Joseph Day

Effects of the Positive Action programme on problem behaviours in elementary school students: A matched-pair randomised control trial in Chicago

This study examined the effects of the Positive Action (PA) programme in Chicago Public Schools on problem behaviours among a cohort of elementary school students from grade three through grade five. Using a matched-pair, randomised control design with 14 elementary schools, approximately 510 fifth-graders self-reported lifetime substance use, serious violence-related behaviour, and current bullying and disruptive behaviours. Three-level (i.e. students nested within schools within school pairs) overdispersed Poisson models were used to examine programme effects on the number of items endorsed for each of the four outcomes. Findings indicated that students in the intervention endorsed 31% fewer substance use behaviours (incidence rate ratio [IRR] = 0.69), 37% fewer violence-related behaviours (IRR = 0.63) and 41% fewer bullying behaviours (IRR = 0.59), respectively, compared to students in the control schools. Reduction in reported disruptive behaviours was of a similar magnitude (27%, IRR = 0.73), but was not statistically significant. These results replicate findings of an earlier randomised trial of the PA programme and extend evidence of its effectiveness to youth attending large urban school systems.

Using Social-Emotional and Character Development to Improve Academic Outcomes: A Matched-Pair, Cluster-Randomized Controlled Trial in Low-Income, Urban Schools

BACKGROUND School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. METHODS The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. RESULTS PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. CONCLUSIONS A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes.

Medical assistant coaching to support diabetes self-care among low-income racial/ethnic minority populations: randomized controlled trial.

Innovative, culturally tailored strategies are needed to extend diabetes education and support efforts in lower-resourced primary care practices serving racial/ethnic minority groups. A randomized controlled trial (RCT) examined the effect of a diabetes self-care coaching intervention delivered by medical assistants and the joint effect of intervention and ethnicity over time. The randomized repeated-measures design included 270 low-income African American and Hispanic/Latino patients with type 2 diabetes. The 1-year clinic- and telephone-based medical assistant coaching intervention was culturally tailored and guided by theoretical frameworks. A1C was obtained, and a self-care measure was completed at baseline, 6 months, and 12 months. Data were analyzed using mixed-effects models with and without adjustment for covariates. There was a significant overall improvement in mean self-care scores across time, but no intervention effect. Results revealed differences in self-care patterns across racial/ethnic subgroups. No differences were found for A1C levels across time or group.

Effects of the Positive Action Program on Indicators of Positive Youth Development Among Urban Youth

This study evaluated effects of Positive Action, a school-based social-emotional and character development intervention, on indicators of positive youth development (PYD) among a sample of low-income, ethnic minority youth attending 14 urban schools. The study used a matched-pair, cluster-randomized controlled design at the school level. A multiple-measure self-report protocol assessed four key strengths and resources for PYD: self-concept, peer affiliations, ethics, and social skills. Students (n = 1170) were assessed from grades 3 to 8; the duration of the intervention, with drop-outs and late entrants was included in analyses. Growth curve analyses revealed evidence of favorable program effects on each of the four types of resources. The study contributes to PYD research by providing evidence for school-based interventions in low-income, urban contexts for ethnic minority youth.

Using the Community Readiness Model as an Approach to Formative Evaluation

This article presents an adapted version of an established model for assessing community readiness along with an illustrative case example from the evaluation of Positive Action, a school-based social and character development intervention, implemented as part of a randomized controlled trial in Chicago Public Schools from 2004 through 2010. Community readiness is an emerging assessment approach that can be used to gauge the level of understanding, desire, and ownership that community members have regarding a community problem and/or intervention. This approach is useful in engaging the community and leveraging particular aspects of readiness that the community may exhibit in order to maximize an intervention’s successful implementation. The article concludes with a discussion of ways in which a community readiness model may be useful in health promotion practice, both in schools and in other community settings.

Internal droplet circulation induced by surface-driven rotation

Abstract This paper presents a combined theoretical/experimental study of internal liquid circulation induced by droplet surface rotation. A numerical model is presented first, examining the fluid transport within a spherical liquid volume whose surface is subjected to rotation about a central axis. The model predicts that the steady-state motion established from spatially nonuniform surface rotation has a helical character and bears little resemblance to the toroidal internal flows developed within droplets under axisymmetric conditions. Similar internal flow patterns are predicted for temporally varying surface rotation occuring during droplet spin-up or spin-down. Planar laser-induced fluorescence is employed to provide high-resolution images of fluid flow developed within millimeter-sized suspended droplets that are exposed to steady laminar air streams to induce repeatable surface rotation. The predicted spiral flow patterns are corroborated by the pendant droplet visualization experiments, and suggest that nonuniform rotation or transient spinning may significantly alter interenal droplet dynamics.

Effects of a School-Based Social-Emotional and Character Development Program on Self-Esteem Levels and Processes: A Cluster-Randomized Controlled Trial:

This study evaluated effects of Positive Action (PA), a school-based social-emotional and character development program, on self-esteem levels and processes among minority, low-income, urban youth. A matched-pair, cluster-randomized controlled trial was conducted in 14 Chicago Public Schools with outcomes assessed longitudinally for a cohort of youth followed from Grades 3 to 8. A total of 1,170 students participated in the study (53% female, 48% African American, and 27% Hispanic). Students in PA schools had more favorable change and endpoint scores on indices of self-esteem in the domains of peer and school and use of both adaptive and (to a lesser extent) maladaptive processes for developing and maintaining self-esteem. These results align with areas of emphasis within the PA program and illustrate how important areas of impact on self-esteem-related outcomes may be overlooked without differentiated assessments of both self-esteem levels and processes.

Meeting the Challenges of Longitudinal Cluster-Based Trials in Schools: Lessons From the Chicago Trial of Positive Action

We describe challenges in the 6-year longitudinal cluster randomized controlled trial (CRCT) of Positive Action (PA), a social–emotional and character development (SECD) program, conducted in 14 low-income, urban Chicago Public Schools. Challenges pertained to logistics of study planning (school recruitment, retention of schools during the trial, consent rates, assessment of student outcomes, and confidentiality), study design (randomization of a small number of schools), fidelity (implementation of PA and control condition activities), and evaluation (restricted range of outcomes, measurement invariance, statistical power, student mobility, and moderators of program effects). Strategies used to address the challenges within each of these areas are discussed. Incorporation of lessons learned from this study may help to improve future evaluations of longitudinal CRCTs, especially those that involve evaluation of school-based interventions for minority populations and urban areas.