Technical Guidance on Combination HIV Preventionclac.cab
This document provides guidance on HIV prevention programs for men who have sex with men (MSM) as part of the US President's Emergency Plan for AIDS Relief (PEPFAR). It summarizes that MSM face a disproportionately high risk of HIV in many countries. An effective prevention program requires a combination of structural, biomedical, and behavioral interventions tailored to the specific risks and needs of MSM. PEPFAR supports integrating community outreach, condom distribution, HIV testing, healthcare linkage, health education, and STI treatment into a comprehensive prevention package for MSM.
Primary Care and Behavioral Health Integration – Leveraging psychologists’ ro...Michael Changaris
Background and Importance: Violence stands as a significant cause of death in the United States, contributing to various health and mental health issues. The role of psychologists has evolved into an essential component of healthcare.
Despite a decrease over several decades, rates of violence have begun to rise again. However, the prevailing approach often focuses on managing the aftermath of violence rather than tackling its underlying causes. Each community possesses its own distinct profile of factors that either elevate or mitigate the risk of violence.
Primary Care Behavioral Health Integration presents a broadly applicable method for preventing violence, offering a hyper-local approach that targets the specific health needs of individuals, families, and communities. By adapting established evidence-based strategies for healthcare improvement, primary prevention can significantly reduce violence.
Methods and Description: This presentation will provide practical tools and general measures to effectively merge behavioral healthcare with primary care systems, fostering violence reduction at the levels of the community, healthcare facility, and healthcare providers. The implementation of universal precautions for violence reduction will be outlined, along with a structured approach to establish violence reduction advocates and teams. These teams will be equipped to assess the unique local risks, manifestations, and impacts of violence within the community they serve.
Outcomes: Through the incorporation of a 7-factor violence risk reduction strategy within primary care behavioral health, collaborative multidisciplinary teams can effectively diminish instances of interpersonal, individual, and community violence. The application of the "four Ts" model (Training, Triage, Treatment, Team Care) empowers primary care clinicians and integrated healthcare settings to enhance individual clinical outcomes, overall clinic population health, and actively champion community-wide violence reduction.
Public Health Association of South Africa (PHASA) poster presentation of the "Theoretical underpinnings of promotion campaigns for
medical male circumcision HIV prevention interventions in sub-Saharan Africa"
The document discusses the development of a mobile application to reduce HIV/STI rates in high-risk populations in Chicago. It notes that rates of HIV/AIDS and other STIs remain higher in Chicago than national averages, especially among men who have sex with men, black individuals, and those over 30. The goal of the app is to provide targeted HIV/STI information, resources, and services to adolescents, young adults, and minorities. The document outlines requirements for the app's design and phases of development, testing, and implementation across mobile platforms.
This document discusses disease surveillance research. It explains that disease surveillance involves the ongoing collection, analysis, interpretation, and dissemination of health data to monitor disease trends and improve public health. A reductionist approach looks at isolating variables to find cause-and-effect relationships, while a complex systems approach considers adaptive and multilevel systems in context. The document also discusses the roles and competencies needed for nurses to participate in surveillance and investigation activities.
PAGE 24The perceptions of health workers on the effecti.docxalfred4lewis58146
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24
The perceptions of health workers on the effectiveness of HIV Prevention Programmes for MSM in Jamaica
May 2013
Abstract
The Jamaican Ministry of Health (MOH) has framed a policy and strategy that allows for sexual health promotion and HIV prevention programmes to be conducted for men who have sex with men (MSM), despite an enforced legal framework which makes it illegal to participate in anal sex. The population of Jamaica’s MSM accounts for the highest HIV prevalence rate on the island. While the National HIV/ STI Programme conducts a government-run programme, a significant portion of the work is conducted by local and internationally funded non-government organizations (NGO). This study seeks to explore the efficiency of these HIV/AIDS prevention programmes from the experiences and perspectives of the health care workers involved in their implementation. It will utilize qualitative research methodology of a descriptive cross-sectional design. The procedure will involve the use of interviews. These will be conducted with health workers in MSM programmes from NGOs and the Jamaica National HIV/STI Programme. It is expected that the results may indicate a view of success with many programmes, with limitations being attributed to the societal and legal framework within which they work. It may also show disparities between government and locally ran programmes conducted by NGOs. The results of this study will be shared and made available to public libraries, the government of Jamaica and other stakeholders working to alleviate the impact of HIV and AIDS in Jamaica and the world. *
Keywords: HIV/AIDS, health promotion and HIV prevention, men who have sex with men (MSM), Jamaica, sexual health, gay men, other MSM and transgender individuals (GMT).Table of Contents
Page #
Abstract
Introduction
Methodology
Discussion
Conclusion
Reflection
References
Appendix Consent
Appendix Draft Interview
Glossary
Privacy Statement
1. Introduction
This study explores the effectiveness of the HIV and AIDS response within the target population of MSM in Jamaica. It investigates, the views and perspectives of the health workers who carry out or implement these programmes.
Thanks to science, the ability to treat and care for persons living with HIV (PLHIV) and AIDS has grown exponentially. Individuals are defying their prognoses and are living with HIV and AIDS for record number of years than they did when the virus was first discovered. Gay, bisexual, transgendered and other men who have sex with men but may not identify as gay, are disproportionately affected by sexually transmitted infections like HIV (MOH, 2011a). For the purpose of this research the term MSM will be defined and utilized as the public health terminology to capture the target audience of all males who have sex with males.
For the purpose of this research.
This document outlines the purpose and context of a research study on the impact of health education on HIV prevention in Canada. [1] The study aims to understand how education impacts various intervention programs and factors that help education be successful. [2] It will also seek to understand perceptions incorporated in education that help HIV education programs. [3] Key issues examined will include whether education targets at-risk groups and whether service providers are flexible in assisting people with HIV.
This document outlines FHI's strategic framework for developing behavior change communication programs for HIV/AIDS prevention. It describes a 12-step process for developing an integrated BCC strategy, including defining goals, involving stakeholders, assessing target populations, developing objectives and messages, pre-testing materials, implementing activities, and evaluating impact through monitoring and feedback. The framework is intended to guide the practical development and implementation of collaborative, evidence-based BCC strategies.
Technical Guidance on Combination HIV Preventionclac.cab
This document provides guidance on HIV prevention programs for men who have sex with men (MSM) as part of the US President's Emergency Plan for AIDS Relief (PEPFAR). It summarizes that MSM face a disproportionately high risk of HIV in many countries. An effective prevention program requires a combination of structural, biomedical, and behavioral interventions tailored to the specific risks and needs of MSM. PEPFAR supports integrating community outreach, condom distribution, HIV testing, healthcare linkage, health education, and STI treatment into a comprehensive prevention package for MSM.
Primary Care and Behavioral Health Integration – Leveraging psychologists’ ro...Michael Changaris
Background and Importance: Violence stands as a significant cause of death in the United States, contributing to various health and mental health issues. The role of psychologists has evolved into an essential component of healthcare.
Despite a decrease over several decades, rates of violence have begun to rise again. However, the prevailing approach often focuses on managing the aftermath of violence rather than tackling its underlying causes. Each community possesses its own distinct profile of factors that either elevate or mitigate the risk of violence.
Primary Care Behavioral Health Integration presents a broadly applicable method for preventing violence, offering a hyper-local approach that targets the specific health needs of individuals, families, and communities. By adapting established evidence-based strategies for healthcare improvement, primary prevention can significantly reduce violence.
Methods and Description: This presentation will provide practical tools and general measures to effectively merge behavioral healthcare with primary care systems, fostering violence reduction at the levels of the community, healthcare facility, and healthcare providers. The implementation of universal precautions for violence reduction will be outlined, along with a structured approach to establish violence reduction advocates and teams. These teams will be equipped to assess the unique local risks, manifestations, and impacts of violence within the community they serve.
Outcomes: Through the incorporation of a 7-factor violence risk reduction strategy within primary care behavioral health, collaborative multidisciplinary teams can effectively diminish instances of interpersonal, individual, and community violence. The application of the "four Ts" model (Training, Triage, Treatment, Team Care) empowers primary care clinicians and integrated healthcare settings to enhance individual clinical outcomes, overall clinic population health, and actively champion community-wide violence reduction.
Public Health Association of South Africa (PHASA) poster presentation of the "Theoretical underpinnings of promotion campaigns for
medical male circumcision HIV prevention interventions in sub-Saharan Africa"
The document discusses the development of a mobile application to reduce HIV/STI rates in high-risk populations in Chicago. It notes that rates of HIV/AIDS and other STIs remain higher in Chicago than national averages, especially among men who have sex with men, black individuals, and those over 30. The goal of the app is to provide targeted HIV/STI information, resources, and services to adolescents, young adults, and minorities. The document outlines requirements for the app's design and phases of development, testing, and implementation across mobile platforms.
This document discusses disease surveillance research. It explains that disease surveillance involves the ongoing collection, analysis, interpretation, and dissemination of health data to monitor disease trends and improve public health. A reductionist approach looks at isolating variables to find cause-and-effect relationships, while a complex systems approach considers adaptive and multilevel systems in context. The document also discusses the roles and competencies needed for nurses to participate in surveillance and investigation activities.
PAGE 24The perceptions of health workers on the effecti.docxalfred4lewis58146
PAGE
24
The perceptions of health workers on the effectiveness of HIV Prevention Programmes for MSM in Jamaica
May 2013
Abstract
The Jamaican Ministry of Health (MOH) has framed a policy and strategy that allows for sexual health promotion and HIV prevention programmes to be conducted for men who have sex with men (MSM), despite an enforced legal framework which makes it illegal to participate in anal sex. The population of Jamaica’s MSM accounts for the highest HIV prevalence rate on the island. While the National HIV/ STI Programme conducts a government-run programme, a significant portion of the work is conducted by local and internationally funded non-government organizations (NGO). This study seeks to explore the efficiency of these HIV/AIDS prevention programmes from the experiences and perspectives of the health care workers involved in their implementation. It will utilize qualitative research methodology of a descriptive cross-sectional design. The procedure will involve the use of interviews. These will be conducted with health workers in MSM programmes from NGOs and the Jamaica National HIV/STI Programme. It is expected that the results may indicate a view of success with many programmes, with limitations being attributed to the societal and legal framework within which they work. It may also show disparities between government and locally ran programmes conducted by NGOs. The results of this study will be shared and made available to public libraries, the government of Jamaica and other stakeholders working to alleviate the impact of HIV and AIDS in Jamaica and the world. *
Keywords: HIV/AIDS, health promotion and HIV prevention, men who have sex with men (MSM), Jamaica, sexual health, gay men, other MSM and transgender individuals (GMT).Table of Contents
Page #
Abstract
Introduction
Methodology
Discussion
Conclusion
Reflection
References
Appendix Consent
Appendix Draft Interview
Glossary
Privacy Statement
1. Introduction
This study explores the effectiveness of the HIV and AIDS response within the target population of MSM in Jamaica. It investigates, the views and perspectives of the health workers who carry out or implement these programmes.
Thanks to science, the ability to treat and care for persons living with HIV (PLHIV) and AIDS has grown exponentially. Individuals are defying their prognoses and are living with HIV and AIDS for record number of years than they did when the virus was first discovered. Gay, bisexual, transgendered and other men who have sex with men but may not identify as gay, are disproportionately affected by sexually transmitted infections like HIV (MOH, 2011a). For the purpose of this research the term MSM will be defined and utilized as the public health terminology to capture the target audience of all males who have sex with males.
For the purpose of this research.
This document outlines the purpose and context of a research study on the impact of health education on HIV prevention in Canada. [1] The study aims to understand how education impacts various intervention programs and factors that help education be successful. [2] It will also seek to understand perceptions incorporated in education that help HIV education programs. [3] Key issues examined will include whether education targets at-risk groups and whether service providers are flexible in assisting people with HIV.
This document outlines FHI's strategic framework for developing behavior change communication programs for HIV/AIDS prevention. It describes a 12-step process for developing an integrated BCC strategy, including defining goals, involving stakeholders, assessing target populations, developing objectives and messages, pre-testing materials, implementing activities, and evaluating impact through monitoring and feedback. The framework is intended to guide the practical development and implementation of collaborative, evidence-based BCC strategies.
This is a proposal for a population health program targeting adolescents aged 12-19 in an underserved African American community. The program aims to address risky sexual behaviors, substance abuse, mental health issues, violence, and obesity through education on safe sex practices, substance abuse counseling, mental health counseling, exercise promotion, and ensuring access to healthcare. The expected outcomes are a reduction in teen pregnancies and STIs, increased enrollment in counseling, and fewer obese adolescents. The program aligns with HP2020 goals and will use social cognitive theory and social media marketing. Potential barriers include lack of stakeholder participation and funding.
LuciousDavis1-Practices in Public Health-01-Unit9_ AssignmentLucious Davis
The document discusses improving global public health through international collaboration. It describes the Global Health Security Agenda created to work with nations and organizations to prevent infectious diseases. Eleven action plans were developed to implement strategies like educating the public on health risks. However, lack of funding is a barrier to properly resourcing programs. Greater investment is needed to address health inequalities and control diseases worldwide in our increasingly interconnected world.
