The Brookline Early Education Project (BEEP): A Comprehensive Birth-to-Kindergarten Program for Children and Their Parents

Investigators: Donald E. Pierson, PhD, Robert I. Sperber, Martha B. Bronson, EdD & Mary-Jane Yurchak, EdD

The Brookline Early Education Project (BEEP) is a comprehensive birth-to-kindergarten program that combines child education and health monitoring services with parent education and support. BEEP utilizes a family-oriented approach designed to reduce learning and adjustment difficulties in school. BEEP consists of three components: 1) Parent Education and Support Program, 2) Child Education Program, and 3) Health and Development Monitoring. The Parent Education and Support Program provides home visits to families, parent discussion groups, a book and toy lending library, and social events. The Child Education Program consists of weekly playgroup sessions and daily prekindergarten classes. Finally, the Health and Development Monitoring program provides nine health and developmental screening exams for children beginning from two weeks of age through age 5. Evaluations of the BEEP program demonstrated higher school functioning in kindergarten and the second grade compared to age-matched peers. At early adulthood, benefits for BEEP participants compared to peers included higher educational attainment, higher income, and more positive health indicators. Click here to view more detailed information on this program.

The Coping Bear: Group and Individual Cognitive-Behavioral Therapy for Children with Anxiety Disorders and their Parents

Investigators: Katharina Manassis, MD & Sandra L. Mendlowitz, PhD

The Coping Bear is an intervention with parental involvement for children with: social phobia, depression, simple phobia, panic disorder, generalized anxiety disorder, and/or separation anxiety disorder. The treatment program utilizes a group process problem-solving approach with the overall goals of: 1) teaching children to recognize their emotional distress, and to learn and practice new coping skills; and 2) facilitating the generalization of these coping skills by involving parents in the treatment process. The program can be implemented in both individual and group settings and includes systematic desensitization techniques, reinforcement principles, approaches to resistant behavior, aids to exposure to anxiety-provoking situations, and relaxation techniques. Two separate randomized clinical trials evaluated the therapeutic efficacy of this program. In the 1999 study, participants were randomly assigned to a child only therapy group (no parental involvement), parent only group (no child involvement), or child and parent group (separate groups of children and parents run concurrently), or a wait list control condition. Less anxiety and depression were reported post-treatment by all children. Children who were treated with their parents used more active coping strategies than children in the other treatment groups. In the 2002 study, participants were randomly assigned to either separate individual therapy sessions for child and for parent, or concurrent child-only and parent-only groups. Assessments pre- and post-treatment showed that regardless of treatment setting, children and mothers reported decreased anxiety and improved global functioning post treatment. In addition, children with high social anxiety had more improvement in an individual treatment setting than in a group setting. Click here to view more detailed information on this program.

The Coping Course for Juvenile Corrections

Investigators: Paul Rohde, PhD, Jenel Jorgensen, MA, John Seeley, PhD, David Mace, ED

THE COPING COURSE utilizes cognitive-behavioral therapy to treat incarcerated youth in closed-custody juvenile facilities. The aims of this intervention are: improving behavior within the facility; reducing negative emotions, including depression, anger, frustration, boredom, sadness, and fear; and enhancing general coping and problem solving skills. THE COPING COURSE consists of 16 group treatment sessions occurring twice a week over 8 weeks. The program uses handouts, structured learning tasks, short quizzes, and homework assignments to teach the following skills in a group treatment setting: social skills, relaxation techniques, identifying and increasing fun activities, changing negative thinking, communication and problem-solving skills, and developing a Life Plan and long term goals. Click here to view more detailed information on this program.

The Future is Ours (FIO)

Investigators: Anke A. Ehrhardt, Heidi Arner, Pam Farquhar, Laura Frye, Jeff Natt, Inez Sieben, Imelda Walavalkar, Susie Hoffman, Jessica Adams-Skinner, & Teresa Exner

The Future Is Ours (FIO) is an eight-session HIV prevention intervention delivered to high-risk heterosexual women in a group setting. FIO is guided by three major theories, Modified AIDS Risk Reduction Model (MARRM), Social Learning Theory, and Gender Theory. The goal of FIO is to empower women to reduce unsafe sexual encounters by increasing the use of male and female condoms and alternate protection strategies including sex without penetration, getting tested for HIV jointly with a partner along with mutual monogamy and a safety agreement, deciding to be celibate, and refusing unsafe sex or deciding to not get involved with a partner who will not use condoms. FIO is a gender-specific HIV/STD risk reduction intervention designed for heterosexually active, at-risk women of diverse ethnicities (African-American/Black, Caribbean, Latina, White), ages 18 to 30, who are not injection drug users, are HIV-negative or of unknown status, are not pregnant or trying to become pregnant, and who live in communities where rates of HIV and other STDs are high.

