Changing the Criminal Justice System Response to Sexual Assault: An Empirical Study of a Participatory Action Research Project.

In jurisdictions throughout the United States, thousands of sexual assault kits (SAKs; also known as a "rape kits") have not been submitted by the police for forensic DNA testing. DNA evidence may be helpful to sexual assault investigations and prosecutions by identifying perpetrators, revealing serial offenders through DNA matches across cases, and exonerating those who have been wrongly accused. This paper describes a longitudinal action research project conducted in Detroit, Michigan after that city discovered approximately 11,000 untested sexual assault kits in a police department storage facility. We conducted a root cause analysis to examine individual, organizational, community, and societal factors that contributed to the development of the rape kit backlog in Detroit. Based on those findings, we implemented and evaluated structural changes to increase staffing, promote kit testing, and retrain police and prosecutors so that cases could be reopened for investigation and prosecution. As we conducted this work, we also studied how this action research project impacted the Detroit criminal justice system. Participating in this project changed stakeholders' attitudes about the utility of research to address community problems, the usefulness of DNA evidence in sexual assault cases, and the impact of trauma on survivors. The results led to new protocols for SAK testing and police investigations, and new state legislation mandating SAK forensic DNA testing.

Predicting physical activity among urban adolescent girls: A test of the health promotion model.

The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (ß = .337; p < .001) and total effect (ß = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (ß = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.

How to Right a Wrong: Empirically Evaluating Whether Victim, Offender, and Assault Characteristics can Inform Rape Kit Testing Policies.

Hundreds of thousands of previously untested sexual assault kits (SAKs) have been uncovered in police property storage facilities across the United States, representing a national failure in institutional response to sexual assault. Faced with this discovery, jurisdictions must now decide if and how they should test these kits. Some stakeholders have suggested prioritizing kits for testing by victim, offender, or assault characteristics, based on the belief that these characteristics can predict the likely utility of DNA testing. However, little research has examined the empirical merits of such prioritization. To address this gap in the literature and inform SAK testing policies, we randomly sampled 900 previously untested SAKs from Detroit, MI. The sampled SAKs were submitted for DNA testing, and eligible DNA profiles were entered into Combined DNA Index System (CODIS), the federal DNA database. Police records associated with each SAK were coded for victim, offender, and assault characteristics, and logistic regression analyses were conducted to test whether these characteristics predict which SAKs yield DNA profiles that match ("hit") to other criminal offenses in CODIS. Testing this sample of previously-untested SAKs produced a substantial number of CODIS hits, but few of the tested variables were significant predictors of CODIS hit rate. These findings suggest that testing all previously-unsubmitted kits may generate information that is useful to the criminal justice system, while also potentially addressing the institutional betrayal victims experienced when their kits were ignored.

Prospects for predictive modeling of transition cow diseases.

Transition cow diseases can negatively impact animal welfare and reduce dairy herd profitability. Transition cow disease incidence has remained relatively stable over time despite monitoring and management efforts aimed to reduce the risk of developing diseases. Dairy cattle disease risk is monitored by assessing multiple factors, including certain biomarker test results, health records, feed intake, body condition score, and milk production. However, these factors, which are used to make herd management decisions, are often reviewed separately without considering the correlation between them. In addition, the biomarkers that are currently used for monitoring may not be representative of the complex physiological changes that occur during the transition period. Predictive modeling, which uses data to predict future or current outcomes, is a method that can be used to combine the most predictive variables and their interactions efficiently. The use of an effective predictive model with relevant predictors for transition cow diseases will result in better targeted interventions, and therefore lower disease incidence. This review will discuss predictive modeling methods and candidate variables in the context of transition cow diseases. The next step is to investigate novel biomarkers and statistical methods that are best suited for the prediction of transition cow diseases.

Tested at Last: How DNA Evidence in Untested Rape Kits Can Identify Offenders and Serial Sexual Assaults.

