Pretest-posttest Change Research Articles

Sadness-Based Approach-Avoidance Modification Training for Subjective Stress in Adults: Pilot Randomized Controlled Trial.

A key vulnerability factor in mental health problems is chronic stress. There is a need for easy-to-disseminate and effective interventions to advance the prevention of stress-related illnesses. App-based stress management trainings can fulfill this need. As subjectively experienced stress may be influenced by dysfunctional beliefs, modifying their evaluations might reduce subjective stress. Approach-avoidance modification trainings (AAMT) can be used to modify stimulus evaluations and are promising candidates for a mobile stress intervention. As the standard training reactions of the AAMT (swiping and joystick motion) have little valence, emotions could be incorporated as approach and avoidance reactions to enhance the effectiveness of AAMTs. We aimed to evaluate the feasibility of a mobile emotion-enhanced AAMT that engages users to display sadness to move stress-enhancing beliefs away and display positive emotions to move stress-reducing beliefs toward themselves (emotion-based AAMT using sadness and positive emotions [eAAMT-SP]). We explored the clinical efficacy of this novel intervention. We allocated 30 adult individuals with elevated stress randomly to 1 of 3 conditions (eAAMT-SP, a swipe control condition, and an inactive control condition). We evaluated the feasibility of the intervention (technical problems, adherence, usability, and acceptability). To explore the clinical efficacy of the intervention, we compared pretest-posttest differences in perceived stress (primary clinical outcome) and 3 secondary clinical outcomes (agreement with and perceived helpfulness of dysfunctional beliefs, emotion regulation, and depressive symptoms) among the conditions. The predetermined benchmarks of 50% for intervention completion and 75% for feasibility of the study design (completion of the study design) were met, whereas the cutoff for technical feasibility of the study design (95% of trials without technical errors) was not met. Effect sizes for usability and acceptability were in favor of the eAAMT-SP condition (compared with the swipe control condition; intelligibility of the instructions: g=-0.86, distancing from dysfunctional beliefs: g=0.22, and approaching functional beliefs: g=0.55). Regarding clinical efficacy, the pretest-posttest effect sizes for changes in perceived stress were g=0.80 for the comparison between the eAAMT-SP and inactive control conditions and g=0.76 for the comparison between the eAAMT-SP and swipe control conditions. Effect sizes for the secondary clinical outcomes indicated greater pretest-posttest changes in the eAAMT-SP condition than in the inactive control condition and comparable changes in the swipe control condition. The findings regarding the feasibility of the intervention were satisfactory except for the technical feasibility of the intervention, which should be improved. The effect sizes for the clinical outcomes provide preliminary evidence for the therapeutic potential of the intervention. The findings suggest that extending the AAMT paradigm through the use of emotions may increase its efficacy. Future research should evaluate the eAAMT-SP in sufficiently powered randomized controlled trials. German Clinical Trials Registry DRKS00023007; https://drks.de/search/en/trial/DRKS00023007.

Belonging mediates changes to resilience among separated siblings at camp-based reunification intervention

Previous work has established camp-based sibling reunification impacts to youths’ resilience and sense of belonging. The current study tested the mediating effects of belonging on pre-test-post test changes to youth resilience. We examined survey data from 2,260 youth who attended one of 16 camp-based reunification programs in the U.S. and Australia. Youth belonging at camp partially mediated pre-test post-test changes to measures of resilience. In a multi-group model, the indirect effects of belonging on youth resilience differed according to youth individual characteristics. Belonging is a resilience promoting mechanism for youth in out-of-home care.

Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy

PurposeBreast cancer (BC) and its treatments significantly impact the psychological wellbeing of women. Interventions offered during cancer survivorship have documented positive consequences for quality of life. However, limited evidence is available regarding the implementation of therapeutic photography. This study investigated the efficacy of the framed portrait experience (FPE) when implemented to BC survivors.MethodsA quasi-experimental study was conducted. Participants were enrolled in a non-randomized pre-post intervention with a comparison group. Forty BC survivors were recruited using a convenience sampling approach; of these, 20 were subsequently allocated to the intervention (FPE group) and 20 to the comparison group. Participants were assessed at pretest and posttest (3 weeks later) using self-reported measures of body image, coping, self-esteem, and self-efficacy. Independent samples t-tests compared group composition at pretest. Mixed between-within 2 × 2 repeated-measures ANOVAs examined pretest–posttest changes in the variables of interest.ResultsNo differences were detected between groups at pretest. A significant interaction effect on body image, problem-focused coping, emotion-focused coping, and in self-efficacy competence subscale (p < 0.05) was identified. Post hoc pairwise comparisons with the Bonferroni correction indicated improvement on these domains in the FPE group vs. comparison group. Additionally, significant main effects of time on self-efficacy total score and magnitude subscale (p < 0.05) were found.ConclusionsPreliminary results support the efficacy of FPE, but further research is needed.Implications for Cancer SurvivorsExistential approaches inclusive of self-portraits and illness narratives can be utilized to support BC survivors in the management of the psychological consequences of the illness.

Fidelity of D.A.R.E. Officers’ Delivery of “keepin’ it REAL” in Elementary & Middle School

The goal of the current study is to examine the degree to which measures of quality of implementation and student engagement moderate pretest–posttest changes in mediating variables that are targeted by DARE “keepin’ it REAL.” DARE officers (10 elementary school, five middle school) taught DARE “keepin’ it REAL lessons to 1,017 elementary students (480 boys and 534 girls) and 435 middle school students (217 boys and 215 girls). We examined teachers’ and students’ ratings of elementary and middle schools in response to DARE officers’ delivery of the program. HLM analyses revealed that students’ engagement was a significant and meaningful predictor of changes in targeted mediators. Teachers’ ratings of student responsiveness added little in terms of understanding these outcomes with main effects observed only for students’ ability to respond to bulling and students’ estimates of peer drug use. Teachers’ ratings of the quality of officer implementation, on the other hand, did add to understanding students’ outcomes. Effects were seen for three (peer norms about drug use, decision-making (DM) skills, intentions to avoid drug use) out of six outcome variables and suggest a stronger positive effect for elementary versus middle school students. At least for these three outcomes, understanding quality of implementation added to our ability to interpret results. Specifically, in addition to students’ engagement, quality of implementation (which varied by grade) contributed to achieving positive changes in students’ outcomes.

Effects of an Agricultural Entrepreneurial Training Program with 40 Military Veteran Beginning Farmers

Military veterans returning from war face challenges when re-entering civilian life. Our aim was to evaluate how effective an agricultural entrepreneurial training program (The Farm and Education Treatment Program) was to equip 90 returning military veterans to become self-employed in food and agriculture and secondarily to support health. While there are several agricultural entrepreneurial training programs available, there are few with the breadth, depth, and empirical outcomes of the present study. Our method used eight measures to assess pretest-posttest differences associated with becoming successfully employed in production agriculture. We assessed pretest-posttest changes before and after returning military veteran beginning farmers participated in our year-long, 188-200-hour Farm and Education Treatment Program. Our program trained two cohorts per year each with 15 participants over three years for a total of 90 participants. Especially during COVID-19 with virtual rather than in-person training, our drop-out rate was high. By the end of the three-year program, 40 military veteran beginning farmers completed the program and provided usable pretest-posttest data for a 44% response rate. Almost 88% (n =35/40) of participants were self-employed in agriculture either full-time (60%) or part-time (28%). When they began, two were full-time farmers/ranchers, one was in agricultural business, and one was a part-time farmer/rancher. Our participants’ greatest statistically significant improvements were on the Skills Assessment measure with Farming Skill Level, Crop Skill Level, and Livestock Skill Level subscales, on the Entrepreneurial Self Efficacy Marketing, Innovation, Financial Control, and Total subscales, and on the Independent Living and Working levels. These measures linked well with the overall program goal, intervention, and outcomes because the bulk of the program addressed these variables. There was no change in physical or psychological domains. We concluded that face-to-face, in-person teaching of the program was much preferred and more effective than virtual, remote teaching during COVID-19. Also eight measures with 671 items are far too many. Future researchers are encouraged to expand the training with practical, evidence-based behavioral health strategies that participants can use to improve their behavioral health and quality of life.

