Conjoint behavioral consultation in rural schools: Do student effects maintain after 1 year?

Challenging behavior problems are common in early childhood and, if left untreated, may escalate into more severe and intractable problems in adolescence and early adulthood. This trajectory is of particular importance in rural schools, where disruptive behaviors are more prominent than in urban and suburban schools. Conjoint behavioral consultation (CBC) is a family-school partnership intervention with documented efficacy in producing immediate decreases in child problem behaviors and increases in child adaptive behaviors and social skills. The purpose of the present study was to determine whether the immediate effects of CBC maintain over a 1-year follow-up period. Participants at study enrollment were students (N = 267) and their parents, as well as both the students' original (N = 152) and subsequent (N = 135) teachers in 45 Midwest rural schools. At the time of initial study enrollment, students were assigned randomly to an active CBC intervention or "business as usual" control condition. Results demonstrated that immediate effects of parent-rated adaptive and social skills and teacher-rated school problems were maintained at the 1-year follow-up. Additionally, for parent-rated adaptive skills and teacher-rated school problems, improvements during the maintenance phase were statistically equivalent to gains in the control group. However, increases in parent-rated social skills for the control group during the follow-up phase significantly outpaced increases among the CBC group. Implications for use of CBC in rural communities, as well as future research directions, are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Sleep and health-related factors in overweight and obese rural women in a randomized controlled trial.

This secondary analysis describes sleep and health-related factors in healthy overweight and obese mid-life and older rural women enrolled in the" Women Weigh-In for Wellness" randomized clinical trial. The aim of the trial was to promote healthy behaviors and weight-loss. We analyzed demographic, anthropometric, and biomarker variables, self-reported measurements of sleep disturbance and pain interference, and objective 24-h sleep/wake patterns at baseline, 6 months, and the change over time. Although self-reported sleep disturbance reflected normal sleep, pain interference was slightly higher than normal. There were associations between higher self-reported sleep disturbance, pain interference and several other variables. Women who achieved 5 % or more weight loss exhibited positive associations between sleep, pain, and health-related factors. Weight loss and lower pain predicted lower self-reported sleep disturbance. Our results suggest that overweight and obese rural women who adopt healthy behaviors and achieve weight loss also may experience improved sleep and other health benefits. Clinical trial # NCT01307644.

The influence of cognitive-perceptual variables on patterns of change over time in rural midlife and older women's healthy eating.

Although studies demonstrate that dietary interventions for healthy adults can result in beneficial dietary changes, few studies examine when and how people change in response to these interventions, particularly in rural populations. The purpose of this study was to examine patterns of change over time in healthy eating behaviors in midlife and older women in response to a one-year health-promoting intervention, and to examine what predictors (perceived benefits, barriers, self-efficacy, and family support for healthy eating) influence the changes during the intervention and follow-up. Data for this secondary analysis were from the Wellness for Women community-based trial. Women (N = 225) between the ages of 50-69 in rural Nebraska, U.S.A., were recruited. A repeated-measures experimental design was used with randomization of two rural counties to intervention (tailored newsletter) or comparison (standard newsletter) groups. Eating behavior was measured by the Healthy Eating Index. The predictor variables were assessed using standard measures. Data analysis was done using latent growth curve modeling. The tailored newsletter group was successful in improving their healthy eating behavior compared to the standard newsletter group during the one-year intervention, at the end of the intervention, and during the follow-up phase. Family support at the end of the intervention was positively associated with healthy eating at the end of the intervention. Perceived barriers had the strongest impact on healthy eating behavior at all time points. Compared to participants in the standard newsletter group, those in the tailored newsletter group perceived more family support and fewer barriers for healthy eating at the end of the intervention (mediation effects). Based on these findings, both family support and perceived barriers should be central components of interventions focused on healthy eating behavior in rural midlife and older women.