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Author(s): Chris Rissel [sup.1] , Santosh Khanal [sup.1] , Jane Raymond [sup.2] , Vanessa Clements [sup.2] , Kit Leung [sup.2] , Michael Nicholl [sup.3] Author Affiliations: (Aff1) NSW Office of [...], Objectives Get Healthy in Pregnancy (GHiP) is a telephone based lifestyle coaching service for pregnant women, in New South Wales, Australia. GHiP had two service options; a telephone-based health coaching program consisting of up to 10 calls and information only (including one call). This study sought to compare the outcomes of the two GHiP options, to determine the characteristics of women likely to use the service and to explore the feedback from women and health professionals. Methods A pragmatic stratified clustered randomised controlled trial was conducted. Two metro and three rural hospitals were randomised into health coaching or information only arms. Self-reported measures of height and weight and health behaviours (dietary and physical activity) were collected at baseline and 36 weeks gestation. Process evaluation included descriptive analysis of routine program data, and semi-structured interviews with participants and health professionals. Results Of 3736 women screened, 1589 (42.5%) were eligible to participate, and of those eligible, 923 (58.1%) were recruited. More women in the health coaching arm gained weight within the target range for their BMI at 36 weeks gestation (42.9%) compared with information only (31.9%). Women found GHiP to be useful and supportive and midwives and doctors said that it facilitated conversations about weight with pregnant women. Conclusions for Practice Telephone-based lifestyle programs integrated with routine clinical care show promise in helping pregnant women achieve healthy gestational weight gain, but in this case was not significantly different from one information telephone call. Strong positive feedback suggests that scaled-up service delivery would be well received. Trial Registration ACTRN12615000397516 (retrospectively registered).

Author(s): Parisa Ghanouni [sup.1] , Tal Jarus [sup.2] , Jill G. Zwicker [sup.2] [sup.3] [sup.4] [sup.5] [sup.6] , Joseph Lucyshyn [sup.7] , Kristin Mow [sup.2] , Alyssa Ledingham [sup.2] Author [...], Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects socio-emotional skills and perspective-taking abilities. Although social stories in a form of virtual reality program can help children with ASD, developing them and identifying appropriate responses might be subjective and thus challenging. Using Delphi method, and guided by general case training, we involved 63 parents and clinicians of individuals with ASD, in two rounds of online iteration to refine the stories. Scenarios that reached a 75% agreement level were accepted. This project is the first study to develop and validate a library of 75 short socio-emotional stories that illustrate various types and intensities of emotion in three social contexts of home, school, and community as the content of a virtual reality program.

Author(s): Ramzi Shawahna [sup.1] [sup.2] [sup.3] , Basel Fahed [sup.3] , Dana Qadri [sup.3] , Lamees Sharawi [sup.3] , Mai Soroghli [sup.3] , Maen Dweik [sup.3] Author Affiliations: (1) 0000 [...], Pharmacists are trusted and easily accessible healthcare providers. We assessed awareness and knowledge of symptoms, etiology, and treatment of autism spectrum disorders (ASDs) among pharmacists practicing in Palestine. The pharmacists reported low familiarity with ASDs. The median score on the 12-item knowledge section was 50.0% with an interquartile range of 16.7%. Having course(s) or lecture(s) on ASDs during pharmacy degree program was significantly associated with familiarity (p value

Physician burnout is the new catch phrase. Recognized as a problem for years, burnout has now become more relevant. It is the sheer volume of cases that has beccome a [...]

Introduction: Few eligible children participate in early intervention (El) programs. The objective of this study was to determine feasibility and outcomes of a novel patient navigation program on El referrals [...]

Author(s): Helen E. Young[sup.1] , Ruth A. Falco[sup.1] , Makoto Hanita[sup.2] Author Affiliations: (1) Department of Special Education, Graduate School of Education, Portland State University, P.O. Box 751, 97207-0751, Portland, [...], This randomized, controlled trial, comparing the Comprehensive Autism Program (CAP) and business as usual programs, studied outcomes for 3-5 year old students with autism spectrum disorder (ASD). Participants included 84 teachers and 302 students with ASD and their parents. CAP utilized specialized curricula and training components to implement specific evidence-based practices both at school and home. A comprehensive set of outcome areas was studied. Hierarchical linear modeling was used to estimate the treatment impact. CAP had small positive impacts on the students' receptive language (effect size of .13) and on their social skills as rated by teachers (effect size of .19). Treatment effects were moderated by severity of ASD.

