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Adherence To Recommendations For Follow-Up To Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Kathryn J. Luchok, Tamra E. Meyer Jun 2007

Adherence To Recommendations For Follow-Up To Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Kathryn J. Luchok, Tamra E. Meyer

CRVAW Faculty Journal Articles

OBJECTIVE: To evaluate whether timely adherence rates differ by race among women with abnormal Pap tests participating in a cost-free or reduced-cost program.

METHODS: Eligible subjects included women aged 47-64 years who received a referral for follow-up care after an abnormal Pap test from 1999 to 2002 in South Carolina (n=330). Adherence was measured as days to receipt of follow-up care after an abnormal Pap test. Cox proportional hazards modeling was used to estimate risk factors associated with time to adherence within 60 and 365 days by race.

RESULTS: African-American and non-Hispanic white women had similar adherence to follow-up. Among …


Commencement Program 2007, Loma Linda University Jun 2007

Commencement Program 2007, Loma Linda University

Commencement Programs

CONTENTS

2 | 2006 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Good Samaritan

6 | The Speakers

13 | The University Honorees

21 | The School Honorees

33 | The Program

  • School of Medicine, 34
  • School of Pharmacy, 45
  • School of Dentistry, 50
  • School of Science and Technology and School of Religion, 60
  • School of Nursing, 68
  • School of Allied Health Professions - Physical Therapy, 75
  • School of Allied Health Professions, 82
  • School of Public Health, 91


Emotional Stroop Effects: Eating Disorders And Obesity, Kristy Anne Kuehfuss Jun 2007

Emotional Stroop Effects: Eating Disorders And Obesity, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

This study addresses the effects of emotional valence on selective processing of body-shape related words in young women who suffer from anorexia, bulimia, or obesity, and non-clinical controls. Research in the area of emotional Stroop interference has indicated that persons with eating disorders, particularly anorectics, show elevated latencies in naming colors of words related to food or body-shape, in contrast to either neutral words, or to non-clinical control groups. One intriguing issue regarding the emotional Stroop interference among various clinical populations relates to the question of whether the interference is due to the emotionality of the relevant words or to …


Female Patients’ Perspectives On The Stages Of Eating Disorder Recovery, Cherish C. Knoll Jun 2007

Female Patients’ Perspectives On The Stages Of Eating Disorder Recovery, Cherish C. Knoll

Loma Linda University Electronic Theses, Dissertations & Projects

Eating disorders are severe psychiatric disorders that most commonly begin in the female population during adolescence and across ethnicity (Lucas, 2004). However, the face of eating disorders is changing as they become more apparent across cultures and lifespan, impacting both young and aging women as well as males. In the past few decades progress has been made in the diagnostic, treatment, and recovery phases of eating disorders. These gains have contributed to a better understanding of eating disorders, assisting in the decrease of mortality and morbidity rates seen in eating disorder patients. Nevertheless, there are significant challenges that still remain …


Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo Jun 2007

Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo

Loma Linda University Electronic Theses, Dissertations & Projects

The study was aimed at determining if cultural beliefs are salient factors contributing to the spread of HIV/AIDS among African born adolescents aged 15 to 19 years living in southern California. We used a cross-sectional design and collected data in two phases. The first phase was qualitative and data were collected from 25 participants in focus groups. The second phase utilized a questionnaire which was developed from the results of the focus group, using the theory of planned behavior. One hundred and thirty-five black African born teenagers between the ages of 15-19 years living in southern California completed the questionnaire. …


A Qualitative Study Of Inpatient Rehabilitation Client Perceptions Of The Semi-Fixed Environment, Liane Hewitt Jun 2007

A Qualitative Study Of Inpatient Rehabilitation Client Perceptions Of The Semi-Fixed Environment, Liane Hewitt

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Literature supports the importance of the environment on promoting or compromising health. However, little is known about how the semi-fixed environment affects client perceptions and recovery from a debilitating condition. The purpose of this study was to investigate beliefs about control within the semi-fixed environment and client perceptions of the rehabilitation process.

