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Inconsistent program engagement is a common barrier in neighborhoods where families face significant structural, economic, and wellbeing challenges. Sulphur Springs is an under-served, low-income, predominantly Black community in Tampa, Florida where funding efforts have catalyzed targeted service responses, yet many agencies continue to report barriers to engaging families in programs. Ethnographic research methods were used to better understand the barriers to engagement in programs at a neighborhood family center. Analysis of in-depth interviews with parents (n = 11) and staff (n = 7) revealed four key areas where participants perceived engagement challenges, including neighborhood conditions, relevance and fit, understanding of Black families' needs, and program infrastructure. The authors highlight perspectives of parents and staff to give voice to important insights that are typically underrepresented in program development and illustrate the numerous—and often subtle—ways that racial ideologies inform program development and acceptance. This study offers suggestions for improving engagement by reconsidering approaches to programming that better meet the needs of Black families in neighborhoods like Sulphur Springs. Highlights: Child-abuse prevention agencies face unique challenges in consistently engaging Black, low-income families in programs. Existing research provides little guidance on how to best adapt prevention services to meet Black families' needs. Evolving rapid qualitative methods are well-suited to examining phenomena of service providers and users in a short timeframe. Neighborhood conditions, relevance and fit, and agency infrastructure were key challenges identified by participants. Addressing organizational capacity to serve Black families and assessing specific community needs may improve engagement. [ABSTRACT FROM AUTHOR]

Objective : This study examines implementation and predictors of caregiver participation in Connecting , a self-directed prevention program to reduce substance use and other behavioral health outcomes among teens in foster care. The program was adapted for foster family settings from an evidence-based universal program. Method: Data are from 110 foster caregivers of youths ages 11 to 15 randomly assigned to the intervention. We describe implementation efforts, level of engagement, and satisfaction. Thirteen predictors of program initiation and completion across multiple domains (e.g., family stressors, relationship quality) were tested using logistic regressions. Results : Among foster families, 89% initiated and 52% engaged in 60% or more of the curriculum activities (completed). Reasons for noncompletion were lack of time, competing needs of other family members, and major stressful events. Program satisfaction was high. Twelve predictors were unrelated to program initiation or completion. Caregivers who smoked cigarettes were less likely to complete the program. Conclusions : Self-administered family-focused interventions reduce many of the barriers to program participation for foster families. Strategies to improve uptake might include reducing the amount of time needed, delivering the program in stages rather than all at once, and better integrating program activities into other family activities. [ABSTRACT FROM AUTHOR]

After‐school youth development programs support social‐emotional functioning which leads to better academic and behavioral outcomes. This article examines three common predictors of social‐emotional functioning individually and concurrently to better understand the role of these predictors in the after‐school setting. The common predictors are staff/student relationships, sense of belonging, and program engagement. That data came from 144, 3rd through 8th grade, students across 9 different elementary and middle school sites who regularly attended a large youth development program. Regression analyses were run and the results indicated that each variable was an individually significant predictor of social‐emotional functioning. Results from multiple regression analyses demonstrated that there was a better model fit when including all three variables in the same model. Interestingly, the results indicated that program engagement was a strong predictor above and beyond staff/student relationships and sense of belonging on self‐management and self‐efficacy. Sense of belonging and program engagement both predicted social awareness. Implications of these findings for after‐school program planning and development are discussed. Practitioner Points: Students enjoyment in engaging with programming was the most important predictor of self‐efficacy and social awareness within an afterschool youth development program.Positive feelings of belonging and good staff/student relationships, in part, predict healthy social/emotional outcomes.With appropriate funding, afterschool settings are places where relationships, belonging, and engagement influence social‐emotional learning (SEL) outcomes and can support the school day SEL curriculum. [ABSTRACT FROM AUTHOR]

