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BackgroundWhile few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. We aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA.MethodsWe conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019. Participants from 130 VHA medical centers treating HCV were sent annual electronic surveys about their use of 73 implementation strategies, organized into nine clusters as described by the Expert Recommendations for Implementing Change taxonomy. Descriptive and nonparametric analyses assessed strategy use over time, strategy attribution to the HIT, and strategy associations with site HCV treatment volume and rate of adoption, following the Theory of Diffusion of Innovations.ResultsBetween 58 and 109 medical centers provided responses in each year, including 127 (98%) responding at least once, and 54 (42%) responding in all four implementation years. A median of 13-27 strategies were endorsed per year, and 8-36 individual strategies were significantly associated with treatment volume per year. Data warehousing, tailoring, and patient-facing strategies were most commonly endorsed. One strategy-"identify early adopters to learn from their experiences"-was significantly associated with HCV treatment volume in each year. Peak implementation year was associated with revising professional roles, providing local technical assistance, using data warehousing (i.e., dashboard population management), and identifying and preparing champions. Many of the strategies were driven by a national learning collaborative, which was instrumental in successful HCV elimination.ConclusionsVHA's tremendous success in rapidly treating nearly all Veterans with HCV can provide a roadmap for other HCV elimination initiatives.

Using a randomized controlled trial, we tested a new teacher professional development program for increasing the language and literacy skills of young Latino English Learners with 45 teachers and 105 students in 12 elementary schools. School-based teams randomly assigned to the intervention received professional development focused on cultural wealth, high-impact instructional strategies, and a framework for collaboration. We observed each teacher three times during the school year and assessed students individually at the beginning and end of the school year using the Woodcock Muñoz Language Survey (WMLS). Using an Intent-To-Treat (ITT) analysis, we found effects for the intervention on teachers' implementation of high-impact instructional strategies and students' language and literacy skills. [This article was published in "American Educational Research Journal" (EJ1167074).]

BackgroundCirrhosis is a rapidly increasing cause of global mortality. To improve cirrhosis care, the Veterans Health Administration (VHA) developed the Hepatic Innovation Team (HIT) Collaborative to support VA Medical Centers (VAMCs) to deliver evidence-based cirrhosis care. This randomized HIT program evaluation aims to develop and assess a novel approach for choosing and applying implementation strategies to improve the quality of cirrhosis care.MethodsEvaluation aims are to (1) empirically determine which combinations of implementation strategies are associated with successful implementation of evidence-based practices (EBPs) for Veterans with cirrhosis, (2) manualize these "data-driven" implementation strategies, and (3) assess the effectiveness of data-driven implementation strategies in increasing cirrhosis EBP uptake. Aim 1 will include an online survey of all VAMCs' use of 73 implementations strategies to improve cirrhosis care, as defined by the Expert Recommendations for Implementing Change taxonomy. Traditional statistical as well as configurational comparative methods will both be employed to determine which combinations of implementation strategies are associated with site-level adherence to EBPs for cirrhosis. In aim 2, semi-structured interviews with high-performing VAMCs will be conducted to operationalize successful implementation strategies for cirrhosis care. These data will be used to inform the creation of a step-by-step guide to tailoring and applying the implementation strategies identified in aim 1. In aim 3, this manualized implementation intervention will be assessed using a hybrid type III stepped-wedge cluster randomized design. This evaluation will be conducted in 12 VAMCs, with four VAMCs crossing from control to intervention every 6 months, in order to assess the effectiveness of using data-driven implementation strategies to improve guideline-concordant cirrhosis care.DiscussionSuccessful completion of this innovative evaluation will establish the feasibility of using early evaluation data to inform a manualized, user-friendly implementation intervention for VAMCs with opportunities to improve care. This evaluation will provide implementation support tools that can be applied to enhance the implementation of other evidence-based practices.Trial registrationThis project was registered at ClinicalTrials.Gov ( NCT04178096 ) on 4/29/20.

