Initial validation of the Health Environment Rating Scale-Early Childhood Consultation-Classroom (HERS-ECC-C)

The present study validated a newly developed easy-to-use observational instrument, the Health Environment Rating Scale-Early Childhood Consultation-Classroom version (HERS-ECC-C), to measure the quality of the classroom environment within early care and education centers participating in a mental health consultation program in a diverse area of the southeastern United States. Using a confirmatory factor analysis, three factors emerged capturing critical aspects of a high-quality classroom environment and demonstrated good reliability: (1) Supportive Practices, Positive Socioemotional Practices, and Classroom Management (α = .88), (2) Health and Family Communication (α = .79), and (3) Individualizing to Children's Needs (α = .80). Criterion-related validity was established through concurrent associations between the three HERS-ECC-C subscales and the domains of the Classroom Assessment Scoring System (CLASS) and predictive associations with the Childcare Worker Job Stress Inventory. The HERS-ECC-C Supportive Practices and Health and Family Communication subscales were associated with all three CLASS domains, and the Individualizing to Children's Needs subscale was associated with the CLASS Instructional support domain. Higher HERS-ECC-C subscale scores were associated with lower teacher-reported job stress. Findings provide initial evidence to support the use and continued development of the HERS-ECC-C as a tool to evaluate programs and classrooms engaged in mental health consultation professional development interventions.

Adaptation and validation of the university-to-work success scale among Chinese university graduates

Introduction

Whether university graduates successfully make the transition from the university to work is critical for their career development. However, a comprehensive measurement of university-to-work success (UWS) that applies across different contexts remains lacking.

Methods

To address this gap, we adapted and validated the first comprehensive UWS measurement, the university-to-work success scale (UWSS), among samples of Chinese university graduates with three studies. We also provided new construct validity evidence for the scale and examined its measurement invariance across gender.

Results

The findings of the current study showed that the 24-item UWSS-Chinese version clearly showed four factors (career satisfaction, income and financial independence, confidence in career future, and adaptation to work) that were consistent with the original scale. Moreover, construct validity analysis revealed that UWSS was positively associated with proposed antecedents (i.e., career adaptability) and outcome (i.e., adult identity). It also showed incremental validity over general indicators of career success (i.e., career adaptability) in predicting adult identity establishment. Additionally, the measurement also showed measurement invariance across gender.

Discussion

Overall, these findings implied that the UWSS-Chinese version had good psychometric properties to be used in future studies and practice in China.

Validity of an online, self-administered Timeline Followback for alcohol use with adolescents

Objective

The Timeline Followback (TLFB) is a widely used and well-validated interview-based tool for assessing patterns of recent health risk behavior. There is some evidence of the validity of the TLFB as a self-administered online tool for assessing alcohol use, but further research is needed to establish its validity in younger populations and populations outside the United States. Further, it is unknown how self-administered online TLFB formats compare to more timesaving and commonly used single-item alcohol questions. The primary aim of the current study was to validate a new online, self-administered TLFB for alcohol use against the TLFB interview in a sample of European (Danish) adolescents aged 16-18 years (N = 30).

Methods

Participants completed a TLFB telephone interview, a self-administered online version of the TLFB, and single-item alcohol questions. Assessments were administered using a within-subject, counter-balanced design. Estimates of number of drinking days, binge-drinking days, maximum drinks consumed on one occasion, total drinks, and drinks per drinking day were compared across metrics.

Results

All correlations between the drinking outcomes assessed via the TLFB interview and the TLFB online were positive, and statistically significant (rss = 0.86-0.94, p < 0.01). Wilcoxon signed-rank tests showed no significant differences between the TLFB interview and the TLFB online on drinking days, binge drinking days, max drinks, and total drinks. Participants reported drinking significantly more drinks per drinking day on the TLFB online (M = 4.66) compared to on the TLFB interview (M = 4.12; p = 0.009).

Conclusion

Overall, the results support the validity of the online, self-administered TLFB in a sample of European (Danish) adolescents.

Measuring valued output in primary care: challenges and reconciliation

INTRODUCTION

Strong primary care has positive impact on patients' and population health, and high continuity of care is one of its hallmarks. Insight into the underlying mechanisms is limited and research on this topic requires measures of primary care outputs, which are states that mediate between processes and outcomes of primary care.

AREAS COVERED

Nine potential outputs of high continuity of care were specified to examine 45 validated patient questionnaires, which were identified in a systematic review. Eighteen questionnaires covered one or more primary care outputs, yet at variable and mostly limited extent.

EXPERT OPINION

Measures of primary care outputs can strengthen clinical and health services research, but such measures have yet to be developed and validated for most primary care outputs. The use of these measures in outcome evaluations of interventions in healthcare would enhance the interpretation of intervention effects. Validated measures are also needed to tap the full potential of advanced methods of data-analysis in clinical and health services research. Better understanding of the primary care outputs may also help to mitigate broader challenges in healthcare systems.

