Combining Food Frequency and Survey Data to Quantify Long-Term Dietary Exposure: A Methyl Mercury Case Study

Twenty-four-hour recall data from the Continuing Survey of Food Intake by Individuals (CSFII) are frequently used to estimate dietary exposure for risk assessment. Food frequency questionnaires are traditional instruments of epidemiological research; however, their application in dietary exposure and risk assessment has been limited. This article presents a probabilistic method of bridging the National Health and Nutrition Examination Survey (NHANES) food frequency and the CSFII data to estimate longitudinal (usual) intake, using a case study of seafood mercury exposures for two population subgroups (females 16 to 49 years and children 1 to 5 years). Two hundred forty-nine CSFII food codes were mapped into 28 NHANES fish/shellfish categories. FDA and state/local seafood mercury data were used. A uniform distribution with minimum and maximum blood-diet ratios of 0.66 to 1.07 was assumed. A probabilistic assessment was conducted to estimate distributions of individual 30-day average daily fish/shellfish intakes, methyl mercury exposure, and blood levels. The upper percentile estimates of fish and shellfish intakes based on the 30-day daily averages were lower than those based on two- and three-day daily averages. These results support previous findings that distributions of "usual" intakes based on a small number of consumption days provide overestimates in the upper percentiles. About 10% of the females (16 to 49 years) and children (1 to 5 years) may be exposed to mercury levels above the EPA's RfD. The predicted 75th and 90th percentile blood mercury levels for the females in the 16-to-49-year group were similar to those reported by NHANES. The predicted 90th percentile blood mercury levels for children in the 1-to-5-year subgroup was similar to NHANES and the 75th percentile estimates were slightly above the NHANES.     

Implemented as intended? Recording family worker activities in a Families First program

In evaluating family preservation services, it is important not only to study the service outcomes and the family characteristics, but also what actually happens during the treatment. This requires a program model. This article describes how a program model works, prescribes how workers should carry it out, and describes how researchers should measure the program's characteristics. The authors use data from Families First in The Netherlands to test the model. Results show that the method of the program meets the specified characteristics. The results are important for treatment, policy, education, and evaluation research.     

When caregiving ends: the course of depressive symptoms after bereavement

This study describes depressive symptoms among caregivers following bereavement and connects these trajectories to earlier features of caregiving using life course and stress process theory. Data are from a six-wave longitudinal survey (five years) of spouses and adult children caring for someone with Alzheimer's Disease. The analytic subsample (N = 291) is defined by death of the care-recipient after the baseline interview. A latent class mixture model is used to identify distinctive clusters of depressive symptoms over time. Of the four trajectories identified, three represent stable symptom levels over time, with two-thirds being repeatedly symptomatic (medium symptom levels), compared to two smaller groups of repeatedly asymptomatic (effectively absent of symptoms) and repeatedly distressed (severe symptoms). In contrast, about one in five caregivers experiences improved emotional well-being over time, the temporarily distressed, who progress from severe to moderate symptom levels. Caregivers with few symptoms before bereavement tend to maintain these states afterwards, but emotionally distressed caregivers tend to become more distressed. Role overload before bereavement substantially increases the odds of following an unfavorable trajectory afterwards, whereas self-esteem and socioemotional support play protective roles. These results demonstrate that caregivers are not uniform in their emotional responses to bereavement, but follow several distinct trajectories. These trajectories are linked to their previous experiences as caregivers, in particular exposure to stressors and access to resources. These findings suggest that intervention during caregiving may facilitate adaptation following death of a loved one.     

