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Collaboration lowers incidence of physical restraint for youth in care

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Michael Nunno and Elliott Smith

Michael Nunno and Elliott Smith

By Sheri Hall for the BCTR

Two BCTR researchers have been working with a Connecticut child welfare agency to implement and evaluate a program that promotes evidence-based approaches in supporting troubled youth. The Cornell researchers and two agency administrators published the results of their collaborative effort in March in the journal Child Welfare under the title “Benefits of embedding research into practice: An agency-university collaboration”.

Since 2009, Michael Nunno and Elliott Smith, members of the research team for the Residential Child Care Project (RCCP), have consulted with Waterford County School in Connecticut, which provides residential and day care to youth with mental health problems, behavioral issues, addiction and emotional problems.

A team of agency executives, clinicians, supervisors and staff members worked with RCCP staff and consultants to learn about and implement the Children and Residential Experiences: Creating Conditions for Change (CARE) program model.  The CARE model is a research-informed framework created at the BCTR by Martha Holden and her RCCP colleagues that focuses on improving interpersonal relationships between caregivers and youth.  Nunno and Smith were part of the effort to examine if CARE was making a difference in the day-to-day life of the children and staff. 

After the school implemented the program, agency administration reported a substantial decrease in physical restraints among the school’s residential population.  Physical restraints are safety interventions that hold a youth in order to contain physical behavior that is likely to result in injury to the youth or others.  They are, however, not without risks to both the child and the staff since they can have harmful or even fatal consequences. 

“The wonderful thing about the Waterford Country School from an evaluator’s perspective is that it has a thirty-year history of collecting and publishing administrative data on measures that matter to practitioners,” Nunno said.  Our job was to portray the data in relevant and meaningful ways so that it could inform practice, soften professional resistance to change, and add to the growing evidence that relationship-based, trauma-informed practice models can create safe and therapeutic physical spaces.”

“By examining the data, we documented a 48 percent decrease in restraint events within Waterford’s residential and shelter settings,” he said. “We were able to verify the staff perceptions and narratives that the Waterford agency was becoming a safer, calmer place.” 

Yet not all Waterford programs saw this decline.  “The day-school data showed an increase in restraints in the corresponding time frame,” Nunno said.  “Although we were all surprised at this finding, our analysis triggered the agency leadership to examine the children’s social and emotional regulation needs.  They involved day-school teachers and children’s families who designed unified approaches to meet those needs.  Within months of implementing these strategies we saw a significant decrease in the use of restraints.”

The partnership between RCCP and the school demonstrates RCCP’s success at monitoring and detecting problems, guiding solutions, improving practice, supporting learning organizations, and contributing more broadly to evidence-based practice. 

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Teen dating violence strong predictor of future abuse

(0) Comments  |   Tags: adolescence,   article,   Deinera Exner-Cortens,   domestic violence,   John Eckenrode,   research,   violence,  
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exner-cortens

Deinera Exner-Cortens

Teens who experience physical or psychological violence in their adolescent dating relationships have a significantly greater risk of suffering abuse in their future adult romantic relationships. A new study, led by University of Calgary, Faculty of Social Work researcher Deinera Exner-Cortens, PhD, has isolated dating violence as a strong predictor that someone will suffer future abuse, even when victimized individuals were compared to others with similar backgrounds but who did not experience dating violence.

Exner-Cortens completed this research as a doctoral student at Cornell, working with John Eckenrode (BCTR associate director and professor of human development), who is also a co-author on the article.

Domestic violence takes a huge toll on the health and well-being of victims and families. Studies have shown that intimate partner violence against women has an estimated societal cost of $5.8 billion. In this light, Exner-Cortens says her study is a wake-up call that adolescent dating violence needs to be taken more seriously.

“When I talk to adolescents, they may not recognize that what they’re experiencing is dating violence,” says Exner-Cortens. “For a lot of them, it's their very first encounter in a romantic setting, so they may not know that it's not healthy. So, from a primary prevention – or stopping it before it starts – standpoint, we want to be communicating healthy relationships messages to adolescents. That you have a right to be safe in your relationship, and if a partner ever makes you feel unsafe or hurts you, that's not okay, and you have a right to leave, and to seek help.”

Exner-Cortens’ study, recently published in the Journal of Adolescent Health, is the first to demonstrate, in a U.S. national sample, that adolescent dating violence is uniquely implicated in a cycle of violence from adolescence to adulthood, even when comparing teens who were matched on key risk factors at the socio-demographic, individual, family, peer, school and community levels.

“For a long time adolescent romantic relationships weren’t a focus in research because people thought that they didn’t really matter for well-being,” explains Exner-Cortens. “This study strongly demonstrates that violence first experienced in adolescent relationships may become chronic, and that adolescent dating violence is an important risk factor for adult partner violence.”

