AN EVALUATION OF A NEW HIRE TRAINING PROGRAM FOR MENTAL HEALTH STAFF IN A NONPROFIT ORGANIZATION

Thesis (Ed.D.) – Indiana University, Department of Instructional Systems Technology, 2021In nonprofit organizations, direct support staff members offering direct services to clients are essential to the day-to-day operations and continuity of client services and care. Despite this critical role, there has been limited research conducted to determine today’s direct support staff's essential training needs. Hence, the primary purpose of this evaluative case study was to assess the strengths, weaknesses, opportunities, and threats of the new hire on-the-job training offered to a group of direct support staff, residential and group home teacher counselors, across two southern states in a U.S. nonprofit organization serving children with mental, behavioral, and emotional disorders. This study’s secondary purpose was to provide recommended areas for improvement of the training. This evaluative case study used the Questionnaire for Professional Training Evaluation (Q4TE), semi-structured interviews, and a document review to answer two research questions. The study findings indicate that direct support staff members have an affinity for workshop-style training and de-escalation approaches such as Collaborative Problem Solving, which enable them to better manage challenging client behaviors in the field of mental health care. The study findings also indicate that direct support staff in nonprofits can be inundated with text-based content in online training modules due to federal and state laws requiring that specific topics be covered. In addition, direct support staff can experience a significant level of discomfort with physical restraints, and thus, special attention should be given to restraints training and development. This study identified opportunities via web-conferencing and videos as having benefits for enhancing the on–the-job training experience of teacher counselors

Dietary Fructose and Glucose Differentially Affect Lipid and Glucose Homeostasis1–3

Absorbed glucose and fructose differ in that glucose largely escapes first-pass removal by the liver, whereas fructose does not, resulting in different metabolic effects of these 2 monosaccharides. In short-term controlled feeding studies, dietary fructose significantly increases postprandial triglyceride (TG) levels and has little effect on serum glucose concentrations, whereas dietary glucose has the opposite effects. When dietary glucose and fructose have been directly compared at ∼20–25% of energy over a 4- to 6-wk period, dietary fructose caused significant increases in fasting TG and LDL cholesterol concentrations, whereas dietary glucose did not, but dietary glucose did increase serum glucose and insulin concentrations in the postprandial state whereas dietary fructose did not. When fructose at 30–60 g (∼4–12% of energy) was added to the diet in the free-living state, there were no significant effects on lipid or glucose biomarkers. Sucrose and high-fructose corn syrup (HFCS) contain approximately equal amounts of fructose and glucose and no metabolic differences between them have been noted. Controlled feeding studies at more physiologic dietary intakes of fructose and glucose need to be conducted. In our view, to decrease the current high prevalence of obesity, dyslipidemia, insulin resistance, and diabetes, the focus should be on restricting the intake of excess energy, sucrose, HFCS, and animal and trans fats and increasing exercise and the intake of vegetables, vegetable oils, fish, fruit, whole grains, and fiber