AIMS:Evaluate the effectiveness of Project Health, a dual obesity and eating disorder prevention program, relative to an educational video control condition and conduct an exploratory test of whether adding evaluative conditioning to the response/attention training component enhances intervention effects. MATERIALS AND METHODS:138 young adults (M age = 19.4; 76% female; 58% White) were randomized to Project Health groups or an educational video control condition. RESULTS:Participants randomized to Project Health showed greater decreases in body fat at posttest (d = -0.23) and 6-month follow-up (d = -0.53) than educational video controls. Intervention effects on change in eating disorder symptoms were nonsignificant at posttest (d = -0.14) but significant at 6-month follow-up (d = -0.33). Adding evaluative conditioning to the food response/attention training significantly enhanced the body fat loss effects at posttest (d = -0.36), but not at 6-month follow-up (d = -0.13); there were significant eating disorder symptom reduction effects by posttest (d = -0.37), but not at 6-month follow-up (d = 0.18). CONCLUSIONS:Project Health produced greater body fat loss/weight gain prevention effects than control participants. However, it only produced marginally greater reductions in eating disorder symptoms, in contrast to past trials. Evaluative conditioning enhanced the body fat loss effects of the food response/attention training element of Project Health. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT06067763.

PurposeTo examine the incremental effectiveness and costs of a motivational enhancement intervention, Connect2Test, embedded in syringe service programs (SSPs) on COVID-19 testing and vaccination uptake among people who inject drugs (PWID).DesignTwo-arm randomized controlled trial.SettingSSPs in Oregon.SamplePWID (n = 349) receiving services at SSPs. Participants were 18 years or older (M = 43.9), English-speaking, and mostly male (60%), White (64%), non-Hispanic (87%), and had low-income.InterventionParticipants were randomized to contingency management (CM; ie, $10 gift card) only (n = 172) or to CM + Connect2Test (n = 177).MeasuresCOVID-19 testing and vaccination (outcomes) and costs associated to Connect2Test training, staff delivery, materials, and facilities.Analysis: Used multilevel logistic regression to compare rates of COVID-19 testing and vaccination administered on the same day of the intervention and anytime during a 9-month follow-up period. Estimated incremental costs of CM + Connect2Test relative to CM-only using the ingredients method and a societal perspective.ResultsRelative to CM-only, the CM + Connect2Test group had 296% greater odds of receiving a vaccination during the 9-month follow-up period (3% vs 11%; OR = 3.96, 95%; CI = 1.43-10.94). No group differences were found for same-day vaccination or testing, or future testing. The estimated cost of a vaccine with Connect2Test was $575.ConclusionsA brief motivational intervention delivered by SSP staff increased COVID-19 vaccination among PWID.

Background We conducted a prospective study to advance knowledge of biological factors that predict the future onset of binge eating and compensatory weight control behaviors because few biological risk factors for eating pathology have been identified. Methods Adolescent girls free of binge eating or compensatory behaviors ( N = 88; M age = 14.5; [SD = 0.9]) completed functional magnetic resonance imaging tasks assessing individual differences in neural responsivity hypothesized to increase risk for onset of binge eating and compensatory behaviors, along with additional self-report measures, and were assessed over a 4-year follow-up. Results Elevated responsivity of regions implicated in attention and valuation (dorsal anterior cingulate cortex; ventromedial prefrontal cortex) to thin models and lower responsivity of a reward valuation region (caudate) to anticipated milkshake tastes (which correlated with feeling fat) predicted the future onset of binge eating or compensatory behaviors over 4-year follow-up. Parental history of binge eating and compensatory behaviors, emotionality, weight/shape overvaluation, feeling fat, and elevated BMI also predicted the future onset of binge eating or compensatory behaviors. Conclusions The evidence that elevated attentional bias for, and valuation of the thin ideal, in combination with lower valuation of high-calorie foods, predicted the future onset of eating-disordered behaviors are novel findings. The evidence that weight/shape overvaluation, feeling fat, elevated body mass, emotionality, and parental history of eating pathology predicted the future onset of eating-disordered behaviors extend past findings.

