The health implications of poor dietary habits among adolescents are increasingly evident with the high prevalence of obesity and diet-related ill health in this population. Of particular concern is the high amount of sugar present in the adolescent diet. Nutrition education is an efficacious strategy to change sugary drink consumption particularly when including experiential strategies but sugar consumption within a more comprehensive diet has not been addressed. Food models have been incorporated as a teaching aid that support experiential activities and there is some evidence that they can be effective. However, there is a lack of evidence on the use of these strategies with adolescents and specifically for reducing sugar consumption across the diet. This study aimed to assess the impact of a two 45-minute interactive nutrition session intervention using food models on adolescent's sugar literacy (knowledge and awareness of added sugar, confidence in label reading to assess sugar content in food, and intention to limit consumption of added sugar). An experimental design with randomization into intervention and control condition and pre and post measures was used to test the efficacy of the intervention. Two hundred and three students ages 14 to 19 from 6 schools on Vancouver Island, BC, Canada participated in the study. The intervention group received two 45-minute interactive nutrition sessions using food models to learn about added sugar content in foods and beverages, recommendations for added sugar in the diet and food group servings in a healthy diet. A questionnaire to evaluate sugar literacy, including student knowledge, self-efficacy and intention to consume less added sugar, was completed at baseline and after the intervention. Adolescents’ knowledge of added sugar in foods and beverages and of the number of servings of food groups in a healthy diet was limited at baseline but improved significantly in the intervention condition [F(1, 201)=104.84, p<.001] compared to the controls. Intention to consume less added sugar increased significantly after the intervention [F(1, 201)=4.93, p=.03] as did label reading confidence [F(1, 201)=14.94, p<.001]. It appears that a brief nutrition education intervention using food models as an experiential learning strategy was efficacious for changing student’s knowledge about sugar guidelines and sugar in food, label reading confidence and intention to change sugar consumption. Further studies are needed to analyze the impact of a sugar literacy intervention using food models on actual sugar consumption in adolescents. / Graduate / 2020-04-26

Acceptance and Commitment Therapy (ACT) is designed to target psychological flexibility, broadly defined as engagement with personal values regardless of the presence of difficult private events. As engagement with valued behaviors is imperative to psychological flexibility, clarification of values is an essential skill for clients to learn. Practicing of skills in treatment has historically been a difficult hurdle for clinicians to implement between sessions for clients as well. The present study examined the utility of a novel values card sort activity, as well as the utility of a rubber band to act as a reminding agent for engagement with values. 112 undergraduate students were randomly assigned to one of three conditions: a values card sort condition, a values card sort condition with a rubber band given to the participant, and a control card sort condition. Each participant completed questionnaires assessing connection with values, lack of contact with values, negative affect, and quality of life at baseline and at a one-week follow-up. A series of ANCOVAs were conducted to determine if there were any group differences between the three conditions at follow-up, with baseline scores as a covariate. The analyses indicate no significant difference between the conditions at follow-up across any of the variables of interest. Endorsement of prior therapy experience suggested unique trends and differential reaction to the card sorting activity. These findings suggest the values card sort may not be an effective intervention for subclinical populations but may be a fruitful intervention for clinically-elevated individuals.

The engagement process in group therapy is a significant step in the treatment of clients in building feelings of safety and inclusion, which becomes challenging when the clientele is attending involuntarily. The following research project monitored the progress of a 20-week batterer intervention program, measuring the perceived effectiveness of the facilitator in engaging the clients, and the congruency of the facilitator’s and the participants perceived level of engagement. The observations of groups and the facilitator’s interview proved helpful in determining that group members and the facilitator did have likeminded perceptions of group engagement, but perception of the level at which the participants were presumably engaged in the therapeutic process was different. This study could impact social work practice by encouraging modification of the criteria for group members, and diversifying the therapeutic techniques used by facilitators.

