Impact of a participatory program to reduce noise in a Neonatal Unit

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.

A behavioral intervention in a cohort of Japanese-Brazilians at high cardiometabolic risk

OBJECTIVE: To assess the effect of a health promotion program on cardiometabolic risk profile in Japanese-Brazilians. METHODS: A total of 466 subjects from a study on diabetes prevalence conducted in the city of Bauru, southeastern Brazil, in 2000 completed a 1-year intervention program (2005-2006) based on healthy diet counseling and physical activity. Changes in blood pressure and metabolic parameters in the 2005-2006 period were compared with annual changes in these same variables in the 2000-2005 period. RESULTS: During the intervention, there were greater annual reductions in mean (SD) waist circumference [-0.5(3.8) vs. 1.2(1.2) cm per year, p<0.001], systolic blood pressure [-4.6(17.9) vs. 1.8(4.3) mmHg per year, p<0.001], 2-hour plasma glucose [-1.2(2.1) vs. -0.2(0.6) mmol/L per year, p<0.001], LDL-cholesterol [-0.3(0.9) vs. -0.1(0.2) mmol/L per year, p<0.001] and Framingham coronary heart disease risk score [-0.25(3.03) vs. 0.11(0.66) per year, p=0.02] but not in triglycerides [0.2(1.6) vs. 0.1(0.42) mmol/L per year, p<0.001], and fasting insulin level [1.2(5.8) vs. -0.7(2.2) IU/mL per year, p<0.001] compared with the pre-intervention period. Significant reductions in the prevalence of impaired fasting glucose/impaired glucose tolerance and diabetes were seen during the intervention (from 58.4% to 35.4%, p<0.001; and from 30.1% to 21.7%, p= 0.004, respectively). CONCLUSIONS: A one-year community-based health promotion program brings cardiometabolic benefits in a high-risk population of Japanese-Brazilians.

Determining acquisition and cessation antecedents to adolescent cigarette smoking for development of intervention strategies

Our national focus and emphasis on the promotion of healthy behavior choices regarding tobacco and other drugs continues to target adolescents. Multiple studies have shown that adolescence is the optimum period for the prevention of substance use initiation as life-long patterns of health behaviors are established during this critical developmental stage. Tobacco use is associated with an increase in morbid and mortal health conditions of which prevalence increases throughout the lifespan. Attention to the antecedents of preventable health conditions aims to modify the risks and identify health promotion factors. Modifying antecedent factors for tobacco initiation in youth and identifying protective factors for successful smoking cessation has major public health implications across the lifespan. Of foremost interest are those risk factors and resultant behaviors that predict a youth's probability of initiating cigarette use and their cessation of cigarette use. Specifically, this dissertation supports previous results identifying intervention variables on the initiation/cessation continuum model especially with the established predictors of smoking (decisional balance and susceptibility) and with more recently identified predictors of smoking (nicotine dependence and withdrawal symptoms) in current and former smokers in a sample of high school students in Austin and Houston, Texas. These results offer insight for the development of appropriate intervention program strategies for our youth. ^

A formative evaluation of the American Diabetes Association's Choosing Health and Sensible Exercise childhood obesity intervention