Towards inclusiveness and sustainability of robot programming in early childhood: Child engagement, learning outcomes and teacher perception

AbstractThe proliferation of screen‐free programmable robotics allows teachers to implement age‐appropriate integrated activities that can promote child learning and development. However, very scarce is known about the challenges of using programmable robots as a tool to empower children in minority communities. This mixed‐methods case study examined a Free Quality Kindergarten situated in a low‐income public housing estate in Hong Kong to explore the affordances and challenges of robot programming (RP) in early childhood education (ECE). Both quantitative and qualitative data were generated through videotaped observations, child assessments and teacher interviews to journey with the teaching team as they managed to implement the newly introduced RP curriculum. Child assessment evidence revealed that there was a statistically significant improvement in CT scores over 6 weeks of RP activities, while the pretest–posttest change of child self‐regulation scores was nonsignificant. Video analysis results further revealed that children's interaction level with the robot kit significantly predicted the change of self‐regulation over time. Qualitative results are presented to explicate the micro, meso and macro conditions that constrain the implementation of RP curriculum, including the following: (a) teachers' limited TPACK in RP education, (b) a disconnect between the RP curriculum and the school‐based curriculum, (c) limited resources and (d) the Confucian tradition and cultural barriers. These illustrate the intricacies involved in the implementation of RP education to empower marginalized children in under‐resourced ECE settings. This study will help bring systemic change to the ECE field by uncovering ecological difficulties in integrating new technologies to promote inclusiveness and sustainability for the future. Practitioner notesWhat is already known about this topic Screen‐free robot programming (RP) is beneficial for preschool children in terms of promoting their computational thinking (CT) and executive functioning. RP can be generally engaging for preschool children from a middle‐class background. What this paper adds The study is addressing the inclusiveness and sustainability according to the learning needs of kindergarten students, especially those from less privileged backgrounds. The story‐based approach to RP can cater to the learning needs and interests of children from a lower socio‐economic background, which is likely to enhance their CT skills. Children with a higher level of interaction with the robot kit benefited more from the RP activities in terms of self‐regulation skills. This study used multiple methods (ie, video analysis, teacher interview and child assessment) to reveal the effects of micro, meso and macro contexts on RP education in an under‐resourced Hong Kong kindergarten. Implications for practice and/or policy RP education should be cautiously prompted in diverse early childhood settings, especially the less privileged institutions, to enhance positive effects. Critical constraints on the use of programmable robots to empower marginalized children should be adequately addressed when trying to integrate RP into early childhood education. Teachers should receive training and continual support in RP‐related pedagogical strategies to facilitate and scaffold children's learning.

A Self-management SMS Text Messaging Intervention for People With Inflammatory Bowel Disease: Feasibility and Acceptability Study.

BackgroundMobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD).ObjectiveThe aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants.MethodsWe developed an SMS text messaging program called Text4IBD. The program sent daily support messages and resources about disease self-management over the course of a 2-week, single-group, pretest-posttest intervention to participants (N=114) diagnosed with IBD. We examined intervention feasibility, acceptability, and engagement through Text4IBD message topic recall and use of resources (ie, visiting supplemental websites recommended by the Text4IBD program). We also assessed pretest-posttest measures of IBD-related distress, self-efficacy, perceived support, use of coping strategies, and medication adherence. Analyses examined participants’ evaluations of the intervention and compared pretest-posttest changes in secondary outcomes using paired-samples statistics.ResultsApproximately all participants who completed the intervention (n=105) were receptive to Text4IBD and viewed the program as feasible and acceptable. In addition, most participants (103/105, 98.1%) recalled at least one of the message topics sent by the program, and 79% (83/105) of them self-reported engaging with at least one of the external self-management resources recommended by the Text4IBD program. Pretest-posttest results showed reduced IBD-related distress (mean 3.33, SD 0.68 vs mean 2.86, SD 0.73; P<.001) and improvements in most other secondary outcomes.ConclusionsFindings from this study highlight the value of SMS text messaging as a useful digital medium for providing support to people with IBD, particularly to those who may struggle with disease-related distress. Text4IBD was highly feasible and acceptable and may help people self-manage their IBD. Future studies should aim to evaluate this program in a randomized controlled trial in clinical settings.

