Timothy D. Nelson

Predictors of Practitioner Self-reported Use of Evidence-Based Practices: Practitioner Training, Clinical Setting, and Attitudes Toward Research

In light of the recent movement toward evidence-based practice (EBP) in mental health services, practitioner adoption of EBPs in clinical settings has emerged as an important area for study. This paper reports on the results of a national online survey of mental health practitioners in an attempt to identify correlates of self-reported EBP use in practice. The survey consisted of 214 mental health practitioners from 15 states drawn from a diverse set of clinical settings and representing a variety of theoretical orientations. The results indicated that practitioner training (i.e., taking a class in EBPs), the perceived openness of the clinical setting toward EBPs, and the practitioner’s attitudes toward treatment research were significant predictors of self-reported EBP use. The relationship between clinical setting and EBP use was partially mediated by attitudes toward treatment research. Negative attitudes toward treatment research partially mediated the relationship between practitioner training and self-reported EBP use. The findings are presented within the context of efforts to increase EBP use in clinical settings and implications for clinical training, treatment research, and EBP dissemination efforts are discussed.

Influences on Practitioner Treatment Selection: Best Research Evidence and Other Considerations

The recent movement toward evidence-based practice in mental health services has highlighted the importance of research evidence in treatment decisions. However, the fact that many treatments with strong research support are not widely used in clinical settings suggests that practitioners’ decisions are not based on research alone but rather are influenced by other considerations. This study examines the relative importance of various considerations on practitioner treatment selection using a national survey of mental health practitioners including doctoral-level psychologists, master’s-level psychologists, and master’s-level clinical social workers (N = 206). Results indicate that practitioners are influenced by a range of considerations including empirical evidence from applied field studies, the perceived flexibility of a treatment, and the appeal of a treatment to colleagues and clients. These findings are discussed within the context of efforts to design, evaluate, and disseminate treatments with research support into clinical settings.

Negative Attitudes Toward Physical Activity: Measurement and Role in Predicting Physical Activity Levels Among Preadolescents

OBJECTIVES To describe the development and validation of a measure of negative attitudes toward physical activity and examine the association between these attitudes and self-reported physical activity among preadolescents. METHOD A school-based sample of 382 fifth and sixth graders (mean age = 10.8) completed measures of attitudes toward physical activity and self-reported physical activity. Body mass index data for the participants was collected as a part of a standard school health assessment. Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were utilized to test the factor structure and predictive value of attitudes toward physical activity. RESULTS Results supported the reliability and concurrent validity of the negative attitudes measure and found a significant association between negative attitudes and physical activity. Negative attitudes was found to be a stronger predictor of physical activity than positive attitudes, which have been the focus of previous research in this area. CONCLUSIONS The results suggest that negative attitudes toward physical activity can be reliably measured and may be an important target for intervention efforts to increase physical activity among children and adolescents.

Pediatric Obesity: Trends and Epidemiology

Pediatric obesity is a prevalent and rapidly increasing problem that poses a serious risk to the health and well-being of the nation’s youths. As epidemiological studies have shed light on the severity of the problem, concern about children’s weight problems has intensified, leading some to refer to pediatric obesity as a new “epidemic” (American Academy of Pediatrics Committee on Nutrition, 2003). In this context, this chapter will provide an overview of the epidemiology of the epidemic as well as a discussion of emerging trends. We will also briefly introduce important topics such as the correlates and consequences of pediatric obesity, prevention, and intervention, all of which will be explored in greater detail throughout the volume.

An Evaluation of a Peer-Based HIV/AIDS Education Program as Implemented in a Suburban High School Setting

ABSTRACT This study presents the results of an evaluation of a peer-based HIV/AIDS education program, the BASE program, as implemented in a suburban high school setting. The participants were 132 high school students who participated in an “AIDS Awareness Day” as a part of the BASE program in their high school. Each student completed preintervention and postintervention measures of HIV knowledge and attitudes toward HIV/AIDS. Results indicated that no significant change in knowledge was observed from preintervention to postintervention. A significant decrease in fear of becoming HIV infected was observed from preintervention to postintervention; however, other attitudes did not change over time. The results suggest limited effectiveness of the program as implemented in changing student knowledge of and attitudes toward HIV/AIDS. The role of fidelity to the original program is highlighted. This study provides relevant data for individuals and organizations who are responsible for selecting and implementing school-based HIV prevention programs, including health educators and health care providers, administrators, and policymakers.