Distance Delivery of Function-Based Skill Training for Providers in Rural Settings

Children with diagnosed disabilities, teachers and classroom staff, and families living in rural areas have difficulty accessing any and all behavioral services, including parent training, due to a lack of providers, distance to clinics, cost of transportation, low income and/or inadequate health insurance, and confidentiality concerns from living in small communities. In this study, Project ECHO (Extension for Community Healthcare Outcomes) was used to train early childhood professionals on how to implement Prevent–Teach–Reinforce for Young Children, which is a step-by-step manualized approach to the assessment and treatment of challenging behavior that reflects a commitment to evidence-based practice. Results of the pilot study, study limitations, and future directions are discussed.

Affordability, Feasibility, and Accessibility: Companion Animal Guardians with (Dis)Abilities’ Access to Veterinary Medical and Behavioral Services during COVID-19

The research aims to explore COVID-19 health and safety protocol impacts on companion animal guardians living with (dis)abilities relating to veterinary medical and behavioral service access. The COVID-19 global public health crisis has impacted almost all international communities; however, vulnerable and marginalized groups have been disproportionately affected. Within the human–companion animal domain, COVID-19-driven societal impacts (e.g., social, health, and economic) not only boomed with new companion animal guardians, but also negatively influenced guardians’ access to veterinary services. Although studies have examined guardian-related COVID-19-specific challenges, there is a paucity of concentration on vulnerable populations, such as persons with disabilities (PWDs). Responding to this research deficit, this study recruited twelve companion animal guardians to participate in semi-structured in-depth interviews, and eight (67%) of the twelve participants self-identified as PWDs. From a PWD perspective, this research reveals three pandemic-triggered primary barriers, preventing PWDs from pursuing veterinary services: (1) service affordability, (2) assistance program feasibility, and (3) veterinary service accessibility. This article argues that PWD-driven approaches could improve existing assistance and support programs to address PWDs’ unique requirements, promoting a healthy human–animal bond.

Patient-centered behavioral services for women veterans with mental health conditions

The Veterans Health Administration (VHA) is undergoing a transformational shift from disease-focused care to a Whole Health model that emphasizes physical, mental, emotional, and spiritual health and well-being. As this shift is occurring, women veterans using VHA services face challenges navigating a system that has historically served a primarily male demographic, without consistent consensus on which services require specialization by gender. A quality improvement project was conducted to solicit feedback on VHA behavioral and wellness programs from women veterans enrolled in VHA mental healthcare services. A multi-disciplinary work group of clinical researchers and healthcare providers developed a needs assessment survey to assess patient needs and preferences for behavioral health services. A convenience sample of female veterans using VHA mental healthcare services within a comprehensive Women’s Health Clinic were invited to complete this anonymous survey. 107 women Veterans 18–65+ years old (65.3% African American; 5.9% LatinX; 54.2% aged under 55) completed the survey. Over 50% of patients endorsed relationships, physical activity, sleep/nightmares, pain management, anger, or spiritual/moral pain as top wellness priorities. Programatic preferences included location (located at the main VA Hospital) and gender composition (female only group formats). Schedule conflicts were the most frequently cited barriers. Results from this quality improvement project highlight considerations for tailoring the content and delivery of behavioral services for women veterans with mental health conditions.

Socio-Ecological Predictors of Resilience Development Over Time Among Youth With a History of Maltreatment

While there is a growing body of research examining resilient development in adolescents with a history of maltreatment, it remains unclear whether youth resilient functioning changes over time and what factors predict such change. The current study aimed to identify the socio-ecological predictors of the change in resilient functioning over time among adolescents with a history of maltreatment. Multinomial logistic regression analyses were conducted with a sample of 771 adolescents drawn from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Over 18 months, 23.2% of the adolescents remained in the less resilience group, 45.4% stayed in the greater resilience group, 17.4% moved from the greater resilience group to the less resilience group, and 14.0% moved from the less resilience group to the greater resilience group. Younger age, better parent-child relationship quality, and neighborhood safety were associated with stable and continued resilient functioning over time. Conversely, child physical abuse, affiliation with deviant peers, and receipt of behavioral services were negatively associated with continued resilience. Our findings suggest that interventions that support adolescents in building positive relationships with their parents and peers may prevent a loss of resilience over time and ensure continued resilient functioning in child welfare-involved adolescents.

A Mixed Method Investigation of Parent Perspectives on Behavioral Services in Primary Care

Primary care is a key setting for the delivery of parent-focused behavioral interventions. Various methods of intervention show promising efficacy, but fail to engage adequate parental participation. The objective of this study was to understand factors underlying parents’ attitudes towards the content, sources, and delivery methods of behavioral guidance in primary care.

Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic

Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March due to the effects of COVID-19 represents a textbook case for rapid adaptation with direct impact on survival of many types of enterprises. We describe here the impact, changes and outcomes achieved by a large, multi-faceted ABA clinical program having: (a) ongoing data that forecasted and tracked changes; (b) staff well practiced with data-based shifts in operations (behavior); and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person to telehealth, and increases in volumes, revenue and margins. We detail regulations and provide actionable steps clinical organizations can take pertinent to this shift now and in the future. The COVID-19 challenges underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field.