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Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we... more
Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we describe an extensive team science effort to develop a transdiagnostic approach to neuromotor health interventions designed to leverage the heightened neuroplasticity of the first year of life. We undertook the following processes: (1) conducted a review of the literature to extract common principles and strategies underlying effective neuromotor health interventions; (2) hosted a series of expert scientific exchange panels to discuss common principles, as well as practical considerations and/or lessons learned from application in the field; and (3) gathered feedback and input from diverse stakeholders including infant caregivers and healthcare providers. The resultant framework was a pragmatic, evidence-based, transdiagnostic approach to optimize neuro...
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Additional file 2: Supplemental File 1. Adapted Versions of the Scales
Additional file 1: Table S1. Intercorrelations and descriptive statistics for ILS. Table S2. Intercorrelations and descriptive statistics for OCRBS. Table S3. Intercorrelations and descriptive statistics for EBPQ. Table S4.... more
Additional file 1: Table S1. Intercorrelations and descriptive statistics for ILS. Table S2. Intercorrelations and descriptive statistics for OCRBS. Table S3. Intercorrelations and descriptive statistics for EBPQ. Table S4. Intercorrelations and descriptive statistics for EBPAS.
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Background A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. This paper describes an instrument that is a component of the Sustainment... more
Background A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. This paper describes an instrument that is a component of the Sustainment Measurement System (SMS), designed to assess both determinants and outcomes of efforts to sustain prevention programs and initiatives. Methods A 42-item scale was administered to 186 representatives of 145 programs funded by 7 SAMHSA prevention grant initiatives. Scale items were identified from qualitative data collected from 45 representatives of 10 programs and 8 SAMHSA program officers and organized into 9 categories of sustainment determinants and sustainment outcomes. Factor structure identified from principal axis factor analysis and elimination of items with CFA coefficients less than .300 resulted in a 35-item scale with 8 determinant factors and 1 outcome factor. Results Confirmatory Factor Analysis provided support for a 35-item model fit to the ...
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Background Although some advances have been made in recent years, the lack of measures remains a major challenge in the field of implementation research. This results in frequent adaptation of implementation measures for different... more
Background Although some advances have been made in recent years, the lack of measures remains a major challenge in the field of implementation research. This results in frequent adaptation of implementation measures for different contexts—including different types of respondents or professional roles—than those for which they were originally developed and validated. The psychometric properties of these adapted measures are often not rigorously evaluated or reported. In this study, we examined the internal consistency, factor structure, and structural invariance of four well-validated measures of inner setting factors across four groups of respondents. The items in these measures were adapted as part of an evaluation of a large-scale organizational change in a rehabilitation hospital, which involved transitioning to a new building and a new model of patient care, facilitated by a significant redesign of patient care and research spaces. Methods Items were tailored for the context an...
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A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance... more
A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance Abuse and Mental Health Services Administration prevention grant initiatives to identify experiences with implementation and sustainability barriers and facilitators; what “sustainability” means and what it will take to sustain their programs; and which Consolidated Framework for Implementation Research (CFIR) elements are important for sustainability. Lists of sustainability determinants and outcomes were then compiled from each data set and compared with one another. Analysis of themes from interviews and free lists revealed considerable overlap between sustainability determinants and outcomes. Four sustainability elements were identified by all three data sets (ongoing coalitions, collaborations, and networks and partnerships; infrastructure and ca...
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Research Interests: Mathematics, Communication, Medical Informatics, Machine Learning, Data Mining, and 13 moreHealth Informatics, Implementation Science, Medicine, California, Humans, Computer Simulation, Feasibility Studies, Diffusion of Innovation, Information Storage and Retrieval, Sensitivity and Specificity, Translational Medical Research, Records as Topic, and Medical and Health Sciences
Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the... more
Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the term "sustainment" and what factors predict or even measure sustainability of effective prevention programs and support systems. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and i...
