Revisiting field experimentation: field notes for the future

Perception of hypotheticality in technology-based business ideas: effects on Opportunity Beliefs from a Construal Level Theory perspective

This research investigates how entrepreneurs perceive the hypothetical nature of technologies (based on situations that are often imagined or theoretical) as a foundation for entrepreneurial endeavors and how this perception influences the formation of business Opportunity Beliefs. Drawing on the Construal Level Theory, we explore the relationship between the perceived hypotheticality of technologies and Opportunity Beliefs. Two experimental studies are conducted to examine these relationships, with Study 1 (n = 177 entrepreneurs) focusing on the perception of innovative technologies as more distant or hypothetical, and Study 2 (n = 404 entrepreneurs) delving into how the perceived distance to technology influences Opportunity Beliefs. The results indicate that entrepreneurs view more innovative technologies as more hypothetical and that hypotheticality mediates the relationship between the perceived degree of innovation and Opportunity Beliefs. We find evidence that Entrepreneurs tend to view the feasibility and fit/alignment of business opportunities more favorably when they perceive the psychological distance (hypotheticality) of the opportunity as closer rather than more distant. However, the difference this difference is nonsignificant in how they evaluate the desirability of the opportunity in any psychological distance. These results provide insight into the cognitive processes of entrepreneurs and offer implications for understanding how entrepreneurs perceive and evaluate business opportunities.

Can a Pessimistic Outlook Moderate the Victimization-Delinquency Relationship?

This study was designed to shed light on the relationship between victimization and offending, a pattern commonly known as the victim-offender overlap, by exploring whether victimization and pessimism toward the future interact in association with self-reported delinquency. This study was performed on 1,300 (444 males, 645 females, and 211 sex not identified) members of the 2018 High School Senior Monitoring the Future cross-sectional study. Multiple regression analysis was conducted using a maximum likelihood estimator and bias-corrected bootstrapped 95% confidence intervals. The analysis revealed that victimization and the victimization × pessimism interaction correlated significantly with delinquency, after controlling for a series of demographic, family, and peer factors. These results indicate that pessimism toward the future may exacerbate the already strong relationship known to exist between victimization and delinquency.

How has the COVID-19 pandemic affected the utilisation of online consultation and face-to-face medical treatment? An interrupted time-series study in Beijing, China

OBJECTIVE

The COVID-19 pandemic has had a major impact on healthcare utilisation. This study aimed to quantify how the online and face-to-face utilisation of healthcare services changed during this time and thus gain insights into the planning of future healthcare resources during the outbreak of infectious diseases.

DESIGN

This work is an interrupted time-series study.

SETTING

Monthly hospital-grade healthcare-service data from 22 tertiary first-class public hospitals managed by the Beijing Hospital Authority and online-consultation data from GoodDoctor were used in this study.

METHODS

This is an interrupted time-series study about the change in face-to-face and online healthcare utilisation before and after the COVID-19 outbreak. We compared the impact of COVID-19 on the primary outcomes of both face-to-face healthcare utilisation (outpatient and emergency visits, discharge volume) and online healthcare utilisation (online consultation volume). And we also analysed the impact of COVID-19 on the healthcare utilisation of different types of diseases.

RESULTS

The monthly average outpatient visits and discharges decreased by 36.33% and 35.75%, respectively, compared with those in 2019 in 22 public hospitals in Beijing. Moreover, the monthly average online consultations increased by 90.06%. A highly significant reduction occurred in the mean outpatients and inpatients, which dropped by 1 755 930 cases (p<0.01) and 5 920 000 cases (p<0.01), respectively. Online consultations rose by 3650 cases (p<0.05). We identified an immediate and significant drop in healthcare services for four major diseases, that is, acute myocardial infarction (-174, p<0.1), lung cancer (-2502, p<0.01), disk disease (-3756, p<0.01) and Parkinson's disease (-205, p<0.01). Otherwise, online consultations for disk disease (63, p<0.01) and Parkinson's disease (25, p<0.05) significantly increased. More than 1300 unique physicians provided online-consultation services per month in 2020, which was 35.3% higher than in 2019.

CONCLUSIONS

Obvious complementary trends in online and face-to-face healthcare services existed during the COVID-19 pandemic. Different changes in healthcare utilisation were shown for different diseases. Non-critically ill patients chose online consultation immediately after the COVID-19 lockdown, but critically ill patients chose hospital healthcare services first. Additionally, the volume of online physician services significantly rose as a result of COVID-19.

The Effect of COVID-19 Restrictions on Routine Activities and Online Crime

Objectives

Routine activity theory suggests that levels of crime are affected by peoples' activity patterns. Here, we examine if, through their impact on people's on- and off-line activities, COVID-19 restriction affected fraud committed on- and off-line during the pandemic. Our expectation was that levels of online offending would closely follow changes to mobility and online activity-with crime increasing as restrictions were imposed (and online activity increased) and declining as they were relaxed. For doorstep fraud, which has a different opportunity structure, our expectation was that the reverse would be true.

Method

COVID-19 restrictions systematically disrupted people's activity patterns, creating quasi-experimental conditions well-suited to testing the effects of "interventions" on crime. We exploit those conditions using ARIMA time series models and UK data for online shopping fraud, hacking, doorstep fraud, online sales, and mobility to test hypotheses. Doorstep fraud is modelled as a non-equivalent dependent variable, allowing us to test whether findings were selective and in line with theoretical expectations.