Background. The increasing prevalence of overweight among youth in the United States, and the parallel rise in related medical comorbidities has led to a growing need for efficient weight-management interventions. Purpose. The aim of this study was to evaluate the effects of the Choosing Health and Sensible Exercise (C.H.A.S.E.) childhood obesity prevention program on Body Mass Index (BMI), physical activity and dietary behaviors. Methods. This study utilized de-identified data collected during the fall 2006 session of the C.H.A.S.E. program. A total of 65 students at Woodview Elementary School and Deepwater Elementary School participated in this intervention. The C.H.A.S.E. program is a 10-week obesity prevention program that focuses on nutrition and physical activity education. Collection of height and weight data, and a health behavior survey was conducted during the first and last week of the intervention. Paired t-tests were used to determine statistically significant differences between pre- and post-intervention measurements. One-way analysis of variance was used to adjust for potential confounders, such as gender, age, BMI category ("normal weight", "at risk overweight", or "overweight"), and self-reported weight loss goals. Data were analyzed using STATA, v. 9.2. Results. A significant decrease in mean BMI (p< 0.05) was found after the 10-week intervention. While the results were statistically significant for the group as a whole, changes in BMI were not significant when stratified by age, sex, or ethnicity. The mean overall scores for the behavior survey did not change significantly pre- and post-intervention; however, significant differences were found in the dietary intention scale, indicating that students were more likely to intend to make healthier food choices (p<0.05). No statistically significant decreases in BMI were found when stratified for baseline BMI-for-age percentiles or baseline weight loss efforts (p>0.05). Conclusion. The results of this evaluation provide information that will be useful in planning and implementing an effective childhood obesity intervention in the future. Changes in the self-reported dietary intentions and BMI show that the C.H.A.S.E. program is capable of modifying food choice selection and decreasing BMI. Results from the behavior questionnaire indicate that students in the intervention program were making changes in a positive direction. Future implementation of the C.H.A.S.E. program, as well as other childhood obesity interventions, may want to consider incorporating additional strategies to increase knowledge and other behavioral constructs associated with decreased BMI. In addition, obesity prevention programs may want to increase parental involvement and increase the dose or intensity of the intervention. ^

An intervention mapping approach: Identification of human trafficking victims by health professionals

Background. Today modern day slavery is known as human trafficking and is a growing pandemic that is a grave human rights violation. Estimates suggest that 12.3 million people are working under conditions of force, fraud or coercion. Working toward eradication is a worthy effort; it would free millions of humans from slavery, mostly women and children, as well as uphold basic human rights. One tactic to eradicating human trafficking is to increase identification of victims among those likely to encounter victims of human trafficking.^ Purpose. This study aims to develop an intervention that improves certain stakeholders' ability, in the health clinic setting, to appropriately identify and report victims of human trafficking to the National Human Trafficking Resource Center.^ Methods. The Intervention Mapping (IM) process was used by program planners to develop an intervention for health professionals. This methodology is a six step process that guides program planners to develop an intervention. Each step builds on the others through the execution of a needs assessment, and the development of matrices based on performance objectives and determinants of the targeted health behavior. The end product results in an ecological, theoretical, and evidence based intervention.^ Discussion. The IM process served as a useful protocol for program planners to take an ecological approach as well as incorporate theory and evidence into the intervention. Consultation with key informants, the planning group, adopters, implementers, and individuals responsible for institutionalization also contributed to the practicality and feasibility of the intervention. Program planners believe that this intervention fully meets recommendations set forth in the literature.^ Conclusions. The intervention mapping methodology enabled program planners to develop an intervention that is appropriate and acceptable to the implementer and the recipients.^

A Young Child's Anxiety and Math Performance: Enhancing Cognitive Behavioral Intervention with Conjoint Behavioral Consultation

Partnering with families, school personnel, and community resources is an important step to supporting the child and family, especially when children might suffer from debilitating anxiety concerns. However, little research examines the impact of anxiety on math performance for young children participating in school-based interventions enhanced by family components. The following research questions were addressed in the study: 1a) Will a young child with elevated levels of anxiety show a decrease in anxiety symptoms with a Cognitive Behavioral framework intervention program for children? 1b) Will anxiety be reduced with the addition of a Conjoint Behavioral Consultation with the family and teacher? 2a) Will a young child show an increase in math performance after participation in a Cognitive Behavioral framework intervention program for children? 2b) Will math performance be increased with the addition of a Conjoint Behavioral Consultation with the family and teacher? A single-subject staggered baseline across situations intervention study addressed whether the Coping Cat, an evidenced-based child-focused intervention now widely used in schools and clinics to treat childhood anxiety, combined with family and school consultation will decrease elevated anxiety levels and improve math performance in an elementary-aged student. The objective was to support mental health development and math performance with an eight-year-old, female elementary student through a collaborative effort of stakeholders in the student's life. Baseline data was collected with repeated measures of anxiety and math performance, and was compared to two intervention phases: first, a child-focused intervention and second, a family and school consultation. The study tested the theory that the Cognitive Behavioral intervention and Conjoint Behavioral Consultation intervention will influence, positively, the anxiety levels and math performance for an elementary-aged student. Results indicate that the child participant with elevated levels of anxiety showed a reduction in symptoms with the introduction of a Cognitive Behavioral framework intervention when compared to her baseline data. The participant showed further reduction in symptoms across the school and home settings with the implementation of Conjoint Behavioral Consultation when compared to baseline and the first intervention phase. Math performance began to increase with the introduction of the Cognitive Behavioral intervention, and continued to improve with the implementation of the Conjoint Behavioral Consultation. Findings suggest that consultation should begin immediately when an intervention is implemented in order to enhance outcomes.

