Program Staff Research Articles

Implementing an evidence-based behavioral weight-loss program in community mental health centers: A randomized pilot study.

Obesity is a leading cause of preventable death among individuals with serious mental illness (SMI). A prior randomized controlled trial demonstrated the efficacy of a lifestyle style intervention tailored to this population; however, such interventions need to be adapted and tested for real-world settings. This study evaluated implementation interventions to support community mental health program staff to deliver an evidence-based lifestyle intervention to clients with obesity and SMI. In this cluster-randomized pilot trial, the standard arm combined multimodal training with organizational strategy meetings and the enhanced arm included all standard strategies plus performance coaching. Staff-coaches delivered a 6-month group-based lifestyle intervention to clients with SMI. Primary outcomes were changes in staff knowledge, self-efficacy, and fidelity scores for lifestyle intervention delivery. Linear mixed-effects modeling was used to analyze outcomes, addressing within-site clustering and within-participant longitudinal correlation of outcomes. Three sites were in the standard arm (7 staff-coaches); 5 sites in the enhanced arm (11 staff-coaches). All sites delivered all 26 modules of the lifestyle intervention. Staff-coaches highly rated the training strategy's acceptability, feasibility and appropriateness. Overall, mean knowledge score significantly increased pre-post by 5.5 (95% CI: 3.9, 7.1) and self-efficacy was unchanged; neither significantly differed between arms. Fidelity ratings remained stable over time and did not differ between arms. Clients with SMI achieved a mean 6-month weight loss of 3.8 kg (95% CI: 1.6, 6.1). Mental health staff delivering a lifestyle intervention was feasible using multicomponent implementation interventions, and preliminary results show weight reduction among clients with SMI. The addition of performance coaching did not significantly change outcomes. Future studies are needed to definitively determine the effect on client health outcomes.

Unveiling the significant contribution of Child and Youth Care Workers in South African township schools

The deployment of Child and Youth Care Workers (CYCWs) in South African schools is a recent development prompted by the growing barriers to learning faced by learners. This study explored the critical role of CYCWs and their contributions to eight township schools in Botshabelo, South Africa. The aim was to explore and understand the experiences of stakeholders’ regarding the contributions of CYCWs within the Thari programme to township schools in South Africa and how their contributions affected the school environment and aided the well-being of learners. The study followed a qualitative case study design, which integrated the insights from the programme staff, CYCWs (n = 9), principals (n = 5), educators (n = 16), and stakeholder forum members (n = 4) forming part of the Thari programme. Programme documents were also analysed as background and the face-to-face individual and group interviews were thematically analysed.Aligned with the developmental approach to social services, the findings revealed that CYCWs partake in diverse semi-professional activities which significantly contribute to helping learners navigate the challenges they experience in their daily lives. These activities encompass providing psychosocial support, conducting awareness campaigns, organising group sessions, and facilitating educational games. Furthermore, they assume the role of surrogate parental figures and role models for children facing vulnerabilities.The study found that the CYCWs registered in the auxiliary category were not supervised by CYCWs in the professional category. They also had restricted access to full-time social workers for referrals. These challenges underscore the pressing need for increased resources and professional development opportunities for CYCWs so that they can fully attend to their responsibilities in schools.Several recommendations are made, such as increasing resources for the Thari programme, investing in CYCW training, promoting collaboration with other professionals, conducting regular evaluations, engaging parents through workshops, and acknowledging the pivotal role of CYCWs as role models and parental figures. The study offers valuable insights into enhancing the impact and effectiveness of CYCW interventions in township schools, thereby contributing to South African children’s holistic development and well-being.

How effective is nutrition training for staff running after school programs in improving quality of food purchased and meal practices? A program evaluation

Objectives / purposeAfter school programs represents a setting for promoting healthy dietary habits. The aim of this study was to evaluate how effective the after school program staff perceived nutrition training aiming to improve quality of food purchased and meal practices. We further aimed to assess the changes in purchase of primarily fish and fish products, whole grains and fruit and vegetables, by collecting receipts from food purchase before and after the intervention.ResultsThis is a mixed methods study. Group interviews with after school staff were carried out and the data was analyzed deductively according to the RE-AIM framework. Receipts from food purchase were collected. Findings from the qualitative interviews indicated that the intervention had been a positive experience for the staff and suggested a new way of working with promoting healthy foods in after school program units. Although there were some challenges reported, the staff made necessary adjustments to make the changes possible to sustain over time. Findings from the receipts support the changes reported by the staff. These showed increased purchase of vegetables, fish, and whole grain in all four after school program units. After school programs in similar settings may expand on these findings to improve the students’ dietary habits.