Results

After controlling for other factors, levels of crime committed online were positively associated with monthly variation in online activities and negatively associated with monthly variation in mobility. In contrast, and as expected, monthly variation in doorstep fraud was positively associated with changes in mobility.

Conclusions

We find evidence consistent with routine activity theory, suggesting that disruptions to people's daily activity patterns affect levels of crime committed both on- and off-line. The theoretical implications of the findings, and the need to develop a better evidence base about what works to reduce online crime, are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10940-022-09564-7.

Age-friendly interventions in rural and remote areas: A scoping review

OBJECTIVES

In 2007, the World Health Organization published a guide on age-friendly cities. However, little is known about interventions that have been implemented to promote age-friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategies, and programs that have been implemented in rural and remote areas to create age-friendly communities.

METHODS

This scoping review used the Joanna Briggs Institute (JBI) methodology.

RESULTS

A total of 219 articles were included in this review. No intervention studies were referred to as 'age-friendly'. However, there were interventions (mostly healthcare-related) that have been implemented in rural and remote areas with older people as participants. There were also non-evaluated community programs that were published in the grey literature. This review identified the common health interventions in older people and the indirect relevance to the WHO age-friendly framework domains in rural and remote contexts.

CONCLUSIONS

The eight age-friendly domains were not explicitly utilised as a guide in the development of interventions for older people in rural and remote settings. Implementation of age-friendly interventions in rural and remote areas requires a multisectoral approach that is tailored to address the specific needs of individual communities. Age-friendly interventions also need to consider socio-ecological factors to adequately and holistically address community needs and ensure long-term sustainability.

Investigating the Parental and Media Influence on Gender Stereotypes and Young Student’s Career Choices in Pakistan

The study aimed to examine the impact of parental influence and media richness on gender stereotypes and career decisions among students at the secondary level in Pakistan. The sample size was 200 students, selected through a simple random sampling technique from government and private schools. Four questionnaires were used to gather data. The data was analyzed quantitatively using the Statistical Package for the Social Sciences (SPSS). Regression analyses were used to investigate the impact of parental influence (β = 0.50) on gender stereotypes and media richness influence (β = 0.26) on gender stereotype beliefs. Furthermore, parental, media, and gender stereotype behavior all have a significant impact on students’ career choices (R² = 0.694). On the scale of the parental influence and media richness, no significant gender differences were found. It is concluded that parental influence has a greater effect on students’ gender stereotyping behavior and career choices.

Thinking out of the box—by thinking in other boxes: a systematic review of interventions in early entrepreneurship vs. STEM education research

Scholars increasingly converge on the view that entrepreneurship education (EE) should start early during the formative years of individuals’ educational careers, ideally in primary and secondary education. They also agree that promotion of attitudinal factors, especially, entrepreneurial self-efficacy (ESE) is of crucial importance. Yet, empirical evidence on effective interventions to foster ESE in early EE is still scarce. Therefore, this study, first, systematically reviews and systematizes this limited literature consisting of eight quantitative studies. Second, in order to develop suggestions for future ESE-oriented interventions in early entrepreneurship education, the study draws on insights from systematically reviewing a second, related yet already more developed literature: research on self-efficacy-oriented interventions in early STEM (science, technology, engineering, and mathematics) education. Third, this study compares the interventions across both research streams in terms of research design, theoretical framework, structure and content of the interventions, and the findings of the studies. As a result, it derives implications for future research on ESE-oriented interventions in early EE: regarding the research design (e.g., use of several treatments); the structure and content of the programs like pedagogical and methodological components (e.g., use of specific learning strategies); analysis of potentially important moderating variables (e.g., gender, social background). Finally, the study discusses the potential for developing cross-disciplinary interventions aimed at simultaneously encouraging self-efficacy in the domains of STEM and entrepreneurship.

A Systematic Review of Empirical Evidence on Art Therapy With Traumatized Refugee Children and Youth

The current global refugee crisis revealed that refugee children, youth, and adults are uniquely vulnerable to traumatic events. Yet, there are only a few studies available that report robust systematic data on art therapy interventions with mental health in recent refugee populations. The purpose of the study is to synthesize and evaluate (a) the available research evidence on the use of art therapy in reducing post-traumatic stress disorder (PTSD) levels in refugees, and (b) the quality of empirical evidence for each of the reviewed studies. The authors adopted the Council for Exceptional Children (CEC) evidence-based practice (EBP) standards and quality indicators to evaluate the methodological soundness of the reviewed studies and the evidence-based classification of art therapy as a treatment intervention. We systematically searched electronic databases of pertinent review articles for the period from 2010 to 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Systematic searches identified 70 research articles but yielded eight eligible journals as per the inclusion criteria. Results indicated that, though considered a promising treatment approach, art therapy is presently classified as an intervention that falls under the category of practice with insufficient evidence. The findings suggest the need for further methodologically sound experimental studies to strengthen the evidence behind art therapy as an intervention to reduce PTSD symptoms in refugees around the world.

