A dissertation submitted in partial fulfilment of the requirements for the degree Doctor of Philosophy in Community Psychology in the Department of Psychology University of Zululand, 2006. / This study was aimed at improving knowledge, attitude and practices of teachers, parents and learners on HIV/AIDS issues in Mthatha schools in Eastern Cape. The specific objective was to promote mental health in the form of improved family communication about HIV/AIDS issues and also to promote the value of psychological interventions among Xhosa families in the Eastern Cape. The target population was drawn among teachers and families of the learners in two schools (urban and rural) in the Mthatha district of Eastern Cape. All participants were given an HTV/AIDS life skills intervention programme for about nine weeks. Quantitative data was collected from a structured questionnaire and qualitative data from a focus group interview. The findings revealed a general improvement in HIV/AIDS knowledge, attitude and practices. Teachers seemed to be more knowledgeable than parents and learners with regard to HIV/AIDS issues. Learners manifested resistance to change in their practices though all participants preferred abstinence or safer sex than the use of condom. Learners seemed resistant to change sexual practices though all participants preferred abstinence or safer sex above condom usage.

Social workers and other human services professionals helping families reintegrate after parental incarceration deal with multiple issues without a model of for facilitating family resilience. The purpose of this phenomenological research study was to explore the essence of the perceived role, activities, and practices of a sample of social workers and other human service professionals engaged in the use of family group conferences (FGCs). FGCs are also referred to as restorative justice, as they inform and assist human service professionals in developing clinical interventions and best practices to support reintegration, family preservation, and stabilization. The framework for this study was built around restorative justice theory, resiliency theory, and a larger social ecological theory and focused on the use of FGCs as a developing practice within family systems and the community. The primary research questions investigated the practitioners' experiences using FGCs. Data came from interviews of participants (15) drawn from professional associations and included their own case notes and reflections. The data was sorted and analyzed with the assistance of qualitative analysis software (Atlas.Ti7) to search for themes that may assist in identifying the phenomenon. The findings suggest that the FGC model should consist of a training curriculum, consistent practice, and dedicated and committed financial resources to support programs. This study impacts social change by informing human services professionals of current best practices and may provide a model of FGCs that will help implement services to families.

The magnitude of internal displacement worldwide is growing every year and represents a tripling of the existing number of refugees worldwide. Internally displaced persons have specific vulnerabilities and the system of assistance to them needs to be adapted and revised. The purpose of this case study was to identify external factors that influence protection interventions for internally displaced persons in humanitarian response. Using Benet's Polarities of Democracy theory and the Theory of Change Conceptual Framework as a framework, the study sought to identify key external factors influencing protection intervention in humanitarian aid settings. Data for this study was gathered through focus group discussions with internally displaced persons in Niger. Key informant and protection cluster members were interviewed and an online survey conducted. In total, 38 persons participated. Content analysis was used to identify significant themes. The data revealed that multiple external factors impacted the effectiveness of protection intervention in humanitarian action. The central theme was a need for strengthened accountability towards affected populations, with other major themes, including donors and their influence; quality of programs - holistic approach, external attention to the crisis; coordination; nature of the crisis; security; position of the government; and data and analysis, also emerging. The findings shed light on the vulnerability of protection intervention in humanitarian settings, and open opportunities for further research in this topic.

Medication administration errors (MAEs) may lead to adverse drug events, patient morbidity, prolonged hospital stays, and increased readmission rates, and may contribute to major financial losses for the health system. MAEs are the most common type of error occurring within the health care setting leading to an estimated 7,000 patient deaths every year. Interventions have been designed to prevent MAEs including education for nurses who administer medications; however, little effort has been made to design systematic educational programs that are based on local needs and contexts. The purpose of this project was to identify internal and external factors related to MAEs at the practice site, develop an education program tailored to the factors contributing to MAEs, and implement the program using a pretest posttest design. The Iowa model was used to guide the project. The 26 nurse participants who responded to an initial survey indicated that nurses felt distractions and interruptions during medication administration, and hesitancy to ask for help or to report medication errors increased MAE risks. After the education program, the pretest and posttest results were analyzed and revealed improvement in knowledge and confidence of medication administration (M = 3.2 pre, M = 3.7 post, p < .05). Open-ended question responses suggested a need for dedicated time for preparation and administration of medications without interruptions. Positive social change is possible as nurses become knowledgeable and confident about medication administration safety and as patients are protected from injury secondary to MAEs.

Patients with Alzheimer's disease or other types of dementia often require long-term care in nursing facilities (NF) where they may display out-of-character behaviors complicating their care. While antipsychotic medications are sometimes prescribed for NF residents, their use is considered inappropriate for the control of dementia behaviors. The Centers for Medicare and Medicaid Services have rated Texas the worst state in the country for the inappropriate use of antipsychotic medications for NF residents with dementia. This project was guided by the star model of knowledge transformation with the goal to reduce inappropriate use of antipsychotic medications through NF staff education. The purpose of this project was to develop an educational program for nurses, direct care staff, pharmacists, and prescribers regarding appropriate use of antipsychotic medications, reduction efforts, alternative non pharmacological interventions, and an associated toolkit of educational resources. The program development was accomplished in conjunction with a team of local experts who provided process evaluation regarding their satisfaction with the planning process through the completion of an anonymous, 10-question, Likert-type survey. All participants scored their results with a (5) strongly agree or (4) agree. A descriptive analysis of the survey data provided information that positively supported the development of the project. At the end of the project, the education program and resources were delivered to the Texas Health and Human Services Commission, with a plan for later implementation and outcome evaluation. This project has the potential to achieve positive social change through reducing the numbers of Texan NF residents with dementia who are inappropriately prescribed antipsychotic medications, which will result in an increase in their quality of life.