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Variations in acquiescence and extremity pose substantial threats to the validity of cross-cultural research that relies on survey methods. Individual and cultural correlates of response styles when using 2 contrasting types of response... more
Variations in acquiescence and extremity pose substantial threats to the validity of cross-cultural research that relies on survey methods. Individual and cultural correlates of response styles when using 2 contrasting types of response mode were investigated, drawing on data from 55 cultural groups across 33 nations. Using 7 dimensions of self-other relatedness that have often been confounded within the broader distinction between independence and interdependence, our analysis yields more specific understandings of both individual- and culture-level variations in response style. When using a Likert-scale response format, acquiescence is strongest among individuals seeing themselves as similar to others, and where cultural models of selfhood favour harmony, similarity with others and receptiveness to influence. However, when using Schwartz's (2007) portrait-comparison response procedure, acquiescence is strongest among individuals seeing themselves as self-reliant but also conne...
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Markus and Kitayama's (1991) theory of independent and interdependent self-construals had a major influence on social, personality, and developmental psychology by highlighting the role of culture in psychological processes. However,... more
Markus and Kitayama's (1991) theory of independent and interdependent self-construals had a major influence on social, personality, and developmental psychology by highlighting the role of culture in psychological processes. However, research has relied excessively on contrasts between North American and East Asian samples, and commonly used self-report measures of independence and interdependence frequently fail to show predicted cultural differences. We revisited the conceptualization and measurement of independent and interdependent self-construals in 2 large-scale multinational surveys, using improved methods for cross-cultural research. We developed (Study 1: N = 2924 students in 16 nations) and validated across cultures (Study 2: N = 7279 adults from 55 cultural groups in 33 nations) a new 7-dimensional model of self-reported ways of being independent or interdependent. Patterns of global variation support some of Markus and…
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Introduction: Fidelity monitoring and feedback are critical components for implementing effective preventive interventions. However, these are also resource intensive for the research team even in efficacy/effectiveness trials, and... more
Introduction: Fidelity monitoring and feedback are critical components for implementing effective preventive interventions. However, these are also resource intensive for the research team even in efficacy/effectiveness trials, and generally too expensive to maintain when the program is implemented fully within the host institution or community. A reasonable goal is to reduce the cost of obtaining reliable and valid fidelity ratings for behavioral intervention programs by an order of magnitude or more. We present a proof of concept of a computational method that measures fidelity in the Familias Unidas intervention. Familias Unidas is a family-focused prevention intervention targeting externalizing behaviors among Hispanic youth. It is delivered by school counselors in Spanish to parents and in the home in English and Spanish. Our work uses speech analysis, knowledge engineering, and computational linguistics to measure fidelity. Methods/ Results: The existing method for rating fide...
Introduction: Prevention research has primarily focused on the development of mobile based applications (apps) for end users with less focus on app development for those whocarry-out evidence based interventions. The use of mobile based... more
Introduction: Prevention research has primarily focused on the development of mobile based applications (apps) for end users with less focus on app development for those whocarry-out evidence based interventions. The use of mobile based apps in the delivery of evidence based interventionscan have an impact on the scalability of an intervention, as well as the fidelity, monitoring, and overall quality of implementation. We present a proof of concept of a mobile base app to carry out and monitor fidelity of the Good Behavior Game. The Good Behavior Game is a 1st and 2nd grade teacher classroom management program that has demonstrated impact on long-term drug abuse, sexual risk behavior, delinquency, and suicidal behavior by socializing children to the student role and reducing aggressive, disruptive behaviors. Methods/Results: The GBG app was produced through a partnership between android developers and Ce-PIM, organized around the American Institutes for Research GBG manual. The GBG ...
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A typical behavioral intervention requires recording the audio or video of the session lead by an intervention agent (facilitator). These recordings offer valuable information for training, supervision, and analysis of intervention... more
A typical behavioral intervention requires recording the audio or video of the session lead by an intervention agent (facilitator). These recordings offer valuable information for training, supervision, and analysis of intervention impact. Yet, they are costly and resource intensive. During efficacy and effectiveness trials, typically more than 90% of the sessions recordings are not coded for fidelity. During implementation of prevention programs, even less sessions are coded for fidelity, and often the required procedures for recording the session and assessing fidelity becomes unsustainable due to cost and time. We propose a way to use computational methods to analyze fidelity automatically. These methods provide promise that enables local organizations to better implement carefully tested evidence-based programs. Our method analyzes the communication between of the facilitator and at least one individual who is the target of the intervention. We demonstrate how these method can u...
