Quality of implementation in evidence-based positive parenting programs in Spain: Introduction to the special issue

The main contribution of this special issue is to present evaluation studies involving large-scale experiences of implementation of positive parenting programs delivered through home, group-based, and on-line formats in Spain. Two research questions were addressed: (1) what factors affect implementation; and (2) for whom and under which implementation conditions the programs lead to positive outcomes. Target populations were mainly families from low and middle socioeconomic backgrounds, and parents at psychosocial risk attending family support services in need of improving their parenting skills. All the programs fall under the umbrella of the positive parenting initiative launched by the Council of Europe, are evidence-based, follow a collaborative schema with national, regional, or local authorities, have multi-site implementation, and are supported by highly experienced researchers from Spanish universities. Special attention is given to the program adaptations to different contexts, the profile of parents who benefited most from the programs, analyses of the implementation process, and the assessment of parenting programs in the community. The information provided will help to increase our knowledge of evidence-based parenting programs in Spain, their implementation processes and results, and the future challenges that need to be addressed to continue the current expansion of evidence-based parenting programs.

Uso de literatura infantil para o desenvolvimento de capacidades emocionais

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Educacional

Efetividade da visita domiciliária na prevenção e reincidência da violência e maustratos sobre crianças e jovens

Introdução Os maus tratos e violência sobre crianças e jovens são um problema civilizacional, estando associados a múltiplos de fatores ambientais e familiares. Agir profissionalmente neste contexto requer o desenvolvimento de programas efetivos. A visita domiciliária é uma intervenção que potencia o estabelecimento de relações confiáveis e próximas entre profissionais de saúde, famílias, e comunidade (Barlow, Davis, Jarret, Mclntosh, Mockford, & Stewart-Brown, 2006), no entanto as evidências sobre a sua efetividade como programa preventivo nesta área não são ainda suficientemente fortes. Objetivos A visita domiciliar é uma intervenção realizada por enfermeiros. No entanto, carece ainda de evidência acerca dos seus benefícios, na prevenção da violência e maus tratos, ou reduzir a sua reincidência, sobre crianças e jovens. Neste contexto, o objetivo central desta investigação consistiu em identificar evidências de efetividade da visita domiciliária na prevenção ou reincidência dos maus tratos sobre crianças e jovens. Metodologia Procedemos a uma revisão integrativa da literatura. Com a expressão de pesquisa Child* AND Neglect* AND Home visiting program* AND Effectiveness*, selecionámos as bases de dados online: Medline; Cinahl; MedicLatina; Academic Search Complete. Através da estratégia PICO, definimos critérios de inclusão e exclusão dos artigos. Incluímos: Participantes - grávidas e pais de crianças até aos cinco anos de idade. Intervenções - a visita domiciliária. Comparações - entre os participantes que receberam visitas domiciliárias e participantes que receberam os cuidados habituais. Outcomes - Elementos caraterizadores de efetividada da vista. Resultados Como principais elementos de caraterizadores da efetividade da visita retivemos os seguintes: - Geralmente os programas de visita domiciliária são mais efetivos na prevenção de comportamentos abusivos do que na sua correção. - Maior prevalência de comportamentos parentais positivos, mais desenvolvimento de vínculo afetivo familiar e maior capacitação parental. - Maior potencial de ajustamento e recurso a estratégias de coping em situações genericamente potenciadoras de stress. Nestas salientam-se os efeitos significativamente mais positivos nas famílias com problemas socioeconómicos e pais com bebés prematuros. - Identificação precoce de situações de vulnerabilidade, potenciadoras de violência, especialmente se realizadas no período pré-natal. - Ao nível da reincidência dos maus tratos é evidenciado, no curto prazo, uma redução significativa do número de agressões físicas e de negligência. - A efetividade é maior em mães jovens e primíparas, quando comparadas com mães multíparas, visto o seu comportamento poder tornar-se mais flexível, plástico e ajustado. - Há necessidade deste programas terem continuidade, refletindo custos elevados. Conclusões Os programas de visita domiciliária têm efetividade em algumas situações. No entanto, se a promoção do papel parental é efetiva, as vantagens podem ser de curto prazo, exigindo continuidade nos programas. Beneficiam particularmente famílias com desvantagens comparativas, em situações de risco socioeconómico, e vulnerabilidades diversas. A visita pré-natal realizada por enfermeiros é especialmente útil e preventiva em mães jovens e primíparas. No entanto, há dúvidas sobre o custo-benefício de alguns programas, obrigando a desenho suficientemente personalizados, tendo em atenção as diferenças de contexto, cultura, valores, crenças, e amplitude de fatores interferentes no funcionamento de cada família.

