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Trust in the potential of education as a common good is the cornerstone of the bond between citizens and their institutions. Changing current patterns entails lifting barriers to a culture of peace and uprooting all forms of violence. Education needs to be resilient enough through its citizen education to provide a framework for thriving societies. Governing education as a common good requires questioning educational models and curricula, considering how notions of peace are integrated into those models, which can serve as a basis for schooling as an integral part of society for the well-being and advancement of citizens. Therefore, we ask, how can citizenship education impact public institutions peace-wise? And conversely, how can citizenship education foster proximity peace and disseminate ethics for citizens, the planet, and peace building. How can citizenship education be beneficial to society as a whole? This article attempts to address these questions by exploring the benefits of rethinking curriculum beyond performance, while recentering and converging efforts into educating caring citizens in peace with each other and their environments.

This systematic review evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities (DD). Twenty-one studies including randomized control trials (n= 9) and quasi-experimental studies (n=12) published between 2010 and 2021 met inclusion criteria related to participant characteristics, intervention type, and child obesity-related outcomes. Five types of intervention programs were identified: aerobic and strength training, sport-based physical activity, aquatic exercise, active video gaming, and diet and lifestyle. Whereas analysis of intervention outcomes, efficacy, and study rigor showed mixed results and weak evidence of effective interventions, this review identified gaps in the literature, promising strategies for addressing obesity in children with DD, and implications for practice and future research.

This work aims to investigate the causes behind teachers leaving their profession in France, as well as the aspects that influence some teachers to stay in. The phenomenon of teacher dropout and abandonment is increasingly prevalent in OECD countries, particularly affecting new teachers. Taking a social psychological perspective, the research delves into the representational content of teachers' attitudes towards their profession. By distinguishing between teacher dropout and abandonment--the latter being considered an earlier phase, the results suggest that pupils play a central role in preventing teachers' dropout, along with the love and passion for teaching and the discipline they teach. Conversely, lack of consideration, inadequate resources, working conditions and classroom management challenges are identified as aspects contributing to increase teachers' dropout phenomenon. The findings provide an empirical basis for future studies and valuable insights for enhancing initial teacher training programmes. Understanding these phenomena through the lens of social representations provides valuable insights for developing supportive environments that foster teacher retention and well-being and facilitate intervention and prevention strategies targeting key elements linked to teachers dropping out.

Students with disabilities (SWDs) are disproportionately at-risk for bullying victimization and perpetration, yet there is a lack of educator-focused professional development targeting prevention for these students. This project sought to address gaps in training through the creation of four online professional development modules: (1) understanding bullying among SWDs, (2) examining risk characteristics, (3) establishing school and classroom prevention strategies, and (4) individual prevention. These modules were iteratively developed with feedback from teachers and staff, incorporating the Multi-Tiered System of Supports (MTSS) framework to focus on interventions rooted in social emotional learning (SEL), and emphasizing the importance of prevention for SWDs.

As cognitively gifted students may be at risk for motivational problems and underachievement, it is critical to find effective ways to motivate them. Grounded in self-determination theory (SDT) and the literature on teacher beliefs and mindsets, the present study examined whether teachers adapt their motivational teaching style as a function of the cognitive ability of students and which factors can explain the variability in teachers' use of (de)motivating styles among gifted versus typical students. Results of linear mixed modeling among 122 teachers in secondary education (73% female; M[subscript age] = 39.52 years) indicated that teachers made more use of autonomy-supportive and chaotic and less use of controlling and structuring practices towards cognitively gifted, relative to typical, students, with differences in the perceived effectiveness of teaching styles by type of student explaining this variability. Regardless of students' giftedness status, teachers' fixed mindset related positively to the use of a controlling and chaotic style and experience in giftedness education related positively to the use of autonomy support. Misconceptions regarding giftedness did not relate to teachers' motivating style. These results inform prevention efforts aimed at improving teachers' motivating styles, to the benefit of the motivation of both cognitively gifted and typical students.

Narratives have been widely acknowledged as a powerful persuasion tool in health promotion and education. Recently, great efforts have been devoted to identifying message components and causal pathways that maximize a narrative's persuasion power. Specifically, we investigated how narrator point of view and readers' subjective relative risk moderate the effects of protagonist competence on intentions to adopt osteoporosis-prevention behaviors, and proposed identification with the protagonist, self-referencing, and fear arousal as three mediators explaining the effect. Women aged 35 to 55, still young enough to reduce osteoporosis risk, read a narrative in which the 60-year-old female character reflects on either taking actions to prevent osteoporosis (competent protagonist) or failing to do so, resulting in osteoporosis (incompetent protagonist) (N = 563). The narratives were told from either the first- or third-person point of view. We found that women who perceived themselves to be at lower risk for developing osteoporosis relative to their peers identified more with the competent protagonist. For women at higher perceived risk, the competent and incompetent protagonists elicited similar levels of identification. Identification was higher when the protagonist's story was told from the first-person perspective, but only for the incompetent protagonist narrative. Identification, self-referencing, and fear arousal played important mediating roles. Implications for theory development and practice are examined.

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many arsoe unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.

Background: The main goal of a health system is to maintain or improve people's health. The COVID-19 pandemic showed the fragility of health systems worldwide. In Mexico, the pandemic affected the performance of the health system, along with the presence of contextual conditions such as its segmentation and high prevalence of chronic diseases. Aims: To analyze from an approach to the functions of the health system, the service delivery, human resources, financing, and stewardship/governance in the local health services of five states of Mexico, from the perspective of the staff working in health centers. Methods: This is an exploratory qualitative study conducted from November 2020 to August 2021, involving 124 health professionals from 39 health facilities (18 rural and 21 urban). The technique used was the semi-structured interview. Interview guides were developed according to core topics. Subsequently, the thematic analysis method was used. Results: The lack of financial resources delayed prevention efforts and made it difficult for health centers to adapt to the crisis. Inequity was found in the distributive efficiency of staff between rural and urban areas and levels of care. In addition, there was evidence of capacity for coordination, capacity sharing, and joint participation between health institutions, civil authorities, and the population to face the emergency. Conclusions: We identified relevant public health actions that showed the capacity of local health services to organize a response to the pandemic at the level of the actors responsible for these services.