The effect of mobile business simulation games in entrepreneurship education: a quasi-experiment

Purpose

During the current global epidemic, e-learning and mobile learning have been rapidly developed in the field of entrepreneurship education. The effect of these learning methods remains to be confirmed. The purpose of this paper is to explore the effect of mobile business simulation games in entrepreneurship education.

Design/methodology/approach

From May 2020 to July 2020, the authors adopted a quasi-experimental design to explore the effect of mobile business simulation games in entrepreneurship education. The authors set up an experimental group to participate in mobile business simulation games, with a total of 105 students, and set up a control group of 100 students. At the beginning and end of the experiment, data on entrepreneurial attitude, self-efficacy, entrepreneurial intention and other related variables were collected. Paired sample T-test and regression analysis were used to analyze the results.

Findings

The authors found that mobile business simulation games can improve entrepreneurial attitudes and self-efficacy, but cannot change entrepreneurial intentions. The paired sample T-test in the experimental group showed that the entrepreneurial attitude and entrepreneurial self-efficacy of the participants were significantly improved, but the entrepreneurial intention did not change significantly. The above three variables did not change significantly in the control group. The research results also show that flow experience is very important in mobile business simulation games, which can improve entrepreneurial attitude and entrepreneurial self-efficacy.

Originality/value

The authors’ findings confirm the positive effects of mobile business simulation games in entrepreneurship education, which can improve entrepreneurial attitudes and entrepreneurial self-efficacy. But the disadvantage of mobile business simulation games is that they cannot increase entrepreneurial intention. In addition, the flow experience needs to be valued in mobile business simulation games. The research in this paper has implications for how mobile learning can be used in entrepreneurship education during the COVID-19 pandemic. In addition, research is of great value on how mobile business simulation games can be improved.

Beyond Experiments

It is often claimed that only experiments can support strong causal inferences and therefore they should be privileged in the behavioral sciences. We disagree. Overvaluing experiments results in their overuse both by researchers and decision makers and in an underappreciation of their shortcomings. Neglect of other methods often follows. Experiments can suggest whether X causes Y in a specific experimental setting; however, they often fail to elucidate either the mechanisms responsible for an effect or the strength of an effect in everyday natural settings. In this article, we consider two overarching issues. First, experiments have important limitations. We highlight problems with external, construct, statistical-conclusion, and internal validity; replicability; and conceptual issues associated with simple X causes Y thinking. Second, quasi-experimental and nonexperimental methods are absolutely essential. As well as themselves estimating causal effects, these other methods can provide information and understanding that goes beyond that provided by experiments. A research program progresses best when experiments are not treated as privileged but instead are combined with these other methods.

Positive Psychology in Context of Peacekeeping Militaries: A Mediation Model of Work-Family Enrichment

Based on the work-family enrichment theory, this study analyzes the contribution of work-family and family-work enrichment to explain the military’s well-being during a peacekeeping mission. The data used were collected in a sample of 306 Brazilian soldiers, who were married and/or had children, during the phase named “employment of troops” (i.e., when peacekeepers had been in the Haitian territory and, as a result, away from their families, for between three to five months). Data analysis was performed using the Structural Equations Model. It was observed that the military’s perception of their spouses’ support for their participation during the mission had a positive relationship with both family-to-work enrichment and work-to-family enrichment, and the work-to-family enrichment mediated the relationship between the perception of the spouses’ support and the military’s health perception and general satisfaction with life. Theoretical and practical implications were discussed and limitations and suggestions for future research were presented.

The mediating role of psychological capital between perceived management commitment and safety behavior

INTRODUCTION

Among attempts that address high incidences of fatalities and injuries in coal mines, increasing attention has been paid to management commitment to complement the traditional focus on technological advances in safety management. However, more research is needed to explain the influence of perceived management commitment, with extant research drawing commonly on Griffin and Neal (2000) to focus on safety knowledge, skills, and motivation. This study draws on social cognitive theory (Bandura, 1986) to investigate psychological capital as a link between thought process and safety behavior.

METHOD

This study uses survey data from 400 frontline workers in China's coal mines to test hypotheses.

RESULT

Results suggest that perceived management commitment to safety correlates positively with workers' safety compliance and participation, and four constituents of psychological capital-self-efficacy, hope, optimism, and resilience-explain the influence of perceived management commitment on safety compliance and participation. Practical Applications: Findings offer both researchers and practitioners an explanation of how perceived management commitment influences safety behaviors, and clarify the roles psychological capital constituents play in explaining the influence of perceived management commitment on safety compliance and safety participation.

Association of Data Integration Technologies With Intensive Care Clinician Performance: A Systematic Review and Meta-analysis

IMPORTANCE

Sources of data in the intensive care setting are increasing exponentially, but the benefits of displaying multiparametric, high-frequency data are unknown. Decision making may not benefit from this technology if clinicians remain cognitively overburdened by poorly designed data integration and visualization technologies (DIVTs).

OBJECTIVE

To systematically review and summarize the published evidence on the association of user-centered DIVTs with intensive care clinician performance.

DATA SOURCES

MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and Web of Science were searched in May 2014 and January 2018.

STUDY SELECTION

Studies had 3 requirements: (1) the study tested a viable DIVT, (2) participants involved were intensive care clinicians, and (3) the study reported quantitative results associated with decision making in an intensive care setting.