Exner-Cortens and colleagues analyzed a sample of 2,161 American male and female heterosexual youth from the National Longitudinal Study of Adolescent to Adult Health. Participants were first interviewed about their dating experiences when they were ages 12-18, and then again five, and 12 years later. To measure dating violence, participants were asked if a partner had ever used insults, name-calling or disrespect in front of others; sworn at them; threatened them with violence; pushed or shoved them; or thrown objects that could hurt. Over a one-year period, about 19 per cent of teen respondents reported dating violence.

Five years after they were first victimized, female victims of adolescent dating violence had almost 1.5 times greater risk for experiencing physical adult intimate partner violence, and male victims had almost twice the risk for experiencing adult intimate partner violence. Individuals who reported intimate partner violence five years after dating violence victimization were also more likely to report intimate partner violence victimization during the twelve-year follow-up. These findings were all in comparison to a group who did not experience dating violence, but who were otherwise very similar in terms of risk history to dating violence victims. Variables used to create this well-matched comparison group included known predictors of adult intimate partner violence, such as child maltreatment, substance use and mental health.

“This is the first study to show that even when we get rid of many other confounding factors, dating violence still emerges as a predictor,” says Exner-Cortens. “Something is happening in those relationships over and above other things that would predict risk. Dating violence appears to set off some sort of cycle in terms of interpersonal violence.”

Exner-Cortens is calling for improved screening for adolescent dating violence in health-care settings, as well as the need for intervention programs for teens who have experienced abuse in their dating relationships. Programs that prevent adolescent dating violence before it starts are also key to intimate partner violence prevention.

Study co-authors are John Eckenrode (Cornell University), John Bunge (Cornell University) and Emily Rothman (Boston University). The research was supported by funding from the Canadian Institutes of Health Research.

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Two in five African-American women know a prisoner

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news-wildeman-inpostRecent research findings, co-authored by BCTR affiliate and fellow Christopher Wildeman (Policy Analysis & Management), show that on average African-American adults, and women in particular, are more likely to be acquainted with someone who is incarcerated  than whites. Forty-four percent of black women and 32 percent of black men have a family member, neighbor, or acquaintance in prison, compared to 12 percent of white women and 6 percent of white men.

In a Cornell Chronicle article, Wildeman notes,

Our estimates show even deeper racial inequalities in connectedness to prisoners than previous work might have implied. Because imprisonment has negative consequences not only for the men and women who cycle through the system but also for the parents, partners and progeny they leave behind, mass imprisonment’s long-term consequences of racial inequality in the United States might be even greater than any of us working in this area had originally suspected.

These results show further racial inequality wrought by the U.S. prison boom, with potentially harmful consequences to families and communities lacking social supports to raise children and manage households.

The study was led by University of Washington associate professor of sociology Hedwig Lee ’03 and co-authored by Wildeman and was published by Du Bois Review: Social Science Research on Race. The article, Racial Inequalities in Connectedness to Imprisoned Individuals in the United States, is co-authored by Tyler McCormick at the University of Washington and Margaret Hicken at the University of Michigan. The study was unfunded.

Wildeman is co-organizer (with Anna Haskins, Sociology, and Julie Poelhmann-Tynan, University of Wisconsin - Madison) of the 2016 Bronfebrenner Conference, which will examine mass incarceration's effects on children.

 

Study: 2 in 5 African-American women know a prisoner - Cornell Chronicle
Racial inequalities in connectedness to imprisoned individuals in the United States - Du Bois Review

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Linking research to the practice of youth development

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0089_12_082.jpg

Stephen Hamilton

A special issue of the journal Applied Developmental Science explores the application of a truly translational research process to "youth development." The issue is edited by Stephen Hamilton, BCTR associate director for youth development.

From the abstract for the issue:

The articles in this special issue address some of the challenges of strengthening the links between research and the practice of youth development and identify some approaches that have worked well. Youth development emerged from practice rather than from theory or research. Research that is most useful in the practice of youth development honors that primacy both by exploring questions that are important in practice and by engaging practitioners as partners, not merely as consumers.

...

A consistent theme of this issue is that the conventional portrayal of research-practice linkage as uni-directional is both inaccurate and inadequate. Different kinds of research inform different dimensions of practice; practice can and should guide research. Efforts to aid practitioners in accessing, understanding, and using research findings should be accompanied by efforts to aid researchers in posing questions about topics that matter to practitioners, conducting research that comprehends the complexity in which those topics are embedded, honoring practitioner wisdom, and enlarging the circle of those who conduct research.

