A time-varying measurement error model for age of onset of a psychiatric diagnosis: applied to first depressive episode diagnosed by the Composite International Diagnostic Interview (CIDI)

A substantial degree of uncertainty exists surrounding the reconstruction of events based on memory recall. This form of measurement error affects the performance of structured interviews such as the Composite International Diagnostic Interview (CIDI), an important tool to assess mental health in the community. Measurement error probably explains the discrepancy in estimates between longitudinal studies with repeated assessments (the gold-standard), yielding approximately constant rates of depression, versus cross-sectional studies which often find increasing rates closer in time to the interview. Repeated assessments of current status (or recent history) are more reliable than reconstruction of a person's psychiatric history based on a single interview. In this paper, we demonstrate a method of estimating a time-varying measurement error distribution in the age of onset of an initial depressive episode, as diagnosed by the CIDI, based on an assumption regarding age-specific incidence rates. High-dimensional non-parametric estimation is achieved by the EM-algorithm with smoothing. The method is applied to data from a Norwegian mental health survey in 2000. The measurement error distribution changes dramatically from 1980 to 2000, with increasing variance and greater bias further away in time from the interview. Some influence of the measurement error on already published results is found.     

Caregivers' perspectives on the SafeCare® programme: Implementing an evidence‐based intervention for child neglect

This qualitative study examined caregivers' experiences with SafeCare®, an evidence‐based programme that focuses on child neglect through modules on health, safety, and parenting. Shortly after completing SafeCare, 30 caregivers participated in a semi‐structured interview about their experiences with the programme. Overall, caregivers indicated that the programme helped with improvements in their parenting skills. Among the factors that contributed to a positive experience were the simplicity of language, the skills‐based approach, and the quality of the relationship with the SafeCare provider. Caregivers also noted several factors that made it difficult to fully benefit from the programme, including financial constraints, removal of their child from the home, and general distrust towards the child welfare system. Findings provide relevant information for SafeCare providers in terms of identifying areas that work well for caregivers completing the programme, as well as areas that might serve as impediments. Implications for contemporary child welfare practice are also considered.     

Modification of Tukey's additivity test

In this paper we discuss testing for an interaction in the two-way ANOVA with just one observation per cell. The known results are reviewed and a simulation study is performed to evaluate type I and type II risks of the tests. It is shown that the Tukey and Mandel additivity tests have very low power in case of more general interaction scheme. A modification of Tukey's test is developed to resolve this issue. All tests mentioned in the paper have been implemented in R package Additivity Tests.     

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Implementation issues for consumer-directed programs: comparing views of policy experts, consumers, and representatives

An increasing number of aging community providers and consumers support consumer-direction (CD) in long-term care services. In regard to devolution, consumer-direction goes beyond the usual approach of shifting responsibilities from the federal government to state governments to bring programs "closer to the people." Consumer-direction goes even further by placing resources directly in the hands of consumers. Yet, many questions remain unanswered regarding how to implement CD personal assistance services in general, and especially for older persons. This article describes the importance of examining views from multiple key stakeholders involved in implementing CD programs. We report on three background studies that have informed the Cash and Counseling Demonstration and Evaluation (CCDE) design and implementation-policy expert interviews as well as surveys and focus groups with consumers and representatives. As a fourth data source, we drew upon experiences in designing the CCDE and initial results from the first year of implementation. Each of the three studies on its own provided essential information for planning the CCDE. However, when we examined the studies together, and added CCDE design and implementation experiences, views expressed by the different stakeholders formed a type of multi-perspective "dialogue" that expanded our knowledge about implementing CD services. We hope this increased knowledge will help expand the availability of such services for consumers of any age who want to direct their own care.     

Instructions for Authors

Instructions for Authors

Instructions for Authors