Translating global evidence into local implementation through technical assistance: a realist evaluation of the Bloomberg philanthropies initiative for global Road safety

BackgroundTraffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS).MethodsWe conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation.ResultsTA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers’ understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up.ConclusionThe program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.

Abstract PO1-03-01: Barriers, facilitators, and challenges for the implementation of a hybrid multidisciplinary lifestyle intervention

Abstract Background. Breast cancer is the leading cause of cancer-related death and disability among young women in Mexico. The physical and psychological symptoms they experience affect their quality of life, physical functioning, and psychological well-being. To address this, the National Cancer Institute in Mexico City developed a program called "Joven & Fuerte" that provides services for young women with breast cancer. Due to the COVID-19 pandemic, the program has migrated to virtual attention and now offers hybrid attention to meet the needs of these patients. The research group developed the "Joven, Fuerte & Saludable" intervention, which is a hybrid (face-to-face and virtual) multidisciplinary lifestyle intervention that includes nutrition, rehabilitation, psychological support, mindfulness intervention, and lifestyle education for early disease young women undergoing oncology treatments. This study aims to evaluate the barriers and facilitators for implementing this lifestyle intervention. Methodology. The study involved young women with early breast cancer enrolled in the "Joven & Fuerte" program in 2022. They were invited to participate in a study to evaluate the barriers, facilitators, and challenges of a hybrid multidisciplinary lifestyle intervention during the first months since the diagnosis (3 months). The intervention included face-to-face consultations for anthropometric and biochemical assessments, interdisciplinary team evaluations, and virtual support through WhatsApp and Zoom. Educational materials such as printed or digital healthy lifestyle guides and educational videos were available on a private Facebook and YouTube group. Follow-up sessions were conducted via phone, video, or on-site visits. To evaluate lifestyle habits and quality of life status, distress, anxiety, and depression validated questionnaires were used. The CFIR and RE-AIM questionnaires were used to identify the barriers and facilitators among the program staff and patients while adopting the intervention. Results. The study found that patients were satisfied with the intervention and educational materials, but there were some barriers for implementation. One of the main barriers was the patients' geographical location, as 62.5% of patients were foreign and lived far from the hospital. Additionally, patients only sometimes used the educational materials due to forgetfulness, lack of time, not having internet access, or low digital literacy. Patients also had difficulty recognizing the impact of a "healthy lifestyle" and prioritized other consultations before the program schedule. Institutional barriers included a lack of human resources, which led to a loss in follow-up and patient motivation due to waiting-list periods. Undergraduate and postgraduate training students were introduced to support the multidisciplinary team in overcoming this challenge. Despite these obstacles, patients reported feeling supported by the multidisciplinary team and experienced benefits such as reduced stress and anxiety and better management of treatment side effects upon completing program activities. An important institutional success was achieved by reducing service waiting times from three months to just 1-2 weeks for all services. Conclusions. Cultural behavior and emotional distress at diagnosis and during the first 3 months of intervention are the major challenges for patients. A hybrid educational intervention seems convenient to make follow-up more practical and accessible. Patients feel motivated because they are in touch with their clinicians and receive fast resolutions to their concerns. Many talented and enthusiastic human resources are needed to implement these interventions, but it is possible for a Latin American public hospital, considering the essential benefits for the patients. Citation Format: Daniela Martinez-Palacios, Marlid Cruz-Ramos, Fernanda Sarahi Fajardo-Espinoza, Yanira Elvira Rodriguez-Fonseca, Alicia Gonzalez-Perez, Aline Barranco-Cortés, Dana Aline Pérez-Camargo, Alejandro Mohar, Cynthia Mayté Villarreal Garza. Barriers, facilitators, and challenges for the implementation of a hybrid multidisciplinary lifestyle intervention [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-03-01.

Development and preliminary validation of a questionnaire for assessing fitness centers

This manuscript comprehensively examines the development and preliminary validation of a questionnaire designed to assess fitness centers. The study aims to address existing gaps in the literature by providing a standardized tool for evaluating the quality of fitness facilities. The study aims to design, validate, and present a preliminary assessment instrument tailored specifically for fitness centers, encompassing various aspects such as program offerings, facility conditions, and staff competencies. The research methods involved the identification of key indicators affecting fitness center services, followed by the generation and validation of questionnaire items through a rigorous statistical analysis. The research subjects consisted of 119 fitness enthusiasts from Angeles City, Philippines, who actively participated in the validation process. The instruments used in data processing included Likert-style rating scales and statistical methods such as Point Biserial Correlation and t-tests. The analysis of data utilized in data processing led to the retention of 59 questionnaire items, demonstrating significant correlation coefficients. The study's results highlight the reliability and validity of the developed questionnaire as a valuable tool for assessing fitness centers, providing insights into client needs and areas for improvement. In conclusion, the preliminary validation of the questionnaire serves as a crucial step towards enhancing the quality and standards of fitness center services, benefiting both managers and regulatory authorities in ensuring the provision of safe and effective fitness facilities.