Objective: To evaluate an online intervention to support family members of individuals who sustained a traumatic brain injury (TBI). Research Design: Randomized control trial. Parallel assignment to TBI Family Support (TBIFS) intervention or enhanced usual care control (TAU). Three testing timepoints: pretest baseline (T1), posttest within 2 weeks of assignment (T2), and follow-up 1 month after posttest (T3). Setting: Online. Participants: Sixty-eight caregivers recruited nationally: 18 years of age or older, English speaking, providing primary caregiving to an adult family member with TBI and mild to moderate disability. Intervention: Eight interactive modules providing information about cognitive, behavioral, and social consequences of TBI, training in problem-solving framework, and application exercises (N = 35). TAU was an informational website (N = 33). Measures: Proximal outcomes-program use, usability, and user satisfaction for TBIFS participants. Primary outcomes-TBI content knowledge, strategy application objective response and open-ended response, and strategy-application confidence. Secondary outcomes-appraisals of burden, satisfaction, uncertainty in mastery, guilt, and negative environment. Results: Proximal outcomes-about 80% of TBIFS participants completed the posttest assessment, and 91% reported moderate to high usability and user satisfaction. Primary outcomes-greater posttest gains in TBI content knowledge for TBIFS than TAU (t = 3.53, p = .0005, adjusted p = .0090, d = 0.91). Gains maintained through follow-up (t = 2.89, p = .0038, adjusted p = .0342, d = 0.90). No other effects for the primary or secondary outcomes. Conclusion: TBIFS improved TBI content knowledge relative to TAU. Modifications might be needed to improve application and distal outcomes for caregivers.

This study investigated the experiences of providers collaborating with child welfare workers using the Quality of Collaboration with Child Welfare (Q-CCW) survey. The findings reveal a significant misalignment between the perceived importance of collaboration and providers' actual satisfaction levels. Despite high valuations of collaboration, participants from a range of professions expressed dissatisfaction with the responsivity and professionalism of workers. They were slightly more satisfied with relational elements of the collaborations. Participants further indicated that their experiences led to poorer outcomes and decreased willingness to continue working on child welfare cases. Providers' responses underscores the need for improvements in collaborative practices.

Developing sound evidence of program effectiveness can be difficult for many programs initiated by schools and communities, and impedes many beneficial programs from broader dissemination. This paper shares results of an evaluation approach used with a bullying and victimization prevention program with elementary school children called the radKIDS® Personal Empowerment and Safety Education Program. The purpose of this study was to examine indicators of initial effectiveness of the radKIDS® program for elementary school child safety skill development and instructor training to reduce child victimization and associated trauma and empower healthy psychosocial child development. The study involved 330 active radKIDS® instructors surveyed during two separate two-week periods, resulting in 148 completed questionnaires (45%). Instructors rated their perceptions of what children effectively learned in radKIDS® , the effectiveness of instructor training, and on Social Emotional Learning (SEL) competencies addressed in the program. Evaluation findings confirmed the theoretical model of the program, and that the developmental safety domains impacting children in radKIDS® differs from those in other bullying prevention interventions focused on SEL and other competencies. Recommended areas of improvement for the program included making training less time consuming and more flexible in delivery, provide more practice opportunities and time on skill acquisition during training, and increase supervision and guidance during program implementation.

BackgroundSuccessful interprofessional collaborations have been identified as a potential solution to mitigate problems associated with negative outcomes for clients involved with the child welfare system. The barriers to collaborative relationships need to be better understood and effectively addressed.ObjectiveTo understand the characteristics, barriers, and facilitators of collaborations between different types of providers and child welfare workers, as well as their impacts.Participants and settingMental health professionals, foster and kinship parents, legal professionals, and other providers responded to an online survey distributed in a Northeastern State of the United States of America.MethodParticipants (n = 208) completed the Quality of Collaboration with Child Welfare survey. Qualitative responses were analyzed by three coders using three levels of axial coding with constant comparison.ResultsParticipants identified different aspects of communication, relationships, and follow-through as key elements of successful collaborations, as well as the items most likely to interfere with their formation. Providers differed somewhat in how concerned they were with various aspects of collaborations in accordance with their professional roles. Barriers to successful collaborations included both individual and systemic factors which often resulted in negative outcomes. Overall, more negative experiences were offered than positive ones.ConclusionsStrategies are needed to improve communication, promote positive relationships, and address systemic barriers to enhance collaboration and, in turn, improve outcomes for child welfare-involved clients.