Developing a Citizen Volunteer Lake Monitoring Program for the Flathead Basin in Northwestern Montana for the early Detection and Prevention of the Introduction of Zebra Mussels and other Aquatic Invasive Species (AIS)

Preventing the introduction of aquatic invasive species (AIS) like zebra and quagga mussels in the U.S. is a high priority. This Capstone demonstrates zebra and quagga mussels are of concern as aquatic invasive species and a volunteer monitoring and intervention program is an effective means for early detection of AIS. This Capstone developed an AIS citizen volunteer lake monitoring program consistent with other programs concerned about AIS prevention and early detection. This Capstone concludes implementing such a voluntary program will help reduce the spread of zebra and quagga mussels and will provide early detection information to appropriate agencies empowered with response actions if species are found.

Increase in skin cancer screening during a community-based randomized intervention trial

Survival from cutaneous melanoma is mainly dependent on the thickness of the lesion at diagnosis. Skin screening may increase detection of thin lesions and hence improve survival. Within a community-based randomized controlled trial of a population screening program for melanoma in Queensland, Australia, 9 communities were randomly assigned to the 3-year intervention and 9 communities to the control group. Skin screening prevalence was monitored by cross-sectional surveys at baseline, 1, 2 and 3 years into the intervention and 2 years later. At baseline, prevalence of whole-body clinical skin examination was similar in intervention and control communities. In intervention communities, the prevalence of whole-body skin examinations increased to 29.2%, an absolute difference of 18% from baseline, with a peak of 34.8% 2 years after baseline, and began to decline again at the end of the intervention period. The largest increases were seen in men and women ≥50 years. Uptake of screening did not differ according to melanoma risk factors; however, the decline in screening was less in participants who reported a number of melanoma risk factors. The prevalence of skin self-examination remained stable during the intervention program. No changes were observed in the control communities. These results indicate that the intervention program significantly increased the prevalence of whole-body clinical skin examinations in intervention communities. Once the intervention program ceased, and particularly after skin clinics ceased, levels of skin screening began to decline. The provision of specialized skin screening clinics may be needed to achieve sufficient screening rates should population based screening for skin cancer be considered. © 2005 Wiley-Liss, Inc.

The identification of early factors related to academic achievement among deaf students

The purpose of this research study was to examine specific factors believed to be related to academic achievement in deaf children. More specifically, this research sought to determine whether there was a significant difference in achievement between those students whose parents use oral communication only and those whose parents use some type of sign language. An additional purpose of this research was to determine if there was a significant difference in academic achievement with those deaf students who used amplification devices early in life. This study also sought to determine whether providing early intervention program which emphasizes and enables parents to develop a language rich environment had a significant impact on the academic achievement of deaf children and whether the age at which initial services are received influence deaf student's subsequent academic achievement. This study examined the relationship, if any, between intellectual ability and academic achievement among deaf children. Finally, this study sought to investigate the relationship between the degree of hearing loss and academic achievement. ^ Purposive sampling was used to select subjects for this study. All 228 eligible Deaf/Hard of Hearing (DHH) students enrolled in a Broward County Public School were included in the original sample. Sixty-one students actually participated in this study. A correlational method of statistical analysis as well as a cross classification (crosstabs) was used to analyze the data. ^ The results show that academic achievement in the areas of reading and mathematics was significantly related to parental mode of communication and the mode of communication used in school. Academic achievement, in the area of reading, was also signficantly related to intellectual ability. The reading achievement was also found to be significantly related to degree of hearing loss. Written language was not significantly related to any factors investigated in this study. ^ Additional research should be conducted to further investigate the low academic achievement among deaf children. The diversity among signing systems at school and between home and school should also be analyzed. Finally, future studies should examine curriculum and instruction methods to increase the academic achievement of deaf children. ^