Differential effects of long-term aerobic versus cognitively-engaging physical activity on children’s visuospatial working memory related brain activation: A cluster RCT

Different types of physical activity are thought to differentially affect children’s brain activation, via physiological mechanisms, or by activating similar brain areas during physical and cognitive tasks. Despite many behavioral studies relying on these mechanisms, they have been rarely studied. This study looks at both mechanisms simultaneously, by examining effects of two physical activity interventions (aerobic vs. cognitively-engaging) on children’s brain activation. Functional Magnetic Resonance Imaging (fMRI) data of 62 children (48.4% boys, mean age 9.2 years) was analyzed. Children’s visuospatial working memory related brain activity patterns were tested using a Spatial Span Task before and after the 14-week interventions consisting of four physical education lessons per week. The control group followed their regular program of two lessons per week. Analyses of activation patterns in SPM 12.0 revealed no activation changes between pretest and posttest (p > .05), and no differences between the three conditions in pretest–posttest changes in brain activation (p > .05). Large inter-individual differences were found, suggesting that not every child benefited from the interventions in the same way. To get more insight into the assumed mechanisms, further research is needed to understand whether, when, for whom, and how physical activity results in changed brain activation patterns.

Formación Flipped en un entorno virtual 3D para el desarrollo de las competencias docentes

The main objective of this study is the results’ evaluation of a training program on active methodologies, aimed at teachers, developed in a virtual 3D environment under a Flipped model. Two criteria are assessed, the first one is the level of acquisition of the program contents (teaching skills) using a one group pre-experimental design carrying out measurements before and after the educational intervention. The second is the opinion of the participants on the role that different aspects of the teaching process had in the acquisition of skills. Pretest-posttest changes of competencies are studied with the Student’s T-test for related groups, item-to-item changes are also checked using the Wilcoxon signed rank test, and Cohen’s D effect sizes are calculated. For the second criterion, the deviation of the participants’ opinion from what was expected in global terms was analyzed, the chi-square statistic for a sample he chi-square statistic was used to compare the observed and expected frequency distribution. The results show that students perceive an improvement in their teaching competence, the greatest change occurs in the digital area with a high effect size (d=0.84), followed by the social, didactic, and innovation and improvement areas. The learning process aspects that contribute most to achieving this goal are frequent teacher feedback, interaction with the teacher and Flipped experiences, all with more than 60 % of cases indicating the highest level of assessment.

Greening the room: A quasi-experimental study on the presence of potted plants in study rooms on mood, cognitive performance, and perceived environmental quality among university students

Due to mounting concerns about the psychological well-being of university students, it is useful to consider whether and how the quality of the physical study environment can improve students' functioning. The present study examined the presence of potted plants within a university library study room on students' self-reported mood (i.e., fatigue and vigor), self-reported cognitive performance (i.e., attention and productivity), perceived environmental quality (i.e., room satisfaction, attractiveness, and comfort), and recorded duration of stay in the study room. We conducted a real-life quasi-experimental study in which potted plants were introduced in one study room (intervention group) whereas nothing changed in another study room (control group). Cross-sectional data of the dependent and co-variables were collected among separate groups of students pre- and post-intervention using questionnaires (N = 445) and recordings of students' duration of stay in the study room (N = 1029). The pretest-posttest change in attractiveness (B = 0.53, 95% CI = 0.33; 0.72) and comfort (B = 0.29, 95% CI = 0.08; 0.51) was greater in the study room with potted plants than the pretest-posttest change in attractiveness and comfort in the study room without plants. Students’ reasons to study in the room with potted plants next time they study included the perceived environmental quality, atmosphere, it being more relaxing, the homey feel, and indoor climate. Nevertheless, the pretest-posttest change in vigor (B = 0.29, 95% CI = −0.57; −0.01) was lower in the room with potted plants than the pretest-posttest change in vigor in the study room without plants, and no meaningful associations between the presence of potted plants and fatigue, cognitive performance, and duration of stay in the study room were found. Overall, findings suggest that students preferred the study room with potted plants to the one without. However, the findings do not support the hypothesis that adding potted plants to a study room improves mood or cognitive performance among students.