The SISTA Project

Investigators: Ralph DiClemente & Gina Wingood

SISTA, a gender-relevant, culturally sensitive group program for African-American women, is designed to be implemented in a community setting. Based on social cognitive theory and the theory of gender and power, SISTA seeks to prevent HIV transmission by promoting consistent condom use. Peer Health Educators lead five two-hour sessions, focusing first on ethnic and gender pride, then moving on to provide knowledge about HIV/AIDS and skills training to promote sexual safety. Each session employs group discussion, lecture, role play activities and written homework to increase retention of risk reduction strategies. Click here to view more detailed information on this program.

Trauma Focused Coping: Group Cognitive-Behavioral Therapy for Children and Adolescents with Post-Traumatic Stress Disorder after Single-Incident Trauma

Investigators: John S. March, MD, MPH & Lisa Amaya-Jackson, MD, MPH

Trauma Focused Coping (TFC) is a group cognitive behavioral therapy treatment program for children and adolescents with post traumatic stress disorder (PTSD) and collateral symptoms of depression, anxiety, anger, and external locus of control originating from single-incident trauma. Based on social learning theory, TFC uses a group skills-oriented cognitive behavioral therapy (CBT) approach and involves 14 weekly sessions in which the first few sessions lay the groundwork for the child to think differently about PTSD. The treatment model is one of graded exposure, and begins with psychoeducation and cognitive therapy before moving to more exposure-based activities. TFC has two overall goals: 1) to help the child organize an accurate trauma narrative that places the trauma in the past and is without cognitive distortions, and 2) to promote behavior consistent with the view that the world is no longer dangerous when threat is truly absent. Each child completes a narrative Chapter Book that tells his or her story, including an accurate telling of the trauma history, its effects on the child's life, and successes in overcoming that history so that the child can live as comfortably as possible in the present. Session components include: psychoeducation, cognitive therapy, exposure-based behavior therapy, generalization training, and relapse prevention. TFC also offers developmentally appropriate treatment adaptations for elementary school-age children and junior high school adolescents including therapeutic modalities such as storybooks, narrative exposure, cognitive games, and peer modeling. Click here to view more detailed information on this program.

Turning Point

Investigators: Russel S. Falck, Robert G. Carlson, & Harvey A. Siegal

Turning Point includes two separate interventions designed to reduce the frequency and probability of injection-risk behavior among IDUs not participating in drug abuse treatment programs. The basic intervention consists of two sessions. In the first session, participants undergo HIV antibody tests and receive pre-test counseling. In the second session, a counselor-educator provides detailed information about HIV and HIV transmission and guides the participant group through activities intended to teach behavioral strategies for avoiding exposure to HIV. Participants in the enhanced intervention complete the basic intervention and attend three additional sessions, in which they address HIV/AIDS pathology, drug addiction, and safer sex practices. Both interventions employ videotape presentations, role-play, hands-on demonstrations, and print materials. The enhanced intervention also employs slide presentations, self-assessment tests, and lecture/discussion. The program's effectiveness was evaluated in Dayton and Columbus, OH. Participants were randomly assigned to one of the two interventions. Surveys were administered to both groups at enrollment and six months after the intervention. A majority of participants in both the standard and enhanced interventions reported safer needle practices at follow-up. Although no difference in needle risk was observed between intervention groups when all subjects were included in analyses, participants in the enhanced intervention who reported unsafe needle practices at enrollment were significantly more likely to report safer needle practices at follow-up than similar participants in the standard intervention (Siegal, Falck, Carlson and Wang, 1995). Click here to view more detailed information on this program.

Voluntary Counseling and Testing for Female Sex Workers (VCT Program)

Investigators: Xiaoming Li, PhD, Bo Wang, PhD, Xiaoyi Fang, PhD, Ran Zhao, MD, Bonita Stanton,MD, Yan Hong, MA, Baiqing Dong, MD, Wei Liu, MD, Yuejiao Zhou, MD, Shaoling Liang, MD, & Hongmei Yang, PhD

