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Summer Youth Employment Programs (SYEPs) help connect youth to opportunities for career exploration, skill development, and mentorship. Despite heightened investment in SYEPs, research regarding positive impacts is limited. Most of the common SYEP evaluation strategies are rooted in deficit thinking and focus on outcomes such as reducing violent crime, risk behaviors, gaps in unemployment, and increasing educational attainment. Despite recent shifts toward approaches that acknowledge structural oppression in adolescent research more broadly, evaluations of SYEPs often perpetuate a discourse of deficiency about marginalized communities by emphasizing disparities without acknowledging the systemic forces that create them. In this article, we utilize the Five Cs of Positive Youth Development to present an alternative set of outcomes identified from focus groups and surveys with youth ages 16 to 24 who participated in SummerWorks, a 10-week SYEP located in Washtenaw County, Michigan. Specifically, we find that SYEPs may help youth make the transition to adulthood, build community and increase their social capital, and access knowledge, resources, and opportunities. Through this approach, we hope to expand the literature on the impacts of SYEPs and encourage antiracist evaluation strategies that build on these findings and challenge deficit thinking.

Background: The Michigan Model for Health™ (MMH) is the official health curriculum for the State of Michigan and prevailing policy and practice has encouraged its adoption. Delivering evidence-based programs such as MMH with fidelity is essential to program effectiveness. Yet, most schools do meet state-designated fidelity requirements for implementation (delivering 80% or more of the curriculum). Methods: We collected online survey (N = 20) and in-person interview (N = 5) data investigating fidelity and factors related to implementation of the MMH curriculum from high school health teachers across high schools in one socioeconomically challenged Michigan county and key stakeholders. Results: We found that 68% of teachers did not meet state-identified standards of fidelity for curriculum delivery. Our results indicate that factors related to the context and implementation processes (eg, trainings) may be associated with fidelity. Teachers reported barriers to program delivery, including challenges with adapting the curriculum to suit their context, competing priorities, and meeting students' needs on key issues such as substance use and mental health issues. Conclusions: Multiple factors influence the fidelity of health curriculum delivery in schools serving low-income students. Investigating these factors guided by implementation science frameworks can inform use of implementation strategies to support and enhance curriculum delivery.

Post-school outcomes are poor for youth with disabilities, in general, but even more discouraging for certain subpopulations of individuals with disabilities, particularly those from culturally and linguistically diverse (CLD) backgrounds. The authors discuss structural inequalities in public schools which potentially contribute to the poorer transition outcomes of CLD youth with disabilities compared with their White peers with disabilities and identify 11 research-based practices (RBPs) for supporting CLD youth with disabilities and their families during the transition planning process. A study is subsequently described involving the development and implementation of a survey measuring the degree to which these 11 RBPs are being implemented in public school districts. The survey was administered during 2011 to 2016 to interdisciplinary transition teams representing more than 90 school districts in the United States who were attending state capacity-building transition services training institutes. Group consensus was sought on the 11 items appearing on the survey. Results from the study found that most school districts were not implementing any of the RBPs to any significant degree, school staff were in need of cultural competence professional development training, CLD families of transition-aged youth with disabilities lacked access to quality resources and supports, and CLD youth with disabilities lacked opportunities to strengthen their self-determination skills. Implications for practice and future research on this topic is presented and discussed.

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs.

Purpose: Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach: The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focusing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings: Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications: This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value: This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

Discusses a school-based prevention program initiated to reduce alcohol, tobacco, and other drug (ATOD) use among adolescents. Investigates changes in reported ATOD use from 1987 to 1991. Significant decreases were found for use of most drugs with the exception of alcohol. Involvement in problem behaviors was the most salient risk factor whereas having a member of a non-using peer group was most salient protective factor. (Author/MKA)

Intervention effects observed in efficacy trials are rarely seen when programs are broadly disseminated, underscoring the need to better understand factors influencing fidelity. The Michigan Model for Health™ (MMH) is an evidence-based health curriculum disseminated in schools throughout Michigan that is widely adopted but delivered with limited fidelity. Understanding implementation determinants and how they influence fidelity is essential to achieving desired implementation and behavioral outcomes. The study surveyed health teachers throughout Michigan (n = 171) on MMH implementation, guided by the Consolidated Framework for Implementation Research. We investigated relationships between context, intervention and provider factors and dose delivered (i.e., the proportion of curriculum delivered by teachers), a fidelity dimension. We also examined whether intervention factors were moderated by provider factors to influence fidelity. Our results indicated that program packaging ratings were associated with dose delivered (fidelity). We also found that this relationship was moderated by teacher experience. The strength of this relationship diminished with increasing levels of experience, with no relationship among the most experienced teachers. Intervention adaptability was also associated with dose delivered. We found no association between health education policies (context), provider beliefs, and dose delivered. Intervention factors are important determinants of fidelity. Our results suggest that providers with more experience may need materials tailored to their knowledge and skill level to support materials' continued usefulness and fidelity long-term. Our results also suggest that promoting adaptability may help enhance fidelity. Implementation strategies that focus on systematically adapting evidence-based health programs may be well suited to enhancing the fidelity of the MMH curriculum across levels of teacher experience. [ABSTRACT FROM AUTHOR]

Since 2006, the University of Michigan School of Dentistry has used a 13-point measure of overall competence instrument to assess fourth-year dental students' end-rotation performance at community clinics. The aim of this study was to assess the reliability and validity of this instrument used by preceptors to rate students' overall competence during community-based dental education experiences. The measure was analyzed using performance ratings for all fourth-year DDS students in the graduating classes of 2012 and 2013 (combined n=201). The results were that interrater agreement was satisfactory and the measure scored high for internal consistency; also, the measure loaded highly on a single overall competence factor. Ratings on this measure did not correlate with students' final cumulative dental school GPA, but showed a significant positive correlation with their fourth-year fall patient management grades (which signify students' conscientiousness in managing patients and their families in a professional and ethical manner). There were differences in grading systems between the 2012 cohort (which used a pass/fail system) and the 2013 cohort (which used a letter grade system) and the mean ratings they received (higher for the 2013 cohort). Overall, the study found that the 13-point measure demonstrated excellent reliability and validity, suggesting it is useful in determining a student's clinical competence in these settings. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the outcome of a Michigan-wide quality improvement effort intended to minimize improper urinary catheter use. The research used data collected during all the stages of a statewide educational intervention encouraging adherence to correct urinary catheter usage. Results of the study indicated a marked decline in catheter use and improved appropriate use compliance.