An increasing number of U.S. law enforcement agencies have disclosed that they have large numbers of untested sexual assault kits (SAKs; also called "rape kits") in police property storage. Whether previously untested SAKs should be tested for DNA evidence has been the subject of considerable public debate. To inform policy and practice regarding rape kit testing, the current study tested a sample of 900 previously unsubmitted SAKs from Detroit, Michigan, and documented the DNA forensic testing outcomes associated with those kits. We assessed how many SAKs yielded DNA profiles eligible for upload into CODIS (Combined DNA Index System), the federal DNA criminal database; how many resulted in a DNA match (termed a "CODIS hit"); and how many of those hits were associated to other sexual assault crimes (i.e., serial sexual assault hits). Overall, there were 259 CODIS hits, 69 of which had DNA matches to another sexual assault case. The potential utility of a DNA profile and CODIS hit may vary depending on whether offender was known or unknown to the victim, so we examined these outcomes separately for SAKs associated with stranger- and non-stranger-perpetrated sexual assaults. We also present six case study examples of how DNA testing and CODIS hits helped identify serial sexual assaults in both stranger and non-stranger sexual assault cases. Implications for rape kit testing policies are discussed.

EATI Island - A virtual-reality-based elder abuse and neglect educational intervention.

Despite high prevalence rates of elder abuse and neglect (EA/N), compliance with mandatory reporting remains low. A lack of practical training on EA/N has been identified as a barrier. This article describes the development, implementation, and evaluation of an innovative virtual-reality-based educational intervention intended to improve EA/N recognition and reporting among nurses and social workers providing in-home services. The educational intervention consisted of two parts, including an introductory course and advanced assessment training in virtual reality. The advanced assessment training was focused on learning to use the QualCare Scale, an instrument used to assess quality of family caregiving. Data was evaluated in terms of user satisfaction, changes in knowledge, and changes in practice. Results indicate that participants were satisfied with the content and format of the training program. Participants made gains in knowledge in identification and had 99% accuracy in their mandatory reporting decisions. Importantly, professionals reported making changes in their daily practice based on knowledge and skills learnt. Evaluation data indicate that this interdisciplinary training program was a satisfactory way to learn that produced changes in knowledge and impacted clinical practice. Few implementation barriers were encountered during this project suggesting it would be replicable.

Comparing the Psychometric Properties of Two Physical Activity Self-Efficacy Instruments in Urban, Adolescent Girls: Validity, Measurement Invariance, and Reliability.

Aims: This study compared the psychometric properties of two self-efficacy instruments related to physical activity. Factorial validity, cross-group and longitudinal invariance, and composite reliability were examined. Methods: Secondary analysis was conducted on data from a group randomized controlled trial investigating the effect of a 17-week intervention on increasing moderate to vigorous physical activity among 5th-8th grade girls (N = 1,012). Participants completed a 6-item Physical Activity Self-Efficacy Scale (PASE) and a 7-item Self-Efficacy for Exercise Behaviors Scale (SEEB) at baseline and post-intervention. Confirmatory factor analyses for intervention and control groups were conducted with Mplus Version 7.4 using robust weighted least squares estimation. Model fit was evaluated with the chi-square index, comparative fit index, and root mean square error of approximation. Composite reliability for latent factors with ordinal indicators was computed from Mplus output using SAS 9.3. Results: Mean age of the girls was 12.2 years (SD = 0.96). One-third of the girls were obese. Girls represented a diverse sample with over 50% indicating black race and an additional 19% identifying as mixed or other race. Both instruments demonstrated configural invariance for simultaneous analysis of cross-group and longitudinal invariance based on alternative fit indices. However, simultaneous metric invariance was not met for the PASE or the SEEB instruments. Partial metric invariance for the simultaneous analysis was achieved for the PASE with one factor loading identified as non-invariant. Partial metric invariance was not met for the SEEB. Longitudinal scalar invariance was achieved for both instruments in the control group but not the intervention group. Composite reliability for the PASE ranged from 0.772 to 0.842. Reliability for the SEEB ranged from 0.719 to 0.800 indicating higher reliability for the PASE. Reliability was more stable over time in the control group for both instruments. Conclusions: Results suggest that the intervention influenced how girls responded to indicator items. Neither of the instruments achieved simultaneous metric invariance making it difficult to assess mean differences in PA self-efficacy between groups.

Feeding Practices and Infant Growth: Quantifying the Effects of Breastfeeding Termination and Complementary Food Introduction on BMI z-Score Growth Velocity through Growth Curve Models.

