Empirically-based Interventions Research Articles

Teacher Perceptions Matter: Psychometric Properties of the Georgia School Personnel Survey of School Climate

There are many measures of student perceptions of school climate; accordingly, there is a staggering amount of research examining those perceptions and related outcomes. There is a comparatively small number of measures examining school personnel perceptions. Of those found, only some had evidence of measurement invariance/equivalence (MI/E). None found with evidence of MI/E had evidence of structural invariance/equivalence (SI/E). This article explores these psychometric properties of The Georgia School Personnel Survey (GSPS) of school climate. We analyzed a representative sample of Georgia school personnel (N = 166,887) through exploratory, confirmatory, and multigroup confirmatory factor analysis. Results indicated that the GSPS has a second-order model containing six first-order subscales loading onto a second-order scale (acting as a measure of whole-school climate). Assessment of MI/E and SI/E suggested that the GSPS is an appropriate measure for comparisons based on gender, racial/ethnic identity, grade level, and job classification. Implications for research and practice will be discussed referencing the Cultural–Ecological Model of School Climate (CEMSC). Impact Statement This research provides psychometric properties for the Georgia School Personnel Survey (GSPS) of school climate, giving school personnel, lawmakers, and researchers information necessary to justify the use of the GSPS as a valid tool to assess and confidently compare staff perceptions of school climate. Specifically, this research provides evidence that the GSPS may be used to compare perceptions of school climate between school staff based on demographic characteristics (gender, racial/ethnic identity, job classification, and grade level). This research may be of special interest to a range of stakeholders, including school psychologists, district- and school-level administrators, and policymakers who are interested in comparing perceptions within schools or systems. School psychologists, who are trained as data-based decision-makers, play an important role as advocates to administrators and other school personnel. Specifically, school psychologists can help teams to analyze and interpret data as part of an empirically-based intervention to address the needs of school personnel. Supplemental data for this article is available online at https://doi.org/10.1080/2372966X.2021.1958645 .

Cognitive Behavior Therapy for Psychosis (CBT-p) as an Adjunct to Competency Restoration

ABSTRACT Adjudicative competence evaluations are the most common forensic evaluation to occur in the United States. As a result of these evaluations, pretrial defendants are often found to be incompetent to stand trial and ordered for competency restoration, with psychotic symptoms as a major barrier to competency. Traditional competency restoration services are sometimes insufficient for restoring such defendants to competency within a reasonable period of time. This can lead to a finding that a defendant is unrestorably incompetent to stand trial and potentially a dismissal of charges. However, if not all available interventions are attempted during the course of competency restoration, this may be perceived as a miscarriage of justice for victims. In other cases, defendants with psychotic symptoms may lack insight into their mental illness, and after being successfully restored to competency, become non-adherent with their prescribed medication regimens and decompensate before their cases are resolved. The authors contend that use of Cognitive Behavior Therapy for psychosis (CBT-p) as an adjunct to traditional competency restoration services may be a means of restoring more defendants to competency, and also strengthening the durability of restored competency, when psychotic symptoms are identified as a barrier to adjudicative competence. This makes use of the skill sets of many clinically trained treatment providers working in forensic settings, and is consistent with recent trends of applying empirically-based interventions designed for use with non-forensic patients in forensic contexts. A case example is included to demonstrate the potential application of CBT-p to competency restoration during the course of individualized intervention.

SACRED Connections: A university-tribal clinical research partnership for school-based screening and brief intervention for substance use problems among Native American youth

ABSTRACT Native American (NA) youth report higher rates of alcohol, marijuana, and drug use than U.S. adolescents from any other racial/ethnic group. Addressing this health disparity is a significant research priority across public health, minority health, and dissemination and implementation (D&I) sciences, underscoring the need for empirically-based interventions tailored for NA youth. Effective D&I with NA youth incorporates NA cultural values and involves tribal elders and stakeholders. SACRED Connections (NIDA R01DA02977) was a university-tribal research partnership that utilized a culturally derived Native-Reliance theoretical framework and a community-based participatory research (CBPR) approach. A significant objective of this randomized controlled trial was to close D&I gaps utilizing the RE-AIM Model and National Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards (HHS, 2019). Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition. Implementation of a developmentally and NA culturally tailored brief protocol revealed: partnering with Native Americans and utilizing CBPR facilitated engagement with this hard-to-reach, underserved community; age and culture are associated with substance use severity among NA teens; a culturally adapted Motivational Interviewing (MI) brief intervention may be effective in reducing marijuana use among NA youth; the Native Reliance theory proved useful as a framework for working with this population; and RE-AIM proved helpful in conceptualizing health equity promoting D&I.

Changing healthcare provider and parent behaviors in the pediatric post-anesthesia-care-unit to reduce child pain: Nurse and parent training in postoperative stress.

Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain. In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically-based intervention which was then evaluated by experienced nurses (N=8) and parents (N=9) during focus groups. After revising the intervention based on focus group feedback, it was tested in Phase 2 using a pre-post study design. Nurses (N=23) who worked in the recovery room were recruited to be part of both pre- and post-intervention data collection periods. Parents were recruited to be part of either the pre- (N=52) or post-intervention (N=60) data collection periods. Nurses and parent-child dyads were recorded in the post anesthesia care unit and videos were coded for the desired (ie, behaviors that may decrease child pain) and non-desired (ie, behaviors that may increase child pain) behaviors. Pain data was collected from the children's medical records to assess pain after surgery. The intervention was given to the nurses and parents in the post-intervention data collection period. Nurses significantly increased their rate of desired behaviors by 231% (P=0.001; Somer's D=1) and significantly decreased their rate of non-desired behaviors by 62% (P=0.004, Somer's D=-0.88, 95% CI [-1.74, -0.03]). Parents significantly increased their rate of desired behaviors by 124% (P=0.033). Moreover, the intervention significantly decreased child pain in the post anesthesia care unit (b=-2.19, SE=0.63, z=-3.46, P=0.001, 95%CI [-3.43, -0.95]). The intervention was effective in changing nurse and parent behaviors as well as child pain after surgery.

A Systematic Review of the Effectiveness of Intergenerational Programs.

Purpose of the study: The objective of the present review study is to identify the determinant elements of the effectiveness of empirically based interventions (EBI) in the field of intergenerational work, contrasting face-to-face and combined (face-to-face and virtual) intervention modalities against variables relating to this field according to EBI indicators.Design and Methods: An extensive literature search returned a total of 553 studies. Of these, just 50 studies met the inclusion criteria of being an empirical investigation of the effectiveness of intergenerational programs that contain appropriate elaboration on theoretical constructs and methods.Results: The descriptive and multivariate analysis conducted demonstrates that programs with a greater number of EBI controls have the greatest effectiveness, regardless of the intervention mode employed, and that this effectiveness is also modulated by other variables such as the participants' disabilities, their literacy level, or their membership of an organization.Conclusions: We examined the implications of these findings, noting the need to increase the number of virtual interventions that could improve the efficiency of the activities undertaken, and at the same time ensuring that EBI indicators are also fulfilled.

Learning Disabilities: Opportunities and challenges in Oman.

Learning Disabilities: Opportunities and challenges in Oman.

Introduction to the Special Issue: Empirically-based Interventions for Emerging Adults with Serious Mental Health Conditions.

Introduction to the Special Issue... Young people in late adolescence and early adulthood have higher rates of serious mental health conditions (SMHCs) than any other age cohort in the U.S. population, yet they are also the age group least likely to engage in services. Research evidence developed over the past decade and a half has amply documented the poor outcomes and difficult life trajectories experienced by older adolescents and young adults with SMHCs; however, only recently has attention been turned to developing interventions that respond to their unique needs and preferences. This special issue of the Journal of Behavioral Health Services & Research highlights new research that contributes to knowledge about interventions and programs that are successful in improving outcomes for emerging adults, older adolescents and young adults between the ages of about 17 and 25, who experience serious mental health conditions. The papers that comprise this special issue describe research that is grounded in what can be described as a “positive developmental” approach to working with emerging adults with SMHCs. The lead article1 for the issue describes this positive developmental approach in terms of a set of core features that are shared across a number of interventions and programs that have empirical evidence of effectiveness for the population. The article points out that, despite the apparent success and growing popularity of interventions and programs that incorporate these shared features, there has not been any clear theoretical description of why or how interventions built around the features should “work” to produce desired outcomes. The article draws on existing research and a blend of theories, including theories of positive development, self-determination, ecological systems and social capital, to propose a general theory of change for positive developmental approaches to improving outcomes for emerging adults with SMHCs. The paper argues that a clearer theoretical specification can contribute to the creation of efficient strategies for building the research base and for training providers to work more effectively with the population. The subsequent papers included in this special issue reflect the diversity of strategies that are being used to develop and evaluate interventions that include features of the positive developmental approach and that are designed specifically to improve outcomes for emerging adults with SMHCs. Several of the papers focus on efforts to adapt interventions that have evidence of success with other populations,2-4 while another paper focuses on an intervention originally developed specifically for emerging adults with SMHCs.5 An additional paper describes research on a culturally grounded intervention approach focused on supporting positive Introduction to the Special Issue: Empirically-based Interventions for Emerging Adults with Serious Mental Health Conditions

Consultants’ Perceptions of School Counselors’ Ability to Implement an Empirically-Based Intervention for Adolescent Social Anxiety Disorder

Social anxiety is highly prevalent but goes untreated. Although school-based CBT programs are efficacious when delivered by specialized psychologists, it is unclear whether school counselors can implement these interventions effectively, which is essential to promote sustainable school programs. We present an initial consultation strategy to support school counselor implementation of group CBT for social anxiety and an evaluation of counselors' treatment fidelity. Counselors were highly adherent to the treatment, but competence varied based on measurement. Counselors and consultants demonstrated good agreement for adherence, but relatively modest correspondence in competence ratings. We discuss future directions for school-based implementation efforts informed by these initial findings.