DATA EXTRACTION AND SYNTHESIS

Of 252 records screened, 20 studies, published from 2004 to 2016, were included. The human factors framework to assess health technologies was applied to measure study completeness, and the Quality Assessment Instrument was used to assess the quality of the studies. PRISMA guidelines were adapted to conduct the systematic review and meta-analysis.

MAIN OUTCOMES AND MEASURES

Study completeness and quality; clinician performance; physical, mental, and temporal demand; effort; frustration; time to decision; and decision accuracy.

RESULTS

Of the 20 included studies, 16 were experimental studies with 410 intensive care clinician participants and 4 were survey-based studies with 1511 respondents. Scores for study completeness ranged from 27 to 43, with a maximum score of 47, and scores for study quality ranged from 46 to 79, with a maximum score of 90. Of 20 studies, DIVTs were evaluated in clinical settings in 2 studies (10%); time to decision was measured in 14 studies (70%); and decision accuracy was measured in 11 studies (55%). Measures of cognitive workload pooled in the meta-analysis suggested that any DIVT was an improvement over paper-based data in terms of self-reported performance, mental and temporal demand, and effort. With a maximum score of 22, median (IQR) mental demand scores for electronic display were 10 (7-13), tabular display scores were 8 (6.0-11.5), and novel visualization scores were 8 (6-12), compared with 17 (14-19) for paper. The median (IQR) temporal demand scores were also lower for all electronic visualizations compared with paper, with scores of 8 (6-11) for electronic display, 7 (6-11) for tabular and bar displays, 7 (5-11) for novel visualizations, and 16 (14.3-19.0) for paper. The median (IQR) performance scores improved for all electronic visualizations compared with paper (lower score indicates better self-reported performance), with scores of 6 (3-11) for electronic displays, 6 (4-11) for tabular and bar displays, 6 (4-11) for novel visualizations, and 14 (11-16) for paper. Frustration and physical demand domains of cognitive workload did not change, and differences between electronic displays were not significant.

CONCLUSIONS AND RELEVANCE

This review suggests that DIVTs are associated with increased integration and consistency of data. Much work remains to identify which visualizations effectively reduce cognitive workload to enhance decision making based on intensive care data. Standardizing human factors testing by developing a repository of open access benchmarked test protocols, using a set of outcome measures, scenarios, and data sets, may accelerate the design and selection of the most appropriate DIVT.

Sharing Positive Experiences Boosts Resilient Thinking: Everyday Benefits of Social Connection and Positive Emotion in a Community Sample

The influence of shared enjoyment and positive affect (PA) on resilient thinking was examined in 191 middle-aged adults (40-65 years), participating in a study of resilience. Participants completed diaries assessing positive events, shared enjoyment, PA, and resilient cognitions (RC). Multilevel structural equation modeling was utilized to examine when and who engages in RC. Participants reported more RC on days they experienced more positive experiences. This relationship was explained by shared enjoyment and PA. Level-1 proportional reduction of variance (PRV) for shared enjoyment, PA, and RC was 9%, 10%, and 35%, respectively. Individuals reporting more positive experiences trended toward a more resilient mindset; PA accounted for this relationship. Shared enjoyment mediated the relationship between interpersonal events and PA. These findings suggest PA is integral to having a resilient mindset, and shared enjoyment is a potential mechanism that may influence PA. Level-2 PRV for shared enjoyment, PA, and RC was 22%, 21%, and 55%, respectively. RC were associated with less depression and anxiety; and greater well-being, vitality, and physical functioning at follow-up.

Lower rates of consistent urine drug tests for prescribed psychotropic medications among patients on opioid replacement therapy

BACKGROUND

Patients on opioid replacement therapy (ORT) to treat opioid use disorder are frequently monitored for these medications, but it is not known if they are also adhering to their psychotropic medications. This is an analysis of measure of potential adherence to psychotropic medications by patients on ORT.

METHODS

This is a retrospective cohort study of patients (n=1470) on antidepressants and/or antipsychotics and tested by the Millennium Health laboratory. Potential adherence to psychotropic medications was measured by urine drug test (UDT) results. The consistency of UDT for expected psychotropic medication in patients on ORT was compared to patients not on ORT (control group) during 3-months period. The study used propensity score methods to match individuals from both groups on their demographics and their psychotropic medication.

RESULTS

There were 457 participants (31.09%) on ORT and 1013 participants (68.91%) in the control group. Only 55.33% of UDTs (n=1388) were consistent for expected psychotropic medications in the ORT group compared to 73.69% of UDTs (n=4953) consistent for expected psychotropic medications in the control group (χ²=172.99, p<0.001). After matching, patients in the ORT group were less likely than the control group to have consistent UDTs for expected psychotropic medications (OR: 0.81, 95% CI: 0.76-0.85, P<0.001).

CONCLUSION

There is a high rate of inconsistent UDT for prescribed psychotropic medication among patients on ORT. This could reflect potential poor adherence. Monitoring adherence to psychotropic medications should be part of every clinical visit for patients on ORT.

