Supporting early oral language skills for English language learners in inner city preschool provision

BACKGROUND: A significant number of children now enter formal education in England with reduced levels of proficiency in oral language. Children who come from disadvantaged backgrounds and who are English language learners (ELL) are at risk of limited oral language skills in English which impacts on later educational achievement. AIMS: This paper reports the development of a theoretically motivated oral language intervention, Talking Time, designed to meet the needs of preschool children with poor language skills in typical preschool provision. SAMPLE: One hundred and forty-two 4-year-old children attending three inner city preschools in a disadvantaged area of London, England. METHOD: This is a quasi-experimental intervention study comparing children exposed to Talking Time with children exposed to a contrast intervention and children receiving the statutory early years curriculum. Measures were taken of both targeted and non-targeted language and cognitive skills. RESULTS: Data were analysed for the ELL. The intervention had a significant effect on vocabulary, oral comprehension, and sentence repetition but not narrative skills. As predicted, there were no effects on the skills which were not targeted. CONCLUSIONS: Regular evidence-based oral language interactions can make significant improvements in children's oral language. There is a need to examine the efficacy of more intensive interventions to raise language skills to allow learners to access the curriculum

Lessons Learned from Community-Based Participatory Research: Establishing a Partnership to Support Lesbian, Gay, Bisexual and Transgender Aging-in-Place.

BACKGROUND: Due to a history of oppression and lack of culturally competent services, lesbian, gay, bisexual and transgender (LGBT) seniors experience barriers to accessing social services. Tailoring an evidence-based ageing in place intervention to address the unique needs of LGBT seniors may decrease the isolation often faced by this population. OBJECTIVE: To describe practices used in the formation of a community-based participatory research (CBPR), partnership involving social workers, health services providers, researchers and community members who engaged to establish a LGBT ageing in place model called Seniors Using Supports To Age In Neighborhoods (SUSTAIN). METHODS: A case study approach was employed to describe the partnership development process by reflecting on past meeting minutes, progress reports and interviews with SUSTAIN's partners. RESULTS: Key partnering practices utilized by SUSTAIN included (i) development of a shared commitment and vision; (ii) identifying partners with intersecting spheres of influence in multiple communities of identity (ageing services, LGBT, health research); (iii) attending to power dynamics (e.g. equitable sharing of funds); and (iv) building community capacity through reciprocal learning. Although the partnership dissolved after 4 years, it served as a successful catalyst to establish community programming to support ageing in place for LGBT seniors. CONCLUSION: Multi-sector stakeholder involvement with capacity to connect communities and use frameworks that formalize equity was key to establishing a high-trust CBPR partnership. However, lack of focus on external forces impacting each partner (e.g. individual organizational strategic planning, community funding agency perspectives) ultimately led to dissolution of the SUSTAIN partnership even though implementation of community programming was realized.Ye

What patients want: Relevant health information technology for diabetes self-management.

Health information technology has great potential to promote efficiency in patient care and increase patient-provider communication, and patient engagement in their treatment. This paper explored qualitatively what patients with type 2 diabetes want from electronic resources that are designed to support their diabetes self-management. Data were collected via interviews and focus groups from managed care patients who had completed participation in either a web-based (MyPath) or in-person group-based (¡Viva Bien!) longitudinal diabetes self-management study. Content analysis identified common themes that highlighted participant interest in virtual and electronic programs to support diabetes self-management goals, and their desired content and features. Eighteen ¡Viva Bien! participants completed telephone interviews and 30 MyPath participants attended seven focus groups in 2010-2011. All participants expressed a preference for face-to-face contact; however, most participants were also interested in using technology as a tool to support daily diabetes self-management decisions and to receive tailored information. Choice of technology, personalized instruction on how to use program features, and the ability to exchange information with their healthcare team were desired by all participants. Participants were divided on whether virtual social support networks should be closed to friends and family, should include other program members (peers), or should be open to anyone with diabetes. Participants aged 65 and older stressed the desire for technical support. What patients wanted from technology is real-time assistance with daily behavioral decision-making, ability to share information with their healthcare team, connections with others for support, and choice.Ye

Safe, Affordable, Convenient: Environmental Features of Malls and Other Public Spaces Used by Older Adults for Walking.