Purpose: The purpose of this pilot study was to evaluate the potential of an innovative high school neuroscience-based health course for implementation feasibility and impact on student outcomes. Methods: Thirteen teachers from two high schools participated in this quasi-experimental pilot study including 395 students (202 in the intervention classes and 193 in the comparison classes). Students completed pre/post online surveys assessing their knowledge, beliefs, and behaviors. Our analysis strategy for multi-item measures was to estimate the effects of the intervention on latent change scores in structural equation models (SEM). Results: Students in the neuroscience health classes showed a significant increase in neuroscience knowledge as compared to students in the comparison group (difference estimate in proportion correct metric, adjusted for covariates = 0.04; 95% CI [0.01, 0.06]). However, none of the other primary outcomes showed a significant difference between conditions. Teachers in the intervention group were observed implementing the neuroscience and health components more often than the self-regulation and growth mindset components. Students in the neuroscience group were more likely to mention the importance of caring for their brain and its link to health behaviors. Conclusions: Findings demonstrate that information about the link between health behaviors and brain functioning can be successfully integrated into a high school health education course, although effects on student health beliefs and behaviors were not observed. Additional development work should focus on clarifying the theoretical mechanisms of change, integrating the neuroscience content with self-regulation and growth mindset, and providing additional professional development for teachers.

This study tested culture-general and culture-specific aspects of adolescent developmental processes by focusing on opportunities and peer support for aggressive and delinquent behavior, which could help account for cultural similarities and differences in problem behavior during adolescence. Adolescents from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States) provided data at ages 12, 14, and 15. Variance in opportunities and peer support for aggression and delinquency, as well as aggressive and delinquent behavior, was greater within than between cultures. Across cultural groups, opportunities and peer support for aggression and delinquency increased from early to mid-adolescence. Consistently across diverse cultural groups, opportunities and peer support for aggression and delinquency predicted subsequent aggressive and delinquent behavior, even after controlling for prior aggressive and delinquent behavior. The findings illustrate ways that international collaborative research can contribute to developmental science by embedding the study of development within cultural contexts.

Safety is essential for life. To survive, humans and other animals have developed sets of psychological and physiological adaptations known as life history (LH) tradeoff strategies in response to various safety constraints. Evolutionarily selected LH strategies in turn regulate development and behavior to optimize survival under prevailing safety conditions. The present study tested LH hypotheses concerning safety based on a 6-year longitudinal sample of 1,245 adolescents and their parents from 9 countries. The results revealed that, invariant across countries, environmental harshness, and unpredictability (lack of safety) was negatively associated with slow LH behavioral profile, measured 2 years later, and slow LH behavioral profile was negatively and positively associated with externalizing behavior and academic performance, respectively, as measured an additional 2 years later. These results support the evolutionary conception that human development responds to environmental safety cues through LH regulation of social and learning behaviors.

This study examined longitudinal links between household income and parents' education and children's trajectories of internalizing and externalizing behaviors from age 8 to 10 reported by mothers, fathers, and children. Longitudinal data from 1,190 families in 11 cultural groups in eight countries (Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and United States) were included. Multigroup structural equation models revealed that household income, but not maternal or paternal education, was related to trajectories of mother-, father-, and child-reported internalizing and externalizing problems in each of the 11 cultural groups. Our findings highlight that in low-, middle-, and high-income countries, socioeconomic risk is related to children's internalizing and externalizing problems, extending the international focus beyond children's physical health to their emotional and behavioral development.

This study assesses how perceptions of school climate and four mediating factors (school connectedness, peer attachment, assertiveness, and empathy) influence reports of bullying behaviors among 2,834 students in 14 middle schools. Results revealed that students in positive school climates reported experiencing fewer physical, emotional, and cyberbullying behaviors. They also reported greater levels of school connectedness, peer attachment, assertiveness, and empathy, which in turn helped explain the influence of perceived school climate on bullying. In addition, the greater levels of empathy that students reported, the more likely they were to report being bullied. These results highlight the role that perceptions of school climate can play in influencing bullying and underscore the importance of mediating factors as schools work to track and improve school climate.

Promoting children's prosocial behavior is a goal for parents, healthcare professionals, and nations. Does positive parenting promote later child prosocial behavior, or do children who are more prosocial elicit more positive parenting later, or both? Relations between parenting and prosocial behavior have to date been studied only in a narrow band of countries, mostly with mothers and not fathers, and child gender has infrequently been explored as a moderator of parenting-prosocial relations. This cross-national study uses 1,178 families (mothers, fathers, and children) from 9 countries to explore developmental transactions between parental acceptance-rejection and girls' and boys' prosocial behavior across 3 waves (child ages 9 to 12). Controlling for stability across waves, within-wave relations, and parental age and education, higher parental acceptance predicted increased child prosocial behavior from age 9 to 10 and from age 10 to 12. Higher age 9 child prosocial behavior also predicted increased parental acceptance from age 9 to 10. These transactional paths were invariant across 9 countries, mothers and fathers, and girls and boys. Parental acceptance increases child prosocial behaviors later, but child prosocial behaviors are not effective at increasing parental acceptance in the transition to adolescence. This study identifies widely applicable socialization processes across countries, mothers and fathers, and girls and boys. [Action editor by Cleopatra Howard Caldwell.]

