No-treatment Comparison Group Research Articles

Training clinicians to deliver group CBT to manage anxiety in youth with ASD: Results of a multisite trial.

Few guidelines are available regarding optimal training models for practitioners delivering cognitive-behavioral therapy (CBT) for anxiety in youth with autism spectrum disorder (ASD). The present study systematically compared 3 instructional conditions for delivering the Facing Your Fears program (FYF) to children with ASD and anxiety. Thirty-four clinicians (Mage = 34 years; 94% women, 88% Caucasian) and an intent-to-treat sample of 91 children with ASD and anxiety (Mage = 11; 84% male 53% Caucasian) met eligibility criteria across 4 sites. A 3-group parallel design via a Latin square procedure was used to randomize 9 teams of clinicians to 1 of 3 training conditions: Manual, Workshop, Workshop-Plus. The effectiveness of instructional condition was assessed via implementation (CBT knowledge, treatment fidelity) and treatment outcomes (reductions in anxiety as measured by the Anxiety Disorders Interview Schedule-Parent (ADIS-P). Clinicians in both Workshop conditions significantly increased CBT knowledge postworkshop, F(1, 18) = 19.8, p < .001. Excellent treatment fidelity was obtained across conditions (above 89%), although clinicians in the Workshop conditions obtained significantly higher fidelity ratings and delivered FYF with greater quality than the Manual condition. Children with ASD demonstrated significant reductions in anxiety symptoms for three of the four anxiety diagnoses, with no differences noted across instructional condition. Rates of improvement were lower than those obtained in a previous controlled trial. Results suggest that although there may be some advantage to participating in a Workshop, clinicians in all conditions could deliver FYF with excellent fidelity and yield positive treatment outcomes. Lack of a no-treatment comparison group limits interpretation of findings. (PsycINFO Database Record

The Effects of AgrAbility on the Mental/Behavioral Health of Farmers and Ranchers with Functional Limitations: A Comparison Study

Background: While research on the quality of life (QOL) levels of farmers and ranchers with disabilities is growing, research focused on interventions that improve their behavioral health is almost nonexistent. The AgrAbility Project, a USDA initiative, offers practical solutions to increase farmers and ranchers with disabilities’ QOL and independent living and working (ILW) levels. Aim of the Study: The objectives of the current study are threefold: first, to assess overall pretest-posttest changes in the ILW and QOL levels of AgrAbility participants; second, to focus on the behavioral health changes of AgrAbility participants; and third, to compare those changes in a group of AgrAbility participants to those of a no-treatment comparison group. Methods: AgrAbility treatment group participants (N = 273) included farmers and ranchers from 14 states with various disabilities who participated in AgrAbility and no-treatment comparison group participants (N = 100) from 17 states. Both groups completed ILW and McGill Quality of Life surveys. Results: Paired samples t-tests indicated that AgrAbility participants’ ILW and QOL improved with large or larger than typical effect sizes. Paired samples t tests indicated that AgrAbility participants’ behavioral health improved significantly with medium effect sizes. Independent samples t tests reported significantly higher gain scores on all three behavioral health subscales for AgrAbility participants compared with the group of non-participants. Conclusions: These results show that participation in the AgrAbility Project was associated with significant improvements in behavioral health when compared to the no-treatment group which experienced no significant change in their behavioral health. The current study makes an initial contribution to the search for an evidence-based intervention for improving the physical and behavioral health of farmers and ranchers with functional limitations.

