Showing papers on "Psychological intervention published in 1996"

The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory.

Abstract: the total number of papers may exceed 10,000. Nevertheless, cost consideration forced us to consider mostly published papers and technical reports in English. 4 Formula 4 in Seifert (1991) is in error—a multiplier of n, of cell size, is missing in the numerator. 5 Unfortunately, the technique of meta-analysis cannot be applied, at present time, to such effects because the distribution of dis based on a sampling of people, whereas the statistics of techniques such as ARIMA are based on the distribution of a sampling of observations in the time domain regardless of the size of the people sample involved (i.e., there is no way to compare a sample of 100 points in time with a sample of 100 people). That is, a sample of 100 points in time has the same degrees of freedom if it were based on an observation of 1 person or of 1,000 people. 258 KLUGER AND DENISI From the papers we reviewed, only 131 (5%) met the criteria for inclusion. We were concerned that, given the small percentage of usable papers, our conclusions might not fairly represent the larger body of relevant literature. Therefore, we analyzed all the major reasons to reject a paper from the meta-analysis, even though the decision to exclude a paper came at the first identification of a missing inclusion criterion. This analysis showed the presence of review articles, interventions of natural feedback removal, and papers that merely discuss feedback, which in turn suggests that the included studies represent 1015% of the empirical FI literature. However, this analysis also showed that approximately 37% of the papers we considered manipulated feedback without a control group and that 16% reported confounded treatments, that is, roughly two thirds of the empirical FI literature cannot shed light on the question of FI effects on performance—a fact that requires attention from future FI researchers. Of the usable 131 papers (see references with asterisks), 607 effect sizes were extracted. These effects were based on 12,652 participants and 23,663 observations (reflecting multiple observations per participant). The average sample size per effect was 39 participants. The distribution of the effect sizes is presented in Figure 1. The weighted mean (weighted by sample size) of this distribution is 0.41, suggesting that, on average, FI has a moderate positive effect on performance. However, over 38% of the effects were negative (see Figure 1). The weighted variance of this distribution is 0.97, whereas the estimate of the sampling error variance is only 0.09. A potential problem in meta-analyses is a violation of the assumption of independence. Such a violation occurs either when multiple observations are taken from the same study (Rosenthal, 1984) or when several papers are authored by the same person (Wolf, 1986). In the present investigation, there were 91 effects derived from the laboratory experiments reported by Mikulincer (e.g., 1988a, 1988b). This raises the possibility that the average effect size is biased, because his studies manipulated extreme negative FIs and used similar tasks. In fact, the weighted average d in Mikulincer's studies was —0.39; whereas in the remainder of the

Speechless Emissaries: Refugees, Humanitarianism, and Dehistoricization

Abstract: Massive displacements of people due to political violence and oppression and the sight-on television and in newspapers-of refugees as a miserable “sea of humanity” have come to seem more and more common. If these displacements, and media representations of them, appear familiar, so too does the range of humanitarian interventions that is routinely activated by the movement of people. The purpose of this chapter is to explore the forms typically taken by humanitarian interventions that focus on refugees as their object of knowledge, assistance, and management, and to trace the effects of these forms of intervention at several different levels.

The Role of Cost-effectiveness Analysis in Health and Medicine

Abstract: Objective. —To develop consensus-based recommendations guiding the conduct of cost-effectiveness analysis (CEA) to improve the comparability and quality of studies. The recommendations apply to analyses intended to inform the allocation of health care resources across a broad range of conditions and interventions. This article, first in a 3-part series, discusses how this goal affects the conduct and use of analyses. The remaining articles will outline methodological and reporting recommendations, respectively. Participants. —The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, was convened by the US Public Health Service (PHS). Evidence. —The panel reviewed the theoretical foundations of CEA, current practices, and alternative procedures for measuring and assigning values to resource use and health outcomes. Consensus Process. —The panel met 11 times during 21/2 years with PHS staff and methodologists from federal agencies. Working groups brought issues and preliminary recommendations to the full panel for discussion. Draft recommendations were circulated to outside experts and the federal agencies prior to finalization. Conclusions. —The panel's recommendations define a "reference case" costeffectiveness analysis, a standard set of methods to serve as a point of comparison across studies. The reference case analysis is conducted from the societal perspective and accounts for benefits, harms, and costs to all parties. Although CEA does not reflect every element of importance in health care decisions, the information it provides is critical to informing decisions about the allocation of health care resources.