Background. Health-promoting behaviors and positive lifestyle changes are crucial for effective stroke prevention. However, individuals at high risk of stroke exhibit poor health behavior due to a deficiency of individual motivation. Moreover, there are only a few studies on health-promoting behaviors that have applied behavior change theories in individuals at high risk of stroke. Objective. This study aimed to use the theory of the planned behavior (TPB) model to investigate determinants of health-promoting behaviors for stroke prevention and control. Method. In this cross-sectional study, 263 participants were recruited from five community health centers in Qingdao. Confirmatory factor analysis was performed to assess the reliability and validity of the constructs, and structural equation modeling was used to analyze the proposed relationships between the TPB-related variables. Results. The attitudes, subjective norms, and perceptions of behavioral control positively influenced behavioral intention. The behavioral intention had a positive effect on health-promoting behaviors. Attitudes, subjective norms, and perceived behavioral control were influenced primarily by the mediating variable behavioral intention to affect health-promoting behaviors. Stroke knowledge was an influential facilitator of behavioral attitudes, subjective norms, and perceived behavior control. Conclusion. The TPB-based model is suitable for explaining health-promoting behaviors in individuals at risk of stroke and for guiding the development of effective health management programs. A comprehensive person-centered motivation behavior strategy that is based on health education and complemented by social support and health resource optimization is critical in promoting health behavior motivation and health promotion behaviors in stroke high-risk groups.

Background: Medicaid is a key policy lever for expanding access to mental health services and supports for children in schools, especially low-income and minority children. This study examines how Medicaid finances mental health promotion and prevention (tier 1), screening and selected interventions (tier 2), and treatment (tier 3) in schools, informing policy recommendations to expand school mental health. Methods: Seventeen key informant interviews were conducted virtually from March to October 2022 with research, practice, and policy leaders in school mental health and Medicaid. Interview transcripts were thematically coded to inform recommendations. Results: Interview themes included that Medicaid is a key funder of mental health services, primarily in tier 3, and that braiding and blending funds is necessary to support services across all tiers in schools. Interviewees underscored the need to expand tier 2 in schools, to expand and diversify the behavioral health workforce (including via non-licensed providers, aligning school-employed provider licensure and billing requirements and building school-community referral relationships), strengthen teaming structures (including state children's cabinets, student case management, and education/Medicaid agency coordination), and leverage technical assistance and training to speed up adoption of new policies (including via guidance and templates that facilitate billing for school health services). Conclusions: Policymakers, practitioners, and advocates can use these findings to identify policies and strategies to expand school mental health and reduce inequities.

Danish schools offering "preparatory basic education and training" (FGU schools) have students that are characterized by having different academic, social, or personal problems. In addition, many FGU students are at high risk of suicidal behavior. Many young people with suicide behavior do not seek help and early identification is important for suicide prevention. Teachers are in a position where it could be relevant to implement a gatekeeper intervention. To ensure successful implementation of an intervention, it is important to establish organizational readiness for change, including its innovation-specific capacity, which are the facilitating requirements in the organization specific to the intervention. We aimed to explore the innovation-specific capacity to implement a gatekeeper intervention at FGU schools in Denmark. This study is based on an online survey completed by teaching staff (n = 251) at FGU schools to explore their overall knowledge about and experience with students' suicidal behavior. Limited knowledge of suicide prevention was found among teaching staff. Most knowledge was from personal experience. There is a need for teaching staff to be educated about suicidal behavior. There is a lack of innovation-specific capacity to implement a gatekeeper intervention.

The objectives of this study were to establish the frequency of violent behaviors present in primary education (PE), to determine differences based on students' grade and gender, and to assess the evolution of behaviors between the fourth and sixth grades of PE. The research design was a cohort longitudinal ex post facto study with three measures. Data was collected at three different moments across fourth, fifth, and sixth grades of PE. The sample was composed of all the students of three public centers located in three localities of Autonomous Community of Navarra (Northern Spain). The centers had to present similar characteristics to each other and to the population of Navarra. The first three centers contacted agreed to participate. The sample was composed of 236 students (110 girls) in PE. Students completed the instrument School Violence Questionnaire-Revised. A descriptive analysis, a bivariate analysis, and a logistic regression model were performed. A gradual increase in the perception of different violent behaviors with differences between boys and girls was found. In fourth grade, there was hardly any perception of information and communication technology-related violence; it then increased until sixth grade. Boys perceived more violence from teachers toward students and among peers. Girls perceived more violent behavior between fourth and fifth grade. Preventive interventions targeting digital violence should be developed at this stage. Considering the differences found according to gender and age, it is highlighted the need to train the educative community in different areas, such as emotional competencies, school coexistence, and the detection and prevention of violent behavior.

Anxiety disorders have been on the rise among adolescents over the past decade. The COVID-19 pandemic appears to have contributed to this increase, putting further pressure on often already overburdened health systems. Universal prevention programs may offer a potential solution, but few have been evaluated in the context of a pandemic. The objective of this article is to measure the impact of a universal prevention program--the HORS-PISTE program--on several anxiety-related variables in the context of a pandemic. The HORS-PISTE program consists of 10 workshops spread over the two first years of high school, secondary 1 and 2 (grade 7 and 8 equivalent). Workshops are held in a classroom setting and focus on the development of psychosocial skills. The study was conducted in Quebec with 1,202 secondary 1 and 2 students (48.7% girls, 51.3% boys) with an average age of 12.58 years ("SD" = 0.75). They completed an assessment protocol before and after participating in the HORS-PISTE program in the autumn of 2020. Their answers were subjected to descriptive analysis and multivariate analysis of variance. Results indicate a significant decrease in symptoms for several of the measured variables between the two measurement times, such as those associated with panic disorder, generalized anxiety disorder, and test anxiety. The results also show a decrease in some variables related to the interference of anxiety symptoms and the cognitive and behavioral vulnerabilities targeted by the program. The discussion highlights possible explanations for the results, as well as how universal prevention programs may contribute to the prevention of anxiety during adolescence, especially in a pandemic context.