A quantitative assessment of the effectiveness of USDA's AgrAbility project

BackgroundThere is evidence that the combination of assistive technology and education increases ability to live and work independently, which in turn increases the quality of life (QOL) levels of adults with disabilities. No previously published treatment-comparison group intervention studies were found with adult farmers and ranchers with disabilities. Knowing how effective USDA's AgrAbility Project is at increasing this population's QOL and independent living and working (ILW) levels will reinforce and inform change in AgrAbility and will provide outcomes for stakeholders and public decision makers to better address agricultural communities' needs. ObjectivesTo assess whether or not AgrAbility is effective for enhancing QOL and ILW levels of agricultural producers with functional limitations and to assess intervention-comparison group differences. MethodsIntervention group participants (N = 225) included ranchers and farmers from 12 states with various disabilities who participated in AgrAbility. Comparison group participants (N = 100) from 17 states also included farmers and ranchers with various disabilities; they received no on-site visits or other AgrAbility services. ResultsIn this 10-year, 27-state study, AgrAbility participants reported statistically significant presurvey-postsurvey improvements in QOL levels (mean presurvey = 5.56; mean postsurvey = 7.13) while comparison group participants reported no change in QOL (mean presurvey = 5.10; mean postsurvey = 4.91). AgrAbility group mean ILW scores rose from 2.86 to 3.71 while comparison group mean ILW scores rose slightly from 3.24 to 3.50. ConclusionsThese results suggest that AgrAbility was effective as compared with a no-treatment comparison group on improving QOL and ILW levels.

Assessing changes in quality of life and independent living and working levels among AgrAbility farmers and ranchers with disabilities

BackgroundWhile emerging research has focused on quality of life (QOL) levels among farmers and ranchers with disabilities, much work is still needed on this largely understudied population. The AgrAbility Project, a USDA initiative, offers pragmatic solutions to increase farmers and ranchers with disabilities' QOL and ability to work and live independently (ILW). ObjectivesTo assess pretest-posttest changes in farmers and ranchers with disabilities' ILW and QOL levels after participating in AgrAbility, to identify demographic predictors of ILW and QOL (e.g. with whom AgrAbility works best), and to determine how much variance in QOL is accounted for by change in ILW levels. MethodsParticipants (N = 191) included farmers and ranchers from 10 states with various disabilities who participated in AgrAbility. They completed ILW and McGill QOL measures before and after AgrAbility. ResultsPaired samples t-tests highlighted that participants' ILW and QOL levels improved (p < 0.001) with large or larger than typical effect sizes. Repeated measures ANOVA indicated that change in ILW over time was qualified by age and origin of disability. Regression results revealed that change in ILW predicted 13% of the variance in QOL change. ConclusionsThese results suggest that participation in the AgrAbility Project was positively associated with increased ILW and QOL levels. AgrAbility participants reported increases in their QOL levels and their ability to continue their work and live in their homes. Further research is needed to compare results with a no-treatment comparison group of similar ranchers and farmers with disabilities.

Adding a Social Marketing Campaign to a School-Based Nutrition Education Program Improves Children’s Dietary Intake: A Quasi-Experimental Study

BackgroundEvidence supports the use of social marketing campaigns to improve nutrition knowledge and reinforce the effects of nutrition education programs. However, the additional effects of parent-focused social marketing with nutrition education have received little attention. ObjectiveOur aim was to assess the impact of the Iowa Nutrition Network’s school-based nutrition education program (Building and Strengthening Iowa Community Support for Nutrition and Physical Activity [BASICS]) and the benefits of adding a multichannel social marketing intervention (BASICS Plus) to increase parent-directed communication. Design and interventionA quasi-experimental design with three study conditions compared a school-based nutrition education program (BASICS) with a school-based and social marketing intervention (BASICS Plus) and a no-treatment comparison group. Participants/settingThe study included 1,037 third-grade students attending 33 elementary schools and their parents. Main outcome measuresMeasures included parents’ reports of their children’s in-home consumption of fruits and vegetables (F/V) and use of low-fat/fat-free milk. Data on F/V were collected using a modified version of the University of California Cooperative Extension Food Behavior Checklist; and data on milk use were collected using two questions from the National Health and Nutrition Examination Survey. Statistical analysesMultilevel, mixed-effect regression models that account for correlation within repeated measures and children within school were used to compare the mean change over time in the outcome variable for one study group with the mean change over time for another study group. ResultsChildren in BASICS increased mean consumption of fruit by 0.16 cups (P=0.04) compared with children in the comparison group. Children in BASICS Plus increased mean consumption of fruit by 0.17 cups (P=0.03) and mean consumption of vegetables by 0.13 cups (P=0.02). Children in BASICS Plus were 1.3 times (P=0.05) more likely to use low-fat/fat-free milk than children in either the BASICS group or the comparison group. ConclusionsGaining parents’ attention and engaging them in healthy eating practices for their children can be a useful way to increase the effectiveness of school-based nutrition education programs. This study demonstrates the benefits of incorporating a parent-focused social marketing campaign in nutrition education interventions.