Application of a Mixed Model Approach for Assessment of Interventions and Evaluation of Programs

Many social programs and programs for prevention of drug use are designed to affect a wide variety of targets, including individuals, families and neighborhoods, and organizations such as schools, companies, or hospitals. The nature of the intervention and the design of the particular study determine the choice of the appropriate unit of analysis in assessments of outcome. When the units of assignment and units of observation differ from one another, that is, when clusters of persons rather than persons are assigned at random to treatments, analyses performed at lower levels in the study hierarchy provide inefficient estimates of parameters and often lead to inappropriate significance tests. The present goal was to illustrate the applications of linear mixed models for evaluating statistically the effectiveness of programs.

Structure and Relationships of University Instructors' Achievement Goals

The present study examines the achievement goals of university instructors, particularly the structure of such goals, and their relationship to biographic characteristics, other aspects of instructors’ motivation, and teaching quality. Two hundred and fifty-one university instructors (184 without Ph.D., 97 with Ph.D., thereof 51 full professors; 146 males, 92 females) answered a questionnaire measuring achievement goals, self-efficacy, and enthusiasm in altogether 392 courses. Teaching quality was assessed using reports from 9,241 students who were attending these courses. Confirmatory factor analyses revealed mastery, performance approach, performance avoidance, work avoidance, and relational goals as being distinguishable from each other. Distinct relationships were found between different instructors’ achievement goals, and gender, age, and career status as well as self-efficacy and enthusiasm. Hierarchical linear models suggested positive associations of instructors’ mastery goals with teaching quality, while negative associations were indicated for performance avoidance goals and work avoidance goals in relation to teaching quality. Exploratory analyses conducted due to a quite large correlation between performance approach and performance avoidance goals indicated that for university instructors, differentiating performance goals into appearance and normative components might also be adequate. All in all, the study highlights the auspiciousness of the theoretical concept of university instructors’ achievement goals and contributes to making it comprehensively accessible.

Research that Guides Practice: Outcome Research in Swedish PhD Theses Across Seven Disciplines 1997-2012

The core of evidence-based practice (EBP) as advocated for within the practice arms of the health and social sciences is to promote the routine incorporation of the best available research evidence into practice efforts. This requires discipline-specific education that is not only grounded in professional practice but also prepares would-be scientists in the application of the sophisticated techniques that characterize today's high research standards. Doctoral-level education is an important primer for future scientific endeavors across disciplines. This study examined 2334 theses published across Sweden in public health, criminology, nursing, psychiatry, psychology, social work, and sociology during the period 1997-2012. Of the theses reviewed, 13% aimed to investigate the effects of interventions. The highest percentage of effectiveness studies was found in nursing, public health, and psychology. The percentage of outcome research increased during the period. Controlled studies (with comparison group and pre- and post-test) occurred primarily within public health, nursing, psychiatry, and psychology. Of the 296 theses that included an intervention effectiveness study, 131 (44%), or 5.6% of all theses reviewed, met all four assessment criteria for quality. PhD education across seven disciplines in Sweden may be producing a professional core of scientists that is ill prepared to produce the type of research that is necessary to inform practice of the effects of its interventions as exposure to the rigors of quality effectiveness research is all but non-existent. This has implications for the advancement of an evidence-based practice and intervention science more broadly.

A Synthesis of Peer-Mediated Academic Interventions for Secondary Struggling Learners

A synthesis of the extant research on peer-mediated reading and math interventions for students in regular or alternative education settings with academic difficulties and disabilities in Grades 6 to 12 (ages 11-18) is presented. Interventions conducted between 2001 and 2012 targeting reading and math were included if they measured effects on at least one academic outcome measure. A total of 13 intervention studies were synthesized in which 10 studies employed an experimental or quasi-experimental design and three studies used a single-case design. Findings from the 13 studies revealed mostly moderate to high effects favoring peer mediation, particularly when implementing a peer-mediated feedback component. In addition, findings suggest such interventions have social validity among adolescents and teachers. More rigorous research on secondary peer-mediated math interventions, peer-mediated interventions in alternative settings, and effective ways to pair dyads to incorporate a structured feedback component is warranted. Implications for peer-mediated instruction for academically struggling adolescents are discussed.

An Evaluation of Weighting Methods Based on Propensity Scores to Reduce Selection Bias in Multilevel Observational Studies

Observational studies of multilevel data to estimate treatment effects must consider both the nonrandom treatment assignment mechanism and the clustered structure of the data. We present an approach for implementation of four propensity score (PS) methods with multilevel data involving creation of weights and three types of weight scaling (normalized, cluster-normalized and effective), followed by estimation of multilevel models with the multilevel pseudo-maximum likelihood estimation method. Using a Monte Carlo simulation study, we found that the multilevel model provided unbiased estimates of the Average Treatment Effect on the Treated (ATT) and its standard error across manipulated conditions and combinations of PS model, PS method, and type of weight scaling. Estimates of between-cluster variances of the ATT were biased, but improved as cluster sizes increased. We provide a step-by-step demonstration of how to combine PS methods and multilevel modeling to estimate treatment effects using multilevel data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K).

Effects of a national safe patient handling program on nursing injury incidence rates

OBJECTIVE

The objective of the study was to identify which components of a system-wide safe patient handling (SPH) program reduced musculoskeletal injury (MSI) due to patient handling among nurses.

METHODS

The 3-year longitudinal study from 2008 to 2011 used a pretest-posttest design. The study was conducted in the Veterans Health Administration, and all medical centers participated. The outcome was 2011 MSI incidence rates due to patient-related handling for nurses, expressed as injuries per 10 000 full-time employees.