Barreras y motivaciones para la afiliación al Seguro Familiar de Salud de per...HFG Project
This report describes the findings and recommendations of the qualitative study on the barriers and motivations to enrolling people living with HIV/AIDS in the Family Health Insurance plan in the Dominican Republic. The study was conducted with the goal of informing institutions in the Dominican Republic, such as the Standardized System of Beneficiaries (SIUBEN), the National Council for HIV and AIDS (CONAVIHSIDA), the National Health Insurance (SENASA), and the United States Agency for International Development (USAID) about the recommended strategies to increase the number of people living with HIV/AIDS enrolled in Family Health Insurance plan. Target populations such as men who have sex with men (MSM), transgender people, and sex workers, and other prioritized populations, such as migrants, were the main focus of the study in order to meet national and international commitments on HIV, aiming to increase access to antiretroviral treatment, as well as to generate the financial sustainability of the Dominican Social Security System (SDSS).
The document discusses the health belief model, which is a theoretical framework used in healthcare to guide health promotion plans and disease prevention. It has five stages: precontemplation, contemplation, preparation, action, and maintenance. The model focuses on perceived susceptibility, severity, benefits, and confidence. It can be used to understand behaviors like substance abuse in youth. Barriers to implementing it include lack of resources. Benefits are improving health knowledge and behaviors.
1) Community-based interventions have been shown to successfully change risky behaviors and prevent HIV transmission when they incorporate cultural elements, community participation, and education programs delivered by community leaders.
2) Effective interventions identify factors influencing HIV transmission, tailor prevention strategies to specific populations, and address barriers like discrimination and lack of culturally competent healthcare services.
3) For HIV-positive injecting drug users, improved access to substance abuse treatment, healthcare, housing support and antiretroviral therapy through community programs can achieve comparable health outcomes to non-drug users.
Baral et al. BMC Public Health 2013, 13482httpwww.biomed.docxjasoninnes20
Baral et al. BMC Public Health 2013, 13:482
http://www.biomedcentral.com/1471-2458/13/482
DEBATE Open Access
Modified social ecological model: a tool to guide
the assessment of the risks and risk contexts of
HIV epidemics
Stefan Baral1*, Carmen H Logie2, Ashley Grosso1, Andrea L Wirtz1 and Chris Beyrer1
Abstract
Background: Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These
factors are representative of social, economic, organizational and political inequities. Associated with an improved
understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV
prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires
epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages.
Discussion: Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or
penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and
structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is
often far more actionable than characterizing individual-level risks. We propose a modified social ecological model
(MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic
HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key
populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The
MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual
HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The
utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM.
Summary: The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV
in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective
integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic
studies has traditionally been on describing individual-level risk factors, the future necessitates comprehensive
epidemiologic data characterizing multiple levels of HIV risk.
Background
There is an increasing recognition of the importance of
the social and structural drivers of acquisition and trans-
mission of HIV [1,2]. While there is no singular defin-
ition, structural drivers can be conceptualized as those
social, economic, organizational, and political power and
domination factors which contribute to social inequities
[2-4]. These structural drivers do not directly cause the
acquisition or onward transmission of HIV; rather they
* Correspondence: [email protected]
...
The document discusses community systems strengthening (CSS) and how it relates to key populations affected by HIV/AIDS. It provides background on key populations and their vulnerability to HIV, as well as the role of the Global Fund in funding programs. It describes how the Global Fund introduced CSS in 2009 to strengthen community mobilization and service delivery. However, CSS faces technical challenges such as unclear definitions and limited tools for assessment. It also faces political challenges like continued skepticism of key population programming. The document concludes with recommendations to strengthen CSS and ensure it effectively serves key populations.
This document provides a comprehensive list of evidence-based practice resources for promoting community health, development, and prevention interventions. It includes over 30 links to databases, organizations, and categories of best practices on topics like adolescent pregnancy, cancer, child and youth development, and more. The resources provide systematic reviews, guidelines, and searchable databases of proven community programs and policies.
Implementing comprehensive HIV/STI programmers with Sex Workersclac.cab
The document presents a tool for implementing comprehensive HIV/STI programs for sex workers. It was developed in response to requests for guidance on how to apply the WHO's 2012 recommendations. The tool provides practical examples from global programs on community empowerment, addressing violence, community-led services, condom programming, clinical services, and program management. Its goal is to support public health officials, NGOs, and health workers in planning, delivering, and monitoring effective HIV/STI interventions for sex workers.
Clinical Case Presentation SummarySummary of Primary and Secon.docxmccormicknadine86
Clinical Case Presentation Summary
Summary of Primary and Secondary Syphilis
In 2017, a total of 30,644 cases of primary and secondary syphilis were reported in the United States, yielding a rate of 9.5 cases per 100,000 population (CDC, 2018). According to the CDC (2018), this rate signifies a 10.5% increase compared with 2016 (8.6 cases per 100,000 population). Syphilis has a high prevalence among certain racial/ethnic groups, as well as in other groups, such as adolescents, sex workers, men who have sex with men (MSM), and sexually abused women (Hollier, 2018). Syphilis is transmitted through direct contact with an ulcerative lesion, or chancre which appears during the primary stage (most infectious) of syphilis (Hollier, 2018). Patients with this infection may seek medical treatment for signs and/or symptoms of primary syphilis (chancre/ulcer), or secondary syphilis (diffuse rash on palms and soles) (Hollier, 2018). On the other hand, patients may be completely asymptomatic and only diagnosed on routine screening.
Yonglin suggested to me one prevention strategy from the CDC called the “Talk, Test, Treat” method that has been suggested by the CDC is the “Talk, Test, Treat” method. Talking involves discussing sexual health history, testing involves screening for syphilis. The CDC recommends screening all sexually active men who have sex with men at least once a year, and more frequently if they are at-risk for infection. Pregnant women should be tested at their first prenatal visit, and at-risk women should be rescreened in their third trimester and again at delivery to prevent congenital syphilis. Lastly, patients need to be treated with benzathine penicillin G who test positive for syphilis.
Evidence-Based Action Plan #1
Implementing a mobile health unit (MHU) or van that offers community-based screening services for at-risk populations, such as female sex workers, men who have sex with men (MSM), and IV drug users could assist with reducing the transmission of primary and secondary syphilis. An MHU can be used as part of a community education, screening, and counselling program to serve urban and rural communities (Khanna & Narula, 2016). The MHU would have to be clearly identified as a free syphilis testing unit in order to make it more appealing to interested individuals who may approach. The health care providers working the mobile unit would be required to obtain a focused health history and patient contact information in order to provide screening results and the necessary follow-up instructions for any positive test results. Studies have shown that MHUs have been very helpful in detecting new cases of syphilis and beneficial to the at-risk population (Lipsitz et al., 2014). Also, MHUs may even increase patient compliance with the follow-up serologic testing that is required after being treated for syphilis, which may be a barrier for patients of low income or who lack transportation. This evidence-based intervention could be ...
The HIV intervention plan aims to address the leading cause of morbidity and mortality in Prince George's County - pediatric HIV. It analyzes HIV case data by age, race, CD4 diagnosis, and ZIP code. The plan involves focus groups to understand prevention needs. It establishes program goals and objectives to educate about transmission risks and promote safe behaviors. Outcomes will evaluate behavior changes and collaboration. The coalition formed, called the HIV Prevention Coalition, brings together stakeholders to develop a broad HIV prevention campaign.
This summary provides an overview of a systematic review of 34 HIV/AIDS mass communication campaigns from 1998 to 2007:
1) The review found that campaigns increasingly employed strategies recommended for effective design such as targeted audiences developed through segmentation, behavior-focused themes, use of behavioral theory, high message exposure, stronger research designs, and inclusion of behavior measures.
2) An examination of 10 campaigns using more rigorous designs found that the majority (8 of 10) demonstrated effects on behavior change or intentions.
3) However, most campaigns still used weak pre-experimental evaluation designs, indicating room for improved evaluation practices.
1) Newly formed public health policies should consider ethics and ensure equitable outcomes for all populations. Without ethics, policies could jeopardize vulnerable groups and reduce health standards.
2) Ethical practices must guide policy implementation and consider visibility, goals, evaluations, and research validity. Partnerships can leverage resources to treat diseases globally in an equitable manner.
3) International policies should prevent inequalities when addressing widespread diseases. Equality is needed for skilled workers to educate communities, but ethics vary between countries.
read and agree in not more that 160 words Sampling Issues and St.docxsimonlbentley59018
read and agree in not more that 160 words
Sampling Issues and Strategies
Pyramids usually tend to be easy to understand and work well to capture tiered concepts, so pyramids have been used to depict the tiered nature of primary healthcare, secondary healthcare, and tertiary healthcare services, which is the inverse relationship of effort needed and health impact of different interventions and nutrition recommendations (Issel et al., 2022). The public health pyramid is divided into four categories: direct healthcare services, enabling services, population-based services and infrastructure services.
The direct services level of the public health pyramid focuses on health programs for individuals. Due to the fact that this service focuses on individuals, the sampling may be a challenge because of who would be participating and non-participating in an intervention or non-interventions. Instead of randomly assigning individuals to either the program or a control group, it might be feasible for participants to become their own type of control (e.g., pretest and posttest) or perhaps future participants can serve as controls while they remain on a waiting list. Additionally, the costs can vary greatly depending on the type of data, and the frequency of data collection as well.
The enabling services, as mentioned above, focuses on groups of individuals and are provided in a wide range of contexts. The sampling issue in this case would be because of the several outcomes. It may be a challenge to recognize and recruit a comparison group with the same characteristics as the program’s participants considering the broad range of contexts. Thus, health services programs may not be appropriate for experimental designs, but can be suitable for quasi-experimental designs instead. Perhaps initiating random assignments can be a possibility depending on the group or at a community level as well.
The population-based level focuses on providing to the entire population. A sampling issue may be that, because this level focuses on a wider range of people, there are limitations of evaluation options to design that can be appropriately implemented among populations. In this case, time-series designs can be useful for evaluating population-level programs. Thus, existing data on populations are likely to be less costly to conduct as well.
The infrastructure services level focuses on all said levels, and interventions touches on changing healthcare operations in an organization or the overall public health system. With that said, the outcome evaluation is likely to determine whether the evaluation show actual changes in the infrastructure or changes to the health status of patients (or clients). Perhaps repeated measures or a time-series design is suitable based on whether the focus is for long-term change, depending on the data that is available at the individual or population level. Additionally, this might be the.
This document is a master's thesis submitted by Jordan Zarone to the Graduate School of Public Health at the University of Pittsburgh in 2014. It examines the history and efficacy of harm reduction programs, specifically needle and syringe exchange programs and housing first models, for reducing HIV transmission among injection drug users in the United States. The thesis reviews primary and secondary literature on these harm reduction approaches. It finds evidence that while direct links between the programs and reduced HIV incidence are complex, there is substantial evidence they are associated with reduced HIV risk behaviors. The thesis concludes harm reduction programs show promise for addressing the disproportionate impact of HIV among injection drug users.
Running head: ASSIGNMENT 3 1
ASSIGNMENT 3
4
Assignment 3
Diamond Fulton-Hicks
Saint Leo University-HCA:402
Mrs.Claudette Andrea
04/05/2020
According to the CDC, Youth Risk Behaviors are used in monitoring the six groups of health-associated practices that are contributing to the top causes of deaths and disability amongst youths and adults. Some of these behaviors are those which are contributing to unintended injuries and violent behavior; sexual practices which lead to unintentional pregnancies and sexually transmitted infections; alcohol and other drug use; tobacco use; detrimental dietary practices; and the insufficient engagement in the physical exercise. This paper is therefore based on discussing these health behaviors top factors associated with the increased death and disability rates amongst youths and adults (Centers for Disease Control and Prevention, n.d).
Alcohol and other drug use
Alcohol and other illicit drug are used by the majority of the youths as compared to tobacco use. It is contributing to about 41 percent of all deaths that are caused by motor vehicles. When compared to other behaviors that put human at risk concerning health, alcohol is causing a wider variety of injuries and it is approximated that 100,000 deaths occurs as a result alcohol consumption every year in the U.S. About 46 percent of Americans have been intoxicated in the previous years and roughly 4 percent have been intoxicated weekly (Kann, et al., 2014).
Behaviors causing unplanned injuries and violence such as suicide
The injuries and violent behavior are considered to be amongst the top causes of death amongst the youth of ages 10 to 24 years. The motor vehicle crashes are contributing to 30 percent of deaths and other accidental injuries contribute to 15 percent. Homicide and suicide are contributing to 15 and 12 percent death cases respectively (Centers for Disease Control and Prevention, n.d).
Tobacco Use
It is estimated that there are about 3,600 adolescents of ages 12 to 17 years in the United States who have tried their first cigarette. The use of cigarettes is contributing to 1 to every 5 deaths (Centers for Disease Control and Prevention, n.d).
Unhealthy Dietary Behaviors
Healthy eating is linked to the reduction in the risks of diseases that exposes individuals to death and these diseases include heart disease. In 2009, it was reported that about 23.3 percent of the high school learners reported increased habit of consuming fruits and vegetables five or more times every day. Studies have shown the relationship in the habit of eating the restaurant foods and the increased BMI thus exposing individuals to diseases such as obesity and other cardiovascular diseases (Kann, et al., 2014).