Background: People with learning disabilities following a long-term stay in forensic settings may experience difficulties reintegrating in the wider community. Indirect interventions can be helpful for care providers and family members to reflect on their practices and improve the quality of life of people with learning disabilities. Although indirect interventions are being implemented in learning disability settings, research is limited. Methods: This clinical case study recounts an indirect intervention with care providers of a male with mild learning disability. Findings: We recount the referral and assessment processes, the initial hypotheses and formulation of the service users' presenting difficulties. We demonstrate how a systemically informed indirect intervention with staff can be used to improve the living conditions of a man with mild learning disability and provide reflections on working with multiple interdependent systems surrounding vulnerable individuals in a specialist learning disability setting. Conclusion: Indirect interventions with the care networks supporting an individual with a learning disability can be a useful way to conceptualise the barriers and facilitators for community integration. Indirect interventions can also offer a reflective space for staff to share their own difficulties and prevent burnout.

Background: We now have sufficient evidence demonstrating inequalities in specific avoidable causes of death for adults with intellectual disability compared to their peers without intellectual disability. Apart from COVID-19, the largest differentials that disadvantage people with intellectual disability are in relation to pneumonia, aspiration pneumonia, epilepsy, cerebrovascular disease, ischaemic heart disease, deep vein thrombosis, diabetes and sepsis. The aim of this systematic review is to report on strategies at the individual, population or policy levels aimed at preventing these conditions that are applicable to adults with intellectual disability and that have been based on or recommended by research. Methods: Systematic review of PUBMED, EMBASE, CINAHL, PsychInfo, Social Care Online, International Bibliography of the Social Sciences (IBSS), Web of Science, Scopus, Overton, the Cochrane Library and Google Scholar databases was carried out. Searches were completed on 30 June 2023. Quantitative, qualitative and mixed-methods research; systematic, scoping or evidence-based reviews; and audit and reports of mortality reviews were included. Publications included in the review were about preventing the eight potentially avoidable causes of death. Findings: Ninety-four papers were included in the review (9 in relation to pneumonia; 11 for aspiration pneumonia; 18 for sudden unexpected death in epilepsy; 7 for cerebrovascular disease; 8 for ischaemic heart disease; 4 for deep vein thrombosis; 31 for diabetes; 6 for sepsis). The eight most frequently occurring potentially avoidable causes of death in people with intellectual disability are very different medical conditions, but they shared striking similarities in how they could be prevented. The literature overwhelmingly implicated the need to make lifestyle changes to address obesity, lack of exercise and poor nutrition, and to have regular medical reviews. In addition, 'whole-population' approaches are required that look beyond the individual to the social determinants of health. Conclusions: We found little peer-reviewed evidence specifically about preventing these conditions in people with intellectual disability. However, most of the literature about preventative strategies pertaining to the general population was applicable to people with intellectual disability, albeit that some 'reasonable adjustments' would be required.

During the COVID-19 pandemic, drastic measures to interrupt SARS-CoV-2 infection chains were implemented. In our study we investigated the consequences of pandemic related restrictions on the social, psychological, and physical well-being of institutionalized adults with intellectual and developmental disabilities. Methods: Online survey among professional caregivers in 71 residential groups, caring for 848 residents. Findings: (i.) A lack of participation concerning infection protection measures of the residents, their relatives, and their caregivers; (ii.) A 20% increase in doctor contacts during the pandemic; (iii.) A considerable deterioration in at least one item of the subdomains mood (49%), everyday skills (51%), social interaction (29%), exercise and coordination skills (12%), behavior (11%) and cognition and communication (7%); (iv.) A deterioration of the overall condition in 41%; Summary: Intensive attempts should be made to find individual and less categorical contra-infectious measures without questioning the basic everyday needs of people with intellectual and developmental disabilities.

School bullying is prevalent among senior-grade pupils, with negative impacts on pupils' physical health and psychosocial adjustment. However, few studies have explored the relationship between the senior-grade pupils experiencing teacher unfairness and their suffering from school bullying. This study aims to investigate the longitudinal associations between perceived teacher unfairness and school bullying victimization, as well as the mediating role of the sense of school belonging therein. The data were collected from 822 pupils ranging from Grade Four to Five (430 boys and 392 girls, M[subscript age] = 10.8, SD[subscript age] = 0.69 at Time 1) over three semesters. The results indicated that (1) perceived teacher unfairness (Time 1) exerted a significantly negative prediction effect on subsequent school bullying victimization (Time 3); (2) the sense of school belonging (Time 2) played a key mediating role in the association between perceived teacher unfairness (Time 1) and school bullying victimization (Time 3); (3) compared to girls, the predictive effect of the sense of school belonging (Time 2) on school bullying victimization (Time 3) was stronger for boys. The results demonstrated the importance of ensuring teacher fairness and cultivating pupils' sense of belonging to the school as a method of preventing school bullying, and also explained the gender differences between boys and girls; thus, the study provided a theoretical and practical basis for preventing bullying in schools.

The current study used thematic analysis to examine school staff perspectives on the impact of the Olweus Bullying Prevention Program (OBPP) on school climate in terms of the quality of student-student and student-teacher relationships in two low-income, urban middle schools in the United States. Data were collected using focus groups and interviews. Participants included teachers (n = 26), administrators (n = 8), and Bullying Prevention Coordination Committee members (BPCCs; n = 8). Results indicated that providing explicit instruction about bullying, nurturing student-teacher trust by effectively addressing student concerns, and providing consistent opportunities for informal, collaborative engagement facilitated positive school-based interpersonal relationships and behavioral change. Implications for policy and intervention development are discussed.