RESULTS

Three organizational risk factors, bed days of care, facility complexity level, and baseline MSI incidence rate, were significantly associated with MSI incidence rate and explained 21% of its variation. Five SPH components, including deployment of ceiling lifts and other new technologies, peer leader effectiveness, competency in SPH equipment use, facility coordinator link with safety committee, and peer leader training, uniquely accounted for an additional 23% of the total variation.

CONCLUSIONS

Findings provide evidence to support the effectiveness of a multicomponent approach to SPH programs given contextual considerations.

A synthesis and meta-analysis of reading interventions using social studies content for students with learning disabilities

A synthesis and meta-analysis of the extant research on the effects of reading interventions delivered using social studies content for students with learning disabilities in kindergarten through Grade 12 is provided. A total of 27 studies met criteria for the synthesis, with 16 studies providing sufficient data for inclusion in the meta-analysis. Reading interventions implemented within the context of social studies have employed the use of graphic organizers, mnemonics, reading and answering questions, guided notes, and multicomponent comprehension instruction. The overall mean effect size for interventions included in the meta-analysis was 1.02, indicating that reading interventions delivered using social studies content have a substantial positive effect on outcomes among students with learning disabilities.

Processes and outcomes of the veterans health administration safe patient handling program: study protocol

Background

Health care workers, such as nurses, nursing aides, orderlies, and attendants, who manually move patients, are consistently listed in the top professions for musculoskeletal injuries (MSIs) by the Bureau of Labor Statistics. These MSIs are typically caused by high-risk patient caregiving activities. In 2008, a safe patient handling (SPH) program was implemented in all 153 Veterans Administration Medical Centers (VAMCs) throughout the United States to reduce patient handling injuries.

Objective

The goal of the present study is to evaluate the effects associated with the national implementation of a comprehensive SPH program. The primary objectives of the research were to determine the effectiveness of the SPH program in improving direct care nursing outcomes and to provide a context for understanding variations in program results across sites over time. Secondary objectives of the present research were to evaluate the effectiveness of the program in reducing direct and indirect costs associated with patient handling, to explore the potential mediating and moderating mechanisms, and to identify unintended consequences of implementing the program.

Methods

This 3-year longitudinal study used mixed methods of data collection at 6- to 9-month intervals. The analyses will include data from surveys, administrative databases, individual and focus group interviews, and nonparticipant observations. For this study, a 3-tiered measurement plan was used. For Tier 1, the unit of analysis was the facility, the data source was the facility coordinator or administrative data, and all 153 VAMCs participated. For Tier 2, frontline caregivers and program peer leaders at 17 facilities each completed different surveys. For Tier 3, six facilities completed qualitative site visits, which included individual interviews, focus groups, and nonparticipant observations. Multiple regression models were proposed to test the effects of SPH components on nursing outcomes related to patient handling. Content analysis and constant comparative analysis were proposed for qualitative data analysis to understand the context of implementation and to triangulate quantitative data.

Results

All three tiers of data for this study have been collected. We are now in the analyses and writing phase of the project, with the possibility for extraction of additional administrative data. The focus of this paper is to describe the SPH program, its evaluation study design, and its data collection procedures. This study evaluates the effects associated with the national implementation of a comprehensive SPH program that was implemented in all 153 VAMCs throughout the United States to reduce patient handling injuries.

Conclusions

To our knowledge, this is the largest evaluation of an SPH program in the United States. A major strength of this observational study design is that all VAMCs implemented the program and were included in Tier 1 of the study; therefore, population sampling bias is not a concern. Although the design lacks a comparison group for testing program effects, this longitudinal field study design allows for capturing program dose-response effects within a naturalistic context. Implementation of the VA-wide SPH program afforded the opportunity for rigorous evaluation in a naturalistic context. Findings will guide VA operations for policy and decision making about resources, and will be useful for health care, in general, outside of the VA, in implementation and impact of an SPH program.

Interventions for reducing alcohol consumption among general hospital inpatient heavy alcohol users: a systematic review

BACKGROUND

There is growing interest in pro-active detection and provision of interventions for heavy alcohol use in the general hospital inpatient population. We aimed to determine, from the available evidence, the effectiveness of interventions in reducing alcohol consumption among general hospital inpatient heavy alcohol users.

METHODS

The following databases were searched for completed and on-going randomised and non-randomised controlled studies published up to November 2012: MEDLINE; C2-SPECTR; CINAHL; The Cochrane Library; Conference Proceedings Citation Index: Science; EMBASE; HMIC; PsycInfo; Public Health Interventions Cost Effectiveness Database (PHICED); and ClinicalTrials.gov. Studies were screened independently by two reviewers. Data extraction was performed by one reviewer and independently checked by a second.

RESULTS

Twenty-two studies which met the inclusion criteria enrolled 5307 participants in total. All interventions were non-pharmacological and alcohol focused. Results from single session brief interventions and self-help literature showed no clear benefit on alcohol consumption outcomes, with indications of benefit from some studies but not others. However, results suggest brief interventions of more than one session could be beneficial on reducing alcohol consumption, especially for non-dependent patients. No active intervention was found superior over another on alcohol consumption and other outcomes.