Recommendations for Modernizing a Culturally Grounded Substance Use Prevention Program for American Indian and Alaska Native Youth.

American Indian and Alaska Native (AI/AN) youth use alcohol and drugs at a higher rate with earlier onset than the overall youth population in the United States. Youth interventions are needed to support the prevention and reduction of substance misuse-related issues. Connecting AI/AN children to their heritage through culturally grounded prevention programs has been shown to be more effective than programs designed for the general population. The objective of this formative evaluation was to provide community-informed updates for an existing culturally grounded substance use prevention program, The Beauty Way. This study was conducted in partnership with an AI/AN-serving community organization using key informant interviews and talking circles with community members and parents. Participants revealed the challenges and obstacles AI/AN youth face, the impact of cultural values, and activities which engage youth to prevent problematic substance use. Recommendations include the importance of 1) incorporating current challenges to behavioral health such as social media and vaping, 2) including cultural values and activities including land-based learning, and 3) creating a robust facilitator guide and hiring culturally sensitive program staff. These results generated recommendations to strengthen the cultural focus and application of The Beauty Way for AI/AN youth.

Harm reduction and treatment: They must be willing to refer patients to each other

I have been thinking a lot about the intersection of harm reduction and treatment. This is at the top of my mind based on my conversations with treatment program staff where they tell me that they believe, or have been told by their regulators, that they must treat folks who are unwilling, or uninterested, in accessing all of the services offered by their program and that they cannot refer folks to other, better suited services, in that instance.

IINVENT pathways and practices: prizing the process over the product

Rural communities need skilled innovators who engage as community members, support economic opportunities, and develop novel ways to solve local problems. Through innovation, Invention Education (IvE) is one way to promote the creativity and problem-solving needed to restore economic vitality to regions of the rural US. IvE pathways support a skilled workforce that communities can draw upon to solve complex problems. Introductory IvE experiences can begin to bolster rural recovery and open prime grounds for innovative solutions. The Office of Precollege Programs at Oregon State University established the iINVENT Program for upper elementary, middle, and high school learners to engage in IvE and act as inventors. In this study, we describe the iINVENT pathways resulting from 8 years of curriculum design and iteration guided by engaged scholarship practices and robust evaluation. Program data from 2019–2023 was collected via learner, educator, community partner, and parent surveys, as well as through observations conducted by program staff and partner instructors. Results from qualitative content and thematic analysis demonstrate the value of introducing learners to IvE and how iINVENT practices support invention educators in impacting youth learners. The findings demonstrate essential practices, successes, and challenges that have shaped the iINVENT pathways and IvE curriculum delivered. Based on these findings and current discourse unfolding throughout the IvE professional community, the authors suggest that a process-oriented invention framework focused on inventiveness and the ways learners can act as inventors is pivotal to broaden access and participation in IvE, providing learners with a more applicable and relatable learning experience to cultivate inventiveness mindsets and skills transferable to all parts of life.

Male perspectives on intimate partner violence: A qualitative analysis from South Africa.

Intimate partner violence (IPV) affects one in four women globally and is more commonly enacted by men than women. Rates of IPV in South Africa exceed the global average. Exploring the background and context regarding why men use violence can help future efforts to prevent IPV. We explored adult men's perspectives of IPV, livelihoods, alcohol use, gender beliefs, and childhood exposure to abuse through a secondary analysis of qualitative interviews that were conducted in South Africa. The setting was a peri-urban township characterized by high unemployment, immigration from rural areas, and low service provision. We utilized thematic qualitative analysis that was guided by the social ecological framework. Of 30 participants, 20 were residents in the neighborhood, 7 were trained community members, and 3 were program staff. Men reported consumption of alcohol and lack of employment as being triggers for IPV and community violence in general. Multiple participants recounted childhood exposure to abuse. These themes, in addition to culturally prescribed gender norms and constructs of manhood, seemed to influence the use of violence. Interventions aimed at reducing IPV should consider the cultural and social impact on men's use of IPV in low-resource, high-IPV prevalence settings, such as peri-urban South Africa. This work highlights the persistent need for the implementation of effective primary prevention strategies that address contextual and economic factors in an effort to reduce IPV that is primarily utilized by men directed at women.