Truancy reduction: Extension of a county program

The primary purpose of this research was to examine the effect of the Truancy Intervention Program (TIP) on attendance patterns of elementary school students. Longitudinal archival data were used from Miami-Dade County Public School system's data system, ISIS. Data included the students' school information from fifth through ninth grade for attendance, academic grades, referral information, and referral consequences. The sample for this study was drawn from students at TIP-participating M-DCPS elementary schools in Miami-Dade County. Data collected spanned five years for each participant from the fifth grade to the ninth grade. To examine the effect of TIP on attendance, participation in middle school TIP was compared with non-TIP participation. In addition to immediate effects on attendance, the durability of the effects of TIP was studied through an analysis of attendance at the ninth grade level. A secondary purpose was to examine the relation of TIP participation to Grade Point Average (GPA). ^ The data were analyzed using 2 (group) x 3 (grade) Repeated Measures Analysis of Variance (ANOVA) on yearly attendance (number of absences), and grade point average for each year. The interaction between group and grade was significant. Post hoc tests indicated that absences were not significantly different in the two programs in seventh, eighth or ninth grade. Students enrolled in a middle school with TIP showed a significantly higher number of absences in ninth grade than for seventh or eighth grade. There were no differences by grade level for students enrolled in non-TIP middle schools. GPA analysis indicated that students enrolled in a non-TIP middle school had a significantly higher GPA across seventh, eighth, and ninth grades when compared to students enrolled at a TIP middle school. ^ An examination of attendance disciplinary referrals and consequences further revealed that the referral rates for students enrolled at a TIP middle school were higher at the seventh, eighth, and ninth grade level, then for students enrolled at a non-TIP middle school. This pattern was not readily apparent at non-TIP middle schools. Limitations of the research were noted and further research regarding program implementation (process evaluation) was suggested. ^

The impact of a family home-learning program on levels of parental/caregiver efficacy

This study sought to determine if participation in a home education learning program would impact the perceived levels of parental self-efficacy of parents/caregivers who participate in the completion of home-learning assignments and increase their levels of home-learning involvement practices. Also, the study examined the relationship between the parental involvement practice of completing interactive home-learning assignments and the reading comprehension achievement of first grade students. A total of 146 students and their parents/caregivers representing a convenience sample of eight first grade classes participated in the study. Four classes (n=74) were selected as the experimental group and four classes (n=72) served as the control group. There were 72 girls in the sample and 74 boys and the median age was 6 years 6 months. The study employed a quasi-experimental research design utilizing eight existing first grade classes. It examined the effects of a home-learning support intervention program on the perceived efficacy levels of the participating parents/caregivers, as measured by the Parent Perceptions of Parent Efficacy Scale (Hoover-Dempsey, Bassler, & Brissie, 1992) administered on a pre/post basis. The amount and type of parent involvement in the completion of home assignments was determined by means of a locally developed instrument, the H.E.L.P. Parent Involvement Home-learning Scale, administered on a pre/post basis. Student achievement in reading comprehension was measured via the reading subtest of the Brigance, CIB-S pre and post. The elementary students and their parents/caregivers participated in an interactive home-learning intervention program for 12 weeks that required parent/caregiver assistance. Results revealed the experimental group of parents/caregivers had a significant increase in their levels of perceived self-efficacy, p<.001, from the pre to post, and also had significantly increased levels of parental involvement in seven home-learning activities, p<.001, than the control group parents/caregivers. The experimental group students demonstrated significantly higher reading levels than the control group students, p<.001. This study provided evidence that interactive home-learning activities improved the levels of parental self-efficacy and parental involvement in home-learning activities, and improved the reading comprehension of the experimental group in comparison to the control.