Efetividade da visita domiciliária na prevenção e reincidência da violência e maustratos sobre crianças e jovens

Introdução Os maus tratos e violência sobre crianças e jovens são um problema civilizacional, estando associados a múltiplos de fatores ambientais e familiares. Agir profissionalmente neste contexto requer o desenvolvimento de programas efetivos. A visita domiciliária é uma intervenção que potencia o estabelecimento de relações confiáveis e próximas entre profissionais de saúde, famílias, e comunidade (Barlow, Davis, Jarret, Mclntosh, Mockford, & Stewart-Brown, 2006), no entanto as evidências sobre a sua efetividade como programa preventivo nesta área não são ainda suficientemente fortes. Objetivos A visita domiciliar é uma intervenção realizada por enfermeiros. No entanto, carece ainda de evidência acerca dos seus benefícios, na prevenção da violência e maus tratos, ou reduzir a sua reincidência, sobre crianças e jovens. Neste contexto, o objetivo central desta investigação consistiu em identificar evidências de efetividade da visita domiciliária na prevenção ou reincidência dos maus tratos sobre crianças e jovens. Metodologia Procedemos a uma revisão integrativa da literatura. Com a expressão de pesquisa Child* AND Neglect* AND Home visiting program* AND Effectiveness*, selecionámos as bases de dados online: Medline; Cinahl; MedicLatina; Academic Search Complete. Através da estratégia PICO, definimos critérios de inclusão e exclusão dos artigos. Incluímos: Participantes - grávidas e pais de crianças até aos cinco anos de idade. Intervenções - a visita domiciliária. Comparações - entre os participantes que receberam visitas domiciliárias e participantes que receberam os cuidados habituais. Outcomes - Elementos caraterizadores de efetividada da vista. Resultados Como principais elementos de caraterizadores da efetividade da visita retivemos os seguintes: - Geralmente os programas de visita domiciliária são mais efetivos na prevenção de comportamentos abusivos do que na sua correção. - Maior prevalência de comportamentos parentais positivos, mais desenvolvimento de vínculo afetivo familiar e maior capacitação parental. - Maior potencial de ajustamento e recurso a estratégias de coping em situações genericamente potenciadoras de stress. Nestas salientam-se os efeitos significativamente mais positivos nas famílias com problemas socioeconómicos e pais com bebés prematuros. - Identificação precoce de situações de vulnerabilidade, potenciadoras de violência, especialmente se realizadas no período pré-natal. - Ao nível da reincidência dos maus tratos é evidenciado, no curto prazo, uma redução significativa do número de agressões físicas e de negligência. - A efetividade é maior em mães jovens e primíparas, quando comparadas com mães multíparas, visto o seu comportamento poder tornar-se mais flexível, plástico e ajustado. - Há necessidade deste programas terem continuidade, refletindo custos elevados. Conclusões Os programas de visita domiciliária têm efetividade em algumas situações. No entanto, se a promoção do papel parental é efetiva, as vantagens podem ser de curto prazo, exigindo continuidade nos programas. Beneficiam particularmente famílias com desvantagens comparativas, em situações de risco socioeconómico, e vulnerabilidades diversas. A visita pré-natal realizada por enfermeiros é especialmente útil e preventiva em mães jovens e primíparas. No entanto, há dúvidas sobre o custo-benefício de alguns programas, obrigando a desenho suficientemente personalizados, tendo em atenção as diferenças de contexto, cultura, valores, crenças, e amplitude de fatores interferentes no funcionamento de cada família.

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies who refer the possible positive effects of physical exercise in functional consequences of PAD.

Intermittent claudication and physical exercise: effectiveness of a home-based program

Peripheral arterial disease (PAD) as a high incidence in general population and 12% to 20% of population with more than 60 years has already clinical symptoms, such as intermittent claudication (IC), pain, loss of strength and functional incapacity. There are already some studies that refer the possible positive effects of physical exercise in functional consequences of PAD. The purpose of this study was to verify the results of a home-based (HB) weekly supervised physical exercise program in patients with IC in consequence of PAD in lower limbs, and observe the medium number of diary steps walked by the subjects of our study.