Height and Weight Measurement and Communication With Families in Head Start: Developing a Toolkit and Establishing Best Practices.

Background: Head start (HS) programs are required to collect children's height and weight data. Programs also communicate these results to families. However, no standardized protocol exists to guide measurements or communicate results. The purpose of this article was to describe the development of a measurement toolkit and best practices for communication. Methods: HS programs contributed to the development and pilot testing of a toolkit for HS staff to guide child measurement. We used a three-phase iterative approach and qualitative methods to develop and test the toolkit, which included a video and handout. In addition, we convened an advisory group to draft best practices for communication. Results: HS program staff appreciated the toolkit materials for their simplicity and content. The advisory group highlighted the importance of weight stigma and the need to be cautious in the way that information is communicated to families. The group underscored the role of emphasizing health behavior change, instead of focusing solely on BMI. Best practices were organized into (1) Policies and procedures for communicating screening results, (2) training for HS program staff to improve communication related to screening and health behaviors, and (3) other best practices to promote health behaviors and coordinate data systems. Conclusions: Our toolkit can improve anthropometric measurements of HS to ensure that potential surveillance data are accurate. Advisory group best practices highlight opportunities for HS to develop and implement policies, procedures, and trainings across the country to improve communication with HS families. Future research should test the implementation of these best practices within HS.

Outpatient Parenteral Antimicrobial Therapy in a Safety Net Hospital: Opportunities for Improvement.

Outpatient parenteral antimicrobial therapy (OPAT) is a safe and cost-effective transitional care approach administered via different delivery models. No standards exist for appropriate OPAT program staffing. We examined outcomes of patients receiving OPAT via different care models to identify strategies to improve safety while reducing health care overuse. Retrospective demographic, clinical, and outcome data of patients discharged with OPAT were reviewed in 2 periods (April-June 2021 and January-March 2022; ie, when staffing changed) and stratified by care model: self-administered OPAT, health care OPAT, and skilled nursing facility OPAT. Of 342 patients, 186 (54%) received OPAT in 2021 and 156 (46%) in 2022. Hospital length of stay rose from 12.4 days to 14.3 in 2022. In a Cox proportional hazards regression model, visits to the emergency department (ED) within 30 days of OPAT initiation (hazard ratio, 1.76; 95% CI, 1.13-2.73; P = .01) and readmissions (hazard ratio, 2.34; 95% CI, 1.22-4.49; P = .01) increased in 2022 vs 2021, corresponding to decreases in OPAT team staffing. Higher readmissions in the 2022 cohort were for reasons unrelated to OPAT (P = .01) while readmissions related to OPAT did not increase (P = .08). In a well-established OPAT program, greater health care utilization-length of stay, ED visits, and readmissions-were seen during periods of higher staff turnover and attrition. Rather than blunt metrics such as ED visits and readmissions, which are influenced by multiple factors besides OPAT, our findings suggest the need to develop OPAT-specific outcome measures as a quality assessment tool and to establish optimal OPAT program staffing ratios.

The leadership of quality strategic for improvement lecture performance toward excellence’s university

This research found the strategic leadership of quality for improving lecture performance at the university as a public service. Leadership strategic aspects have affected the lecture performance. This research uses mix methods design. This research has been developed by strategic leadership for a quality model at the University of Mataram with qualitative case study. This research found strategy leadership of quality has an effective contribution to improving the lecture, dean, and head of study’s program performance at the University of Mataram, The strategy leadership for quality has more contributions to improve the lectures and education staff of study program. The faculty leadership element, namely the dean and head of a study program, has a considerable contribution to improving the performance of the institution he leads. The dean of the faculty must be able to plan educational and research programs well, this is seen from the planning, coordination, monitoring, and evaluation of each organizational unit within the University of Mataram. Furthermore, the head of the study program must also be able to transform superior study programs, such as doctoral study programs, and doctoral study programs at the University of Mataram.

A survey of state and local practices encouraging pediatric COVID-19 vaccination of children ages 6 months through 11 years

ObjectiveThis report highlights state and local practices for optimizing the pediatric COVID-19 vaccination program for children ages 6 months through 11 years. MethodsState and local practices designed to optimize pediatric COVID-19 vaccine uptake were identified from a range of sources, including immunization program, CDC, and partner staff; and media stories or program descriptions identified via online searches. ResultsA range of practices were identified across different categories: provider-focused practices, school-based practices, jurisdiction or health department-based activities, community-focused practices involving partners, use of vaccination incentives, and Medicaid-related practices. ConclusionsImmunization programs and stakeholders implemented a variety of practices to meet the challenge of the pediatric COVID-19 vaccination program. The key findings may serve to inform not only the current pediatric COVID-19 vaccination program, but also future outbreak response work and routine immunization activities.

