Does the Andersen Behavioral Model of Health Services Use predict college students’ use of on-campus mental health services?

Abstract

Objective: 10–50% of college students meet the diagnostic criteria for one or more mental illnesses; unfortunately, less than half seek treatment. This study assessed the predictive power of specific variables on students’ use of on-campus mental health resources using the American College Health Association’s National College Health Assessment (ACHA-NCHA) II. Participants: Respondents included undergraduate and graduate students ages 18–35?years (n?=?96,121). Methods: We analyzed data from the ACHA-NCHA II Fall 2014 and Spring 2015. Andersen’s Behavioral Model of Health Services Use enabled selection of predisposing, enabling, and need predictor variables; these were analyzed individually and collectively. Results: Predisposing, enabling, and need variables accounted for 9%, 2.3%, and 17% of the overall variance. Significant variables associated with a student’s decision to access on-campus mental health services accounted for 23% of variance total. Conclusions: This insight could allow universities to better recognize students at-risk for needing but not accessing mental health services.     

Assembling the "Empire of Morality": State Building Strategies in Catholic Ecuador, 1861–1875

This article studies the efforts of the Ecuadorian government between 1861 and 1875 to construct a "truly catholic nation". It examines the implementation and engagement of centralized initiatives of morality and religiosity, and reflects on its implications for the repositioning of state-society boundaries. Specifically, it considers the government's efforts after 1869 to centrally coordinate the institutions of municipal government and Church, and to redeploy them for national moralizing ends. It assesses the substantial achievements and limits of this model for strengthening state power and for disseminating "national" meanings of citizenship and progress.     

Perceived Risks of Conventional and Organic Produce: Pesticides, Pathogens, and Natural Toxins

Public risk perceptions and demand for safer food are important factors shaping agricultural production practices in the United States. Despite documented food safety concerns, little attempt has been made to elicit consumers' subjective risk judgments for a range of food safety hazards or to identify factors most predictive of perceived food safety risks. In this study, over 700 conventional and organic fresh produce buyers in the Boston area were surveyed for their perceived food safety risks. Survey results showed that consumers perceived relatively high risks associated with the consumption and production of conventionally grown produce compared with other public health hazards. For example, conventional and organic food buyers estimated the median annual fatality rate due to pesticide residues on conventionally grown food to be about 50 per million and 200 per million, respectively, which is similar in magnitude to the annual mortality risk from motor vehicle accidents in the United States. Over 90% of survey respondents also perceived a reduction in pesticide residue risk associated with substituting organically grown produce for conventionally grown produce, and nearly 50% perceived a risk reduction due to natural toxins and microbial pathogens. Multiple regression analyses indicate that only a few factors are consistently predictive of higher risk perceptions, including feelings of distrust toward regulatory agencies and the safety of the food supply. A variety of factors were found to be significant predictors of specific categories of food hazards, suggesting that consumers may view food safety risks as dissimilar from one another. Based on study findings, it is recommended that future agricultural policies and risk communication efforts utilize a comparative risk approach that targets a range of food safety hazards.     

Subsidiary-level determinants of global initiatives in multinational corporations

This article examines subsidiary-level factors that promote global initiatives in MNCs. Global initiatives are a key capability of MNCs that domestic firms do not possess, yet there has been little research on how MNCs promote initiatives on a global basis. I draw principally on the knowledge-based view to develop a model in which three subsidiary-level variables explain the propensity of the MNC to pursue global initiatives. These variables are: (1) inter-unit networking, (2) subsidiary learning from internal and external sources, (3) shared strategic goals. A survey of 118 subsidiary managers, triangulated with interviews with 20 key informants, provides support for the hypothesized effect of subsidiary learning and shared strategic goals on global initiatives. The result for inter-unit networking is less clear. These variables combine to activate initiatives within the MNC and thus act as a source of competitiveness on a worldwide basis. The results have important implications for MNC managers as well as for theory, and these are discussed.     

Beyond Individualised Approaches to Diabetes Type 2

Explanations for type 2 diabetes are broadened beyond the individual body and ‘bad lifestyles’ to include major institutions, the social and material contexts of food and eating, and employment. Precarious employment, a social determinant of health, encourages changes to food practices, lowers working conditions, worsens health, can bring poverty and increases shift work, a causal risk factor for diabetes. Scientists have played a part in revolutionising foods and technologies which minimise labour and movement. There are excess additives in processed food. Genetic explanations for the higher rates of diabetes in First Nations peoples give way to social explanations: colonial history, British/Euro‐American cuisine, food insecurity, trauma and social conditions resulting in chronic stress. Self‐management education takes a ‘nutritionist’ approach towards food and eating and tends to minimise the social context and skills of those with the condition particularly women workers in poorer social groups who have higher rates of diabetes (T2DM).     

Transitional compass: anti-capitalist pathways in the interstitial spaces of capitalism*

ABSTRACT

The focus of the special issue explores the forms of power used, engendered, and (re)produced to challenge structures of economic, social and political power that produce inequality as well as concrete empirical examples of movements, workers’ struggles, and initiatives in challenging inequality. The idea of ‘transitional compass’ looks beyond protest politics to what we call ‘generative’ politics that builds the alternatives in the interstitial spaces of capitalism. Resistance to power emerges through engendering counter-hegemonic projects that are intertwined with alternative everyday practices. To concretize the conceptual framing, we focus on the emancipatory possibilities of a universal basic income, the use of law in tackling inequality in health and education, creative initiatives to establish a people-centred food system, new forms of organizing by precarious workers, democratic possibilities in local state delivery, and reconceptualizing the good life by looking at issues of happiness and ecosocialism.     

A generalized model of logistic regression for clustered data

This paper proposes a generalized logistic regression model that can account for the correlation among responses on subunits. The subunits may arise as data on multiple observations within an individual. This method generalizes earlier work by Rosner (1984 a,b) and others. Methodological generalizations include: (1) the use of the more general Polya-Eggenberger distribution instead of the beta-binomial distribution to model the correlation structure, so that cases with negative, positive, or zero intraclass correlation can be handled; (2) a stepwise approach; (3) linear and non-linear regression; and, (4) the inclusion of the case of a truncated distribution. The model can accommodate missing data and covariates on the unit and subunit level. The derivative-free simplex algorithm is used to estimate the parameters.

The model is applied to data describing the progression of obstruction in coronary disease where multiple arterial segments are studied for each patient. The correlation in response that may exist for these multiple segments is accounted for in the analyses while attempting to examine associations with individual-specific (e.g., history of diabetes) and segment-specific (e.g., initial percent stenosis) covariates. Analyses were performed on a data set describing 382 patients with unoperated coronary artery disease and two coronary angiograms separated by at least one month and on a data set describing 284 patients undergoing percutaneous transluminal coronary angioplasty and studied by coronary angiograms.     

Making Development Assistance More Effective Through Using Political‐economy Analysis: What Has Been Done and What Have We Learned?

Politics often explains where development assistance has been effective and where it has not. Yet, until the 2000s there has been little focus by development agencies on political issues. This has recently begun to change with political‐economy analysis (PEA) now being more systematically used by development agencies to understand the real world. Nigeria and Bangladesh are two positive examples. Much remains to be done in these countries and more widely, to ensure stronger uptake of PEA. On the supply side this includes getting the ‘product’ right, and better communicating the message. On the demand side, there is a need to take more account of the incentives facing development agencies and to gather more systematic evidence on the operational impact of PEA to date.