The effectiveness of a teacher’s training workshop on Media Smart Program

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

The effectiveness of the Media Smart Program on promoting the critical thinking of children towards the use of celebrities in television advertising

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

A randomized controlled trial of the effectiveness of a Computer-Assisted Cognitive Remediation (CACR) program in adolescents with psychosis or at high risk of psychosis: Short term and long term outcomes

The present study investigates the short- and long-term outcomes of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk. 32 adolescents participated in a blinded 8-week randomized controlled trial of CACR treatment compared to computer games (CG). Clinical and neuropsychological evaluations were undertaken at baseline, at the end of the program and at 6-month. At the end of the program (n = 28), results indicated that visuospatial abilities (Repeatable Battery for the Assessment of Neuropsychological Status, RBANS; P = .005) improved signifi cantly more in the CACR group compared to the CG group. Furthermore, other cognitive functions (RBANS), psychotic symptoms (Positive and Negative Symptom Scale) and psychosocial functioning (Social and Occupational Functioning Assessment Scale) improved signifi cantly, but at similar rates, in the two groups. At long term (n = 22), cognitive abilities did not demonstrated any amelioration in the control group while, in the CACR group, signifi cant long-term improvements in inhibition (Stroop; P = .040) and reasoning (Block Design Test; P = .005) were observed. In addition, symptom severity (Clinical Global Improvement) decreased signifi cantly in the control group (P = .046) and marginally in the CACR group (P = .088). To sum up, CACR can be successfully administered in this population. CACR proved to be effective over and above CG for the most intensively trained cognitive ability. Finally, on the long-term, enhanced reasoning and inhibition abilities, which are necessary to execute higher-order goals or to adapt behavior to the ever-changing environment, were observed in adolescents benefi ting from a CACR.

Cost-effectiveness of an exercise intervention program in perimenopausal women: the Fitness League Against MENopause COst (FLAMENCO) randomized controlled trial.

BACKGROUND The high prevalence of women that do not reach the recommended level of physical activity is worrisome. A sedentary lifestyle has negative consequences on health status and increases health care costs. The main objective of this project is to assess the cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. METHODS/DESIGN The present study is a Randomized Controlled Trial. A total of 150 eligible women will be recruited and randomly assigned to either a 16-week exercise intervention (3 sessions/week), or to usual care (control) group. The primary outcome measure is the incremental cost-effectiveness ratio. The secondary outcome measures are: i) socio-demographic and clinical information; ii) body composition; iii) dietary patterns; iv) glycaemic and lipid profile; v) physical fitness; vi) physical activity and sedentary behaviour; vii) sleep quality; viii) quality of life, mental health and positive health; ix) menopause symptoms. All outcomes will be assessed at baseline and post intervention. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct a cost effectiveness analysis from a health system perspective. DISCUSSION The intervention designed is feasible and if it proves to be clinically and cost effective, it can be easily transferred to other similar contexts. Consequently, the findings of this project might help the Health Systems to identify strategies for primary prevention and health promotion as well as to reduce health care requirements and costs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02358109 . Date of registration: 05/02/2015.

Effectiveness of the KiVa Antibullying Program

According to the participant role approach (Salmivalli, Lagerspetz, Björkqvist, Österman, & Kaukiainen, 1996), bullying is a group phenomenon that is largely enabled and maintained by the classmates taking on different participant roles (e.g., reinforcers or assistants of the bully). There is, however, very little evidence on whether the bystander behaviors actually have an effect on the risk for victimization. Furthermore, the participant role approach implies that the bystanders should be used in putting an end to bullying. This view has been put into practice in the KiVa antibullying program, but it has not yet been investigated whether the program is effective. Four studies were conducted to investigate, (a) whether the behaviors of bystanders have an effect on the risk for victimization (Study I) and (b) whether the KiVa program reduces bullying and victimization and has other beneficial effects as well (Studies II–IV). The participants included large samples of elementary and lower secondary school students (Grades 1–9) from Finland. The assessments were done with web-based questionnaires including questions about bullying and victimization (both self- and peer reports), and about several bullying-related constructs. The results of this thesis suggest that bystander behaviors in bullying situations may influence the risk for victimization of vulnerable students. Moreover, the results indicate that the KiVa antibullying program is effective in reducing victimization and bullying. The program effects are larger in elementary schools than in lower secondary schools, whereas in Grades 8 and 9, they are larger for boys than girls for some peer-reported outcomes. The magnitude of the overall effects can be considered practically significant when obtained in a large-scale dissemination of the program.

