Goal-oriented evaluation for program planning: A case study

Utilizing a contextual model of evaluation, a goal-oriented method was applied to the Health Psychology program, a doctoral program in its early stages at the University of California, San Francisco. There were five stages involved in implementing this method: (1) clarification of the goals and objectives of the program, (2) prioritizing the objectives, (3) judging the attainment of the objectives, (4) organization of faculty/student input, and (5) feedback to the program management. All faculty members and students were invited to participate as selfevaluators in this evaluation effort. The results indicated that there were significant differences between the faculty group and the student group on their ranking and rating of the importance of specific educational and resource objectives. A one year follow-up was obtained by interviewing the director of the program to assess the impact of the project on program planning. The advantages and disadvantages of the approach were discussed in light of this attempt to analyze a new educational program.     

Treating and Drinking Well Water in the Presence of Health Risks from Arsenic Contamination: Results from a U.S. Hot Spot

The Safe Drinking Water Act of 1974 regulates water quality in public drinking water supply systems but does not pertain to private domestic wells, often found in rural areas throughout the country. The recent decision to tighten the drinking water standard for arsenic from 50 parts per billion (ppb) to 10 ppb may therefore affect some households in rural communities, but may not directly reduce health risks for those on private wells. The article reports results from a survey conducted in a U.S. arsenic hot spot, the rural area of Churchill County, Nevada. This area has elevated levels of arsenic in groundwater. We find that a significant proportion of households on private wells are consuming drinking water with arsenic levels that pose a health risk. The decision to treat tap water for those on private wells in this area is modeled, and the predicted probability of treatment is used to help explain drinking water consumption. This probability represents behaviors relating to the household's perception of risk.     

Using the ICF as a conceptual framework to guide ergonomic intervention in occupational rehabilitation

Traditional treatment of work-related musculoskeletal disorders focuses on the body functions and body structures aspects of the injury, with little or no attention paid to ergonomics as a form of treatment. The use of ergonomics in preventing disability in injured workers is a relatively new area of study. There are a number of factors that may contribute to the lack of emphasis on ergonomic interventions in the prevention of disability following musculoskeletal injury. For instance, a review of the knowledge base suggests that there is a lack of a formal conceptualization or standardized approach to ergonomics in the return to work process. In part, this lack of consistency may be due to the varied disciplinary backgrounds of ergonomists, leading individuals to view ergonomics from a specific perspective, rather than utilizing a transdisciplinary approach. The purpose of this paper is to introduce a new practice model of occupational rehabilitation ergonomics. The model draws upon the International Classification of Functioning, Disability, and Health (ICF) and merges this with basic ergonomic and rehabilitation principles.     

Left behind in the return-to-work journey: consumer insights for policy change and practice strategies

This study examined system barriers that precluded injured workers from accessing services and supports in the return-to-work (RTW) process. A grounded theory approach was used to investigate injured worker experiences. Methods included in-depth telephone interviews and the constant comparative method to analyze the data. Findings revealed that consumers experienced tensions or a tug-of-war between the RTW system, the health care system, and in accessing and using knowledge. Over time consumers reflected upon these tensions and initiated strategies to enhance return to function and RTW. Insights from consumer-driven strategies that might inform future policy change and promote positive service delivery for injured workers are examined.     

Homophobic and sexist yet uncontested: examining football fan postings on Internet message boards

Although a homophobic and sexist archetype of heterosexual masculinity has been thought to permeate competitive teamsport, matters have been rapidly changing. This is evident in research on openly gay athletes, attitudes among heterosexual athletes, and recent studies on decreasing homophobia among sport media content. In this research, however, we examine how some men still adhere to a homophobic and sexist masculine deposition when discussing sport on the Internet. A textual analysis was used to analyze hegemonic masculinity from a popular American football message board. Although posts related to hegemonic masculinity did not permeate the data, we found that this traditional form of masculinity was upheld through misogyny, homophobia, and the objectification of women. Thus, whereas mainstream sport media is increasingly policed for homophobia and sexism, this research shows that the anonymity of the Internet permits hegemonic masculinity to flourish in specific locations, without contestation.     

Hazard ratio inference in stratified clinical trials with time‐to‐event endpoints and limited sample size

The stratified Cox model is commonly used for stratified clinical trials with time‐to‐event endpoints. The estimated log hazard ratio is approximately a weighted average of corresponding stratum‐specific Cox model estimates using inverse‐variance weights; the latter are optimal only under the (often implausible) assumption of a constant hazard ratio across strata. Focusing on trials with limited sample sizes (50‐200 subjects per treatment), we propose an alternative approach in which stratum‐specific estimates are obtained using a refined generalized logrank (RGLR) approach and then combined using either sample size or minimum risk weights for overall inference. Our proposal extends the work of Mehrotra et al, to incorporate the RGLR statistic, which outperforms the Cox model in the setting of proportional hazards and small samples. This work also entails development of a remarkably accurate plug‐in formula for the variance of RGLR‐based estimated log hazard ratios. We demonstrate using simulations that our proposed two‐step RGLR analysis delivers notably better results through smaller estimation bias and mean squared error and larger power than the stratified Cox model analysis when there is a treatment‐by‐stratum interaction, with similar performance when there is no interaction. Additionally, our method controls the type I error rate while the stratified Cox model does not in small samples. We illustrate our method using data from a clinical trial comparing two treatments for colon cancer.