Suicidal behaviour is a major socio-health problem worldwide. However, there are few empirically validated programs for universal prevention of suicidal behaviour in school settings. The aim of the present study was to design and validate the "PositivaMente" program for the prevention of suicidal behaviour in school-age adolescents aged 14-15 from the North of Spain. A quasi-experimental design was used with pre- and post-treatment evaluation with experimental and control groups and a six-month follow-up. The final sample consisted of 264 participants (M = 14.30 years, SD = 0.56; 54.5% girls), with 161 participants in the experimental group and 103 in the control group. Measuring instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, depressive symptomatology, prosocial behaviour, subjective well-being, and self-esteem. The "PositivaMente" program was designed and implemented in educational settings. A statistically significant improvement in subjective well-being was found, as well as a statistically significant reduction in emotional problems and problems with peers among female participants in the experimental group versus those in the control group at the 6-month follow-up. However, male participants did not seem to benefit from the program. The overall evaluation from the sample and satisfaction with "PositivaMente" were positive. Empirically supported actions for the prevention of suicidal behaviour need to be designed in order to make informed decisions. Future studies should implement the "PositivaMente" program with other populations and contexts, develop a brief version, and collect information on cost-effectiveness.

Various scholars have confirmed that teacher safety against learner victimization is a growing concern worldwide, and this problem is exacerbated by a lack of understanding and readiness to implement policies to address this matter. In this regard, policy implementation by middle leaders (MLs) in creating safe school environments has attracted much less interest as a possible way of addressing issues of teacher safety and the prevention of learner victimization. MLs are regarded as individuals who have the potential to lead, plan, inspire and persuade, and in so doing, they are in an ideal position to translate policy into practice. As such, this paper provides a qualitative policy document analysis of The National School Safety Framework (NSSF) premised on the theory that every individual in the school experiences safety in dissimilar ways and has unique safety needs. The NSSF is endorsed by the Department of Basic Education to guide in addressing issues of violence and safety in South African schools. Underpinned by the rational choice theory and utilizing policy document analysis, texts in the NSSF were analysed and interpreted to propose transformative policy strategies that can assist MLs in managing teachers' safety at schools more effectively. The findings suggest that administrative duties and a lack of time make it difficult for MLs to create a safe and supportive learning environment in schools. Another finding was that there is no clear plan outlined in the NSSF to guide MLs to pursue teacher safety against learner victimization in schools. To assist MLs, this paper proposes transformative policy strategies that can assist them in promoting teacher safety and preventing learner victimization in schools. The paper recommends that more explicit interpretation and implementation strategies be communicated with schools to assist them in fighting the war against violence in schools.

The objectives of this article are to examine the epidemiology of suicide for Black college men; social determinants of mental health, mental health inequities, and suicide prevention for Black college men; role of mental health utilization for Black college men; role of culture in addressing mental health needs for Black college men; racial trauma and mental health for Black college men; role of socio-economic barriers for Black college men; mental health needs of Black college men amid the COVID-19 pandemic; mental health needs of African and Caribbean college men; mental health needs of Black gay, bisexual, queer, and trans+ college men; and implications for colleges and universities in addressing the mental health needs of Black college men.

This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment.

Sexual violence (SV) on college campuses disproportionately affects cisgender (nontransgender) women, sexual minorities (e.g., gays/lesbians, bisexuals), and gender minority (e.g., transgender/nonbinary) people. This study investigates gender and sexual behavior differences in common SV intervention targets--SV-related knowledge, prevention behaviors, and care-seeking. We analyzed cross-sectional survey data, collected in 9/2015-3/2017, from 2202 students aged 18-24 years attending college health and counseling centers at 28 Pennsylvania and West Virginia campuses. Multivariable multilevel models tested gender and sexual behavior differences in SV history; recognition of SV; prevention behaviors (self-efficacy to obtain sexual consent, intentions to intervene, positive bystander behaviors); and care-seeking behaviors (knowledge of, self-efficacy to use, and actual use of SV services). Adjusting for lifetime exposure to SV, compared with cisgender men, cisgender women had higher recognition of SV and reproductive coercion, prevention behaviors, and care-seeking self-efficacy (beta range 0.19-1.36) and gender minority people had higher recognition of SV and intentions to intervene (beta range 0.33-0.61). Cisgender men with any same-gender sexual partners had higher SV knowledge (beta = 0.23) and self-efficacy to use SV services (beta = 0.52) than cisgender men with only opposite-gender partners. SV history did not explain these differences. Populations most vulnerable to SV generally have higher SV knowledge, prevention behaviors, and care-seeking behaviors than cisgender men with only opposite-gender sexual partners. Innovative SV intervention approaches are necessary to increase SV-related knowledge among heterosexual cisgender men and may need to target alternative mechanisms to effectively reduce inequities for sexual and gender minority people.

Using a randomized controlled trial, we investigated changes in both sexual harassment (SH) perpetration and victimization of 2104 middle school students in New York City who received divergent saturation and dosage levels of "Shifting Boundaries," an SH prevention program, which was represented by the length of the program. We assessed the saturation effect of the program by comparing the outcomes across respondents from 26 schools in which there were varying percentages of students enrolled in the program. The data suggested that, overall, the program was effective in reducing sexual harassment victimization but achieved a null effect against respondents' SH perpetration and that neither the length nor the school-saturation level of the program exerted a significant effect on SH perpetration. Although the data indicated a significant difference in SH victimization between the treatment and control group, when comparing subgroups who received treatment with divergent saturation and dosage levels, no statistically significant difference was identified. Our results suggested that the program effect was not contingent on the portion of students in a school who enrolled in the program, nor was it contingent on the dosage.

Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the "Dating Matters" comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive relationship behaviors in high school (9th-11th grades), when compared with a standard of care intervention. "Dating Matters" includes programs for sixth to eighth grade youth and their parents, training for school staff, a youth communications program, and policy and data activities implemented in the community. Self-report survey data were collected from students in 46 middle schools that were randomly assigned to condition within site. Students completed two surveys (fall and spring) in each middle school grade and a single survey in the spring of each high school grade. This study examined self-reported TDV perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills in the high school follow-up. While varying patterns emerged, latent panel models demonstrated significant program effects for all outcomes. "Dating Matters" students reported 19% reduced risk for TDV perpetration, 24% reduced risk for TDV victimization, 7% reduced risk for use of negative conflict strategies, and 3% more use of positive relationship skills, on average across time and cohort, than standard of care students. On average, "Dating Matters," implemented in middle school, continued to be more effective at reducing TDV perpetration, TDV victimization, and use of negative conflict resolution strategies in high school than an evidence-based comparison program.