Secondary special education and transition research is crucial for improving outcomes for students with disabilities during their transition to postschool life. However, rural schools are underrepresented in this field, hindering the development of tailored interventions that can support youth with disabilities as they transition into adult life in rural communities. This manuscript offers a framework for (a) recruiting rural schools in secondary special education and transition research, (b) emphasizing facilitators that can support community partnerships in research, including tailored strategies to support research collaboration with rural communities, and (c) addressing barriers to rural school recruitment such as geographical isolation and limited resources. Drawing from experience with recruiting schools for the Communicating Interagency Relationships and Collaborative Linkages for Exceptional Students (CIRCLES) intervention, we offer guidance for researchers, stressing flexibility and clear communication to effectively engage rural schools. By integrating these insights, researchers can develop more inclusive recruitment approaches, advancing secondary special education and transition research to better support outcomes for secondary students with disabilities in rural settings.

Justice-involved youth have a high risk of reoffending after release, indicating the need for evidence-based reentry programming. This paper presents the results of a two-year post-release non-randomized comparison study. The study examined the impact of enhanced transition programming, delivered through Reentry Intervention and Support for Engagement by Integrating Technology (RISE-IT), on recidivism by comparing two groups, youth who received enhanced vs. traditional transition services in a secure care facility. Enhanced services included: enhanced reception, assessment & classification, transition planning, vocational preparation, merging two worlds curriculum, and 30-day aftercare support. Results indicate that youth who received enhanced services through RISE-IT had significantly lower rates of recidivism. Limitations and implications for practice, as well as future research, are discussed.

A rapidly growing body of research indicates that the quality of children's relationships with teachers can affect students' emotional, behavioral, and school related adjustment. The vast majority of this research has relied on measures that assess teacher-rather than student-perceptions of these relationships. In this study, we administered a student self-report measure of teacher-student relationships (TSR) to 185 children, all of whom had emotional and behavioral problems. Children's special education teachers (N = 76) also completed a validated measure of TSR. Results of a confirmatory factor analysis of child ratings confirmed a model that included three TSR factors: Communication, Trust, and Alienation. Analyses of similarities between student and teacher views of their relationship with one another suggested limited concordance, however, student perceptions of TSR were robust predictors of their emotional, behavioral, and school adjustment even after controlling for teacher perceptions of TSR. These findings provide preliminary support for the importance assessing student perceptions of TSR and initial evidence for the construct validity, reliability and criterion-related validity of a child report measure of teacher-student relationships among students with emotional and behavioral problems.

Abstract Background Despite ongoing efforts to introduce evidence-based interventions (EBIs) into mental health care settings, little research has focused on the sustainability of EBIs in these settings. College campuses are a natural place to intervene with young adults who are at high risk for mental health disorders, including eating disorders. The current study tested the effect of three levels of implementation support on the sustainability of an evidence-based group eating disorder prevention program, the Body Project, delivered by peer educators. We also tested whether intervention, contextual, or implementation process factors predicted sustainability. Methods We recruited 63 colleges with peer educator programs and randomly assigned them to (a) receive a 2-day Train-the-Trainer (TTT) training in which peer educators were trained to implement the Body Project and supervisors were taught how to train future peer educators (TTT), (b) TTT training plus a technical assistance (TA) workshop (TTT + TA), or (c) TTT plus the TA workshop and quality assurance (QA) consultations over 1-year (TTT + TA + QA). We tested whether implementation support strategies, perceived characteristics of the intervention and attitudes towards evidence-based interventions at baseline and the proportion of completed implementation activities during the implementation year predicted three school-level dichotomous sustainability outcomes (offering Body Project groups, training peer educators, training supervisors) over the subsequent two-year sustainability period using logistic regression models. Results Implementation support strategies did not significantly predict any sustainability outcomes, although a trend suggested that colleges randomized to the TTT + TA + QA strategy were more likely to train new supervisors (OR = 5.46, 95% CI [0.89–33.38]). Colleges that completed a greater proportion of implementation activities were more likely to offer Body Project groups (OR = 1.53, 95% CI [1.19–1.98]) and train new peer educators during the sustainability phase (OR = 1.39, 95% CI [1.10–1.74]). Perceived positive characteristics of the Body Project predicted training new peer educators (OR = 18.42, 95% CI [1.48–299.66]), which may be critical for sustainability in routine settings with high provider turnover. Conclusions Helping schools complete more implementation activities and increasing the perceived positive characteristics of a prevention program may result in greater sustainment of prevention program implementation. Trial Registration This study was preregistered on 12/07/17 with ClinicalTrials.gov, ID NCT03409809, https://clinicaltrials.gov/ct2/show/NCT03409809 .