Still not that bad for the grey city: A field study on the restorative effects of built open urban places

Attention Restoration Theory (ART) and Stress Recovery Theory (SRT) highlight the restorative properties of natural or green environments. However, the study of the psychological benefits obtained through contact with built open urban places, such as squares or streets, has received far less attention. In this paper we present a within-subjects pretest-posttest quasi-experimental field study that assessed the restoration experience of a sample of university students (N = 34) visiting two squares in a European city. Statistical analyses revealed that participants' attentional performance improved and negative affect (depression and stress) decreased after spending 20 min in the squares. There was no increase in positive affect. Nature orientedness was significantly related to some of the pretest-posttest changes, leading to lower fatigue and attentional restoration in one square. The results suggest that built open urban settings can provide some restorative benefits.

Optimizing Fluency Training for Speaking Skills Transfer: Comparing the Effects of Blocked and Interleaved Task Repetition

AbstractIn an exploration of the effects of task‐repetition practice on fluency development, English‐as‐a‐foreign language learners performed three oral narrative tasks involving six‐frame cartoons for 3 consecutive days. They engaged in task‐repetition practice under either a blocked (Day 1: A‐A‐A; Day 2: B‐B‐B; Day 3: C‐C‐C) or an interleaved (Day 1: A‐B‐C; Day 2: A‐B‐C; Day 3: A‐B‐C) task repetition schedule. The results yielded by a posttest involving new six‐frame cartoons indicated that blocked practice resulted in greater fluency development (faster articulation rate and shorter mid‐clause pause duration) than did interleaved practice. Moreover, the learners in the blocked‐practice group tended to pause more frequently at clause boundaries. Blocked practice also led to significantly longer mean length of run and higher phonation/time ratio during training, although this advantage failed to transfer to meaningful pretest–posttest changes. These dynamic fluency developmental patterns are discussed to elucidate the underlying proceduralization in L2 speech processes.

Effect of Educational Program based on the Theory of Planned Behavior on Prostate Cancer Screening: A Randomized Clinical Trial.

Background and Aims:Prostate cancer screening applied for early diagnosis of prostate cancer. But it is not usually pursued by men. This study was conducted to determine the effect of educational program based on the Theory of Planned Behavior (TPB) on prostate cancer screening.Methods:A randomized clinical trial was carried out on 68 middle-aged men referring to community houses in Iran. Samples were selected consecutively considering the inclusion criteria. Then block randomization was used to assign the participants into two groups. Data collection included demographic characteristics, knowledge and construct of TPB (Attitude towards the behavior, Subjective norms, Perceived behavioral control, behavioral intention) and behavior. The participants in the intervention group attended a theory based program 4 session twice per week. The participants were evaluated before and two month after the intervention. P <0.05 was considered statistically significant.Results:After the 2 months intervention, the pretest-posttest changes in the intervention group compared to the control group were in the Knowledge 9.26 ± 3.5 vs. 0.03 ± 1.68, Attitude 11.46 ± 3.5 vs. -0.16 ± 1.39, Subjective norms 3.16 ± 2.6 vs. 0.29 ± 1.3, Behavioral control 6.76 ± 4 vs. 0.12 ± 1.60 and Behavioral intention 1.4 ± 1.54 vs. 0.00 ± 1.00 (P < 0.05). While none of the subjects in control group performed the prostate screening, 10 people (33.2%) performed it in the intervention group. (P < 0.001).Conclusions:Educational program based on TPB has a positive effect on prostate cancer screening. It is recommended to set up regular training programs based on TPB to encourage middle-aged men for prostate cancer screening.