Outcome Measures for Health Education and Other Health Care Interventions

Abstract: Introduction Conceptional Basis for the Chronic Disease Self-Management Study Construction of Measures of Behaviors, Self-Efficacy and Outcomes Tables Appendices Summary and Instructions

Evaluation of psychotherapy. Efficacy, effectiveness, and patient progress.

Abstract: Treatment-focused research is concerned with the establishment of the comparative efficacy and effectiveness of clinical interventions, aggregated over groups of patients. The authors introduce and illustrate a new paradigm-patient-focused research-that is concerned with the monitoring of an individual's progress over the course of treatment and the feedback of this information to the practitioner, supervisor, or case manager.

Measuring patient benefit from otorhinolaryngological surgery and therapy.

Abstract: The Glasgow Benefit Inventory (GBI) is a measure of patient benefit developed especially for otorhinolaryngological (ORL) interventions. Patient benefit is the change in health status resulting from health care intervention. The GBI was developed to be patient-oriented, to be maximally sensitive to ORL interventions, and to provide a common metric to compare benefit across different interventions. The GBI is an 18-item, postintervention questionnaire intended to be given to patients to fill in at home or in the outpatient clinic. In the first part of the paper, five different ORL interventions were retrospectively studied: middle ear surgery to improve hearing, provision of a cochlear implant, middle ear surgery to eradicate ear activity, rhinoplasty, and tonsillectomy. A criterion that was specific to the intervention was selected for each study, so that the patient outcome could be classified as above and below criterion. In all five interventions, the GBI was found to discriminate between above- and below-criterion outcomes. The second part of the paper reports on the results and implications of a factor analysis of patient responses. The factor structure was robust across the study, and so led to the construction of subscales. These subscales yield a profile score that provides information on the different types of patient benefit resulting from ORL interventions. The GBI is sensitive to the different ORL interventions, yet is sufficiently general to enable comparison between each pair of interventions. It provides a profile score, which enables further breakdown of results. As it provides a patient-oriented common metric, it is anticipated that the GBI will assist audit, research, and health policy planning.

Mental health service use in the community and schools: Results from the four-community MECA study

Abstract: Objective To describe the use of mental health and substance abuse services by children and adolescents as reported from the four community sites included in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Method As part of the MECA survey, questions were developed to identify children and adolescents utilizing mental health and substance abuse services. Youths aged 9 through 17 years and a parent/ caretaker were interviewed. Because the investigators had concerns about the capacities of the younger children in the study to describe their use of mental health services, more extensive questions were asked of parents than of youths. Results The procedures developed by the MECA project identified patterns of service use that varied in the four communities surveyed. Agreement between reports of parents and youths regarding the use of mental health and substance abuse services showed substantial Inconsistencies, similar to reports of psychiatric disorders. At three of the four sites, the majority of children meeting criteria for a psychiatric disorder and scoring 60 or less on the Children's Global Assessment Scale reported some mental health–related service in the previous year, although at two of the sites fewer than 25% of these youths were seen in the mental health specialty sector. Conclusion Community surveys show great promise for monitoring the need for mental health and substance abuse services and for identifying patterns of use.

Disability resulting from occupational low back pain. Part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins.

Abstract: This is the second of two papers that systematically review available scientific evidence on the causes of disability from occupational low back pain, and the effectiveness of interventions to prevent it after its onset (secondary prevention). This paper reviews the national history of how back pain and the risk factors for its extension into chronic disability, followed by a critical summary of intervention studies attempting to reduce the duration of this disability, and to evaluate the results.

Psychosocial interventions for patients with coronary artery disease: a meta-analysis.