CONCLUSIONS

Brief interventions of more than one session could be beneficial on reducing alcohol consumption among hospital inpatients, especially for non-dependent patients. However, additional evidence is still needed before more definitive conclusions can be reached.

Field Experiments on Sensitive Organizational Topics

Organizational scholars study a number of sensitive topics that make employees and organizations vulnerable to unfavorable views. However, the typical ways in which researchers study these topics—via laboratory experiments and field surveys—can be laden with problems. In this article, the authors argue that the difficulties in studying sensitive topics can be overcome through the underutilized method of field experiments, detail strategies for conducting high-quality experimental field studies, and offer suggestions for overcoming potential challenges in data collection and publishing. As such, this article is designed to serve as a guide and stimulus for using the valuable methodological tool of field experiments.

Experimental design and primary data analysis methods for comparing adaptive interventions

In recent years, research in the area of intervention development has been shifting from the traditional fixed-intervention approach to adaptive interventions, which allow greater individualization and adaptation of intervention options (i.e., intervention type and/or dosage) over time. Adaptive interventions are operationalized via a sequence of decision rules that specify how intervention options should be adapted to an individual's characteristics and changing needs, with the general aim to optimize the long-term effectiveness of the intervention. Here, we review adaptive interventions, discussing the potential contribution of this concept to research in the behavioral and social sciences. We then propose the sequential multiple assignment randomized trial (SMART), an experimental design useful for addressing research questions that inform the construction of high-quality adaptive interventions. To clarify the SMART approach and its advantages, we compare SMART with other experimental approaches. We also provide methods for analyzing data from SMART to address primary research questions that inform the construction of a high-quality adaptive intervention.

Internalizing symptoms: effects of a preventive intervention on developmental pathways from early adolescence to young adulthood

This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.

A synthesis of read-aloud interventions on early reading outcomes among preschool through third graders at risk for reading difficulties

A synthesis and meta-analysis of the extant research on the effects of storybook read-aloud interventions for children at risk for reading difficulties ages 3 to 8 is provided. A total of 29 studies met criteria for the synthesis, with 18 studies providing sufficient data for inclusion in the meta-analysis. Read-aloud instruction has been examined using dialogic reading; repeated reading of stories; story reading with limited questioning before, during, and/or after reading; computer-assisted story reading; and story reading with extended vocabulary activities. Significant, positive effects on children's language, phonological awareness, print concepts, comprehension, and vocabulary outcomes were found. Despite the positive effects for read-aloud interventions, only a small amount of outcome variance was accounted for by intervention type.

Preventing weight gain in first year college students: an online intervention to prevent the "freshman fifteen"

The transition to college has been identified as a critical period for increases in overweight status. Overweight college students are at-risk of becoming obese adults, and, thus prevention efforts targeting college age individuals are key to reducing adult obesity rates. The current study evaluated an Internet intervention with first year college students (N=170) randomly assigned to one of four treatment conditions: 1) no treatment, 2) 6-week online intervention 3) 6-week weight and caloric feedback only (via email), and 4) 6-week combined feedback and online intervention. The combined intervention group had lower BMIs at post-testing than the other three groups. This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students.

Preference in random assignment: implications for the interpretation of randomized trials

Random assignment to a preferred experimental condition can increase service engagement and enhance outcomes, while assignment to a less-preferred condition can discourage service receipt and limit outcome attainment. We examined randomized trials for one prominent psychiatric rehabilitation intervention, supported employment, to gauge how often assignment preference might have complicated the interpretation of findings. Condition descriptions, and greater early attrition from services-as-usual comparison conditions, suggest that many study enrollees favored assignment to new rapid-job-placement supported employment, but no study took this possibility into account. Reviews of trials in other service fields are needed to determine whether this design problem is widespread.

A Synthesis of Reading Interventions and Effects on Reading Comprehension Outcomes for Older Struggling Readers

This article reports a synthesis of intervention studies conducted between 1994 and 2004 with older students (Grades 6-12) with reading difficulties. Interventions addressing decoding, fluency, vocabulary, and comprehension were included if they measured the effects on reading comprehension. Twenty-nine studies were located and synthesized. Thirteen studies met criteria for a meta-analysis, yielding an effect size (ES) of 0.89 for the weighted average of the difference in comprehension outcomes between treatment and comparison students. Word-level interventions were associated with ES = 0.34 in comprehension outcomes between treatment and comparison students. Implications for comprehension instruction for older struggling readers are described.

Anhedonia as a phenotype for the Val158Met COMT polymorphism in relatives of patients with schizophrenia

The Val(158)Met polymorphism of the catechol-O-methyltransferase (COMT) gene has been associated with aspects of schizophrenia that are possibly related to the disorder's pathogenesis. The present study investigated the Val(158)Met polymorphism in relation to anhedonia--a construct central to negative schizotypy. Anhedonia and other schizotypal characteristics were assessed in relatives of patients with schizophrenia, relatives of patients with bipolar disorder, and nonpsychiatric controls using the Chapman schizotypy scales and the Schizotypal Personality Questionnaire. Compared with controls, relatives of individuals with schizophrenia had elevated scores on Chapman scales for social anhedonia and physical anhedonia, while relatives of patients with bipolar disorder exhibited only increased scores on the Social Anhedonia Scale. As a group, relatives of patients with schizophrenia who were homozygous for the val allele of the COMT polymorphism showed the highest elevations in self-reported social and physical anhedonia. Associations with the COMT polymorphism were absent in relatives of patients with bipolar disorder and control participants. Findings suggest that anhedonia is manifest in individuals who carry genetic liability for schizophrenia and is associated with the Val(158)Met polymorphism of the COMT gene.