Developmental coordination disorder (DCD) impacts the quality of life and ability to perform coordinated actions in 5% of school-aged children. The quality of body representations of individuals with DCD has been questioned, but never assessed. We hypothesize that children with DCD have imprecise body representations in the sensory and motor domains. Twenty neurotypical children, seventeen children with DCD (8-12 years old) and twenty neurotypical adults (25-45 years old) performed both sensory and motor body representation tasks: a limb identification and a limb movement task. We observed lower accuracy in the sensory task but not in the motor task. In both tasks, we observe a larger amplitude of errors, or synkinesis, in children with DCD than in neurotypical children. In neurotypical children, accuracy was lower than in neurotypical adults in the motor and sensory task, and the amplitude of sensory errors and synkinesis was higher than in neurotypical adults. Using a linear regression model, we showed that sensory accuracy is a good predictor of synkinesis production, and that synkinesis production is a good predictor of sensory accuracy, as can be expected by the perception-action loop. Results support the hypothesis of an imprecision of body representation in DCD. We suggest that this imprecision arises from noise in the body representation used at the level of internal models of action. Future studies may assess whether slower plasticity of body representations, initial imprecision, or both may account for this observation. At the clinical level, prevention strategies targeting body representation in early childhood are strategically important to limit such impairments.

Early childbearing is associated with high maternal stress and family violence. However, the long-term effects of rapid repeat pregnancy (RRP) in young motherhood on child outcomes remain largely unknown. This study examined the pathways between maternal RRP at young ages and child psychosocial problems and emergency room visits in later years. A total of 232 Chinese mother-child dyads provided baseline data in 2015 (Time 1; T1) and follow-up data 6 years later in 2021 (Time 2; T2). At T1, mothers completed questionnaires about child physical abuse frequency and family cohesion and reported their own stress levels. At T2, mothers were re-surveyed with the same questionnaires about child physical abuse frequency and family cohesion. Children's psychosocial problems were assessed through parent proxy-reports and records of emergency room visits were retrieved from hospital databases. After adjusting for demographic information, maternal history of RRP was associated with child physical abuse at T1 ([beta] = 0.15, p < 0.05) and in turn linked to child physical abuse recurrence ([beta] = 0.22, p < 0.01) and emergency room visits at T2 ([beta] = 0.22, p < 0.001). Improved family cohesion over time did not break the link between maternal RRP and child physical abuse recurrence. Poor family dynamics can lead to child physical abuse recurrence and worsen developmental outcomes in children, particularly when coupled with other risk factors such as maternal RRP at young ages. Early interventions to enhance support and reduce vulnerabilities are important for preventing child physical abuse in at-risk families.

Scientific and technological advancements over the last three decades have failed to reduce the widespread prevalence of academic dishonesty in higher education, in large part because institutional barriers prevent faculty from adopting existing tools to curb cheating. We conducted a systematic literature review of research on cheating and found that the majority of studies propose new tools without advancing theory or even utilizing existing theory. Although some studies note the systemic nature of academic misconduct, the academic integrity literature requires a robust theoretical framework to model its systemic nature and derive practical strategies. Building on theory from several domains, we propose a systemic model of academic (mis)conduct which predicts group-level effects on students and offers practical guidance for faculty overcoming institutional barriers to curb cheating. We leverage game theory for useful models of systemic, group-level phenomena in this context, and we leverage education reform literature for insights on how to support instructors' adoption of new tools. Our model, the spectrum of academic conduct, identifies trust as a single dimension governing both cheating behaviors and productive learning behaviors. Integrating insights from pedagogy, conflict management, and organizational psychology, we discuss multiple practical strategies to lower students' opportunity, motivation, and rationalization to cheat.

Suicide remains a leading cause of death among adolescents and exists in detectable rates for younger children as well. Underserved ethnic and racial groups face barriers to effective mental health care, making it critical that school psychologists be prepared to incorporate cultural considerations for suicide prevention and intervention. School psychologists play a critical role in suicide prevention and are ethically responsible for maintaining current knowledge of the literature on prevention and intervention strategies for students at risk of suicide. This articles describes how culturally responsive suicide prevention and intervention includes developing an awareness of the disparities which exist in the communities school psychologists serve, engaging in self and systemic evaluations, developing awareness of different options for different populations, and committing to strategic improvements.

Considerable research documents that LGBTQ youth are more likely to experience mental health challenges than their heterosexual peers, including higher rates of depression and suicidal thoughts and behaviors. This first Science-to-Practice Brief summarizes a study on protective factors related to depression and suicidality among U.S. sexual and gender minority adolescents. It emphasizes the need for school professionals to consider the impact of the intersectionality of LGBTQ students' sexual orientation, gender identity, sex, and race/ ethnicity, and it summarizes specific recommendations for implementing multitiered systems of support for LGBTQ youth in schools.

Background: Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. Method: Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (=60 years, N = 391). Results: People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). Conclusion: There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.

Background: During the COVID-19 pandemic, the United States' Centers for Disease Control and Prevention (CDC) created guidance documents that were too complex to be read and understood by the majority of adults with intellectual and developmental disabilities who often read at or below a third-grade reading level. This study explored the extent to which these adults could read and understand CDC documents simplified using Minimised Text Complexity Guidelines. Method: This study involved 20 participants, 18-48 years of age. Participants read texts and responded to multiple-choice items and open-ended questions to gather information about how they interacted with and understood the texts. Results: The results provide initial evidence that the Minimised Text Complexity Guidelines resulted in texts that participants could read and understand. Conclusion: Implications for increasing the accessibility of public health information so that it can be read and understood by adults with extremely low literacy skills are discussed.