Physical Inactivity
The decline in physical activity is common among children when they get older. Most of the youths are spending their time in a sedentary lifestyle such as watching television with less participation in physical ...
Mwananawe Aimable has extensive experience working with NGOs on projects focused on poverty alleviation, gender equality, health, education, and more. As the National Coordinator of IMRO, he oversees various projects funded by partners like USAID, UNICEF, and the Global Fund related to HIV prevention, care, treatment, and advocacy for key populations. He has also contributed to regional strategic plans and is the country focal point for an HIV prevention and treatment alignment project. Mwananawe has published several abstracts and articles on topics like developing human rights strategies for female sex workers in Rwanda and HIV prevention for men who have sex with men. He holds degrees in international relations and diplomacy
The Law of Healthcare AdministrationAuthorsShowalter,.docxjmindy
The Law of Healthcare Administration
Authors:
Showalter, J. Stuart
Publication Information:
Ed.:
Eighth edition. Chicago, Illinois : Health Administration Press. 2017
Resource Type:
eBook.
Description:
The Law of Healthcare Administration offers a thorough examination of health law in the United States from a management perspective. Using plain language accessible to nonlawyers, the book moves from broadbrush treatments of the US legal system and the history of medicine to specific issues that affect healthcare leaders daily, including contracts, torts, taxation, antitrust laws, regulatory compliance, and, most pressing, health insurance reform and the important changes that have taken place since the Affordable Care Act (ACA) became law in 2010. The legal concepts discussed in the book are amply supported by reallife examples, detailed explanations, and excerpts from decisions of federal and state courts.
Subjects:
Medical laws and legislation--United States
Medical care--Law and legislation--United States
Hospitals--Law and legislation--United States
we reviewed informed consent in the case of competent adults. There are many “gray” areas of consent in cases of children or incompetent adults; however, the law has sought to provide clear guidance for health care providers and legal guardians.
Review pages 393-411 in the Showalter textbook and choose at least one of the subtopics in this section regarding consent. Provide an explanation of the “gray area” of your choosing, including any relevant legal cases discussed, and how this is handled under the law.
Showalter, J. S. (2017) Consent. In
The Law of Healthcare Administration
(pp. 393-411). Chicago, IL: Health Administration Press. Retrieved from the Trident Online Library.
Related
rrent User Level:
Unlimited User
Hide Table of ContentsTable of Contents
Brief Contents
·
Detailed Contents
·
Preface
·
Chapter 1 The Anglo-American Legal System
·
Chapter 2 A Brief History of Medicine
·
Chapter 3 Health Reform, Access to Care, and Admission and Discharge
·
Chapter 4 Contracts and Intentional Torts
·
Chapter 5 Negligence
·
Chapter 6 The Organization and Management of a Corporate Healthcare Institution
·
Chapter 7 Liability of the Healthcare Institution
·
Chapter 8 Medical Staff Privileges and Peer Review
·
Chapter 9 Health Information Management
·
Chapter 10 Emergency Care
·
Chapter 11 Consent for Treatment and Withholding Consent
·
Chapter 12 Taxation of Healthcare Institutions
·
Chapter 13 Competition and Antitrust Law
·
Chapter 14 Issues of Reproduction and Birth
·
Chapter 15 Fraud Laws and Corporate Compliance
·
Glossary
·
Case Index
·
Index
·
About the Author
.
The law that legalized medical marijuana in Florida in 2016Wri.docxjmindy
The law that legalized medical marijuana in Florida in 2016
Write TWO paragraphs describing the law or policy
First paragraph: clearly define the law or policy, date when it took effect, and identify what problem it is trying to solve (why was it enacted?)
Second paragraph: identify the agency or organization responsible for its implementation or oversight and explain whether or not the law or policy seems to be effective in its implementation.
Sources: 2-4 sources are required for the proposal. A reference page with proper Chicago Style format required.
.
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This is a proposal for a population health program targeting adolescents aged 12-19 in an underserved African American community. The program aims to address risky sexual behaviors, substance abuse, mental health issues, violence, and obesity through education on safe sex practices, substance abuse counseling, mental health counseling, exercise promotion, and ensuring access to healthcare. The expected outcomes are a reduction in teen pregnancies and STIs, increased enrollment in counseling, and fewer obese adolescents. The program aligns with HP2020 goals and will use social cognitive theory and social media marketing. Potential barriers include lack of stakeholder participation and funding.
LuciousDavis1-Practices in Public Health-01-Unit9_ AssignmentLucious Davis
The document discusses improving global public health through international collaboration. It describes the Global Health Security Agenda created to work with nations and organizations to prevent infectious diseases. Eleven action plans were developed to implement strategies like educating the public on health risks. However, lack of funding is a barrier to properly resourcing programs. Greater investment is needed to address health inequalities and control diseases worldwide in our increasingly interconnected world.
Barreras y motivaciones para la afiliación al Seguro Familiar de Salud de per...HFG Project
This report describes the findings and recommendations of the qualitative study on the barriers and motivations to enrolling people living with HIV/AIDS in the Family Health Insurance plan in the Dominican Republic. The study was conducted with the goal of informing institutions in the Dominican Republic, such as the Standardized System of Beneficiaries (SIUBEN), the National Council for HIV and AIDS (CONAVIHSIDA), the National Health Insurance (SENASA), and the United States Agency for International Development (USAID) about the recommended strategies to increase the number of people living with HIV/AIDS enrolled in Family Health Insurance plan. Target populations such as men who have sex with men (MSM), transgender people, and sex workers, and other prioritized populations, such as migrants, were the main focus of the study in order to meet national and international commitments on HIV, aiming to increase access to antiretroviral treatment, as well as to generate the financial sustainability of the Dominican Social Security System (SDSS).
The document discusses the health belief model, which is a theoretical framework used in healthcare to guide health promotion plans and disease prevention. It has five stages: precontemplation, contemplation, preparation, action, and maintenance. The model focuses on perceived susceptibility, severity, benefits, and confidence. It can be used to understand behaviors like substance abuse in youth. Barriers to implementing it include lack of resources. Benefits are improving health knowledge and behaviors.
1) Community-based interventions have been shown to successfully change risky behaviors and prevent HIV transmission when they incorporate cultural elements, community participation, and education programs delivered by community leaders.
2) Effective interventions identify factors influencing HIV transmission, tailor prevention strategies to specific populations, and address barriers like discrimination and lack of culturally competent healthcare services.
3) For HIV-positive injecting drug users, improved access to substance abuse treatment, healthcare, housing support and antiretroviral therapy through community programs can achieve comparable health outcomes to non-drug users.
Baral et al. BMC Public Health 2013, 13482httpwww.biomed.docxjasoninnes20
Baral et al. BMC Public Health 2013, 13:482
http://www.biomedcentral.com/1471-2458/13/482
DEBATE Open Access
Modified social ecological model: a tool to guide
the assessment of the risks and risk contexts of
HIV epidemics
Stefan Baral1*, Carmen H Logie2, Ashley Grosso1, Andrea L Wirtz1 and Chris Beyrer1
Abstract
Background: Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These
factors are representative of social, economic, organizational and political inequities. Associated with an improved
understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV
prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires
epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages.
Discussion: Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or
penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and
structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is
often far more actionable than characterizing individual-level risks. We propose a modified social ecological model
(MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic
HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key
populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The
MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual
HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The
utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM.
Summary: The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV
in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective
integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic
studies has traditionally been on describing individual-level risk factors, the future necessitates comprehensive
epidemiologic data characterizing multiple levels of HIV risk.
Background
There is an increasing recognition of the importance of
the social and structural drivers of acquisition and trans-
mission of HIV [1,2]. While there is no singular defin-
ition, structural drivers can be conceptualized as those
social, economic, organizational, and political power and
domination factors which contribute to social inequities
[2-4]. These structural drivers do not directly cause the
acquisition or onward transmission of HIV; rather they
* Correspondence: [email protected]
...
The document discusses community systems strengthening (CSS) and how it relates to key populations affected by HIV/AIDS. It provides background on key populations and their vulnerability to HIV, as well as the role of the Global Fund in funding programs. It describes how the Global Fund introduced CSS in 2009 to strengthen community mobilization and service delivery. However, CSS faces technical challenges such as unclear definitions and limited tools for assessment. It also faces political challenges like continued skepticism of key population programming. The document concludes with recommendations to strengthen CSS and ensure it effectively serves key populations.
This document provides a comprehensive list of evidence-based practice resources for promoting community health, development, and prevention interventions. It includes over 30 links to databases, organizations, and categories of best practices on topics like adolescent pregnancy, cancer, child and youth development, and more. The resources provide systematic reviews, guidelines, and searchable databases of proven community programs and policies.
Implementing comprehensive HIV/STI programmers with Sex Workersclac.cab
The document presents a tool for implementing comprehensive HIV/STI programs for sex workers. It was developed in response to requests for guidance on how to apply the WHO's 2012 recommendations. The tool provides practical examples from global programs on community empowerment, addressing violence, community-led services, condom programming, clinical services, and program management. Its goal is to support public health officials, NGOs, and health workers in planning, delivering, and monitoring effective HIV/STI interventions for sex workers.
Clinical Case Presentation SummarySummary of Primary and Secon.docxmccormicknadine86
Clinical Case Presentation Summary
Summary of Primary and Secondary Syphilis
In 2017, a total of 30,644 cases of primary and secondary syphilis were reported in the United States, yielding a rate of 9.5 cases per 100,000 population (CDC, 2018). According to the CDC (2018), this rate signifies a 10.5% increase compared with 2016 (8.6 cases per 100,000 population). Syphilis has a high prevalence among certain racial/ethnic groups, as well as in other groups, such as adolescents, sex workers, men who have sex with men (MSM), and sexually abused women (Hollier, 2018). Syphilis is transmitted through direct contact with an ulcerative lesion, or chancre which appears during the primary stage (most infectious) of syphilis (Hollier, 2018). Patients with this infection may seek medical treatment for signs and/or symptoms of primary syphilis (chancre/ulcer), or secondary syphilis (diffuse rash on palms and soles) (Hollier, 2018). On the other hand, patients may be completely asymptomatic and only diagnosed on routine screening.
Yonglin suggested to me one prevention strategy from the CDC called the “Talk, Test, Treat” method that has been suggested by the CDC is the “Talk, Test, Treat” method. Talking involves discussing sexual health history, testing involves screening for syphilis. The CDC recommends screening all sexually active men who have sex with men at least once a year, and more frequently if they are at-risk for infection. Pregnant women should be tested at their first prenatal visit, and at-risk women should be rescreened in their third trimester and again at delivery to prevent congenital syphilis. Lastly, patients need to be treated with benzathine penicillin G who test positive for syphilis.
Evidence-Based Action Plan #1
Implementing a mobile health unit (MHU) or van that offers community-based screening services for at-risk populations, such as female sex workers, men who have sex with men (MSM), and IV drug users could assist with reducing the transmission of primary and secondary syphilis. An MHU can be used as part of a community education, screening, and counselling program to serve urban and rural communities (Khanna & Narula, 2016). The MHU would have to be clearly identified as a free syphilis testing unit in order to make it more appealing to interested individuals who may approach. The health care providers working the mobile unit would be required to obtain a focused health history and patient contact information in order to provide screening results and the necessary follow-up instructions for any positive test results. Studies have shown that MHUs have been very helpful in detecting new cases of syphilis and beneficial to the at-risk population (Lipsitz et al., 2014). Also, MHUs may even increase patient compliance with the follow-up serologic testing that is required after being treated for syphilis, which may be a barrier for patients of low income or who lack transportation. This evidence-based intervention could be ...
The HIV intervention plan aims to address the leading cause of morbidity and mortality in Prince George's County - pediatric HIV. It analyzes HIV case data by age, race, CD4 diagnosis, and ZIP code. The plan involves focus groups to understand prevention needs. It establishes program goals and objectives to educate about transmission risks and promote safe behaviors. Outcomes will evaluate behavior changes and collaboration. The coalition formed, called the HIV Prevention Coalition, brings together stakeholders to develop a broad HIV prevention campaign.
This summary provides an overview of a systematic review of 34 HIV/AIDS mass communication campaigns from 1998 to 2007:
1) The review found that campaigns increasingly employed strategies recommended for effective design such as targeted audiences developed through segmentation, behavior-focused themes, use of behavioral theory, high message exposure, stronger research designs, and inclusion of behavior measures.
2) An examination of 10 campaigns using more rigorous designs found that the majority (8 of 10) demonstrated effects on behavior change or intentions.
3) However, most campaigns still used weak pre-experimental evaluation designs, indicating room for improved evaluation practices.
1) Newly formed public health policies should consider ethics and ensure equitable outcomes for all populations. Without ethics, policies could jeopardize vulnerable groups and reduce health standards.
2) Ethical practices must guide policy implementation and consider visibility, goals, evaluations, and research validity. Partnerships can leverage resources to treat diseases globally in an equitable manner.