Participant engagement in structured lifestyle change programs (LCPs) is essential for adopting behaviors that promote weight loss; however, the challenges to, and facilitators that promote, engagement with such programs are not well understood. We conducted a mixed-methods study among real-world LCP participants to assess factors associated with program engagement and to examine the reasons for withdrawal. Using electronic health records (EHR), we identified LCP eligible participants between 2010 and 2017. Multivariable logistic regression was used to assess associations between program engagement and baseline characteristics. Semi-structured interviews with LCP participants were conducted and thematically analyzed to examine reasons for withdrawal. A total of 1,813 LCP participants were included. The median number of sessions attended was 10 of 21–25 sessions. Highest LCP engagement was associated with factors potentially related to self-efficacy/motivation, such as older age, higher baseline weight, prior healthcare utilization and an absence of a history of smoking or depression. Engagement was also negatively associated with being Non-Hispanic Black versus White. The qualitative analysis of the interviews revealed four general themes pertaining to participants' withdrawal: competing priorities, perceived program effectiveness, characteristics of the program, and facilitator-related factors. Taken together, results from this mixed-methods study suggest that motivation and self-efficacy are important for program engagement; future LCP enhancements should incorporate flexible formats that may help participants manage competing priorities and maximize personal and cultural relevance for all racial/ethnic groups, especially those who have not benefitted fully. Furthermore, participants should be encouraged to set realistic goals to manage expectations. [ABSTRACT FROM AUTHOR]

To identify factors independently associated with program participation and knowledge of campus processes to address sexual assault and harassment complaints. 1,182 undergraduates who completed the University of Michigan's 2015 campus climate survey on topics of sexual assault and harassment (67% response rate). We analyze survey responses to estimate multivariable models that identify subgroups of the student population least likely to have participated in programs or to know campus processes. Students living off campus, not involved in major organizations, and males are less likely to report attending programming. Students not involved in major organizations and females are less likely to report knowing campus processes. Specific student subpopulations are more difficult to engage in programs designed to reduce sexual assault and harassment. Targeting additional effort to these groups may improve campus sexual climate. Careful analyses of campus climate survey data can help construct campus-specific priorities for these interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Women with gestational diabetes have low diet quality. We evaluated the effectiveness of a group-based lifestyle modification program for improvement of dietary quality in women with previous gestational diabetes predominantly within their first postnatal year. Methods Women were randomised to intervention (n = 284) or usual care (n = 289). Dietary data was collected at baseline and twelve months using a food frequency questionnaire and recoded into the Australian Recommended Food Score (ARFS). Mixed model analyses investigated the intervention effect on ARFS (per-protocol-set (PPS) excluded women without the minimum intervention exposure). Results Baseline mean total ARFS was low (31.8 ± 8.9, maximum score = 74) and no significant changes were seen in total ARFS (Cohen’s D = − 0.06). 2% reduction in alcohol for intervention (0.05, 0.26) compared with − 1% for usual care (Odds ratio: 0.68; 95%CI 0.46, 0.99). Dairy ARFS sub-category significantly improved (low fat/saturated fat foods) in the intervention group over time compared with usual care for the PPS analysis (dairy + 0.28 in intervention (95%CI 0.08, 0.48) compared with + 0.02 in usual care (95%CI -0.14, 0.18) (group-by-treatment interaction p = 0.05, Cohen’s D = 0.14)). Conclusions Engaging with the intervention improved aspects of diet quality that aligned with minimum intervention exposure, but the total diet quality remains low. Further research is needed to improve diabetes prevention program engagement. Trial registration Australian New Zealand Clinical Trials Registry ANZCTRN12610000338066, April 2010.

Youths’ perspectives are often unexplored in youth program development and implementation. This article examined youths’ perspectives of a 4-H youth prevention program called “Health Rocks!” that is designed to promote healthful decision-making skills, stress coping, and socioemotional skills related to substance use. Qualitative and quantitative data were collected and analyzed. Qualitative findings reveal that participants appreciated the fun and engaging curriculum, valued program staff who were interactive, and enjoyed the hands-on program activities. Participants also reported that the program positively impacted their knowledge and skills. Quantitative results show that participants who perceived the program as fun were significantly more likely to report engagement in the program, and participants who had positive views towards the program staff were significantly more likely to report knowledge after the program and engagement in Health Rocks! Findings have broader implications for future youth prevention program development, illustrating the need for engaging adult leaders and program activities to enhance the overall program experience for youth participants.