BACKGROUND: Infant feeding practices are a focus of early obesity prevention. We tested whether infant growth velocity increased after breastfeeding termination and complementary food introduction. METHODS: Our secondary analysis included a sample of 547 mother-infant dyads from a longitudinal randomized controlled trial conducted in Michigan and Colorado. Infant anthropometrics at birth, baseline, and 6- and 12-month follow-up were standardized to BMI-for-age z-score (ZBMI) according to World Health Organization (WHO) growth charts. We used growth curve models with time-varying predictors to quantify effects of breastfeeding termination and timing of complementary food introduction on growth velocity. RESULTS: Median breastfeeding duration was 2.0 months [confidence interval (CI) = 2.0-2.5]; median introduction of complementary foods occurred at 3.0 months (CI = 2.8-3.2). Breastfed infants not yet introduced to complementary foods had an average ZBMI growth velocity of 0.050 (CI = -0.013 to 0.113) z-score units per month [zpm], not significantly faster than WHO growth trajectory (p = 0.118) defined as 0 zpm. Breastfeeding termination had negligible effect on ZBMI growth velocity (γ11 = 0.001, CI = -0.027 to 0.030, p = 0.927). Introduction of complementary foods increased ZBMI growth velocity relative to an average child in the sample, but not significantly (γ12 = 0.033, CI = -0.034 to 0.100, p = 0.334). Growth velocities for infants receiving complementary foods both before and after breastfeeding termination were significantly faster than the WHO growth trajectory (0.083 zpm, CI = 0.052-0.114, and 0.084 zpm, CI = 0.064-0.105, respectively, p's < 0.001). CONCLUSIONS: Average postcomplementary food introduction growth velocity was significantly higher than WHO growth trajectory, but did not differ from the sample's initial average trajectory. Growth curve models can accurately estimate effects of feeding practices on infant growth to direct obesity prevention efforts.

Identifying elder abuse & neglect among family caregiving dyads: A cross sectional study of psychometric properties of the QualCare scale.

BACKGROUND/OBJECTIVES: Universal screening for elder abuse and neglect is a current controversy in geriatrics, fueled by the lack of evidence on valid and reliable instruments. Since each U.S. State and many other countries have their own legal definitions of what constitutes elder abuse and neglect, this further complicates instrument development and clinical assessment. The purpose of this paper is to present data on the sensitivity and specificity of the QualCare Scale, an instrument with utility in detecting clinically significant elder abuse and neglect among older adults receiving care at home. DESIGN: Data used in this analysis were collected during a training program in which trainees completed assessments (N=80) of standardized case scenarios of caregiving dyads. Trainees completed the QualCare Scale during each assessment. SETTING: This training program, including the assessments of the standardized case scenarios, was completed using a custom designed virtual-reality platform. Trainees were able to interact with the environment, older adult and caregiver within the case scenario. PARTICIPANTS: Thirty-six nurses and social workers from two Michigan Medicaid Waiver Sites participated in the training program. Each participant assessed between one and five scenarios, yielding the sample of 80 assessments used in this analysis. MEASUREMENTS: The research team designed each standardized case scenario to reflect whether or not the QualCare Scale subscale score should indicate reportable elder abuse and neglect per the State statute. Accordingly, the research team's QualCare Scale scores for each scenario were used as the gold standard criterion of clinical significance for comparison against the participant's assessment scores. RESULTS: Sensitivity and specificity for each of the six QualCare subscales was determined. Overall, the subscales had high sensitivity (≥0.811) but a wide range for specificity (0.167-1.000). CONCLUSION: The QualCare Scale can be an effective tool in detecting clinically significant elder abuse and neglect among older adults receiving care at home. This tool is suitable and feasible for use by practitioners working in home care. The QualCare Scale score indicating clinically significant or reportable elder abuse and neglect can be raised or lowered to be consistent with State or Country statutes, or simply used to create appropriate care plans to support caregiving. Findings from the QualCare Scale can support the multidisciplinary team in planning for and evaluating preventative interventions.

Forward Head Posture and Activation of Rectus Capitis Posterior Muscles.

