Indicators and Indices of Child Well-being: A Brief American History

This paper traces the history of indicators and indices of child well-being from its origins in the social indicator movement of the 1970s through recent developments in the field. Initial work calling for comprehensive sets of indicators of child well-being and later recommendations for indicator improvement are detailed. Products that resulted from these recommendations, such as comprehensive indicator reports and online resources are described. The development of child well-being indices is shown to parallel the history of indicators. The contributions of state and international indicator and index projects are included as well. Important aspects of child well-being indicator development are uncovered through documenting its history, including the need to focus on subjective as well as objective measures of well-being, and the need to develop indicators for the multiple ecological contexts of children’s lives, but to separate measures of context from measures of child outcomes. A rough consensus emerges across the history of indicator efforts on the critical domains of child well-being: physical, psychological, cognitive, social, and economic well-being. Recent recognition of the importance of indicators of positive development is noted. This paper was funded by the KIDS COUNT project of the Annie E. Casey Foundation.     

Preliminary Evaluation of the Validity and Reliability of the Spanish Version of the Therapeutic Alliance with Clinician (TAC) Questionnaire

As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New Haven area in Connecticut. These sites included a community health center (n = 40), a community behavioral health center (n = 40), and a faith-based agency (n = 23). As part of this study, the English version of the Therapeutic Alliance with Clinician (TAC) questionnaire was translated into Spanish and administered to our sample of Hispanic women. Results on the psychometric properties of the Spanish version of the TAC are presented in this article.     

贸易自由化环境中的女性迁移流动及其对生殖健康的影响

贸易自由化引致包括女性劳动力在内的大规模乡城劳动力迁移 ,不可避免地影响着流动女性的生殖健康。通过分析社会经济相关因素以及各级政府管理、服务因素 ,本文认为贸易自由化促进的劳动力迁移对女性劳动者的生殖健康产生一定的积极影响 ;但同时 ,户籍制度的限制、工作生活环境的压力以及生殖健康服务的缺乏也在威胁流动女性的生殖健康。由此提出 :在贸易自由化的环境中改进流动人口计划生育管理和生殖健康服务 ,不但有利于流动女性的健康和发展 ,也是经济社会可持续发展的要求     

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).     

我国老年人健康自评影响因素分析

健康自评是研究对象对自身健康的主观感受,是调查中经常运用的变量。健康自评能够反映健康状态的主观和客观两个方面,因此健康自评可以作为评价老年人健康状况的一个重要指标。采用2002年全国老年调查数据,做不同老年人群体的健康自评的差异性分析并进一步探究影响因素。旨在回答我国老年人健康自评的影响因素,对老年人自身和政策制定者提供参考依据。健康的生活方式对健康自评有积极的影响,身体的健康和健康自评有很强的相关性,老年人的社会人口学特征对健康自评影响十分有限。     

Cross-Cultural Analyses of Determinants of Quality of Life and Mental Health: Results from the Eurohis Study

Recent projects on international instrument development have produced a wide array of health indicators that may be used for cross-cultural field-testing, however more information on their cross-cultural performance in relation to health determinants is necessary. The current study approaches one step for international conceptual validation by analysing the association between various health determinants and different types of health outcomes (mental health, quality of life) across a range of countries or geographical areas. The current study is based on the EUROHIS project that has been conducted in a sample of 4849 adults across 10 European countries. Results highlight that interactions between health determinants with subjective mental health, general health and quality of life (QoL) differ between Western European countries, Eastern European countries and the Newly Associated States as well as Israel. Using a MIMIC model approach, we were able to show that the impact of each of the sociodemographic variables cannot be interpreted on the basis of its single loading but only seeing the interacting with other indicators. Future studies should include sociodemographics in MIMIC models in each latent factor before carrying out regressions on a larger scale. Future investigations will require larger and representative samples to (a) test models on latent factors of mental health and QoL and (b) on the basis of these findings test overall structural models across countries.     

The health expectancies of older Australians

Health expectancies of the states ‘Disability-free’ and ‘Disabled’ are estimated for Australian females and males aged 60 and over, both by cohort from 1980 and current for survey years 1981, 1988, 1993 and 1998. Modifications of recently developed logistic regression techniques are used rather than the standard 1971 method due to Sullivan. Results from the three later surveys are broadly similar and differ in important respects from those of the 1981 survey. Based on the last three surveys our estimates support the view that, depending on age, two-thirds or more of the increase in female life expectancy over the decade 1988–1998 is spent in the Disabled state. The situation is worse for elderly men, for whom all of the increased years of expected life are estimated to be spent in the Disabled state. The findings do not support rectangularization of the survival curve or Disability-free survival curve.     

Sibling rivalry and the gender gap: evidence from child health outcomes in Ghana

When capital and labor markets are imperfect, choice sets narrow, and parents must choose how to ration available funds and time between their children. One consequence is that children become rivals for household resources. In economies with pro-male bias, such rivalries can yield gains to having relatively more sisters than brothers. Using a rich household survey from Ghana, we find that on average if children had all sisters (and no brothers) they would do roughly 25-40% better on measured health indicators than if they had all brothers (and no sisters). The effects are as large as typical quantity-quality trade-offs, and they do not differ significantly by gender. Received: 22 May 1996 / Accepted: 13 July 1998     

Measurement of the quality of family planning services

The quality of health services is a subject of increasing interest to health care providers and organizations responsible for financing and promoting health services. The importance of the client's perspective (and by inference, the perspective of potential clients, as well) is now well established, but efforts to define and measure quality have thus far been limited to the perspective of experts even when the experts claim to speak for the clients. In this paper we utilize family planning programs to explore issues of the quality of health services. We propose that a better understanding of the view of quality actually held by family planning program clients will clarify the influence of quality on the use of services, a clarity that has not been possible by looking at quality only as defined by providers, managers or experts. We review the literature on quality of services and identify the gaps in research that must be filled if a better understanding of what quality is and how it relates to service outcomes is to be obtained. A first step must be the research required to develop a set of measures of quality that reflects the multi-dimensional nature of quality, includes the clients' view of services in the definition of quality, and incorporates methodologies required to ascertain the true view of clients. Finally, we suggest that dimensions of quality identified as important for clients as a group will be more predictive of use of services than dimensions identified as important to providers.     

累积生态资源在积极心理健康教育中的作用——对青少年意向性自我调节培养机制的实证研究

通过对1 154名初一至高三学生的调查,探索累积生态资源、青少年自我效能感与意向性自我调节三者之间的关系。具体来说,青少年拥有的生态资源数量正向预测意向性自我调节水平,而青少年的自我效能感中介作用于生态资源数量与意向性自我调节的关系。这表明,累积生态资源既可直接对青少年意向性自我调节产生积极影响,又可通过自我效能感对意向性自我调节产生间接作用。因此,在推进积极心理健康教育的进程中,需要凸显青少年在自身发展中的自主性以及多重生态资源的联合作用。