Prevention scientists have called for more research on the factors affecting the implementation of substance use prevention programs. Given the lack of literature in this area, coupled with evidence that children as early as elementary school engage in substance use, the purpose of this study was to identify the factors that influence the implementation of substance use prevention programs in elementary schools. This study involved a mixed methods approach comprised of a survey and in-person interviews. Sixty-five guidance counselors and teachers completed the survey, and 9 guidance counselors who completed the survey were interviewed individually. Correlation analyses and hierarchical multiple regression were conducted. Quantitative findings revealed ease of implementation most frequently influenced program implementation, followed by beliefs about the program’s effectiveness. Qualitative findings showed curriculum modification as an important theme, as well as difficulty of program implementation. The in-person interviews also shed light on three interrelated themes influencing program implementation – The Wheel, time, and scheduling. Results indicate the majority of program providers modified the curriculum in some way. Implications for research, policy, and practice are discussed, and areas for future research are suggested.

Burnout is a problem that impacts the physician population disproportionately compared to other professions in the United States, and its consequences affect not only physicians but their patients and the healthcare system as a whole. In particular, physician trainee years are associated with a significant degree of burnout, and these years are important for establishing self-care practices and perspectives from which a physician will draw throughout the rest of his or her career. Trainee years are not only uniquely important years for the establishment of burnout resiliency, but they also may be uniquely suited to the integration of burnout resiliency programs due to their curricular structure. A number of burnout resiliency programs have been developed and tested in the trainee population, however little evidence exists for consistent efficacy or for which elements confer efficacy. The present article identifies, reviews, synthesizes and evaluates the current literature on burnout prevention programs in the trainee population and proposes a research protocol for the implementation of a curriculum-based burnout resiliency program called the “Integrative Wellness Initiative” featuring wellness classes, mindfulness and incentivized exercise.

The importance and use of data and information to make sound programmatic decisions are receiving increased attention as state and federal funding for public health programs grows tighter and as demands for accountability continue. This dissertation provides insight into fundamental questions regarding the utilization of a Web-based reporting system on knowledge management practices for Tobacco Prevention Programs and examines what happened in Texas after the merger of the Tobacco Prevention Program into the Substance Abuse Prevention Program. A phenomenological qualitative approach was used to explore meaning of actions and to identify common themes as they relate to information sharing and utilization of Texas’ Program Management and Tracking System (PMATS). Twenty-four semi-structured interviews were conducted. First, core functions of PMATS are examined through the experiences of its end-users; and second, the impact of the merger on retention and use of PMATS within the Department of State Health Services is explored. Four themes were identified as they relate to core functions of PMATS, including its use as a codification system, its use to track performance measures, and its use for report generation and for programmatic decision-making. These four primary uses of PMATS remained the same pre- and post- merger, although how the systems were utilized during these periods differed. A central theme that permeated all interviews was the impact of the merger of the Tobacco Control Program into the Substance Abuse Program on individual beliefs and attitudes (i.e., job security, low morale, etc.), on systems characteristics (i.e. feedback, internal reporting structures, etc.), and on organizational culture (i.e., training, leadership, etc.). Since entering into PMATS was contractually required, individual attitudes and beliefs did not impact use of PMATS. However, competing IT systems, lack of a champion, lack of knowledge and support by upper management, and lack of communication were identified as key influences on systems characteristics and on organizational culture, which ultimately contributed to the termination of PMATS. Both applied research and practice recommendations are discussed, including IT due diligence, creating a knowledge culture, and network analysis of information sharing practices. / text

The present study examines the issue of minority participation in a multi-faceted prevention program for youth with problem behavior. Historically, participation in such research programs has been low (Myers, Alvy, Richardson, Arrington, Marigna, Huff, Main, & Newcomb, 1990; Coie, 1996; Spoth & Redmond, 2001). Targeted prevention programs, which design their interventions for populations that are susceptible to negative outcomes, face more obstacles to participation than most participants of universal prevention programs. Targeted populations, specifically families with children with problem behavior, are usually under great duress, suffer multiple hardships, and have high adversity characteristics, (e.g., low socioeconomic status, insularity, single-parent families, and low levels of education). As has long been documented, minority status is usually associated with this heightened risk status (Prinz & Miller, 1991). A common suggestion in the prevention and therapeutic treatment literature is the use of minority staff members to increase the likelihood of participation of minority parents (Prinz, Smith, Dumas, Laughlin, White & Barron, 2001). This argument is most prevalent in the literature regarding Latino clients (Sue, Fujino, Hu, Takeuchi, & Zane, 1991). This study attempts to predict minority parents' participation quality (PQ) from demographic variables (e.g., level of adversity, ethnicity), participation rate (PR) (e.g., amount of participation measured by minutes and contacts), and ethnic matching. This study also offers insight on how PQ and PR relate to one another. The results of this study imply that PQ and PR relate differently for Latino parents than they do for parents from other ethnicities. The relationship of these variables has implications for frequency of dosages in an intervention, especially for interventions that attempt to reach distinct populations.