3) International policies should prevent inequalities when addressing widespread diseases. Equality is needed for skilled workers to educate communities, but ethics vary between countries.
read and agree in not more that 160 words Sampling Issues and St.docxsimonlbentley59018
read and agree in not more that 160 words
Sampling Issues and Strategies
Pyramids usually tend to be easy to understand and work well to capture tiered concepts, so pyramids have been used to depict the tiered nature of primary healthcare, secondary healthcare, and tertiary healthcare services, which is the inverse relationship of effort needed and health impact of different interventions and nutrition recommendations (Issel et al., 2022). The public health pyramid is divided into four categories: direct healthcare services, enabling services, population-based services and infrastructure services.
The direct services level of the public health pyramid focuses on health programs for individuals. Due to the fact that this service focuses on individuals, the sampling may be a challenge because of who would be participating and non-participating in an intervention or non-interventions. Instead of randomly assigning individuals to either the program or a control group, it might be feasible for participants to become their own type of control (e.g., pretest and posttest) or perhaps future participants can serve as controls while they remain on a waiting list. Additionally, the costs can vary greatly depending on the type of data, and the frequency of data collection as well.
The enabling services, as mentioned above, focuses on groups of individuals and are provided in a wide range of contexts. The sampling issue in this case would be because of the several outcomes. It may be a challenge to recognize and recruit a comparison group with the same characteristics as the program’s participants considering the broad range of contexts. Thus, health services programs may not be appropriate for experimental designs, but can be suitable for quasi-experimental designs instead. Perhaps initiating random assignments can be a possibility depending on the group or at a community level as well.
The population-based level focuses on providing to the entire population. A sampling issue may be that, because this level focuses on a wider range of people, there are limitations of evaluation options to design that can be appropriately implemented among populations. In this case, time-series designs can be useful for evaluating population-level programs. Thus, existing data on populations are likely to be less costly to conduct as well.
The infrastructure services level focuses on all said levels, and interventions touches on changing healthcare operations in an organization or the overall public health system. With that said, the outcome evaluation is likely to determine whether the evaluation show actual changes in the infrastructure or changes to the health status of patients (or clients). Perhaps repeated measures or a time-series design is suitable based on whether the focus is for long-term change, depending on the data that is available at the individual or population level. Additionally, this might be the.
This document is a master's thesis submitted by Jordan Zarone to the Graduate School of Public Health at the University of Pittsburgh in 2014. It examines the history and efficacy of harm reduction programs, specifically needle and syringe exchange programs and housing first models, for reducing HIV transmission among injection drug users in the United States. The thesis reviews primary and secondary literature on these harm reduction approaches. It finds evidence that while direct links between the programs and reduced HIV incidence are complex, there is substantial evidence they are associated with reduced HIV risk behaviors. The thesis concludes harm reduction programs show promise for addressing the disproportionate impact of HIV among injection drug users.
Running head: ASSIGNMENT 3 1
ASSIGNMENT 3
4
Assignment 3
Diamond Fulton-Hicks
Saint Leo University-HCA:402
Mrs.Claudette Andrea
04/05/2020
According to the CDC, Youth Risk Behaviors are used in monitoring the six groups of health-associated practices that are contributing to the top causes of deaths and disability amongst youths and adults. Some of these behaviors are those which are contributing to unintended injuries and violent behavior; sexual practices which lead to unintentional pregnancies and sexually transmitted infections; alcohol and other drug use; tobacco use; detrimental dietary practices; and the insufficient engagement in the physical exercise. This paper is therefore based on discussing these health behaviors top factors associated with the increased death and disability rates amongst youths and adults (Centers for Disease Control and Prevention, n.d).
Alcohol and other drug use
Alcohol and other illicit drug are used by the majority of the youths as compared to tobacco use. It is contributing to about 41 percent of all deaths that are caused by motor vehicles. When compared to other behaviors that put human at risk concerning health, alcohol is causing a wider variety of injuries and it is approximated that 100,000 deaths occurs as a result alcohol consumption every year in the U.S. About 46 percent of Americans have been intoxicated in the previous years and roughly 4 percent have been intoxicated weekly (Kann, et al., 2014).
Behaviors causing unplanned injuries and violence such as suicide
The injuries and violent behavior are considered to be amongst the top causes of death amongst the youth of ages 10 to 24 years. The motor vehicle crashes are contributing to 30 percent of deaths and other accidental injuries contribute to 15 percent. Homicide and suicide are contributing to 15 and 12 percent death cases respectively (Centers for Disease Control and Prevention, n.d).
Tobacco Use
It is estimated that there are about 3,600 adolescents of ages 12 to 17 years in the United States who have tried their first cigarette. The use of cigarettes is contributing to 1 to every 5 deaths (Centers for Disease Control and Prevention, n.d).
Unhealthy Dietary Behaviors
Healthy eating is linked to the reduction in the risks of diseases that exposes individuals to death and these diseases include heart disease. In 2009, it was reported that about 23.3 percent of the high school learners reported increased habit of consuming fruits and vegetables five or more times every day. Studies have shown the relationship in the habit of eating the restaurant foods and the increased BMI thus exposing individuals to diseases such as obesity and other cardiovascular diseases (Kann, et al., 2014).
Physical Inactivity
The decline in physical activity is common among children when they get older. Most of the youths are spending their time in a sedentary lifestyle such as watching television with less participation in physical ...
Mwananawe Aimable has extensive experience working with NGOs on projects focused on poverty alleviation, gender equality, health, education, and more. As the National Coordinator of IMRO, he oversees various projects funded by partners like USAID, UNICEF, and the Global Fund related to HIV prevention, care, treatment, and advocacy for key populations. He has also contributed to regional strategic plans and is the country focal point for an HIV prevention and treatment alignment project. Mwananawe has published several abstracts and articles on topics like developing human rights strategies for female sex workers in Rwanda and HIV prevention for men who have sex with men. He holds degrees in international relations and diplomacy
The Law of Healthcare AdministrationAuthorsShowalter,.docxjmindy
The Law of Healthcare Administration
Authors:
Showalter, J. Stuart
Publication Information:
Ed.:
Eighth edition. Chicago, Illinois : Health Administration Press. 2017
Resource Type:
eBook.
Description:
The Law of Healthcare Administration offers a thorough examination of health law in the United States from a management perspective. Using plain language accessible to nonlawyers, the book moves from broadbrush treatments of the US legal system and the history of medicine to specific issues that affect healthcare leaders daily, including contracts, torts, taxation, antitrust laws, regulatory compliance, and, most pressing, health insurance reform and the important changes that have taken place since the Affordable Care Act (ACA) became law in 2010. The legal concepts discussed in the book are amply supported by reallife examples, detailed explanations, and excerpts from decisions of federal and state courts.
Subjects:
Medical laws and legislation--United States
Medical care--Law and legislation--United States
Hospitals--Law and legislation--United States
we reviewed informed consent in the case of competent adults. There are many “gray” areas of consent in cases of children or incompetent adults; however, the law has sought to provide clear guidance for health care providers and legal guardians.
Review pages 393-411 in the Showalter textbook and choose at least one of the subtopics in this section regarding consent. Provide an explanation of the “gray area” of your choosing, including any relevant legal cases discussed, and how this is handled under the law.
Showalter, J. S. (2017) Consent. In
The Law of Healthcare Administration
(pp. 393-411). Chicago, IL: Health Administration Press. Retrieved from the Trident Online Library.
Related
rrent User Level:
Unlimited User
Hide Table of ContentsTable of Contents
Brief Contents
·
Detailed Contents
·
Preface
·
Chapter 1 The Anglo-American Legal System
·
Chapter 2 A Brief History of Medicine
·
Chapter 3 Health Reform, Access to Care, and Admission and Discharge
·
Chapter 4 Contracts and Intentional Torts
·
Chapter 5 Negligence
·
Chapter 6 The Organization and Management of a Corporate Healthcare Institution
·
Chapter 7 Liability of the Healthcare Institution
·
Chapter 8 Medical Staff Privileges and Peer Review
·
Chapter 9 Health Information Management
·
Chapter 10 Emergency Care
·
Chapter 11 Consent for Treatment and Withholding Consent
·
Chapter 12 Taxation of Healthcare Institutions
·
Chapter 13 Competition and Antitrust Law
·
Chapter 14 Issues of Reproduction and Birth
·
Chapter 15 Fraud Laws and Corporate Compliance
·
Glossary
·
Case Index
·
Index
·
About the Author
.
The law that legalized medical marijuana in Florida in 2016Wri.docxjmindy
The law that legalized medical marijuana in Florida in 2016
Write TWO paragraphs describing the law or policy
First paragraph: clearly define the law or policy, date when it took effect, and identify what problem it is trying to solve (why was it enacted?)
Second paragraph: identify the agency or organization responsible for its implementation or oversight and explain whether or not the law or policy seems to be effective in its implementation.
Sources: 2-4 sources are required for the proposal. A reference page with proper Chicago Style format required.
.
The latter half of the twentieth century witnessed the rise of the i.docxjmindy
The latter half of the twentieth century witnessed the rise of the international development sector, bringing with it new government agencies and international organizations (see Appendix – International Education and Development Timeline). Education played a pivotal role in the new development sector: Rostow’s (1960) modernization theory stipulated that investments in education would put Third World countries on the path to development, eventually transforming them into industrialized societies similar to those in Western Europe and North America.
However, the experiences of Zambia and Nepal show that the relationship between education and development is not straightforward or deterministic. Zambia initially concentrated on secondary and technical education, but was later hard-hit by structural adjustment programmes and burdened with debt. Nepal’s history shows not only that primary education can be rapidly expanded in just a few generations, but also that this expansion can marginalize many groups within a society.
The most important outcome of the post-war period was a set of ideas about what development is and what it means to be developed. These were articulated by development theorists such as Rostow (1960) as well as through international development organizations (e.g. UNDP, World Bank, USAID). The notions that former colonies should develop into industrial nations, that international aid could facilitate the economic growth required, and that investments in education were one way they could do so, all emerged during this period. More than 60 years later, these ideas still underlie much of the work within the field of international development as well as the ways in which development is constructed in popular media and the press. However, the next chapter examines how challenges to these underlying ideas have redefined development work and the role of education within it.
In your own words, define development. What does it mean for a society to be developed? Is education necessary for development, and is it sufficient to ensure development?
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The larger the mass of a star, the higher the internal pressures. Hi.docxjmindy
The larger the mass of a star, the higher the internal pressures. Higher internal pressures causes higher temperatures and it is temperature that determines the types of fusion that can occur deep in a stars interior. Discuss all of the types of fusion that can occur in stars, the temperatures at which each begins, and the mass required to produce each temperature.
we need two different versions of the discussion posts. 200 words each one.
.
The Latin term meaning father of his country” which is implied as m.docxjmindy
The Latin term meaning “father of his country” which is implied as meaning the government is the true guardian of the needy and infirmed children.
2.
__________________ were a sixteenth century English set of laws which vagrants and abandoned and neglected children were bound to masters as indentured servants.
3.
Early English courts established to protect the property rights and welfare of the minor children of affluent families.
4.
Civic leaders who focused their attention on the misdeeds of poor children to control their behavior were called:
5.
In 1816, The Society for the Prevention of Pauperism was established to:
6.
When the first House of Refuge opened in New York the Society for the Prevention of Pauperism and the __________________ were influential in establishing such positive steps for juveniles.
7.
In 1853, New York philanthropist Charles Loring Brace helped developed the _______________________ as an alternative for dealing with neglected and delinquent youths.
8.
The first juvenile court was established in this state in 1899.
9.
The Juvenile Court Act of 1899 set up an independent court to handle criminal law violations by children under 16 years of age as well as created:
10.
The case of the
Kent v. United States (1966)
ruled that:
11.
The ___________________________ established the a federal office on delinquency prevention and was enacted to identify the needs of youth and to fund programs aimed at deterring juvenile crime.
12.
A noncriminal youth who falls under the jurisdiction of the courts by reason of having engaged in behavior prohibited to minors, such as truancy.
13.
The Court case of ________________ ruled that a minor has basic due process rights at trial.
14.
The Court case of ________________ ruled that the level of evidence for the finding of juvenile delinquency is proof beyond a reasonable doubt.
15.
Held that the Fourth Amendment guarantee against unreasonable searches is not violated by drug testing all students who choose to participate in interscholastic athletics.
16.
In 1974, Congress passed the ______________________, which provides funds to states to bolster their services for maltreated children and their parents.
17.
According to the shifting philosophies of juvenile justice outlined in your text, the time from 1950-1970 recognized that:
18.
There are more than 450 juvenile ________________ who focus on providing treatment for youth accused of substance abuse offenses.
19.
A program developed in Arizona in an effort to reduce adolescent involvement in criminal behavior that has since been added to school curricula in all 50 states is known as:
20.
The Supreme Court held that the _______________ protections against unreasonable search and seizures apply to students but that the need to maintain an orderly educational environment modifies the needs for warrants and probable cause.
21.
Which of the following is not a Supreme Court case dealing with searching for drugs in associatio.
THE LASTING IMPACT OF MENDEZ V. WESTMINSTER IN THE STRUGGLE .docxjmindy
This document summarizes the 1947 Mendez v. Westminster Supreme Court case, which ruled that segregating Mexican American students into separate schools violated the 14th Amendment. It discusses how this case paved the way for the 1954 Brown v. Board of Education decision banning racial segregation in schools. The case involved Mexican American parents in California suing to allow their children to attend white schools rather than segregated Mexican schools with inferior conditions. Thurgood Marshall participated in this case and it influenced his strategy in Brown v. Board.