Do Children and Adolescents With Mild Traumatic Brain Injury and Persistent Symptoms Benefit From Treatment? A Systematic Review.

To review the literature on treatment interventions in children and adolescents with mild traumatic brain injury (mTBI) and persistent symptoms. Systematic review of the literature yielding 6 studies incorporating 421 children and adolescents with mTBI. A variety of medical and nonmedical interventions have been used to treat the persistent symptoms of mTBI in children and adolescents. Treatment included medications for headaches, transcranial stimulation for headaches, giving information booklets, nurse visits, cognitive and physical rest, and active rehabilitation (exercise). All 6 studies reported positive results; but none was a randomized controlled trial, only 1 included a no-treatment comparison group, and none compared different interventions. It is difficult to determine whether the positive findings resulted from intervention or reflected natural resolution of the symptoms with time. There is a need for more, higher-quality studies of interventions designed to reduce the duration and severity of persistent postconcussion symptoms.

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

Objective: This study examined the effects of a single-session motivational interviewing–based in-person brief alcohol intervention that contained student-athlete–specific personalized drinking feedback. Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy episodic drinking. Methods: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers' alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted 3 months post intervention. Results: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no-treatment comparison group. Conclusions: Student-athlete–specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.

An outcome evaluation of the implementation of the Outward Bound Singapore five-day “intercept” program

The present study evaluated an Outward Bound Singapore five-day “intercept” program for 136 adolescent participants, aimed at addressing frequent deliberate truancy and absenteeism from school and within-school extracurricular activities using a quasi-experimental design with a matched no-treatment comparison group. Findings suggested that there is some preliminary evidence that such a program could yield positive outcomes in terms of adolescents being more behaviorally engaged in school as demonstrated by improved attendance of both academic and non-academic activities up to 3 months after the conclusion of the intervention program. Goal setting had a short-term positive effect with intervention participants improving significantly more so than comparison participants at 1-month post intervention but not at 3-month follow up. For problem solving, although the intervention group participants improved more than comparison participants at both 1-month post intervention and at 3-month follow up, these effects were not statistically significant. Research and practice implications were discussed.

Claiming Positive Results From Negative Trials: A Cause for Concern in Randomized Controlled Trial Research - Author's Reply

Claiming Positive Results From Negative Trials: A Cause for Concern in Randomized Controlled Trial Research - Author's Reply

Integrating self-regulation in whole-class reciprocal teaching: A moderator–mediator analysis of incremental effects on fifth graders’ reading comprehension

In this classroom intervention study, reciprocal teaching (RT) of reading strategies was combined with explicit instruction in self-regulated learning (SRL) to promote the reading comprehension of fifth-grade students (N=306). Twelve intact classes were randomly assigned either to an RT+SRL condition or to an RT condition without explicit instruction in self-regulation. Three additional classes served as a no-treatment comparison group. Strategies instruction was delivered by trained assistants in conventional German language lessons. Students practiced the application of these strategies in small groups. Both at posttest and at maintenance (8weeks after the intervention), students in the two intervention conditions (RT and RT+SRL) outperformed comparison students in measures of reading comprehension, strategy-related task performance, and self-efficacy for reading. Relative to RT students, students in the RT+SRL condition were better able to maintain training-induced performance gains over the follow-up interval. A moderated mediation analysis revealed that this difference in the sustainability of the two treatments was (a) mediated by the successful mastery of the learned strategies and (b) most evident among students with poor reading fluency skills.

How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P.

BackgroundInterventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal.MethodsEvaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis.ResultsA total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79). Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87)). The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest statements.ConclusionsIn volunteer populations over the short term, mothers generally report that Triple P group interventions are better than no intervention, but there is concern about these results given the high risk of bias, poor reporting and potential conflicts of interest. We found no convincing evidence that Triple P interventions work across the whole population or that any benefits are long-term. Given the substantial cost implications, commissioners should apply to parenting programs the standards used in assessing pharmaceutical interventions.See related commentary: http://www.biomedcentral.com/1741-7015/10/145

Changes in Physician Costs among High-Cost Transcendental Meditation Practitioners Compared with High-Cost Nonpractitioners over 5 Years

To determine whether the Transcendental Meditation (TM) technique can affect the physician costs of consistently high-cost people. Quasi-experimental, longitudinal, cost-minimization evaluation. This 14-year, preintervention-postintervention study retrospectively assessed government payments to physicians for treating the TM and no-treatment (NT) groups. Province of Quebec, Canada. The highest-spending 10% of 1418 Quebec health insurance enrollees who practiced the TM technique were compared with the highest 10% of 1418 subjects who were randomly selected from enrollees of the same age, sex, and region. TM participants had chosen to begin the technique prior to choosing to enter the study. Annual payments to private physicians in all treatment settings. The Quebec government health insurance agency provided the total physician payments for each of the 2836 subjects from 1981 to 1994. Other medical expense data for individuals were unavailable. Data were adjusted for medical cost inflation. For each subject, least-squares regression slopes were calculated to estimate preintervention and postintervention annual rates of change in payments. The groups' means, slopes, and medians were compared using both parametric and nonparametric tests. Before starting meditation, the yearly rate of increase in payments to physicians between groups was not significantly different. After commencing meditation, the TM group's mean payments declined $44.93 annually (p = .004), whereas the NT comparison group's payments exhibited nonsignificant changes. After 1 year, the TM group decreased 11%, and after 5 years their cumulative reduction was 28% (p = .001). The results suggest the intervention may be an effective method for reducing physician costs. Randomized studies are recommended.

Clinician's Commentary

Jennifer Robertson, Janice Eng, and Chihya Hung are to be commended for conducting a clinical trial on the effects of functional electrical stimulation (FES) on gait and balance for individuals recovering from stroke. Stroke rehabilitation is a major emphasis of physical therapy, yet despite the activity limitations and participation restrictions associated with this common condition, evidence for physical therapy outcomes is only just beginning to accumulate. For this reason, trials that report data on the effects of specific physical therapy interventions are valuable. One of the positive findings of Robertson et al.'s study was that some stroke patients showed improvements in toe clearance during the swing phase of gait after four sessions of FES training. Others showed improvements in balance function. Changes in gait speed and balance confidence, as measured on the Activities-specific Balance Confidence Scale (ABC),1 were not found to be significant in this small sample of community-based persons living with stroke. Robertson et al.'s paper highlights the challenges of reporting and conducting controlled trials on the effectiveness, efficacy, or outcomes of physical therapy interventions post-stroke. One of the biggest challenges is to recruit a sufficiently large sample to detect statistically and clinically significant effects of a given intervention. Robertson et al. tested a convenience sample of 15 chronic stroke patients; as they point out in their paper, a sample of 59 participants would have been required to identify changes in balance with FES as measured by the ABC. It is also possible that effect sizes might have been larger in a more acute sample of stroke patients, given that most recovery occurs in the first 6 months following an infarct or haemorrhage. In addition, the effect sizes might have been larger if patients had received a dosage of therapy greater than 8 hours spread over a 1-month period. Another challenge is to select the research design most appropriate to address the research questions under consideration. Robertson et al. used a before–after study design in which all stroke patients were measured before and after four 2-hour sessions of physical therapy that incorporated FES training. While this design allows change scores to be reported, it does not control for practice effects or for the specific effects of physical therapy; changes in performance can occur that are not attributable to the specific interventions used (in this case, FES). The non-specific effects of being treated or tested and/or the effects of the passage of time may contribute to the changes noted. For this reason, some advocate the use of randomized controlled clinical trial (RCT) designs, in which patients are randomly allocated to one or more physical therapy interventions or to a no-treatment comparison group. By comparing the relative changes in two or more such groups, researchers can obtain more information on the specific effects of therapies such as FES. Nevertheless, sometimes it can be useful to report data from small samples using a before–after design, in order to gain effect-size data that can then be used to determine the sample size required for a large-scale RCT. Yet another challenge is to determine the most appropriate measurement tools to quantify balance. Robertson et al. used the ABC as a measure of balance confidence and fear of falling, and the Berg Balance Scale (BBS) to measure balance. The extent to which these tools measure similar or different constructs remains open to question. Moreover, one of the underlying assumptions of the study was that improving toe clearance during the swing phase of gait using FES would reduce the risk of trips and falls. Trips and falls were not monitored, however, and doing so would require a comprehensive method of data collection. The gold standard for collecting data on falls is the annual falls calendar, a tool whereby patients record the frequency and outcomes of falls on a daily basis for 12 months.2 Implementing a 12-month data-collection process would be time consuming; nevertheless, if the aim is to understand the nexus between balance and falls, such a method would probably be worth the investment of resources. Conducting trials that measure the effects of physical therapy interventions is challenging, yet such trials are very much needed. Robertson et al. are to be commended for embarking on the ambitious task of quantifying how physical therapy incorporating FES can affect gait and balance. Their well-written paper adds valuable information that can be used in clinical practice. Clinical trial guidelines, such as those documented by the Consolidated Standards of Reporting Trials (CONSORT) statement,3 provide further information on optimal methods for reporting the findings of RCTs of physical therapy and other interventions.