Abstract: Background: Narrative review strategies and meta-analyses have shown that drug treatment and exercise rehabilitation regimens can reduce psychological distress and postmyocardial infarction mortality and recurrence. Objective: To question whether the addition of psychosocial interventions improves the outcome of a standard rehabilitation regimen for patients with coronary artery disease. Methods: We performed a statistical meta-analysis of 23 randomized controlled trials that evaluated the additional impact of psychosocial treatment of rehabilitation from documented coronary artery disease. Anxiety, depression, biological risk factors, mortality, and recurrence of cardiac events were the clinical end points that were studied. Mortality data were available from 12 studies, and recurrence data were available from 10 of the 23 studies. Results: The studies had evaluated 2024 patients who received psychosocial treatment vs 1156 control subjects. The psychosocially treated patients showed greater reductions in psychological distress, systolic blood pressure, heart rate, and cholesterol level (with effect size differences of 0.34, -0.24, -0.38, and -1.54, respectively). Patients who did not receive psychosocial treatment showed greater mortality and cardiac recurrence rates during the first 2 years of follow-up with log-adjusted odds ratios of 1.70 for mortality (95% confidence interval [CI], 1.09 to 2.64) and 1.84 for recurrence (CI, 1.12 to 2.99). Conclusions: The addition of psychosocial treatments to standard cardiac rehabilitation regimens reduces mortality and morbidity, psychological distress, and some biological risk factors. The benefits were clearly evident during the first 2 years and were weaker thereafter. At the clinical level, it is recommended to include routinely psychosocial treatment components in cardiac rehabilitation. The findings also suggest an urgent need to identify the specific, most effective types of psychosocial interventions via controlled research. (Arch Intern Med. 1996;156:745-752)

Is dental health education effective? A systematic review of current evidence

Abstract: In order that health service resources are allocated in the way which most benefits the population, systematic review of the available evidence regarding the effectiveness of programmes and interventions are required. This study examined papers relating to dental health education interventions, which were published between 1982 and 1994 (n = 143). Each was scored by two independent researchers according to twenty predetermined validity criteria. For each paper which achieved a validity score of more than 12 (n = 37), data concerning the objectives of the intervention, the types and numbers of participants, and the outcomes, were extracted from the article. Where sufficient data were provided in a paper which met more than 15 of the validity criteria quantitative meta-analysis was carried out i.e. the results of the studies were pooled in order to calculate an overall intervention effect with confidence intervals. This combination of qualitative and quantitative review techniques showed that dental health interventions have: a small positive, but temporary effect on plaque accumulation (reduction in plaque index = 0.37 95% CI -0.29-0.59); no discernible effect on caries increment and a consistent positive effect on knowledge levels. The results of this analysis suggest that further efforts to synthesise current information about dental health education, in a systematic way, are required, along with maintenance of rigorous scientific standards in evaluation research.

The health care experience of patients with low literacy.

Abstract: Objectives To understand the difficulties that patients with poor reading ability have interacting with the health care system and to identify the coping mechanisms they use to deal with these problems. Design Focus groups and individual interviews with patients who are illiterate and patients with low literacy. Setting Two large, urban public hospitals. Participants Sixty patients with marginal to poor reading abilities as measured by the Rapid Estimate of Adult Literacy in Medicine were interviewed in focus groups or individual interviews. Measurements and main results Patients with low literacy harbor a deep sense of shame, which is reinforced by hospital staff who become frustrated or angry when someone cannot complete a form or read instructions. Seeking medical care is intimidating for patients with low literacy because they cannot understand signs and registration forms. Many patients recounted serious medication errors resulting from their inability to read labels. To cope with these problems, the patients with low literacy rely heavily on oral explanations, visual clues, and demonstrations of tasks to learn new material. Most also use a friend or family member as a surrogate reader. Conclusions Patients with poor reading ability have important problems accessing the health care system, understanding recommended treatments, and following the instructions of providers. Because of their shame, patients with low literacy may be unwilling to disclose their problem to health care providers, and screening tests of reading ability may be necessary to identify those who need special assistance. Patients' coping mechanisms give insight into possible interventions that may improve their interactions with the health care system.

The costs of asthma

Abstract: At present, asthma represents a substantial burden on health care resources in all countries so far studied. The costs of asthma are largely due to uncontrolled disease, and are likely to rise as its prevalence and severity increase. Costs could be significantly reduced if disease control is improved. A large proportion of the total cost of illness is derived from treating the consequences of poor asthma control-direct costs, such as emergency room use and hospitalizations. Indirect costs, which include time off work or school and early retirement, are incurred when the disease is not fully controlled and becomes severe enough to have an effect on daily life. In addition, quality of life assessments show that asthma has a significant socioeconomic impact, not only on the patients themselves, but on the whole family. Underuse of prescribed therapy, which includes poor compliance, significantly contributes towards the poor control of asthma. The consequences of poor compliance in asthma include increased morbidity and sometimes mortality, and increased health care expenditure. To improve asthma management, international guidelines have been introduced which recommend an increase in the use of prophylactic therapy. The resulting improvements in the control of asthma will reduce the number of hospitalizations associated with asthma, and may ultimately produce a shift within direct costs, with subsequent reductions in indirect costs. In addition, costs may be reduced by improving therapeutic interventions and through effective patient education programmes. This paper reviews current literature on the costs of asthma to assess how effectively money is spent and, by estimating the proportion of the cost attributable to uncontrolled disease, will identify where financial savings might be made.