CONTEXT: Rectus capitis posterior (RCP) muscles have physical attachments to the pain-sensitive spinal dura. Atrophy of these muscles is associated with chronic headache in some patients. The authors suspect that the significance of atrophy in the RCP muscles has been undervalued because the functional role of these muscles is not well defined. OBJECTIVE: To determine whether a statistically significant change in normalized levels of electromyographic activity in RCP muscles occurs when the head is voluntarily moved from a self-selected neutral head position to a protruded head position. METHODS: Fine wire, intramuscular electrodes were used to collect electromyographic data as asymptomatic participants moved their head from a neutral head position into a forward head position and back into the neutral head position. This sequence was repeated 4 times. Normalized levels of electromyographic activity were quantified using a 2-head position × 2 sides of the body repeated measures design that incorporated mixed-effects ß regression models. RESULTS: Twenty participants were studied. Electromyographic activity collected from RCP muscles was found to increase as the head was voluntarily moved from a self-selected neutral head position (11% of maximum voluntary isometric contraction [MVIC] in RCP minor, 14% of MVIC in RCP major) into a protruded head position (35% of MVIC in RCP minor, 39% of MVIC in RCP major) (P<.001). CONCLUSION: Rectus capitis posterior muscles may contribute to segmental stabilization of the occipitoatlantal and atlantoaxial joints by helping to maintain joint congruency during movement of the head.

Comparing Standard and Selective Degradation DNA Extraction Methods: Results from a Field Experiment with Sexual Assault Kits.

A growing number of U.S. cities have large numbers of untested sexual assault kits (SAKs) in police property facilities. Testing older kits and maintaining current case work will be challenging for forensic laboratories, creating a need for more efficient testing methods. METHODS: We evaluated selective degradation methods for DNA extraction using actual case work from a sample of previously unsubmitted SAKs in Detroit, Michigan. We randomly assigned 350 kits to either standard or selective degradation testing methods and then compared DNA testing rates and CODIS entry rates between the two groups. RESULTS AND CONCLUSIONS: Continuation-ratio modeling showed no significant differences, indicating that the selective degradation method had no decrement in performance relative to customary methods. Follow-up equivalence tests indicated that CODIS entry rates for the two methods could differ by more than ±5%. Selective degradation methods required less personnel time for testing and scientific review than standard testing.

Examining patterns of multivariate, longitudinal symptom experiences among older adults with type 2 diabetes and cancer via cluster analysis.

PURPOSE: Diabetes and cancer are chronic conditions that produce symptoms, some unique to each condition and others common to both. Previous studies have reported on subgroups of patients who experience distinct combinations of symptoms in cross-sectional samples and the univariate longitudinal trajectories of individual symptoms. The literature currently lacks examples of research that take a multivariate longitudinal perspective to understanding patients' symptom experiences. The purpose of this study was to identify subgroups of patients who share distinct multivariate longitudinal profiles with respect to how symptom severity changes over time for a set of five symptoms (pain, fatigue, change in appetite, nausea, and numbness and tingling). METHODS: This exploratory study included 43 participants with pre-existing diabetes from eight community-based cancer centers who were receiving chemotherapy for a solid tumor. Using baseline and 8-week data, a model-based cluster analysis with Bayesian regularization was used to identify subgroups. RESULTS: Two groups were identified. Group 1 experienced mild symptoms that changed very little at 8 weeks; group 2 experienced mild to moderate symptom severity, with small increases in fatigue, nausea, and numbness and tingling. Effect size confidence intervals suggest that level of depression, length of time with diabetes, and severity of diabetes at baseline may differ between groups. CONCLUSIONS: More research in this area is needed to further test this model, address limitations associated with analyzing a small sample, and explore factors that may be associated with changes in the overall symptom experience for patients with diabetes and cancer.

Activation of rectus capitis posterior major muscles during voluntary retraction of the head in asymptomatic subjects.

OBJECTIVE: The purpose of this study was to assess levels of electromyographic activity measured from rectus capitis posterior major (RCPM) muscles of asymptomatic subjects as their heads moved from a self-defined neutral position to a retracted position. METHODS: A 2 × 2 within-subjects factorial research design was used. Disposable, intramuscular electrodes were used to collect electromyographic data from asymptomatic subjects between the ages of 20 and 40 years old. Data analysis was performed using mixed effects ß regression models. RESULTS: Activation of RCPM muscles was found to significantly increase (P < .0001) as the head moved from a self-defined neutral position to a retracted position. Rectus capitis posterior major muscle activation levels, measured as a function of head position, have not been previously reported. CONCLUSIONS: The findings from this study showed that RCPM muscle activation significantly increases during voluntary retraction of the head.

