A puzzlement: health-related organisations in the Nonprofit Almanac

Conclusion Data systems created with one purpose inevitably have shortcomings when used for other purposes, so it is not surprising that a database compiled from informational tax returns has serious flaws when used to compile a statistical picture of the non-profit sector. The two-digit NTEE level of aggregation that is published in theAlmanac conceals many problems that appear when the IRS-based data are broken down to the three-digit level.Identification of the problems in the NTEE and in the use of the IRS data is a necessary step toward their correction. At this point, it is clear that the IRS-based numbers in theAlmanac should be regarded, at best, as rough approximations and as a starting point for additional work. My assessment of theAlmanac suggests that, at least as far as health care is concerned, the NTEE needs revision. Correcting the problems with the IRS data will be much, much more difficult.I am grateful for assistance from Steve Noga, Chris Toppe and Virginia Hodgkinson at Independent Sector.     

Screening for patients with alcohol problems: severity of patients identified by the CAGE.

Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems.     

EFFECTS OF A PREPAID NONMONETARY INCENTIVE ON RESPONSE RATES AND RESPONSE QUALITY IN A FACE-TO-FACE SURVEY

We conducted a randomized experiment on a face-to-face interviewsurvey in order to test the effects on response rates of a prepaidnonmonetary incentive. Results showed a statistically significantincrease in response rates, mostly through reduction in refusalrates, in the half sample that received the incentive (a gift-typeballpoint pen) as compared with a no incentive control group.The effect appears to be due to greater cooperation from incentiverecipients at the initial visit by an interviewer. Unexpectedly,the incentive group also showed a significantly higher rateof sample ineligibility, possibly due to easier identificationof vacant residences or nonexistent addresses. In addition,evidence suggests greater response completeness among respondingincentive recipients early in the interview, with no evidenceof increased measurement error due to the incentive.     

Public Perceptions about Food Safety in the United States and Japan1

Abstract Consumer concerns over pesticide residues and food additives have been growing in industrialized societies, including the United States and Japan. However, little comparative research has been carried out to determine which household characteristics may be significantly associated with these heightened concerns, and whether or not the same factors are useful for understanding variation in these worries in more than one society. This paper examines food safety attitudes in Seattle, Washington, and Kobe, Japan, and discovers that while the absolute level of expressed concern is higher in Kobe, the predictive power of household characteristics in explaining attitudinal differences within countries is similar. Implications for rural areas and future research on family structures in capitalist societies are discussed.     

TESTING SPHERICITY UNDER A MIXTURE MODEL

The robustness of Mauchly's sphericity test criterion when sampling from a mixture of two multivariate normal distributions is studied. The distribution of the sphericity test criterion when the sample covariance matrix has a non-central Wishart density of rank one is derived in terms of Meijer's G-functions; its distribution under the mixture model is then deduced. The robustness is studied by computing actual significance levels of the test under the mixture model using the critical values under the usual normal model.     

Agency costs,property rights,and the evolution of labor unions

Collective bargaining requires that an agent represent workers. This paper examines the implications for the trade union movement of the resulting agency costs. Without transferable rights in the union, union members lack the means and incentive to bring forth the innovative agent controls common to the modern corporation. Considerations of the bargaining strengths of employers and employees, each represented by an agent, provide an explanation of the simultaneous decline of private sector union membership (corporate share holders have been more successful at lowering agency costs) and growth of public sector union representation (where the union official, a “double agent,” serves the interest of both employee and bureaucratic employer). The authors acknowledge the helpful remarks Donald L. Martin whose earlier research on property rights in unions inspired this effort. Don Bellante’s work was supported by a grant from the Research Committee of the College of Business Administration, University of South Florida.     

Evaluation of an educational intervention upon knowledge, attitudes, and behavior concerning drinking/drugged driving.

The Contra Costa County educational program for juveniles found guilty of driving under the influence (DUI) was evaluated. Over 600 juveniles convicted of DUI from 1983 to 1988 formed the study group for this research and of these over 100 participated in the educational program. Assessment of program participants was conducted for knowledge, attitudes and behavior. Participants demonstrated increased knowledge, stronger attitudes against driving under the influence, and less risky alcohol and automobile related behaviors. County juvenile records analyzed by the logit procedure showed that class participants had a significantly lower number of repeat offenses compared to non-program participants that could not be explained by race, offense severity, age or gender.     

Cognitive-behavioral-expressive interventions with aggressive and resistant youths.

Research into the nature of aggressive behavior in youths has demonstrated that these youths are often the victims of abuse, exhibit aggressive behavior in early childhood, and remain aggressive into young adulthood. The treatment approach described in this article is a modification of Monahan's [1981] model of the prediction of violent behavior and the anger-management approach of Novaco [1985], and integrates the developmental models of Piaget [1963] and Erikson [1959]. The program is a combination of cognitive, behavioral, and expressive therapies and is targeted to the reduction of dysfunctional cognitive, affective, behavioral, and problem-solving patterns of aggressive youths. As referrals of such aggressive clients are often involuntary, interventions with unwilling and resistant clients are also presented.     

A note on inverse estimation in non-linear models

The problem of estimating the value of an x variable for a given proportion of an observed value of the y variable is consdered for a non-linear model. Asymptotic confidence limits are obtained and an application of the method is illustrated witreal data.