Response to Intervention (RTI) programs are designed to support students at risk of failing in school due to academic or behavioral problems. When RTI programs are applied inconsistently due to teachers' resources or knowledge, students may be wrongly identified for special education services. The purpose of this qualitative bounded descriptive case study was to explore K-4 general education teachers' experiences with RTI program implementation and the extent teachers used the RTI program in their classrooms. This study was guided by Gagné's conditions of learning theory. A purposeful sampling of 10 K-4 general education teachers, who taught an RTI program, volunteered and participated in individual semistructured interviews and classroom observations. Data were analyzed thematically using open, axial, and thematic coding. Participants revealed they needed materials and time to prepare and use interventions and desired parental participation in team meetings. Numerous interventions, large class sizes, and scheduling constraints with specialists were obstacles implementing RTI. Academic specialists' expertise, teaching methods, and assessment data assisted planning and implementing RTI in the classroom. Teachers demonstrated a high frequency of events of learning in lessons. Based on the findings, it is recommended that district personnel develop a tiered system of teacher support and a shared vision for an RTI plan, provide teachers with necessary materials and resources to deliver instruction, and plan actions for parental involvement. These endeavors may contribute to positive change by improving general education teachers' instruction to help students at risk of failure to be successful, thus, reducing unnecessary special education referrals.

Guided by Premack and Woodruff's theory of the mind and Bandura's social learning theory, this qualitative study examined the issue of bullying at school, and whether teachers' childhood experiences of bullying had effects on how they, as adults, handled bullying situations in their classrooms. Convenience sampling was used to administer the Bauman, Rigby, and Hoppa Handling Bullying Questionnaire to 22 middle school educators with three or more years of teaching experience at the participating school, to determine their responses to bullying scenarios. Twelve educators completed the questionnaire. Data collected from the questionnaire were analyzed for frequencies of responses. Teachers' responses to how they might handle bullying appeared similar across the sample for most items, indicating that they would intervene and communicate the concern. Six of the 12 educators voluntarily agreed to be interviewed to gain a deeper understanding of how they manage bullying situations at school and whether they thought bullying incidents experienced as a child affected their responses as teachers. Interview data were transcribed and analyzed using open and selective coding to identify common themes. Two of the participants reported being bullied as children; however, they did not report an effect of that childhood bullying on their current handling of bullying at school. Interview participants also reported the need for training related to protocols for addressing bullying at school. The findings led to the development of a professional development series, Recognize, Respond, and Reduce, which can create positive social change by equipping teachers to handle bullying in their classrooms. By preparing teachers to respond to bullying, school leaders may create a safer learning environment for students, teachers, and the community as a whole.

Teacher turnover has a significant effect on the overall success of schools. The use of comprehensive turnaround strategies such as the conservatorship process created a problem for a small Southeastern high school by affecting teacher retention rate. A qualitative approach was used to investigate how aspects of turnaround strategies influenced teacher morale, which may have contributed to the small Southeastern high school's lower than average teacher retention rate. Bandura's self-efficacy theory provided the conceptual framework for this qualitative case study. The research question addressed teachers' perspectives of morale as well as their views and experiences with the conservatorship process. Semistructured interviews were conducted with 8 teachers who were actively employed at the school before the conservatorship process and were retained by the district. After coding each interview, 6 themes emerged relating to factors that influence teachers' perspectives of morale: (a) powerlessness, (b) excessive visitations, (c) loss of confidence, (d) ineffective instructional practices, (e) stress and burnout, and (f) ineffective professional development opportunities. As a result, a professional development project was created to train administrative leaders and teachers on the benefits of the distributed leadership framework, including how to use teachers' experiences and expertise in school reform efforts. The impact of this study is the potential to affect teacher morale positively and promote positive social change in the high school by fostering an environment in which stakeholders work collaboratively to increase the teacher retention rate, furthering the success of this small Southeastern high school.

Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module toolkit that identifies best practices for nurses to address issues of medication adherence with adult patients with Type II diabetes. Future implementation of these toolkit resources may enhance nurses' ability to teach adult patients how to adhere to their medication regimen. Five participants, all considered professional diabetes content experts, were invited to evaluate the educational module toolkit subject matter. The completion response rate was 100% (n = 5). The content experts rated survey items using a 5-point Likert scale where 1= strongly disagree, 2= disagree, 3= not applicable, 4 = agree and 5= strongly agree and responded to 2 questions that allowed for narrative feedback. The experts were satisfied with the content of the educational module toolkit; suggesting that the toolkit may serve as a functional guide for nurses assisting adult patients with diabetes. Improved medication regimen compliance may produce cascading effects; helping these patients achieve a better quality of life while producing positive social change within their families and communities.

Over the years, many interventions have been used to ameliorate couple distress and increase relationship satisfaction. These interventions have been getting shorter in duration. The purpose of this pilot study was to test the feasibility and impact of a brief intervention using a solution-focused approach (SFBT) for couples. The brief intervention included two two-hour consultations. Data were collected from 30 couples and were analyzed using a repeated measures design. The analyses yielded mixed results. There were statistically significant improvements in the areas of individual well-being and relationship knowledge. There were no significant differences in terms of marital satisfaction, communication skills, and readiness to change, although positive trends were observed in this pilot phase. Implications for future research and development are discussed.