The late 1920s and 1930s were a time when many Americans endured the.docxjmindy
The late 1920s and 1930s were a time when many Americans endured the humiliation of rampant racism as well as crushing poverty. Yet most mainstream popular music (exemplified by the Tin Pan Alley style) avoided these issues and focused instead on escapist themes of privacy and romance.
Why might this have been the case? Do you feel that contemporary popular music also focuses on escapist themes like the 1920s and 1930s or do you feel that it tackles the relevant issues of the day? Do you feel that popular music works best as an escape from the problems of the world or as a forum to explore and engage in such issues? Please be as specific as possible in citing examples
.
The last term you attended at Waldorf you dropped a course while on .docxjmindy
The last term you attended at Waldorf you dropped a course while on Satisfactory Academic Progress Warning which caused your dismissal. If you would like to appeal this dismissal and reinstate yourself into the program you’ll need to complete the attached form and write a statement.
1. Provide a typed and signed statement describing the circumstances that led to your lack of academic progress while on Satisfactory Academic Progress. Be specific and concise in your explanation as to why you were unable to make successful progress.
(My mother became ill in July 2017, I had to care for her. She passed away in October 2017) .
2. Provide a plan of action that you will use to ensure your future academic success. Include information on how much time a day/week you will dedicate to your coursework.
3. Develop a plan with your advisor to repeat courses as needed and include this with your appeal.
In your appeal statement, you may include that we’ve discussed if your return is accepted you’ll retake your failed course and dropped course first. EDU 5102 Student-Centered Differentiated Learning and EDU 5100 Personal Leadership Skills and Team Building are the two you’ll need to have done.
.
The last topic to be covered in this course is Chapter 14, Social .docxjmindy
The last topic to be covered in this course is Chapter 14, Social Movements.
Choose to view one of the movies in this Unit, either
The Garden
(in English and somein Spanish with English subtitles) or
Holding Ground Parts 1 and 2.
Then consider the following social justice issues listed below that have impacted physiological, social, psychological and spiritual human behavior and development on the macro (societal) and mezzo (family and community) person and environmental dimensions of human functioning. These issues could serve as the foundation to the creation of a social movement in your local (city, small town), state, or federal level. Choose a topic that you have some passion for that you or others known to you have experienced. If you have your own topic, not on the list, check with the Instructor.
Some examples are:
Medical health care costs
Disability accessibility
Housing conditions (lack of or segregated sub-standard housing and rent)
Environmental air/ground conditions (e.g. sinkholes in a neighborhood, ground pollution causing birth defects, etc.)
Nutrition needs (e.g. hunger, poverty, etc.)
Political representation (e.g. lack of access to voter registration, municipal representation, or suppression)
Safety measures - (e.g. police profiling, lack of police patrols, neighborhood violence, racial violence)
Unemployment – e.g. layoffs, segregated workplaces by gender/race/age
Poverty – low income, lack of health insurance, lack of access to payment for medications.
High property taxes
Neglected or segregated schools
Banking and regulatory practices that may profile or discriminate against specified populations
Discriminatory practices involving vulnerable minority populations
Toxic air/water pollution
Conduct a literature review of 10 peer-reviewed sources to research the social justice aspects of your chosen issue and its consequences - e.g. physiological, political, social, psychological, and spiritual consequences on the macro (societal, community) and mezzo (family and community) personal and environmental dimensions. Integrate by way of in-text cited content the research findings into your paper’s content from the Hutchison text - e.g. Chapters 13 on Communities and Chapter 14 on Social Movement and from the supplemental sources. Instructions on how to write a literature review is posted under Assignments. (See above.)
Respond to the following:Explain historically how this issue came to be and the current conditions that are impacting on what specific population/s of people. Discuss the importance of your issue. “What are the two or three cultural frames that would motivate people to engage in collective action on this issue….How important do you think emotions are in motivating people to participate in [this] social movement activity (Hutchison, 2019, 450)?” Explain and support your rationale by way of in-text cited content.
What “Elite Allies” (p. 436) could be recruited as influential forces to a.
The last quarter of the 19th century saw a shift within the art worl.docxjmindy
The last quarter of the 19th century saw a shift within the art world from male-dominated history and genre scenes to female-dominated interiors and landscapes, along with a shift in artistic discourse from the theories of John Ruskin to those of James Abbott McNeill Whistler. Describe the theories of each of these figures and why this shift occurred. Then discuss the differences between the two types of art associated with these theories, using specific examples.
200-300 Words, work sited
.
The last answer didnt actually help, so I am reposting this.P.docxjmindy
*The last answer didn't actually help, so I am reposting this.*
Performance Management Process Phases
Using the internet
, research the employee performance management process. There is a wealth of articles and resources for each phase of the process
The phases:
Establishing Performance Goals
Developing Performance Plans
Giving and Receiving Feedback
Evaluating Performance
Identify and explain each phase, then discuss the best practice for that phase.
2-3 pages;
Double spaced, APA formatted.
Provide links to all resources used for this paper - no need to include citations or a full reference page just the links will do. Please use free web sources.
.
The Lab assignment will be graded out of 100 points. There are .docxjmindy
The Lab assignment will be graded out of 100 points. There are multiple parts or tasks that make up each Lab.
This document can be downloaded here :
Lab4CFall20v1.docx
The code you need to start with :
Lab4Part1.c
The data file you need :
Lab4giftList.txt
(Note that this file name doesn't match the code so you'll need to adjust that.)
Some tasks ask you to write code, and specify what name to use for the file in NetBeans. You need to use exactly the name that is given (do not change the case, or make any other modification). Remember, the name of the main class must match the filename.
There are further instructions at the bottom (after the questions) about how to save the file from NetBeans in order to be able to turn it in.
For every lab assignment you need to create an answers file. In this answers file you will put in answer any questions that are asked, you will show the output of code that you write and you will reference any code files that you create for a given question. See below for more details about what goes in the answers file.
Your answers document needs to be named with your initials and the last four digits of your ID number and then Lab#answers. So if my initials are JCMT and the last four digits of my ID are 1234, then the answers file for my Lab 4 would be
JCMT1234Lab3answers
.
The ONLY acceptable file formats are Word document, OpenOffice document, and PDF.
Put your last name, first name and UTA ID in the file on the first line.
[-5 deduction if not**]
Label the answers for each question with the number/letter of the question.
Separate each answer from the next answer by at least two blank lines
.
[-5 deduction if not**]
Include EVERY question number/letter combination from the assignment in your answers document. If the question is a coding question telling you to save a file, for example some question numbered 17.b), then in your answers document you should have a line like the following for question 17.b):
17.b) Please see file Lab1Part3.c for this question.”
Put all your question answers the answer document.
If the lab question asks you to show the output of a doing some particular thing with the code, then you must also put a screenshot of the output in the answer document. For output that takes up more than one screen, make multiple pictures so that every screen is recorded. If you do not include the screenshots in your answer document, then the questions that should have had screenshots will be considered “Not answered” and will be awarded ZERO 0 points.
Each task below will instruct you where to put your answers. If the task says to “Save your program as file
XYZ1234Lab1Task1.c
” then this .c file should be turned in as part of the assignment along with the answers file.
Every lab assignment has a given due date. No late labs will be accepted. (Five minutes late is still late.) Lab assignments will be posted on Canvas. If you are unable to turn in your .
The knowledge of your Learning Patterns provides you with an .docxjmindy
“The knowledge of your Learning Patterns provides you with an explanation
of how you learn, not an excuse for failing to put forth the effort to learn.”
—Christine A. Johnston (2010, p. 107)
4Developing an Adept Mind
keithpix/iStock/Thinkstock
Learning Outcomes
After reading this chapter, you should be able to
• Define the term adept mind.
• Explain the role critical thinking plays in becoming a successful student.
• Demonstrate critical reading within the college learning context.
• Describe how your Patterns affect your critical-reading skills.
• Demonstrate critical writing within the college learning context.
• Describe how your Patterns affect your critical-writing skills.
• Explain how critical-thinking skills contribute to academic integrity.
“In order to thrive in the 21st Century, intentional learners should be
empowered through a mastery of intellectual and practical skills, informed
about forms of inquiry, and responsible for their personal actions.”
—J. Doherty and K. Ketchner (2005, p. 1)
Section 4.2Becoming a Critical Thinker
4.1 The Adept Mind
Chapter 3 was devoted to helping you understand how to use metacognition, the learning
techniques known as decoding and FITing, and personalized strategies to become a more
intentional learner. This chapter builds on that knowledge by framing how to use your Learn-
ing Patterns to develop an adept mind.
The adept mind helps you succeed in all areas of life. It is one that makes good decisions and
can discern the difference between fact and fiction. It studies a situation’s complexity, weighs
the facts, examines the logic behind a choice, and determines whether a choice is appropriate.
The adept mind is intentional, stable, and often methodical and always seeks to improve its
efficiency and effectiveness. The adept mind is vital not only to the work of a student, but also
to the experience of being a parent, employee, or volunteer. No matter what you are called
on to do in life, you will need an adept mind to navigate the change you encounter and the
growth you seek.
The adept mind uses the critical skills of thinking, reading, and writing—skills this chap-
ter explores in depth—and uses them with integrity. The word critical is not one students
embrace easily. It has a negative connotation and suggests that someone has found fault with
something you have done. It conjures up images of a scolding voice, red pen marks, or nega-
tive comments. When applied to thinking, reading, and writing, however, the word critical
takes on a different meaning. To be critical means to delve deeper into a topic to better under-
stand, evaluate, and take a position on it. As you will see at the end of the chapter, being criti-
cal also means becoming able to use your research with honesty and originality.
4.2 Becoming a Critical Thinker
When you engage in critical think-
ing, you embark on an ongoing quest
to improve how you think. Thinking
critically requires you to b.
The Kite Runner contains many families that suffer in their own uniq.docxjmindy
The Kite Runner contains many families that suffer in their own unique way. Two different fathers in the novel both are overbearing in their own way, which leads to their families falling apart. The author uses these families to dimistrait the theme of how overbearing parents will cause their kids to resent their family. The main character Amir's family's major source of unhappiness was Baba's decision to father an illegitimate child with the servant’s son. This created an unhealthy dynamic between The legitimate and illegitimate son where the legitimate son constantly had to fight for and earn his father's affection from the illegitimate son. It got so bad that Amir, the legitimate child, forced the two families to separate. Ironically, Baba showing his son too much affection is what separated them in the end. Amir’s wife Soraya has a broken family of her own. Her father was a famous General back in Afghanistan, but now does nothing but run a resale store as a hobby and cash in welfare checks. He sees himself as above the rest of his countrymen and too important to work labor. While he does nothing to improve his standard of living, he expects his daughter to not only be successful in school but pursue a high-paying job to his specification. This pressure makes Soray act out and rebel, leading her to compromise her Purity Within The Afghani community. This sacrifices her chance at marrying, one of the major ways his family could have moved up socially and economically. Both of these fathers put unrealistic expectations on their children leading to broken families in a different way. Baba’s unrealistic expectations led Amir into destroying the family he loved while Sayora’s father's overbearingness led her to ruin his family’s pride which he valued over everything.
.
The Key cross-cultural themes of the project are country values and .docxjmindy
The Key cross-cultural themes of the project are country values and hofstede dimensions. Projects should be 23 pages long.
Project framework: Title page, table of contents, introduction, various chapters, conclusion, bibliography, appendics
project guidelines
Example: different leadership styles - USA, Vietnam and Singapore compared
Format of the project:
1. Discuss and analyse the determinants of culture in the country chosed: History, Religion, Social Structure, Political Philosophy, Economy, Language and education
2. Look at Hofstede Dimensions and World Values Survey to find background info
3. Other theoretical Perspectives
4. Conclusion must be about the cultural environment for business in the given country
5. Project Resources:
a. Hofstede Home page: http://www.geert-hofstede.com
b. World Values Survey: http://www.worldvaluessurvey.com
c. CIA World Fact Book: http://www.cia.gov/library/publications/the-world-factbook/index.html
d. Background information: Country statistical organization, the wall street journal, business week, the economist
6. Key Outcomes:
a. The demonstration of an ability to discuss and analyse the contents of this module
b. The exploration of the different dimensions of the global cultural environment
c. The identification of the main issues and challenges relating to culture and its impact on facing businesses today
d. Comprehensive business report on the application of the course concept within your own work place or one which you are familiar with
7. Using Harvard Referencing
.
The kind of relationships that society expects from its citizens an.docxjmindy
“The kind of relationships that society expects from its citizens and the way it organizes its important institutions – the family, the system of governance and control – can either nurture or stunt people’s impulses to give help to relatives, friends, and needy strangers” (Mandell and Schram, 2012, p. 28).
After watching the
Meaning of Human Services
video, and reflecting on the quote above, use the outline below to describe the history of human services in western society.
History of Human Services
. Discuss the history of helping behavior and human services in western culture. What factors have influenced our ability and willingness to help society members?
Changing Nature of Helping
. Describe how societal circumstances shape helping behavior. Explain the principle of reciprocity and its relation to western cycles of giving and helping. Be sure to include such philosophies as means tested vs. universal programs, culture of poverty vs. opportunity theory, etc.