The effects of an individualized clinical reading program on kindergarten and beginning grade one at -risk students: A longitudinal study

This was a longitudinal study that investigated the effects of an early intervention program which was implemented at the beginning of formal reading instruction and used individual clinical instruction with at-risk students. A total of 37 private school students were divided into three cognitive ability groups and evaluated over a three year period using the reading comprehension and study skills sections of the Stanford Achievement Tests (1982) administered annually. At-risk students were matched with a normal peer group for gender, cognitive ability, and time at school. Results showed there were no significant differences in the reading comprehension scores for program and non-program students. However, the at-risk group showed significantly lower scores on the study skills section at the end of grade three. These results indicate that early reading intervention for at-risk students promotes compensation and helps develop processes for adequate reading comprehension but these students continue to have weaker linguistic abilities. ^

The Impact of a Family Home-learning Program on levels of Parental/Caregiver Efficacy

This study sought to determine if participation in a home education learning program would impact the perceived levels of parental self-efficacy of parents/caregivers who participate in the completion of home-learning assignments and increase their levels of home-learning involvement practices. Also, the study examined the relationship between the parental involvement practice of completing interactive home-learning assignments and the reading comprehension achievement of first grade students. A total of 146 students and their parents/caregivers representing a convenience sample of eight first grade classes participated in the study. Four classes (n=74) were selected as the experimental group and four classes (n=72) served as the control group. . There were 72 girls in the sample and 74 boys and the median age was 6 years 6 months. The study employed a quasi-experimental research design utilizing eight existing first grade classes. It examined the effects of a home-learning support intervention program on the perceived efficacy levels of the participating parents/care¬givers, as measured by the Parent Perceptions of Parent Efficacy Scale (Hoover-Dempsey, Bassler, & Brissie, 1992) administered on a pre/post basis. The amount and type of parent involvement in the completion of home assignments was determined by means of a locally developed instrument, the H.E.L.P. Parent Involvement Home-learning Scale, administered on a pre/post basis. Student achievement in reading comprehension was measured via the reading subtest of the Brigance, CIB-S pre and post. The elementary students and their parents/caregivers participated in an interactive home-learning intervention program for 12 weeks that required parent/caregiver assistance. Results revealed the experimental group of parents/caregivers had a significant increase in their levels of perceived self-efficacy, p<.001, from the pre to post, and also had significantly increased levels of parental involvement in seven home-learning activities, p<.001, than the control group parents/caregivers. The experimental group students demonstrated significantly higher reading levels than the control group students, p<.001. This study provided evidence that interactive home-learning activities improved the levels of parental self-efficacy and parental involvement in home-learning activities, and improved the reading comprehension of the experimental group in comparison to the control.

FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

Effects of a rhythmic and choreographic program in obese and overweight participants

Introduction: Currently there is a growing trend in the prevalence of overweight and obesity. This increased prevalence trend leads to an increase in the costs of health care. Objective: The aim of the present study was to analyze the effects on physical fitness and bone mineral density through an intervention program of physical activity based on rhythmic and choreographic activities in an overweight and obese population. Method: An 8-month physical activity based on rhythmic and choreographic activities was conducted in overweight and obese people. Thirty-four participants aged 50.43 ± 10.57 with a body mass index (BMI) 38.37 ± 4.82 took part in the physical activity program. This study assesses the effects of fitness, percentage of body fat and bone mineral density (BMD). Results: After an 8-month physical activity intervention program based on rhythmic and choreographic activities, significant differences were found in: percentage of body fat (p = 0.004), aerobic capacity (p = 0.023), flexibility of the lower limbs (flexibility in the right leg p = 0.029 and left leg p = 0.002), balance (p < 0.001), strength in lower limbs (p = 0..003) and strength in upper limbs (p < 0.001). Besides that, significant differences were found in parameters related with BMD such as T-Score (p = 0.025) and Z-Score (p = 0.012), Bone Quality Index (BQI) (p = 0.026) and an increase in Broadband Ultrasound Attenuation (BUA) although not a statistically significant one (p = 0.939). Conclusions: These findings suggest that a physical activity program based on rhythmic and choreographic activities can act as a preventive method of mobility and fragility, as well as preventing bone loss.