Children of parents with mental illness (COPMI) are often referred to in the literature as invisible given the lack of services dedicated to this large population at increased risk for a multitude of psychosocial difficulties. Of the services available, few have been empirically validated. This study undertook a qualitative evaluation of Kids in Control, a psycho-education and support program intended to enhance the resilience of children of mentally ill parents. The goals of this study were to: determine whether the program was beneficial to the participants, identify the critical program elements deemed helpful/unhelpful by the participants, determine whether program objectives were being met, and to provide insight on how to improve the program to better meet the needs of this population. It is ultimately hoped that this research will give children of parents with mental illness a voice, thereby boosting their visibility and contributing to their psychosocial well being. Flanagan’s (1954) critical incident technique (CIT) was employed to determine the participants’ perceptions of helpful and unhelpful aspects of the program. Twelve participants (10 boys, 2 girls) ranging in age from 8-12 were recruited from 4 groups held in the Lower Mainland of British Columbia. Semi-structured interviews were conducted, followed by telephone interviews to discuss and verify the information shared. Participants reported a total of 121 critical incidents, which were classified into 8 helpful categories (105 incidents) and 2 unhelpful categories (16 incidents). The eight helpful categories were: identifying, communicating and managing feelings; learning about mental illness; helpful messages about responsibility, control, and empowerment; effective facilitator group management skills; having fun; connecting with other children experiencing parental mental illness; learning about stigma; and identifying supports. The unhelpful categories were: ineffective facilitation skills, and disruptive behaviour exhibited by other group members. Participants recommended improvements related to the areas of group instruction, time management, and group management. In addition, a 10-point rating scale was administered to determine the participants’ overall perception of program helpfulness. A mean rating of 7.63 was obtained which corresponds to very helpful on the scale. A comparison of incident categories with program objectives indicated a high degree of consistency, with a few exceptions. Implications for program improvements, wider program dissemination, and counselling practice are discussed. In addition, methodological issues related to using the critical incident technique with children are outlined.

The present study examines the issue of minority participation in a multi-faceted prevention program for youth with problem behavior. Historically, participation in such research programs has been low (Myers, Alvy, Richardson, Arrington, Marigna, Huff, Main, & Newcomb, 1990; Coie, 1996; Spoth & Redmond, 2001). Targeted prevention programs, which design their interventions for populations that are susceptible to negative outcomes, face more obstacles to participation than most participants of universal prevention programs. Targeted populations, specifically families with children with problem behavior, are usually under great duress, suffer multiple hardships, and have high adversity characteristics, (e.g., low socioeconomic status, insularity, single-parent families, and low levels of education). As has long been documented, minority status is usually associated with this heightened risk status (Prinz & Miller, 1991). A common suggestion in the prevention and therapeutic treatment literature is the use of minority staff members to increase the likelihood of participation of minority parents (Prinz, Smith, Dumas, Laughlin, White & Barron, 2001). This argument is most prevalent in the literature regarding Latino clients (Sue, Fujino, Hu, Takeuchi, & Zane, 1991). This study attempts to predict minority parents' participation quality (PQ) from demographic variables (e.g., level of adversity, ethnicity), participation rate (PR) (e.g., amount of participation measured by minutes and contacts), and ethnic matching. This study also offers insight on how PQ and PR relate to one another. The results of this study imply that PQ and PR relate differently for Latino parents than they do for parents from other ethnicities. The relationship of these variables has implications for frequency of dosages in an intervention, especially for interventions that attempt to reach distinct populations.

