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Today, intrauterine devices (IUDs) are used by over 100 million women worldwide, making it the most popular reversible method of birth control. Approximately only 2% of American women, however, choose to use this method of birth control. The purpose of this study was to explore clinical services providers' (CSP) behavioral intention to provide the IUD. An instrument based on the theory of reasoned action (TRA) surveyed National Association of Nurse Practitioners in Women's Health (NPWH). A total of 695 participants appropriately completed the survey, resulting in approximately a 30% response rate. Pearson Product Moment Correlations assessed the linear relationship(s) among summed scales and individual instrument items. Hierarchical regression identified the level of variance accounted for by TRA scales and the knowledge scale. Consistent with TRA tenets, statistically significant associations were found among TRA constructs and behavioral intention; whereas knowledge, while a statistically significantly correlated variable with behavioral intention, was not a predictor of behavioral intention. Future research should continue to explore factors of IUDs use, including those not a part of TRA. Health educators should plan programs to assist in health information delivery, and develop social marketing campaigns to help women seeking family planning services become effective consumers of health information about IUDs.

There is a dearth of research available on child services in the community mental health setting in the fields of psychology and counseling. The purpose of this study was to conduct an experimental evaluation of university-based play therapy clinical services with children aged 3 to 10 years old and to explore dimensions of the effectiveness of child-centered play therapy (CCPT) with children. This study examined real-life clinical services to the largest number of child participants in decades of mental health research, especially in the field of play therapy. Archival data from cases of 364 children served through a university-based play therapy clinic in the southwestern United States was examined. The effectiveness of child-centered play therapy (CCPT) was measures by a decrease in a child's behavioral problems perceived by a parent/guardian measured by scores of the Internalizing Problems, Externalizing Problems and Total Problems on the Child Behavioral Checklist (CBCL) and a reduction of parent-child relationship stress manifested in the Child Domain, Parent Domain and Total Stress Score on the Parenting Stress Index (PSI). Data from pretest and posttest was gathered for use in the analysis. Independent samples t-test, repeated measures analysis of variance, and ordinary least squares regression, including effect sizes, were utilized to detect the differences between groups and the treatment effects. After receiving individual CCPT, results of this study demonstrated statistically significant differences on overall CBCL and PSI measures, with the exception on Parent Domain. Additionally, findings highlighted the effectiveness of individual CCPT through demonstrated moderate to large effects over time (partial η2 = .097 to .201). Individual CCPT also revealed very large effects (η2 = .26 to .37) when specifically examined with participants who completed play therapy treatment. Further, statistically significant predictions were found on CBCL and PSI measures, with the exception on Total Problems. Termination and family relationship concern variables were found as strong contributors on predicting greater improvement. Based on the statistical, practical, and clinical significances, the primary contribution of this study is the fully exploration of child characteristics and effectiveness of play therapy for children who seek mental health services.

Unauthorized reproduction of this article is prohibited. Objective: The role of local health departments (LHDs) as a clinical service provider remains a salient topic of discussion. As local and state health departments continue to migrate away from clinical services, there is need to understand the impact on these transitions on access to care in a given community. The purpose of this study was to examine the impact of clinical capacity reductions in LHDs on receipt of annual family planning visits among South Carolina women. Design: A rolling panel of women eligible for Medicaid between 2001 and 2012 was created. Receipt of an annual visit for each year of Medicaid eligibility was tracked over time. A typology reflecting changes in county capacity for clinical services was used as the independent variable. We estimated multivariate generalized estimating equation models, which examined changes in population-averaged probabilities (marginal means) of annual family planning visits over time by level of county typology. Results: Approximately 325 269 unduplicated women were included in the panel, with 25.18% receiving an annual visit in a given year. On average, receipt of annual visits in counties with notable reductions in LHD clinical capacity tended to be fewer over time (-0.022; 95% CI [confidence interval],-0.028 to-0.017) as among counties with reduced capacity that included a specific clinic closing (-0.032; 95% CI,-0.037 to-0.028). However, the magnitude of observed differences between county typologies was relatively small. Conclusions: Evidence of service discontinuity was present. However, differences occurred later in the study period following the economic recession. Our findings suggest that counties that reduced capacity did not lose ground but were unable to meet increasing demand from the economic recession relative to those that did not reduce capacity even when closing a clinic. As LHDs discontinue or significantly reduced clinical services, fulfilling the assurance role is important for transitioning women to other sources of care.

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Abstract Many women who survived sex trafficking continue to suffer from severe and persistent psychological distress even after the traditional treatment and rehabilitation program. The lingering psychological symptoms that these survivors suffer make reintegration into their families and communities difficult. This phenomenological study identified the restorative factors that helped some women who were earlier engaged in sex trafficking to recover, readjust, and reintegrate into their families and communities. Six female survivors of human trafficking and six program directors/counselors at different rehabilitation centers were individually interviewed in in-depth with semi-structured questionnaires and audio recorded. I kept diary of my readings and observation of the participants during the interviews to maintain the rigor and established trustworthiness of the study. With NVivo 11 plus Software, the information were coded to identify the different patterns. The Manen's hermeneutic descriptive phenomenological interpretative approach was employed to sort out the emerging themes. The findings were grouped under the perspectives of survivors and program directors/counselors. Both survivors and program directors/counselors agreed that factors such as supports from family/friends, medical treatments, counseling, and individual characteristics promoted recovery. The theories of social support, self-efficacy, and resilience guided the understanding of the recovery process of the survivors. For positive social change, this study provides information that families, communities, and society can become more aware of the ways to improve survivors' support systems and build a sustainable community that cares and supports survivors for a successful integration into families and communities.

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