The issue includes the following articles (BCTR staff in bold):

Stephen F. Hamilton (2015) Linking Research to the Practice of Youth Development, Applied Developmental Science, 19:2, 57-59, DOI: 10.1080/10888691.2015.1030016

Stephen F. Hamilton (2015) Translational Research and Youth Development, Applied Developmental Science, 19:2, 60-73, DOI: 10.1080/10888691.2014.968279

Reed W. Larson, Kathrin C. Walker, Natalie Rusk & Lisa B. Diaz (2015) Understanding Youth Development from the Practitioner's Point of View: A Call for Research on Effective Practice, Applied Developmental Science, 19:2, 74-86, DOI: 10.1080/10888691.2014.972558

Mary Agnes Hamilton & Stephen F. Hamilton (2015) Seeking Social Inventions to Improve the Transition to Adulthood, Applied Developmental Science, 19:2, 87-107, DOI: 10.1080/10888691.2014.975227

Jane Powers, Mary Maley, Amanda Purington, Karen Schantz & Jutta Dotterweich (2015) Implementing Evidence-Based Programs: Lessons Learned From the Field, Applied Developmental Science, 19:2, 108-116, DOI: 10.1080/10888691.2015.1020155

Nicole Yohalem & Vivian Tseng (2015) Commentary: Moving From Practice to Research, and Back, Applied Developmental Science, 19:2, 117-120, DOI: 10.1080/10888691.2014.983033

 

Linking research to the practice of youth development - Applied Developmental Science

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Priorities in addressing elder mistreatment

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"Elder mistreatment is recognized internationally as a prevalent and growing problem, meriting the attention of policymakers, practitioners, and the general public," begins the abstract of an article by lead author Karl Pillemer in a recent special issue of The Gerontologist focusing on the 2015 White House Conference on Aging. The 2015 conference will examine “elder financial exploitation, abuse and neglect” as one of four priority topics. Elder Mistreatment: Priorities for Consideration by the White House Conference on Aging (co-authored by Marie-Therese Connolly, Risa Breckman, Nathan Spreng, and Mark S. Lachs) reviews key issues in the field of elder mistreatment, emphasizes the public health importance of the problem, and proposes three major challenges to be addressed in order to create a comprehensive, coordinated response to elder mistreatment: research, direct services, and policy.

Full abstract:
Elder mistreatment is recognized internationally as a prevalent and growing problem, meriting the attention of policymakers, practitioners, and the general public. Studies have demonstrated that elder mistreatment is sufficiently widespread to be a major public health concern and that it leads to a range of negative physical, psychological, and financial outcomes. This article provides an overview of key issues related to the prevention and treatment of elder mistreatment, focusing on initiatives that can be addressed by the White House Conference on Aging. We review research on the extent of mistreatment and its consequences. We then propose 3 challenges in preventing and treating elder mistreatment that relate to improving research knowledge, creating a comprehensive service system, and developing effective policy. Under each challenge, examples are provided of promising initiatives that can be taken to eliminate mistreatment. To inform the recommendations, we employed recent data from the Elder Justice Roadmap Project, in which 750 stakeholders in the field of elder mistreatment were surveyed regarding research and policy priorities.

Elder mistreatment: Priorities for consideration by the White House Conference on Aging - The Gerontologist

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Strengthening 4-H by analyzing enrollment data

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Stephen Hamilton

The June issue of the Journal of Extension includes an article co-authored by Stephen Hamilton (BCTR Associate Director for Youth Development) with Angela Northern (4-H Research Specialist, Erie County) and Robbie Neff (student). Strengthening 4-H by analyzing enrollment data examines findings with the aim of understanding trends in enrollment and dropout rates. Beginning during a summer internship Neff developed and refined a process using Excel to analyze 4-H enrollment data, then progressively simplified the process and built a graphic interface that enables county staff with no statistical expertise to query the data and present findings. Neff has been working with Minnesota 4-H to adapt his tool to their system and has received inquires from other states. Work will continue this coming year to get this process into use and adapt it to the new 4-H data collection system.

Abstract:
The study reported here used data from the ACCESS 4-H Enrollment System to gain insight into strengthening New York State's 4-H programming. Member enrollment lists from 2009 to 2012 were analyzed using Microsoft Excel to determine trends and dropout rates. The descriptive data indicate declining 4-H enrollment in recent years and peak enrollment at grade 5. New members are more likely to drop out than members who have been involved for more than a year. New members who are high school students drop out at the highest rate. Returning members who are high school students drop out at the lowest rate.