To examine whether the cultural normativeness of parents' beliefs and behaviors moderates the links between those beliefs and behaviors and youths' adjustment, mothers, fathers, and children (N = 1,298 families) from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and the United States) were interviewed when children were, on average, 10 years old and again when children were 12 years old. Multilevel models examined 5 aspects of parenting (expectations regarding family obligations, monitoring, psychological control, behavioral control, warmth/affection) in relation to 5 aspects of youth adjustment (social competence, prosocial behavior, academic achievement, externalizing behavior, internalizing behavior). Interactions between family level and culture-level predictors were tested to examine whether cultural normativeness of parenting behaviors moderated the link between those behaviors and children's adjustment. More evidence was found for within- than between-culture differences in parenting predictors of youth adjustment. In 7 of the 8 instances in which cultural normativeness was found to moderate the link between parenting and youth adjustment, the link between a particular parenting behavior and youth adjustment was magnified in cultural contexts in which the parenting behavior was more normative.

Background: Most studies of the effects of parental religiousness on parenting and child development focus on a particular religion or cultural group, which limits generalizations that can be made about the effects of parental religiousness on family life. Methods: We assessed the associations among parental religiousness, parenting, and children's adjustment in a 3-year longitudinal investigation of 1,198 families from nine countries. We included four religions (Catholicism, Protestantism, Buddhism, and Islam) plus unaffiliated parents, two positive (efficacy and warmth) and two negative (control and rejection) parenting practices, and two positive (social competence and school performance) and two negative (internalizing and externalizing) child outcomes. Parents and children were informants. Results: Greater parent religiousness had both positive and negative associations with parenting and child adjustment. Greater parent religiousness when children were age 8 was associated with higher parental efficacy at age 9 and, in turn, children's better social competence and school performance and fewer child internalizing and externalizing problems at age 10. However, greater parent religiousness at age 8 was also associated with more parental control at age 9, which in turn was associated with more child internalizing and externalizing problems at age 10. Parental warmth and rejection had inconsistent relations with parental religiousness and child outcomes depending on the informant. With a few exceptions, similar patterns of results held for all four religions and the unaffiliated, nine sites, mothers and fathers, girls and boys, and controlling for demographic covariates. Conclusions: Parents and children agree that parental religiousness is associated with more controlling parenting and, in turn, increased child problem behaviors. However, children see religiousness as related to parental rejection, whereas parents see religiousness as related to parental efficacy and warmth, which have different associations with child functioning. Studying both parent and child views of religiousness and parenting are important to understand the effects of parental religiousness on parents and children.

There is strong evidence of a positive association between corporal punishment and negative child outcomes, but previous studies have suggested that the manner in which parents implement corporal punishment moderates the effects of its use. This study investigated whether severity and justness in the use of corporal punishment moderate the associations between frequency of corporal punishment and child externalizing and internalizing behaviors. This question was examined using a multicultural sample from eight countries and two waves of data collected one year apart. Interviews were conducted with 998 children aged 7-10 years, and their mothers and fathers, from China, Colombia, Italy, Jordan, Kenya, Philippines, Thailand, and the United States. Mothers and fathers responded to questions on the frequency, severity, and justness of their use of corporal punishment; they also reported on the externalizing and internalizing behavior of their child. Children reported on their aggression. Multigroup path models revealed that across cultural groups, and as reported by mothers and fathers, there is a positive relation between the frequency of corporal punishment and externalizing child behaviors. Mother-reported severity and father-reported justness were associated with child-reported aggression. Neither severity nor justness moderated the relation between frequency of corporal punishment and child problem behavior. The null result suggests that more use of corporal punishment is harmful to children regardless of how it is implemented, but requires further substantiation as the study is unable to definitively conclude that there is no true interaction effect.

