Clinic Capacity Management: Planning Treatment Programs that Incorporate Adherence

For infectious diseases like tuberculosis and HIV, treatment adherence plays an important role in treatment effectiveness and epidemic control. Studies of some infectious diseases indicate that patients who live closer to their health facilities maintain higher adherence; however, most models ignore the heterogeneity of patients' adherence. Clinics must balance knowledge about adherence with epidemic growth when creating successful treatment programs. We develop an optimization model that integrates a clinic's capacity decisions with population health outcomes. We find that incorporating adherence into clinic planning models can lead to decisions that significantly improve outcomes. For example, in a realistic case study of the HIV epidemic in Zambia, we find that decision makers who ignore decreasing adherence make suboptimal decisions and overestimate the effectiveness of their treatment programs by as much as 94%. Our model is a first step toward understanding the relationship between adherence and health delivery.     

The Impact of Skinner's Verbal Behavior on Organizational Behavior Management

In the book Verbal Behavior, Skinner provided a comprehensive, behavioral account of language. While the impact of Skinner's analysis on empirical research has been examined broadly, this review of the literature focused on studies relevant to organizational behavior management (OBM). Both empirical and nonempirical journal articles in OBM were analyzed, along with several influential books in the field. The results of this review indicate that the conceptual framework provided in Verbal Behavior has had virtually no impact on empirical research in OBM and very limited impact on conceptual work. Potential reasons for this lack of influence are discussed, and further research on verbal behavior in organizations is encouraged.     

Efficient Estimators for Regressing Regression Coefficients

The Chow test compares regressions developed from two samples from possibly different populations. Its use has traditionally been recommended only when the number of observations in one of the samples does not exceed the number of predictor variables. It is shown that when that condition is not satisfied, the test remains uniformly most powerful (UMP) among a certain class of tests against an important class of alternatives.     

Community Effects on Youth Sexual Activity

Using longitudinal data from the National Survey of Children, we examined the impact of community socioeconomic status on four dimensions of adolescent and young adult premarital sexual activity—the timing of first intercourse, the frequency of intercourse, the number of different sex partners, and the likelihood of engaging in unprotected intercourse. We found significant positive effects of a multiitem index of community socioeconomic disadvantage on all but the timing of first premarital intercourse, net of controls for the socioeconomic and demographic status of adolescents and their families. None of the most commonly cited explanations for neighborhood effects on adolescent behavior can fully explain these associations. Only the attitudes and behaviors of peers account for even a small portion of the observed impact of community disadvantage on youth sexual behavior. Adolescents' acceptance of premarital childbearing, educational aspirations and attachment to school, and parental supervision, although frequently associated with youth sexual behavior, do little to mediate the impact of community disadvantage on sexual activity.