Beliefs about personhood are understood to be a defining feature of individualism-collectivism (I-C), but they have been insufficiently explored, given the emphasis of research on values and self-construals. We propose the construct of... more
Beliefs about personhood are understood to be a defining feature of individualism-collectivism (I-C), but they have been insufficiently explored, given the emphasis of research on values and self-construals. We propose the construct of contextualism, referring to beliefs about the importance of context in understanding people, as a facet of cultural collectivism. A brief measure was developed and refined across 19 nations (Study 1: N = 5,241), showing good psychometric properties for cross-cultural use and correlating well at the nation level with other supposed facets and indicators of I-C. In Study 2 ( N = 8,652), nation-level contextualism predicted ingroup favoritism, corruption, and differential trust of ingroup and outgroup members, while controlling for other facets of I-C, across 35 nations. We conclude that contextualism is an important part of cultural collectivism. This highlights the importance of beliefs alongside values and self-representations and contributes to a wid...
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African Americans and Hispanics in the US have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations.... more
African Americans and Hispanics in the US have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. While a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We propose that innovative approaches involving computational technologies ...
Implementation science has great potential to improve the health of communities and individuals who are not achieving health equity. However, implementation science can exacerbate health disparities if its use is biased toward entities... more
Implementation science has great potential to improve the health of communities and individuals who are not achieving health equity. However, implementation science can exacerbate health disparities if its use is biased toward entities that already have the highest capacities for delivering evidence-based interventions. In this article, we examine several methodologic approaches for conducting implementation research to advance equity both in our understanding of what historically disadvantaged populations would need—what we call scientific equity—and how this knowledge can be applied to produce health equity. We focus on rapid ways to gain knowledge on how to engage, design research, act, share, and sustain successes in partnership with communities. We begin by describing a principle-driven partnership process between community members and implementation researchers to overcome disparities. We then review three innovative implementation method paradigms to improve scientific an...
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This study explored whether cultural identity predicts health lifestyle behaviors. Participants included 302 recently immigrated (<5 years in the U.S.) Latinx adolescents (53% boys; mean age 14.51 years at baseline) from Miami and Los... more
This study explored whether cultural identity predicts health lifestyle behaviors. Participants included 302 recently immigrated (<5 years in the U.S.) Latinx adolescents (53% boys; mean age 14.51 years at baseline) from Miami and Los Angeles. Participants completed cultural identity measures at baseline and 1-year post baseline. A path analysis was used to estimate associations between cultural identities (ethnic, national, and bicultural) and health lifestyle behaviors (physical activity, diet, and sleep hygiene). Ethnic identity positively predicted diet. Results also indicated a significant interaction between ethnic and national identity on sleep hygiene. Specifically, when national identity was high (+1 SD), ethnic identity positively predicted sleep hygiene. This study focuses on health lifestyle behaviors such as physical activity, diet, and sleep hygiene in this population. Results highlight the need to explore the protective nature of cultural identity retention in rela...
Research Interests: Psychology and Medicine
This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino... more
This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino adolescents (Mage = 14.51) and parents (Mage = 41.09; N = 302) completed measures of these constructs. Latent growth modeling indicated that adolescent and parent family functioning remained stable over time. Early levels of family functioning predicted adolescent and parent outcomes. Baseline adolescent cultural stress predicted lower positive adolescent and parent family functioning. Latent class growth analyses produced a two-class solution for family functioning. Adolescents and parents in the low family functioning class reported low family functioning over time. Adolescents and parents in the high family functioning class experienced increases in family functioning.
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This study examined directionality between personal (i.e., coherence and confusion) and cultural identity (i.e., ethnic and U.S.) as well as their additive effects on psychosocial functioning in a sample of recently immigrated Hispanic... more
This study examined directionality between personal (i.e., coherence and confusion) and cultural identity (i.e., ethnic and U.S.) as well as their additive effects on psychosocial functioning in a sample of recently immigrated Hispanic adolescents. The sample consisted of 302 recent (<5 years) immigrant Hispanic adolescents (53% boys; Mage = 14.51 years at baseline; SD = .88 years) from Miami and Los Angeles who participated in a longitudinal study. Results indicated a bidirectional relationship between personal identity coherence and both ethnic and U.S. identity. Ethnic and U.S. affirmation/commitment (A/C) positively and indirectly predicted optimism and negatively predicted rule breaking and aggression through coherence. However, confusion predicted lower self-esteem and optimism and higher depressive symptoms, rule breaking, unprotected sex, and cigarette use. Results further indicated significant site differences. In Los Angeles (but not Miami), ethnic A/C also negatively p...
