Use of Theory-Driven Report back to Promote Lung Cancer Risk Reduction

Report back is active sharing of research findings with participants to prompt behavior change. Research on theory-driven report back for environmental risk reduction is limited. The study aim is to evaluate the impact of a stage-tailored report back process with participants who had high home radon and/or air nicotine levels. An observational one-group pre-post design was used, with data collection at 3, 9, and 15 months post intervention. Participants from the parent study (N = 515) were randomized to the treatment or control group and this sample included all 87 treatment participants who: (1) had elevated radon and/or air nicotine at baseline; and (2) received stage-tailored report back of their values. Short-term test kits measured radon; passive airborne nicotine samplers assessed secondhand smoke (SHS) exposure. Stage of action was categorized as: (1) ‘Unaware’, (2) ‘Unengaged’, (3) ‘Deciding’, (4) ‘Action’, and (5) ‘Maintenance’. Interventions were provided for free, such as in-person radon and SHS test kits and a brief telephonic problem-solving consultation. Stage of action for radon mitigation and smoke-free policy increased from baseline to 3 months and remained stable between 3 and 9 months. Stage of action for radon was higher at 15 months than baseline. Among those with high baseline radon, observed radon decreased by 15 months (p \u3c 0.001). Tailored report back of contaminant values reduced radon exposure and changed the health behavior necessary to remediate radon and SHS exposure

Authentic Youth Engagement in Environmental Health Research and Advocacy

Training in environmental health (EH) engages and inspires youth to tackle health promotion and policy change. Yet, there is little guidance on how to successfully nurture and sustain youth engagement. This paper compares four case studies of youth engagement to promote EH in rural and urban communities using the Youth Empowerment Solutions (YES!) framework. Of the case studies in rural (Central Appalachia) and urban (Cincinnati, Ohio) communities, two employ citizen science approaches using PhotoVoice and environmental sampling; one engages youth in a science communication camp; and one focuses on policy advocacy. We compare and contrast these case studies using the YES! Critical Components and Empowerment levels. The case studies were discussed at the 2020 Partnerships in Environmental Public Health Meeting, where participants identified challenges and possible solutions for promoting and maintaining authentic youth engagement in EH research and advocacy. Analysis of the case studies indicated that youth engagement activities focusing on the individual were more common than those targeting the organizational setting or the community. Youth demonstrate agency to impact EH issues in their communities by engaging in hands-on opportunities to practice citizen science and advocacy. Overcoming challenges to authentic young engagement is important to sustain this work

'You've got to keep account of heads all the time': staff perceptions of caring for people with dementia

Research aim: Little is known regarding the pressures of working within dementia care units, as the majority of literature has focused broadly on long-term care rather than the provision of specialised dementia care. This study aimed to explore the perceptions of staff in relation to their capacity to manage behaviour and care needs of people with dementia living within the dementia-specific environment. Individual interviews were conducted with 35 care staff from three dementia care units in Brisbane, Australia. Major findings: Four themes were identified: role definition, relationships, workplace environment, and workforce issues. Although the findings highlight the importance of peer support for staff when managing difficult situations, questions regarding the quality of peer support and its impact on care provision were raised. Conclusions: Dementia units are complex systems with well-motivated and educated staff contributing to the effectiveness of the care. An understanding of care staff, perceptions of their role and its effects on care practices can help to identify appropriate support structures and training strategies, thereby improving job satisfaction for staff and quality of life for the residents with dementia.Griffith Health, School of Nursing and MidwiferyFull Tex

Routine activities and proactive police activity: a macro-scale analysis of police searches in London and New York City

This paper explored how city-level changes in routine activities were associated with changes in frequencies of police searches using six years of police records from the London Metropolitan Police Service and the New York City Police Department. Routine activities were operationalised through selecting events that potentially impacted on (a) the street population, (b) the frequency of crime or (c) the level of police activity. OLS regression results indicated that routine activity variables (e.g. day of the week, periods of high demand for police service) can explain a large proportion of the variance in search frequency throughout the year. A complex set of results emerged, revealing cross-national dissimilarities and the differential impact of certain activities (e.g. public holidays). Importantly, temporal frequencies in searches are not reducible to associations between searches and recorded street crime, nor changes in on-street population. Based on the routine activity approach, a theoretical police-action model is proposed

Cops, Teachers, and the Art of the Impossible: Explaining the lack of diffusion of impossible job innovations

In their now classic Impossible Jobs in Public Management, Hargrove and Glidewell (1990) argue that public agencies with limited legitimacy, high conflict, low professional authority, and weak agency myths have essentially impossible jobs. Leaders of such agencies can do little more than cope, which is also a theme of James Q. Wilson (1989), among others. Yet in the years since publication of Impossible Jobs, one such position, that of police commissioner has proven possible. Over a sustained 17-year period, the New York City Police Department has achieved dramatic reductions in crime with relatively few political repercussions, as described by Kelling and Sousa (2001). A second impossible job discussed by Wilson and also by Frederick Hess (1999), city school superintendent, has also proven possible, with Houston and Edmonton having considerable academic success educating disadvantaged children. In addition, Atlanta and Pittsburgh enjoyed significant success in elementary schooling, though the gains were short-lived for reasons we will describe. More recently, under Michelle Rhee, Washington D.C. schools have made the most dramatic gains among city school systems. These successes in urban crime control and public schooling have not been widely copied. Accordingly, we argue that the real conundrum of impossible jobs is why agency leaders fail to copy successful innovations. Building on the work of Teodoro (2009), we will discuss how the relative illegitimacy of clients and inflexibility of personnel systems combine with the professional norms, job mobility and progressive ambition of agency leaders to limit the diffusion of innovations in law enforcement and schooling. We will conclude with ideas about how to overcome these barriers