“Thank You for Including Us!” – Introducing a Community‐Based Collaborative Approach to Translating Clinic Materials

When working with clients in another language, having culturally relevant and properly translated clinic materials is vital to effective clinical practice. Not having them presents a barrier for bilingual therapists and their clients. This paper reviews common translation methods and introduces a multi‐level, community‐based approach for translating clinic materials for non‐English speaking clients. Informed by decolonizing practices, this five‐tier method includes members from the target community as cultural brokers to verify the accuracy and nuances of language for their cultural group, as well as a constant comparative method to ensure methodological rigor in the process of inclusion. We present community member's feedback and recommendations, as well as discuss advantages and challenges of using this collaborative culturally responsive translation method.     

“Contrary to All the Other Shit I’ve Said”: Trans Men Passing in the South

Qualitative Sociology - This article examines the influence of geographic location on trans men’s desire to pass in the southeastern United States. Through 51 in-depth interviews with trans...     

Trajectories of Interracial Heterosexual Couples: A Longitudinal Analysis of Relationship Quality and Separation

Minimal research has examined interracial couples’ relationship satisfaction and dissolution patterns over time. Using dyadic data across 8 years, we examined potential differences in relationship quality trajectories through latent growth curve modeling with 1,336 couples as well as differential risks for relationship dissolution through logistic regression between same‐race and interracial relationships using a different subset of 2,370 couples. Results indicated that women in interracial relationships were significantly lower in initial relationship quality than women in same‐race relationships. Further, interracial couples of Black‐Hispanic partnerings were twice as likely to separate across 8 years than same‐race couples. These results suggest that despite interracial relationships not substantively differing from same‐race couples in trajectories of relationship quality, specific Black‐Hispanic interracial couples are at a higher risk of eventual separation.     

Kernel density estimation under negative superadditive dependence and its application for real data

In this paper, the kernel density estimator for negatively superadditive dependent random variables is studied. The exponential inequalities and the exponential rate for the kernel estimator of density function with a uniform version, over compact sets are investigated. Also, the optimal bandwidth rate of the estimator is obtained using mean integrated squared error. The results are generalized and used to improve the ones obtained for the case of associated sequences. As an application, FGM sequences that fulfil our assumptions are investigated. Also, the convergence rate of the kernel density estimator is illustrated via a simulation study. Moreover, a real data analysis is presented.     

Graphical representation of survival curves in the presence of time-dependent categorical covariates with application to liver transplantation

Graphical representation of survival curves is often used to illustrate associations between exposures and time-to-event outcomes. However, when exposures are time-dependent, calculation of survival probabilities is not straightforward. Our aim was to develop a method to estimate time-dependent survival probabilities and represent them graphically. Cox models with time-dependent indicators to represent state changes were fitted, and survival probabilities were plotted using pre-specified times of state changes. Time-varying hazard ratios for the state change were also explored. The method was applied to data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Survival curves showing a ‘split’ at a pre-specified time t allow for the qualitative comparison of survival probabilities between patients with similar baseline covariates who do and do not experience a state change at time t. Time since state change interactions can be visually represented to reflect changing hazard ratios over time. A2ALL study results showed differences in survival probabilities among those who did not receive a transplant, received a living donor transplant, and received a deceased donor transplant. These graphical representations of survival curves with time-dependent indicators improve upon previous methods and allow for clinically meaningful interpretation.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.