Does goal ambiguity influence the program structure of nonprofit human service organizations?

This study presents an alternative to outcome management based on accountability by analyzing the ambiguity of nonprofit human service organizations’ program goals and program structures. A total of 761 programs were chosen from the 2010–2020 annual plans of P Rehabilitation Center for analysis. The program goals were analyzed according to quantitative accuracy and outcome attainability standards and the program structures were analyzed using the program theory model. Human service organizations need to have a logical program structure according to the program goal, and it is necessary to minimize logical errors in the program structure.

Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study

Neurocognitive late effects following the diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) commonly include impaired executive functions (EFs), with negative consequences for one’s health-related quality of life and mental health. However, interventions for EF impairments are scarce. Thus, the aims of this study were to (1) explore the feasibility and acceptability of the cognitive rehabilitation program Goal Management Training (GMT) and (2) examine whether GMT is associated with positive outcomes across cases of ALL survivors with EF complaints. Four participants (median age 31.5 years) underwent nine GMT modules in a total of five group sessions. Rehabilitation was focused on compensatory strategies to improve real-life EFs. Participants were evaluated at 2-week and 6-month follow-ups. Evaluation of feasibility and acceptability included adherence, a semi structured interview, self-reports, and safety. Additionally, therapists’ experience with implementation was evaluated. Outcome measures included self-reports and neurocognitive tests of attention, EF, and processing speed. All participants completed GMT and rated the intervention as useful, suitable, and satisfactory. The reliable change index showed improved daily life EFs (two participants) and neurocognitive performance (three participants) at 6-month follow-up. Additionally, all participants improved on a “real-life” task involving EF. A future randomized controlled trial is recommended.

Onchocerciasis drug development: from preclinical models to humans

Twenty diseases are recognized as neglected tropical diseases (NTDs) by World Health Assembly resolutions, including human filarial diseases. The end of NTDs is embedded within the Sustainable Development Goals for 2030, under target 3.3. Onchocerciasis afflicts approximately 20.9 million people worldwide with > 90% of those infected residing in Africa. Control programs have made tremendous efforts in the management of onchocerciasis by mass drug administration and aerial larviciding; however, disease elimination is not yet achieved. In the new WHO roadmap, it is recognized that new drugs or drug regimens that kill or permanently sterilize adult filarial worms would significantly improve elimination timelines and accelerate the achievement of the program goal of disease elimination. Drug development is, however, handicapped by high attrition rates, and many promising molecules fail in preclinical development or in subsequent toxicological, safety and efficacy testing; thus, research and development (R&D) costs are, in aggregate, very high. Drug discovery and development for NTDs is largely driven by unmet medical needs put forward by the global health community; the area is underfunded and since no high return on investment is possible, there is no dedicated drug development pipeline for human filariasis. Repurposing existing drugs is one approach to filling the drug development pipeline for human filariasis. The high cost and slow pace of discovery and development of new drugs has led to the repurposing of “old” drugs, as this is more cost-effective and allows development timelines to be shortened. However, even if a drug is marketed for a human or veterinary indication, the safety margin and dosing regimen will need to be re-evaluated to determine the risk in humans. Drug repurposing is a promising approach to enlarging the pool of active molecules in the drug development pipeline. Another consideration when providing new treatment options is the use of combinations, which is not addressed in this review. We here summarize recent advances in the late preclinical or early clinical stage in the search for a potent macrofilaricide, including drugs against the nematode and against its endosymbiont, Wolbachia pipientis.

Balancing String Instruction in an Instrumental Lab Setting: An Intrinsic Evaluative Case Study

There is an expected increase in the need to provide adequate string-specific training for non-string specialists in the future and for preservice music teachers to develop the requisite pedagogical content knowledge to teach a variety of instruments. A multiyear instrumental lab ensemble university course was designed to help preservice music teachers integrate knowledge and skills in various instrument- and ensemble-specific areas. The purpose of this intrinsic evaluative study was to determine the extent to which the new course was successful toward these aims. Data included interviews of students and instructors, observations of lab classes, and reflective journals of teaching faculty and two external observers. Data were coded and then analyzed using the program goal statements found in the course syllabus. Findings indicated that students considered the lab format more authentic to their teacher preparation than their previous coursework, and that performance and pedagogy skills on secondary instruments elevated more rapidly than anticipated. Recommendations include the need for more explicit connection between course readings and lab activities, and improved guidelines for course teaching assistants.

Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents

Smoking prevalence among female adolescents in South Korea has increased gradually, despite a decreasing trend seen for male adolescents. Smoking scenes or cigarette advertisements in the media have influenced female adolescents’ initiation into smoking. It is therefore crucial to develop a smoking prevention program to enhance female adolescents’ smoking media literacy by implementing gender-specific interventions. The purpose of this study is to describe how intervention mapping protocol (IMP) was used to develop a media literacy-based smoking prevention program (MLSP) for female adolescents. The IMP was used in six steps: needs assessment (literature review and focus groups comprising 24 female adolescents and 12 teachers), program goal setting, selection of intervention methods, production of program components and materials, program implementation planning, and program evaluation by ten experts and three adolescents. Six performance objectives and 14 change objectives were generated. Each module consisted of theory-based methods such as raising consciousness. Half of the modules covered topics regarding smoking media literacy, while half covered topics related to gender-specific intervention. The major advantages of utilizing IMP are that MLSP has been developed to reflect multiple perspectives, including of adolescents, teachers, and professors through a systematic process, and identified to be acceptable and valid.

Describing Transitions in Adherence to Physical Activity Self-monitoring and Goal Attainment in an Online Behavioral Weight Loss Program: Secondary Analysis of a Randomized Controlled Trial (Preprint)

BACKGROUND Standard behavioral weight loss interventions often set uniform physical activity (PA) goals and promote PA self-monitoring; however, adherence remains a challenge and recommendations may not accommodate all individuals. Identifying patterns of PA goal attainment and self-monitoring behavior will offer a deeper understanding of how individuals adhere to different types of commonly prescribed PA recommendations (ie., minutes of moderate-to-vigorous physical activity [MVPA] and daily steps) and guide future recommendations for improved intervention effectiveness. OBJECTIVE This study examined weekly patterns of adherence to steps-based and minutes-based PA goals and self-monitoring behavior during a 6-month online behavioral weight loss intervention. METHODS Participants were prescribed weekly PA goals for steps (7,000 to 10,000 steps/day) and minutes of MVPA (50 to 200 minutes/week) as part of a lifestyle program. Goals gradually increased during the initial 2 months, followed by 4 months of fixed goals. PA was self-reported daily on the study website. For each week, participants were categorized as “adherent” if they self-monitored their PA and met the program PA goal, “suboptimally adherent” if they self-monitored but did not meet the program goal, or “nonadherent” if they did not self-monitor. The probability of transitioning into a less adherent status was examined using multinomial logistic regression. RESULTS Individuals (N=212) were predominantly middle-aged females with obesity, and 31.6% self-identified as a racial/ethnic minority. Initially, 34.4% were categorized as “adherent” to steps-based goals (51.9% “suboptimally adherent” and 13.7% “nonadherent”), and there was a high probability of either remaining “suboptimally adherent” from week-to-week or transitioning to a “nonadherent” status. On the other hand, 70.3% of individuals started out “adherent” to minutes-based goals (16.0% “suboptimally adherent” and 13.7% “nonadherent”), with “suboptimally adherent” seen as the most variable status. During the graded goal phase, individuals were more likely to transition to a less adherent status for minutes-based goals (OR 1.39, 95% CI 1.31-1.48) compared to steps-based goals (OR 1.24, 95% CI 1.17-1.30); however, no differences were seen during the fixed goal phase (minutes-based goals: OR 1.06, 95% CI 1.05, 1.08 versus steps-based goals: OR 1.07, 95% CI 1.05, 1.08). CONCLUSIONS States of vulnerability to poor PA adherence can emerge rapidly and early in obesity treatment. There is a window of opportunity within the initial two months to bring more people towards “adherent” behavior, especially those who fail to meet the prescribed goals but engage in self-monitoring. While this study describes the probability of adhering to steps-based and minutes-based targets, it will be prudent to determine how individual characteristics and contextual states relate to these behavioral patterns, which can inform how best to adapt interventions. CLINICALTRIAL This study was a secondary analysis of a pre-registered randomized trial (Trial Registration: ClinicalTrials.gov NCT02688621).

New forms of employment and workers' health

Globalization and digitalization give rise to a complex of problems of economics, sociology, and occupational health. The prevalence of precarious employment (PE) is growing. In connection with the COVID-19 pandemic and the economic crisis, employment and social well-being have become acute. The study aims to review literature and essays on PE as a problem of occupational health and a new social determinant of workers' health. The author has made the analysis of documents from WHO, ILO, European Union, etc., scientific literature and essays on the problem of PE and its impact on somatic (including reproductive) health, mental health, and workers' social well-being. The legal bases of labor and health protection are considered. The informal economy, the terminology of forms of PE, and the ILO Convention No. 175 on part-time work and the Convention No. 177 on home work and the Decent Work Initiative were analyzed. The characteristics and prevalence of PE, examples of forms of work organization, affected groups of the population, and sectors of the economy are considered. Vulnerable groups are women (especially pregnant women), young and elderly workers, migrants, and the most unfavorable situation is in construction, agriculture, catering, tourism, etc., and much better in the public sector. PE and its impact on health are an essential topic in social epidemiology, and affective health problems are almost as severe as unemployment. PE is often associated with poor working conditions, physically demanding work and an increased risk of accidents, with young workers more often affected. The lack of confidence in keeping a job negatively affects mental health - the odds ratio is over 1.5. PE is associated with impaired reproductive behavior and reproductive health and the birth of children with low body weight. The features of home work, its pros, and cons are given. An analysis of employment from the standpoint of occupational health revealed the relationship between forms of employment and indicators of health and quality of life and made it possible to complete some generalizations and formulate the principles of work and health. The future of labor, new occupations, knowledge, and skills are considered. In the United Nations Development Program, Goal 8, Decent Work and Economic Growth, is to achieve full employment and decent work for all by 2030. PE is becoming more frequent; therefore, further data collection and research into its effects among new groups of workers is necessary. Soon, the digitalization of the economy and society will cause a paradigm shift in occupational health: the future of occupational health is the prevention of occupational diseases and work-related disorders.