Caring for relatives with serious mental illness: the development of the Experience of Caregiving Inventory.

Abstract: The aim of this study was to develop a practical, comprehensive, and valid self-report measure of the experience of caring for a relative with a serious mental illness. The notion of caregiver "burden' was rejected; instead caregiving was conceptualised within a 'stress-appraisal-coping' framework. A 66-item version of the Experience of Caregiving Inventory (ECI) was derived from analyses of responses from 626 caregivers, and then tested on an independent sample of 63 relatives of patients with schizophrenia recently in acute care. The extent to which the ECI complied with the stress-coping model was tested, especially the degree to which it, in association with coping, predicted psychological morbidity in carers. Ten sub-scales with good internal consistency resulted from our analyses, eight negative (difficult behaviours; negative symptoms; stigma; problems with services; effects on the family; the need to provide backup; dependency; loss) and two positive (rewarding personal experiences; good aspects of the relationship with the patient). The ECI, in conjunction with coping style, predicted a large proportion of the variance in the General Health Questionnaire (GHQ). We concluded that the ECI taps salient dimensions of caregiving distinct from, although linked with, coping and psychological morbidity. It has potential as a useful outcome measure for interventions aimed at promoting caregiver well-being.

Improving the clinical practice of violence risk assessment. Technology, guidelines, and training.

Abstract: Despite a long history of interest in, and criticism of, the ability of mental health professionals to assess and predict violence, there have been few efforts to develop or evaluate interventions to improve decision making in this area. This article provides a brief overview of recent research developments on violence risk. Drawing on these advances, 3 recommendation are outlined for improving the clinical practice of risk assessment: (a) to improve assessment technology, (b) to develop clinical practice guidelines, and (c) to develop training programs and curricula. Language: en

Dropping out of child psychotherapy: Issues for research and implications for practice.

Abstract: Dropping out of psychotherapy among children and adolescents is a significant problem affecting 40-60 percent of the cases receiving outpatient care. I review research on premature termination from treatment and current issues raised by that work. Our research work on dropping out of treatment among children referred for conduct disorder is highlighted to convey a risk factor and burden-of-treatment model to identify and explain who drops out of treatment and why. Factors that predict dropping out of treatment, the clinical outcomes of children who drop out and influences that moderate the impact of risk factors are discussed. A risk-factor model can aid clinical practice. Those in practice can readily test a variety of factors to determine whether such factors predict premature termination. Once at-risk cases are identified, interventions can be used early in treatment to retain cases. Efforts to establish a therapeutic alliance at the earliest points of contact within families is one such strategy. Some...

Market barriers to energy efficiency: A critical reappraisal of the rationale for public policies to promote energy efficiency

Abstract: This report reviews current perspectives on market barriers to energy efficiency. Ratepayer-funded utility energy-efficiency programs are likely to change in scope, size, and nature as the deregulation process proceeds; the authors research focuses on understanding to what extent some form of future intervention may be warranted and how they might judge the success of particular interventions, especially those funded by ratepayers. They find that challenges to the existence of market barriers have, for the most part, failed to provide a testable alternative explanation for evidence suggesting that there is a substantial ``efficiency gap`` between a consumer`s actual investments in energy efficiency and those that appear to be in the consumer`s own interest. They then suggest that differences of opinion about the appropriateness of public policies stem not from disputes about whether market barriers exist, but from different perceptions of the magnitude of the barriers, and the efficacy and (possibly unintended) consequences of policies designed to overcome them. They conclude that there are compelling justifications for future energy-efficiency policies. Nevertheless, in order to succeed, they must be based on a sound understanding of the market problems they seek to correct and a realistic assessment of their likely efficacy. This understanding can only emerge from detailed investigations of the current operation of individual markets.