Children of parents with mental illness (COPMI) are often referred to in the literature as invisible given the lack of services dedicated to this large population at increased risk for a multitude of psychosocial difficulties. Of the services available, few have been empirically validated. This study undertook a qualitative evaluation of Kids in Control, a psycho-education and support program intended to enhance the resilience of children of mentally ill parents. The goals of this study were to: determine whether the program was beneficial to the participants, identify the critical program elements deemed helpful/unhelpful by the participants, determine whether program objectives were being met, and to provide insight on how to improve the program to better meet the needs of this population. It is ultimately hoped that this research will give children of parents with mental illness a voice, thereby boosting their visibility and contributing to their psychosocial well being. Flanagan’s (1954) critical incident technique (CIT) was employed to determine the participants’ perceptions of helpful and unhelpful aspects of the program. Twelve participants (10 boys, 2 girls) ranging in age from 8-12 were recruited from 4 groups held in the Lower Mainland of British Columbia. Semi-structured interviews were conducted, followed by telephone interviews to discuss and verify the information shared. Participants reported a total of 121 critical incidents, which were classified into 8 helpful categories (105 incidents) and 2 unhelpful categories (16 incidents). The eight helpful categories were: identifying, communicating and managing feelings; learning about mental illness; helpful messages about responsibility, control, and empowerment; effective facilitator group management skills; having fun; connecting with other children experiencing parental mental illness; learning about stigma; and identifying supports. The unhelpful categories were: ineffective facilitation skills, and disruptive behaviour exhibited by other group members. Participants recommended improvements related to the areas of group instruction, time management, and group management. In addition, a 10-point rating scale was administered to determine the participants’ overall perception of program helpfulness. A mean rating of 7.63 was obtained which corresponds to very helpful on the scale. A comparison of incident categories with program objectives indicated a high degree of consistency, with a few exceptions. Implications for program improvements, wider program dissemination, and counselling practice are discussed. In addition, methodological issues related to using the critical incident technique with children are outlined.

Children of parents with mental illness (COPMI) are often referred to in the literature as invisible given the lack of services dedicated to this large population at increased risk for a multitude of psychosocial difficulties. Of the services available, few have been empirically validated. This study undertook a qualitative evaluation of Kids in Control, a psycho-education and support program intended to enhance the resilience of children of mentally ill parents. The goals of this study were to: determine whether the program was beneficial to the participants, identify the critical program elements deemed helpful/unhelpful by the participants, determine whether program objectives were being met, and to provide insight on how to improve the program to better meet the needs of this population. It is ultimately hoped that this research will give children of parents with mental illness a voice, thereby boosting their visibility and contributing to their psychosocial well being. Flanagan’s (1954) critical incident technique (CIT) was employed to determine the participants’ perceptions of helpful and unhelpful aspects of the program. Twelve participants (10 boys, 2 girls) ranging in age from 8-12 were recruited from 4 groups held in the Lower Mainland of British Columbia. Semi-structured interviews were conducted, followed by telephone interviews to discuss and verify the information shared. Participants reported a total of 121 critical incidents, which were classified into 8 helpful categories (105 incidents) and 2 unhelpful categories (16 incidents). The eight helpful categories were: identifying, communicating and managing feelings; learning about mental illness; helpful messages about responsibility, control, and empowerment; effective facilitator group management skills; having fun; connecting with other children experiencing parental mental illness; learning about stigma; and identifying supports. The unhelpful categories were: ineffective facilitation skills, and disruptive behaviour exhibited by other group members. Participants recommended improvements related to the areas of group instruction, time management, and group management. In addition, a 10-point rating scale was administered to determine the participants’ overall perception of program helpfulness. A mean rating of 7.63 was obtained which corresponds to very helpful on the scale. A comparison of incident categories with program objectives indicated a high degree of consistency, with a few exceptions. Implications for program improvements, wider program dissemination, and