Methodologic challenges of e-health research

In this article, research-based strategies used in a web-based study to assess the impact of participation in cancer-related mailing lists on cancer survivors and caregivers are highlighted. The paper presents alternative methods of measuring response rates in Internet surveys. Response rate estimation, based on American Association for Public Opinion Research guidelines, ranged between 15% and 24.9% for the study. Several strategies were implemented to increase survey participation and reduce item nonresponse. Few participants opted for a telephone survey as an alternative to a web-administered design (mixed-mode administration). Using time-stamp data to diagnose places in the questionnaire where respondents prematurely exited or broke off survey participation, we were able to decrease premature break offs. A lottery was also implemented to increase response rates. The experience of obtaining institutional review board approval for the lottery is also described. Preliminary data indicate slight increases in response rates subsequent to implementing the lottery.     

Contraceptive use in South Africa under apartheid

In this paper, patterns of contraceptive use among black South African women in the late 1980s are examined. Multilevel logit models are used to evaluate the extent to which segregation of the African population into homelands gave rise to uneven patterns of contraceptive use; how this pattern was shaped by variations in family-planning acceptability; and the way in which the system of male labor migration and social and economic inequities across communities affected women's use of contraceptives. Results show that variation in contraceptive use across homeland areas diminished with the addition of community controls for development and migration. Controlling for unobserved heterogeneity indicated that localized conditions could offset the advantages or disadvantages of living in a former homeland.     

Social Support for Exercise by Experts in Older Women Post–Hip Fracture

ABSTRACT

Using the data of the Baltimore Hip Study 5 (a home-based exercise intervention), this study examined how social support for exercise by experts (SSE-E) affected the self-efficacy, outcome expectations, and exercise behavior among older women following a hip fracture. The total sample included 164 females aged 65 years (M = 81.0; SD = 6.9) who had surgical repair of a nonpathologic hip fracture. Model testing showed a direct relationship between SSE-E and outcome expectations for exercise. There was, however, no direct or indirect relationship between SSE-E and self-efficacy or exercise behavior. The positive effect of SSE-E on the outcome expectations for exercise in older women recovering from a hip fracture provides an opportunity for health care providers in improving physical activity in this population.     

Erratum to: Does National Income Inequality Affect Individuals’ Quality of Life in Europe? Inequality,Happiness, Finances,and Health

Social Indicators Research -     

Gender Differences in the Perception of Genetic Engineering Applied to Human Reproduction

A questionnaire-survey of public perception of the desirability, risks, and benefits associated with current and potential applications of genetic engineering techniques to manipulate the outcome of human reproduction was conducted on 111 male and 135 female respondents. The proportion (63%) of male respondents who hold a positive impression that genetic engineering is a socially beneficial field of scientific research was significantly higher than the corresponding proportion (46%) of female respondents (p = 0.008). Similarly, in comparing somatic (non-reproductive cells) and germ-line (reproductive cells) gene therapy, most males (58%) foresaw no detrimental impacts of somatic cell gene therapy, but most females (60%, including 49% who opted for case-by-case evaluation) disapprove of even this form of therapy (p = 0.04). Most people remain fearful of germ-line therapy, but significantly more men (23%) than women (16%) support the development of genetic engineering for manipulating human germ-line cells (p = 0.04). There are no significant differences between male and female respondents with respect to genetic manipulation to correct inborn errors of metabolism or fetal deformity. The results of this study support the view that women tend to be more cautious than men with respect to acceptance of novel genetically-based procedures aimed at altering pregnancy outcome and offspring phenotype. Gender-based educational programs regarding the human genome project and human genetic engineering may be warranted to promote concordant decision-making in family planning and counseling.     

Mental health and wellbeing of care leavers: Making sense of their perspectives

Despite considerable quantifiable data about the circumstances of care leavers in the United Kingdom, there is less qualitative data about how these circumstances are experienced. This article is underpinned by positioning theory, with a particular focus on the unfolding personal narratives of young care leavers in relation to their mental health and wellbeing and the role of a life‐skills programme in supporting them in this respect. The research illustrates that leaving care projects, such as the one in the current study, are more focused on employment and housing issues than on addressing the mental health and wellbeing needs of young people. Our analysis of interviews with young people illustrates the ambiguity of understandings of concepts such as “mental health” and “wellbeing,” and the complexity of responses to questioning around this area. This illustrates one of the major problems in evaluating the outputs and outcomes of such projects in terms of simplistic targets, where mental health and wellbeing are not clearly defined or understood by young people themselves. The current research provides a more complex picture. More research is needed that involves in‐depth and longitudinal assessment of specific mental health needs of care leavers and how they can be addressed successfully.