Development and Validation of a Physical Food Security Tool for Older Adults

BACKGROUND

Current measures of food insecurity focus on economic access to food, but not on the physical aspect of food insecurity that captures the inability to access food or prepare meals. This is particularly relevant among the older adult population who are at a high risk of functional impairments.

OBJECTIVES

To develop a short-form physical food security (PFS) tool among older adults using statistical methods based on the Item Response Theory (Rasch) model.

METHODS

Pooled data from adults aged ≥60 y of the NHANES (2013-2018) (n = 5892) were used. The PFS tool was derived from the physical limitation questions included in the physical functioning questionnaire of NHANES. Item severity parameters, fit and reliability statistics, and residual correlation between items were estimated using the Rasch model. The construct validity of the tool was assessed by examining associations with the Healthy Eating Index (HEI)-2015 scores, self-reported health, self-reported diet quality, and economic food insecurity, using weighted multivariable linear regression analysis, controlling for potential confounders.

RESULTS

A 6-item scale was developed, which had adequate fit statistics and high reliability (0.62). It was categorized based on raw score severity into high, marginal, low, and very low PFS. Very low PFS was associated with respondent's self-reported poor health (OR = 23.8; 95% CI: 15.3, 36.9; P < 0.0001), self-reported poor diet (OR = 3.9; 95% CI: 2.8, 5.5; P < 0.0001), low and very low economic food security (OR = 6.08; 95% CI: 4.23, 8.76; P < 0.0001), and with lower mean HEI-2015 index score, in comparison to older adults with high PFS (54.5 compared with 57.5, P = 0.022).

CONCLUSIONS

The proposed 6-item PFS scale captures a new dimension of food insecurity that can inform on how older adults experience food insecurity. The tool will require further testing and evaluation in larger and different contexts to demonstrate its external validity.

Integrative data analysis of self-efficacy in 4 clinical trials for alcohol use disorder

BACKGROUND

Self-efficacy has been proposed as a key predictor of alcohol treatment outcomes and a potential mechanism of success in achieving abstinence or drinking reductions following alcohol treatment. Integrative data analysis, where data from multiple studies are combined for analyses, can be used to synthesize analyses across multiple alcohol treatment trials by creating a commensurate measure and controlling for differential item functioning (DIF) to determine whether alcohol treatments improve self-efficacy.

METHOD

The current study used moderated nonlinear factor analysis (MNLFA) to examine the effect of treatment on self-efficacy across four different treatment studies (N = 3720; 72.5% male, 68.4% non-Hispanic white). Self-efficacy was measured using the Alcohol Abstinence Self-Efficacy Scale (AASE) in the COMBINE Study (n = 1383) and Project MATCH (n = 1726), and the Drug Taking Confidence Questionnaire (DTCQ) in two studies of Telephone Continuing Care (TEL Study 1: n = 303; TEL Study 2: n = 212). DIF was examined across time, study, treatment condition, marital status, age, and sex.

RESULTS

We identified 12 items from the AASE and DTCQ to create a commensurate measure of self-efficacy using MNLFA. All active treatments, including cognitive-behavioral treatment, a combined behavioral intervention, medication management, motivation enhancement treatment, telephone continuing care, twelve-step facilitation, and relapse prevention, were associated with significant increases in self-efficacy from baseline to posttreatment that were maintained for up to a year. Importantly, treatment as usual in community settings, which consisted of weekly group therapy that included addiction counseling and twelve-step recovery support, was not associated with significant increases in self-efficacy.

CONCLUSIONS

Alcohol self-efficacy increases following treatment and numerous evidence-based treatments are associated with significant increases in self-efficacy, which are maintained over time. Community treatment that focuses solely on addiction counseling and twelve-step support may not promote increases in self-efficacy.

Automatic Generation of Number Series Reasoning Items of High Difficulty

Number series reasoning items have been frequently used in educational assessment. This study reviewed the previous literature investigating features relating to item difficulty and developed a new automatic generator for number series reasoning items. Ninety-two items were generated and administered to 466 students. The results showed that the test achieved acceptable reliability. Items requiring two arithmetic operations were of particularly high difficulty. All stimulus features implemented in the automatic item generator proved to be significant predictors of item difficulty, explaining 77% of the total variance. This suggests that the automatic number series reasoning item generator was capable of generating items of considerably predictable difficulty. More importantly, the resulting items covered a wide range of difficulty levels, meeting the particular need for items of high difficulty.

Virtual Learning Simulations in High School: Effects on Cognitive and Non-cognitive Outcomes and Implications on the Development of STEM Academic and Career Choice

The present study compared the value of using a virtual learning simulation compared to traditional lessons on the topic of evolution, and investigated if the virtual learning simulation could serve as a catalyst for STEM academic and career development, based on social cognitive career theory. The investigation was conducted using a crossover repeated measures design based on a sample of 128 high school biology/biotech students. The results showed that the virtual learning simulation increased knowledge of evolution significantly, compared to the traditional lesson. No significant differences between the simulation and lesson were found in their ability to increase the non-cognitive measures. Both interventions increased self-efficacy significantly, and none of them had a significant effect on motivation. In addition, the results showed that the simulation increased interest in biology related tasks, but not outcome expectations. The findings suggest that virtual learning simulations are at least as efficient in enhancing learning and self-efficacy as traditional lessons, and high schools can thus use them as supplementary educational methods. In addition, the findings indicate that virtual learning simulations may be a useful tool in enhancing student's interest in and goals toward STEM related careers.