Description de l’implantation d’un programme de prévention des problèmes de comportement à l’adolescence

This paper describes a comprehensive approach to preventing a variety of adolescent problem behaviors, including drug use, delinquency, violence, school dropout and teenage pregnancy. The experimental intervention is designed to enhance protection and reduce risk for these adolescent problem behaviors. The project, Raising Healthy Children (RHC), extends earlier work conducted in the Seattle Social Development Project (Hawkins, Catalano, Morrison, O'Donnell, Abbott & Day, 1992; O'Donnell, Hawkins, Catalano, Abbott & Day, 1995). The interventions are guided by the Social Development Model (Catalano & Hawkins, 1996), a theory that explains the development of both prosocial and antisocial behavior. Because risk and protective factors for these problems are found in multiple social domains, the interventions address these factors through developmentally appropriate strategies in the three major socializing institutions, the family, school, and peer groups. The "school intervention strategy " provides a series of instructional improvement workshops and classroom coaching designed to increase student's commitment and attachment to school while reducing academic failure. The "family intervention strategy " provides parenting workshops and home-based services to increase parents' skills in child rearing, to increase attachment and commitment to the family while decreasing family management problems. The "peer intervention strategy" provides children the opportunity to learn and practice social and emotional skills in the classroom and in social situations. These combined strategies are described in detail. Preliminary analyses reveal significant effects of these strategies on reducing early risk and increasing protection

What exactly do RCT findings tell us in education research?

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.The paper addresses issues related to whether null RCT findings can by themselves be a secure indicator of programme failure. This is done by drawing on the findings of the evaluation of the Integrated Group Reading (IGR) programme using a number of teacher case studies. The case studies illustrate how the same intervention can be implemented differently in local circumstances, with different outcomes. The different ways in which IGR was implemented reflect how teachers experienced the pressures of the national curriculum, their attitudes to the IGR approach to reading, the school ethos and the resources and support available – and point to how IGR use might be enhanced to result in more significant reading gains. The paper argues that in addition to the statistical findings evaluators ought to pay attention to the context in which a programme is implemented, especially when it comes to complex interventions trialled in real classrooms. It is also concluded that it is preferable to avoid asking whether a programme works or not for all and under any circumstances. A focus on the different ways that programmes work under different circumstances and when implemented by different people is a more useful perspective. This might not provide the certainty that policy makers would likely opt for, but it captures more the complexity associated with teaching programme evaluation.The IGR project has been funded by the Nuffield Foundation. The views expressed are those of the authors and not necessarily those of the Foundation

Help when it's needed first: A controlled evaluation of brief, preventive behavioral family intervention in a primary care setting

This study evaluated the effects of a brief 3- to 4-session behavioral family intervention program for parents of preschool-aged children in a primary care setting, compared to parents in a wait-list control condition. Parents receiving the Primary Care Triple P-Positive Parenting Program intervention reported significantly lower levels of targeted child behavior problems, dysfunctional parenting, and reduced parental anxiety and stress in comparison to wait-listed parents at postassessment. These short-term effects were largely maintained at 6-month follow-up assessment of the intervention group. Implications of these findings for the prevention of behavioral and emotional problems in children are discussed

Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol

<p>Abstract</p> <p>Background</p> <p>Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. There is some evidence to suggest that these poor health outcomes are partly due to clinical practice variation, which can stem from failure to apply the best available research evidence in clinical practice, otherwise known as knowledge translation (KT). Surprisingly, clinical practice variation, even for common acute paediatric conditions, is pervasive. Clinical practice variation results in unnecessary medical treatments, increased suffering, and increased healthcare costs. This study focuses on improving health outcomes for common paediatric acute health concerns by evaluating strategies that improve KT and reduce clinical practice variation.</p> <p>Design/Methods</p> <p>Using a multiple case study design, qualitative and quantitative data will be collected from four emergency departments in western Canada. Data sources will include: pre- and post-implementation focus group data from multidisciplinary healthcare professionals; individual interviews with the local champions, KT intervention providers, and unit/site leaders/managers; Alberta Context Tool (ACT) survey data; and aggregated patient outcome data. Qualitative and quantitative data will be systematically triangulated, and matrices will be built to do cross-case comparison. Explanations will be built about the success or lack of success of the clinical practice guidelines (CPG) and clinical pathways (CPs) uptake based upon the cross-case comparisons.</p> <p>Significance</p> <p>This study will generate new knowledge about the potential causal mechanisms and factors which shape implementation. Future studies will track the impact of the CPG/CPs implementation on children's health outcome, and healthcare costs.</p

