A comment on ‘social and economic factors in Hong Kong's fertility decline’ by Sui-Ying Wat and R. W. Hodge

The recent article by Wat and Hodge appears to make incorrect inferences about the relation of certain social and economic indicators (infant mortality, employment opportunities for women, and education) to Hong Kong's fertility decline, based on a multiple regression of these variables to the crude birth rate of Hong Kong for 1951–1967. Such modernization measures probably have at least a long-run causal relation to fertility decline. It is also possible that the family planning programme ofHong Kong may have added little to the effects, as the authors suggest. However, I do not believe that their multiple regression analysis establishes these conclusions.     

Facilitators of prenatal care access in rural Appalachia

BackgroundThere are many providers and models of prenatal care, some more effective than others. However, quantitative research alone cannot determine the reasons beneficial models of care improve health outcomes. Perspectives of women receiving care from effective clinics can provide valuable insight.MethodsWe surveyed 29 women receiving care at a rural, Appalachian birth center in the United States with low rates of preterm birth. Semi-structured interviews and demographic questionnaires were analyzed using conventional qualitative content analysis of manifest content.FindingsInsurance was the most common facilitator of prenatal access. Beneficial characteristics of the provider and clinic included: personalized care, unrushed visits, varied appointment times, short waits, and choice in the type and location of care.ConclusionThere is a connection between compassionate and personalized care and positive birth outcomes. Women were willing to overcome barriers to access care that met their needs. To facilitate access to prenatal care and decrease health disparities, healthcare planners, and policy makers need to ensure all women can afford to access prenatal care and allow women a choice in their care provider. Clinic administrators should create a welcoming clinic environment with minimal wait time. Unrushed, woman-centered prenatal visits can increase access to and motivation for care and are easily integrated into prenatal care with minimal cost.     

Application of Anbar's Approach to Hypothesis Testing to Detect the Difference between Two Proportions

In this paper, Anbar's (1983) approach for estimating a difference between two binomial proportions is discussed with respect to a hypothesis testing problem. Such an approach results in two possible testing strategies. While the results of the tests are expected to agree for a large sample size when two proportions are equal, the tests are shown to perform quite differently in terms of their probabilities of a Type I error for selected sample sizes. Moreover, the tests can lead to different conclusions, which is illustrated via a simple example; and the probability of such cases can be relatively large. In an attempt to improve the tests while preserving their relative simplicity feature, a modified test is proposed. The performance of this test and a conventional test based on normal approximation is assessed. It is shown that the modified Anbar's test better controls the probability of a Type I error for moderate sample sizes.     

Implementation fidelity in a teacher-led alcohol use prevention curriculum

There is now ample evidence that teachers tend to make substantial modifications to both the prescribed content and methods of the curricula they administer, and that such modifications are likely to attenuate curricula effects. We examine the fidelity with which teachers implement "Protecting You, Protecting Me," an underage alcohol use prevention curriculum. Findings suggest that while teachers attempted to implement most sections of a lesson, the lessons taught were consistently--and often extensively--adapted. We conclude that since teachers are likely to continue to modify lessons, curriculum developers and trainers should enhance their understanding of how prevention curricula are taught under real world conditions, help teachers to reinforce key curriculum concepts, and consider modifying those curricular sections that teachers are adapting with greatest frequency.     

Child outcome measures in the study of child care quality

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.     

Residents’ Reactions to Earthquake Early Warnings in Japan

This article empirically examines the effectiveness of earthquake early warning (EEW) in Japan based on experiences of residents who received warnings before earthquake shaking occurred. In Study 1, a survey (N = 299) was conducted to investigate residents’ experiences of, and reactions to, an EEW issued in Gunma and neighboring regions on June 17, 2018. The main results were as follows. (1) People's primary reactions to the EEW were mental, not physical, and thus motionless. Most residents stayed still, not for safety reasons, but because they were focusing on mentally bracing themselves. (2) Residents perceived the EEW to be effective because it enabled them to mentally prepare, rather than take physical protective actions, before strong shaking arrived. (3) In future, residents anticipate that on receipt of an EEW they would undertake mental preparation as opposed to physical protective actions. In Study 2, a survey (N = 450) was conducted on another EEW issued for an earthquake offshore of Chiba Prefecture on July 7, 2018. Results were in line with those of Study 1, suggesting that the findings described above are robust. Finally, given people's lack of impetus to undertake protective action on receipt of an EEW, this article discusses ways to enhance such actions.