This research project focuses on how social workers can improve the healthcare experience for people who are homeless. The twelve participants in this study were recruited from a homeless shelter located in Southern California. Data was collected for this study using qualitative methods by means of interviews. Interviews were conducted in person, audio recorded, and then transcribed for data analysis. Findings from this study indicated that the concepts of time, perception of needs being met, service connection, staff interaction, social work intervention, and potential social work intervention were all connected to whether participants viewed their healthcare visit as a negative experience or a positive experience. In addition, findings from this study revealed a low percentage of reported social work encounters at healthcare facilities among study participants. Results from this study have implications for social work practice in regards to location of social work intervention at healthcare facilities and extension of social work roles in healthcare settings.

The roles of reading specialists differ from campus to campus throughout the study site due to varied implementations of Response to Intervention (RTI). To ensure that students were receiving consistent interventions based on their needs, the site needed to examine how and when instructional services were delivered to struggling students, as well as the role of the reading specialist in the process. The purpose of this qualitative case study was to explore the perceptions, experiences, and roles of reading specialists as the RTI framework was implemented at the elementary school level. This study was guided by Vygotsky's social constructivist learning theory, which holds that understanding is built through interactions, observations, and experiences. The research questions focused on the reading specialists' understanding of RTI, reading specialists' roles in RTI, challenges of implementing RTI, and professional development provided on RTI. Data were transcribed, categorized, open coded, and thematically analyzed. Member checks were used to strengthen the trustworthiness of the findings. Results revealed 5 major themes: understanding the RTI process, supporting struggling students, lack of funding and resources, collaboration/communication, and staff development. The findings can contribute to positive social change by leading administrators, instructional support teachers, and reading specialists to an increased understanding of the RTI process, and thereby improving RTI implementation procedures for struggling readers and subsequently increasing student achievement.

The effects of coteaching instruction used by speech language pathologists (SLP) and 1st grade teachers on students' early literacy skills have not been widely examined in current literature. This lack of research may hinder the efforts of SLPs to provide support services for students with and without disabilities who struggle with early literacy skills. Guided by the ecological systems theory, this quasi-experimental study examined the impact of coteaching instruction on students' literacy skills by comparing scores of 2 groups, experimental group who received coteaching and control group who did not receive coteaching instruction. The scores were measured by the final Test of Early Literacy Nonsense Word Fluency Subtest (TELNWFS). A purposeful sampling method was used to select 166 1st grade students as participants. The SLP and 1st grade classroom teachers' use of coteaching instruction served as the treatment or independent variable. The covariate was the scores of the initial TELNWF scores, which was used to control for preexisting reading skills of the participants. The dependent variable was the scores of the final TELNWF. The results of ANCOVA test revealed that there was no significant difference between TELNWF scores of experimental and control group. Implications for positive social change include modifying or reevaluating the use of coteaching instruction between the SLP and 1st grade classroom teachers. This study will help the faculty at the treatment school make informed decisions about instructional models that should or should not be used to address early literacy skills of 1st grade students within the treatment school.

1 / Veronica Coriano

Exposure to noise in hospital intensive care units (ICUs) can disrupt patients’ sleep and delay their recovery. In this intervention study, noise levels were measured in eight patient rooms of a medical ICU (MICU) every minute with sound level meters for eight weeks before and after an intervention. Implemented over six weeks, the intervention was designed to educate nurses and other staff members to reduce noise levels through behavior modification, including instituting a “quiet time” in the afternoons, encouraging patients to keep televisions off or at lower volumes, and speaking more quietly during conversations. Sound equivalent levels (Leq) were calculated from one-minute measurements for each hour in each room. These hourly Leq (Leq-H) values were compared by pod (group of rooms within the MICU), room position (in proximity to a central nurses’ station), occupancy status, and time of day. Days with more than ten hours of one-minute noise levels above 60 dBA were flagged as the loudest time periods and compared to MICU activity logs. The intervention was ineffective with Leq-H values always above World Health Organization guidelines for ICUs (35 dBA in day; 30 dBA at night) before and after the intervention. Leq-H values frequently exceeded more modest project goals during the day regardless of the intervention (50% of Leq-H > 55 dBA both pre- and post-intervention) and at night (68% and 62% of Leq-H > 50 dBA pre- and post-intervention). Statistical analysis of the Leq-H suggests a general source is contributing to the high baseline noise in the MICU, most likely the heating, ventilation, and air-conditioning (HVAC) system. Our analysis of one-minute data indicated that high noise was often associated with high-volume respiratory-support devices. We concluded that our intervention focusing on administrative controls (e.g., education and training) was not enough to reduce noise in the MICU but that an intervention designed with engineering controls (e.g., shielding, substitution) would be more effective.

