Evaluation & the Health Professions最新文献

Existing research has shown that parental behavior can influence the onset and persistence of adolescent depression; however, the initial treatment guidelines do not include parental involvement, and there is no established protocol for engaging parents. For this study, the Doepressie parent training protocol was designed to teach parents ways to help their child cope with depression, and this study sought to evaluate the feasibility and changes in parenting of combining individual cognitive behavioral therapy (CBT) for adolescents with parent training. Because of the heterogeneity observed in adolescents with depression, a single-case design study with daily diaries for parents was conducted. Adolescents (N = 9; mean age = 15.9, SD = 1.05) with major depressive disorder and their parents participated in this study. Parents reported that the parent training was feasible. After treatment, two-thirds of the adolescents no longer met the criteria for major depressive disorder. Most of the parents reported positive effects on their child's mood and activity level, problem-solving skills with their child, and parental responsiveness and competence. Four parents demonstrated medium positive change. Involving parents in the treatment of adolescent depression has significant clinical benefits. Because of the heterogeneity of adolescent depression, the impact of parental involvement varies.

In the United States, only approximately one-third of students read at or above proficiency level. Moreover, the difference in reading proficiency of students is severely disproportionate for students with disabilities compared to students without disabilities. Reading fluency is a precursor for academic success and one of the six aspects of reading that contributes to effective reading skills. Many studies have examined the effectiveness of repeated reading to improve reading fluency. However, existing literature has mixed evaluations of whether repeated reading can be considered evidence-based reading intervention practice for students with disabilities. The current study examined the effects of a repeated reading intervention on reading fluency for three middle school students with learning disabilities. To address limitations of traditional single-case experimental design analytical methods such as visual analysis and nonoverlap indices, our study provided empirical researchers with a step-by-step procedure of using an advanced statistical method for single-case experimental designs, namely, generalized linear mixed models (GLMM) to analyze data. The results presented by GLMMs showed that repeated reading intervention can significantly improve reading fluency for some students with learning disabilities. Implications, limitations, and future directions from both empirical and methodological perspectives were also discussed.

Generalized linear mixed models (GLMMs) have great potential to deal with count and rate data in single-case experimental designs (SCEDs). However, applied researchers face challenges to apply such an advanced approach in their own studies. Hence, our study aimed to provide a tutorial and demonstrate a step-by-step procedure of using GLMMs to handle SCED count and rate outcomes. We utilized an empirical examplewith a purpose to examine the effect of prelinguistic milieu teaching (PMT) on prelinguistic intentional communication for six school-age children with autism. The outcomes were sustained intentional communication (frequency count) and initiated intentional communication (rate). A step-by-step analytical approach with GLMMs was illustrated and associated R and SAS code was provided. The results overall supported the original conclusions of the effectiveness of PMT, whereas additional evidence regarding the precise estimate of the individual treatment effect and between-case variation of the treatment effect were also interpreted. The implications of the similarities and differences between the findings based on GLMMs and from the original study were discussed.

Parents with borderline personality disorder (BPD) experience deficiencies in parenting skills leading to increased family burden, stress, mental health problems in children and even family violence. The present study evaluated a Dutch version of the parenting training based on Dialectical Behavior Therapy (DBT) for mothers with BPD. A multiple baseline single-case experimental design study was conducted with standardized and idiosyncratic assessments of parenting behavior and parental stress before, biweekly during, and after training. Participants (N = 10) were mothers with a BPD diagnosis with a child under the age of 6. Four participants discontinued the training. Among six training completers, clinically reliable improvements in parenting skills were most pronounced for inconsistent discipline, involvement, positive parenting and corporal punishment. Frequent, idiosyncratic assessments showed that for six mothers training had a positive effect on parenting skills, while for five mothers this effect was large. Overall, less improvement was found for parenting stress. DBT parenting training seems to have clinical value for mothers with BPD struggling with raising their children. Most prominent improvement was found in relation to mothers disciplining their child in a more consistent manner. The complexity and heterogeneity of mothers with BPD requires a more idiosyncratic, patient-centered approach. This study was registered (retrospectively) in ISRCTN (ID ISRCTN74447767). https://www.isrctn.com/ISRCTN74447767, March 2022.

The Low Back Activity Confidence Scale (LoBACS) is a 15-item scale designed to assess low back pain (LBP) through self-efficacy, a key predictor of functional recovery. This study aimed to culturally adapt and evaluate the validity and reliability of the Turkish version of LoBACS in patients with LBP. The translation and adaptation followed Beaton et al.'s protocol. Content and face validity were assessed with a pre-patient group. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to evaluate construct validity. Internal consistency, as well as test-retest reliability, were evaluated in a sample of 150 patients aged 18-70 years. Concurrent validity was measured alongside the Oswestry Back Pain Disability Questionnaire (ODQ) and Quebec Back Pain Disability Scale (QBPDS). Two factors emerged from factor analysis, with item loadings for Functional Self-efficacy (FnSE) ranging from 0.745 to 0.896 and for Self-Regulatory and Exercise Self-efficacy (Self-Reg&ExSE) from 0.817 to 0.940. Cronbach's alpha was high for FnSE, Self-Reg&ExSE, and the total scale (α = 0.941). Total correlation for each item ranged between 0.770 and 0.925. Test-retest reliability was also high (r = 0.941, p < .01). LoBACS showed moderate agreement with ODQ and QBPDS, demonstrating concurrent validity. In conclusion, the Turkish version of LoBACS is a valid and reliable tool for measuring LBP-related self-efficacy.