Despite the rekindled interest in emotions and individual differences in second language acquisition (SLA) under the influence of positive psychology, the interrelationships among regulatory focus, L2 grit and achievement emotions remain under-researched. Drawing on structural equation modeling (SEM) approach, this study aimed to examine the predictive effects of regulatory focus on L2 grit through the mediation of achievement emotions. A total of 1043 non-English major undergraduates from a comprehensive university in central China participated in the study. Data were collected with a questionnaire adapted from three published scales and analyzed using multiple regression and multiple mediation analysis with a 1000-bootstrap method. Results showed that all three psychological constructs under investigation were correlated with each other and regulatory focus had an indirect predictive effect on L2 grit, which was mediated by achievement emotions. As with the mediating effect of achievement emotions, enjoyment and boredom had a partial mediating effect on the relationship between promotion focus and L2 grit, whereas hope and anxiety had a full mediating effect on the relationship between prevention focus and L2 grit. The findings are discussed in relation to the identified mediating mechanism for regulatory focus and L2 grit in boosting L2 learning motivation among Chinese English-as-a-foreign-language (EFL) learners.

COVID-19 disproportionally impacted the health and well-being of older adults--many of whom live with chronic conditions--due to their higher risk of dying and being hospitalized. It also created several secondary pandemics, including increased falls risk, sedentary behavior, social isolation, and physical inactivity due to limitations in mobility from lock-down policies. With falls as the leading cause of preventable death and hospitalizations, it became vital for in-person evidence-based falls prevention programs (EBFPPs) to pivot to remote delivery. In Spring 2020, many EBFPP administrators began re-designing programs for remote delivery to accommodate physical distancing guidelines necessitated by the pandemic. Transition to remote delivery was essential for older adults and persons with disabilities to access EBFPPs for staying healthy, falls and injury free, out of hospitals, and also keeping them socially engaged. We collaborated with the Administration on Community Living (ACL), the National Council on Aging (NCOA), and the National Falls Prevention Resource Center (NFPRC), for an in-depth implementation evaluation of remotely delivered EBFPPs. We examined the process of adapting and implementing four EBFPPs for remote delivery, best practices for implementing the programs remotely within the RE-AIM evaluation framework. This enhances NFPRC's ongoing work supporting dissemination, implementation, and sustainability of EBFPPs. We purposively sampled organizations for maximum variation in organization and provider type, geographic location, and reach of underserved older populations (Black, Indigenous, or other People of Color (BIPOC), rural, disabilities). This qualitative evaluation includes provider-level data from semi-structured interviews (N = 22) with program administrators, staff, and leaders. The interview guide included what, why, and how adaptations were made to EBFPP interventions and implementation strategies using Wiltsey-Stirman (2019) adaptations framework (FRAME), reach, and implementation outcomes (acceptability, feasibility, fidelity, and costs; Proctor et al., 2011), focusing on equity to learn for whom these programs were working and opportunities to address inequities. Findings demonstrate remote EBFPPs made planned and fidelity-consistent adaptations to remote delivery in partnership with researchers and community organizations, focusing on participant safety both in program content and delivery. Supports using and accessing technology were needed for delivery sites and leaders to facilitate engagement, and improved over time. While remote EBFPP delivery has increased access to EBFPPs for some populations from the perspective of program administrator, leaders, and staff (e.g., caregivers, rural-dwellers, persons with physical disabilities), the digital divide remains a barrier in access to and comfort using technology. Remote-delivered EBFPPs were acceptable and feasible to delivery organizations and leaders, were able to be delivered with fidelity using adaptations from program developers, but were more resource intensive and costly to implement compared to in-person. This work has important implications beyond the pandemic. Remote delivery has expanded access to groups traditionally underserved by in-person programming, particularly disability communities. This work will help answer important questions about reach, accessibility, feasibility, and cost of program delivery for older adults and people with disabilities at risk for falls, those living with chronic conditions, and communities most vulnerable to disparities in access to health care, health promotion programming, and health outcomes. It will also provide critical information to funders about elements required to adapt EBFPPs proven effective in in-person settings for remote delivery with fidelity to achieve comparable outcomes.

Diabetes is a significant population health threat. Evidence-based interventions, such as the Centers for Disease Control and Prevention's National Diabetes Prevention Program and diabetes self-management education and support programs, can help prevent, delay, or manage the disease. However, participation is suboptimal, especially among populations who are at an increased risk of developing diabetes. Evaluations of programs reaching populations who are medically underserved or people with lower incomes can help elucidate how best to tailor evidence-based interventions, but it is also important for evaluations to account for cultural and contextual factors. Culturally responsive evaluation (CRE) is a framework for centering an evaluation in the culture of the programs being evaluated. We integrated CRE with implementation and outcome constructs from the Adapted Consolidated Framework for Implementation Research (CFIR) to ensure that the evaluation produced useful evidence for putting evidence-based diabetes interventions to use in real-world settings, reaching populations who are at an increased risk of developing diabetes. The paper provides an overview of how we integrated CRE and CFIR approaches to conduct mixed-methods evaluations of evidence-based diabetes interventions.

In this paper, we report findings from a larger study that investigated design failure, as a phenomenon, in instructional design (ID) practice from the perspective of ID practitioners. Following an interpretive phenomenological study design, we interviewed 17 ID practitioners working in diverse settings, seeking their stories of design failure. Throughout the interviews and the analysis of the practitioners' stories of design failures, we found that ID practitioners define design failure in different ways that are mostly not captured in design literature, that is: design failure as "failure during use of design," design failure as "failure during process of design," design failure as "an opportunity for reflection on design actions," design failure as "an outcome or an event that needs to be avoided/prevented during the process of design," and design failure as "an outcome or an event that could not be avoided/prevented during the process of design." These findings and our discussions of them emphasize the generative role design failure plays in ID practice, the richness and the complexity of this phenomenon, and point to implications for IDT scholarship and ID education. In an upcoming paper, we report what ID practitioners attribute design failure to and what is the essence of design failure in ID practice.

