The Survey of Attitudes Toward Homeless People: The Validation of a New Instrument Assessing Negative Attitudes Toward Homeless People

Homeless individuals are often the targets of negative stereotypes and significant stigmatization, which can contribute to restrictive and punitive approaches to ending homelessness. Many researchers and policymakers have sought to understand and change attitudes toward the homeless to allow for consideration of a broader range of responses to addressing homelessness. Despite attention paid to understanding attitudes, a lack of reliable and valid measurement creates methodological barriers to assessing people’s attitudes and comparing those attitudes across studies and populations. Attitudes toward homeless persons have been demonstrated to be quite complex, which has likely impeded the development of valid and reliable measurement tools. There is a need to identify those elements of psychological theory that can best represent people’s complex attitudes toward homeless individuals. This dissertation proposed a new theoretical framework for understanding attitudes toward homeless people by integrating four theories: stereotype content model, dehumanization, attribution theory, and integrated threat theory. This model was used to inform item development for an assessment tool that reliably measures attitudes toward homeless persons. This dissertation aimed to develop a valid and reliable measure of cognitive attitudes toward homeless people that clarifies the complexities of attitudes toward the homeless. It was conducted in three studies. Study 1 included a factor analysis of a large dataset (n = 899) from community random digit dial surveys to examine the psychometric properties of the most commonly used measure of attitudes toward homelessness, the Attitudes toward Homelessness Inventory (Kingree & Daves, 1997). Study 2 developed and tested a large item pool based on the constructs proposed in the theoretical framework. The item pool was pilot tested online (n = 2105). The best performing items were selected to create the one-factor Survey of Attitudes toward Homeless People (SAHP). In Study 3, confirmatory factor analysis was used to verify the one-factor structure and item fit in a new online sample (n = 824). In addition, construct validity and test-retest reliability was examined to establish the SAHP’s nomological network and to examine stability. The final 9-item measure demonstrated excellent internal consistency, strong test-retest reliability at 9 months, and strong construct validity (i.e., strong associations with intergroup disgust sensitivity, intergroup anxiety, blame, anger, pity, help, danger, fear, avoidance, segregation, coercion, past contact with homeless individuals, and germ aversion). The new measure offers a more reliable and more theoretically-based assessment of attitudes toward homeless individuals, which may afford greater personalization of interventions targeting public attitude change

Psycho-Ecological Systems Model: A Systems Approach to Planning and Gauging the Community Impact of Community-Engaged Scholarship

This article presents the Psycho-Ecological Systems Model (PESM) – an integrative conceptual model rooted in General Systems Theory (GST). PESM was developed to inform and guide the development, implementation, and evaluation of transdisciplinary (and multilevel) community-engaged scholarship (e.g., a participatory community action research project undertaken by faculty that involves graduate and/or undergraduate students as service-learning research assistants). To set the stage, the first section critiques past conceptual models. Following a description of GST, the second section provides a comprehensive description of PESM, which represents an integration of three conceptual developments: the ecological systems model (Bronfenbrenner, 1979), the biopsychosocial model (Kiesler, 2000), and the principle of reciprocal determinism (Bandura, 1978). In the third section, we discuss implications of PESM for community-based research. A greater emphasis on the development of integrative conceptual frameworks may increase the likelihood that community-based research projects will: (a) address complex questions; (b) develop and implement efficacious (and sustainable) transdisciplinary (and multilevel) projects; (c) assess constructs at multiple levels using a blend of quantitative and qualitative approaches; and (d) utilize multiple research designs and methods to systematically examine hypotheses regarding a project’s influence on outcome variables and process variables

Replication of an emergency department-based recovery coaching intervention and pilot testing of pragmatic trial protocols within the context of Indiana's Opioid State Targeted Response plan