Motherhood and mental health

Abstract: 1. The desire for children 2. Pregnancy and mental health 3. A portfolio of postpartum disorders 4. Puerperal psychosis 5. Infant loss 6. The mother-infant relationship 7. Child abuse and neglect 8. Infanticide 9. Drugs, prescribed and abused 10. Postpartum mental illness and the family 11. Services

Telephone Counseling for Smoking Cessation: Effects of Single-Session and Multiple-Session Interventions

Abstract: Smokers (N = 3,030) were randomized to receive 1 of 3 interventions: (a) a self-help quit kit, (b) a quit kit plus 1 telephone counseling session, or (c) a quit kit plus up to 6 telephone counseling sessions, scheduled according to relapse probability. Both counseling groups achieved significantly higher abstinence rates than the self-help group. The rates for having quit for at least 12 months by intention to treat were 5.4% for self-help, 7.5% for single counseling, and 9.9% for multiple counseling. The 12-month continuous abstinence rates for those who made a quit attempt were 14.7% for self-help, 19.8% for single counseling, and 26.7% for multiple counseling. A dose-response relation was observed, as multiple sessions produced significantly higher abstinence rates than a single session. The first week after quitting seems to be the critical period for intervention.

The team climate inventory: Development of the tci and its applications in teambuilding for innovativeness

Abstract: This article describes the development and application of a measure of group processes and climate for innovation–the Team Climate Inventory. It focuses on shared objectives or vision; group participation and safety; team support for innovation; and the group's task orientation. Two case studies of diagnostic interventions, employing the Team Climate Inventory, are described.

Controlling ourselves, controlling our world: Psychology's role in understanding positive and negative consequences of seeking and gaining control.

Abstract: This article begins by examining psychology's contributions to understanding the positive consequences of control for individual mental and physical health. Person-environment control mismatches and the negative personal, interpersonal, and societal consequences of seeking and having control are then discussed. As corrections to mismatches and negative consequences, three methods of analyses are provided. First, definitional and conceptual precision is offered, including a more careful matching of control-related interventions to multidimensional, individual-specific control profiles. Second, therapeutic assessment and interventions are placed within a biopsychosocial model of control. Finally, philosophy of science and paradigmatic issues underlying control theories are highlighted, particularly as they affect psychology's role in examining values toward which control efforts should be directed. These topics are important for people's personal and collective well-being.

Career development for women in academic medicine: Multiple interventions in a department of medicine.

Abstract: Objective. —To determine the gender-based career obstacles for women in an academic department of medicine and to report the interventions to correct such obstacles (resulting from the evaluation) and the results of these interventions. Design. —Intervention study, before-after trial, with assessment of faculty concerns and perceived change through structured, self-administered questionnaires. Setting. —The Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md. Participants. —Full-time faculty. Interventions. —Multifaceted intervention from 1990 through 1995 to correct gender-based career obstacles reported by women faculty, including problem identification, leadership, and education of faculty, and interventions to improve faculty development, mentoring, and rewards and to reduce isolation and structural career impediments. Main Outcome Measures. —Retention and promotion of deserving women faculty, salary equity, quality of mentoring, decreased isolation from information and colleagues, integration of women faculty into the scientific community, and decreased manifestations of gender bias. Results. —Junior women were retained and promoted, reversing previous experience, with a 550% increase in the number of women at the associate professor rank over 5 years (from 4 in 1990 to 26 in 1995). Interim 3-year follow-up showed a 183% increase in the proportion of women faculty who expected they would still be in academic medicine in 10 years (from 23% [7/30] in 1990 to 65% [30/46] in 1993). One half to two thirds of women faculty reported improvements in timeliness of promotions, manifestations of gender bias, access to information needed for faculty development, isolation, and salary equity. Men also reported improvements in these areas. Conclusions. —The outcomes reported here indicate that it is possible to make substantive improvements in the development of women's careers, that an institutional strategy to this end can be successful in retaining women in academic medicine, and that such interventions are likely to benefit all faculty. Long-term interventions appear essential.

Preventing childhood disorders, substance abuse, and delinquency.

Abstract: Outcome studies have shown that treatment does not work if administered too late. Preventing Childhood Disorders, Substance Abuse, and Delinquency presents the newest research on the effectiveness of prevention and early intervention programs with children, from birth to adolescence. The contributors to this volume examine the theory and practice of leading programs designed to prevent social and behavioral problems--including violence and substance abuse--in children and adolescents. The innovative programs analyzed here focus on social skills training for children with conduct disorders, anger coping group work for aggressive children, parent training programs, life skills training for substance abuse prevention, and programs for high-risk youth and rural populations. All designed to intervene before the onset of disorders or to deal effectively with problems when they first appear, many of the programs also emphasize strengthening family, school, and community involvement for successful risk reduction. Clinical psychologists and human services professionals who work with children and youths will find Preventing Childhood Disorders, Substance Abuse, and Delinquency illuminating. This book also will be of interest to policy makers who are looking for more effective and efficient interventions to child and adolescent problems