counselling practice are discussed. In addition, methodological issues related to using the critical incident technique with children are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Philosophiae Doctor - PhD / The study aimed to pilot-test the effectiveness of the Olweus Bullying Prevention Intervention Programme (OBPP) at two selected primary schools in the Western Cape; and to compare the differences in reported incidents of bullying between the control schools (CSs) and intervention schools (ISs), after the OBPP intervention. On the basis of these aims, the stated objectives were to measure bullying behaviour for pre-test and post-test comparisons with the CSs after the implementation of the OBPP at the ISs; and to investigate the effectiveness of the OBPP by comparing the ISs and CSs for programme targets. Three main hypotheses were formulated and tested, including: (1) There is no statistically significant difference in the mean rank of learners’ exposure to various types of bullying, characteristics (grade level and gender) of the perpetrator, locations of where the bullying occurred, disclosure of the bullying incident, participants’ and peers’ feelings of support, reactions and attitudes when experiencing or witnessing a bullying incident, parents’ and teachers’ reactions and efforts to support and protect victims and participants’ reports of satisfactory schooling environments at the ISs and CSs before and after intervention; (2) There is no statistically significant difference in mean rank of learners’ exposure to various types of bullying, characteristics (grade level and gender) of the perpetrator, locations of where the bullying occurred , disclosure of the bullying incident, participants’ and peers’ feelings of support, reactions and attitudes when experiencing or witnessing a bullying incident, parents’ and teachers’ reactions and efforts to support and protect victims and participants’ reports of satisfactory schooling environments between females’ and males’ reports before and after intervention; (3)There is no statistically significant difference in mean rank of learners’ exposure to various types of bullying, characteristics (grade level and gender) of the perpetrator, locations of where the bullying occurred , disclosure of the bullying incident, participants’ and peers’ feelings of support, reactions and attitudes when experiencing or witnessing a bullying incident, parents’ and teachers’ reactions and efforts to support and protect victims and participants’ reports of satisfactory schooling environments between females’ and males’ at the ISs and CSs before and after intervention. In order to provide the relevant theoretical orientations to the study, the Olweus Approach, served as a framework for investigating the prevalence and extent of bullying in the selected schools, while Bronfenbrenner’s Ecological theoretical framework was used to inform the study. In order to reach these objectives, a quantitative method using a questionnaire to collect data and a quasi-experimental design with intervention (ISs) and control (CSs) groups was used. The following are the main findings in terms of tested hypotheses: Firstly, there is a positive statistically significant difference concerning the CSs variables that include peer support toward bullying (school 2 and 4) where females represented higher mean ranks than males at school 2 and males were represented by higher mean ranks compared to females for school 4. Furthermore, for the variables peer attitudes toward bullying (school 4) and reported satisfactory schooling environments (school 4), more females than males attested for both. This suggests a favourable effect without the intervention. Furthermore, there is a statistically significant difference concerning the ISs variables that include characteristics (grade level and gender) of the perpetrator (school 1), disclosure of the bullying incident (school 1), peer reaction and attitudes toward bullying (school 1), parents’ and teachers’ reactions and efforts to support and protect victims against bullying (school 1 & 3), class teacher efforts to support and protect victims of bullying (school 1) as well as reported satisfactory schooling environments ( school 1). Secondly, it is noteworthy that for all the variables that presented statistically significant differences between females and males at baseline and follow up for the ISs – on average more females compared to males attested to this. Finally, statistically significant differences in terms of overall positive improvements i.e. N=200 that reported been bullied at baseline, was highlighted at only one of the ISs (school 1). Variables in this regard, included exposure to various types of bullying, characteristics (grade and level) of the perpetrator, disclosure of the bullying and reports of having a satisfactory schooling environment and noteworthy is that more males than females attested to be exposed to various types of bullying. These findings confirmed that the implementation of the OBPP has shown to be an effective programme at instilling an anti-bullying culture in terms of the named variables. The study therefore recommends, among others, that schools address existing bullying behaviour and prevent further bullying by building and enhancing existing connections between itself and the community which it serves; that the staff as a whole sets the standards of advocating an anti-bullying culture; and that teacher training colleges and universities offer the guidelines of the OBPP as a part of the students’ curriculum requirements. / National Development Agency (NDA) and the University of the Western Cape

