The PALS parenting support programme: lessons learned from the evaluation of processes and outcomes

Although there has recently been a rise in parenting support programmes within the UK, only a minority of these programmes have benefited from evaluation of either outcomes or processes. This paper describes the development of the PALS programme (Parents Altogether Lending Support), reporting both on its effectiveness in improving parents' interactions with their children and on the lessons that were learned about embedding such a programme within the local community. Over the 18‐month period of the programme, a total of 17 courses were run, with 75 parents and carers (primarily mothers) participating in the programme overall. Evaluation results indicated that participants enjoyed the course and found it beneficial, particularly in terms of altering their own actions in specific ways that were able to promote better behaviour on the part of their children. Participants also valued the opportunity to share their experiences with other parents. The key lesson identified in regard to the development of parenting programmes concerned the need for the community to feel a sense of ownership for the initiative. Copyright © 2002 John Wiley & Sons, Ltd.     

The Farm Crisis and Mental Health: A Longitudinal Study of the 1980s1

Abstract This paper examines rural/urban differences and trends in mental health during the farm crisis of the 1980s in a large panel sample from a midwestern state. A community research perspective, which attributes differences to life styles, culture, and community context, is contrasted with an economic stress perspective, which focuses on individual differences in economic circumstances as determinants of rural-urban differences in mental health. Survey samples from 1981, 1986, and 1989 are used to examine differences among seven categories of community type. Multiple regression analysis of the trend and panel data provide support for both the individual economic distress and community context models.     

Valuation of childhood risk reduction: the importance of age, risk preferences, and perspective.

This article explores two problems analysts face in determining how to estimate values for children's health and safety risk reductions. The first addresses the question: Do willingness‐to‐pay estimates for health risk changes differ across children and adults and, if so, how? To answer this question, the article first examines the potential effects of age and risk preferences on willingness to pay. A summary of the literature reporting empirical evidence of differences between willingness to pay for adult health and safety risk reductions and willingness to pay for health and safety risk reductions in children is also provided. The second dimension of the problem is a more fundamental issue: Whose perspective is relevant when valuing children's health effects—society's, children's, adults‐as‐children, or parents'? Each perspective is considered, followed ultimately by the conclusion that adopting a parental perspective through an intrahousehold allocation model seems closest to meeting the needs of the estimation problem at hand. A policy example in which the choice of perspective affects the outcome of a regulatory benefit‐cost analysis rounds out the article and emphasizes the importance of perspective.     

Prehistoric landscapes of the sonoran desert Hohokam

The Hohokam of southern Arizona are noted for greater duration of settlement than other major agricultural traditions in the archaeological record of the southwestern United States, including the Anasazi and Mogollon. The 40,000 square mile area inhabited by the Hohokam is marked by low elevation desert basins, but encompasses a range of topographic and climatic variability that shaped opportunities for prehistoric farming technologies. Irrigation from rivers was frequently associated with the longterm persistence of individual sites, while floodwater farming along ephemeral drainages was more often correlated with continuous occupation of hydrologically favored zones. Renewal of fields by waterborne nutrients and efficient practices in the use of natural resources countered the limited mobility options afforded by the Hohokam environment.In spite of a restrictive agricultural setting and an essentially static suite of productive technologies over many centuries, relationships among population, settlement, and landuse were redefined in evolving social and economic configurations. An example from the Tucson Basin illustrates differentiated patterns of settlement and agriculture arising in conjunction with increased levels of population and territorial integration in the late prehistoric period. Community organization among interrelated settlements incorporated a diversity of topographic zones and agricultural technologies in this high-risk context for prehistoric cultivators.     

Grandparental childcare in Australia: gender differences in the correlates of providing regular grandparental care while parents work

Grandparents’ regular care for children while parents work has been mostly studied from the parental perspective. This paper focuses on the grandparents. Using the Australian Bureau of Statistics Time Use Survey 2006 (N = 7672) we investigate regular-caring grandparents’ demographic characteristics, which childcare activities they undertake, and how regular childcare provision relates to their time in other activities, subjective time pressure and satisfaction. Results indicate the correlates and nature of regular care differ by gender. Regular and non-regular-caring grandmothers’ relative time allocation to different childcare tasks barely differs, while regular-caring grandfathers’ care includes a much higher proportion of active care and travel than non-regular-caring grandfathers’. Regular care provision is associated with less leisure than non-regular-caring counterparts for both genders, but with only grandmothers’ housework, personal care and sleep time. Providing regular care doubles the likelihood of grandmothers reporting high subjective time pressure compared to non-regular-caring grandmothers; there is no association between regular care and time pressure for grandfathers. We conclude that in taking on regular care, grandparents echo the gender patterns found among parents, namely that it is women who are disproportionately impacted by meeting family care needs.     

Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program

With the passage of the Patient Protection and Affordable Care Act (ACA) of 2010, the health insurance literacy of Americans became a critical issue. In response, a consumer education program was created and tested by university researchers and educators associated with Cooperative Extension. This article draws extensively on the emerging literature on health insurance literacy and on data from participants in the Smart Choice Health Insurance? program. The intent of the study was to understand socio-demographic and environmental variables that predict initial health insurance literacy and gains in health insurance literacy. A standardized instrument measuring health insurance literacy was used to collect the data. Multivariate analysis showed higher income consumers demonstrated greater initial health insurance literacy scores compared to middle income consumers, whereas younger, male and lower educated consumers reported lower initial health insurance literacy. After participating in the Smart Choice Health Insurance? program, consumers who made greater gains in their health insurance literacy tended to be female, higher income, and consumers residing in states that showed supportiveness of the ACA. The findings highlight the importance of considering sociodemographic characteristics in program design and delivery, as well as how contextual issues, such as the political environment, might impact the delivery of educational efforts. Findings from the analyses help inform ways to adapt and tailor educational opportunities that focus on health insurance literacy for a range of consumers.     

The Ebb and Flow of Environmentalism

This essay examines the pattern of ebb and flow in the environmental movement in the United States. Although the movement has experienced periods of expansion and contraction over the last century, environmentalism has sustained significant mobilization with the evolution of its organizational forms and tactics. Mass demonstrations and other forms of public protest defined the emergence of the modern environmental movement in the 1960s and early 1970s, and grassroots action remains important, particularly in response to the urgency of climate change. However, the movement has also relied increasingly on institutionalized organizational forms and conventional tactics such as litigation and lobbying. Some critics argue that decentralized networks and disruptive tactics are essential for inspiring a new era of impassioned environmental activism, while others contend that the complexity of current environmental problems requires more formalized structures and focused legislative advocacy. We conclude that the diversity of organizational forms and activities in the environmental movement has maintained the movement over many decades, and that this diversity can aid in effecting comprehensive change.     

Heterogeneity in treatment effects across diverse populations

Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.