Methodologic challenges of e-health research

In this article, research-based strategies used in a web-based study to assess the impact of participation in cancer-related mailing lists on cancer survivors and caregivers are highlighted. The paper presents alternative methods of measuring response rates in Internet surveys. Response rate estimation, based on American Association for Public Opinion Research guidelines, ranged between 15% and 24.9% for the study. Several strategies were implemented to increase survey participation and reduce item nonresponse. Few participants opted for a telephone survey as an alternative to a web-administered design (mixed-mode administration). Using time-stamp data to diagnose places in the questionnaire where respondents prematurely exited or broke off survey participation, we were able to decrease premature break offs. A lottery was also implemented to increase response rates. The experience of obtaining institutional review board approval for the lottery is also described. Preliminary data indicate slight increases in response rates subsequent to implementing the lottery.     

Student assistance program: a new approach for student success in addressing behavioral health and life events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

Adjustment to disability

This article will focus on the biopsychosocial challenges encountered when an individual is disabled at an early age as well as when an individual acquires a disability later in life. Two case examples will focus on the adaptations/life choices that are necessary to adequately meet psycho/social/developmental needs and enhance individual self esteem. The case of Rita, a woman who lost her hearing at age two, highlights the importance of integrating a biopsychosocial approach to understand the multiple challenges and adaptations of individuals who are disabled at an early age. Laureen, a woman who acquired a spinal cord injury during her late teen years, described her struggles as a young adult adapting to a physical disability. Both cases highlight the importance of integrating an ecological/systems framework focusing on a biopsychosocial perspective, emphasizing the interrelationship between biological, psychological, social, technological, cultural and political factors.     

Offending behaviour in care: is children's residential care a ‘criminogenic’ environment?

This paper focuses on offending behaviour and children in residential care. The paper considers whether children's residential care is a ‘criminogenic’ environment, i.e. whether this type of care environment helps to provide the conditions that produce crime or criminality. The paper draws on the findings from recently completed research on 10 children's homes in a large county local authority in England. This paper focuses on the patterns shown in trend data collected on problematic and offending data across these homes over a 7‐year period (2001–2007) and a 1‐year cohort study of 46 young people. Interviews with care staff and young people are used to contextualize these patterns. The data provide evidence of an environment where conflict and offending behaviour are common. It is argued that the residential care environment, particularly for older teenagers, often presents a set of risks that tend to reinforce offending behaviour and that this is in part due to its ‘last resort’ status.     

Physical activity and fitness among midlife and older rural women

This study investigated physical activity and fitness of midlife and older rural women. Random-digit dialing was used to recruit 225 women (57.9 +/- 5.6 years old). Self-reported activity (moderate activity, flexibility, and strength) and fitness (body composition, flexibility, strength, and estimated VO(2max)) were assessed. The women demonstrated low daily energy expenditure (30.74 +/- 10.63 kcal x kg(-1) x day(-1)) and estimated VO(2max) (20.12 +/- 7.81 ml x kg(-1) x min(-1)), with 51.5% reporting fair or poor health. Few women reported meeting Healthy People 2010 targets for moderate activity (43.1%), flexibility (28.9%), or strength )14.2%). When classified by estimated VO(2max) into three categories, differences were observed for body-mass index, percent body fat, sit and reach, and timed chair stands, with the poorest performance by those with low cardiorespiratory fitness. Adherence to Healthy People 2010 targets for moderate activity and strengthening was associated with higher cardiorespiratory fitness. These rural women are targets for physical activity interventions because of their sedentary behaviors and low cardiorespiratory fitness.     

Inconsistencies in reporting the occurence and timing of first intercourse among adolescents

Two types of reporting inconsistency for sexual initiation were analyzed--event occurrence and its timing--using data from two waves of the National Longitudinal Study of Adolescent Health (Add Health). Overall, 11.1% of those who reported they were sexually active at the time of first interview denied this at the subsequent one. Males of each race/ethnic group had higher percentages of inconsistency than their female counterparts. Being older, not living with parents, or having a highly educated mother was negatively associated with rescinding. Among those reporting sexual experience at both interviews, only 22.2% reported the same date of first sex. On average, teens revised their age at first sex to older ages, and boys, especially African American boys, had large variability in reporting dates, as did teens with lower verbal ability. Seven strategies for resolving inconsistent reports are presented and implications for substantive findings are discussed.     

A Sea of Trouble: A Relational Approach to the Culturally Sensitive Treatment of a Severely Disturbed Client

In this article we will show how a relational approach provides a conceptual framework that shapes and informs culturally sensitive practice with a severely disturbed client. We argue that a relational approach facilitates therapeutic action through the intense focus on countertransference, the close attention to enactments, and the therapist's authenticity and self-disclosure. Additionally, we emphasize that a therapeutic matrix that includes the cultural, racial, socioeconomic, and institutional factors, increases the likelihood clinicians will attend to what Perez-Foster calls their dissociated and disavowed personal values. We present a case that had a less than satisfactory outcome where the therapist found herself in a sea of trouble. The case illustrates how a relational approach enhanced the therapist's understanding of the case and allowed her to continue to work with a difficult and challenging client. We conclude by suggesting that our conceptual understanding of this case exemplifies a necessary and appropriate focus for future social work research and practice.     

The Effects of Children, Dual Earner Status, Sex Role Traditionalism, and Marital Structure on Marital Happiness Over Time

In this study, the link between marital happiness and the advent of children is demonstrated, accounting for dual earner status, sex role traditionalism, and marital structure. A subset of 1,275 respondents from a longitudinal data set (Marital Instability Over the Life Course: A Three Wave Panel Study, 1980–1988) whom remained married through the 3 waves was used to compare the level of marital happiness of respondents who added children between waves to those who did not. Although the addition of children negatively affected marital structure and thus indirectly lowered marital happiness, results showed children also had positive counterbalancing direct effects. Dual-earner status, income, and sex role nontraditionalism were shown to mitigate the negative effects of children on marital happiness.