John D. Hall

Effects of a Culturally Sensitive Education Program on the Breast Cancer Knowledge and Beliefs of Hispanic Women

PURPOSE/OBJECTIVES To determine the effectiveness of a multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program for Hispanic women. DESIGN Experimental (post-test only, control-group design). SETTING The parish hall of a Roman Catholic Church in northeastern Arkansas. SAMPLE 31 Hispanic women aged 25-56 residing in northeastern Arkansas. METHODS The experimental group received a multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program; the control group received general nutritional information. Both groups completed the Breast Cancer Knowledge Test and Breast Cancer Screening Belief Scales so that the researchers could measure dependent variables. Data were analyzed with t tests. MAIN RESEARCH VARIABLES Knowledge of and beliefs about breast cancer. FINDINGS The experimental group scored significantly higher on the Breast Cancer Knowledge Test than did the control group. The control group scored significantly higher than the experimental group on the barriers to mammography scale and the benefits of breast self-examination scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS The multifaceted, culturally sensitive, and linguistically appropriate breast cancer education program appeared to be responsible for increased knowledge of breast cancer and reduced barriers to mammography. IMPLICATIONS FOR NURSING Education may change Hispanic womens knowledge and beliefs about breast cancer. An intervention designed and implemented by nurses can play a significant role in meeting the strong need for culturally sensitive and linguistically appropriate breast cancer educational programs for Hispanic women. Such programs should focus on helping Hispanic women understand their personal risks related to breast cancer and reduce barriers they perceive to early screening and detection.

Family factors in preschool assessment and intervention: A validity study of parenting stress and coping measures ☆

Abstract The assessment of family variables is central to recent legislation related to special services for young children. This study examined the relationship between the Parenting Stress Index (PSI) and the Family Crisis Oriented Personal Evaluation Scales (F-COPES) with low-socioeconomic-status caregivers of preschool children. Correlations revealed that the PSI and F-COPES measure relatively independent constructs. The findings also suggest that passive appraisal (inactive or passive coping strategies) is related more to parenting stress than other coping strategies. The combined effect of assessing parent and child functioning rather than one in isolation may assist in more effective identification of risk status.

Teaching Breast Cancer Screening to African American Women in the Arkansas Mississippi River Delta

PURPOSE/OBJECTIVES To determine the effectiveness of a multifaceted, culturally sensitive breast cancer education program for African American women in the Arkansas Mississippi River Delta. DESIGN Experimental (i.e., posttest only, control group design). SETTING African American churches and a county Extension Homemakers Club sponsored through the Arkansas Extension Homemakers council. SAMPLE 53 African American women. The experimental group included 30 participants who had a mean age of 56 years, and the control group consisted of 23 participants with a mean age of 51 years. METHODS After the presentation of a multifaceted, culturally sensitive breast cancer education program, a variety of instruments were administered to participants in the experimental group that measured dependent variables. Subjects in the control group completed the same instruments in the absence of a viable intervention. Data were analyzed using t tests. MAIN RESEARCH VARIABLES Knowledge and beliefs about breast cancer. FINDINGS The experimental groups mean scores were significantly higher than the control groups on the Breast Cancer Knowledge Test and the susceptibility scale of the Breast Cancer Screening Belief Scales. The experimental group also scored significantly higher than the control group on the confidence scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS The multifaceted, culturally sensitive breast cancer education program appeared to be responsible for the differences in scores between the experimental and control groups. IMPLICATIONS FOR NURSING Culturally sensitive group educational programs aimed at helping African American women in the rural South become more knowledgeable about breast cancer and early detection clearly are needed. Such efforts also must focus on increasing womens confidence in effectively performing regular breast self-examination as well as their understanding of personal risk. Healthcare professionals play a major role in the development and implementation of these programs.

Naturalistic Intervention Design for Young Children: Foundations, Rationales, and Strategies

Naturalistic intervention design may lead to an expanded range of promising interventions for young children. Interventions described as naturalistic are (a) generalized from developmental studies of competent caregivers, (b) founded on the realities of settings, and (c) based on the predicted success of the least intrusive intervention likely to accomplish the desired goals. Naturalistic intervention design stresses the need for assessment and intervention to occur within significant settings and with caregivers (and peers) who have the greatest opportunity to interact with children experiencing learning or behavioral difficulties. Thus, the focus of the analysis is on (a) environments; (b) experiences provided to children; and, as critical features, (c) evident, emerging, and accessible skills of caregivers that facilitate learning or the development of alternative responses for maladaptive behaviors. Naturalistic intervention design may help achieve acceptability, generality of behavioral change, and ethnic validity.

