Using data from a biracial community sample of adolescents, the present study examined trajectories of alcohol use and abuse over a 15-year period, from adolescence into young adulthood, as well as the extent to which these trajectories were differentially predicted by coping and enhancement motives for alcohol use among the 2 groups. Coping and enhancement motivations (M. L. Cooper, 1994) refer to the strategic use of alcohol to regulate negative and positive emotions, respectively. Results showed that Black and White youth follow distinct alcohol trajectories from adolescence into young adulthood and that these trajectories are differentially rooted in the regulation of negative and positive emotions. Among Black drinkers, coping motives assessed in adolescence more strongly forecast differences in alcohol involvement into their early 30s, whereas enhancement motives more strongly forecast differences among White drinkers. Results of the present study suggest that different models may be needed to account for drinking behavior among Blacks and Whites and that different approaches may prove maximally effective in reducing heavy or problem drinking among the 2 groups.
Studied the effectiveness of a school-based mental health service model, PALS (Positive Attitudes toward Learning in School), focused on increasing initial and ongoing access to services, and promoting improved classroom and home behavior for children referred for Disruptive Behavior Disorder (DBD) from three high poverty urban elementary schools. Classrooms were randomly assigned to PALS or referral to a neighborhood mental health clinic, with children identified by teacher referral and follow-up parent andeher ratings. Results indicated significant service engagement and retention for PALS (n=60) versus families referred to clinic (n=30), with over 80% of PALS families retained in services for 12 months. PALS services were correlated with positive changes in children's behavior as rated by parents, and with improvements in children's academic performance as rated by teachers. Implications for the design and delivery of mental health services for children and families living in high-poverty urban communities are discussed.
ⅢUniversity-community partnerships are widely recognized as critical to the success of community research and advocacy work but difficult to form and sustain. This article will describe a unique facet of that partnership, namely the collaboration between mental health clinicians and community consultants, a partnership that our data suggest was a cornerstone of our schoolbased mental health service program called PALS, an ecological model designed to engage African American families living in urban poor communities in mental health services. The service model was designed to promote children's learning and positive behavior through supporting teachers and encouraging parental involvement in school. In PALS, parent representatives from the community and clinicians from the university worked together in school-based teams to support children, families, and teachers. This article will discuss the evolution of our clinician-consultant partnership and several lessons that emerged regarding the incorporation of community members into the world of academia, research, and mental health service delivery.
This study examined urban educators’ attitudes toward commonly recommended interventions for students with Attention Deficit Hyperactivity Disorder (ADHD). Participants included 358 pupil personnel services (PPS) professionals—school psychologists, social workers, and counselors—and 70 classroom teachers from urban elementary schools. On average, PPS professionals and classroom teachers expressed little confidence in the effectiveness of commonly used classroom, mental health, and pharmacological treatments for ADHD. For PPS professionals, a moderately positive correlation was found between self-confidence and effectiveness ratings for classroom interventions and mental health interventions, and a small positive association was found between knowledge of ADHD and effectiveness ratings for medication. Teacher self-confidence was positively associated with effectiveness ratings for classroom interventions. Knowledge of ADHD was negatively correlated with teacher perceptions of the effectiveness of classroom and mental health interventions. Neither child gender nor ADHD subtype influenced effectiveness ratings. Results are discussed in regard to the urgent need for urban educators to experience greater success in their efforts to implement interventions for students with ADHD and for research focused on the unique needs of children residing in urban, low-income communities.
Background: A variety of ‘structured support services’ (services) are available to patients (e.g. genetics, fertility, counseling, physical functioning, nutrition). Many of these services have value for breast cancer survivors (survivors) as they are often likely to face issues regarding genetic factors, fertility, parenting, relationships, work, and financial hard-ships. As part of an ongoing CDC-funded initiative, we report about barriers to services use for survivors. Methods: We used lean techniques to analyze system complexity including: process mapping; inventorying support services, providers/staff, and referral methods; stake holder leadership events; and Kaizen events to facilitate system improvements. Results: We identified several barriers to patients getting services which reflect the complexity of cancer care delivery in an academic cancer center including: varying care pathways, lack of standard processes; lack of staff awareness of available service (hospital staff are located in 5 different clinics and include physicians, APPs, clinic nurses, nurse navigators, and patient schedulers); numerous different contact and referral methods to services (tribal knowledge of staff necessary to make SS referrals). We initially identified 7 and found 38 services through inventorying and mapping systems. We implemented a number of systematic and non-systematic interventions to address these barriers. Systematic implementations include assisting in the development and piloting new patient orientation binders to include services, implementation of a revised scheduling form to streamline referrals, created and disseminated a quick reference referral guide to educate staff for how to make referrals. Non-systematic interventions included hosting services fair for breast cancer providers to meet and learn about them and advertising services on waiting room TVs. Conclusions: Patients and providers both perceive many challenges accessing support services. Applying improvements in a complex health care system is difficult and incrementally addresses identified barriers. We will now be measuring the impact of these changes on the receipt of support services in breast cancer survivors. Funding: CDC Grant 1U58DP003414 (PI Marks, L.). Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-09-14.
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