A readability analysis of online mental health resources.

Analyzing the reading grade level of online mental health information is an important first step in ensuring that information is largely accessible by the general public, so as not to perpetuate existing health disparities across socioeconomic groups. The present study systematically examined grade-level readability of mental health information related to various psychiatric diagnoses, obtained from 6 highly utilized mental health websites, using a generalized estimating equations approach. Results suggest that, in general, the readability of mental health information is largely well above the 6th-to-8th grade level recommended by several national health organizations, including the CDC and NIH (Kutner, Greenberg, Jin, & Paulsen, 2006; National Institutes of Health, 2001, 2017), with reading-grade-level estimates from the model ranging from 5.62 to 17.9. Further efforts are required to ensure that writers of online health information do not exacerbate existing health disparities by ignoring these guidelines. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychosocial Determinants of Teens' Online Engagement in Drug Prevention Social Media Campaigns: Implications for Public Health Organizations.

Social networking sites (SNSs) now serve as a primary form of communication among adolescents. Consequently, drug prevention campaigns delivered through SNSs have the potential to reach a wide network of adolescents if teens are willing to engage in the message diffusion process by commenting on, "liking," following, creating, or sharing prevention messages with their networked peers. However, little is known about the psychosocial factors that influence adolescents' willingness to participate in drug prevention social media campaigns. We use qualitative methods to explore reasons why adolescents may or may not want to engage in the message diffusion process. We conducted four semi-structured focus groups with a total of 33 high school students from various school- and community-based youth programs in Rhode Island. Focus groups were followed by a brief self-administered questionnaire collecting information about participants' social media use to augment qualitative findings. Overall, findings reveal that engaging teens in the message diffusion process can be advantageous but difficult to accomplish due to multiple factors. Most notably, asking adolescents to participate in drug prevention campaigns delivered through SNSs means also asking youth to violate online norms that promote drug use, which could in turn subject them to peer reprisal. We conclude that future studies should begin to investigate strategies addressing the various challenges we identified. Meanwhile, prevention specialists should consider alternative or supplemental evidence-based approaches to drug prevention rather than invest resources into activities that may offer little return on investment.

Help Seeking Attitudes Among Cambodian and Laotian Refugees: Implications for Public Mental Health Approaches.

This is a pilot study of demographic and acculturation factors in relation to attitudes toward seeking psychological help among Lao and Cambodian refugees and immigrants in the United States of America. Cambodian and Laotian American adults in the United States of America were approached to complete help-seeking attitudes and acculturation scales. T test and hierarchical multiple regression analyses were used to analyze the relationships between the demographic and acculturation variables, and attitudes toward seeking psychological help. Out of 270 target subjects approached there were 108 respondents. Of the demographic variables, gender was associated with favorable attitudes towards psychological help-seeking. As expected, women were significantly more likely than men to recognize the need for help, to seek psychological help, to be more open to discussing mental health problems, and have more confidence in professional services. Acculturation was more powerfully associated with help- seeking attitudes than any of the demographic variables. In hierarchical multiple regression, acculturation contributed significant unique variance over and beyond the entire set of demographic variables to openness to discussing problems and having confidence in professional help. The findings of this pilot study suggest that there are significant barriers to seeking psychological help among Lao and Cambodian Americans. Attention to the issues of gender and levels of acculturation may improve access.

Evaluating environmental change strategies: challenges and solutions.

In this introductory article we define environmental change strategies (ECS), summarize the primary challenges associated with evaluating ECS, and provide an overview of the methods researchers have employed to begin to address these challenges. This special issue provides a range of examples, from researchers and practitioners in the field, of different approaches for addressing these challenges. These articles present new methods to understand and test how ECS are implemented and propose methods to evaluate their implementation. The content of the articles covers multiple public health issues, including substance abuse prevention, tobacco control, HIV prevention, and obesity prevention. This special issue is intended to build the evidence base for effective ECS, generate compelling discussion, critical analyses, and spur future research that will help improve the implementation and evaluation of ECS.

Coalitional capacities and environmental strategies to prevent underage drinking.

Coalitions are the most common platform for implementing community-level environmental strategies (ES), such as media, policy, or enforcement for substance use prevention. The current study examines the associations between two types of coalition capacity (general and innovation-specific) and ES implementation efforts and outputs within 14 intervention communities over a three-year period. Efforts refer to the amount of energy exerted to implement an ES while outputs refer to the materials produced through these efforts. Quantitative measures of capacity were provided by coalition key informants and expert-raters. Additionally, Training and Technical Assistance (TTA) provided proactively to improve the implementation of ES was also examined. Greater general capacity, as rated by a coalition informant, was associated with more ES policy effort. Both expert-rated general and innovation-specific capacity, however, were associated with greater ES outputs. Study results also found that community coalitions that endorsed weaker mobilization, structure and task leadership, (measures of general capacity), utilized more TTA compared to those who perceived their coalition as having greater capacity. Moreover, communities that utilized more TTA resources reported a greater number of successful policy changes. The study supports the need to consider both general and innovation-specific capacity for ES implementation and offers promising preliminary findings regarding the role of TTA for improving coalitions' capacity to facilitate policy change.

The interactive systems framework applied to the strategic prevention framework: the Rhode Island experience.

The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171-181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data-driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes.

Cultivating systemic capacity: the Rhode Island tobacco control enhancement project.

This paper describes the Rhode Island Tobacco Control Enhancement Project (TCEP), a state-university-community technical assistance system. TCEP was developed under the auspices of the Rhode Island Department of Health's Tobacco Control program and was designed to build capacity among nine community-based organizations to mount comprehensive tobacco control interventions in five diverse communities within the state. This paper: (1) provides a description of community mobilization; (2) presents a logic model for planning and decision making used by state-university-community partners; (3) describes training, technical assistance services and implementation; and, (4) describes the evaluation and program improvement activities used to support on-going project development.

Community coalitions and prevention: a panel discussion.

On January 20, 2004, at the Community Anti-Drug Coalitions of America (CADCA) National Leadership Forum in Washington, D.C., joined with CADCA to sponsor a panel discussion on the possibilities of science-based prevention. CADCA represents some 5,000 local drug abuse prevention agencies; its National Community Anti-Drug Coalition Institute seeks to foster its members' use of appropriate standards for evaluation and research.

Community interventions and effective prevention.

The prevalence of pregnancy, substance abuse, violence, and delinquency among young people is unacceptably high. Interventions for preventing problems in large numbers of youth require more than individual psychological interventions. Successful interventions include the involvement of prevention practitioners and community residents in community-level interventions. The potential of community-level interventions is illustrated by a number of successful studies. However, more inclusive reviews and multisite comparisons show that although there have been successes, many interventions did not demonstrate results. The road to greater success includes prevention science and newer community-centered models of accountability and technical assistance systems for prevention.

Supporting community-based prevention and health promotion initiatives: developing effective technical assistance systems.

As research evidence for the effectiveness of community-based prevention has mounted, so has recognition of the gap between research and community practice. As a result, state and local governments are taking a more active role in building the capacity of community-based organizations to deliver evidence-based prevention interventions. Innovations are taking place in the establishment of technical assistance or support systems to influence the prevention and health education activities of community-based organizations. Several challenges for technical assistance systems are described: (1) setting prevention priorities and allocating limited technical assistance resources, (2) balancing capacity-building versus program dissemination efforts, (3) collaborating across categorical problem areas, (4) designing technical assistance initiatives with enough "dose strength" to have an effect, (5) balancing fidelity versus adaptation in program implementation, (6) building organizational cultures that support innovation, and (7) building local evaluative capacity versus generalizable evaluation findings.