A Geospatial Analysis of CDC-funded HIV Prevention Programs for African Americans in the United States

Given the increase in HIV/AIDS infection rates among racial and ethnic minorities, particularly African Americans, this study was undertaken as part of a larger research effort to examine the distribution of HIV prevention services focusing on African American populations within the United States. Data were gathered via a national survey of community-based organizations (CBOs) funded by the Centers for Disease Control and Prevention (CDC). A geocoded national database was constructed to identify, locate, and map these HIV prevention programs. A total of 1,020 CBOs responded to the survey, yielding a response rate of 70.3%. These CBOs administered a total of 3,028 HIV prevention programs. Data describing intervention types and persons served, combined with the address and service area of responding CBOs, were integrated with census data (2000) and analyzed by using a geographic information system (GIS). The results of our national level analysis show that HIV prevention services for African Americans have fair coverage where African Americans comprise a substantial proportion of the population in urban areas in northeastern states, but that HIV prevention services for African Americans are inadequately distributed in the southeastern states. A local-level analysis was conducted for Alabama, where 68% of HIV/AIDS cases are among African Americans. Specific interventions such as street and community outreach, health communications, and public information are fairly well provided to African Americans in more urban cities in Alabama, however, individual- and group-level interventions have poor coverage in rural areas where a large percentage of African-Americans live. Overall, our study illustrates that the use of GIS adds value when used with other data sources to provide prevention services that are accessible to the populations most in need

Restructuring the Michigan Child Care Fund: Reducing Costs and Improving Outcomes

Michigan’s policy to distribute the Child Care Fund (CCF) to counties at a flat rate of 50% as stated in the Michigan Comprehensive Laws 400.117a provides no structured incentive to the counties to use evidence based practices that are cost-effective for locally based delinquent youth intervention programs. This policy analysis answers the following questions: (1) would retaining delinquent youth in the community produce a cost benefit and/or better outcomes than confinement and (2) is public safety at risk if delinquent youth are retained in the community? Utilizing a policy analysis framework our evidence found that community based services provide better outcomes than confinement for delinquent youth and that retaining delinquent youth in the community does not represent an increased risk to public safety. Policy change is recommended to incentivize the use of best practices which may produce significant economic and social benefits to the state and delinquent youth who should receive the best possible care. This can be accomplished through a shift in state reimbursement rates from the current 50% rate to an increased rate for evidence based strategies

Using an Accessible Room Multisensory Stimulation Environment to Reduce Dementia Associated Behaviors

Objectives: To reveal whether an accessible open floorplan Multisensory Stimulation Environment (MSSE) room design has a positive impact as a nonpharmacologic intervention for episodes of Behavioral and Psychological Symptoms of Dementia (BPSD) in older adults living in a Memory Care Assisted Living (MCAL) facility as well as reducing the need for direct care supervision. Methods: Retrospective pre/post cohort design of 24 residents living in a Midwest MCAL facility in the United States with a diagnosis of dementia and over 65 years of age, analyzed by secondary medical chart review for 12 months to assess impact of an accessible open floorplan MSSE room design. The pre/post design analyzed secondary data over two periods of time; 6 months prior to the MSSE installation and 6 months following the MSSE installation. Results: Following the installation of an open floorplan MSSE, the number of observed BPSD episodes changed from 367 (17%) pre-test to 298 (10%) post-test over a 12-month time period. The Comparison of Proportions test determined that the difference in the proportion of BPSD episodes documented was statistically significant with clinical implications. Conclusions: The accessible open floorplan MSSE room design, located within a single-site MCAL facility, utilized as a nonpharmacological intervention for BPSD, was found in this explorative study to be effective and potentially clinically meaningful in improving behavioral episodes for older adults diagnosed with dementia in MCAL settings