Increasing Access To Perinatal Mental Health Care: The Perinatal Psychiatry Access Program Model.

Perinatal psychiatry access programs offer a scalable approach to building the capacity of perinatal professionals to identify, assess, and treat mental health conditions. Little is known about access programs' implementation and the relative merits of differing approaches. We conducted surveys and semistructured interviews with access program staff and reviewed policy and procedure documents from the fifteen access programs that had been implemented in the United States as of March 2021, when the study was conducted. Since then, the number of access programs has grown to thirty state, regional, or national programs. Access programs implemented up to five program components, including telephone consultation with a perinatal psychiatry expert, one-time patient-facing consultation with a perinatal psychiatry expert, resource and referral to perinatal professionals or patients, trainings for perinatal professionals, and practice-level technical assistance. Characterizing population-based intervention models, such as perinatal psychiatry access programs, that address perinatal mental health conditions is a needed step toward evaluating and improving programs' implementation, reach, and effectiveness.

Mobilizing community-driven health promotion through community granting programs: a rapid systematic review.

Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes. A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings. Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds. This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization. PROSPERO #CRD42023399364.

(1315) - International Survey: Ventricular Assist Device Program Staffing Structure and the Role of VAD Coordinator

(1315) - International Survey: Ventricular Assist Device Program Staffing Structure and the Role of VAD Coordinator

A contextualised Internationalisation of the curriculum: A case study in China

China is often seen as a home country of international students in higher education internationalisation. Little is known how Chinese institutions actively engage in multi-modal and multi-lateral internationalised practices. This paper offers an updated insight of higher education internationalisation in a context outside the dominant western landscape through a case study set in an international college in China. Making use of the existing frameworks of internationalisation of the curriculum (IoC), the current case study focuses on three key aspects of the curriculum: program development, student experience and staff perspectives. A mixed-method approach was used to collect data from three sources: institutional archives and course materials, and student and staff surveys. Triangulated data show that the curriculum was well aligned within the existing IoC frameworks. The curriculum incorporated international content and comparative approaches. Local socio-cultural values were also embedded in joint programs. Both students and academics’ perspectives of an internationalised curriculum showed a high level of alignment with the western community. Student and staff data also revealed urgent need to enhance the level of internationalisation, including English competence of discipline academics, people-to-people connection between local Chinese students and incoming international students, student and staff mobility opportunities, and teaching and research development for academic staff. This study hopes to contribute to the current knowledge of internationalisation of the curriculum with updated understanding in a Chinese context. This paper also provides insight in internationalisation implemented at the curriculum level in China, a context that presents much difference from but relates closely with the western context.

Tobacco smoking and nicotine vaping in persons with first episode psychosis

Tobacco smoking is highly prevalent in persons with psychosis and is the leading cause of preventable mortality in this population. Less is known about tobacco smoking in persons with first episode psychosis (FEP) and there have been no estimates about the prevalence of nicotine vaping in FEP. This study reports rates of tobacco smoking and nicotine vaping in young people with FEP enrolled in Coordinated Specialty Care programs in Pennsylvania and Maryland. Using data collected from 2021 to 2023, we examined lifetime and recent smoking and vaping and compared smokers and vapers to nonusers on symptoms, functioning, and substance use. The sample included 445 participants aged 13–35 with recent psychosis onset. Assessments were collected by program staff. Overall, 28 % of participants engaged in either smoking or vaping within 30 days of the admission assessment. Smokers and vapers were disproportionately male, cannabis users, and had lower negative symptom severity than non-smokers. Vapers had higher role and social functioning. Both smoking and vaping were related to a longer time from psychosis onset to program enrollment. We compare these findings to previous studies and suggest steps for addressing smoking and vaping in this vulnerable population.

Authentic Learning: Financial Literacy in Postsecondary Bridging Experiences

We applied the most significant change analytical approach to explore what summer bridging camp participants characterized as valuable to their post-high school transitions. Through interviews, program documents, dialogue with program staff, curriculum review, and observations, our participants identified the curriculum on managing their personal finances as the most impactful and useful for their future planning. In this qualitative study, we used an interpretive framework of authentic learning to present and organize our description of the curriculum and find that both the content and the real-life activities resonated with students as they planned for their lives after high school graduation. Our discussion considers our findings in the context of school-based and informal financial literacy education and makes recommendations for authentic learning as a sound theoretical approach for designing financial literacy curricula.