A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.     

Weight loss practices and body weight perceptions among US college students

OBJECTIVE: The authors assessed associations between body weight perception and weight loss strategies. PARTICIPANTS: They randomly selected male and female college students (N = 38,204). METHODS: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. RESULTS: Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. CONCLUSIONS: These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.     

The Impact of Social Desirability Biases on Self-Report Among College Student and Problem Gamblers

The impacts of two types of social desirability bias, self-deceptive enhancement (SDE) and impression management (IM), were examined on self-reports of gambling problems, measured by the South Oaks Gambling Screen (SOGS), and recent gambling behavior, as measured by the Timeline Followback (TLFB) method, in a sample of college students (N = 191), and a sample of treatment-seeking problem gamblers (N = 49). Consistent with our expectations, IM was negatively associated with SOGS scores in both samples. IM was most highly correlated with SOGS scores among treatment-seeking participants (r = −.44, p < .01). Substantial numbers of participants in both samples had high enough IM scores as to call into question the validity of their self-report gambling data, according to published interpretive guidelines. With respect to SDE, we had predicted that it would be positively related to gambling behaviors and gambling-related problems, but found that SDE was inversely related to SOGS scores in both samples. Very little evidence was found for social desirability effects on TLFB scores. Thus, preliminary evidence was obtained that self-report data on gambling problems, but not on gambling behavior (frequency of gambling and amount of time and money spent), may be susceptible to the effects of impression management in both college students and treatment-seeking gamblers.     

Is Maternal and Child Health Service use a Causal Gateway to Subsequent Contraceptive use?: A Multi-Country Study

The purpose of this study is to examine the relationship between MCH service utilization and contraceptive use in five countries: Bolivia, Guatemala, Indonesia, Morocco, and Tanzania. The analysis is carried out at the level of the individual woman, with contraceptive-use status modeled as a function of: (1) the availability, quality, and packaging of MCH and family planning services; (2) community- and individual-level determinants of health service and contraceptive use; and (3) intensity of prior MCH service use. Data for the analysis comes from DHS data on women of reproductive age linked with data from service-availability surveys. We use full-information, maximum-likelihood regression techniques to control for the effects of unobserved heterogeneity that might otherwise bias our estimates. In three of the five countries (Morocco, Guatemala, and Indonesia) the results of the analysis suggest that the intensity of MCH service use is positively associated with subsequent contraceptive use among women, even after controlling for observed and unobserved individual- and community-level factors. This result lends support to the proposition that, at least in the context of these three countries, the intensity of MCH service per se use does have a “causal” impact on subsequent contraceptive use, even after controlling for factors that “predispose” sample women to use health care services.     

Legal Status and the Stability of Coresidential Unions

Using data from the National Longitudinal Study of the High School Class of 1972, we examine the effect of the legal status of coresidential unions on the likelihood of dissolution. We find that legal unions are much more stable than nonlegal unions. In addition, current legal status is more important for predicting stability of union than is legal status at the initiation of the union. We also find that the effect of current legal status remains constant over various durations of unions and that legalizing a nonlegal union has little effect beyond that expected on the basis of a occupying a particular legal status.     

Measuring temporal stability in regression models of population estimation

This paper introduces an empirical indicator designed to measure the temporal stability of regression models used to produce subnational population estimates. Analysis of 67 counties in Florida centers on 1970 total population estimates generated from ratio-correlation and difference-correlation models. Comparisons are made between eight different regression specifications and employ a quantitative measure of relative estimate accuracy. The major findings of this study are that (a) variable measurement and type are important determinants of estimate accuracy, and (b) although temporal stability of the coefficients impacts estimation errors, the influence is not as pervasive as is suggested in the literature.     

Confidence intervals for postcensal state population estimates

This paper develops a methodology for constructing confidence intervals around postcensal state population estimates. Using regression equations, forecast intervals are derived around the average age-specific death rates over the postcensal estimation period. These results, combined with the number of postcensal deaths and the most current census counts, are translated into confidence intervals for the age structure. Two approaches are offered for constructing total population confidence intervals. One examines a simulated distribution while the other focuses on the mathematical derivation of population means and variances. The methodology is illustrated by deriving statistically defensible confidence intervals around the July 1, 1975 population of Florida.     

Mobile phones in Africa: how much do we really know?

Mobile phones are a crucial mode of communication and welfare enhancement in poor countries, especially those lacking an infrastructure of fixed lines. In recent years much has been written about how mobile telephony in Africa is rapidly reducing the digital divide with developed countries. Yet, when one examines the evidence it is not at all clear what is really happening. In one country, Tanzania, for example, some observers point to the fact that 97% of the population lives under the mobile footprint, while others show that ownership is very limited. These extreme values prompted us to review the situation in Africa as a whole, in an effort to discover what is really going on.     

Techniques For Developing Health Quality of Life Scales for Point of Service Use

Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of HQOL outcomes into patient care. However, the length of many HQOL instruments poses a challenge in terms of patient burden, as well as clinic flow time. The most popular paradigm for scale construction utilizes classical test theory methodology and can lead to excessive and redundant items in an effort to bolster reliability measurements such as Cronbach’s alpha above levels of accepted reliability. This paper presents techniques for utilizing item response theory to arrive at single item scales that are diagnostically informative and short enough to have clinical utility. A danger of such dramatic scale reduction is that validity might be compromised. This danger is addressed in terms of criterion related validity and sensitivity to clinical changes over a 36 months period. The reduction methods are illustrated using selected scales from the Arthritis Impact Measurement Scales 2 (AIMS2) with data obtained from the study Pharmaceutical Care Outcomes: The Patient Role (PCOPR).     

U.S. population in the 21st century: Which scenario is reasonable?

A major Census Bureau study released in January 1989 has evoked renewed warnings in the media and among some population analysts that the U.S. faces population decline in the next century if it does not increase fertility and/or raise immigration. The report's middle scenario rests on an assumed future total fertility rate (TFR) of 1.8, life expectancy of 81.2 years, and net immigration of 500,000 annually. These mid-range assumptions would yield a United States population of 268 million by 2000, peaking at 302 million in 2040 and falling to 292 million by 2080. Questionable assumptions in the report's most likely scenario are discussed. These are:

1. that immigrants bear children at the same rate as their equivalent age and racial group in the United States population.
2. that the high TFR of Hispanics will not raise the overall 1.8 TFR foreseen for whites as the Hispanic proportion of the white population continues to grow.
3. that net yearly immigration will fall to 575,000 in 1990 and 500,000 by 2000. The Census Bureau's "high" assumption of 800,000 net yearly may be more realistic.

The report's low growth scenario projects future population size that is more reassuring than alarming: 264 million in 2000, rising to 288 million in 2030, and falling to 266 million in 2080. Thus, in ninety years the United States would still have 20 million more people than now. While some fear that such slow growth will lower United States influence and bring labor shortages and an aging population, the nation's quality of life would be less at risk with a population of 266 million than with one approaching the one-half billion projected by the Census report's high estimates.