Author(s): Nora Wells[sup.1] , Suzanne Bronheim[sup.2] , Stephen Zyzanski[sup.3] , Clarissa Hoover[sup.1] Author Affiliations: (1) Family Voices, Inc., Albuquerque, NM, USA (2) Georgetown University, Washington, DC, USA (3) Case Western [...], The objective of this study was to create a psychometrically sound measure of family-centered care, the Family-Centered Care Assessment (FCCA), developed through a process led by families in collaboration with maternal and child health leaders. The items for the FCCA scale were initially developed by families of children and youth with special needs in partnership with pediatric providers and researchers. Using an Institutional Review Board-approved research protocol, the questions were revised based on input from focus groups of diverse parents in three states. Parental responses (N = 790) to the revised 59-item survey were collected online from families in 49 states. Item distributions uniformly showed excellent spread. A principal axes factor analysis confirmed the existence of a single factor. Rasch modeling item analyses identified a reduced subset of 24 items that demonstrated excellent psychometric properties. All items met the criteria for a linear Rasch scale. Empirical evidence in support of the construct validity of the 24-item measure was derived: all items had a positive and substantial item-total correlation; person alpha scale reliability was >0.80 and the item reliability was >0.90; both separation indices were >2.0; infit and outfit statistics were within 0.5-1.5; and item difficulties ranged between -2 and +2 logits. Strong rank-ordered associations and large effect sizes were observed for six indicators of quality of care. This study's family-led process produced a tool, the FCCA, to measure families' experience of care with excellent psychometric properties.

Author(s): Mary H. Hodges[sup.1] , Fatmata F. Sesay[sup.1] , Habib I. Kamara[sup.1] , Emmanuel D. Nyorkor[sup.1] , Mariama Bah[sup.1] , Aminata S. Koroma[sup.2] , Joseph N. Kandeh[sup.3] [sup.4] , Rasmata [...], Since 2004, twice-yearly mass vitamin A supplementation (VAS) has equitably reached over 85 % of children 6-59 months old in Sierra Leone. However infants who turn 6 months after the event may wait until they are 11 months old to receive their first dose. The effectiveness of integrating VAS at 6 months into the Expanded Program of Immunization (EPI) in a revised child health card was studied. Health facilities matched according to staff cadre and work load were assigned to provide either a &apos;mini package&apos; of VAS and infant and young child feeding (IYCF), a &apos;full package&apos; of VAS, IYCF and family planning (FP), or &apos;child health card&apos; only. 400 neonates were enrolled into each group, caregivers given the new child health card and followed until they were 12 months old. More infants in the full: 74.5 % and mini: 71.7 % group received VAS between 6 and 7 months of age compared with the new CH card only group: 60.2 % (p = 0.002, p < 0.001 respectively). FP commodities were provided to 44.5 % of caregivers in the full compared with

Author(s): Renata E. Howland[sup.1] , Ann M. Madsen[sup.1] , Amita Toprani[sup.1] [sup.2] , Melissa Gambatese[sup.1] , Candace Mulready-Ward[sup.1] , Elizabeth Begier[sup.1] Author Affiliations: (1) New York City Department of Health [...], National birth registration guidelines were revised in 2003 to improve data quality; however, few studies have evaluated the impact on local jurisdictions and their data users. In New York City (NYC), approximately 125,000 births are registered annually with the NYC Department of Health and Mental Hygiene, and data are used routinely by the department&apos;s maternal and child health (MCH) programs. In order to better meet MCH program needs, we used Centers for Disease Control and Prevention guidelines to assess birth data usefulness, simplicity, data quality, timeliness and representativeness. We interviewed birth registration and MCH program staff, reviewed a 2009 survey of birth registrars (n = 39), and analyzed 2008-2011 birth records for timeliness and completeness (n = 502,274). Thirteen MCH programs use birth registration data for eligibility determination, needs assessment, program evaluation, and surveillance. Demographic variables are used frequently, nearly 100 % complete, and considered the gold standard by programs; in contrast, medical variables&apos; use and validity varies widely. Seventy-seven percent of surveyed birth registrars reported [greater than or equal to]1 problematic items in the system; 64.1 % requested further training. During 2008-2011, the median interval between birth and registration was 5 days (range 0-260 days); 11/13 programs were satisfied with timeliness. The NYC birth registration system provides local MCH programs useful, timely, and representative data. However, some medical items are difficult to collect, of low quality, and rarely used. We recommend enhancing training for birth registrars, continuing quality improvement efforts, increasing collaboration with program users, and removing consistently low-quality and low-use variables.