Chronic tic disorders (CTDs), including Tourette’s disorder and persistent motor or vocal tic disorder, are neurobiological conditions affecting an estimated 3 to 4 percent of children and adolescents. These disorders include the presence of motor and/or phonic tics, which can range in number, frequency, and severity. Although CTDs are typically treated through medications, the available medications have the potential of adverse side effects, do not result in long-term coping strategies, and may not be effective or preferable for all individuals. Habit reversal training (HRT), a behavioral intervention for tics, has been identified as a well-established treatment. The purpose of habit reversal is to build an individual’s awareness of his or her tics and disrupt tics through developing a competing behavioral response. One avenue or service delivery that has not yet been explored for individuals with CTDs is use of a parent-mediated approach to habit reversal. Parent-mediated interventions have been used successfully with children with challenging behavior and autism. They are based on a triadic model, in which a therapist works directly with a parent to teach the therapeutic techniques. Parents, in turn, work directly with their children while receiving feedback from the therapist. The current study investigated a parent-mediated habit reversal intervention for the treatment of chronic tic disorders in two children. A delayed multiple baseline design was used. Baseline data were collected for three sessions. Intervention was delivered over six sessions, during which time coaching was faded. Follow up data collection occurred one month after the end of treatment. Based on changes in parental fidelity of implementation from baseline to intervention, this study provides preliminary evidence for parents being trained as therapists and providing habit reversal training strategies to their children. This treatment was reported as acceptable by both parent participants and by one of the child participants. Treatment motivation remained high and stable throughout baseline, intervention, and follow up. Child motivation was more variable during baseline, intervention, and follow up. Tic severity was also variable and more research would be needed to determine the impact of treatment for tics. Limitations and implications for future research are provided.

CHIK is a viral infection transmitted by the Aedes aegypti mosquito which causes an illness with symptoms of severe joint pain, high fever, and rash. The joint pain can continue for months, causing disability and economic strain on families. This study included implementation of a baseline needs assessment, and development, implementation, and evaluation of an experimental community-based educational intervention in rural Tamil Nadu, India. A total of 184 households, across 12 purposively sampled villages (six intervention and six control), participated in the needs assessment between August and December 2010. The experimental community-based educational intervention was implemented between December 2010 and August 2011, in the six intervention villages. A total of 180 households, from the same 12 villages, participated in the post-intervention evaluation. A randomized block design with repetition was used to test whether there was a change in CHIK knowledge scores from baseline to post-intervention in the treatment group. A model including respondent variables, household larval status, household container larval status, recent experience with CHIK, numbers of livestock, socioeconomic position (SEP) variables, and water variables were used to predict CHIK knowledge scores in rural Tamil Nadu. Respondent age, measures of luxury amenities and water source were statistically significant predictors of knowledge in this model. The CHIK knowledge score increased from 9.0 to 9.4 in the intervention group (p=0.6457) and from 8.5 to 9.2 in the control group (p=0.393), showing that the educational intervention did not increase CHIK knowledge in the intervention group. Although this low-cost intervention, utilized in a resource poor area of Tamil Nadu, India did not result in an increase of CHIK knowledge, the process of developing the educational intervention may provide a template for future interventions. Future studies should investigate methods of sustainability in the use of educational messages.