Improving the Reputation of Cooperative Extension as a Source of Prevention Education for Youth and Families: The Effects of the PROSPER Model

Has the reputation of the Cooperative Extension Service (CES) changed over time as a result of its involvement in PROSPER, a community-based partnership designed to provide evidence-based prevention education programs? With deficits facing federal and state governments, budget cuts continue to threaten the viability and growth of CES. Moreover, changing legislative priorities make it easy for CES youth and family programs to be forgotten by policy makers. Thus, increasing the positive reputation of CES as an important and effective force in making the lives of youth and families better is essential for growing CES\u27s stakeholder advocate base

Salivary Cortisol Mediates Effects of Poverty and Parenting on Executive Functions in Early Childhood

In a predominantly low-income population-based longitudinal sample of 1,292 children followed from birth, higher level of salivary cortisol assessed at ages 7, 15, and 24 months was uniquely associated with lower executive function ability and to a lesser extent IQ at age 3 years. Measures of positive and negative aspects of parenting and household risk were also uniquely related to both executive functions and IQ. The effect of positive parenting on executive functions was partially mediated through cortisol. Typical or resting level of cortisol was increased in African American relative to White participants. In combination with positive and negative parenting and household risk, cortisol mediated effects of African American ethnicity, income-to-need, and maternal education on child cognitive ability.

Communication is Key: State-level Organizational Correlates of Readiness for Evidence-based Programming within the Cooperative Extension System

The necessity to implement evidence-based programs to support the healthy development of youth and families is becoming part of national policy. Organizations that are not “ready” to do so will likely lose resources, disallowing them to serve as they have set out to do. Consequently, the current survey study draws from a national sample of Cooperative Extension personnel in 2009 to examine characteristics within their organizational context that facilitate successful change related to youth/family programming. Data were collected from 946 4-H/youth development or Family and Consumer Sciences employees at all levels. Self-reported indices of each state organization’s openness to change, leadership, morale, communication, and resources were constructed to assess the organizational context. Dependent variables included indicators of readiness to implement prevention and evidence-based programming. Results suggest that the organizational context was strongly associated with indicators of readiness for evidence-based prevention programming, and specifically, the clarity of communication was most important

Modeling multiple risks during infancy to predict quality of the caregiving environment: Contributions of a person-centered approach

The primary goal of this study was to compare several variable-centered and person-centered methods for modeling multiple risk factors during infancy to predict the quality of caregiving environments at six months of age. Nine risk factors related to family demographics and maternal psychosocial risk, assessed when children were two months old, were explored in the understudied population of children born in low-income, non-urban communities in Pennsylvania and North Carolina (N = 1047). These risk factors were 1) single (unpartnered) parent status, 2) marital status, 3) mother’s age at first child birth, 4) maternal education, 5) maternal reading ability, 6) poverty status, 7) residential crowding, 8) prenatal smoking exposure, and 9) maternal depression. We compared conclusions drawn using a bivariate approach, multiple regression analysis, the cumulative risk index, and latent class analysis (LCA). The risk classes derived using LCA provided a more intuitive summary of how multiple risks were organized within individuals as compared to the other methods. The five risk classes were: married low-risk; married low-income; cohabiting multiproblem; single low-income; and single low-income/education. The LCA findings illustrated how the association between particular family configurations and the infants’ caregiving environment quality varied across race and site. Discussion focuses on the value of person-centered models of analysis to understand complexities of prediction of multiple risk factors

Investigating the Potential Causal Relationship Between Parental Knowledge and Youth Risky Behavior: a Propensity Score Analysis

This longitudinal study aims to explore the potential causal relationship between parental knowledge and youth risky behavior among a sample of rural, early adolescents (84% White, 47% male). Using Inverse Propensity Weighting, the sample was adjusted by controlling for 33 potential confounding variables. Confounding variables include other aspects of the parent-child relationship, parental monitoring, demographic variables and earlier levels of problem behavior. The effect of parental knowledge was significant for youth substance and polysubstance use initiation, alcohol and cigarette use, attitudes towards substance use, and delinquency. Our results suggest that parental knowledge may be causally related to substance use during middle school, as the relationship between knowledge and youth outcomes remained after controlling for 33 different confounding variables. The discussion focuses on understanding issues of causality in parenting and intervention implications