An analysis of survival time to re-arrest in treated and non-treated jailers

Incarceration is a costly intervention that does not always prevent future crime. Clinicians working in criminal justice settings are in a unique position to monitor programming to reduce recidivism. We investigated the impact of self-control training on re-arrest in a jail population. Treatment that allotted more time for behavioral rehearsal was expected to reduce future arrest. One hundred inmates completed measures of problem-solving and self-control skills. Forty participants received group training in self-control skills, 40 received the same protocol plus 10 minutes for behavioral rehearsal, and 20 served as a no-treatment comparison group. Participants who completed treatment were less likely to recidivate three years after release from jail, with a trend toward lower recidivism rates for self-control training plus behavioral rehearsal. Training in self-control skills can be useful for preventing re-arrest and these effects may be enhanced by adding a brief behavioral rehearsal of the targeted skills.

Effect sizes of non-surgical treatments of non-specific low-back pain.

Numerous randomized trials have been published investigating the effectiveness of treatments for non-specific low-back pain (LBP) either by trials comparing interventions with a no-treatment group or comparing different interventions. In trials comparing two interventions, often no differences are found and it raises questions about the basic benefit of each treatment. To estimate the effect sizes of treatments for non-specific LBP compared to no-treatment comparison groups, we searched for randomized controlled trials from systematic reviews of treatment of non-specific LBP in the latest issue of the Cochrane Library, issue 2, 2005 and available databases until December 2005. Extracted data were effect sizes estimated as Standardized Mean Differences (SMD) and Relative Risk (RR) or data enabling calculation of effect sizes. For acute LBP, the effect size of non-steroidal anti-inflammatory drugs (NSAIDs) and manipulation were only modest (ES: 0.51 and 0.40, respectively) and there was no effect of exercise (ES: 0.07). For chronic LBP, acupuncture, behavioral therapy, exercise therapy, and NSAIDs had the largest effect sizes (SMD: 0.61, 0.57, and 0.52, and RR: 0.61, respectively), all with only a modest effect. Transcutaneous electric nerve stimulation and manipulation had small effect sizes (SMD: 0.22 and 0.35, respectively). As a conclusion, the effect of treatments for LBP is only small to moderate. Therefore, there is a dire need for developing more effective interventions.

Impact of a Self-Help Intervention on Performance of Headache Management Behaviors: A Self-Efficacy Approach