Background Findings from brain imaging studies with small samples can show limited reproducibility. Thus, we tested whether the evidence that a transdiagnostic eating disorder treatment reduces responsivity of brain valuation regions to thin models and high-calorie binge foods, the intervention targets, from a smaller earlier trial emerged when we recruited additional participants. Methods Women with DSM-5 eating disorders (N = 138) were randomized to the dissonance-based body project treatment (BPT) or a waitlist control condition and completed functional magnetic resonance imaging (fMRI) scans assessing neural response to thin models and high-calorie foods at pretest and posttest. Results BPT v. control participants showed significantly greater reductions in responsivity of regions implicated in reward valuation (caudate) and attentional motivation (precuneus) to thin v. average-weight models, echoing findings from the smaller sample. Data from this larger sample also provided novel evidence that BPT v. control participants showed greater reductions in responsivity of regions implicated in reward valuation (ventrolateral prefrontal cortex) and food craving (hippocampus) to high-calorie binge foods v. low-calorie foods, as well as significantly greater reductions in eating disorder symptoms, abstinence from binge eating and purging behaviors, palatability ratings for high calorie foods, monetary value for high-calorie binge foods, and significantly greater increases in attractiveness ratings of average weight models. Conclusions Results from this larger sample provide evidence that BPT reduces valuation of the thin ideal and high-calorie binge foods, the intervention targets, per objective brain imaging data, and produces clinically meaningful reductions in eating pathology.

Collaborations in child welfare are crucial for addressing complex needs and improving outcomes for children and their families. In this study we aimed to develop and validate the Quality of Collaboration with Child Welfare (Q-CCW) scale to assess working relationships between providers and child welfare workers. The scale was developed to assess four attributes of collaboration: quality of the working relationship, responsiveness, joint understanding, and communication. Following its construction, the scale was administered to a sample of 208 participants, including mental health clinicians, foster/kinship parents, and lawyers/evaluators. Exploratory factor analysis revealed a one-factor solution, indicating a unified construct of quality collaboration, that demonstrated reliability. The Q-CCW can facilitate the measurement and improvement of collaborations in child welfare, thereby contributing to enhanced service delivery and positive outcomes for children and families.

OBJECTIVE:Test whether a group-delivered dissonance-based transdiagnostic eating disorder treatment, Body Project Treatment (BPT), produces greater reductions in eating disorder symptoms and higher abstinence from eating disorder behaviors and remittance from eating disorder diagnoses than group-delivered transdiagnostic interpersonal psychotherapy (IPT). METHOD:Women with a range of eating disorders (N = 73) were randomized to 8-week group-implemented BPT or IPT and completed surveys and masked diagnostic interviews at pretest, posttest, and 6-month follow-up. RESULTS:Participants randomized to BPT versus IPT showed significantly greater reductions in eating disorder symptoms (d = -.75), pursuit of the thin ideal (d = -.87), anxiety symptoms (d = -.76), and social impairment (d = -.59) through 6-month follow-up. By end of treatment, participants randomized to the BPT versus IPT did not significantly differ on abstinence from binge eating and purging (49% vs. 40%, respectively) or remittance from eating disorder diagnoses (54% vs. 40%, respectively). Participants randomized to BPT versus IPT did not differ significantly in average session attendance (5.8 vs. 6.9, respectively) or average homework assignments completed (4.6 vs. 5.6, respectively). The within-condition reductions in eating disorder symptoms for BPT did not significantly differ when implemented in person versus via synchronous video telepsychiatry (d = -1.39 vs. -1.09, respectively), though these effects should be considered preliminary because of the small cell sizes. CONCLUSIONS:The evidence that BPT produces greater reductions in eating disorder symptoms, pursuit of the thin ideal, anxiety symptoms, and social impairment than IPT is encouraging because it provides some assurance that the effects are present equating for the effects of expectancies, demand characteristics, and nonspecific factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Introduction: College students face increased risk for a variety of mental health problems but experience barriers to treatment access. Prevention programs, including those implemented by peer educators, may decrease treatment needs and increase service access. We examined the implementation of an evidence-based eating disorder prevention program, Body Project , delivered by college peer educators at 63 colleges/universities, comparing three levels of implementation support: (1) Train-the-Trainer (TTT) training; (2) TTT plus a technical assistance workshop (TTT + TA); and (3) TTT + TA with one year of quality assurance calls (TTT + TA + QA). The present study tested the degree to which indicators proposed by the Consolidated Framework for Implementation Research (CFIR) were associated with core implementation outcomes. Method: We tested whether indices of CFIR domains (i.e., perceived intervention characteristics, outer and inner setting factors, provider characteristics, and implementation process) were correlated with three implementation outcomes (program reach, fidelity, effectiveness) during a 1-year implementation period. Results: Greater program reach was associated with implementation process, specifically the completion of more implementation activities (β = 0.46). Greater program fidelity was associated with higher positive (β = 0.44) and lower negative (β = − 0.43) perceptions of the Body Project characteristics, and greater reported general support for evidence-based practices (β = 0.41). Greater effectiveness was associated with lower negative perceptions of Body Project characteristics ( d = 0.49). Conclusions: Several implementation determinants proposed by the CFIR model predicted outcomes, especially intervention fidelity. Across the outcomes of interest, implementation determinants related to peer educator and supervisor perceived characteristics of the specific intervention and general attitudes towards evidence-based practices emerged as robust predictors to inform future work investigating ongoing implementation and sustainability of programs in university settings.