The impact of community-wide teen pregnancy prevention initiatives (CWIs) on local U.S. birth rates among adolescents aged 15 to 19 years was examined using synthetic control methodology within a quasi-experimental design. CWIs were implemented in 10 U.S. communities from 2010 to 2015. Each initiative implemented evidence-based teen pregnancy prevention interventions at local organizations and enhanced best practices in adolescent reproductive health care at local health centers, while engaging diverse community sectors. The synthetic control method was used to estimate the impact of each CWI on overall and race- and ethnicity-specific teen births relative to rates in synthetic control communities. Additionally, we estimated the overall effect of CWIs across communities by pooling results from the 10 synthetic control case studies using the mean percentile rank. Pooled data across all 10 communities indicated an estimated average of 6.6 fewer births per 1000 teens per year overall during the initiative relative to each community's synthetic control (p = 0.001). By race and ethnicity, there were an estimated average of 6.4 fewer births per 1000 teens per year among Black teens (p = 0.03), 10.7 fewer births among Hispanic teens (p = 0.03), and 4.2 fewer births (p = 0.10) among White teens. Results from individual communities indicated an intervention effect on overall and/or race/ethnicity-specific teen birth rates in five communities. This study demonstrates the value of synthetic control methods in evaluating community-level outcomes of programmatic efforts. Findings indicate the CWIs had a positive impact on teen birth rates and have the potential to address racial and ethnic disparities in those rates.

As the public health framework has been implemented in schools through multi-tiered systems of support, as in Positive Behavioral Interventions and Supports (PBIS), a prominent interpretation has been that 80% of students will benefit from universal or Tier 1 schoolwide behavior support, around 15% will require added selective or Tier 2 targeted support, and 5% will require the more intensive selective or Tier 3 intervention. The PBIS framework also emphasizes the use of tiered logic, with strengthened efforts at the universal and selective levels when student behavioral or mental health needs exceed expected levels. The prediction that 5% of students will require indicated support was based mostly on students at risk for discipline encounters (i.e., office discipline referral data) and, more recently, systematic screening data, but this percentage remains an interpretation of the public health framework. Further, epidemiologic data over the past decade show that rates of childhood mental health disorders have risen and are even higher now as schools struggle to recover from the COVID-19 pandemic - much higher than 15% and 5% for selective and indicated levels. Thus, we believe it is time to revisit projections of the number of students in need of Tier 2 and Tier 3 support. In this position paper, we review the evidence for escalating youth mental health needs and discuss the implications for the tiered prevention framework in schools. We describe strategies to expand the availability of preventive intervention supports beyond Tier 1 efforts and conclude with recommendations for practice, policy, and research in this peri-COVID recovery era.

Large-scale, evidence-based interventions face challenges to program fidelity of implementation. We developed implementation strategies to support teachers implementing an evidence-based HIV prevention program in schools, Focus on Youth in The Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT) in The Bahamas. We examined the effects of these implementation strategies on teachers' implementation in the subsequent year after the initial implementation during the COVID-19 pandemic. Data were collected from 79 Grade 6 teachers in 24 government elementary schools. Teachers completed training workshops and a pre-implementation questionnaire to record their characteristics and perceptions that might affect their program fidelity. School coordinators and peer mentors provided teachers with monitoring, feedback, and mentoring. In Year 1, teachers on average taught 79.3% of the sessions and 80.8% of core activities; teachers in Year 2 covered 84.2% of sessions and 72.9% of the core activities. Teachers with "good" or "excellent" school coordinators in the second year taught significantly more sessions on average (7.8 vs. 7.0, t = 2.04, P < 0.05) and more core activities (26.3 vs. 23.0, t = 2.41, P < 0.05) than teachers with "satisfactory" coordinators. Teachers who had a "good" or "satisfactory" mentor taught more sessions than teachers who did not have a mentor (7.9 vs. 7.3; t = 2.22; P = 0.03). Two-level mixed-effects model analysis indicated that teachers' program fidelity in Year 1, confidence in the execution of core activities, and school coordinators' performance were significantly associated with Year 2 implementation dose. Implementation of FOYC + CImPACT was significantly associated with improved student outcomes. Teachers maintained high fidelity to a comprehensive HIV prevention program over 2 years during the COVID-19 pandemic. Future program implementers should consider additional implementation support to improve the implementation of school-based programs.

Schools are a critical setting to promote healthy youth development through the provision of evidence-based programs (EBPs), yet preventive EBPs in schools are underutilized. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework highlights numerous factors that may influence program adoption during the Exploration phase and progress monitoring during the Implementation phase. However, no research has systematically and simultaneously identified the factors that influence school administrators' decision-making during these important processes. We conducted semi-structured interviews with 24 school administrators in the Midwestern region of the U.S. to understand how they weigh various considerations that inform their adoption and progress monitoring of prevention programs. Results indicated that school administrators consider five separate factors during the adoption decision, prioritized in the following order: (1) need for the program; (2) school community buy-in; (3) contextual fit; (4) resources; and (5) program characteristics (including the evidence-base). Further, administrators consider five indicators to monitor program performance, prioritized as follows: (1) intervention fidelity; (2) quantitative and qualitative data that determine if the identified need was met; (3) school community buy-in; (4) resource consumption; and (5) program characteristics. Implications for prevention scientists and suggestions for future research are discussed.

This study examined the relation between both implementation fidelity and quality and the outcomes of two different anti-bullying interventions targeting distinct processes involved in bullying: moral disengagement and social norms. In total, 34 French-speaking Belgian teachers from six elementary schools were trained to deliver either the moral disengagement or the social norms intervention to their Grade 4-6 students (N = 747, 50.4% boys) in a randomized controlled trial. Students reported their moral disengagement, perceived injunctive class norm toward bullying, and bullying behaviors in the fall and spring of the 2018-2019 school year. Teachers' implementation fidelity and quality were assessed through direct observation in each class by two independent raters with a satisfying interrater reliability. A multiplicative moderated mediation model using latent change scores revealed that both greater fidelity and quality amplified students' decrease in moral disengagement, which was accompanied by a decrease in bullying. Importantly, when quality was sufficient, fidelity did not matter. However, higher fidelity could compensate for a lack of quality. Contrary to expectations, there was no significant change in students' perceptions of the class injunctive norm, even under ideal implementation conditions. Alternative mediators should thus be considered. Because implementation by teachers inevitably fluctuates, anti-bullying program components should be evaluated under various implementation conditions to determine their cost-effectiveness ratio and to gain insights into how anti-bullying programs work.