Electromyographic activity of rectus capitis posterior minor muscles associated with voluntary retraction of the head.

BACKGROUND CONTEXT: The functional role of rectus capitis posterior minor (RCPm) muscles is not well defined. To the best of our knowledge, electromyographic (EMG) data from RCPm muscles in humans have never been collected and analyzed. PURPOSE: To test the null hypothesis that there will be no difference in normalized levels of EMG activity measured from RCPm muscles with the head in a neutral position and with the head in a retracted position. STUDY DESIGN: A repeated measures design intended to quantify normalized levels of EMG activity measured from RCPm muscles. METHODS: Disposable 25-gauge, bipolar fine wire hooked electrodes were used to collect EMG data from both right and left RCPm muscles from 17 asymptomatic subjects. Data were collected while subjects performed five trials with the head maintained in a neutral position; performed three maximal voluntary isometric contraction efforts; performed four trials with the head maintained in a retracted position. Mixed effects beta regression models were used to analyze the data. RESULTS: Normalized EMG activity of RCPm muscles collected with the subject's head held in a retracted position was significantly higher (p<.0001) than normalized EMG activity collected with the subject's head held in a self-selected, neutral position. CONCLUSIONS: Rectus capitis posterior minor muscles are active when the head is held in a neutral position and show a significant increase in activity when the head is held in a retracted position.

Sex determination of human skeletal populations using latent profile analysis.

Accurately estimating biological sex from the human skeleton can be especially difficult for fragmentary or incomplete remains often encountered in bioarchaeological contexts. Where typical anatomically dimorphic skeletal regions are incomplete or absent, observers often take their best guess to classify biological sex. Latent profile analysis (LPA) is a mixture modeling technique which uses observed continuous data to estimate unobserved categorical group membership using posterior probabilities. In this study, sex is the latent variable (male and female are the two latent classes), and the indicator variables used here were eight standard linear measurements (long bone lengths, diaphyseal and articular breadths, and circumferences). Mplus (Muthén and Muthén: Mplus user's guide, 6th ed. Los Angeles: Muthén & Muthén, 2010) was used to obtain maximum likelihood estimates for latent class membership from a known sample of individuals from the forensic data bank (FDB) (Jantz and Moore-Jansen: Database for forensic anthropology in the United States 1962-1991, Ann Arbor, MI: Interuniversity Consortium for Political and Social Research, 2000) (n = 1,831), yielding 87% of correct classification for sex. Then, a simulation extracted 5,000 different random samples of 206 complete cases each from the FDB (these cases also had known sex). We then artificially imposed patterns of missing data similar to that observed in a poorly preserved bioarchaeological sample from Medieval Asturias, Spain (n = 206), and ran LPA on each sample. This tested the efficacy of LPA under extreme conditions of poor preservation (missing data, 42%). The simulation yielded an average of 82% accuracy, indicating that LPA is robust to large amounts of missing data when analyzing incomplete skeletons.

An investigation of the dynamic processes promoting citizen participation.

This study expanded the citizen participation literature by examining the dynamic nature of citizen participation and the extent to which the factors associated with citizen participation may be moderated by resident leadership status. Longitudinal survey data collected from 542 residents in one small Midwestern city implementing a community change initiative provide some insight into the challenges surrounding the promotion of an active citizenry. Within this one community, citizenship behaviors of emergent resident leaders and residents uninterested in a leadership role were influenced, to some extent, by different factors and the importance of these factors shifted in only a 2 years time span. Future research is needed to determine if the dynamics uncovered in this study were due to the initiative or to the nature of citizen participation processes.

Climate and landscape factors associated with Buruli ulcer incidence in Victoria, Australia.