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.

BACKGROUND:Depression is one of the most common complications of childbirth, and is experienced by approximately 17% of pregnant women and 13% of postpartum women. An estimated 85% of these women go untreated-an alarming statistic given the serious consequences for the mother, her child, other family members, and society. Professional societies (the American College of Obstetricians and Gynecologists and American Academy of Pediatrics) have recommended improvements in screening and treatment. Meta-analyses indicate that cognitive behavioral therapy eHealth interventions are efficacious for depression, generally, and for perinatal depression, specifically. Earlier controlled trials have established the effectiveness and acceptability of MomMoodBooster (including an Australian version, MumMoodBooster), an eHealth program for ameliorating postpartum depression.OBJECTIVE:This study aimed to evaluate the effectiveness of a perinatal version of MomMoodBooster encompassing both prenatal and postpartum content in a healthcare delivery setting already providing universal screening and referral of at-risk patients as part of routine care.STUDY DESIGN:A practical effectiveness study randomly assigned 95 pregnant and 96 postpartum women screened as depressed and satisfying eligibility criteria to experimental groups: the healthcare organization's perinatal depression care program (routine-care group) and routine care+MomMoodBooster2 program (eHealth group). Eligibility criteria included: pregnant or <1 year postpartum, ≥18 years of age, no active suicidal ideation, access to broadband internet via desktop/laptop, tablet, or smartphone, and English language proficiency.RESULTS:Intent-to-treat analyses of group effects used fixed-effects growth models to assess 12-week posttest change in outcomes. Results showed that both groups had significantly decreased depression severity, anxiety, stress, and automatic thoughts, and increased behavioral activation and self-efficacy. Relative to the routine-care group, the eHealth group displayed significantly greater decreases in depression severity and stress. These group comparisons were not moderated by depression severity (screening or baseline), anxiety, stress, or pregnant/postpartum status. Almost all (93%; n=89) women in the eHealth group visited their program, of whom 99% visited program sessions (M sessions visited=4.3±2.0; M total session duration=73.0±70.2 minutes; 49% viewed all 6 sessions). Among confirmed eHealth program users who provided ratings, 96% (79/82) rated their program as easy to use, 83% rated it helpful, and 93% (76/82) indicated that they would recommend it.CONCLUSION:Results support the effectiveness of using MomMoodBooster2 as a treatment option for perinatal women with depression, especially when combined with universal depression screening and referral. Consequently, the eHealth program shows promise as a tool to increase the reach of treatment delivery and to potentially reduce the number of untreated perinatal women with depression.

Background. This study tested whether the dissonance-based Body Project eating disorder prevention program reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over long-term follow-up.Methods. Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N = 1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up differed between Body Project and control participants.Results. Peer-led Body Project groups produced a 46% reduction in onset of subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED did not significantly differ between peer-led Body Project participants and control participants.Conclusions. Results support the dissemination of the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk factor for eating disorders targeted in the Body Project, may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types.