Effectiveness of life skills training on the total behaviour of six individuals in a job preparation program

In the first week of a Job preparation Program all twelve female members of the class were invited to be part of a study to determine the effect of Life Skills training on their behaviour over the twelve-week period of the program. Six females volunteered and each was interviewed four times during the Job preparation Program and once after the program ended. The interviews focused on three areas of skill deficiency addressed in Life Skills lessons: their knowledge about themselves and attitude towards themselves; their interpersonal relationships; and their problem-solving ability. The participants' comments over the sixteen-week period of the interviews were used to decide if the total behaviour of the participants, (i.e., what they did, thought, and felt) changed so that each became more effective in satisfying her needs. The study suggested that the total behaviour of three of the six women changed so that they became more effective in satisfying their needs. The fourth female's total behaviour changed in only two of the three areas focused on in the interviews, and the total behaviour of the fifth and sixth females showed no change.

The Effectiveness of the precision fluency shaping program controlling stuttering behaviour in adults

This study was done to test the effectiveness of the Precision Fluency Shaping Program in controlling stuttering behaviour in adults. Two sites were chosen, each using the Precision Fluency Shaping Program to treat stuttering. At each clinic, a Speech Patbologist made a random selection of the subjects' pre- and post-therapy video-taped interviews, totalling 20 in all. During the interviews, the clients were asked questions and re~d a short passage to determine the frequency of stuttering in natural conversation and in reading. Perceptions of Stuttering Inventory questionnaires vvere also filled in before and after therapy. Two judges were trained to identify stuttering behaviour, and were given an inter-rater reliability test at selected intervals throughout the study. Protocols",:m.a;d;6 of each interview tape, were scored for (a) stuttering behaviour and (b) words spoken or read. An Analysis of Variance Repeated Measures Test was used to compare before and after scores of conversations, readings, and Perceptions of Stuttering Inventory to determine whether the Precision Fluency Shaping Program controlled stuttering behaviour significantly. A Pearson R Correlation Test was also administered to determine if a relationship existed bet\veen Perceptions of Stuttering Inventory and (i) conversation and (ii) reading scores.

The effectiveness of a multisensory writing program in improving cursive writing ability in children with sensorimotor difficulties

It is estimated that five to ten percent of children experience sensory motor difficulties that result in various learnlng disabilitiies , among them. inabllity to output Information on paper in the appropriate manner (Ayres ,1985). The relationship between sensorimotorabillty and handwriting is well documented in the literature (Freeman,1917; Townsend , 1951; Nlkola-Ll sa, 1987). While much of the literature is inconclusive, there are findings to suggest that muitisensory handwriting programmes are an effective approach to improvlng writing abIlity in these chlldren. For a number of years, Occupational Therapists have been involved in the remediation of handwriting utllizing , amongst other approaches . multisensory programmes. While subjective assessments of effectiveness have been extremerly positive. scientIfic evaluation has been minimal . If further intervention in this area is to occur, it Is essential that the profession be able to justify the existence of such programmes . The purpose of this study was to examine what effects a multlsensory writing prog~am would have on the curslve writing ability of chlldren with sensorimotor dlfficulties. A single case with multiple baselines across be havlours design was used , with the behavlours being cursive writing abilIty of fIve distInct letter groups. The fIve groups were taught in random order, one group every two weeks , In a one-hour session. Repeated measurements of writing speed and qualIty for each letter group were made. This design was repeated over three other cases . Results of the study yielded statistical signifi cance in trend changes In specIfic letter groups for all of the chlldren following interventlon. One child achieved statistical significance In the overall change In quality , while none of the children achieved overall statistical significance In speed score changes . Teacher reports and an assessment of written language prior to and following the program suggest that Intervention may have had a positive effect on self-confidence in written output, and on the maturlty of written expression in some of the cases . Further research in this field is needed to validate the continual use of multisensory writing programmes by Occupational Theraplsts worklng with this specific population and to provide some directlon with regards to the Integration of multlsensory writing programmes within the regular academic remedial programme .