To characterize Michigan’s high viral meningitis incidence rates, 8,803 cases from 1993-2001 were analyzed for standard epidemiological indices, geographic distribution, and spatio-temporal clusters. Blacks and infants were found to be high-risk groups. Annual seasonality and interannual variability in epidemic magnitude were apparent. Cases were concentrated in southern Michigan, and cumulative incidence was correlated with population density at the county level (r=0.45, p<0.001). Kulldorff’s Scan test identified the occurrence of spatio-temporal clusters in Lower Michigan during July-October 1998 and 2001 (p=0.01). More extensive data on cases, laboratory isolates, sociodemographics, and environmental exposures should improve detection and enhance the effectiveness of a Space-Time Information System aimed at prevention. [ABSTRACT FROM AUTHOR]

The Michigan Non-Verbal Series has been developed to measure vision, hand and eye coordination, and observation and comparison of simple objects. It incorporates the following: 1. Uniformity of tasks to give equivalent measuring units. The emphasis is placed on observation and comparison rather than information. 2. Wide range of complexity without changes in objects or directions. Each level of complexity measured separately. 3. Four repetitions of equivalent forms to secure more equivalence of individual efficiency, and records of improvement and variability. 4. The selection of fairly adequate samples of the Detroit white population from 5 to 20 years of age, and norms for each age group on each repetition of the series. 5. The calculation of absolute zeros in each scale and their use in a graphic profile sheet for individual scores. [ABSTRACT FROM AUTHOR]

Question In acutely ill, hospitalized medical patients, how do the Intermountain, IMPROVE, Padua, and Kucher risk assessment models compare for predicting venous thromboembolism (VTE)? Methods Design Validation cohort study to compare 4 previously developed clinical prediction guides (Intermountain, IMPROVE, Padua, and Kucher). Setting Michigan Hospital Medicine Safety Consortium (HMS), which includes 48 hospitals in Michigan, USA. Patients 63 548 adults ≥ 18 years of age (mean age 66 y, 56% women) who were hospitalized for ≥ 2 days for a medical service. Exclusion criteria included surgical procedure during hospitalization, direct admission to an intensive care unit or for end-of-life care, admission for presumed VTE or VTE in the past 6 months, admission for observation, readmission within 90 days of discharge from a hospitalization included in the HMS, receipt of systemic anticoagulation on day 1 or 2 of hospitalization, or pregnancy. Description of prediction guide The Intermountain model included previous VTE, peripherally inserted central catheter, current cancer, and immobility. The IMPROVE model included previous VTE, thrombophilia, current cancer, and age > 60 years. The Padua model included previous VTE, thrombophilia, current cancer, immobility, surgery or trauma within the past month, age > 70 years, body mass index (BMI) > 30 kg/m2, congestive heart failure, myocardial infarction or stroke within the past month, use of hormone therapy, and presence of sepsis, pneumonia, rheumatoid arthritis, or other acute infection. The Kucher model included previous VTE, thrombophilia, current cancer, surgery within the past month, age > 70 years, BMI > 30 kg/m2, immobility, and use of hormone therapy or oral contraceptives. Outcomes Hospital-associated, image-confirmed VTE (upper and proximal lower extremity deep venous thrombosis and pulmonary embolism) 3 to 90 days after admission. Main results 1.1% of patients developed VTE at 90 days. Calibration (hazard ratios) and discrimination c-statistics) of the models for the entire population are in the Table. Conclusion In acutely ill, hospitalized medical patients, the Intermountain, IMPROVE, Padua, and Kucher risk assessment models had good calibration but poor discrimination for venous thromboembolism. [ABSTRACT FROM AUTHOR]

Background: Patients hospitalized for acute medical illness are at increased risk for venous thromboembolism. Although risk assessment is recommended and several at-admission risk assessment models have been developed, these have not been adequately derived or externally validated. Therefore, an optimal approach to evaluate venous thromboembolism risk in medical patients is not known.Methods: We conducted an external validation study of existing venous thromboembolism risk assessment models using data collected on 63,548 hospitalized medical patients as part of the Michigan Hospital Medicine Safety (HMS) Consortium. For each patient, cumulative venous thromboembolism risk scores and risk categories were calculated. Cox regression models were used to quantify the association between venous thromboembolism events and assigned risk categories. Model discrimination was assessed using Harrell's C-index.Results: Venous thromboembolism incidence in hospitalized medical patients is low (1%). Although existing risk assessment models demonstrate good calibration (hazard ratios for "at-risk" range 2.97-3.59), model discrimination is generally poor for all risk assessment models (C-index range 0.58-0.64).Conclusions: The performance of several existing risk assessment models for predicting venous thromboembolism among acutely ill, hospitalized medical patients at admission is limited. Given the low venous thromboembolism incidence in this nonsurgical patient population, careful consideration of how best to utilize existing venous thromboembolism risk assessment models is necessary, and further development and validation of novel venous thromboembolism risk assessment models for this patient population may be warranted. [ABSTRACT FROM AUTHOR]