Background: This paper explores how implementation and refinement of an early intervention (EI) program for children with delayed development was informed by an iterative, intentional and structured process of measurement. Providing access to early intervention therapy for children in rural areas of India is challenging due to a lack of rehabilitation therapists and programs. Following a biopsychosocial framework and principles of community-based rehabilitation, a non-governmental organization, Amar Seva Sangam (ASSA), overcame those barriers by designing a digital technology supported EI program in rural Tamil Nadu, India. Program objectives included providing service access; supporting program engagement, child development and school enrollment; and positioning the intervention for scale-up. This paper contributes to a growing body of literature on how program design and implementation can be informed through a cyclical process of data collection, analysis, reflection, and adaptation.Methods: Through several strands of data collection, the design and implementation of the EI program was adapted and improved. This included qualitative data from focus groups and interviews with caregivers and service providers, and a mobile application that collected and monitored longitudinal quantitative data, including program engagement rates, developmental progression, caregiver outcomes, and school enrollment status.Results: Measurements throughout the program informed decision-making by identifying facilitators and barriers to service providers' quality of work-life, family program engagement, and school enrollment. Consultation with key stakeholders, including caregivers and service providers, and data driven decision making led to continual program changes that improved service provider quality of work-life, program engagement and school enrollment. These changes included addressing gender-related work challenges for service providers; forming caregiver support networks; introducing psychological counseling for caregivers; providing medical consultations and assistive devices; creating community awareness programs; improving access to therapy services; focusing on caregiver education, motivation and support; and advocacy for accessibility in schools.Conclusion: The process of using evidence-informed and stakeholder driven adaptations to the early intervention program, led to improved service provider quality of work-life, greater program engagement, improved school enrollment and positioned the intervention for scale-up, providing lessons that may be beneficial in other contexts.

The Nurse‐Family Partnership® (NFP) is an evidence‐based home‐visiting program for low‐income, first‐time mothers. NFP® has demonstrated benefits for reducing child maltreatment and improving parenting, child development and families' economic self‐sufficiency. It is now implemented widely in the US where, despite the use of home visits, which generally reduce barriers to program participation, only 35% of clients nationwide complete the 2.5‐year program. This concurrent mixed‐methods study was conducted in 2013 in an urban northeastern US NFP site and included administrative program data, surveys (n = 56), in‐depth interviews (n = 14) with nurse home visitors, and focus groups with nurse supervisors (n = 13). We explored associations between nurses' attrition rates and their perspectives on client attrition and retention strategies. We further conducted an inductive thematic analysis of the qualitative data. Findings indicate that nurses' attrition rates were not significantly associated with their views and strategies to retain clients. Nurses and supervisors noted that clients' competing priorities and 'chaotic lives' primarily explained attrition. They thought that clients often left the program upon receiving enough information and skills or achieving key milestones, which may reflect reaching a saturation point, albeit prior to the full completion of the program. We offer recommendations to assess performance based on client accomplishments rather than whether they participated until the prescribed endpoint. [ABSTRACT FROM AUTHOR]

An examination of the content and processes of evidence-based programs is critical for empirically evaluating theories about how programs work, the "action theory" of the program (West et al. in American Journal of Community Psychology, 21, 571-605, 1993). The New Beginnings Program (NBP; Wolchik et al., 2007), a parenting-after-divorce preventive intervention, theorizes that program-induced improvements in parenting across three domains: positive relationship quality, effective discipline, and protecting children from interparental conflict, will reduce the negative outcomes that are common among children from divorced families. The process theory is that home practice of program skills related to these parenting domains is the primary mechanism leading to positive change in parenting. This theory was tested using multi-rater data from 477 parents in the intervention condition of an effectiveness trial of the NBP (Sandler et al. 2016a, 2016b). Four research questions were addressed: Does home practice of skills predict change in the associated parenting outcomes targeted by the program? Is the effect above and beyond the influence of attendance at program sessions? What indicators of home practice (i.e., attempts, fidelity, efficacy, and competence) are most predictive of improvements in parenting? Do these indicators predict parenting improvements in underserved subpopulations (i.e., fathers and Latinos)? Structural Equation Modeling analyses indicated that parent-reported efficacy and provider-rated parent competence of home practice predicted improvements in the targeted parenting domains according to both parent and child reports. Moreover, indicators of home practice predicted improvements in parenting for fathers and Latinos, although patterns of effects varied by parenting outcome. [ABSTRACT FROM AUTHOR]