BACKGROUND: Midlife and older adults use shopping malls for walking, but little research has examined mall characteristics that contribute to their walkability. METHODS: We used modified versions of the Centers for Disease Control and Prevention (CDC)-Healthy Aging Research Network (HAN) Environmental Audit and the System for Observing Play and Recreation in Communities (SOPARC) tool to systematically observe 443 walkers in 10 shopping malls. We also observed 87 walkers in 6 community-based nonmall/nongym venues where older adults routinely walked for physical activity. RESULTS: All venues had public transit stops and accessible parking. All malls and 67% of nonmalls had way finding aids, and most venues (81%) had an established circuitous walking route and clean, well-maintained public restrooms (94%). All venues had level floor surfaces, and one-half had benches along the walking route. Venues varied in hours of access, programming, tripping hazards, traffic control near entrances, and lighting. CONCLUSIONS: Despite diversity in location, size, and purpose, the mall and nonmall venues audited shared numerous environmental features known to promote walking in older adults and few barriers to walking. Future research should consider programmatic features and outreach strategies to expand the use of malls and other suitable public spaces for walking.Ye

Assessing language skills in adolescents with autism spectrum disorder

Language abilities in adolescents with autism spectrum disorders (ASDs) are variable and can be challenging to ascertain with confidence. This study aimed to compare and evaluate different forms of language assessment: standardized language testing, narrative analysis and parent/teacher reports. 14 adolescents with ASD and 14 typically developing adolescents matched on age, gender and nonverbal ability were assessed using a number of standardized assessments for receptive and expressive language skills, a standardized narrative test, two experimental narrative assessments and a parent/teacher report measure of pragmatics. The findings were that, although adolescents with ASD scored within the normal range on expressive and receptive language, their performance on narrative tasks revealed difficulties with both structural and evaluative language. It should be noted that both teachers and parents rated the pragmatic language skills of the young people with ASD as significantly lower than those of the typically developing group but parents were more likely than teachers to additionally identify difficulties in speech and syntax. The implications of these results for professionals in terms of assessing the language skills of adolescents with ASD and for the planning of appropriate intervention are discussed

Examining the sustainability potential of a multisite pilot to integrate alcohol screening and brief intervention within three primary care systems.

The U.S. Preventive Services Task Force recommends that clinicians adopt universal alcohol screening and brief intervention as a routine preventive service for adults, and efforts are underway to support its widespread dissemination. The likelihood that healthcare systems will sustain this change, once implemented, is under-reported in the literature. This article identifies factors that were important to post implementation sustainability of an evidence-based practice change to address alcohol misuse that was piloted within three diverse primary care organizations. The Centers for Disease Control and Prevention funded three academic teams to pilot and evaluate implementation of alcohol screening and brief intervention within multi clinic healthcare systems in their respective regions. Following the completion of the pilots, teams used the Program Sustainability Assessment Tool to retrospectively describe and compare differences across eight sustainability domains, identify strengths and potential threats to sustainability, and make recommendations for improvement. Health systems varied across all domains, with greatest differences noted for Program Evaluation, Strategic Planning, and Funding Stability. Lack of funding to sustain practice change, or data monitoring to promote fit and fidelity, was an indication of diminished Organizational Capacity in systems that discontinued the service after the pilot. Early assessment of sustainability factors may identify potential threats that could be addressed prior to, or during implementation to enhance Organizational Capacity. Although this study provides a retrospective assessment conducted by external academic teams, it identifies factors that may be relevant for translating evidence-based behavioral interventions in a way that assures that they are sustained within healthcare systems.Ye