The VCT Program aims to increase STI/HIV testing, awareness of infection, STI/HIV knowledge, and consistent use of condoms among female sex workers in China in order to ultimately reduce rates of STI infections. The VCT Program demonstrated increases in knowledge of STI/HIV knowledge and consistent condom use, and decreases in STI incidence. The VCT Program is composed of a pre-test counseling session, STI/HIV testing, and a post-test counseling session. During the first 25-minute VCT counseling session, the counselor works with the participant to: complete a risk assessment; identify challenges related to risk reduction; create a risk reduction plan; and practice condom use skills. After the first counseling session, the participant completes STI/HIV testing. During the 20-minute post-test counseling session, the counselor shares test results and reviews treatment options and risk reduction plans. The VCT Program was originally implemented in a suburban area of Nanning in southern China with female sex workers recruited from entertainment establishments. This program's voluntary counseling and testing content and approach may be useful in increasing testing and safer sex behaviors in many different types of communities and populations. Click here to view more detailed information on this program.

WILLOW: HIV Transmission Reduction Among Women Living with HIV

Investigators: Wingood, GM, DiClemente, RJ, MikHail, I, Lang, DL, Hubbard McCree, D, Davies, SL, Hardin, JW, Hook, EW & Saag, M

Traditional methods of preventing the transmission of STIs and HIV/AIDS focus on decreasing risk behaviors while increasing condom usage among individuals who are HIV negative. Included in those methods are individual counseling and group interventions. Few risk reduction interventions are developed specifically for women who have tested positive for HIV, despite data that indicate that a growing number of women acquired their infections through heterosexual contact. WILLOW was designed as a group intervention for African American women. The intervention incorporates elements of sexual risk reduction and social networking to reduce STI/HIV sexual transmission and to enhance psychosocial mediators and structural factors associated with preventive behaviors over a one-year period. The evaluation of WILLOW was a randomized controlled study including 366 women who were assigned to either the intervention (n=190) or comparison (n=176) conditions. Criteria for eligibility included: HIV+ serostatus; aged 18-50; and sexually active during the past six months. Following a baseline assessment, women were randomly assigned to one of two conditions. Follow-up assessments were conducted at six and twelve months post intervention. Over the 12-month follow-up period, women in the intervention group, as compared to their comparison group counterparts, reported fewer incidents of unprotected vaginal intercourse (1.8 vs. 2.5; P=0.022); were less likely to report never using condoms (OR=0.27; P=0.008); had a lower rate of bacterial infections (OR=0.19, P=0.006); reported greater HIV knowledge and condom use self-efficacy, more network members, fewer beliefs that condoms interfere with sex, and fewer partner-related barriers to condom use; and demonstrated greater skill in using condoms. Click here to view more detailed information on this program.

Wise Guys: A Male-Oriented Teen Pregnancy Prevention Program

Investigators: Children's Home Society of NC

The Wise Guys program is designed to prevent adolescent pregnancy by teaching adolescent males self-responsibility in the areas of sexual development, decision-making, and relationships. The Wise Guys program is a weekly, 10-session group intervention for adolescent males that is delivered by a staff educator. Each session is approximately 45 to 60 minutes long. The program may be offered in a variety of settings including, but not limited to, school athletic programs, faith-based institutions, juvenile detention center, and other community sites. The program is available only as a shipped hard copy package. The Wise Guys program covers a broad range of topics including: masculinity, communication, relationships, dating violence, fatherhood, values, goal setting, decision making, sexuality, sexually transmitted infections, contraception, and abstinence. Participatory lessons and activities focus on assisting youth to identify their long-range personal and career goals so that they can use those goals to direct the decisions they make throughout adolescence. Wise Guys has been demonstrated to effectively improve adolescent males' knowledge of sexual behavior and reproductive behavior, and their knowledge of STI transmission, and to instill desirable attitudes toward sex and appropriate behavior in sexual relationships. The Wise Guys evaluation found: - Participants had significantly higher scores than controls at both posttest and follow-up (p = .007) on general knowledge of sexual behavior and reproductive biology. - Participants had significantly higher scores than controls at both posttest and follow-up (p = .000) on knowledge of STI transmission. - Scores for participants were higher than those of controls at all 3 data points, but were significantly higher at posttest and follow-up (p = .013) on attitudes toward sex and appropriate behavior in sexual relationships. - Regression analyses confirmed that participation in Wise Guys was significantly associated with higher posttest and follow-up general knowledge, STI knowledge, and desirable attitude scores, independent of age, grade, race, or pretest scores. - To assess the relative importance of participation in the Wise Guys program for predicting every time contraception at 6-month follow-up, regression analyses were done using age, grade, race, and participation in Wise Guys as the independent variables. The strongest and only statistically significant predictor of contraception use "every time" was participation in the Wise Guys curriculum. Click here to view more detailed information on this program.