A continuous-time Markov chain approach with the analytic likelihood in studies of behavioral changes

Abstract

We develop an analytic likelihood approach for a four-state CTMC by solving the backwards Kolmogorov differential equations, reducing this bias in transition rate estimates. A simulation study is performed to assess the performance of this new method and confirms that it achieves good coverage probabilities with low bias and standard errors. Finally, we analyzed data from Project SUCCESS to estimate the study each participant’s transitions among behavioral stage, consisting of risky drinking and possible ineffective using of contraception, which comprise the primary endpoint of risk of an alcohol-exposed pregnancy.     

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14–17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.     

Pornography and Marriage

We used data on 20,000 ever-married adults in the General Social Survey to examine the relationship between watching pornographic films and various measures of marital well-being. We found that adults who had watched an X-rated movie in the past year were more likely to be divorced, more likely to have had an extramarital affair, and less likely to report being happy with their marriage or happy overall. We also found that, for men, pornography use reduced the positive relationship between frequency of sex and happiness. Finally, we found that the negative relationship between pornography use and marital well-being has, if anything, grown stronger over time, during a period in which pornography has become both more explicit and more easily available.     

NGOs and rural movements in contemporary South Africa

This article provides a critical examination of relationships between non-governmental organisations (NGOs) and rural movements in post-apartheid South Africa, particularly with regard to the possible subordination of movements to NGOs. In discussing NGOs as a particular organisational form, and in reviewing some arguments pertaining to NGOs and rural movements globally, I explore whether NGOs in South Africa have a progressive role to play in agrarian transformation.     

24-month update on the impact of roundtables on permanency for youth in foster care

Although the number of children in foster care has decreased in recent years (U.S. DHHS, 2012), additional strategies are needed to help youth achieve legal permanency before they age out of foster care. One such strategy is the permanency roundtable, which convenes a team of professionals to facilitate the permanency planning process by identifying realistic solutions to permanency obstacles for youth. Nearly 500 youth went through the initial permanency roundtable process in Georgia in 2009. Just over half were male (57%) and over nine in ten (92%) were African American. At the start of the roundtables, the median age was 13, and the median length of stay in foster care was 52 months. Two years after their roundtable, 50% of the nearly 500 children had achieved legal permanency. Analyses, presented separately for three age groups (0–6, 7–12, and 13–18), examine outcomes and predictors of legal permanency. Recommendations, limitations, and areas for future research are discussed.     

Disparities in Access to Health Care Among Middle-Aged and Older Adults with Disabilities

Disability is increasing among middle-aged adults and, reversing earlier trends, increasing among older adults as well. Disability is experienced disproportionately by Black and lower socioeconomic status (SES) individuals. We used Medical Expenditure Panel Survey data to examine health care disparities in access to health care for middle-aged (31 to 64 years of age) and older (65+ years of age) adults with disabilities by race and ethnicity, education, and income (n = 13,174). Using logistic regression, we examined three measures of potential (e.g., usual source of care), and three measures of realized (e.g., counseling related to smoking) access. Middle-aged and older minority individuals with disabilities had lower relative risks of having usual sources of care and higher relative risks of having suboptimal usual sources of care (e.g., a place rather than a person) than White adults with disabilities. There were SES effects observed for middle-aged adults with disabilities across most measures that were, for certain measures, more pronounced than SES effects among older adults with disabilities. These findings are important, since health resources (e.g., a usual source of care) may mediate relations among disability, morbidity, and mortality. Policy actions that may mitigate the disparities we observed include financial incentives to support access to an optimal usual source of care and mechanisms to foster behavioral interventions related to smoking and exercise. Ensuring that these actions address the specific concerns of individuals with disabilities, such as physical accessibility and provider cultural competency, is essential.     

Past and new victimization among African American female drug users who participated in an HIV risk‐reduction intervention

This study examined to what extent a culturally and women‐specific sexual risk reduction intervention resulted in a decline of new victimization. Additionally, we sought to identify factors associated with new victimization, defined as victimization during the 6 months after enrollment in the study. Female African American drug users (N = 333, ages 18–59 years) completed questionnaires. Past victimization was a major predictor of new victimization. The likelihood of new victimization, however, declined significantly when compared to past victimization. Factors associated with victimization included enhanced intervention assignment, frequency of drug use, and lifestyle factors such as criminal behavior, drug use in a public setting, and living in an unstable situation. Results indicate the need to incorporate strategies to reduce victimization in HIV/AIDS and other health‐related prevention and intervention programs.     

Research Note—Multiple Time Point Course Evaluation and Student Learning Outcomes in an MSW Course

ABSTRACT

Evaluation methods play a key role in measuring student learning outcomes. Yet traditional assessments focus on assessing student satisfaction with instructors or courses rather than their progress toward competencies. In addition, the common pretest-posttest assessment is problematic because of response-shift bias. Although multiple time point assessment is suggested, very little is known about its application and potential in social work education. This research note examines how student self-assessments of their progress on core competencies in an MSW-level social work course change across three time points (pretest, posttest, retrospective test). The findings suggest that students underrated and overrated their competencies at the pretest. We argue that using multiple time point self-assessment addresses this internal validity threat and should be considered in social work course evaluation.