Design and Method. This study utilized a basic qualitative research design with 10 rehabilitation clients whose average inpatient length of stay was 14 days. Data were collected in two phases. Phase I included two inpatient visits involving semi-structured interviews on the rehabilitation process and …


Adjusting For Covariates In Studies Of Diagnostic, Screening, Or Prognostic Markers: An Old Concept In A New Setting, Holly Janes, Margaret Pepe May 2007

Adjusting For Covariates In Studies Of Diagnostic, Screening, Or Prognostic Markers: An Old Concept In A New Setting, Holly Janes, Margaret Pepe

UW Biostatistics Working Paper Series

The concept of covariate adjustment is well established in therapeutic and etiologic studies. However, it has received little attention in the growing area of medical research devoted to the development of markers for disease diagnosis, screening, or prognosis, where classification accuracy, rather than association, is of primary interest. In this paper, we demonstrate the need for covariate adjustment in studies of classification accuracy, discuss methods for adjusting for covariates, and distinguish covariate adjustment from several other related but fundamentally different uses for covariates. We draw analogies and contrasts throughout with studies of association.


Post Traumatic Stress Symptoms And Critical Incident Stress Debriefing (Cisd) In Emergency Medical Services (Ems) Personnel., Ginger Lee Woods May 2007

Post Traumatic Stress Symptoms And Critical Incident Stress Debriefing (Cisd) In Emergency Medical Services (Ems) Personnel., Ginger Lee Woods

Electronic Theses and Dissertations

EMS personnel were examined for Post Traumatic Stress symptoms and the usefulness of Critical Incident Stress Debriefing (CISD) using the Los Angeles Symptom Checklist (LASC) and a demographics questionnaire. This study revealed that women in this group show higher PTSD symptoms than male coworkers. Level of Training (LOT) of the EMS provider did not demonstrate a significant difference in whether a provider developed PTSD. EMS personnel receiving debriefing actually suffered greater levels of PTSD than those that did not receive debriefing. And 16% of EMS providers in this study suffered from PTSD, while approximately 20% suffered from partial PTSD or …


Low-Income Minority Mothers’ Reports Of Infant Health Care Utilisation Compared With Medical Records, Kennan D. Murray, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kiely May 2007

Low-Income Minority Mothers’ Reports Of Infant Health Care Utilisation Compared With Medical Records, Kennan D. Murray, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This study aimed to investigate mothers’ reporting of the nature, location, frequency and content of health care visits for their infants, as compared with data abstracted from the infants’ medical records. It was part of a community-based parenting intervention designed to improve preventive health care utilisation among minority mothers in Washington, DC. Mothers 18 years old with newborn infants and with poor or no prenatal care were enrolled in the study. A total of 160 mother–infant dyads completed the 12-month study. Mothers were interviewed when the infants were 4, 8 and 12 months old, and were asked to recall infant …


Health Barriers, Health Perceptions, And Cardiovascular Risk Factors Of Adolescent Black American Males, Desmarie Jackson Decuir May 2007

Health Barriers, Health Perceptions, And Cardiovascular Risk Factors Of Adolescent Black American Males, Desmarie Jackson Decuir

Theses and Dissertations (ETD)

Area of Investigation: Cardiovascular (CV) diseases are the leading cause of death among Black American adult males. Health behaviors that contribute to CV disease are probably learned during adolescence yet few researchers have studied the factors that influence health promotion behaviors in adolescent Black American males. This study described the health barriers, health perceptions (health self-efficacy and health status), and CV risk factors reported by and the influence of these variables on health promotion behaviors of a sample of Black American adolescent males without known CV disease.

Methods and Procedures: A descriptive correlation study design was used to …


Is Mri-Based Volume A Mediator Of The Association Of Cumulative Lead Dose With Cognitive Function?, Brian S. Caffo, Sining Chen, Walter Stewart, Karen Bolla, David Yousem, Christos Davatzikos, Brian S. Schwartz Apr 2007

Is Mri-Based Volume A Mediator Of The Association Of Cumulative Lead Dose With Cognitive Function?, Brian S. Caffo, Sining Chen, Walter Stewart, Karen Bolla, David Yousem, Christos Davatzikos, Brian S. Schwartz

Johns Hopkins University, Dept. of Biostatistics Working Papers

This work considers the pathway through which past occupational lead exposure impacts cognitive function using cross-sectional data. It is motivated by studies linking cumulative lead dose with brain volumes, volumes with cognitive function, and lead dose with cognitive function. It is hypothesized that the brain regions associated with lead mediate a portion of the association between lead dose and cognitive function. The data were derived from an ongoing study of 513 former organolead manufacturing workers. Using MRIs, a novel analysis was performed to investigate Mediation. Volumes associated with cognitive function and lead dose were derived using registered images and used …


Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo Apr 2007

Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: Education and training build community research capacity and have impact on improvements of health outcomes.