Author(s): Suzanne D. Thomas[sup.1] , Jodi L. Hudgins[sup.2] , Donald E. Sutherland[sup.2] , Brittany L. Ange[sup.3] , Sandra C. Mobley[sup.4] [sup.5] Author Affiliations: (1) College of Nursing, Georgia Regents University, [...], The objective of this methodology note is to examine perinatal program evaluation methods as they relate to the life course health development model (LCHD) and risk reduction for poor birth outcomes. We searched PubMed, CDC, ERIC, and a list from the Association of Maternal and Child Health Programs (AMCHP) to identify sources. We included reports from theory, methodology, program reports, and instruments, as well as reviews of Healthy Start Programs and home visiting. Because our review focused upon evaluation methods we did not include reports that described the Healthy Start Program. The LCHD model demonstrates the non-linear relationships among epigenetic factors and environmental interactions, intentionality or worldview within a values framework, health practices, and observed outcomes in a lifelong developmental health trajectory. The maternal epigenetic and social environment during fetal development sets the stage for the infant&apos;s lifelong developmental arc. The LCHD model provides a framework to study challenging maternal child health problems. Research that tracks the long term maternal-infant health developmental trajectory is facilitated by multiple, linked public record systems. Two instruments, the life skills progression instrument and the prenatal risk overview are theoretically consistent with the LCHD and can be adapted for local or population-based use. A figure is included to demonstrate a method of reducing interaction among variables by sample definition. Both in-place local programs and tests of best practices in community-based research are needed to reduce unacceptably high infant mortality. Studies that follow published reporting standards strengthen evidence.

Author(s): Nicole A. Stadnick[sup.1] , Aubyn Stahmer[sup.1] [sup.2] , Lauren Brookman-Frazee[sup.1] Author Affiliations: (1) Department of Psychiatry, University of California, San Diego, San Diego, CA, USA (2) Department of Psychiatry [...], This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary aim was to compare child and parent outcomes between the intervention group and a community comparison for 30 young children with ASD at baseline and 12 weeks. The secondary aim was to identify parent factors associated with changes in child outcomes. Results indicated significant improvement in child communication skills and a strong trend for parent intervention adherence for the intervention group from baseline to 12 weeks. Higher baseline parenting stress was negatively related to child social gains from baseline to 12 weeks. Findings provide further support for delivering parent-mediated interventions in community settings to children with ASD.

Recent rehabilitation counseling (RC) literature advocates for knowledge about the types of services that improve employment rates for persons with low employment outcomes, and discusses the need to demonstrate the [...], Leadership across the state-federal Vocational Rehabilitation (VR) Program must be strategic in demonstrating accountability for employment outcomes given ever-present internal and external challenges to its operations. In order to reach for excellence in performance, leadership must have a lens toward systems thinking and build the components of a high performing organization. The authors introduce rehabilitation professionals to a context of performance in the state-federal VR Program and discuss the planning processes involved to manage a system that addresses employment outcomes. We provide information on the components of high performance organizations; systems thinking; strategic development, implementation, and leadership; and tools for use in project planning and tracking effectiveness of state agency services and practices. We discuss training and practice implications.

Objective: Effective tobacco control policies include price increases through taxes, restrictions on smoking in public and work places, adequately funded mass media campaigns, bans on advertising, health warnings on packages and cessation assistance. As these policies have been largely implemented in Australia, what next should the country do in tobacco control? Methods: Ninety-one Australian tobacco control stakeholders took part in a web-based survey about the future of tobacco control policies. Results: The policy deemed most important in decreasing smoking was to increase excise and customs duty by 30%. Other policies receiving high support included: funding mass media campaigns through tax hypothecation; introducing retail display bans; plain packaging of tobacco products; and banning smoking in outdoor dining areas. Reintroducing the sale of smokeless tobacco products received the least support. Conclusion: Countries that have largely implemented the provisions of the Framework Convention on Tobacco Control must maintain commitments to proven tobacco control measures, but also provide global leadership through the adoption of innovative policies. Implications: The release of the Australian 2009 National Preventative Health Taskforce's report presents an opportunity to translate these ideas into action. Key words: smoking, tobacco, public health, health policy. Aust NZ J Public Health. 2010; 34:447-50 doi: 10.1111/j.1753-6405.2010.00588.x

Much of the frustration that permeates efforts to improve the lives of people in the developing world springs from the fact that the commonly identified roots of the problem are [...]