PROFESSIONAL STAGE ART AS AN EXPRESSION OF NATIONAL, SPIRITUAL AND CULTURAL PROPERTIES OF THE UKRAINIAN DIASPORA

The section is devoted to the activities of professional theater artists of the diaspora in the second half of the 20th beginning of the 21st centuries. Diaspora artists aimed to preserve and increase their professional experience. Being far away from the homeland, they tried to live in the spiritual, cultural and national traditions of their people, involving participation of the young generation born outside the country. One of the most important tasks is to teach the Ukrainian literary language by means of the performing arts, to acquaint with the best examples of the spiritual and cultural heritage of Ukrainians, in particular in the field of speech, drama, music, and so on. The works of T. Shevchenko, I. Franko and Lesia Ukrainka are in the forefront of the repertoire of theaters (studios, circles). From the standpoint of ideological principles related to the consolidation of Ukrainians abroad, it should be considered as a program goal of creative activity. Poetry and prose of different genres with the collective and individual stage embodiment took on the varied forms of «poetic theater», «theatrical spectacle», «literary concert», «literary program», and «mono-theater». In addition, some reader performances (in diaspora periodicals – recitation) are part of «memory evenings», «anniversary evenings», «festive academies», etc. The genre of «melodeclamation» is also widespread among the diaspora environment.

Starting Them Young: Introducing High School Students to Community Gerontology

The Clinical Research Experience Internship Program (CREST) provides participants with foundations in scientific research appropriate for high school students interested in clinical careers in health-related disciplines (for example, nursing). The overall program goal is to provide research and career experiences to individuals from disadvantaged backgrounds, racial/ethnic minorities, and others who are underrepresented in these fields. The focus of this presentation is that part of the CREST program that has been ongoing since 2013. One program mentor has provided an internship experience to 22 high school students training in and work experience with community-based programs designed to improve health for older adults (identified as ‘community gerontology’). This poster presentation describes some of these experiences (e.g., preparation of caregiver support materials, preparation of nutrition based materials for congregate meal sites for older adults, coaches’ training and program implementation of several evidence-based community programs). Students have worked with older adults in senior housing facilities, supported housing complexes for veterans, and congregate meal sites for older adults. Because of the program experience, the CREST program helps dispel common stereotypes about older adults and encourages students exploring possible clinical career options to consider focusing on older adults as client populations. Program components are described which can allow conference participants to decide on the applicability of this type of programming for their own communities. Qualitative data are presented that provide insights into these experiences as these influence choice of college major and projected career paths and attitudes about working in community-based healthcare with older people.

Medical Students' Longitudinal Learning With Older Adults: Geriatrics Education Mentor Program

The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentor (GEM) Program is in its sixth year. It's a joint project between older community living adults and 2nd year medical students within the Osteopathic Clinical Skills course. The GEM program goal is to foster understanding and importance of the person/patient-provider relationship. Pairs of osteopathic medical students (N=87 +/- 5) were assigned to an older adult GEM (mentor) volunteer (N=87 +/-5) living within a 50 mile radius of UNECOM. Snowball sampling was used to recruit the GEMs; student participation is required. Four (4) home visits were conducted over 9 months with an assigned GEM; each visit included a new assignment. Students observed, summarized, and recorded experiences communicated by the GEM for each cumulative assignment. Data from assignments were “graded” and content analyses of open ended evaluation/summary questions were conducted. This program is UNE IRB approved. Student pairs completed all assignments. Assignments analysis on Blackboard revealed that students developed respect and awareness of life and medical experiences of the GEM; expressed understanding of the GEM’s life experiences and goals for what “matters most”. Relationships with older adults were established while students maintained professionalism and succeeded in competent and confident interactions. Documentation review from the 4 assignments aided in building students’ geriatrics knowledge, attitudes and skills. Pre-clinical medical education tends to be episodic; providing an opportunity to establish longitudinal assignments over the course of the academic year with the same older adult augments relationship skills and learning in geriatrics.