Objectives: This manuscript describes the training and educational approaches to building research capacity that were utilized in a community-based participatory research program serving a Puerto Rican population and identifies barriers and strategies for overcoming them.

Methods: A process evaluation identified a multitiered approach to training and education that was critical to reaching the broad community.

Results: This approach included four major categories providing a continuum of education and training opportunities: networking, methods training, on-the-job experience, and community education. Participation in these opportunities supported the …


Bridging The Critical Chasm Between Service And Research: The Cancer Information Service’S Collaboratory, Linda Squiers, Nigel Bush, Robin C. Vanderpool, Ludmila Cofta-Woerpel, Cecilia Fabrizio Apr 2007

Bridging The Critical Chasm Between Service And Research: The Cancer Information Service’S Collaboratory, Linda Squiers, Nigel Bush, Robin C. Vanderpool, Ludmila Cofta-Woerpel, Cecilia Fabrizio

Health, Behavior & Society Faculty Publications

As a collaboratory for cancer communication and education research, the National Cancer Institute's (NCIs) Cancer Information Service (CIS) is in an ideal position to bridge the critical chasm that exists between service and research. This article describes the CIS' current research program as well as the CIS Research Agenda launched in 2005. The CIS' progress in developing and supporting recently funded studies that address this agenda is detailed. The unique resources and opportunities available to researchers, public health practitioners, health care providers, and community-based organizations interested in developing collaborative cancer communication and cancer education studies with the CIS are identified …


A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed Apr 2007

A Case Study Of School Age Female Minority Athletes Who Became Pregnant, Floyd Jones Phd, Jennifer Y. Mak, Phyllis A. Jones Ed

Management Faculty Research

The purpose of this study is to provide an in-depth understanding of ''What had happened to the urban minority female athletes who became pregnant while playing high school basketball?'' The study wanted to provide a qualitative analysis of rich narrative data collected from questionnaire interviews of two separate groups (one in Pittsburgh, the other in New York City). The findings of this study suggest that in fact urban female African-Americans athletes still received benefits from sports participation.


Cost Effectiveness Of Screening Of All Newly Recruited Employees For Diabetes At A Tertiary Care Hospital, Niloufer Sultan Ali, Ali Khan Khuwaja Apr 2007

Cost Effectiveness Of Screening Of All Newly Recruited Employees For Diabetes At A Tertiary Care Hospital, Niloufer Sultan Ali, Ali Khan Khuwaja

Department of Anaesthesia

Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources . However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over …


Modifying And Validating A Quality Of Life Measure To Fit Your Patient Population, Michelle R. Johnson, J Ross Maclean, Rebecca L. Rogers, Donna M. Fick, Andre Kallab Apr 2007

Modifying And Validating A Quality Of Life Measure To Fit Your Patient Population, Michelle R. Johnson, J Ross Maclean, Rebecca L. Rogers, Donna M. Fick, Andre Kallab

Journal of the Georgia Public Health Association

Introduction: A well-developed quality of life (QoL) instrument is valuable in identifying the burden of illness. We were interested in exploring whether existing QoL instruments were suitable for patients in our medical setting and, if not, whether this could be rectified by adapting an existing valid and reliable instrument to meet the specific needs of our patient population. For the purposes of this study, we chose to evaluate the quality of life of patients with breast cancer. Specifically, we were interested in two aspects of QoL in women with breast cancer. The first was whether existing instruments were pertinent to …


Relationship Of Fruit And Vegetable Servings And Self-Reported Diabetics In The Southeast And Northeast, Marylen Rimando, Faye Lopez, Haritha Battula Apr 2007

Relationship Of Fruit And Vegetable Servings And Self-Reported Diabetics In The Southeast And Northeast, Marylen Rimando, Faye Lopez, Haritha Battula

Journal of the Georgia Public Health Association

According to the American Diabetes Association, most diabetic patients are not consuming the recommended 3-5 servings of vegetables and 2-4 servings of fruits a day. This study examined fruit and vegetable servings of self-reported diabetics (N=35,407) in select southeastern and northeastern states using Behavioral Risk Factor Surveillance System (BRFSS) 2005 data. The estimate for both fruit and vegetable servings and self-reported diabetes was determined using multivariate logistic regression, adjusting for sociodemographics and geographic region. The results indicated a significant difference between fruit and vegetable servings for diabetics and non-diabetics (p<0.0001). A higher percentage of diabetics in the northeast consumed more than three servings of fruit and vegetables when compared to diabetics in the southeast. Respondents in the northeast were 21% more likely to consume five or more servings of fruit and vegetables and 16% less likely to be diabetic than those in the southeast after adjusting for age, race, sex, and geographic region. In conclusion, diabetics in the northeast consumed more servings of fruit and vegetables than did those in the southeast. Multiple factors influence fruit and vegetable consumption and diabetes and should be considered when developing targeted nutritional interventions. Diabetes educators, nurses, and physicians can encourage diabetic patients to consume more fruit and vegetables and motivate them to continue eating fruit and vegetables.