In the present analysis, we test the dual systems model of adolescent risk taking in a cross-national sample of over 5,200 individuals aged 10 through 30 (M = 17.05 years, SD = 5.91) from 11 countries. We examine whether reward seeking and self-regulation make independent, additive, or interactive contributions to risk taking, and ask whether these relations differ as a function of age and culture. To compare across cultures, we conduct 2 sets of analyses: 1 comparing individuals from Asian and Western countries, and 1 comparing individuals from low- and high-GDP countries. Results indicate that reward seeking and self-regulation have largely independent associations with risk taking and that the influences of each variable on risk taking are not unique to adolescence, but that their link to risk taking varies across cultures.

Restorative practices in schools lack rigorous evaluation studies. As an example of rigorous school-based research, this article describes the first randomized control trial of restorative practices to date, the Study of Restorative Practices. It is a 5-year, cluster-randomized controlled trial (RCT) of the Restorative Practices Intervention (RPI) in 14 middle schools in Maine to assess whether RPI affects both positive developmental outcomes and problem behaviors and whether the effects persist during the transition from middle to high school. The 2-year RPI began in the 2014-2015 school year. The study's rationale and theoretical concerns are discussed along with methodological concerns including teacher professional development. The theoretical rationale and description of the methods from this study may be useful to others conducting rigorous research and evaluation in this area.

Growing attention is being paid to individuals' implicit beliefs about the nature of intelligence. However, implicit beliefs about giftedness are currently underexamined. In the current study, we examined academically gifted adolescents' implicit beliefs about both intelligence and giftedness. Overall, participants' implicit beliefs about giftedness and intelligence were significantly positively correlated while also having statistically significant mean differences, suggesting that they perceived the nature of the two constructs differently. Specifically, many students viewed intelligence as malleable (incremental view) and giftedness as fixed (entity view), whereas very few students viewed giftedness as malleable and intelligence as fixed; however, heterogeneity was observed. The beliefs identified in the current study provide important insight into the domain-specific nature of implicit beliefs of gifted students and suggest that caution be used against using terms like giftedness and intelligence interchangeably.

"Curriculum-Based Measurement" (CBM) is a direct method of academic assessment used to screen and evaluate students' skills and monitor their responses to academic instruction and intervention. Interventioncentral.org offers a math worksheet generator at no cost that creates randomly generated "math curriculum-based measures" (M-CBMs). In this study, we examined the test-retest reliability and alternate-form reliability of four parallel, randomly generated M-CBMs designed to assess multiple arithmetic skills (addition, subtraction, multiplication, and division). The participants (N = 283 sixth-grade students) completed each M-CBM worksheet twice during a semester. According to our results, these M-CBMs have moderate test-retest and alternate-form reliability. Applying the Spearman-Brown Prophecy Formula revealed that aggregating M-CBMs increases the reliability of these measures to acceptable levels for progress monitoring (i.e., above .80).

Background: It is generally believed that parental rejection of children leads to child maladaptation. However, the specific effects of perceived parental acceptance-rejection on diverse domains of child adjustment and development have been incompletely documented, and whether these effects hold across diverse populations and for mothers and fathers are still open questions. Methods: This study assessed children's perceptions of mother and father acceptance-rejection in 1,247 families from China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States as antecedent predictors of later internalizing and externalizing behavior problems, school performance, prosocial behavior, and social competence. Results: Higher perceived parental rejection predicted increases in internalizing and externalizing behavior problems and decreases in school performance and prosocial behavior across 3 years controlling for within-wave relations, stability across waves, and parental age, education, and social desirability bias. Patterns of relations were similar across mothers and fathers and, with a few exceptions, all nine countries. Conclusions: Children's perceptions of maternal and paternal acceptance-rejection have small but nearly universal effects on multiple aspects of their adjustment and development regardless of the family's country of origin.

Despite growing concern about the need to develop talent across the globe, relatively little empirical research has examined how students develop their academic talents. Toward this end, the current study explored how academically talented students from the United States and India spend their time both in and out of school. Indian students reported spending roughly 11 more hours on academics than their U.S. peers during the weekend in both STEM (science, technology, engineering, and math) and non-STEM topics. U.S. students reported spending about 5.4 more hours than their Indian peers on non-STEM academics during the week, leaving an approximately 7-hour-a-week academic gap between U.S. and Indian students. Additionally, U.S. students reported using electronics over 14 hours per week more than their Indian peers. Indian students also reported having control over a greater proportion of their time during the week than U.S. students did. Generally, there were far more cross-cultural differences than gender differences. These results inform discussions on how academically talented students develop within educational systems as well as what each culture supports in and out of school.