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Objectives. To evaluate the effectiveness of an evidence-based, parent-centered intervention, Familias Unidas, delivered by nonresearch personnel, in preventing substance use (alcohol, illicit drugs) and sex without a condom among... more
Objectives. To evaluate the effectiveness of an evidence-based, parent-centered intervention, Familias Unidas, delivered by nonresearch personnel, in preventing substance use (alcohol, illicit drugs) and sex without a condom among Hispanic adolescents. Methods. A randomized controlled trial (n = 746) evaluated the effectiveness of Familias Unidas among Hispanic eighth graders (age range = 12–16 years), relative to prevention as usual, within a public school system. School personnel, including social workers and mental health counselors, were trained to deliver the evidence-based intervention. Participant recruitment, intervention delivery, and follow-up ran from September 2010 through June 2014 in Miami–Dade County, Florida. Results. Familias Unidas was effective in preventing drug use from increasing and prevented greater increases in sex without a condom 30 months after baseline, relative to prevention as usual. Familias Unidas also had a positive impact on family functioning and ...
Research Interests: Program Evaluation, Risk Taking, Health Services Research, Adolescent, Medicine, and 12 moreHumans, Female, Florida, Male, School health services, Condoms, Parent‐child Relations, Sexually Transmitted Diseases, Adolescent Behavior, Primary Prevention, Substance-Related Disorders, and Medical and Health Sciences
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Research Interests: Psychology, Clinical Psychology, Health Psychology, Depression, Individuality, and 15 moreRisk Taking, Acculturation, Adolescent, Medicine, Immigrants and Emigrants, Los Angeles, Humans, United States, Female, Male, Young Adult, Psychosocial, Self Concept, Longitudinal Studies, and Youth & Adolescence
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Research Interests: Psychology, Parenting, Acculturation, Adolescent, Medicine, and 15 moreFamily Psychology, Immigrants and Emigrants, Humans, Smoking, Aggression, Female, Alcohol Drinking, Male, Depressive Disorder, Conduct Disorder, Family Relations, Self Concept, Longitudinal Studies, Psychological Stress, and Substance-Related Disorders
Latino/a youth are at risk for alcohol use. This risk seems to rise with increasing US cultural orientation and decreasing Latino cultural orientation, especially among girls. To ascertain how acculturation may influence Latino/a youth... more
Latino/a youth are at risk for alcohol use. This risk seems to rise with increasing US cultural orientation and decreasing Latino cultural orientation, especially among girls. To ascertain how acculturation may influence Latino/a youth alcohol use, we integrated an expanded multi-domain model of acculturation with the Theory of Reasoned Action. Participants were 302 recent Latino/a immigrant youth (141 girls, 160 boys; 152 from Miami, 150 from Los Angeles) who completed surveys at 4 time points. Youth completed measures of acculturation, attitudes toward drinking, perceived subjective norms regarding alcohol use, intention to drink, and alcohol use. Structural equation modeling indicated that collectivistic values predicted more perceived disapproval of drinking, which negatively predicted intention to drink. Intention to drink predicted elevated alcohol use. Although the association between collectivistic values and social disapproval of drinking was relatively small (β = .19, p &l...
Research Interests: Sociology, Psychology, Cognitive Science, Immigration, Ethnicity And Health, and 15 moreAcculturation, Adolescent, Medicine, Los Angeles, Humans, Female, Alcohol Drinking, Florida, Male, Attitude, Longitudinal Studies, Public health systems and services research, Psychological Theory, Adolescent Behavior, and Underage Drinking
Research Interests: Psychology, Parenting, Adolescent Health, Acculturation, Adolescent, and 15 moreMedicine, Immigrants and Emigrants, Immigrants, Latinos, Humans, Female, Alcohol Drinking, Male, Family Functioning, Longitudinal Studies, Sex Factors, Family Conflict, Likelihood Functions, Unsafe Sex, and HIV infections
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Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver... more
Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement 6 months postbaseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms 1 year postbaseline (outcomes). Mea...