Youths’ Substance Use and Changes in Parental Knowledge-Related Behaviors During Middle School: A Person-Oriented Approach

Parental knowledge is a key protective factor for youths’ risky behavior. Little is known about how longitudinal combinations of knowledge-related behaviors are associated with youths’ substance use. This longitudinal study uses Latent Transition Analysis to identify latent patterns of parental knowledge-related behaviors occurring in mother-youth dyads during middle school and to investigate how changes in knowledge-related patterns are associated with youths’ substance use in Grade 6 and the initiation of substance use from Grade 6 to 8. Using a sample of 536 rural dyads (53% female, 84% White), we assessed mother and youths’ reports of parental knowledge, active parental monitoring efforts, youth disclosure, and parent-youth communication to identify six latent patterns of knowledge-related behaviors: High Monitors, Low Monitors, Communication-Focused, Supervision-Focused, Maternal Over-Estimators, and Youth Over-Estimators. Fifty percent or more of dyads in the High Monitors, Communication-Focused and Youth Over-Estimators were in the same status in both 6th and 8th grade: 98% of Low Monitors in Grade 6 were also in this status in Grade 8. The initiation of alcohol, smoking, and marijuana was associated significantly with transitions between patterns of knowledge-related behaviors. The initiation of alcohol and smoking were associated with increased odds of transitions into the Low Monitors from the Communication-Focused, Supervision-Focused, and Maternal Over-Estimators. However, the initiation of substance use was associated with decreased odds of transitions from the High Monitors to the Low Monitors and with increased odds of transitions from High Monitors to Supervision-Focused. The discussion focuses on the value of using a person-oriented dyadic approach with multiple reporters to study changes in knowledge-related behaviors over the middle school period

Patient Surgical Outcomes When Surgery Residents Are the Primary Surgeon by Intensity of Surgical Attending Supervision in Veterans Affairs Medical Centers

OBJECTIVE: Using health records from the Department of Veterans Affairs (VA), the largest healthcare training platform in the United States, we estimated independent associations between the intensity of attending supervision of surgical residents and 30-day postoperation patient outcomes. BACKGROUND: Academic leaders do not agree on the level of autonomy from supervision to grant surgery residents to best prepare them to enter independent practice without risking patient outcomes. METHODS: Secondary data came from a national, systematic 1:8 sample of n = 862,425 teaching encounters where residents were listed as primary surgeon at 122 VA medical centers from July 1, 2004, through September 30, 2019. Independent associations between whether attendings had scrubbed or not scrubbed on patient 30-day all-cause mortality, complications, and 30-day readmission were estimated using generalized linear-mixed models. Estimates were tested for any residual confounding biases, robustness to different regression models, stability over time, and validated using moderator and secondary factors analyses. RESULTS: After accounting for potential confounding factors, residents supervised by scrubbed attendings in 733,997 nonemergency surgery encounters had fewer deaths within 30 days of the operation by 14.2% [0.3%, 29.9%], fewer case complications by 7.9% [2.0%, 14.0%], and fewer readmissions by 17.5% [11.2%, 24.2%] than had attendings not scrubbed. Over the 15 study years, scrubbed surgery attendings may have averted an estimated 13,700 deaths, 43,600 cases with complications, and 73,800 readmissions. CONCLUSIONS: VA policies on attending surgeon supervision have protected patient safety while allowing residents in selected teaching encounters to have limited autonomy from supervision

doi:10.1016/j.ecresq.2010.07.003

a b s t r a c t Recently, research has begun to identify cognitive and social-emotional predictors of early academic success. Yet few studies have examined the mechanisms by which children's social-emotional skills are associated with later academic success. The present study examines the associations between preschool emotion knowledge, kindergarten attention skills, and first grade academic competence in a sample of mostly disadvantaged children. Results indicate that attention during kindergarten is a significant mediator of this association, even after accounting for the effects of maternal education, family income, and children's age, sex, and receptive vocabulary skills. The findings provide further support for the implementation of preventive curricula that focus on both social and emotional development as well as attentional development as one strategy for improving future academic success in young children

Update to the effectiveness and cost-effectiveness of a mindfulness training programme in schools compared with normal school provision (MYRIAD): study protocol for a randomised controlled trial.