From 1978 to 1983, researchers at the University of North Carolina conducted a National Evaluation of Rural Primary Care Programs. Thirty years later, many of the programs they studied have closed, but the challenges of providing rural health care have persisted. I explored the histories of 4 surviving rural primary care programs and identified factors that contributed to their sustainability. These included physician advocates, innovative practices, organizational flexibility, and community integration. As rural health programs look ahead, identifying future generations of physician advocates is a crucial next step in developing the rural primary care workforce. It is also important for these programs to find ways to cope with high rates of staff turnover. (doi:10.2105/AJPH.2008.146050)

Evidence-based management is emerging in the helping professions in response to heightened demands for public accountability and organizational performance. This paper defines evidence-based management and reviews its origins in the health care and business sectors and its recent incorporation into the social work profession. A case study describes the efforts of one social service agency to use evidence-based management to improve the performance of its child welfare and mental health programs. Consideration is given to the similarities between the dominant models of evidence-based management and evidence-based practice, the challenges facing administrators seeking to incorporate evidence-based management processes into social service agencies, and the implications of evidence-based management for social service agency practice and social work management. KEYWORDS evidence-based management, evidence-based practice, decision making, organizational performance, public accountability

Following the success of the United States' President's Emergency Plan for AIDS Relief (PEPFAR) the government plans to launch a new proposal program called the Mother and Child Campaign. The main aim of this campaign is to focus on the health needs of young children and their mothers, who are the hardest hit by deadly diseases.

Purpose: We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants. Design and Methods: Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations involving culturally relevant foods, stress reduction techniques, and communicating with racially/ethnically diverse physicians. We recruited participants from senior center members, area churches, and word of mouth. We conducted baseline and 4-month post-interviews. Results: A total of 569 African American elders attended an introductory session, with 519 (91%) enrolling in the 6-session program. Of the 519, 444 (86%) completed [greater than or equal to] 4 sessions and 414 (79%) completed pre--post interviews. We found small but statistically significant improvements for exercise (p = .001), use of cognitive management strategies (p = .001), energy/fatigue (p = .001), self-efficacy (p = .001), health distress (p = .001), and illness intrusiveness in different life domains (probabilities from .001-.021). We found no changes for health utilization. Outcomes did not differ by gender, number of sessions attended, number and type of chronic conditions, facilitator, leader, or recruitment site. Implications: The CDSMP can be translated for delivery by trained senior center personnel to African American elders. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities. Key Words: Evidence-based, Translational research, Community participation, Disease management, Program sustainability, Chronic illness

Previous research indicates that the Internet, electronic mail (e-mail), and printed materials can be used to deliver interventions to improve physical activity in people with type 2 diabetes. However, no studies have been conducted investigating the effect of e-mail or print delivery of an exercise program on muscular strength and aerobic capacity in people with type 2 diabetes. The purpose of this clinical trial was to investigate the impact of e-mail vs. print delivery of an exercise program on muscular strength and aerobic capacity in people with type 2 diabetes. Nineteen participants with type 2 diabetes were allocated to either a group that was delivered a prescribed exercise program using e-mail (e-mail group, n = 10) or a group that was delivered the same prescribed exercise program in print form (print group, n = 9). Chest press and leg press estimated one-repetition maximum (1-RM) scores as well as estimated peak oxygen uptake (V[O.sub.2]peak) were measured at baseline and follow-up. Intention-to-treat analysis indicated significant improvements in chest press (mean = 7.00 kg, p = 0.001, effect size = 2.22) and leg press (mean = 19.32 kg, p = 0.002, effect size = 1.98) 1RM scores and V[O.sub.2]peak (mean = 9.38 mL of oxygen uptake per kilogram of body mass per minute, p = 0.01, effect size = 1.45) within the e-mail group. Within the print group, significant improvements in chest press (mean = 9.13 kg, p = 0.01, effect size = 1.49) and leg press (mean = 16.68 kg, p = 0.01, effect size = 1.31) 1-RM scores and V[O.sub.2]peak (mean = 5.14 ml of oxygen uptake per kilogram of body mass per minute, p = 0.03, effect size = 1.14) were found. No significant between-group differences in improvements were found. Clinicians can deliver a prescribed exercise program, either by e-mail or in print form, to significantly improve muscular strength and aerobic capacity in people with type 2 diabetes, and expect similar outcomes. KEY WORDS type 2 diabetes, muscle strength, oxygen consumption, exercise