Introduction: The main objective of this research was to analyze the relationship between Emotional Intelligence (EI) and victimization and aggression through social networks in adolescents. Bullying causes situations of conflict between students and teachers, being currently a phenomenon of great importance in the socio-educational environment requiring special attention, where EI acts as a protective mechanism against such situations, which differs in relation to gender and socio-family environment. Method: A cross-sectional, descriptive, and ex post facto study was carried out. The sample consisted of 126 students between 15 and 17 years of age, 51.6% male and 48.4% female; differentiations are established according to this as part of the study method. The instruments used were the Bar-On Emotional Intelligence Inventory, the School Victimization Scale, and the Scale of aggressions through cell phones and the Internet (CYB-AG), using IBM SPSS software for statistical analysis. Results: The results obtained confirmed that the subjects who had suffered bullying or cyberbullying had a slightly lower level of EI and that, although traditionally the relationship between bully-bullied was emphasized, there are more factors that affect these cases with gender. Given that a higher score in EI is presented in the case of the female gender than in the male gender, being more significant in the stress management dimension. Discussion or Conclusion: The school and the family must work together to prevent peer violence, because it has serious consequences on those who suffer it. School bullying not only influences to a great extent the EI of the victims, but also bullying is determined by the low EI of the aggressors, certainly in relation to the management of stress.

Trauma-Informed Elementary Schools (TIES) is a pilot program designed to bring trauma-informed services to early elementary schools in a rural state. Although two sequential TIES pilot studies found significantly positive outcomes in cultivating a trauma-sensitive school climate and culture, the program has been limited to a few schools and has not yet been assessed for broader impact on primary stakeholders. The current study explored stakeholders' input in development of a comprehensive intervention plan by identifying the benefits and challenges of implementing the program and contributing their perspectives on strengthening the program. The study also explored the challenges of implementing the TIES program during the COVID-19 pandemic to optimize the program for its unique rural environment. Fourteen semistructured interviews were conducted via Zoom or in person. Two coauthors primarily used thematic analysis to categorize findings from transcribed interviews with NVivo. The participants identified positive impact of the program on children's socioemotional learning and support with special attention to children in need and the overall improvement of general educational tasks for all children as a whole classroom. The results highlight the importance of the program as perceived by primary stakeholders and provide specific suggestions for improvement.

Purpose: To explore factors influencing compliance with COVID-19 recommended preventive behaviours focusing on types of information sources about COVID-19, learning about disinfectant use and constructs of the Health Belief Model among adolescents at the start of the COVID-19 pandemic. Design: Cross-sectional descriptive design. Setting: A survey was distributed electronically to organisations, parents and student groups in Southern California 10 months after the declaration of the COVID-19 pandemic. Sample: A total of 217 students aged between 12 and 19 years old. Measures: Questions were adapted from a previous nationwide online survey about COVID-19. Analysis: Descriptive and logistic regression analyses were used to analyse the data. Results: The most common type of information (communication) source was an interpersonal one (parents), and the least common type was an official (federal, school) source. Statistically significant better protective behaviours aligned with COVID-19 recommendations were seen in students who received more information from official sources; less information from social media or friends; believed in the accuracy and benefits of utilising the COVID-19 pandemic information and learned about the use of disinfectants and were confident in cleaning surfaces of devices and equipped. However, those who perceived themselves at risk of COVID-19 infection and had perceived high risks in general reported lower (but not statistically significant) compliance with protective behaviour. The level of knowledge about COVID-19 was not statistically associated with compliance with protective behaviour. Conclusion: Parents' role in guiding adolescents is critical. Evidence-based information about COVID-19 should be delivered through official sources to facilitate adolescents' understanding and active participation in public health efforts.

African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.

When teaching infection prevention and control (IPC), nursing education tends to focus on skills and fostering good practice rather than challenging students' thinking. Therefore, students' misconceptions about IPC receive less attention than they deserve. The purpose of the study was to make an inventory of student nurses' misconceptions about IPC before instruction and to make these misconceptions visible to teachers. The study was conducted in one vocational institute in Finland and is based on the answers of 29 practical nurse students before IPC training. The students took an online test requiring them to justify their answers to two multiple-true--false questions: 1) What is the main route of transmission between patients in healthcare facilities, and 2) What is the most effective and easiest manner to prevent the spreading of pathogens, e.g., multi-resistant bacteria in long-term care facilities? Analysis of the students' written justifications resulted in three mental models: 1) the Household Hygiene Model manifesting lay knowledge learned in domestic situations, 2) the Mixed Model consisting of lay knowledge, enriched with some professional knowledge of IPC, and 3) the Transmission Model manifesting a professional understanding of IPC. The first two mental models were considered to be misconceptions. Only one of the participants showed a professional understanding (i.e., the Transmission Model). To conclude, student nurses manifested systematic patterns of misconceptions before instruction. Unless the students are confronted with their misconceptions of IPC during instruction, it is likely that these misconceptions will impede their learning or make learning outcomes transient.

Young adult refugees have suboptimal primary care use, including having a regular provider and engaging with a regular source of care for primary and preventive healthcare needs. Our purpose was to understand how young adult refugees (ages 18-29 years) resettled to the United States understand and experience primary care. We conducted 23 semi-structured interviews with young adult refugees and explored their ideas about and experiences of key characteristics of primary care. Emergent themes were synthesized. Young adult refugees reported a lack of an understanding of the idea of primary care. However, they also described the lack of accepted key components of primary care, such as being the first contact and providing continuity, coordination and comprehensiveness. The importance of developing an ability to ask questions, get answers and feel empowered was a facilitator of primary care successes. Young refugees lack access to healthcare that exemplifies quality primary care. Improving understanding of the primary care model and its value as well as increasing access and ease of engagement could improve primary care engagement for young adult refugees.