P1-S6.25 The male reproductive health project: using research-based interventions to increase male clients and STI testing at family planning clinics

BackgroundWomen comprise >95% of US family planning (FP) clinic clients. The Male Reproductive Health Project (2008–2013) is a national research demonstration effort implementing empirically-based interventions to increase male FP clients...

From Research to Practice: An Integrative Framework for the Development of Interventions for Children with Fetal Alcohol Spectrum Disorders

Since fetal alcohol syndrome was first described over 35years ago, considerable progress has been made in the delineation of the neurocognitive profile in children with prenatal alcohol exposure. Preclinical investigators have made impressive strides in elucidating the mechanisms of alcohol teratogenesis and in testing the effectiveness of pharmacological agents and dietary supplementation in the amelioration of alcohol-induced deficits. Despite these advances, only limited progress has been made in the development of evidence-based comprehensive interventions for functional impairment in alcohol-exposed children. Having performed a search in PubMed and PsycINFO using key words, interventions, treatment, fetal alcohol syndrome, prenatal alcohol exposure, and fetal alcohol spectrum disorders, we found only 12 papers on empirically-based interventions. Only two of these interventions had been replicated and none met the criteria of "well-established," as defined by Chambless and Hollon (Journal of Consulting and Clinical Psychology 66(1):7-18, 1998). There has been only limited cross-fertilization of ideas between preclinical and clinical research with regard to the development of interventions. Therefore, we propose a framework that allows integrating data from preclinical and clinical investigations to develop comprehensive intervention programs for children with fetal alcohol spectrum disorders. This framework underscores the importance of multi-level evaluations and interventions.

Examining smoking and cessation during pregnancy among an Appalachian sample: a preliminary view.

BackgroundSeveral transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies.ResultsThe reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women's social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be depressed, reject authority, and perceived little control over issues related to being pregnant.ConclusionThese findings support the argument that standard substance use treatments and polices based on stages-of-change theories may not be effective for all individuals particularly those experiencing significant developmental changes in their lives. Greater success might be obtained from treatment programs designed to recognize the impact of these transitions as it relates to the substance use. The changing experiences of pregnant women in terms of their identity development, views of others, and their relationships have not been adequately addressed in existing cessation programs. Empirically-based interventions targeting these lifestyle characteristics may lead to increased cessation success among pregnant women.

Addressing the Issue of Falls off Playground Equipment: An Empirically-Based Intervention to Reduce Fall-Risk Behaviors on Playgrounds

The present study evaluated the impact of an intervention to reduce fall-risk behaviors on playgrounds among children 6-11 years of age. Children completed posters indicating risky playground behaviors they would and would not do. In the intervention group, video and audio presentations were used to expose children to injury occurrences so that injury vulnerability was communicated in a fear-evoking way. In the control group, children only completed the pre- and post-intervention measures. Significant decreases in intentions to risk-take were obtained in the intervention, but not the control group. Effectiveness did not vary with children's age or sex, but was greater for those scoring high in sensation-seeking. A fear-appeals approach proved successful to reduce intended fall-risk behaviors, particularly for children high in sensation-seeking whose risk-taking is motivated by affect arousal.

Randomized controlled trial of music during kangaroo care on maternal state anxiety and preterm infants’ responses

The purpose of this randomized controlled trial was to investigate the influences of music during kangaroo care (KC) on maternal anxiety and preterm infants’ responses. There are no experimental studies that explore the influences of combination of music and KC on psychophysiological responses in mother–infant dyads. Purposive sampling was used to recruit 30 hospitalized preterm infants body weight 1500 gm and over, gestational age 37 weeks and lower from two NICUs. Mother–infant dyads were randomly assigned to the treatment and the control group using permuted block randomization stratified on gender. There were 15 mother–infant dyads in each group. Subjects in the treatment dyads listened to their choice of a lullaby music during KC for 60 min/section/day for three consecutive days. Control dyads received routine incubator care. Using a repeated measures design with a pretest and three posttests, the responses of treatment dyads including maternal anxiety and infants’ physiologic responses (heart rate, respiratory rate, and O 2 saturation) as well as behavioural state were measured. The results revealed that there were no significant differences between the two groups on infants’ physiologic responses and the values were all in the normal range. However, infants in the treatment group had more occurrence of quiet sleep states and less crying ( p < 0.05 – 0.01 ). Music during KC also resulted in significantly lower maternal anxiety in the treatment group ( p < 0.01 ). Maternal state anxiety improved daily, indicating a cumulative dose effect. The findings provide evidence for the use of music during KC as an empirically-based intervention for bahavioural state stability and maternal anxiety in mother–infant dyads.