 

Strengthening 4-H by analyzing enrollment data

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New article: “Grandparent Coresidence and Family Well-Being”

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Rachel Dunifon and Kimberly Kopko

Rachel Dunifon and Kimberly Kopko

The BCTR's Rachel Dunifon and Kimberly Kopko (with Kathleen Ziol-Guest) authored a new article that looks at the effects of grandparents living with families. Grandparent Coresidence and Family Well-Being was published in The ANNALS of the American Academy of Political and Social Science this summer.

Abstract:
U.S. children today have increasingly diverse living arrangements. In 2012, 10 percent of children lived with at least one grandparent; 8 percent lived in three-generational households, consisting of a parent and a grandparent; while 2 percent lived with a grandparent and no parent in the household. This article reviews the literature on grandparent coresidence and presents new research on children coresiding with grandparents in modern families. Findings suggest that grandparent coresidence is quite common and that its prevalence increased during the Great Recession. Additionally, these living arrangements are diverse themselves, varying by the marital status of the parent, the home in which the family lives, and the economic well-being of the family. Suggestions for future research are also proposed.

Grandparent Coresidence and Family Well-Being

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Overcoming older African Americans’ reluctance to participate as research subjects

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Myra Sabir, Assistant Professor of Human DevelopmentMyra Sabir, former Bronfenbrenner Life Course Center postdoctoral fellow and assistant director, is the primary author of a recent article in The Journal of Aging Studies on the difficulties of recruiting older African Americans as research subjects. The BCTR's Karl Pillemer is co-author.

The paper's abstract:

Well-known trust-building methods are routinely used to recruit and retain older African Americans into scientific research studies, yet the quandary over how to overcome this group's hesitance to participate in research remains. We present two innovative and testable methods for resolving the dilemma around increasing older African Americans' participation in scientific research studies. Certain specific and meaningful experiential similarities between the primary researcher and the participants, as well as clear recognition of the elders' worth and dignity, improved older African Americans' willingness to adhere to a rigorous research design. Steps taken in an intervention study produced a potentially replicable strategy for achieving strong results in recruitment, retention and engagement of this population over three waves of assessment. Sixty-two (n = 62) older African Americans were randomized to treatment and control conditions of a reminiscence intervention. Sensitivity to an African American cultural form of respect for elders (recognition of worth and dignity), and intersections between the lived experience of the researcher and participants helped dispel this population's well-documented distrust of scientific research. Results suggest that intentional efforts to honor the worth and dignity of elders through high level hospitality and highlighting meaningful experiential similarities between the researcher and the participants can improve recruitment and retention results. Experiential similarities, in particular, may prove more useful to recruitment and retention than structural similarities such as age, race, or gender, which may not in themselves result in the trust experiential similarities elicit.

An intensely sympathetic awareness: Experiential similarity and cultural norms as means for gaining older African Americans' trust of scientific research - Journal of Aging Studies

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New study finds that exercise gives cancer survivors a sense of control

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The BCTR's Mary Maley is lead author on a new article in the Journal of Education Nutrition and Behavior: A Second Chance: Meanings of Body Weight, Diet and Physical Activity to Women Who Have Experienced Cancer. The article, co-authored by BCTR faculty affiliate Carol Devine, outlines how exercise creates empowering experiences for women recovering from cancer, while considering their diet can be stressful.

Mary Maley is an Extension Associate with the BCTR, working with both the BCTR Research Synthesis Project and the ACT for Youth Center of Excellence. Mary’s research and extension interests focus on connecting research and evaluation to practice and policy-making to promote public health and well-being. Previously, Mary worked with the Program on Breast Cancer and Environmental Risk Factors (BCERF) in the Sprecher Institute for Comparative Cancer Research at Cornell, with a focus on building community capacity to address obesity prevention for breast cancer risk reduction using an ecological approach.

For cancer survivors, diet distresses while exercise inspires - Cornell Chronicle

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Whitlock study finds that self-injury in young adults indicates suicide risk

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A paper published by the Journal of Adolescent Health on December 4th reports the findings of a longitudinal study on non-suicidal self-injury (NSSI) led by BCTR and Human Development researcher Dr. Janis Whitlock. In a Cornell Chronicle article on the study, Dr. Whitlock describes the findings:

While we can't conclude that self-injury leads to later suicide attempts, it is a red flag that someone is distressed and is at greater risk. This is important because self-injury is a relatively new behavior that does not show up much in the literature as a risk factor for suicide. It also suggests that if someone with self-injury history becomes suicidal, having engaged in NSSI may make it much easier to carry out the physical actions needed to lethally damage the body.

BCTR co-authors on the paper include BCTR director John Eckenrode, and Amanda Purington, project coordinator for the Cornell Research Program on Self-Injurious Behavior.

Nonsuicidal Self-injury as a Gateway to Suicide in Young Adults

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