Clinicians’ Perception Of Inmates’ Satisfaction With Mental Health Services, Jerry B. Daniel, Wynne S. Korr Apr 2007

Clinicians’ Perception Of Inmates’ Satisfaction With Mental Health Services, Jerry B. Daniel, Wynne S. Korr

Journal of the Georgia Public Health Association

A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate …


Messages Of Maternity: The Relationship Of State And Ngo Institutions To Reproductive Health Services And The Construction Of Family In Jordan, Julia Shatz Apr 2007

Messages Of Maternity: The Relationship Of State And Ngo Institutions To Reproductive Health Services And The Construction Of Family In Jordan, Julia Shatz

Independent Study Project (ISP) Collection

This project examines the ways in which family planning and reproductive health services and the institutions that provide them contribute to constructing definitions of family and motherhood in Jordan. The study is based on personal interviews conducted with representatives at six institutions – the Ministry of Health, the Higher Population Council, the Jordanian Association for Family Planning and Protection, Queen Zein Al Sharaf Institute for Development, the Arab Women’s Organization, and the Jordanian Women’s Union. This paper addresses the issues of family planning as a method of population control, the integrated medical and educational approach currently popular in family planning …


A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith Apr 2007

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …


Food Facilities, Food Service Workers And The Flow Of Food: Food-Borne Illnesses In Taiwan's Preschools, Shu-Chen Lin Mar 2007

Food Facilities, Food Service Workers And The Flow Of Food: Food-Borne Illnesses In Taiwan's Preschools, Shu-Chen Lin

Graduate Student Dissertations, Theses, Capstones, and Portfolios

This study examined food-borne illnesses in Taiwan's preschools which are a major cause of personal distress and preventable death. They are of particular concern in preschools as very young children are highly susceptible to food-borne illnesses. Previous studies that comprehensively investigated the factors impacting food-borne illnesses in Taiwan were not found in the literature. The development of a universal food safety model is necessary as a means to measure relevant constructs. Application of the model should be able to prevent the occurrence of food-borne illnesses in organizations. This explanatory (correlational) study examined the relationships among food facilities, food service workers, …


Patient Advocacy Resource Manual, Jeff Hope Mar 2007

Patient Advocacy Resource Manual, Jeff Hope

Student Organizations

Patient Advocacy began as a freestanding group, formed by medical students who wanted to help homeless men and women with their psychosocial needs, such as finding a job, obtaining health insurance, and joining a drug and alcohol rehabilitation program. Later, we merged with Jeff HOPE to form an organization that can address all of the needs of our patients. This combination of energies and talents has proven quite beneficial, especially because our patients often need services that are beyond the scope of what the Jeff HOPE medical clinic can provide. Thus, one of our most important responsibilities is to link …


Use Of Complementary And Alternative Medicine For Weight Control In The United States, Patricia A. Sharpe, Heidi M. Blanck, Joel E. Williams, Barbara E. Ainsworth, Joan M. Conway Mar 2007

Use Of Complementary And Alternative Medicine For Weight Control In The United States, Patricia A. Sharpe, Heidi M. Blanck, Joel E. Williams, Barbara E. Ainsworth, Joan M. Conway

Faculty Publications

Objectives: The purpose was to assess the prevalence and correlates of complementary and alternative medicine use for weight control.

Design: A list-assisted random-digit-dialed telephone survey of adults was conducted in the fall of 2002 (n = 11,211). The focus of the study was complementary and alternative medicine (CAM) use, other than dietary supplements, in the previous 12 months.

Settings/location: The sample of respondents was drawn from the total noninstitutionalized U.S. adult population residing in telephone-equipped locations.