Solving the opioid crisis requires immediate, innovative, and sustainable solutions. A number of promising strategies are being carried out by U.S. states and territories as part of their Opioid State Targeted Response (STR) plans funded through the 21st Century Cures Act, and they provide an opportunity for researchers to assess effectiveness of these interventions using pragmatic approaches. This paper describes a pilot study of Project Planned Outreach, Intervention, Naloxone, and Treatment (POINT), the intervention that served as the basis for Indiana's STR-funded, emergency department (ED)-based peer specialist expansion that was conducted in preparation for a larger, multisite pragmatic trial. Through the pilot, we identified, documented, and corrected for challenges encountered while implementing planned study protocols. Per the project's funding mechanism, the ability to move to the larger trial was determined by the achievement of 3 milestones: (1) successful replication of the intervention; (2) demonstrated ability to obtain the necessary sample size; and (3) observe a higher level of engagement in medication for addiction treatment in the POINT group compared to standard care. Overall implementation of the study protocols was successful, with only minor refinements to proposed procedures being required in light of challenges with (1) data access, (2) recruitment, and (3) identification of the expansion hospitals. All three milestones were reached. Challenges in implementing protocols and reaching milestones resulted in refinements that improved the study design overall. The subsequent trial will add to the limited but growing evidence on ED-based peer supports. Capitalizing on STR efforts to study an already scaling and promising intervention is likely to lead to faster and more sustainable results with greater generalizability than traditional, efficacy-focused clinical research

A Technology-Based Training Tool for a Health Promotion and Sex Education Program for Justice-Involved Youth: Development and Usability Study

BackgroundJustice-involved youth are especially vulnerable to mental health distress, substance misuse, and risky sexual activity, amplifying the need for evidence-based programs (EBPs). Yet, uptake of EBPs in the justice system is challenging because staff training is costly in time and effort. Hence, justice-involved youth experience increasing health disparities despite the availability of EBPs. ObjectiveTo counter these challenges, this study develops and pilot-tests a prototype of a technology-based training tool that teaches juvenile justice staff to deliver a uniquely tailored EBP for justice-involved youth—PHAT (Preventing HIV/AIDS Among Teens) Life. PHAT Life is a comprehensive sex education, mental health, and substance use EBP collaboratively designed and tested with guidance from key stakeholders and community members. The training tool addresses implementation barriers that impede uptake and sustainment of EBPs, including staff training and support and implementation costs. MethodsStaff (n=11) from two juvenile justice settings pilot-tested the technology-based training tool, which included five modules. Participants completed measures of HIV and sexually transmitted infection (STI) knowledge, sex education confidence, and implementation outcomes such as training satisfaction, adoption, implementation, acceptability, appropriateness, and sustainability. PHAT Life trainers assessed fidelity through two activity role plays participants submitted upon completing the training modules. ResultsParticipants demonstrated increases in HIV and STI knowledge (t10=3.07; P=.01), and were very satisfied (mean 4.42, SD 0.36) with the training tool and the PHAT Life curriculum. They believed that the training tool and curriculum could be adopted, implemented, and sustained within their settings as an appropriate and acceptable intervention and training. ConclusionsOverall, the results from this pilot test demonstrate feasibility and support continuing efforts toward completing the training tool and evaluating it within a fully powered randomized controlled trial. Ultimately, this study will provide a scalable option for disseminating an EBP and offers a more cost-effective and sustainable way to train staff in an EBP

Replication of an emergency department-based recovery coaching intervention and pilot testing of pragmatic trial protocols within the context of Indiana's Opioid State Targeted Response plan

Solving the opioid crisis requires immediate, innovative, and sustainable solutions. A number of promising strategies are being carried out by U.S. states and territories as part of their Opioid State Targeted Response (STR) plans funded through the 21st Century Cures Act, and they provide an opportunity for researchers to assess effectiveness of these interventions using pragmatic approaches. This paper describes a pilot study of Project Planned Outreach, Intervention, Naloxone, and Treatment (POINT), the intervention that served as the basis for Indiana's STR-funded, emergency department (ED)-based peer specialist expansion that was conducted in preparation for a larger, multisite pragmatic trial. Through the pilot, we identified, documented, and corrected for challenges encountered while implementing planned study protocols. Per the project's funding mechanism, the ability to move to the larger trial was determined by the achievement of 3 milestones: (1) successful replication of the intervention; (2) demonstrated ability to obtain the necessary sample size; and (3) observe a higher level of engagement in medication for addiction treatment in the POINT group compared to standard care. Overall implementation of the study protocols was successful, with only minor refinements to proposed procedures being required in light of challenges with (1) data access, (2) recruitment, and (3) identification of the expansion hospitals. All three milestones were reached. Challenges in implementing protocols and reaching milestones resulted in refinements that improved the study design overall. The subsequent trial will add to the limited but growing evidence on ED-based peer supports. Capitalizing on STR efforts to study an already scaling and promising intervention is likely to lead to faster and more sustainable results with greater generalizability than traditional, efficacy-focused clinical research