Modifying beliefs and attitudes to exceeding the speed limit: An intervention study based on the theory of planned behavior

Abstract: This study builds on previous theory of planned behavior (TPB) studies in which we identified the beliefs and values which predict intention to commit driving violations. Four short experimental videos were developed in order to assess the effectiveness of an intervention grounded in the TPB. Three of the videos featured the major constructs of the TPB model. The fourth video featured anticipated regret, an addition to the TPB model which had previously been shown to add significantly to its predictive performance (Parker, Manstead, & Stradling, 1995). Results indicated that two of the videos brought about statistically significant belief changes with respect to scores on TPB items, and significant changes in general attitudes toward speeding. Discussion centers on the problems encountered in operationalizing the TPB constructs and on the potential of theory-based interventions to induce attitude change.

Interventions for Caregivers of Patients with Alzheimer's Disease: A Review and Analysis of Content, Process, and Outcomes

Abstract: Current reviews of the caregiver intervention literature have focused primarily on the outcomes of interventions for caregivers and general methodological limitations of individual studies (i.e., sampling and recruitment issues, adequacy of outcome measures, and generalization issues). Little attention has been paid to the specific factors affecting the therapeutic process, including the intensity and integrity of the interventions used. The purpose of this review is to examine closely the content and process of Alzheimer's disease (AD) caregiver interventions. We describe the types of interventions currently in use, factors affecting intervention outcomes, and we conclude with specific recommendations for the application of intervention technology and for the documentation of intervention research.

Occurrence, recognition, and outcome of psychological disorders in primary care

Abstract: Objective: The authors' goal was to cross-validate the earlier finding of the Groningen Primary Care Study that recognition of psychological disorders was associated with better patient outcomes. Method: The 12-item General Health Questionnaire was used to screen 1,271 consecutive primary care patients. A stratified sample of 340 of these patients participated in the second-stage baseline series of interviews, which included the Composite International Diagnostic Interview, the occupational role section of the Social Disability Schedule, the 28-item General Health Ouestionnaire, and the SCL-90. Three months later 209 of the patients completed the 28-item General Health Questionnaire and the SCL-90, and 12 months later 213 of the patients completed the second-stage baseline series of interviews. The study was carried out in six primary care practices (11 general practitioners) in the northern part of The Netherlands. Results: Recognition of psychological disorders was associated with higher initial severity of psychopathology and occupational disability and with a psychological reason for the medical encounter. Recognition rates were higher for anxiety than for depression. Patients whose psychological disorders were recognized did not have better outcomes than those whose psychological disorders were not recognized. Conclusions: Recognition of psychological disorder was not associated with better outcome. Recognition is a necessary but not a sufficient condition for delivery of treatment according to clinical guidelines. Increasing recognition is likely to improve outcomes only if general practitioners have the skills and resources to deliver adequate interventions.

Applying cognitive-social theory to health-protective behavior: breast self-examination in cancer screening.

Abstract: This article applies recent developments in cognitive-social theory to health-protective behavior, articulating a Cognitive-Social Health Information Processing (C-SHIP) model. This model of the genesis and maintenance of health-protective behavior focuses on the individual's encodings and construals, expectancies, affects, goals and values, self-regulatory competencies, and their interactions with each other and the health-relevant information in the course of cognitive-affective processing. In processing health information, individuals are assumed to differ in both the accessibility of these mental representations and the organization of relationships among them. In this article, the model is applied to analyze and integrate the often-confusing findings on breast self-examination in cancer screening. Implications are considered for assessments and interventions to enhance adherence to complex, long-term, health-protective regimens, tailored to the needs and characteristics of the individual.

Conditions of Successful Third-Party Intervention in Intrastate Conflicts

Abstract: Since the end of the cold war, foreign policy makers appear to be devoting increasing amounts of energy to containing intrastate conflicts. They are doing so, moreover, with little guidance from the social science community. This article uses data on all third-party interventions into intrastate conflicts since 1944 to assess historical patterns of intervention strategies and their relative success rates. Building on this, it uses a logit analysis to develop prescriptive outlines for future intervention attempts. The results demonstrate that it is the characteristics of the intervention strategy rather than the characteristics of the conflict that largely determine the success of the intervention.