This study evaluated the importance of modeling and performance accomplishment of behavior on enhancing headache management self-efficacy and increasing acquisition and implementation of four headache self-management behaviors: headache diary use, limiting medication overuse, relaxation, and stretching. Primary headache disordered patients (n = 51) were randomly assigned to 3 conditions: self-efficacy videotape treatment (SET; education + modeling and performance of behavior), information-only videotape treatment (IOT; education only), or no-treatment comparison (NTC). The SET group reported higher self-efficacy scores than the NTC at immediate post-treatment. At 1-month follow-up, the SET group reported more headache diary use than the IOT and NCT groups, whereas both the SET and IOT groups reported more frequent performance of the relaxation and stretching behaviors than the NTC group. Despite a smaller sample size, the SET treatment produced a slight increase in headache management self-efficacy immediately after treatment, as well as increased performance of three of the four headache management behaviors at 1-month follow-up. A reduction in self-efficacy following the immediate posttreatment period suggests that multiple treatment exposure may be necessary to effect long-lasting change with respect to self-efficacy, behavioral performance and ultimately changes in headache activity. Although limited in their ability to provide feedback and reinforcement, the potential benefits for patients and health care professionals warrant continued development and study of behavior theory-driven self-help treatment for headache. Future studies should include a larger sample that consists of motivated patients with less severe headache problems who may be more apt to benefit from such theory-driven strategies.

PROTOCOL: The Effects of Non‐Custodial Employment Programs on the Recidivism Rates of Ex‐Offenders

PROTOCOL: The Effects of Non‐Custodial Employment Programs on the Recidivism Rates of Ex‐Offenders

Outcomes of Parent Education Programs Based on Reevaluation Counseling

We report two studies in which a parent education program based on Reevaluation Counseling was field-tested on mothers randomly assigned to treatment groups or equivalent, no-treatment comparison groups. The goal was to evaluate the program's viability, whether there were measurable effects, whether those effects were sustained over time, and whether the program was effective among diverse populations. The first study involved middle income, married mothers (n = 25) with at least one child younger than age five. Eleven members of the no-treatment group participated in the program three months later. Pretest, posttest, and follow-up measures included a parental attitude survey and a parenting stress index. The second study involved 18 black mothers with children enrolled in Head Start. Six members of the no-treatment group participated in the program two months later. Added to the pretest, posttest, and follow-up measures were a parent attitude research instrument and a parenting practices questionnaire. Results were replicated within and across studies. Significant effects suggest that the program can reduce parenting-related stress, improve parental attitudes, and encourage authoritative parenting practices, although some effects tend to diminish somewhat over time. The program appears viable with mothers of various social status groups.

The Development and Validation of an Interactive Hypermedia Program for Teaching a Self-Advocacy Strategy to Students with Disabilities

Educators agree that students with disabilities need to acquire self-advocacy skills. Despite the existence of validated methods to teach these skills, evidence suggests that they are seldom explicitly taught. Time and opportunities to teach these skills in both the general and special education setting are minimal. One possible solution is to use instructional technology. The purpose of this project was to develop and validate an Interactive Hypermedia Program (IHP) to teach a self-advocacy strategy to secondary-level students with disabilities. The strategy for which the IHP was developed and tested is the Self-Advocacy Strategy (Van Reusen, Bos, Schumaker, &amp; Deshler, 1994). The instruction for the strategy was originally validated by Van Reusen, Deshler, and Schumaker (1989). With input from student, teacher, design, and technical consultants, the IHP was created. Students who had learning disabilities, behavior disorders, and other health impairments learned the strategy via the IHP or through live instruction. A multiple-baseline design was used to show the effects of the instruction. In addition, a no-treatment comparison group was included for comparative purposes. At the conclusion of instruction, each student ran his or her own IEP conference. Results showed that the IHP was as effective in teaching students with learning disabilities to use the strategy as live instruction. Further research is warranted to determine if this medium is effective in teaching students other types of strategies.

The evaluation of a sexual assault risk reduction program: A multisite investigation.

This article summarizes the results of the Ohio University Sexual Assault Risk Reduction Project, which is a program designed to reduce college women's risk for sexual assault. The program was evaluated at 2 separate universities with 762 women. Participants were randomly assigned either to the program or to the no-treatment comparison group, and they completed measures that assessed sexual victimization, dating behaviors, sexual communication, and rape empathy at the pretest and at the 2-month and 6-month follow-ups. At the 2-month follow-up, there were no differences between the groups on any of the outcome measures. However, those women who were moderately victimized during the 2-month follow-up were significantly less likely to be revictimized during the 6-month follow-up period if they participated in the program.