The research described in this thesis reviewed previous uses of Interactive Voice Response (IVR), developed appropriate software, and employed IVR to obtain self-report of sensitive issues in surveys and conduct brief public health interventions. Chapter 1 introduces IVR and describes a systematic critical review of the use of IVR. IVR is a telephone interviewing technique where the human speaker is replaced by a high quality recorded interactive script to which the respondent provides answers by pressing the keys of a touch-telephone (touchphone). IVR has numerous advantages, including: economy, autonomy, confidentiality, access to certain population groups, improved data quality, standardised interviewing, multi-lingual interfaces, and detailed longitudinal assessments. Despite this, there have been few survey applications of IVR compared to alternative methods such as Computer-Assisted Telephone Interview (CATI). There has not been any evaluation of the use of IVR for asking sensitive questions in surveys or as a tool for health promotion at the community level. A literature review, described in Chapter 2, was conducted to identify other methods of asking sensitive questions. The literature review identified 19 different methods. Those methods that were most successful were those that provided the greatest degree of anonymity to the respondent. It was suggested that IVR may be a suitable method for community surveys. As described in Chapter 3, a custom software called Generalized Electronic Interviewing System (GEIS) was developed. This provided both CATI and IVR interviewing modes. As described in Chapter 4, it was found that the response rate obtained using IVR was unacceptably low, and an alternative interviewing method, the Hybrid method was developed. In the Hybrid method the interview was initiated by the interviewer but completed using IVR with GEIS. As described in Chapter 5, the IVR, CATI and Hybrid methods were used to investigate self-reported rates of alcohol and drug consumption within a telephone household survey of 2880 households. The self-report rates were compared to the National Drug Strategy Household Survey (NDSHS). Response rates did not differ significantly between the CATI and Hybrid methods, however the response rate for IVR was significantly less than the other methods. The Hybrid and IVR methods obtained significantly higher self-report consumption rates for alcohol and marijuana, and significantly higher hazardous drinking scores using Alcohol Use Disorders Identification Test (AUDIT). In Chapter 6 a pilot of an IVR cervical screening brief advice interface is described. A total of 5000 households were contacted by the IVR system. The system randomly selected an eligible woman aged 18-69 per household and determined her cervical screening status. A total of 661 women listened to the IVR message. The IVR call was shown to be acceptable and inexpensive compared to a mail pamphlet intervention. In Chapter 7 a randomized controlled trial of an IVR cervical screening brief advice involving 17,008 households is described. Cervical screening rate data were obtained from the Health Insurance Commission (HIC) for a period spanning six months before and following the intervention. The cervical screening rate was increased in the intervention postcodes by 0.43% compared to the control postcodes, and the increase was greater for older women at 1.34%. This was a desirable outcome since this group is considered to be an at-risk group. The overall conclusion was that IVR technology could be feasibly used to contact women to deliver brief interventions aimed at increasing cervical screening rates, but the cost per screen was likely to be high. It is suggested that an IVR system could be linked to cervical screening registers to more directly and economically contact women, and provide an efficacious complementary approach to the existing letter reminder system. / PhD Doctorate

Texte abrégé et remanié de: Diss.--Philosophische Fakultät--Humboldt-Universität zu Berlin, 2000. / Bibliogr. p. 197-202.

Research indicates the potential utility of schools as sites for service delivery of mental health interventions. The application of solution-focused brief therapy (SFBT) within the school domain is reflected in the child psychotherapy literature. Findings on the use of SFBT in school settings suggest that it may be well suited to school contexts given its time-efficient, goal-directed, and strengths-based behavioral approach. The primary purpose of this study was to determine the effectiveness of SFBT with at-risk youth in an alternative school setting. The researcher utilized a multiple case study design to examine the impact of a 6-session SFBT intervention on adolescent behavioral outcomes. Six students were randomized to one of three baseline conditions and received the SFBT intervention following baseline data collection. Data were obtained from multiple raters at baseline, posttest, and 6-week follow-up. In addition, students completed self-reported ratings at the beginning of each SFBT intervention session. Data were evaluated using non-regression approaches and visual analyses. Preliminary results indicated that four out of six students exhibited reliable change (6-point increase in post-ORS mean scores), and four out of the six students demonstrated clinically significant change (baseline ORS mean scores below the adolescent clinical cutoff of <28). Results also indicated a decrease in total problem behavior scores at posttest for all informants on a normed assessment of emotional and behavioral functioning. Follow-up data were collected for four out of six students, and results suggested that this decrease in ratings was maintained or decreased further across all raters for three out of the four student participants. Overall, preliminary results indicated the potential utility of SFBT with at-risk youth in an alternative school environment. Strengths and limitations of the current study, as well as additional research aims (e.g., impact of therapist alliance, fidelity monitoring in SFBT) and future research areas are also presented.