BACKGROUND: MYRIAD (My Resilience in Adolescence) is a superiority, parallel group, cluster randomised controlled trial designed to examine the effectiveness and cost-effectiveness of a mindfulness training (MT) programme, compared with normal social and emotional learning (SEL) school provision to enhance mental health, social-emotional-behavioural functioning and well-being in adolescence. The original trial protocol was published in Trials (accessible at https://doi.org/10.1186/s13063-017-1917-4 ). This included recruitment in two cohorts, enabling the learning from the smaller first cohort to be incorporated in the second cohort. Here we describe final amendments to the study protocol and discuss their underlying rationale. METHODS: Four major changes were introduced into the study protocol: (1) there were changes in eligibility criteria, including a clearer operational definition to assess the degree of SEL implementation in schools, and also new criteria to avoid experimental contamination; (2) the number of schools and pupils that had to be recruited was increased based on what we learned in the first cohort; (3) some changes were made to the secondary outcome measures to improve their validity and ability to measure constructs of interest and to reduce the burden on school staff; and (4) the current Coronavirus Disease 2019 (SARS-CoV-2 or COVID-19) pandemic both influences and makes it difficult to interpret the 2-year follow-up primary endpoint results, so we changed our primary endpoint to 1-year follow-up. DISCUSSION: These changes to the study protocol were approved by the Trial Management Group, Trial Steering Committee and Data and Ethics Monitoring Committees and improved the enrolment of participants and quality of measures. Furthermore, the change in the primary endpoint will give a more reliable answer to our primary question because it was collected prior to the COVID-19 pandemic in both cohort 1 and cohort 2. Nevertheless, the longer 2-year follow-up data will still be acquired, although this time-point will be now framed as a second major investigation to answer some new important questions presented by the combination of the pandemic and our study design. TRIAL REGISTRATION: International Standard Randomised Controlled Trials ISRCTN86619085 . Registered on 3 June 2016

Teachers "Finding Peace in a Frantic World": An Experimental Study of Self-Taught and Instructor-Led Mindfulness Program Formats on Acceptability, Effectiveness, and Mechanisms.

Mindfulness training (MT) is considered appropriate for school teachers and enhances well-being. Most research has investigated the efficacy of instructor-led MT. However, little is known about the benefits of using self-taught formats, nor what the key mechanisms of change are that contribute to enhanced teacher well-being. This study compared instructor-led and self-taught MT based on a book (Williams & Penman, 2011) in a sample of secondary school teachers. We assessed expectancy, the degree to which participants believed the intervention was effective, their program engagement, well-being and psychological distress, and evaluated whether mindfulness and self-compassion skills acted as mediators of outcomes. In total, 206 teachers from 43 schools were randomized by school to an instructor-led or self-taught course-77% female, mean age 39 years (SD = 9.0). Both MT formats showed similar rates of participant expectancy and engagement, but the instructor-led arm was perceived as more credible. Using linear mixed-effects models, we found the self-taught arm showed significant pre-post improvements in self-compassion and well-being, while the instructor-led arm showed such improvements in mindfulness, self-compassion, well-being, perceived stress, anxiety, depression, and burnout. Changes over time significantly differed between the groups in all these outcomes, favoring the instructor-led arm. The instructor-led arm, compared with the self-taught, indirectly improved teacher outcomes by enhancing mindfulness and self-compassion as mediating factors. Mindfulness practice frequency had indirect effects on teacher outcomes through mindfulness in both self-taught and instructor-led arms. Our results suggest both formats are considered reasonable, but the instructor-led is more effective than the self-taught. Trial registration: ISRCTN18013311