A youth development program: lasting impact.

The purpose of the study was to examine whether participation in a youth development program positively impacted participants' adult outcomes. Length of time adolescents spent in a comprehensive youth development program was correlated to their adult outcomes and functioning was assessed. All 141 adult past participants of a youth development program were identified. A survey was administered to 97% of the past participants located. School completion, higher education, alcohol and drug use, pregnancy and childbearing, employment, and involvement with the juvenile and adult justice systems were assessed. Degree of involvement in the program (low, medium, and high) was calculated and correlated with outcomes. Of the six areas surveyed, statistically significant findings (p<0.05) were obtained in three: education, employment, and criminal justice. Nonsignificant, but positive, trends were observed in the areas of pregnancy/parenthood and illicit drug use. Best outcomes were achieved with those who participated for at least 201 days.

Predictors of alcohol and crack cocaine use outcomes over a 3-year follow-up in treatment seekers.

This study identified predictors of long-term alcohol and crack cocaine use outcomes in individuals participating in the Persistent Effects of Treatment Study. The domains that were assessed included motivation, self-efficacy, social support, psychiatric severity, employment, housing status, and self-help group attendance at baseline and 6, 12, 24, and 30 month follow-ups. In alcohol users, higher perceived seriousness of substance use problems, self-efficacy, and self-help group attendance, as well as lower social support for substance use, consistently predicted better alcohol use outcomes in the subsequent assessment period. In crack cocaine users, only self-efficacy consistently predicted cocaine use outcomes. Higher self-efficacy during follow-up was predicted by lower perceived seriousness of substance use and lower alcohol use frequency in the prior assessment period, whereas greater self-help group attendance was predicted by greater perceived seriousness of substance use, and lower substance use frequency.

Understanding residents' work: moving beyond counting hours to assessing educational value.

PURPOSE: To begin to understand how residents' work affects their own educations and the hospitals in which most of their training takes place, the authors undertook a systematic review of the literature analyzing residents' activities. This review sought to analyze resident physicians' activities to assess the educational value of residents' work. METHOD: The published literature was searched in 2001 using the Medline and Science Citation Index databases, and the unpublished literature was searched using bibliographies and key informants. One hundred six studies were rated for methodological rigor using the Cochrane Collaboration protocol, as modified by Bland et al. for nonclinical trials. Only those studies undertaken following the Bell Commission's report in 1987 and whose methodological rigor score fell at or above the median for all studies rated were included in the data synthesis. Results data from 16 studies that included over 1,000 residents in six different specialties, were combined under the definitions of types of residents' activities: marginal, patient care, teaching and learning, and other. RESULTS: This preliminary analysis found that residents devoted approximately 36% of their effort to direct patient care necessary to achieve specialty-specific learning objectives, 15% to the residency program's organized teaching activities, and potentially as much as 35% to delivering patient care of marginal or no educational value. An additional 16% of residents' waking time on duty was spent in other, unspecified activities. CONCLUSION: It is possible and potentially valuable to consider not only the number of hours worked by residents, but the educational content of their work when considering residency work and hour reforms