Evaluation of two school-based HIV prevention interventions in the border city of Tijuana, Mexico

This research project examined the individual and combined effectiveness of an HIV prevention workshop and a free condom distribution program in four high schools in Tijuana, Mexico. Adolescents (N = 320) completed baseline measures on sexual practices and theoretical correlates and participated in a two-part study. In Study 1, students were randomly assigned to an HIV prevention workshop or a control condition, with a 3-month follow-up assessment. Results indicate three significant workshop benefits regarding HIV transmission by altering sexual initiation, access to condoms, and traditional beliefs regarding condoms. In Study 2, we set up a condom distribution program at two of the participating schools, and students completed a 6-month follow-up assessment. Results indicate that exposure to the workshop followed by access to the condom distribution program yielded two beneficial results for reducing HIV transmission: moderating sexual initiation and increasing condom acquisition. Access to the condom distribution program alone had no effects on behavioral and psychosocial correlates of HIV transmission. We discuss implications of these results.     

The last mile of the way: understanding caregiving in African American families at the end-of-life

This research is based on in-depth ethnographic interviews and focus groups with 88 African American family caregivers from various regions of the United States during a stressful time in their family development--caregiving at the end-of-life--and the grieving during the aftermath. The study employed a stratified purposeful sampling strategy. Subjects were African Americans from the Northern, Southern, and Midwestern United States. Formal care is complicated by the distrust that many African Americans hold toward the health care system, which has resulted from years of exclusion, racism and discrimination. The findings highlight the importance of hearing from African American families to gain an understanding of what services, including family therapy and other psychotherapy, they will need during this process.     

Evaluating from the outside: conducting cross-cultural evaluation research on an American Indian reservation

There is limited guidance for conducting competent and responsive cross-cultural evaluation research with American Indian communities. The authors draw on Fisher and Ball's Tribal Participatory Research Model to highlight ways in which this project is attempting to be culturally appropriate and sensitive as they partner with an American Indian community to implement and evaluate a youth-based initiative. Challenges encountered during the evaluation are shared, as well as the authors' collective responses to such challenges. Implications for future cross-cultural evaluation researchers are also discussed in light of these experiences.     

Substance use and vulnerability to sexual and physical aggression: a longitudinal study of young adults

Using data from 2,170 individuals who participated in Waves 8 (age 23) and 9 (age 29) of a multiyear panel study, this study examined whether alcohol and marijuana use in young adulthood increase one's risk for experiencing subsequent sexual or physical assault victimization, whether victims' own violent behavior or involvement in the sale of drugs explain any effects of substance use on victimization, and whether these associations differ by gender. Controlling for prior victimization, we found that marijuana use, but not alcohol use, predicted women's and men's subsequent sexual victimization and men's subsequent physical assault victimization, and that heavy alcohol use, but not marijuana use, predicted women's subsequent physical assault victimization. Whereas the links from marijuana use to victimization were explained by users' own violent behavior, the link from alcohol use to women's physical assault victimization was not.     

The use of temporary restraining orders (TROs) as a strategy to address intimate partner violence

One of the most prominent interventions developed to protect victims in domestic abuse cases is the temporary restraining order or "TRO," the purpose of which is to restrain an alleged defendant from further harassment or abuse against a plaintiff. This report analyzes 397 restraining order petitions, and subsequent arrest and conviction data for TRO defendants from 1996 to 1998. Findings confirm that TRO petitioners report many types of abuse and while half of TRO defendants do not re-offend, a small percent of defendants are responsible for multiple police reports, arrests, and criminal violations. Outcome data are discussed for program and policy implications.     

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.     

Effects of information on college students' perceptions of antidepressant medication

The authors examined the impact of pharmaceutical companies' advertisements on college students' perceptions of depression and concomitant treatment with antidepressants among 13 male and 31 female undergraduates from a midwestern university. The students were randomly assigned to groups that read either pharmaceutical company advertisements or scientific information about depression and its treatment. The analysis revealed that 40% of the women in the advertisement condition as opposed to 1 woman (6%) in the scientific condition rated themselves as having mild, moderate, or severe depression on the Beck Depression Inventory, second edition. Women in the advertisement condition were significantly more likely to believe that depression required treatment with antidepressant medication and were more willing than women in the scientific condition to suggest antidepressant treatment to others.