Tyrimai rodo, kad į valstybės globą patenka psichikos sveikatos sunkumų turintys vaikai, kuriems būtina įvairių psichikos sveikatos priežiūros specialistų pagalba. Vis tik pastebima, kad psichologinė pagalba globojamiems vaikams ne tik Lietuvoje, bet ir užsienyje dažniausia teikiama nesistemingai, taikant metodus, kurių efektyvumas patvirtintas kitose amžiaus, socialinio statuso ar problemų grupėse, tad specifinių psichologinės pagalbos metodų, efektyviai veikiančių būtent globojamų vaikų grupėje, klausimas išlieka itin aktualus. Pagrindinis šio tyrimo tikslas – nustatyti Į sprendimus sutelkto trumpalaikio konsultavimo (SSTK) galimybes, skatinant geresnį globojamų paauglių psichologinį-socialinį funkcionavimą ir problemų sprendimą, bei veiksnius, susijusius su geresniais konsultavimo rezultatais. Tyrime dalyvavo 228 paaugliai (12-18 m.), gyvenantys vaikų globos namuose. 47 iš jų buvo konsultuoti, taikant SSTK modelį, 47 – sudarė kontrolinę grupę. Tyrime taikyti metodai: 1) trys psichologinio-socialinio funkcionavimo vertinimo metodai, 2) penki poveikio efektyvumo vertinimo metodai. Tyrimo planą sudarė trys etapai: 1) vaikų globos namuose gyvenančių paauglių psichologinio-socialinio funkcionavimo tyrimas; 2) poveikio vykdymas; 3) vaikų globos namuose gyvenančių paauglių psichologinio-socialinio funkcionavimo pokyčių, praėjus šešioms savaitėms po pirmojo įvertinimo, tyrimas. Tyrimo rezultatai parodė, kad SSTK yra efektyvus vaikų globos namuose gyvenančių paauglių problemoms... [toliau žr. visą tekstą] / Most of studies have revealed that children entering foster care have various mental health problems and need help of mental health care professionals. Unfortunately, many authors notice that psychological help rendered for foster children lack organization, for mental health care professionals giving services for foster children are forced to use methods, which empirically are tested among adults or among children having specific mental health disorders or to use methods without empirical proof. Thus issue concerning effective psychotherapeutic methods for foster children remains especially relevant. The aim of the study is to assess the potential of Solution-Focused Brief Therapy (SFBT) improving psychosocial functioning of adolescents in foster care and factors related to better outcome of the SFBT. Research group consisted of 228 adolescents living in foster care homes (12-18 years old). 47 adolescents participated in SFBT group, 47 adolescents from the rest of the group were selected for control group. Research methods: 1) three methods for evaluation of psychosocial functioning; 2) five methods for evaluation of intervention outcomes. Research consisted of three stages: 1) evaluation of the psychosocial functioning of adolescents living in foster care; 2) intervention for treatment group; 3) evaluation of the changes in psychosocial functioning after the period of 6 weeks since first evaluation. Research results demonstrated that SFBT is an effective method for... [to full text]