Assistance dog puppies live with their raisers for up to 16 months before entering advanced training and, hopefully, becoming qualified to help people with a disability. Almost half of the puppies fail to meet the behavioural standards required for assistance dogs, and some puppy raisers produce more behaviourally favourable puppies than others. It is unclear what factors influence puppy-raising practice quality. To understand this, we interviewed 17 participants, including experienced puppy raisers (n = 8), provider organisation staff (n = 4), and those who have served both as puppy raisers and staff (n = 5). Results of a thematic analysis suggest three groups of influencing factors, namely intrapersonal factors, social support, and puppy characteristics. Intrapersonal factors such as expectations, competency, perseverance and passion were reported to influence puppy raisers’ experiences, puppy-raising quality, and continuity of service. Contextual factors such as availability of social support (informational and emotional supports) and less-demanding puppies both led to positive puppy-raising experiences, while the former also contributed to puppy raisers’ perceptions of competency. Future research should quantitatively examine the interrelationships of these factors concerning puppies’ behavioural development. Meanwhile, organisations could consider these factors when developing their recruitment and puppy-raiser support programs.

There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers ( M age = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs. [ABSTRACT FROM AUTHOR]

Background: In 2006, the Dutch government initiated Hello World, an email-based program promoting healthy lifestyles among pregnant women through quizzes with pregnancy-related questions. In 2008, an updated version was released. The present study aimed to (1) examine the reach of Hello World and the representativeness of its users for all pregnant women in the Netherlands, (2) explore the relationship between program engagement and lifestyle characteristics, and (3) explore the relationship between the program content participants accessed (content on smoking, physical activity, and nutrition) and their lifestyle characteristics. Methods: Data from 4,363 pregnant women were included. After registration, women received an online questionnaire with demographic and lifestyle questions. To evaluate their representativeness, their demographic characteristics were compared with existing data for Dutch (pregnant) women. Women were classified on the following lifestyle characteristics: smoking, nutrition, physical activity, and pre-pregnancy weight status. Program use was tracked and the relationships between lifestyle characteristics, program engagement, and the percentage of smoking, physical activity, and nutrition questions accessed after opening a quiz were explored using Mann--Whitney U tests and Kruskal-Wallis tests. Results: Hello World reached ±4% of its target population. Ten percent of participants were low educated and 22% immigrants. On average, women received 6.1 (SD:2.8) quiz emails and opened 32% of the associated quizzes (2.0, SD:2.1). A significant positive association was found between the number of quizzes opened and the number of healthy lifestyle characteristics. After opening a quiz, women accessed most smoking, nutrition, and physical activity questions. Significant relationships were found between several lifestyle characteristics and the percentage of smoking, physical activity, and nutrition questions accessed. However, between-group differences were small, quiz topics were largely unrelated to their lifestyle characteristics, and inconsistencies were found regarding the directions of these associations. Conclusions: Hello World reached ±4% of its target population, which is lower than the reach of its previous version (±8%). Relatively few low educated and immigrant women registered for the program. Active participation in the program was positively associated with the number of healthy behaviours participants engaged in. The program content participants chose to access was largely unrelated to their lifestyle characteristics. [ABSTRACT FROM AUTHOR]