Girls' disruptive behavior and its relationship to family functioning: A review

Although a number of reviews of gender differences in disruptive behavior and parental socialization exist, we extend this literature by addressing the question of differential development among girls and by placing both disruptive behavior and parenting behavior in a developmental framework. Clarifying the heterogeneity of development in girls is important for developing and optimizing gender-specific prevention and treatment programs. In the current review, we describe the unique aspects of the development of disruptive behavior in girls and explore how the gender-specific development of disruptive behavior can be explained by family linked risk and protective processes. Based on this review, we formulate a gender-specific reciprocal model of the influence of social factors on the development of disruptive behavior in girls in order to steer further research and better inform prevention and treatment programs

Advancing Research on Racial–Ethnic Health Disparities: Improving Measurement Equivalence in Studies with Diverse Samples

To conduct meaningful, epidemiologic research on racial–ethnic health disparities, racial–ethnic samples must be rendered equivalent on other social status and contextual variables via statistical controls of those extraneous factors. The racial–ethnic groups must also be equally familiar with and have similar responses to the methods and measures used to collect health data, must have equal opportunity to participate in the research, and must be equally representative of their respective populations. In the absence of such measurement equivalence, studies of racial–ethnic health disparities are confounded by a plethora of unmeasured, uncontrolled correlates of race–ethnicity. Those correlates render the samples, methods, and measures incomparable across racial–ethnic groups, and diminish the ability to attribute health differences discovered to race–ethnicity vs. to its correlates. This paper reviews the non-equivalent yet normative samples, methodologies and measures used in epidemiologic studies of racial–ethnic health disparities, and provides concrete suggestions for improving sample, method, and scalar measurement equivalence

A cluster randomised controlled trial of an intervention to promote healthy lifestyle habits to school leavers:Study rationale, design, and methods

BACKGROUND: Physical inactivity and a poor diet predict lifestyle diseases such as diabetes, cardiovascular disease, and certain types of cancer. Marked declines in physical activity occur during late adolescence, coinciding with the point at which many young people leave school and enter the workforce and begin to take greater control over their lifestyle behaviours. The work outlined within this paper sought to test a theoretically-informed intervention aimed at supporting increased engagement in physical activity and healthy eating habits in young people at the point of transition from school to work or work-based learning. As actively engaging young people in initiatives based on health messages is challenging, we also tested the efficacy of financial incentives in promoting initial engagement with the programme. METHODS/DESIGN: A three-arm cluster-randomised design was used. Participants were school pupils from Year 11 and 13 (i.e., in their final year of study), aged 16–18 years. To reduce contamination effects, the unit of randomisation was school. Participants were randomly allocated to receive (i) a 12-week behavioural support intervention consisting of six appointments, (ii) a behavioural support intervention plus incentives (totalling £40), or (iii) an information-only control group. Behavioural support was provided by fitness advisors at local leisure centres following an initial consultation with a dietician. Sessions focused on promoting habit formation through setting implementation intentions as part of an incremental goal setting process. Consistent with self-determination theory, all advisors were trained to provide guidance in an autonomy-supportive manner so that they were equipped to create a social context supportive of autonomous forms of participant motivation. The primary outcome was objectively assessed physical activity (via GT1M accelerometers). Secondary outcome measures were diet, motivation and habit strength. Data were collected at baseline, post-intervention (12 weeks) and 12 months. DISCUSSION: Findings of this trial will provide valuable insight into the feasibility of promoting autonomous engagement in healthy physical activity and dietary habits among school leavers. The research also provides much needed data and detailed information related to the use of incentives for the initial promotion of young peoples’ behaviour change during this important transition. TRIAL REGISTRATION: The trial is registered as Current Controlled Trials ISRCTN55839517