BACKGROUND: Buruli ulcer (BU), caused by Mycobacterium ulcerans (M. ulcerans), is a necrotizing skin disease found in more than 30 countries worldwide. BU incidence is highest in West Africa; however, cases have substantially increased in coastal regions of southern Australia over the past 30 years. Although the mode of transmission remains uncertain, the spatial pattern of BU emergence in recent years seems to suggest that there is an environmental niche for M. ulcerans and BU prevalence. METHODOLOGY/PRINCIPAL FINDINGS: Network analysis was applied to BU cases in Victoria, Australia, from 1981-2008. Results revealed a non-random spatio-temporal pattern at the regional scale as well as a stable and efficient BU disease network, indicating that deterministic factors influence the occurrence of this disease. Monthly BU incidence reported by locality was analyzed with landscape and climate data using a multilevel Poisson regression approach. The results suggest the highest BU risk areas occur at low elevations with forested land cover, similar to previous studies of BU risk in West Africa. Additionally, climate conditions as far as 1.5 years in advance appear to impact disease incidence. Warmer and wetter conditions 18-19 months prior to case emergence, followed by a dry period approximately 5 months prior to case emergence seem to favor the occurrence of BU. CONCLUSIONS/SIGNIFICANCE: The BU network structure in Victoria, Australia, suggests external environmental factors favor M. ulcerans transmission and, therefore, BU incidence. A unique combination of environmental conditions, including land cover type, temperature and a wet-dry sequence, may produce habitat characteristics that support M. ulcerans transmission and BU prevalence. These findings imply that future BU research efforts on transmission mechanisms should focus on potential vectors/reservoirs found in those environmental niches. Further, this study is the first to quantitatively estimate environmental lag times associated with BU outbreaks, providing insights for future transmission investigations.

Effects of trap type, placement and ash distribution on emerald ash borer captures in a low density site.

Effective methods for early detection of newly established, low density emerald ash borer (Agrilus planipennis Fairmaire) infestations are critically needed in North America. We assessed adult A. planipennis captures on four types of traps in a 16-ha site in central Michigan. The site was divided into 16 blocks, each comprised of four 50- by 50-m cells. Green ash trees (Fraxinus pennsylvanica Marshall) were inventoried by diameter class and ash phloem area was estimated for each cell. One trap type was randomly assigned to each cell in each block. Because initial sampling showed that A. planipennis density was extremely low, infested ash logs were introduced into the center of the site. In total, 87 beetles were captured during the summer. Purple double-decker traps baited with a blend of ash leaf volatiles, Manuka oil, and ethanol captured 65% of all A. planipennis beetles. Similarly baited, green double-decker traps captured 18% of the beetles, whereas sticky bands on girdled trees captured 11% of the beetles. Purple traps baited with Manuka oil and suspended in the canopies of live ash trees captured only 5% of the beetles. At least one beetle was captured on 81% of the purple double-decker traps, 56% of the green double-decker traps, 42% of sticky bands, and 25% of the canopy traps. Abundance of ash phloem near traps had no effect on captures and trap location and sun exposure had only weak effects on captures. Twelve girdled and 29 nongirdled trees were felled and sampled in winter. Current-year larvae were present in 100% of the girdled trees and 72% of the nongirdled trees, but larval density was five times higher on girdled than nongirdled trees.

Who participates and why: building a process model of citizen participation.

Initiating and sustaining sufficient levels of participation among residents in low-income and urban neighborhoods have become significant focuses of many initiatives that strive to develop healthy communities. This study examines the factors associated with citizen participation levels in resident leaders and followers in seven low-income neighborhoods in one community. Overall, the findings suggest that different factors facilitate participation in leaders and followers. Leaders are more likely to actively participate in neighborhood and community affairs if they perceive themselves as having the skills needed to organize others and make change happen. Whereas perceived skill levels also matter for followers, these residents are strongly influenced by the norms for activism within their neighborhood. These norms mediate the impact of neighborhood readiness and capacity for change on citizen participation levels. Implications for funders and practitioners interested in promoting healthy communities are discussed.

GIS applications for community-based research and action: mapping change in a community-building initiative.

In this article we review practical and research applications for the use of geographic information systems (GIS) in the program development and evaluation of a community-building initiative designed to improve economic and educational outcomes in a Midwestern city. We discuss the use of GIS for targeting neighborhoods for program selection, random selection of survey respondents, verification of stratification and representativeness of survey samples, and linking survey data to data regarding physical and demographic characteristics of the community. We explore the benefits and challenges of using GIS with community audiences and highlight additional quantitative analysis tools for future use in this ongoing initiative.