Aesthetic sense and social cognition: : a story from the Early Stone Age

Human aesthetic practices show a sensitivity to the ways that the appearance of an artefact manifests skills and other qualities of the maker. We investigate a possible origin for this kind of sensibility, locating it in the need for co-ordination of skill-transmission in the Acheulean stone tool culture. We argue that our narrative supports the idea that Acheulean agents were aesthetic agents. In line with this we offer what may seem an absurd comparison: between the Acheulean and the Quattrocento. In making it we display some hidden complexity in human aesthetic responses to an artefact. We conclude with a brief review of rival explanations—biological and/or cultural—of how this skills-based sensibility became a regular feature of human aesthetic practices

Psychometric evaluation of goal orientation measures in sport

The concept of achievement goals has received increasing attention in recent years among researchers in sport psychology. The two types of goal orientation conceived in academic settings, namely 'task' and 'ego', have been the focus of much research and form the basis of several instruments designed to measure achievement goals in sport. The unmodified use of these constructs has been criticized, however, and some caution needs to be exercised in employing the existing scales. The current paper reviews recent arguments relating to the concepts termed goal orientation and goal involvement. It also provides an empirical examination of these critiques through close scrutiny of data collected from 201 athletes who completed four different instruments purporting to measure goal orientation. Confirmatory factor analysis and “latent-trait” Rasch analyses were performed on scores obtained from these measures. Results confirmed that the concept of goal orientation should be further operationalized and the concepts better defined. Furthermore, the establishment of specific measurement tools for goal involvement and orientation has to be preceded by a clear conceptual distinction between the two concepts, and a clear definition of the components and structure of a transitory state of goal involvement

A national, geographic database of CDC-funded HIV prevention services: development challenges and potential applications

Abstract Background From 2000–2002, the Centers for Disease Control and Prevention (CDC) funded a study that was designed to improve the information available to program planners about the geographic distribution of CDC-funded HIV prevention services provided by community-based organizations (CBOs). Program managers at CDC recognized the potential of a geographic information system (GIS) to organize and analyze information about HIV prevention services and they made GIS a critical component of the study design. The primary objective of this study was to construct a national, geographically-referenced database of HIV prevention services provided by CDC-funded CBOs. We designed a survey instrument to collect information about the geographic service areas where CBOs provided HIV prevention services, then collected data from CBOs that received CDC funding for these services during fiscal year 2000. We developed a GIS database to link questionnaire responses with GIS map layers in a manner that would incorporate overlapping geographies, risk populations and prevention services. We collected geographic service area data in two formats: 1) geopolitical boundaries and 2) geographic distance. Results The survey response rate was 70.3%, i.e. 1,020 of 1,450 community-based organizations responded. The number of HIV prevention programs administered by each CBO ranged from 1 to 23. The survey provided information about 3,028 prevention programs, including descriptions of intervention types, risk populations, race and ethnicity, CBO location and geographic service area. We incorporated this information into a large GIS database, the HIV Prevention Services Database. The use of geopolitical boundaries provided more accurate results than geographic distance. The use of a reference map with the questionnaire improved completeness, accuracy and precision of service area data. Conclusion The survey instrument design and database development procedures that we used for this study successfully met our objective. The development of the HIV Prevention Services Database for CDC is an important step toward the implementation of a spatial decision support system. Due to the costs involved in a nationwide survey such as this, we recommend that future data collection efforts use Web-based survey methodologies that incorporate interactive maps.</p

Validating the Utility of the Spanish Version of the American Diabetes Association Risk Test

The American Diabetes Association (ADA) Risk Test, often used for decisions to blood glucose screen or not, lacks studies reporting the reliability or validity for the Spanish version of the tool. The objective of this study is to further validate the utility of the Spanish version of theADA’s RiskTest for Latino Populations. A convenience sample of 316 Latinos participated in this study. A positive but weak statistical correlation was found between blood glucose and the Risk Test score (.138), suggesting low reliability and validity of the Spanish version of the instrument. Two internal consistency estimates of reliability techniques were computed for the Risk Test for diabetes scale items, indicating low reliability