Browsing by Author "Jayawardene, Wasantha"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial
    (JMIR Publications, 2021-01-06) Agley, Jon; Jun, Mikyoung; Eldridge, Lori; Agley, Daniel L.; Xiao, Yunyu; Sussman, Steve; Golzarri-Arroyo, Lilian; Dickinson, Stephanie L.; Jayawardene, Wasantha; Gassman, Ruth; School of Social Work
    Background: Schools increasingly prioritize social-emotional competence and bullying and cyberbullying prevention, so the development of novel, low-cost, and high-yield programs addressing these topics is important. Further, rigorous assessment of interventions prior to widespread dissemination is crucial. Objective: This study assesses the effectiveness and implementation fidelity of the ACT Out! Social Issue Theater program, a 1-hour psychodramatic intervention by professional actors; it also measures students' receptiveness to the intervention. Methods: This study is a 2-arm cluster randomized control trial with 1:1 allocation that randomized either to the ACT Out! intervention or control (treatment as usual) at the classroom level (n=76 classrooms in 12 schools across 5 counties in Indiana, comprised of 1571 students at pretest in fourth, seventh, and tenth grades). The primary outcomes were self-reported social-emotional competence, bullying perpetration, and bullying victimization; the secondary outcomes were receptiveness to the intervention, implementation fidelity (independent observer observation), and prespecified subanalyses of social-emotional competence for seventh- and tenth-grade students. All outcomes were collected at baseline and 2-week posttest, with planned 3-months posttest data collection prevented due to the COVID-19 pandemic. Results: Intervention fidelity was uniformly excellent (>96% adherence), and students were highly receptive to the program. However, trial results did not support the hypothesis that the intervention would increase participants' social-emotional competence. The intervention's impact on bullying was complicated to interpret and included some evidence of small interaction effects (reduced cyberbullying victimization and increased physical bullying perpetration). Additionally, pooled within-group reductions were also observed and discussed but were not appropriate for causal attribution. Conclusions: This study found no superiority for a 1-hour ACT Out! intervention compared to treatment as usual for social-emotional competence or offline bullying, but some evidence of a small effect for cyberbullying. On the basis of these results and the within-group effects, as a next step, we encourage research into whether the ACT Out! intervention may engender a bystander effect not amenable to randomization by classroom. Therefore, we recommend a larger trial of the ACT Out! intervention that focuses specifically on cyberbullying, measures bystander behavior, is randomized by school, and is controlled for extant bullying prevention efforts at each school.
  • Thumbnail Image
    Item
    HIV pre‐exposure prophylaxis uptake by advanced practice nurses: Interplay of agency, community and attitudinal factors
    (Wiley, 2019-11) Jayawardene, Wasantha; Carter, Gregory; Agley, Jon; Meyerson, Beth; Garcia, Justin R.; Miller, Wendy; School of Nursing
    Aims To identify associations among agency, community, personal and attitudinal factors that affect advanced practice nurses’ uptake of HIV pre‐exposure prophylaxis, an intervention consists of emtricitabine/tenofovir once‐daily pill, along with sexual risk reduction education. Design Cross‐sectional. Methods During March‐May 2017, randomly selected Indiana advanced practice nurses were invited to complete an online survey, consisted of several validated self‐rating measures (N = 1,358; response = 32.3%). Final sample (N = 369) was predominantly White, non‐Hispanic, female advanced practice nurses in urban practices (mean age = 46). Conceptual model for structural equation model included 29 original/composite variables and five latent factors. Results Final model consisted of 11 variables and four factors: agency, community, HIV prevention practices (including screening) and motivation to adopt evidence‐based practices overall. Community had direct effects on HIV prevention practices (estimate = 0.28) and agency (estimate = 0.29). Agency had direct effects on HIV prevention practices (estimate = 0.74) and motivation to adopt evidence‐based practices (estimate = 0.24). Community had indirect effects, through agency, on the two remaining factors. Conclusion Barriers exist against pre‐exposure prophylaxis implementation, although practice guidelines are available. HIV prevention practices must be integrated across organizational structures, especially in high‐risk communities, whereas practice change is more effective when focused on changing providers’ attitudes towards intervention. When planning a pre‐exposure prophylaxis intervention, advancing inputs from healthcare professionals, organizational leadership and community members, is crucial to success. Impact In settings where advanced practice nurses are primary contact points for health care, they may be best positioned to have an impact on implementation of HIV risk reduction strategies. Further research is needed to optimize their contributions to pre‐exposure prophylaxis implementation.
  • Thumbnail Image
    Item
    HIV/AIDS and Substance Use Prevention for African American Young Adults: Field Evaluation of “Color it Real”
    (Sage, 2021) Agley, Jon; Xiao, Yunyu; Jayawardene, Wasantha; Gay, Albert; King, Rosemary; Horne, Kelly; Walker, Roland; School of Social Work
    In the United States, African Americans continue to bear a disproportionate amount of risk from HIV and illicit drug use, highlighting the importance of culturally responsive prevention programming. Manualized HIV and substance use prevention curricula that are conceptually African centered are few, and evaluative data of such programs are sparse. This research brief aims to describe a field evaluation of the “Color it Real” (CIR) program, a 6-session, 12-hr HIV and substance use prevention curriculum for African American males and females aged 18 to 24 years. Participants (n = 225) were recruited using convenience sampling from two cities within a high-risk county in Indiana. Attitudes, knowledge, and confidence related to HIV and substance use were assessed before and after the intervention. Wilcoxon and McNemar tests were used to compare pretest and posttest scores, and binary logistic regression models were used to examine sociodemographic associations with outcomes. Among the analytic sample (n = 195), the CIR program was associated with several improved attitudes and increased knowledge related to HIV and substance use, but not with increased confidence in sexual negotiation skills. These findings represent the first published data from CIR since the developers’ original study, and support continued use of the curriculum by our program. Given the positive findings (i.e., attitudes and knowledge) and community receptiveness to CIR, we believe that a randomized, controlled trial of the intervention that includes longitudinal behavioral measurement would be a meaningful addition to prevention research.