Effectiveness of Gabapentin in Reducing Cravings and Withdrawal in Alcohol Use Disorder: A Meta-Analytic Review.

The current meta-analysis synthesizes previous findings on the effect of gabapentin on alcohol withdrawal and craving. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, a search for relevant English-language literature published between January 1999 and February 2019 was conducted using PubMed and Google Scholar with the keywords alcohol use disorder, alcohol dependence, alcohol withdrawals, alcohol craving, "gabapentin in alcohol use, consumption," and "gabapentin in alcohol withdrawals." Studies were included wherein gabapentin was used as an adjunctive or primary treatment of alcohol dependence/withdrawal. Studies included participants diagnosed with alcohol use disorder using DSM-IV, DSM-IV-TR, DSM-5, or the International Classification of Diseases, Tenth Revision (ICD-10). The search, as well as data extraction, was carried out by 3 blinded authors to preserve precision, using a template in Microsoft Excel to extract the needed data. Following the review of the initial 65 returns, 2 authors independently judged each trial by applying the inclusionary and exclusionary criteria, and any remaining disagreements were resolved by involving a third independent author. A total of 10 studies met the inclusion criteria and were selected for analysis. Subjects in these 10 studies were pooled using standard techniques of meta-analysis. Three sets of meta-analyses examined outcomes from (1) single-group pretest-posttest changes, (2) posttest differences between independent groups, and (3) differences in pretest-posttest change scores between independent groups. Statistically significant effect sizes were found for craving (P < .01) and withdrawal (P < .01, P < .001) in the meta-analysis of single-group pretest-posttest outcome changes and were associated with a high level of heterogeneity. In contrast, the meta-analyses of posttest differences between independent groups-that of differences in pretest-posttest change scores between independent groups-did not yield significant effect sizes. Our analysis of pooled data provides evidence that the use of gabapentin to manage alcohol withdrawal symptomatology and related cravings is at least moderately effective. However, given the limited number of available well-designed studies, these findings require further support through more rigorously designed studies.

Effects of Current and Enhanced Tobacco Corrective Messages on Smokers' Intention to Quit Smoking and Intention to Purchase Cigarettes.

A federal court has ordered tobacco companies to issue corrective messages to address tobacco-related misperceptions. This study examined the effects of viewing current versus two enhanced versions of tobacco corrective messages on smokers' intention to quit smoking and intention to purchase cigarettes. US adult smokers (N = 803) were randomly assigned to view (1) two current tobacco corrective messages (Current), (2) two corrective messages that include an industry deception statement (Industry Deception), or (3) two corrective messages with an industry deception statement and testimonials of people harmed by smoking (Industry Deception + Testimonial). Outcomes were pretest-posttest change in intentions to quit smoking and posttest intention to purchase cigarette measures. Intention to quit smoking increased significantly after viewing the Current corrective messages versus baseline. In addition, viewing the Industry Deception + Testimonial messages increased intention to quit smoking compared with the Current corrective condition and the Industry Deception condition. Hispanic smokers had increased intention to quit smoking and decreased intention to purchase cigarettes to a greater degree than non-Hispanic smokers in response to Industry Deception + Testimonial messages. There was no significant difference in intention to purchase cigarettes across conditions. Enhancing the current corrective statements by including an industry deception statement and testimonials may strengthen effects and contribute to remedying the effects of tobacco misinformation. Previous research has found that draft or proposed versions of tobacco industry corrective messages are effective in correcting beliefs and knowledge. However, studies have not examined how the current court-ordered corrective messages could change intention to quit smoking and intention to purchase cigarettes nor whether enhanced messages could perform better. Study findings suggest that the current corrective messages can increase smokers' intention to quit smoking beyond their baseline intention. More importantly, enhancing corrective messages by including an industry deception statement and testimonial was found to be more effective than current corrective messages. Findings can inform future iterations of tobacco correctives and strategies to reverse the effects of tobacco misinformation.