The risk of adolescent pregnancy is elevated among teens living in areas of concentrated poverty. Although the majority of adolescent sexual risk reduction programs are based in schools, delivering programming in the neighborhood setting is an innovative approach that may enhance the engagement of high-risk youth. This study evaluates the process of implementing an adolescent pregnancy prevention program in the context of low-income, urban housing developments. The primary aims of this paper are: (1) to provide a detailed description of the recruitment and retention strategies employed by a pregnancy prevention program based in low-income housing; (2) to describe the feasibility of recruiting and retaining participants for this type of program; and (3) to examine the percentage of participants enrolled through different recruitment strategies. Some 305 adolescents from eight low-income, urban communities were included in the process study. Results revealed that successful recruitment and retention of adolescents in a pregnancy prevention program within low-income housing is feasible. Within two months, 95% of the recruitment goal was met, with the largest percentage of participants enrolled following door-to-door recruitment. Average session attendance was 70%, and 92% of participants were retained through post-intervention assessment. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Objective. To document the impact of consumer self-selection of service providers on their service receipt and attendance in a psychiatric rehabilitation program. Methods. Staff (8 FTE) in a new drop-in resource center tracked their service activities and contacts with consumers using daily service logs. Consumers (N = 46) checked their service needs at enrollment, and recorded their attendance on daily sign-in sheets. Regression analyses were conducted to examine correlations between these service measures and each consumer's count of key providers, with key provider defined as any staff worker with whom the consumer logged the equivalent of more than a full workday of contact (9+ hours) during a 6-month study period. Results. Service log findings suggest that key service providers were chosen by consumers through informal social interactions with staff Members who had more key providers were more active in the program and more likely to have checked a need for psychiatric care at enrollment. In spite of member choice of provider, caseloads remained small and staff were able to dedicate their time to services related to their specialty training. Conclusions. Facility-based programs can encourage consumer self-selection of service providers without overloading staff or restricting specialty services if they provide ample time for staff and consumers to get to know one another in informal social interactions. [ABSTRACT FROM AUTHOR]

Abstract: Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal “Feelings” diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group''s productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected. [Copyright &y& Elsevier]

Simple Summary: Puppy raisers (or foster families) are volunteers who care for assistance dog puppies until they are ready to learn how to help people with a disability. During this period, some puppies develop behaviours unsuitable for assistance roles and end up changing careers or being rehomed as pets, which is wasteful. Puppy raisers control the early experiences of their puppies, and they vary in their puppy-raising outcomes, but we do not know what specifically helps some puppy raisers produce puppies that are behaviourally suitable for an assistance role. In this study, we interviewed 17 people from seven countries who were either experienced puppy raisers or provider program staff, or both. Their responses suggested several individual factors (expectations, competency, perseverance and passion) and social factors (informational and emotional supports), in addition to the puppies' characteristics, that influenced the experiences and perceived effectiveness of their puppy-raising practices. These factors are also evident in other well-established areas of research (e.g., education, volunteerism, social support, and organisational performance). We propose recommendations for assistance dog organisations based on those relevant frameworks, which focus on enhancing puppy raisers' competency, positive experiences, and program retention. Assistance dog puppies live with their raisers for up to 16 months before entering advanced training and, hopefully, becoming qualified to help people with a disability. Almost half of the puppies fail to meet the behavioural standards required for assistance dogs, and some puppy raisers produce more behaviourally favourable puppies than others. It is unclear what factors influence puppy-raising practice quality. To understand this, we interviewed 17 participants, including experienced puppy raisers (n = 8), provider organisation staff (n = 4), and those who have served both as puppy raisers and staff (n = 5). Results of a thematic analysis suggest three groups of influencing factors, namely intrapersonal factors, social support, and puppy characteristics. Intrapersonal factors such as expectations, competency, perseverance and passion were reported to influence puppy raisers' experiences, puppy-raising quality, and continuity of service. Contextual factors such as availability of social support (informational and emotional supports) and less-demanding puppies both led to positive puppy-raising experiences, while the former also contributed to puppy raisers' perceptions of competency. Future research should quantitatively examine the interrelationships of these factors concerning puppies' behavioural development. Meanwhile, organisations could consider these factors when developing their recruitment and puppy-raiser support programs. [ABSTRACT FROM AUTHOR]