration may serve as a marker for ongoing risk behavior or health disparities. We examined factors associated with a history of incarceration among HIV-positive clients of housing agencies in Baltimore, Chicago, and Los Angeles (N = 581). We used logistic regression to conduct analyses. Of the 581 participants, 68% (n = 438) reported a history of incarceration: 32% (n = 182) had spent more than 1 year incarcerated. After adjustment for covariates, incarceration history was associated with having ever injected drugs, ever engaged in sex exchange, and ever experienced physical abuse. Incarceration history was also associated with having a detectable HIV viral load, better mental health, and being a biological parent. It was not associated with current risk behavior. Service providers may explore possible increased need for medical support among homeless PLWHA with a history of incarceration.

Systems change as an outcome and a process in the work of community collaboratives for health.

The widespread development of comprehensive community initiatives that aim to improve community health is driven by the need to change the systems charged with delivering the services and creating the policies related to a variety of health outcomes. Georgia's Family Connection initiative is the nation's largest statewide network of community collaboratives for health, with collaboratives operating in 159 counties. Data on community context, collaborative processes, engagement in systems change, and changes in programs and activities implemented, gathered consistently at the collaborative level over 3 years, will be used to answer the following questions. How do community contexts and the structure and processes of collaboratives affect implementation of systems change? How do systems changes affect intermediate outcomes such as the type of programs offered in a community? Longitudinal change in systems change and program implementation is described and significant predictors of between-collaborative variation in longitudinal change for each outcome are identified.

Prostate cancer support groups: a literature review.

This article provides an overview of research literature related to cancer support groups, with particular reference to prostate cancer groups. Randomized studies of cancer support groups primarily focus on short-term psychoeducational and/or supportive/expressive groups for women with breast cancer. Many of these studies suggest that the interventions lead to a pronounced improvement in psychological functioning and may in some instances increase longevity. Regarding prostate cancer support group members, information and education are especially valued. Open-ended, psychoeducational groups with large meetings, expert speakers, and structured, efficient organizations appear most beneficial to prostate cancer group members. The literature only partially answers a number of significant questions, including the types of group most appropriate for people with specific diseases, process variables most significant to the success of groups, and specific factors that are barriers to group involvement by certain populations.