Music improves sleep quality in older adults

The aim of this paper is to report an investigation of the effects of soft music on sleep quality in older community-dwelling men and women in Taiwan. Sleep is a complex rhythmic state that may be affected by the ageing process. Few studies have focused on the effects of music, a non-pharmacological method of improving the quality of sleep in older adults. A randomized controlled trial was used with a two-group repeated measures design. Sixty people aged 60-83 years with difficulty in sleeping were recruited through community leaders and screened using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale. Those reporting depression, cognitive impairment, medical or environmental problems that might interfere with sleep; and those who used sleeping medications, meditation, or caffeine at bedtime were excluded. Participants listened to their choice among six 45-minute sedative music tapes at bedtime for 3 weeks. There were five types of Western and one of Chinese music. Sleep quality was measured with the PSQI before the study and at three weekly post-tests. Groups were comparable on demographic variables, anxiety, depressive symptoms, physical activity, bedtime routine, herbal tea use, napping, pain, and pretest overall sleep quality. Music resulted in significantly better sleep quality in the experimental group, as well as significantly better components of sleep quality: better perceived sleep quality, longer sleep duration, greater sleep efficiency, shorter sleep latency, less sleep disturbance and less daytime dysfunction (P = 0.04-0.001). Sleep improved weekly, indicating a cumulative dose effect. The findings provide evidence for the use of soothing music as an empirically-based intervention for sleep in older people.

Skills for Social and Academic Success: A School-Based Intervention for Social Anxiety Disorder in Adolescents

This paper describes Skills for Academic and Social Success (SASS), a cognitive-behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their child's anxiety. Initial findings regarding the program's effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.

Challenges for HIV Vaccine Dissemination and Clinical Trial Recruitment: If We Build It, Will They Come?

HIV vaccine availability does not guarantee uptake. Given suboptimal uptake of highly efficacious and already accessible vaccines in the United States, low vaccine coverage in the developing world, and the expectation that initial HIV vaccines will be only partially efficacious, the public health community will face formidable challenges in disseminating U.S. Food and Drug Administration (FDA)-approved HIV vaccines. HIV/AIDS stigma, fear of vaccine- induced HIV infection, social side effects of testing HIV-positive, and mistrust of government and research present additional obstacles to HIV vaccine dissemination. Increased risk behaviors because of HIV vaccine availability can undermine the effectiveness of partially efficacious vaccines in reducing HIV incidence. HIV vaccine efficacy trials also face significant challenges in recruitment of sufficient volunteers and possible increases in risk behaviors due to trial participation. Planning and designing interventions to facilitate successful recruitment for large-scale phase 3 efficacy trials is a vital step towards U.S. FDA-approved HIV vaccines. Rather than despair in the face of momentous HIV vaccine dissemination challenges, or presume unrealistically that vaccine uptake will ensue automatically and that risk behavior increases will not occur, let us deem the estimated 10-year window to an approved HIV vaccine as an opportunity to investigate and confront these challenges. A consumer research agenda founded on social marketing principles is needed to facilitate the design of empirically-based interventions tailored to the unique needs and preferences of specific segments of consumers. Social marketing interventions may increase future HIV vaccine uptake and clinical trial participation, and mitigate increases in HIV risk behaviors.

Adolescent Preventive Health and Teams-Games-Tournaments

The problematic behaviors of teenagers and the subsequent negative consequences are extensive and well documented: unwanted pregnancy, substance abuse, violent behavior, depression, and social and psychological consequences of unemployment. In this article the authors review an approach that uses a cooperative learning, empirically-based intervention that employs peers as teachers. This intervention of choice is Teams-Games-Tournaments (TGT), a paradigm backed by four decades of empirical support. The application of TGT in preventive health programs incorporates elements in common with other prevention programs that are based on a public health orientation and comprise the essential components of health education, that is skills training and practice in applying skills. The Teams-Games-Tournaments intervention supports the idea that children and adolescents from various socioeconomic classes, between the ages of 8 to 18, in classrooms or groups ranging in size from 4 to 17 members, can work together effectively in cooperative instructional situations where group members serve as teachers for one another. Teams-Games-Tournaments has been applied successfully in such diverse areas as adolescent development, sexuality education, psychoactive substance use, anger control, coping with depression and suicide, nutrition, comprehensive employment preparation, and family intervention. This article reviews the extensive research on TGT using examples of successful projects in substance abuse and nutrition. Issues are raised that relate to the implementation of preventive health strategies for adolescents, including cognitive aspects, social and family networks, and intervention components.