Psychological treatment for family members of children with cancer: A systematic review and meta-analysis.

This meta-analytical study examined the effects of psychological treatments applied to family members of children and adolescents with cancer, as well as the characteristics of the studies that can be associated with their effects. Four databases were searched between January 1980 and January 2017; the references of the located studies were reviewed, and emails were sent to experts in this topic. Forty articles fulfilled the selection criteria. The standardized mean pretest-posttest (or pretest-follow-up) change was used as the effect-size index for the treatment and control groups. The 40 articles included 40 treatment groups and 21 control groups. When treatment and control pretest-posttest mean effects were compared, psychological interventions revealed positive, statistically significant results for anxiety (dadj =0.339) and problem-solving skills (dadj =0.385) and, to a lesser extent, for posttraumatic stress (dadj =0.224). No statistically significant differences were found for mood (dadj =0.147), acute stress (dadj =-0.010), coping skills (dadj =0.123), social support (dadj =0.245), or quality of life (dadj =0.538). Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures. Behavioral interventions seem to be the most promising. Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment. At follow-up, the intervention benefits were diminished. The application of psychological interventions is recommended to mitigate the negative psychological repercussions in this population.

Users' Opinion About a Virtual Reality System as an Adjunct to Psychological Treatment for Stress-Related Disorders: A Quantitative and Qualitative Mixed-Methods Study.

This study aims to explore patients’ and therapists’ attitudes about the psychological treatment they received (patients) or applied (therapists). The treatments were standard CBT protocols for post-traumatic stress disorder (PTSD), complicated grief (CG), or adjustment disorders (ADs), depending on each patient diagnosis. The treatments were delivered following a traditional format or supported by a virtual reality (VR) system “EMMA’s WORLD” designed for the treatment of stress-related disorders. “EMMA’s WORLD” is a VR application in which patients can explore negative experiences using different virtual elements that can be customized to make them more meaningful to the user. The sample was composed of two groups: the “professionals” (N = 10) were all clinical psychologists who applied the same psychological treatment in both the traditional format (“traditional condition”) and using the VR system (“EMMA” condition). The second group consisted of a sample of patients (N = 50) who met the criteria for at least one of three different diagnoses: PTSD (N = 15), CG (N = 15), or AD (N = 20). 25 patients received treatment in the traditional format and 25 supported by the VR system. The patients were asked about their expectations (before treatment) and satisfaction (after treatment) with the treatment they received. All the therapists were asked their opinions about both treatment conditions. A mixed-methods approach using quantitative and qualitative methodologies was used. In both conditions, high scores were observed, and the patient’s opinions were even better when they have already received the treatments. A more pronounced pre-test–post-test change in the EMMA therapy group than in the traditional group was observed. EMMA’s World was well-accepted by both patients and therapists, and it helped to foster motivation in patients, while helping the therapist to apply the treatment. Thus, VR can be useful as an adjunct tool to enhance the treatment.

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.

Evaluation of engineering and technology activities in primary schools in terms of learning environment, attitudes and understanding

Because the importance of science, technology, engineering and mathematics (STEM) education continues to be recognised around the world, we developed and validated an instrument to assess the learning environment and student attitudes in STEM classrooms, with a specific focus on engineering and technology (E&T) activities in primary schools. When a four-scale instrument assessing classroom cooperation and involvement and student enjoyment and career interest was administered to 1095 grade 4–7 students in 36 classes in 10 schools, data analyses supported its factorial validity and reliability. When the new questionnaire and understanding scales were used to evaluate E&T activities, statistically-significant pretest–posttest changes in career interest and understanding (with large effect sizes ranging from 0.70 to 0.81 standard deviations) supported the efficacy of the instructional activities.

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.