Child Developmentaleducational Status in Kindergarten and Family Coping as Predictors of Parenting Stress: Issues for Parent Consultation

This study examined the relationship among three constructs that frequently form the basis for parent consultation in early intervention, parenting stress, family coping, and developmental/educational status. Parents (N = 116) of kindergarten children completed the Parenting Stress Index (PSI) and the Family Crisis Oriented Personal Evaluation Scales (F-COPES), while their children were administered the Early Screening Profiles (ESP). Pearson correlations among the PSI, F-COPES, and the ESP revealed low positive to moderately negative correlations; most of the correlations were negative. These negative correlations were expected because coping and developmental/educational attainment may be related inversely to parenting stress. A stepwise multiple regression analysis revealed that the ESP Total Score and two coping strategies, Passive Appraisal and Reframing, accounted for 27.1%o of the variance on the PSI Total Scores. Implications for parent consultation are discussed.

Classification of Risk Status in Preschool Screening: A Comparison of Alternative Measures

The present study examined the classification agreement associated with estimates of risk status across alternative measures for 84 caregivers and preschool children of low socioeconomic status. The study focused on the child variable of educational risk as measured by two instruments: Developmental Indicators for the Assessment of Learning-Revised (DIAL-R) and Screening Children for Related Early Educational Needs (SCREEN). Family risk was measured by the Parenting Stress Index (PSI). Overall, the classification agreement for each comparison was low. The professional practice of preschool screening may require significant reappraisal with regard to classification problems related to risk status and developmental skills.

Classification of Risk Status in Kindergarten Screening: A Comparison of Alternative Measures

This study examined the classification agreement associated with estimates of risk status across alternative measures for 92 kindergarten children and their caregivers. The study focused on the child variable of educational risk as measured by two instruments: Developmental Indicators for the Assessment of Learning-Revised (DIAL-R) and Early Screening Profiles (ESP). Family risk was measured by the Parenting Stress Index (PSI). Overall, the classification agreement between the measures designed to assess educational risk was moderate, but higher than past similar studies with preschool children. In contrast, the classification agreement between the measures of educational and family risk was low. The practice of kindergarten screening may need to be expanded to allow for the assessment of other critical variables, such as family risk.

ADHD Assessment: A Comparison of Negative versus Positive Symptom Formats

Abstract This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the childs behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.

Screening Young Children's Social Behaviors: An Examination of Decision Reliability with Alternative Measures.

Abstract This study examined decision reliability associated with estimates of risk status for 114 first grade students. The study focused on social behaviors as measured by the School Social Behavior Scales (SSBS) and Social Skills Rating System (SSRS). Overall, the decision reliability between the two measures designed to assess social behaviors was moderate when social behaviors were rated by the teacher and low when assessed by alternative raters (i.e., teacher versus parent). Screening practices that include alternative assessment methods (such as interviews and observations) should be considered by special services personnel in addition to traditional standardized procedures.

The Reliability of Randomly Generated Math Curriculum-Based Measurements:

Curriculum-Based Measurement (CBM) is a direct method of academic assessment used to screen and evaluate students’ skills and monitor their responses to academic instruction and intervention. Interventioncentral.org offers a math worksheet generator at no cost that creates randomly generated math curriculum-based measures (M-CBMs). In this study, we examined the test–retest reliability and alternate-form reliability of four parallel, randomly generated M-CBMs designed to assess multiple arithmetic skills (addition, subtraction, multiplication, and division). The participants (N = 283 sixth-grade students) completed each M-CBM worksheet twice during a semester. According to our results, these M-CBMs have moderate test–retest and alternate-form reliability. Applying the Spearman–Brown Prophecy Formula revealed that aggregating M-CBMs increases the reliability of these measures to acceptable levels for progress monitoring (i.e., above .80).