Chaque année, de nombreux programmes de prévention des dépendances sont implantés dans les écoles québécoises. L'efficacité de ces programmes peut être minée par différents facteurs, dont le manque d’adaptation du programme aux caractéristiques de la population ciblée (Grover, 2010; Grover, Cram et Bowman, 2007; McKennitt, 2007) et les problèmes d'implantation (Janosz, 2010; Joly, Tourigny et Thibaudeau, 2005). Ainsi, un programme probant pourrait s'avérer peu efficace s’il est mal adapté ou mal implanté (Botvin, Baker, Dusenbury, Tortu et Botvin, 1990; Chen, 2015; Dumas, Lynch, Laughlin, Smith et Prinz, 2001; Dusenbury, Brannigan, Falco et Hansen, 2003; Janosz, 2010; Rohrbach, Graham et Hansen, 1993; Rossi, Lipsey et Freeman, 2004) ou encore créer des effets iatrogènes chez la population ciblée (Botvin et Griffin, 2007; Craplet, 2006; Sohn, 2000; Werch et Owen, 2002). Au Québec, si l’étude de l'adaptation et de l’implantation des programmes de prévention en milieu scolaire apparait limitée pour la population générale (Janosz, 2010; Roberge, Choinière et Laverdure, 2009), elle semble absente chez la population autochtone. Or, dans certaines communautés autochtones québécoises, des taux élevés de consommation de psychotropes sont rapportés, sans compter que l'initiation à l’alcool et aux drogues survient à un âge précoce (Cotton et Laventure, 2013; Pronovost, Plourde, Alain, Eveno et Laperrière, 2009). Les particularités culturelles et la dispersion géographique de certaines communautés d'une même Nation peuvent complexifier l'implantation des programmes (Dell et al., 2012; Grover, 2010; Grover et al., 2007; McKennitt, 2007; Whitbeck, Walls et Welch, 2012). Pour offrir des programmes de prévention qui répondent aux besoins des jeunes autochtones, leur adaptation et l’évaluation de leur implantation apparaissent alors essentielles (Kumpfer, Pinyuchon, de Melo et Henry, 2008; McKleroy et al., 2006; Ringwalt et Bliss, 2006; Wingood et DiClemente, 2008). Cette thèse par articles a pour but d’expérimenter l'adaptation culturelle d'un programme de prévention. À cette fin, le premier article vise à identifier les facteurs facilitant ou entravant l’implantation initiale d’un programme de prévention des dépendances (Système d) chez les élèves innus du Québec d'âge scolaire primaire. Le second article vise à illustrer le processus d’adaptation de ce même programme, puis à vérifier la fidélité de son implantation en ce qui a trait à l'adhérence au contenu. Cette thèse comporte un devis de recherche mixte incorporé. Dans le volet qualitatif, différents répondants ont été rencontrés afin de documenter leur satisfaction et d’identifier les facteurs ayant facilité et entravé l'implantation: les animateurs du programme (n=6), les intervenants scolaires (n=2), les enseignants (n=2), la direction de l'école (n=1) et les parents des élèves ayant participé à la version initiale du programme (n=9). Dans le volet quantitatif, des journaux de bord ont permis de compléter l'identification des facteurs, en plus de mesurer l'adhérence au contenu de la version initiale du programme puis de sa version adaptée. Les résultats obtenus ont permis d’identifier différents facteurs entravant l'implantation du programme (manque de disponibilité des membres du personnel scolaire, complexité de certains concepts). D’autres facteurs ont toutefois facilité l’implantation du programme (adaptation en cours d’animation, capacité de résolution de problèmes des animateurs et des enseignants). Si certains de ces facteurs (formation au programme, aptitudes des personnes qui implantent) sont également observés en milieu scolaire non autochtone, d'autres facteurs (implication de membres du Conseil de bande, barrières de la langue et de la culture) apparaissent plus spécifiques au contexte communautaire autochtone. L’identification de ces facteurs, bien qu'elle ne concerne qu'une communauté autochtone, pourrait être transposée à d’autres communautés afin optimiser l’implantation et l'adaptation des programmes de prévention dans leurs écoles. Les principales adaptations apportées au programme Système d concernent la restructuration du protocole d'intervention (réduction de la durée des ateliers, ajout d'un cinquième atelier ainsi que d'un volet communautaire), la diversification des méthodes pédagogiques utilisées et l’intégration de références culturelles autochtones dans le contenu du programme. Il semble toutefois que l'adaptation du programme, bien que nécessaire pour correspondre à la réalité des élèves innus, se soit avérée insuffisante pour augmenter l'adhérence à son contenu. L'ensemble des résultats obtenus dans cette thèse permet de sensibiliser les différents praticiens des milieux scolaires autochtones, dont les psychoéducateurs, sur l'importance de sélectionner, implanter et adapter avec soin des programmes afin de prévenir adéquatement les dépendances auprès des jeunes autochtones.