Cycles of Helping
. Discuss the cycles of helping in the American society as they relate to welfare, juvenile justice, mental illness, and criminal justice. In your opinion, are we doing enough in these areas? If not, why not?
Your assignment should be two- to three-pages in length (excluding title and reference pages), and must include a minimum of three scholarly sources to substantiate your argument. At least two of these must be scholarly, peer-reviewed sources that were published within the past five years. Your paper and all sources must be formatted according to the APA guidelines
.
THE KING COMPANY BACKGROUND The King Company experiences man.docxjmindy
THE KING COMPANY BACKGROUND The King Company experiences many of the difficulties common in today’s business climate. In response to declining sales, the company must transform itself from a strategy of expansion and high profit to one of cost containment and staff reductions.The case discusses the organization and provides details of the human resource department. Also presented are e-mails from various staff members. The e-mails identify specific problems that need to be addressed by the HR department and provides a look at King’s overall culture. You may find the tone of some e-mails to be unprofessional. This is a good lesson for us all--As much as we enjoy informality in the workplace, all documents and correspondence— including e-mails—can be retained and are discoverable in litigation. Managers must be cautious in their writing because inappropriate language may be impossible to defend in court.
Employees In the Case:
Amera, Argonta---Accounting employee
Andreas, Gary---employee on workers’ comp
Call, Jake---Compensation & Benefits Manager
Dean, Don---C.E.O.
Dugas, Karla---Benefits Coordinator
Folkner, Meg---Supervisor, CAD Design
Grant, Alan---Current HR Director
Honduras, Margo---Previous HR Director
Jones, Lyle---Production Employee
Madison, Charles---Senior V.P.
Petersen, Matt---Production Supervisor, Team 3
Planky, Burt---fishing buddy
Putt, Tonia---CAD Designer
Rey, Dave---Production Foreman
Sanders, Tomas---Design Manager
Scholl, Karmen---HRD Manager
Simms, Bertie---Designer
Smith, Mike---V.P.
Songun, Amy---Accounting Supervisor
Stone, Guy---Production Supervisor
Tu, Kevin---Staffing Manager
Varn, Juan---Safety & Security Manager
Warner, Salty---union promoter
White, Shaun---Employee Relations Manager
COMPANY BACKGROUND:
The King Company is a small manufacturing company located in a mid-sized city in the upper Midwest. King manufactures high-quality specialty components for the computer industry. The company was founded in 1994 by current CEO, Don Dean. Dean was a talented young engineer in Silicon Valley. When the industry hit the skids in the early 1990s, he found himself out the door with little more than an entrepreneurial spirit and a small severance. Dean left California, moved back to his home state and used his severance to finance The King Company, starting the company in small rented quarters in a nearly vacant strip mall. He brought in Cliff Madison early on as chief financial officer. Dean was smart enough to know that he had no head for figures, but Madison did. Madison was an old college buddy, a super accounting wiz, and somebody Dean could trust to squeeze as much mileage as possible out of his severance money. It was a good match. Madison managed the business, and Dean was the idea man and designer of the specialty components, patents of which were the backbone of King’s success. Today, the low-rent strip mall is a part of company history, and King employs 835 full-time workers.
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The Kind of leader I want to be
About 1 page
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The key issue is why its challenging to implement transformational .docxjmindy
The key issue is why it's challenging to implement transformational change to the organization and why the organizations resist change.
Transformational changes are the most difficult since they require radical and significant changes to organizational structures, strategies, culture, and ethics.
Describe how organizations develop strategies, routines and processes that make them reliable and accountable to transformational change.
Describe bureaucracies, institutionalization, cognitive scripts as factors making organizations more resistant to change.
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How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Main Java[All of the Base Concepts}.docxadhitya5119
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How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
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Pride Month Slides 2024 David Douglas School District
The International Journal ofInterdisciplinary Social and.docx
1. The International Journal of
Interdisciplinary Social
and Community Studies
TheSoCIalSCIenCeS.Com
VOLUME 7 ISSUE 4
_____________________________________________________
_____________________
Exploring the Strategic Prevention
Framework (SPF) and Its Application to a
Comprehensive Substance Abuse and HIV/
AIDS Prevention Initiative
Evidence from Project C.O.P.E. (Communities Organizing
for Prevention and Empowerment)
ROBERT REID AND PAULINE GARCIA-REID
THE INTERNATIONAL JOURNAL OF INTERDISCIPLINARY
SOCIAL AND COMMUNITY STUDIES
thesocialsciences.com
First published in 2013 in Champaign, Illinois, USA
by Common Ground Publishing LLC
www.commongroundpublishing.com
ISSN: 2324-7576
3. HIV/AIDS poses a serious public health threat in the United
States. Of particular concern has been the detrimental impact
that this crisis has wrought on urban centers, where people
of color, particularly racial and ethnic minority youth, are
disproportionately impacted by this twin epidemic. The U.S.
federal government has made a concerted effort to fund
demonstration projects through its Minority AIDS Initiative
(MAI) in geographic areas with high rates of substance abuse
and HIV/AIDS prevalence, with the specific intent of
introducing culturally-resonant, model prevention protocols
with proven effectiveness. Responding to this public health
emergency, the U.S. Substance Abuse and Mental Health
Services Administration (SAMHSA), Center for Substance
Abuse Prevention (CSAP), introduced the Strategic Prevention
Framework (SPF) to guide prevention planning and
implementation efforts throughout the U.S. This paper
illustrates the five steps of the SPF (e.g., assessment, capacity,
planning, implementation, and evaluation) by describing its
application to Project C.O.P.E. (Communities Organizing
for Prevention and Empowerment), which is a comprehensive
substance abuse and HIV/AIDS prevention program
located in the northeastern United States.
Keywords: Substance Abuse and HIV/AIDS, Culturally-Tailored
Model Prevention Protocols, Racial and Ethnic Urban
Minority Youth, Strategic Prevention Framework (SPF)
The Twin Epidemic – Substance Abuse and HIV/AIDS
he twin epidemics of substance abuse and HIV/AIDS pose a
serious public health threat in
the United States. A significant body of research has shown that
risky behaviors
associated with drug use continue to fuel the spread of HIV
4. infection (National Institute
on Drug Abuse (NIDA) 2012). Of particular concern has been
the impact that this crisis has
wrought on urban minority communities, where African
Americans and Hispanics now constitute
57% of all HIV/AIDS cases (Centers for Disease Control and
Prevention (CDC) 2011a; CDC
2011b; NIDA 2012). Throughout these urban centers, racial and
ethnic minority youth have
suffered due to the health consequences of drug abuse and HIV.
Approximately 39% of the new
infections are occurring in young people between the ages of 13
to 29, and of those, 65% are
among African Americans (CDC 2011a; CDC 2011c; NIDA
2012). A similar trend emerges
for Hispanics in which the HIV infection rate in 2009 was
nearly three times higher than among
their non-minority counterparts (CDC 2011b). Based on these
sobering statistics, it becomes
1 This paper was prepared with the support of the U.S.
Department of Health and Human Services (HHS), Substance
Abuse and Mental Health Services Administration (SAMHSA),
Center for Substance Abuse Prevention (CSAP), Grant
No. SP-15104. The views expressed in this paper are those of
the authors and do not necessarily represent the position of
the sponsoring agency.
2 An earlier version of this paper was presented at the Seventh
International Conference on Interdisciplinary Social
Science, Barcelona, Spain, July 27, 2012.
T
The International Journal of Interdisciplinary Social and
6. and ethnically diverse youth in a northeastern urban community.
The target community
identified for this project has among the highest rates in the
state for both substance abuse and
HIV/AIDS infection among African American and
Hispanic/Latino residents. Prevention
programs, however, are scarce. As a collaborative venture
between a public university and
numerous community-based organizations, this initiative has
embraced the five stages of the
Strategic Prevention Framework (SPF) – e.g., assessment,
capacity building/mobilization,
strategic planning, model program implementation, and
evaluation (SAMHSA 2008) – with the
purpose of empowering a community to take action in
promoting positive youth development.
This paper will illustrate the five steps of the SPF by describing
its application to our project.
Strategic Prevention Framework (SPF)
Nearly a decade ago, SAMHSA introduced the newly formulated
SPF to address the substance
abuse prevention needs for state and local communities (Arthur,
Hawkins, Brown, Briney,
Oestrerle, and Abbott 2010, 246; Flewelling, Birckmayer, and
Boothroyd 2009, 388; Piper,
Stein-Seroussi, Flewelling, Orwin, and Buchanan 2012, 68).
The SPF is grounded in a public
health approach to prevention that examines a constellation of
risk and protective factors across
multiple systems such as individual/peer, family, school/work,
and community (NIDA 2003, 6),
which may either impede or promote population-level change
(Community Anit-Drug Coalitions
of America (CADCA) 2009a, 5). This public health model
7. involves the integration of five major
steps: 1) organize the community to profile needs and resources;
2) mobilize and/or build
capacity to address needs; 3) develop a comprehensive strategic
plan; 4) implement evidence-
based prevention strategies and activities; and 5) monitor,
evaluate, and sustain (Imm et al., 2007,
3; SAMHSA n.d.). By incorporating the common components
of effective prevention
programming through a risk and protective factor lens, the SPF
has a wide range of applicability
in preventing a host of public health concerns that may include
the prevention of underage
drinking and smoking, cancer, or diabetes (CADCA 2009a ;
Flewelling et al. 2009, 388).
The SPF is driven on the concept of outcome-based prevention
(SAMHSA n.d.). Funders
have become increasingly concerned about the lack of
quantifiable evidence in demonstrating
program effectiveness. By adhering to a data-driven approach,
community-level prevention
programs are being held more accountable for producing
measurable results pertaining to their
defined goals and objectives (Reid 1999, 43). The SPF also
allows for a more expansive
approach to prevention, as compared to prior prevention
initiatives that have often operated in
silos by focusing on a singular social problem with limited and
non-evidence based interventions
(Flewelling 2009, 390). This was demonstrated in the latter
part of the 1980s and the early 1990s
when the response to HIV prevention focused on theory-based,
cognitive behavioral models of
behavior change (Beeker et al., 1998, 832). Since the
introduction of the SPF, initiatives have
8. begun to emerge that move beyond individual-level
interventions and are now more
14
REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
comprehensive, coordinated, and far more capable of reaching a
broader audience (SAMHSA
n.d.).
Figure 1: SAMHA’s Five Steps of the Strategic Prevention
Framework (Inn et al. 2007, 3;
SAMHSA n.d.)
The Importance of Cultural Competence
SAMSHA has identified cultural competence as an integral
component to the SPF. Cultural
competence refers to the beliefs, knowledge, and skills
necessary to work effectively with
individuals different from one's self and further recognizes that
issues of social justice are critical
to the process (CADCA 2009c,11; Resnicow, Soler, Braitwaite,
Ahluwala, and Butler 2000,
272). According to Imm and others (2007), “a commitment to
cultural competence ensures that
there is respect for the complexities of multiple cultures in
communities” (3). Attending to the
9. needs of diverse communities, the SPF requires that cultural
competencies be infused and
integrated across all five steps. Many prevention programs
have begun to identify ways to
increase ethnic/cultural awareness and pride, develop conflict
resolution skills, and promote pro-
social competencies that focus predominantly on the external
characteristics (i.e., surface
structure of culture). These prevention initiatives tend to rely
on people, language, food, and
music that are known to and preferred by the intended
population to increase the receptivity,
comprehension, and acceptance of messages (273). Yet, the
deeper structure level of culture is
also needed to determine how social, psychological, and
environmental factors can shape
behavior within and across ethnic groups. It is recommended
that strategies targeting substance
abuse and HIV/AIDS prevention among racial and ethnic
minority youth embrace various
dimensions of cultural sensitivity that will not only increase the
receptivity of the interventions
(i.e., surface structure activities), but will also combine culture,
history, social forces, and core
values as an avenue to stimulate change (i.e., deep structure)
(273). Programs should consider
tailoring their prevention messages to attend to the specific
strengths and needs of their
respective communities (Reid, Garcia-Reid, Klein, and
McDougall 2008, 419). For instance,
15
10. THE INTERNATIONAL JOURNAL OF INTERDISCIPLINARY
SOCIAL AND COMMUNITY STUDIES
understanding the importance of immediate and extended family
ties in the Hispanic community
(known as familismo) can help shape preventive interventions
that resonate with its intended
audience.
The Importance of Sustainability
Sustainability refers to the “ability of a program to maintain the
human, social and material
resources needed to achieve long-term goals for community
change” (CADCA 2009e, 10). As a
“cross cutting” element of the SPF, it should also be considered
throughout the assessment,
capacity, planning, implementation, and evaluation phases.
Sustainability activities need to be
introduced during the early stages of an initiative being mindful
of long-term goals for
community change. However, achieving these goals will not
only require maintaining existing
resources (e.g., human, social, and material), but also
identifying and leveraging additional
opportunities for growth and development (10). For example, a
sustainability working group
may be formed at the onset of the project with the purpose of
exploring and identifying various
funding streams at the federal, state, and local levels, as well as
private foundations. The success
of sustaining a viable prevention program depends on a
multitude of factors, such as creating a
stable infrastructure, providing quality training systems, and
securing community support.