Evidentiary Pluralism as a Strategy for Research and Evidence-Based Practice in Rehabilitation Psychology

This paper examines the utility of evidentiary pluralism, a research strategy that selects methods in service of content questions, in the context of rehabilitation psychology. Hierarchical views that favor randomized controlled clinical trials (RCTs) over other evidence are discussed, and RCTs are considered as they intersect with issues in the field. RCTs are vital for establishing treatment efficacy, but whether they are uniformly the best evidence to inform practice is critically evaluated. We argue that because treatment is only one of several variables that influence functioning, disability, and participation over time, an expanded set of conceptual and data analytic approaches should be selected in an informed way to support an expanded research agenda that investigates therapeutic and extra-therapeutic influences on rehabilitation processes and outcomes. The benefits of evidentiary pluralism are considered, including helping close the gap between the narrower clinical rehabilitation model and a public health disability model. KEY WORDS: evidence-based practice, evidentiary pluralism, rehabilitation psychology, randomized controlled trials.

The need for substance abuse after-care: longitudinal analysis of Oxford House

AIMS

There is a need to explore the processes of social support and self-efficacy change over time among individuals in recovery homes, and to assess the extent to which residents remain abstinent, obtain and maintain employment, refrain from criminal activity, and utilize health care systems both while within the and after leaving such settings.

DESIGN

Residents were recruited and interviewed at an initial baseline phase and then re-interviewed at three subsequent 4-month intervals.

SETTING

Oxford Houses are recovery home residences for individuals with substance abuse and dependence problems who seek a supportive, democratic, mutual-help setting.

PARTICIPANTS

A national US sample of Oxford House residents (n=897: 604 men, 293 women).

MEASUREMENTS

Information was gathered on abstinence, social support, self-efficacy, employment, criminal history, and medical care utilization.

FINDINGS

Change in cumulative abstinence was predicted by support for alcohol use, abstinence self-efficacy, and length of residency in OH (i.e., less than versus >or=6 months), even after controlling for initial time spent in OH.

CONCLUSIONS

Results suggest that receiving abstinence support, guidance, and information from recovery home members committed to the goal of long-term sobriety may enhance residents' abstinence self-efficacy and enable persons recovering from alcohol and other drug addiction to reduce the probability of a relapse.

Community-based prevention of marital dysfunction: multilevel modeling of a randomized effectiveness study

This study is a cluster randomized controlled trial of the Prevention and Relationship Enhancement Program (PREP; H. J. Markman, S. M. Stanley, & S. L. Blumberg, 2001). Fifty-seven religious organizations (ROs), consisting of 217 newlywed couples, were randomly assigned to 1 of 3 intervention conditions: PREP delivered by university clinicians (U-PREP), PREP delivered by RO clergy (ROPREP), and naturally occurring (NO) marriage preparation. Self-reported relationship satisfaction, negative behavior, and positive behavior were assessed at preintervention, postintervention, and 1-year follow-up. Trajectories of relationship satisfaction showed no change over time and did not differ across conditions. Trajectories of negative behavior for RO-PREP wives showed significantly greater linear declines in comparison with NO trajectories. Trajectories of positive behavior for NO and U-PREP partners showed significant declines compared with RO-PREP trajectories. Effectiveness, transportability, and dissemination of marital distress prevention programs in community settings are discussed.

Population stratification in the candidate gene study: fatal threat or red herring?

Advances in molecular genetics have provided behavioral scientists with a means of investigating the influence of genetic factors on human behavior. Unfortunately, recent candidate gene studies have produced inconsistent results, and a frequent scapegoat for the lack of replication across studies is the threat of population stratification. This review of the literature on population stratification suggests that the threat may be a red herring. Reliable findings will require improved specification and measurement of the behavioral phenotypes in question, a renewed focus on internal validity, and the specification and testing of genetic factors in the context of longitudinal multivariate models. In this respect, behavioral scientists are well suited to investigating genetic factors that influence psychological mechanisms.

An alternative paradigm for clinical nursing research: an exemplar

Effectiveness research is undertaken to evaluate the effects of interventions in achieving desired outcomes when tested in the real-world conditions of everyday practice. Although the randomized clinical trial (RCT) is considered the gold standard for effectiveness research, its feasibility, generalizability, and the clinical utility of its results are being questioned. This state of the science prompted the call for a paradigm shift, characterized by alternative methods for clinical research. The alternative methods attempt to account for clinical realities when conducting research, with the goal of minimizing discrepancies in the perspective and assumptions underlying practice and research. In this article a theory-driven approach to intervention evaluation is presented as a viable alternative paradigm for clinical research. The application of this approach demands changes in four aspects of research: participant selection criteria, assignment to treatment options, delivery of the intervention, and selection of outcome measures. The changes are discussed at the conceptual level and illustrated with examples from an ongoing multisite study aimed at determining the usefulness of this theory-driven approach to intervention evaluation.