Investigating impacts of complex sampling on latent growth curve modelling

We investigate the impacts of complex sampling on point and standard error estimates in latent growth curve modelling of survey data. Methodological issues are illustrated with empirical evidence from the analysis of longitudinal data on life satisfaction trajectories using data from the British Household Panel Survey, a national representative survey in Great Britain. A multi-process second-order latent growth curve model with conditional linear growth is used to study variation in the two perceived life satisfaction latent factors considered. The benefits of accounting for the complex survey design are considered, including obtaining unbiased both point and standard error estimates, and therefore correctly specified confidence intervals and statistical tests. We conclude that, even for the rather elaborated longitudinal data models that were considered, estimation procedures are affected by variance-inflating impacts of complex sampling.     

Obesity and hospitalization over the adult life course: does duration of exposure increase use?

Consistent with a new genre of research on life-course analyses of health-service use, this study explores the consequences of long-term exposure to a risk factor. Drawing from cumulative-disadvantage theory, the study examines whether obesity, especially chronic obesity, increases hospitalization admission and length of stay. Analyses make use of hospital records abstracted over 20 years from a national survey of adults 41 to 77 years of age at baseline (n = 4,574). Multiple measures of body weight are used to calculate adult obesity duration. Results reveal that obesity increased hospital admissions and length of stay over the 20 years studied. Among persons obese at any time during the study, years of obesity also led to longer stays. The findings highlight the utility of measures of the duration of risk exposure for both life-course studies of health and tests of cumulative-disadvantage theory.     

First stirrings: cultural notes on orgasm, ejaculation, and wet dreams

Both the findings and the limitations of numeric milestone research in sexology have a bearing on the pedagogical status of pleasure, as well as the cultural underpinnings of the notion of a psychosexual milestone. An overview is offered of international data pertaining to the chronology of three "milestones" in sexual autobiography: first orgasm (orgasmarche), first ejaculation (oigarche), and first wet dream (nocturnal emission). Methodological problems associated with the measurement of these variables are discussed. These problems are then situated in a culturalist perspective. It is concluded that orgasms are cultural artifacts in terms of their chronological occurrence as well as perceived salience, necessity, and "age appropriateness".     

Differences by gender, ethnicity, and acculturation in the efficacy of the keepin' it REAL model prevention program

This study examined whether the efficacy of keepin' it REAL, a model program for substance use prevention in schools, was moderated by gender, ethnicity, and acculturation. Gender differences in program efficacy may arise through boys' higher risk of drug use, inadequate attention to girls' developmental issues, or cultural factors like polarized gender expectations. Data came from a randomized trial in 35 Phoenix, Arizona, middle schools involving 4,622 mostly Latino 7th graders. Using multi-level mixed models and multiple imputation missing techniques, results for the total sample showed no gender differences in program effects on recent substance use, but the program was more effective in fostering boys' than girls' anti-drug norms. Subgroup analyses demonstrated several more beneficial program effects for boys than girls (less alcohol and cigarette use and stronger anti-drug norms), but only among less acculturated Latinos. There were no gender differences in program effects among more acculturated Latinos, nor among non-Latino whites.     

Effects of a single-lesson tobacco prevention curriculum on knowledge, skill identification and smoking intention

One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not to smoke. Data were collected, via electronic keypads, from students visiting a non-school, health education center in Michigan (n = 704 intervention and 85 comparison). Contingency table Chi-squared tests and t-tests demonstrated that a single lesson can improve general knowledge and ability to identify appropriate refusal techniques. Improvement in intent not to smoke was not significant because both groups had very high intent prior to implementation. Similar to results from other programs, multivariate logistic regression of gender, general knowledge, and skill identification revealed that only the skill variable was associated with intent not to smoke at pretest. Recommendations are given for further research and for designing more effective curricula or programs.     

Trustworthiness in evaluation practice: an emphasis on the relational

As canons for trustworthiness developed explicitly in the discourse of qualitative inquiry, the emphasis was on procedural matters rather than fundamentally relational ones. A nod was made to the relational in such strategies as “member checks” but the issues of how the evaluator actually relates to participants and to the larger communities of practice and discourse—matters subsumed under moral principles and ethical standards—were often marginalized. This chapter posits that the first consideration in designing and conducting rigorous evaluation inquiry, and in critiquing the results of any research, should be the study's trustworthiness. Judging a study's trustworthiness, however, should focus on much more than procedural matters; it should also rely on moral principles and ethical standards which specifically address how we relate to an evaluation's participants. Central to these considerations are cross-cultural sensibilities about the nuanced meanings associated with any principles and standards. The chapter provides a theoretical framework for this position and offers two illustrative examples in the form of dialogues.     

Mindfulness: an intervention for anxiety in schizophrenia

Despite evidence that individuals with schizophrenia spectrum disorders experience significant and persistent symptoms of anxiety, there are few reports of the use of empirically supported treatments for anxiety in this population. This article describes how we have tried to adapt mindfulness interventions to help individuals with schizophrenia who experience significant anxiety symptoms. Although mindfulness has been widely used to help individuals without psychosis, to our knowledge, this is the first study adapting it to help those with schizophrenia manage worry and stress. We provide an overview of the intervention and use an individual example to describe how our treatment development group responded. We also explore directions for future research of mindfulness interventions for schizophrenia.     

Quality of life among lifetime victimized men

Quality of life was compared for lifetime victimized (n = 353) and nonvictimized men (n = 167) for demographic and quality of life variables by a cross-sectional design. The univariate analyses showed that victims compared to nonvictims had a lower quality of life, were younger, more often had upper secondary school education, and were more often blue-collar/low white-collar workers, on student allowances, on unemployment, financially strained, and smokers. The regressions revealed that unemployment, financial strain, smoking, depression, and home/public abuse were associated with reduced quality of life among victimized men. Being a blue-collar/low/intermediate white-collar worker and social support were related to increased quality of life. This study may have provided new insights into the experiences of quality of life of victimized men.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.