Subjects: The sampling procedures were designed to obtain adequate representation of Hispanic and non-Hispanic black respondents. Data from the total sample of 11,211 …


Assessing The Unreliability Of The Medical Literature: A Response To "Why Most Published Research Findings Are False", Steven Goodman, Sander Greenland Feb 2007

Assessing The Unreliability Of The Medical Literature: A Response To "Why Most Published Research Findings Are False", Steven Goodman, Sander Greenland

Johns Hopkins University, Dept. of Biostatistics Working Papers

A recent article in this journal (Ioannidis JP (2005) Why most published research findings are false. PLoS Med 2: e124) argued that more than half of published research findings in the medical literature are false. In this commentary, we examine the structure of that argument, and show that it has three basic components:

1)An assumption that the prior probability of most hypotheses explored in medical research is below 50%.

2)Dichotomization of P-values at the 0.05 level and introduction of a “bias” factor (produced by significance-seeking), the combination of which severely weakens the evidence provided by every design.

3)Use of Bayes …


Social Determinants Of Health And Disease Working Together, Amresh Srivastava Feb 2007

Social Determinants Of Health And Disease Working Together, Amresh Srivastava

Psychiatry Presentations

No abstract provided.


Inside Unlv, Diane Russell, Shane Bevell, David Ashley, Lori Bachand, Grace Russell, Mamie Peers Feb 2007

Inside Unlv, Diane Russell, Shane Bevell, David Ashley, Lori Bachand, Grace Russell, Mamie Peers

Inside UNLV

No abstract provided.


Validation Of The Physical Activity Questionnaire For Older Children In Children Of Different Races, Justin B. Moore, John C. Hanes Jr., Paule Barbeau, Bernard Gutin, Roberto P. Treviño, Zenong Yin Feb 2007

Validation Of The Physical Activity Questionnaire For Older Children In Children Of Different Races, Justin B. Moore, John C. Hanes Jr., Paule Barbeau, Bernard Gutin, Roberto P. Treviño, Zenong Yin

Faculty Publications

The Physical Activity Questionnaire for Older Children (PAQ-C) is a validated self-report measure of physical activity widely used to assess physical activity in children (8-14 years of age). To date, however, the instrument has been validated in largely White Canadian samples. The purpose of the present article is to determine the pscyhometric properties of the PAQ-C for African American, European American, and Hispanic children. Two studies were conducted in which independent samples were administered the PAQ-C, along with varying indices of cardiovascular fitness, fatness, and psychological measures related to physical activity. Results showed that the reliability and validity of the …


Family Systems: Perceptions Of Elderly Patients And Their Attendents Presenting At A University Hospital In Karachi, Pakistan, Ahmed Itrat, Ather Mohammed Taqui, Fahd Qazi, Waris Qidwai Feb 2007

Family Systems: Perceptions Of Elderly Patients And Their Attendents Presenting At A University Hospital In Karachi, Pakistan, Ahmed Itrat, Ather Mohammed Taqui, Fahd Qazi, Waris Qidwai

Department of Family Medicine

Objective:

To know the present status of family systems in Pakistan, changes they are undergoing and implications of such trends on health of the elderly population.

Methods:

A cross-sectional study was carried out at the out-patient clinics, AgaKhan University Hospital, using convenience sampling method. Verbal informed consent was taken from the participants. The questions included demographic profile, satisfaction with current family system, opinions about changing trends of family systems, and their implications on health. Analysis was done using SPSS 13.0.

Results:

Four hundred subjects aged 65 and above were interviewed, out of which 226 (56.5%) were living in the …


Convenient Care Clinics: The Future Of Accessible Health Care, Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B. Nash Feb 2007

Convenient Care Clinics: The Future Of Accessible Health Care, Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B. Nash

College of Population Health Faculty Papers

The need for accessible, affordable, quality health care in the United States has never been greater. In response to this need, convenient care clinics (CCCs) are being launched across the country to help provide care to meet the basic health needs of the public. In CCCs, highly qualified health care providers diagnose and treat common health problems, triage patients to the appropriate level of care, advocate for a medical home for all patients, and reduce unnecessary visits to emergency rooms and Urgent Care Clinics. CCCs have been called a "disruptive innovation" because they are consumer driven. They serve as a …


An Administrator's Guide To Implementing Effective Dual Immersion Programs, Melanie Dawn Mcgrath Jan 2007

An Administrator's Guide To Implementing Effective Dual Immersion Programs, Melanie Dawn Mcgrath

Theses Digitization Project

This project fills a void in the area of dual immersion program implementation. Although there are general guidelines that exist, there is a paucity of specific guidelines that explicitly delineate the implementation of these critical components in the current accountability climate. We need to move beyond general categories and tailor them to the unique needs program models within situated contexts.