11. Additional elements to consider throughout this process include
building ownership among
stakeholders, disseminating program successes, investing in
capacity, and developing the systems
necessary to support these activities over time (SAMHSA n.d.).
Step 1: Assessment
Because the nature and extent of drug abuse and the HIV/AIDS
epidemic vary widely,
prevention strategies must be adapted to local community needs
and resources. Local drug use
and HIV/AIDS risk-behavior patterns must be tracked to refine
program approaches over time
and to evaluate program outcomes. Conducting a community-
wide needs assessment to identify
the magnitude of particular social problem emerges as the first
step in the SPF (CADCA 2009a,
10; Imm et al. 2007, 13). This process includes an assessment
of the risk and protective factors
associated with the problem. To address the intractable nature
of substance abuse and the spread
of HIV infection among urban minority youth, a coordinated
and sustained prevention initiative
that adheres to the SPF will focus on identifying common risk
factors while promoting protective
factors (SAMHSA n.d.). According to a cost-effectiveness
study of school-based drug
prevention programs conducted by Caulkins and colleagues
(1999, xxxii), the implementation of
nationwide model prevention programs seems to be justifiable
in that the resulting benefits would
likely outweigh the costs of the resources used to implement
such interventions. In addition, it
provides an opportunity to identify community assets and
resources, while simultaneously
12. exploring gaps in services and capacity.
In developing a comprehensive needs assessment to profile
population needs, we utilized a
multi-level approach that included a variety of data collection
methods and resources. During
both our first and second waves of funding (e.g., 2003-08 and
2008-13), the systematic gathering
and analysis of data regarding our target population involved
the following: 1) conducting focus
groups and semi-structured qualitative interviews with at-risk
African American and
Hispanic/Latino adolescents; and 2) administering a school-
wide youth survey to assess the
degree of substance abuse involvement and the level of HIV-
risk-taking behaviors among a
random sample of urban minority youth. This survey contained
CSAP-Core Measures
(SAMHSA 2008) and sexual behavior questions from the CDC
Youth Risk Behavior Survey
(CDC 2012). The interview guides and questionnaires identified
for these data-collection
processes were developed using a risk and protective factor
framework (i.e., examining issues
16
REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
across the following life domains: individual/peer, family,
school, and community) and included
13. outcome measures pertaining to sexual health and drug use.
Focus group interviews revealed significant concerns among
youth in the identified service
area. For example, adolescents who participated in the
interview process poignantly described an
insidious presence of drugs, crime, and violence that is ravaging
their community. These
findings were further substantiated by a comprehensive, school-
wide, needs assessment survey
that was administered to 991 high school students in our target
community (see Table 1.). Risk
factors contributing to the needs of our study population are
highlighted below:
Table 1. Needs Assessment Findings
Individual Risk Factors
Sexual Risk
intercourse.
first time before the
age of 16.
4 sexual partners.
physically forced to have
sexual intercourse against their will.
Alcohol and Drug Use
nts reported using alcohol, with more
than 20% claiming
that they were younger than 13 years of age when they had their
14. first alcoholic
beverage.
be very easy to obtain
alcohol.
one third of the students drank alcohol within the past
30 days, and more
than 20% admitted to drinking 5 or more drinks in a row within
a couple of hours.
very easy for them to
obtain drugs like
cocaine, LSD, or methamphetamines.
Other Individual Risks
sad, or depressed
within the 6 months prior to the survey.
Peer Risk Factors
half of the respondents have friends who are gang
members.
Family Risk Factors
lack of communication
among their family members.
in
their families.
School Risk Factors
15. their school staff.
presence in their
schools.
Community Risk Factors
e respondents acknowledged drug selling
and crime in their
neighborhoods.
In our effort to assess the target community’s readiness for
change, we also embarked upon
the following activities: 1) focus-group interviews with key
community stakeholders (e.g., local
politicians, clergy, law enforcement, school officials, and
business leaders) to determine what
17
THE INTERNATIONAL JOURNAL OF INTERDISCIPLINARY
SOCIAL AND COMMUNITY STUDIES
factors place youth at risk for substance abuse and HIV
infection, and explore the ways in which
adolescents are protected from engaging in risk-taking
behaviors; 2) a community-network
analysis to identify community assets and resources, as well as
gaps in services and capacity; and
3) a random digit dialing (RDD) survey to evaluate the impact
16. of substance abuse and escalating
HIV infection rates among a randomly selected sample of
community residents. These collective
needs assessment activities helped our initiative meet a variety
of objectives – e.g., enabled
consensus about the scope and detrimental impact of substance
use and HIV/AIDS problems in
the community; provided collateral support in identifying the
underlying factors that contribute
to those problems; aided in the identification and analysis of
environmental, social, and
individual factors associated with the primary areas of concern;
and guided the selection of
policies and programs aimed at reducing substance use and
HIV/AIDS problems in the
community and establishing a baseline to track progress
(CADCA 2009a, 11; SAMHSA n.d.).
Step 2: Capacity
Once communities have completed their needs assessment
activities and have identified their
prevention priorities, they can begin to enhance capacity and
harness local resources as a means
to implement effective programs, practices, and strategies.
Success during this “capacity-
building” phase of the SPF framework will require that
programs and practices are accepted and
well-supported by the community. Building trust among
community stakeholders is not an easy
undertaking as it requires time to cultivate relationships and
partnerships. Program developers
are encouraged to engage community members in the
development, implementation, and
evaluation phases of the proposed intervention. In addition to
adopting this collaborative
17. approach, it is important to introduce prevention protocols that
show sustainable, outcome-driven
results. These combined efforts could increase the likelihood of
obtaining demonstrable program
outcomes.
Research has demonstrated the importance of community
support and involvement at the
local level to help initiate such policy changes and to sustain
durable shifts in the social
environment (CADCA 2009b, 9; NIDA 2003, 13; SAMHSA
n.d.). SAMHSA’s Collaborative
for the Application of Prevention Technologies has identified
four key components of the
capacity-building phase and is illustrated with specific
examples from our initiative (SAMHSA
n.d.):
Improving Awareness of Substance Abuse and HIV/AIDS
Problems and
Readiness of Stakeholders to Address These Problems
During the initial stages of our funding cycle, several focus
group interviews were conducted
with key stakeholders in the community to explore the service
needs of its adolescent population.
One of the more salient themes that emerged from the findings
was that the social problems
plaguing youth were exacerbated by unmet treatment needs and
gaps in social-service delivery
among the city’s community-based organizations. Group
members represented all segments of
the community, such as municipal government, law
enforcement, health and human services,
faith-based institutions, community-based organizations,
parents, youths, and the public school
18. district. Participants indicated that the service delivery system
for at-risk youth was hampered by
the following factors: 1) lack of integration and coordination
among service providers; 2)
evidence of a gang problem plaguing youth in the identified
community; and 3) lack of resources
for adolescents who are at risk for substance abuse and HIV
infection. For example, throughout
the entire community that is comprised of approximately 30,000
youth under the age of 18, there
was only one substance abuse prevention program and two HIV
prevention programs serving the
entire city. The focus groups further revealed a strong
commitment among community members
18
REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
and stakeholders in attending to the myriad of public health
problems adversely impacting the
city’s racial and ethnic minority youth.
Strengthening Existing Partnerships and/or Identifying New
Opportunities
for Collaboration
Engaging and involving a range of partners committed to a
similar vision is an essential aspect of
community mobilizing. By developing an expansive network of
community providers, there are
19. increased opportunities to share resources and information, and
to reach greater numbers of at-
risk youth with a host of strategies, in a variety of settings
(SAMHSA n.d.). For example, during
the early stages of this process, we cultivated numerous
relationships with key stakeholders
throughout the community, which included Memoranda of
Understanding with more than thirty
community-based organizations such as clergy, law
enforcement, municipal government, and the
local school district. Building a prevention team that represents
the various sectors of the
population and have a range of expertise in or represent the
target population will improve
outcomes leading to sustained results.
Improving Organizational Resources
At the local level, this often refers to the establishment of
planning groups that reflect the
demographics of the community, with a particular emphasis on
improving workflow efficiency
and effectiveness (e.g., identifying members, delegation of
responsibilities, and decision-making)
(SAMHSA n.d.). Community-level planning groups that are on
the frontlines may further
expand their reach by eliciting the support of other state-level
systems such as juvenile justice
and public safety. These entities can provide skills, training,
and technical assistance regarding
the implementation of policy initiatives that will augment the
planning and development of
coordinated prevention activities. Regarding our present work
in the community, we have served
on various coalitions, task forces, and substance abuse and
HIV/AIDS planning workgroups at
20. both the municipal and state levels, all with the shared purpose
of improving the quality of life
for at-risk youth.
Developing and Preparing the Prevention Workforce
The effectiveness of any prevention initiative depends on the
training, knowledge, and
experience of the staff delivering the intervention. Through a
solid workforce development plan,
programs are encouraged to provide ample opportunities for
practitioners to become well-versed
in a variety of intervention approaches that will enable them to
effectively intervene on behalf of
their service population (SAMHSA n.d.). For instance, our
prevention team is predominately
comprised of a blend of undergraduate majors from the fields of
family and child studies, public
health, psychology, and sociology and graduate level social
workers, counselors, and public
health educators with extensive experience working with high-
risk populations. Prevention
intervention specialists are provided with ongoing intensive
trainings facilitated by the program
coordinator and enhanced by experts in their respective fields of
practice on topics ranging from
sexual health, gangs, youth violence conflict negotiation,
decision-making, cultural competence,
and diversity. To further develop their understanding of the
community, prevention team
members volunteer at community-based organizations
throughout the service area prior to
initiating the health education workshops. Additionally, as a
means of strengthening our
community ties and increasing receptivity, we introduced
culturally-tailored prevention
21. intervention approaches that were shown to be effective in
preventing and reducing the onset of
substance abuse and HIV transmission among at-risk minority
subpopulations. Finally, to create
awareness and to mobilize the community toward action, our
prevention team provided
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SOCIAL AND COMMUNITY STUDIES
workshops and training for community stakeholders, service
providers, and families on strategies
to address a variety of social problems impacting at-risk
adolescents in the target community.
These collective activities enabled our team to galvanize the
community around these pressing
issues, thereby leading to the development of a strategic plan to
help guide our work in the
community.
Step 3: Planning
A comprehensive strategic plan is an integral component of the
SPF framework as it not only
provides a vision for prevention programming, but more
important, it articulates a clear direction
for organizing and implementing prevention activities.
According to SAMHSA (2008), “the
strategic plan must be based on documented needs, build on
identified resources/strengths, set
measurable objectives and include the performance measures
22. and baseline data against which
progress will be monitored ” (8). It is also important to note
that this is not a static process, and
as a prevention program evolves, its plan must be continuously
assessed and adjusted in response
to ongoing needs assessment and monitoring activities
(Flewelling et al. 2009, 389). Further,
intensive efforts should be undertaken at the inception of the
planning process to integrate
sustainability activities that will contribute to the permanent
expansion of coordinated prevention
programs throughout the community.
The strategic planning process requires that a diverse group of
stakeholders create a plan
with goals, objectives, and action steps aimed at addressing the
social problems impacting their
community. Table 2. illustrates the goals and measurable
objectives that emanated from our
project’s strategic planning process:
Table 2. Strategic Planning – Project Goals and Objectives
Project Goals Objectives
1. Decrease the incidence of substance
abuse and HIV infection among African
American and Hispanic/Latino youth in an
urban community located in the
northeasternUnited States
1a) Program participants will report a
reduction in neighborhood, family, peer
group, and individual risk factors.
1b) Program participants will report an
increase in attachment to community and
family, increased pro-social norms,
23. improved school performance, and greater
involvement with pro-social activities and
peers.
2. Increase the capacity for integrated
prevention activities in the community.
2a) Increase social network and support
systems that can promote and sustain social
cohesion in the community;
2b) Increase opportunities for youth to
function as active and contributing members
of the community and participate in
cooperative learning and shared decision
making; and
2c) Establish cultural norms that set high
standards of behavior for young people,
including clear norms regarding drug use
and sexual behavior, and that value youth as
community members. *It is important to
note that changing “cultural norms” is
considered a distal outcome, which will
require time, resources, and community
20
REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
investment to realize.
3. Increase service utilization and
participation in substance abuse and HIV
24. prevention activities by at-risk youth, which
will include referrals to HIV counseling and
testing sites.
3a) Engage children in educational
enrichment and skill-building activities;
build morale and foster attachment to the
goals of the program; and
3b) Maximize the number of youth who
complete the program and are referred to pre
and posttest HIV counseling and testing
sites.
4. Increase cultural identity and pride
among at-risk youth.
4a) Provide programs and messages that use
culture, ethnicity, history, and core values as
a medium to motivate behavior change; and
4b) Ensure that staff are sensitive to the
cultural needs of the target population.
Once the goals and objectives have been identified, the planning
group adopts a logic model,
or framework for action, which essentially serves as a graphical
representation of the project. As
an illustrative planning tool, the logic model links inputs
(resources) and program components
(activities) that have been identified to bring about the desired
outputs (objectives) and outcomes
(goals) (CADCA 2009d, 13;,SAMHSA 2008, 42). Logic models
further serve to inform the fifth
and final phase of the SPF framework – i.e., evaluation – by
allowing prevention programs to
critically analyze the progress that they are making toward their
25. goals.