This study evaluated LLInC (Leerkracht-Leerling Interactie Coaching in Dutch, or Teacher Student Interaction Coaching), an intervention targeted at teachers' mental representations to improve dyadic teacher-child relationship quality. Four teachers and eight children from Dutch elementary schools participated in this single case study. Teachers themselves selected two children with whom they experienced a difficult relationship. The results indicated that teachers' global judgments of relationship quality improved from pretest to posttest for almost all teacher-child dyads. Day-to-day perceptions of conflict, closeness, and self-efficacy improved for a few teacher-child dyads, and especially for teacher-child dyads of the second targeted child. This implies that LLInC is especially helpful when carried out for at least two teacher-child dyads. The results of this study suggest that LLInC is promising, especially with regard to teachers' global relationship perceptions. However, LLInC should be further evaluated using a larger, representative sample, especially with regard to day-to-day perceptions of relationship quality.

Secure residential care (SRC) is criticized for several reasons. Therefore, in many countries, the general policy is to limit the length of stay of adolescents in SRC. However, research on length of stay and treatment effects of SRC on adolescents' behavioral problems is sparse. Using single case experimental designs with time-series, forty adolescents referred to SRC completed a questionnaire on behavioral and attention problems every two weeks during a baseline (A) and treatment period (B). Two-level regression analyses were used to investigate the effects of SRC on behavioral and attention problems. In addition, we tested whether length of stay moderated effectiveness. On the individual level, the treatment showed a positive statistically significant effect on the behavioral problems of 0%-8% of the adolescents and a statistically significant negative effect on behavioral problems was found in 3%-10% of the adolescents. On the group level, adolescents showed no significant decrease in problem behavior or attention problems from baseline to discharge. Length of stay did not moderate the results. Based on the results we conclude that most adolescents fail to improve. In addition, length of stay was not associated with effectiveness, nor could it be explained by adolescents' characteristics.

There are many ways proposed to achieve better societal outcomes (e.g., in health, education, and well-being) including: (1) bridging research and practice, (2) building the motivation and capacity of service delivery organizations (e.g., schools, hospitals, clinics, and community-based organizations) to innovate, and (c) providing service delivery systems with high-quality support via training and technical assistance. The Interactive Systems Framework for Dissemination and Implementation (ISF) was developed to describe how relevant systems, organizations, and processes can interact and work toward these goals. Stimulated by the 13 articles contained in the two special issues of Strengthening the Science and Practice of Implementation Support: Evaluating the Effectiveness of Training and Technical Assistance Centers, we describe several enhancements to the ISF including: how service delivery systems can operate better, how motivation and capacity can be built, and how training and technical assistance centers can provide more evidence-informed technical assistance and other promising innovations. ISF 2.0 incorporates these and other enhancements with the goal of achieving better outcomes. We conclude that the actions and accountability of funders and of organizations and systems to funders would accelerate progress in the systems to achieve outcomes-and result in improving the science and practice of implementation support.

Despite a growing body of research demonstrating the value of using evidence-based programs and practices (EBPPs) to address health and education issues, the gap between research evidence and practice in education and human services continues to be a vexing problem. Technical assistance (TA) is widely accepted as a key strategy to support evidence-based programs and practices (EBPP) uptake and implementation. However, little is known about how TA practices are used in TA delivery. Moreover, little attention has been paid to building the capacity of TA providers and assessing the fidelity of the implementation of TA practices. The case example presented in this article describes one organization's efforts to develop common language and definitions of TA services, core principles, and methods, and to standardize the delivery of TA by enhancing the capacity and retention of TA providers. We conclude with recommendations about how like organizations can employ similar efforts to improve the quality and consistency of TA delivery, thereby establishing a foundation for building a strong evidence base.

In low- and middle-income countries (LMICs), barriers such as low system readiness, contextual mismatches, and resource limitations impede effective implementation of evidence-based interventions. This commentary offers insights into overcoming these challenges with a case study of the PRISM project, designed to reduce behavioral and psychological symptoms of dementia in older adults living in Thailand. The case highlights how combining two evidence-based models - the Reducing Disability in Alzheimer's Disease clinical intervention and the Getting To Outcomes implementation science process enhances program success. Using interviews with stakeholders across various health system levels, we identify factors critical to successful program implementation: (1) integrating interventions into policy frameworks, (2) empowering local implementers, (3) fostering collaborative learning, and (4) adapting interventions to local contexts. The case demonstrates that building system readiness through local engagement and ownership is central to scaling up health programs in LMICs. This commentary's contribution lies in its emphasis on the role of implementation science as a vehicle for translating research into practice. It presents a practical, adaptive model for embedding interventions into routine health systems, thereby offering a pathway for successfully scaling up evidence-based programs in LMICs. Such findings provide lessons for overcoming barriers to implementation in resource-limited environments.