Journal of Prevention & Intervention in the Community最新文献

Home-delivered meals have shown considerable promise in overcoming nutritional challenges among homebound older adults facing food insecurity and the risk of diabetes, while nutrition counseling provides knowledge and skills for diabetes management. The purpose of this study was to identify the impact of a program combining nutrition counseling with home-delivered meals by examining the use of hospital services 6 months before and after participating in the program. This study included 1009 clients who are at risk for diabetes and who received home-delivered meals and nutrition counseling via Meals on Wheels in Fort Worth, Texas. Hospital service data were extracted from a regional claims database. Generalized linear models were performed to examine changes in use of hospital services 6 months before and after program participation. The mean number of emergency department visits and hospitalizations decreased from 0.69 to 0.50 (p < .001) and from 0.35 to 0.22 (p < .001), respectively. The findings of this study indicate that combining structured nutritional counseling with home-delivered meals may contribute to reducing healthcare use among older adults facing the challenges of diabetes and food insecurity.

Objective: This study aims to determine whether current tobacco and/or alcohol use is associated with setting preferences for seeking support for substance use (SU) and mental health (MH) services to African Americans ages 50 and older.

Methods: Data from 368 African American individuals (aged 50+) who participated in a community-based needs assessment survey were used. Preferences included community-based (e.g., health centers) and traditional settings (e.g., doctor's office). SU was measured as a categorical variable detailing past-month use of conventional cigarettes and alcohol graded by risk levels. Logistic regression models tested the associations between SU and setting preference before and after adjusting for the influence of self-reported MH diagnoses.

Results: Prior to adjustment for the influence of MH outcomes, high-risk use of tobacco and alcohol in the past month was associated with a lower odds of preferring MH/SU support in traditional settings (OR = 0.23, 95% CI = 0.06-0.85) compared to participants engaged in no-/low- risk substance use. This association was no longer significant after accounting for the influence of mental health symptoms and covariates.

Discussion: These results provide preliminary evidence that mental health outcomes mediate the association between substance use and setting preference for seeking MH/SU support in traditional settings.

Translational significance: This exploratory study encourages additional investigation of the association between substance use, setting preferences, and the likelihood of seeking treatment in community health centers using larger sample sizes. Additional opportunities to offer mental health/substance use support to African American older adults within clinical settings should be explored.

A collaborative partnership among community-based organizations (CBOs) could strengthen local services and enhance the capacity of a community to provide services as well as meet the diverse needs of older adults. The United Way of Tarrant County developed the LIVE WELL Initiative, partnering with six CBOs to provide nine evidence-based or evidence-informed health interventions to improve the health and lower healthcare costs of vulnerable individuals at risk for poor health. The nine programs include specific target areas, such as falls prevention, chronic disease self-management, medication management, and diabetes screening and education. A total of 63,102 clients, nearly 70% of whom were older adults, were served through the Initiative. Significant improvements in self-reported health status were observed among served clients. The percentage of clients reporting self-rated health as good, very good, and excellent increased from 47.5% at baseline to 61.1% at follow-up assessment. The mean healthy days improved from 16.9 days at baseline to 20.6 days at follow-up assessment. Additional improvements in program-specific outcomes demonstrated significant impacts of targeted intervention focus among served clients by program. The findings of this study emphasize that the impact of a collaborative partnership with multiple CBOs could promote health and well-being for older adults.

Community-level health promotion programs offer opportunities to improve the lives of older adults and improve the cultural narrative about aging. However, age-discrimination, ageism, and negative attitudes about aging, across the systematic ecological community levels have undermined older adult health. While the longevity of a society is a marker for success worldwide, age-discrimination and ageism, seen through limited community-level health advancement opportunities, have thwarted progress toward societal elderhood, even in the most developed and advanced nations. As a society, we need to continue to push for community-level prevention and intervention across the older age spectrum, to continue human advancement through late life.

The following paper is the result of a semester-long program evaluation course at Spalding University, located in Louisville, Kentucky. During the course, the students were connected to Bridgehaven, a community based psychiatric rehabilitation and recovery program, also located in Louisville, Kentucky. The researchers of this project studied the long-term effectiveness of its Cognitive Enhancement Therapy (CET) program. Based on the data, the results did not yield significant results. However, this is potentially due to the low sample size and incomplete data set. In lieu of this, the researchers offered some recommendations to improve the collection of client information and possible future research.

This article presents the reflections and insights of a graduate of Spalding's Psy.D. program who took the Program Evaluation course that is the focus of this special issue 20 years ago and has made Program Evaluation a central component of his career. Helpful elements of the course are noted as are ways that the course could have been strengthened then as well as now. Implications of these insights for the future of the course are also detailed.

This cross-sectional study was conducted as an experiential project in a graduate Program Evaluation class. We worked together as a team to solve difficulties that occurred when evaluating a program for the first time, including overcoming initial fears and identifying the appropriate focus. The goal of this study was to identify the most common barriers to attendance at Bridgehaven Mental Health Services, a community-based outpatient program tailored to aid in the transition from hospitals to community living. External barriers to attendance were examined by an adapted version of the Structural Barriers to Clinic Attendance Scale (SCBA) and a researcher-created qualitative measure. Between-group t-tests and non-parametric analyses indicated that a far walk from the bus stop and negative perceptions of staff behavior were significant external barriers to Bridgehaven attendance among 42 adult members with severe mental illness. Additionally, themes from the qualitative data revealed that 74.7% of members viewed other obligations and appointments as barriers to their attendance. About half of the members surveyed indicated the positive impact of groups on attendance. Overall findings revealed the importance of considering external barriers, particularly issues related to transportation, scheduling, and social perceptions when identifying solutions to declining attendance rates. Through the process of conducting this study, we learned invaluable skills (e.g., problem-solving, teamwork, collaboration, and flexibility) that will carry with us as we evaluate programs in the future.

A program evaluation of a community outpatient mental health program was conducted as part of a required course in Spalding University's School of Professional Psychology. Specifically, the program evaluation examined how the client-specific factors of motivation to change were related to attendance and participation in services. Motivation to change was assessed by surveying program participants utilizing the University of Rhode Island Change Assessment (URICA). Students hypothesized stage of change would be significantly correlated with attendance rates. Results indicate stage of change was related to attendance, with pre-contemplation scores negatively associated with attendance although most of the specific analyses were not statistically significant. Students' experiences and feedback regarding conducting the program evaluation are discussed.

This article provides details of the background for the focus of this special issue-the accounts from groups of students who conducted evaluations of a local agency while enrolled in a Program Evaluation course in a Psy.D program. These projects were a part of the 5th year that students in the course worked explicitly with an agency on a Program Evaluation. Important themes and insights from the experiences of all 5 years are presented. Analysis of course evaluation data indicates these evaluation group projects were associated with a significant increase in the rating students gave the course. Comments from students on the evaluation forms likewise support the value of this experience, as well as pointing out some additional areas for consideration.