Figure 2. provides a sample logic model that was developed for
the purpose of our project.
21
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Figure 2: Logic Model
Step 4: Implementation
U.S. federal initiatives, sponsored by both CSAP and the CDC, ,
have been launched to promote
widespread dissemination of science-based prevention strategies
in disproportionately at-risk
minority communities. The evidence-based programs identified
through these U.S. federal
registries and listings are based on research that indicates a
comprehensive approach to
prevention should reduce risk factors (i.e., sexual risk-taking
behaviors) while enhancing
protective factors (i.e., personal negotiation and resistance
skills). According to Arthur et al.
(2010), “these initiatives are intended to disseminate prevention
research, encourage data-driven
planning, and mobilize community stakeholders to utilize
tested, effective strategies to prevent
adolescent drug use and related problems” (246).
To meet this objective, in 2003, SAMHSA initiated the National
26. Registry of Evidence-based
Programs and Practices (NREPP) project as a systematic way to
identify, promote, and
implement science-based prevention strategies (SAMHSA 2012;
Sherman 2010, 2; Springer and
Philips 2007, 2). Model program status requires that protocols
are carefully implemented,
thoroughly evaluated, and produce consistent, positive, and
replicable results that are readily
disseminated to the broader prevention community. In addition
to NREPP, the CDChas
22
REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
developed a compendium of HIV risk reduction (RR) evidence-
based behavioral interventions
(EBIs) that are classified as either best-evidence or good-
evidence (CDC n.d.b). These
interventions represent the strongest HIV behavioral
interventions in the scientific literature to
date that have been rigorously evaluated and have demonstrated
evidence of efficacy. The
compendium includes individual, group, and community-level
behavioral interventions for high-
risk populations that focus on sex or drug-related risk behaviors
and have proven to either reduce
HIV or STD incidence or HIV-related risk behaviors, or
increase HIV risk-reduction behaviors
(CDC n.d.b). Key to successfully addressing the concomitant
27. problems of substance abuse and
HIV/AIDS will be the integration of evidence-based programs at
the local level. For example,
community-based organizations are on the front lines of
mitigating the multitude of health
disparities experienced by vulnerable members of the
population and are well positioned to
address their service needs.
According to the prevention principles proposed by NIDA
(2003) , “Community prevention
programs that combine two or more effective programs can be
more effective than a single
program alone” (13). Building upon these guiding principles, we
have adopted an eclectic
substance abuse and HIV prevention approach that includes
community mobilizing, intensive
case management, and interactive education-based
interventions. The intensive case
management model (i.e., CASASTART) and HIV/AIDS
prevention curricula (e.g., Be Proud! Be
Responsible, Focus on Youth, and Street Smart) have been
rigorously field-tested and evaluated
by CSAP and the CDC.. Based on prior research, this multi-
tiered strategy has proven to be an
effective method for reducing substance abuse and HIV risk
among African American and
Hispanic/Latino adolescents (13). The following section
provides a description of the model
programs included in our initiative:
Model Programs
CASASTART
This CSAP-endorsed prevention protocol (Striving Together to
28. Achieve Rewarding Tomorrows)
has been identified by SAMHSA as a model substance abuse
prevention program. CASASTART
was originally developed as a substance abuse and violence
prevention program serving high-risk
adolescents and their families living in socially distressed
neighborhoods (Murray 1999, 8;
Murray and Belenko 2005, 919). The program is a
comprehensive, neighborhood-based, school-
centered model that aims to provide coordination among police,
schools, and community-based
organizations to achieve two goals: 1) to redirect and build
resiliency in the lives of youth who
are at risk of using drugs, becoming delinquent, or dropping out
of school; and 2) to reduce and
control illegal drug use and related crime in the neighborhoods
where the adolescents live to
make the areas safer and more nurturing environments (9).
CASASTART has served as our
program’s organizing framework and we have incorporated core
elements of this model (e.g.,
community mobilizing and intensive case management) into our
comprehensive prevention plan
as a means of addressing the unique demands of at-risk youth in
our service area.
To further contextualize our prevention plan, we have identified
three CDC-endorsed HIV
prevention curricula (e.g., Be Proud! Be Responsible!, Focus on
Youth, and Street Smart) that are
culturally responsive and attend to the service needs of our
target population (CDC n.d.a,c,d).
Salient aspects from each of these behavioral interventions
(e.g., small group discussions,
interactive group activities, video presentations, and condom
demonstrations) have been
29. integrated into our prevention intervention service plan.
Be Proud! Be Responsible!
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Be Proud! Be Responsible! encourages participants to build a
sense of pride and self-worth,
develop a futuristic orientation, and behave in a responsible
manner. The curriculum consists of
six, 50-minute modules and employs educational videos, films,
role-plays, games, exercises, and
condom demonstrations to increase knowledge of HIV
transmission and prevention, risk
reduction, condom use, safe-sex behaviors, confidence, personal
negotiation and resistance skills
(CDC n.d.a).
Focus on Youth (FOY)
Focus on Youth (FOY) is an eight-session intervention that
utilizes discussions, games, and
multimedia formats to actively engage youth in HIV/AIDS
education/prevention activities. The
program is comprised of seven, 90-minute sessions that focuses
on decision-making, negotiation
skills, communication, values clarification and goal setting, as
well as educational information
pertaining to condom use. Health education topics also include
30. facts regarding AIDS, STIs,
contraception, and human development. The curriculum is
further enhanced by booster sessions
in which program participants are given specific challenges to
work through to reinforce the
skills (e.g., decision making, communication, and condom use)
that were developed throughout
the primary phase of the protocol (CDC n.d.c ).
Street Smart
Street Smart is a multisession, skills-building program that was
originally developed to help
groups of runaway youth reduce unprotected sex, number of sex
partners, and substance use.
Delivered in a small, group session format, the intervention
consists of eight, 1.5 to 2 hour
sessions delivered over a two to six week period. During the
initial stage of the intervention,
HIV/AIDS prevention information is shared through multi-
media approaches, such as video and
art workgroups. This provides a comfortable and safe forum in
which youth review and discuss
commercial HIV/AIDS prevention videos and then develop their
dramatizations, public service
announcements, commercials, and rap songs. The primary focus
of these sessions is a social
skills building approach, with a particular emphasis on
assertiveness and coping. Exercises are
then introduced to help adolescents identify their emotional and
behavioral reactions and
unrealistic expectations in potentially high-risk situations (CDC
n.d.d).
Step 5: Assess Performance
31. Ongoing monitoring and performance assessment activities are
integral components to ensuring a
program’s success. Through a carefully orchestrated evaluation
plan, programs are able to gauge
their effectiveness, ensure the quality of the proposed
interventions (i.e., fidelity), identify best
practices, and encourage continuous quality improvement
(SAMHSA 2008, 13). A variety of
evaluation designs and data collection methods may be utilized
to conduct the process and
outcome evaluations. The process, or formative, evaluation
phase of the project may include
focus group and semi-structured interviews with program staff
and key informants (e.g., referral
sources, advisory board members, and program participants),
participant observation, and
archival program records such as staffing patterns, attendance
sheets, meeting minutes, and other
records required of the initiative (CADCA 2008, 16). The
purpose of the formative evaluation is
to assess the degree to which the services provided accurately
replicate the selected prevention
models and preserve its fidelity. For example, we recently
conducted qualitative interviews with
at-risk youth who have not participated in our program as a
means of understanding
environmental influences that may impede their receptiveness to
HIV/AIDS prevention messages
in their community. A recurring theme that emerged among the
adolescents was the lack of
support that they received from adults in their neighborhoods,
including parents and teachers.
24
32. REID & GARCIA-REID: SPF AND ITS APPLICATION TO
SUBSTANCE ABUSE PREVENTION INITIATIVE
In addition to collecting and analyzing process information, it is
important to identify the
program/contextual factors (i.e., dosage data), and consider
individual/peer, family, school, and
community-level variables, which may be associated with the
desired program outcomes (i.e., a
reduction in substance abuse and HIV/AIDS risk taking
behaviors). An outcome evaluation
provides data to help ascertain whether the prevention strategies
delineated in the strategic plan
meet the intended goals and objectives of the initiative
(CADCA 2008, 18). There are many
issues to consider when embarking upon an outcome evaluation
– e.g., survey development, data
collection, evaluation design, data analysis, and reporting – that
require careful planning and
implementation (18). For our purposes, we used performance
measures identified by SAMHSA
that defined key priority areas related to substance abuse and
HIV/AIDS knowledge, perceptions,
and behaviors (SAMHSA 2008, 12). By incorporating a quasi-
experimental pretest-posttest
nonequivalent comparison group design, we were able to show
that our interventions were on
track to achieving many of its critical programmatic objectives.
For instance, preliminary
analyses have revealed that program participants with higher
levels of program involvement (i.e.,
dosage) tended to report lower levels of tobacco use, alcohol,
and illicit drug use.
33. However, there are inherent limitations when embarking upon
this type of outcome-based
evaluation research with an adolescent population. More
specifically, obtaining parental consent
among targeted youth has been at times challenging due to a
lack of cooperation in returning the
necessary forms and paperwork. While addressing this issue
has not been an insurmountable
obstacle to overcome, it has required a significant re-allocation
of resources, manpower, and
time. Consistent with the SPF guidelines, we have begun to
disseminate our evaluation findings
with the broader prevention community to share both lessons
learned and program successes.
Concluding Comments
The strategic prevention framework (SPF) served as an
invaluable tool in guiding our prevention
work in a disenfranchised, urban community. From the initial
steps of the process, we identified
a paucity of prevention programs serving a large city that has
been inundated by a multitude of
public health concerns. Unfortunately, a lack of resources, poor
coordination among service
providers, and major gaps in service delivery have compounded
the myriad of social problems
experienced by adolescents residing in this high-risk
community. As a collaborative effort
between a public university and numerous social service
agencies, our project has helped
transform the way the community is served by increasing the
capacity of local, community-based
organizations. With the support of our partners, our prevention
team has developed a
34. comprehensive strategic plan that has led to the coordination
and implementation of culturally
appropriate, evidence-based substance abuse and HIV/AIDS
prevention protocols with proven
effectiveness throughout the target community. Through a
rigorous evaluation process, we were
able to demonstrate that youth participating in our program
exhibited significant reductions in
alcohol and drug use behaviors and marked increases in social
support, family cohesion, and
community involvement. We will continue to work toward
sustaining and expanding the scope
of services in our ongoing effort to mitigate the adverse health
consequences associated with
illicit drug use and risky sexual behaviors among vulnerable and
at-risk urban minority
adolescents.
25
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ABOUT THE AUTHORS
Dr. Robert Reid: Robert J. Reid, PhD, is an Associate Professor
in the Department of Family and
Child Studies, College of Education and Human Services, at
Montclair State University. His
research has focused on the development, coordination, and
testing of community-wide
prevention initiatives to reduce risk factors and to promote
protective factors associated with
various health behaviors, such as adolescent substance abuse,
sexual risk, and youth violence.
Dr. Reid’s research has continually examined the factors that
may either enhance or constrain the
quality of life for children, families, and communities. Since
2003, he has served as Principal
Investigator on a Minority AIDS Initiative (MAI) grant, which
is funded by the U.S. Department
of Health and Human Services, Substance Abuse and Mental
Health Services Administration
(SAMHSA), Center for Substance Abuse Prevention (CSAP).
Through this decade-long
initiative, Dr. Reid has developed and coordinated
comprehensive substance abuse and
HIV/AIDS prevention services targeting underserved racial and
ethnic minority youth in the city
27
41. THE INTERNATIONAL JOURNAL OF INTERDISCIPLINARY
SOCIAL AND COMMUNITY STUDIES
of Paterson, New Jersey. More recently, Dr. Reid has been
funded by the White House Office of
National Drug Control Policy and SAMHSA to continue his
prevention work in the Paterson
community by developing the infrastructure of an anti-drug
coalition targeting at-risk
urban minority adolescents.
Dr. Pauline Garcia-Reid: Pauline Garcia-Reid, PhD, is an
Associate Professor in the
Department of Family and Child Studies, College of Education
and Human Services, with an
affiliate appointment in the Center for Child Advocacy and
Policy, College Humanities and
Social Sciences, at Montclair State University. Her research
interests include youth substance
use and violence prevention, social justice and advocacy within
a culturally-grounded social
work lens, and practice and research with racial and ethnic
minority children and families. She
has also served as a technical advisor to the SAMHSA National
Registry of Effective Prevention
Programs Project (NREPP).
28
42. The International Journal of Interdisciplinary Social
and Community Studies is one of eight thematically
focused journals in the collection of journals that
support the Interdisciplinary Social Sciences
knowledge community—its journals, book series,
conference and online community.
The journal presents studies of the social that exemplify
the disciplinary and interdisciplinary practices of the
social sciences.
As well as papers of a traditional scholarly type, this
journal invites case studies that take the form of
presentations of practice—including documentation of
socially-engaged practices and exegeses analyzing the
effects of those practices.
The International Journal of Interdisciplinary Social and
Community Studies is a peer-reviewed scholarly journal.
ISSN 2324-7576
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