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

Išanalizavus Lietuvos strateginio planavimo raidą, strateginį planavimą reglamentuojančius teisės aktus, atlikus Vidaus reikalų ministerijos 2007–2009 m. strateginio veiklos plano analizę ir atsižvelgiant į atliktą tyrimą galima pateikti išvadas, į kurias galėtų atsižvelgti strateginį planavimą vykdančios ir diegiančios valstybės institucijos bei tobulinant Strateginio planavimo metodiką. Institucijos, rengdamos strateginį veiklos planą, turi tinkamai įvertinti turimus išteklius, išanalizuoti išorinę ir vidinę aplinką, suvokti grėsmes, galimybes, stiprybes ir silpnybes, sugebėti tinkamai parengti strateginį veiklos planą ir jį įgyvendinti, analizuoti ir sugebėti taikyti užsienio šalių patirtį strateginio planavimo srityje. Pirmame darbo skyriuje nagrinėjama Lietuvos strateginio planavimo raida, aptariamos problemos, su kuriomis buvo susiduriama diegiant strateginį planavimą, analizuojami Strateginio planavimo metodikos pokyčiai. Antrame skyriuje analizuojama, ar Vidaus reikalų ministerijoje efektyviai vykdomas strateginis veiklos planavimas bei tinkamai parengtas strateginis veiklos planas, kaip vykdoma stebėsena ir atsiskaitymas už rezultatus, analizuojama, ar strateginis veiklos planavimas vykdomas vadovaujantis metodika. Trečiame skyriuje apibendrinami atlikto tyrimo metu gauti rezultatas, įvardijamos problemos ir didžiausią įtaką turintys veiksniai įtakojantys strateginį veiklos planavimą. Pabaigoje apibendrinamos išvados ir pateikiami pasiūlymai strateginio planavimo... [toliau žr. visą tekstą] / Having analysed the development of the Lithuanian strategic planning and the legislation regulating strategic planning, having analysed the strategic action plan of the Ministry of the Interior for 2007–2009 and taking into account the study performed it is possible to draw conclusions that could be taken into account by agencies which carry out and develop strategic planning, as well as to improve the Strategic planning methodology. Agencies which draft their strategic action plan have to properly assess their resources, analyse external and internal conditions, realise threats, opportunities strengths, and weaknesses, be able to properly draft strategic action plan and carry it out, analyse and apply best practices of foreign countries in the sphere of strategic planning. Initial section of the thesis analyse development of the Lithuanian strategic planning, discusses the issues that have been faced in implementing strategic planning, analyses changes to Strategic planning methodologies. The seconde chapter assesses whether the Ministry of the Interior is carrying out an effective strategic planning and whether it has a proper strategic action plan, how monitoring and reporting is done, analyses whether strategic action planning is based on Strategic planning methodology. The third chapter summarises results obtained during the study, issues and factors with greatest influence are brought forward. The thesis ends with conclusions and suggestions for improvement of strategic... [to full text]

The aim of the study was to look at a particular work group of housing supporters, whomhave implemented two special working methods in their work. The methods have been implemented by two of the housing supporters that also have special education in the methodsSOC (Sense of Coherence) and solution focused brief therapy. The study is based on anethnographic observation and analysis of documents that are used in the implementation. To analyse the information that was given at the observation and in the document I´ve used a theory which illustrates the significance of developing professions so their knowledge become legitimate. I´ve also used a theory that illustrates the importance of implementation and how it´s done at its best. In conclusion, the study shows that the work group have the will to implement new methods in their work. The working group also has the ability to carry out the implementation, butthey are not aware of their own expertise, which should be clarified in order to achieve successful implementation. Difficulties have been demonstrated in terms of the understanding of the new working methods. These difficulties with the understanding of the methods can be a barrier to successful implementation or do so the implementation will take longer time to become successful. The two colleges with specified knowledge became leaders to the group and steered the work group to make decisions based on the methods of SOC and solution focused brief therapy. The investment in providing the housing supporters with special education, space to implement these two working methods also gave effects on the organization.

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

Motorised countries have more fatal road crashes in rural areas than in urban areas. In Australia, over two thirds of the population live in urban areas, yet approximately 55 percent of the road fatalities occur in rural areas (ABS, 2006; Tziotis, Mabbot, Edmonston, Sheehan & Dwyer, 2005). Road and environmental factors increase the challenges of rural driving, but do not fully account for the disparity. Rural drivers are less compliant with recommendations regarding the “fatal four” behaviours of speeding, drink driving, seatbelt non-use and fatigue, and the reasons for their lower apparent receptivity for road safety messages are not well understood. Countermeasures targeting driver behaviour that have been effective in reducing road crashes in urban areas have been less successful in rural areas (FORS, 1995). However, potential barriers to receptivity for road safety information among rural road users have not been systematically investigated. This thesis aims to develop a road safety countermeasure that addresses three areas that potentially affect receptivity to rural road safety information. The first is psychological barriers of road users’ attitudes, including risk evaluation, optimism bias, locus of control and readiness to change. A second area is the timing and method of intervention delivery, which includes the production of a brief intervention and the feasibility of delivering it at a “teachable moment”. The third area under investigation is the content of the brief intervention. This study describes the process of developing an intervention that includes content to address road safety attitudes and improve safety behaviours of rural road users regarding the “fatal four”. The research commences with a review of the literature on rural road crashes, brief interventions, intervention design and implementation, and potential psychological barriers to receptivity. This literature provides a rationale for the development of a brief intervention for rural road safety with a focus on driver attitudes and behaviour. The research is then divided into four studies. The primary aim of Study One and Study Two is to investigate the receptivity of rural drivers to road safety interventions, with a view to identifying barriers to the efficacy of these strategies.

Thesis (D. Min.)--Covenant Theological Seminary, 2002. / Abstract. Includes bibliographical references (leaves 96-99).