Occupational Health Literacy Scale (OHLS): development and validation of a domain-specific measuring instrument

Occupational health literacy (OHL) is a domain-specific approach that can empower people to make health-appropriate decisions in the work environment. OHL comprises the knowledge, skills and willingness of people to access and process health-related information and to apply it in work situations. The aim of this study was to evolve a conceptual model and validate a scale for OHL, that can be used in many sectors in the Western industrial countries, which does not yet exist. After piloting, item selection and alteration were carried out in a pretest with n = 163 working adults in diverse small- and medium-sized enterprises in Germany. The resulting OHL items were validated in a main survey with n = 828 participants working in small- and medium-sized enterprises and among them 47.5% people with migration background. The final 12-item questionnaire had good structural characteristics and is reliable and valid for measuring OHL. Using exploratory structural equation modeling, good fit indices (root mean square error of approximation = 0.063, comparative fit index = 0.940) confirmed a two-factor structure: (i) knowledge and skill-based processing of health information (internal consistency α = 0.88) and (ii) willingness and responsibility for occupational health (α = 0.74). The OHL scale fills the gap regarding domain-specific OHL questionnaires for working adults in diverse sectors in Western industrial countries. The Occupational Health Literacy Scale can be used to identify the needs of employees and companies and then to adapt and evaluate health promotion measures. Further research could include validation and use in other countries and large companies.

Validation of the PowerRef 3 for Measuring Accommodation: Comparison With the Grand Seiko WAM-5500A Autorefractor

Purpose

This validation study examines the PowerRef 3 as a method for measuring accommodation objectively. We assess agreement with refractive measurements obtained simultaneously by the Grand Seiko WAM-5500A autorefractor.

Methods

Refractive measurements were recorded simultaneously using the PowerRef 3 and WAM-5500A in 32 noncyclopleged participants aged 15 to 46 years. Accommodative states were recorded for 10 seconds at six accommodative demands (5 diopters [D], 4 D, 3 D, 2.5 D, 2 D, and 0 D) while participants fixated a high-contrast Maltese cross. WAM-5500A measurements were converted to power in the vertical meridian for comparison with PowerRef 3 data. Dioptric difference values were computed, and agreement was assessed using Bland-Altman plots with 95% limits of agreement (LOA) and intraclass correlation coefficient analyses.

Results

The mean absolute dioptric differences measured 0.14 D or less across accommodative demands. Analyses showed an excellent intraclass correlation coefficient across the tested demands (0.93). Bland-Altman plots indicated a bias of -0.02 D with 95% LOA of -1.03 D to 0.99 D. The 95% LOA was smallest for the 3 D demand (-0.71 D to 0.64 D), and largest at 5 D demand (-1.51 D to 1.30 D).

Conclusions

The mean dioptric differences between the PowerRef 3 and WAM-5500A autorefractor were small and not clinically significant. While some variability in agreement was observed depending on the tested demand, the PowerRef 3 demonstrated good agreement with the WAM-5500A.

Translational Relevance

The PowerRef 3 may be used to obtain objective measures of accommodation both monocularly and binocularly and provides a more flexible method, especially in pediatric populations.

Family Resilience Scale Short Form (FRS16): Validation in the US and Chinese Samples

Family resilience, which refers to the processes through which a family adapts to and thrives from adversities, has growing importance in recent years. In response to the need for further research on family resilience, the present research aims to abbreviate and validate Sixbey's Family Resilience Assessment Scale (FRAS) into a 16-item version Family Resilience Scale Short Form in the US (FRS16) and Chinese (FRS16_C) samples. The samples included 1,236 (Study 1) and 1,135 (Study 2) participants from the US and China, respectively. Results of confirmatory factor analysis (CFA) supported the proposed three-factor structure of FRS16: Family Communication and Connectedness, Positive Framing, and External Support across two samples. Overall, the reliability and validity of full and subscales of FRS16 and FRS16_C were satisfactory. Multi-group CFA revealed that both configural and metric invariance are supported, suggesting that participants in the US and Chinese samples assign comparable meaning to the latent factors of FRS16. Results suggested that FRS16 and FRS16_C are valid instruments for family resilience in the US and Chinese samples.

Novel Validated Index for the Measurement of Disinformation Susceptibility at the County Level

In the past decade, disinformation has become an increasingly dangerous enemy of public health, scientific advancement, and social stability. To address and counter this trend, it is essential to first identify communities most at risk for disinformation. The Jin-Hafiz Disinformation Index (JHDI) is developed and validated as a tool to counter disinformation and address deficits of good information on a county level in the United States. Once vulnerable communities are identified with the JHDI, targeted interventions with community partnerships can be conducted to address knowledge concerns.

"Stop the Bleed" Education Assessment Tool (SBEAT): Development and Validation

As part of the national Stop the Bleed campaign in the United States, more than a million people have received bleeding control training through the work of many organizations. These public and professional educational experiences are ideally grounded in health sciences, clinical, and educational evidence to be most effective. However, there is currently no standard tool for evaluating the educational quality of these programs. We developed and validated the Stop the Bleed Education Assessment Tool (SBEAT) to provide a standard measure of life-threatening bleeding educational programs knowledge learning outcomes to aid in evaluation and development of this public health program.

The SBEAT development included medical, clinical, and educational experts to derive and validate learning outcomes. Specific item writing incorporated focus groups for input on language and then pilot testing before a full community pilot test established a data set, for which a Rasch methodology was applied. The resulting tool used 34 items embedded in 19 survey questions, with item separation statistic of 5.56 (0.97 reliability) and person separation statistic of 2.09 (0.81 reliability) for 171 persons. Overall, the Cronbach Alpha (KR-20) person score “test reliability” equaled 0.85 (SEM = 2.24).

The SBEAT project establishes a standardized assessment tool to evaluate the cognitive aspects of first aid for life threatening bleeding. Comparison of outcomes from different teaching styles and methods will allow for the development of best practices for future bleeding control education and help organizations demonstrate value to learners, funders, and policy makers, and advance health sciences education. SBEAT offers a measure for which educational efficiency and efficacy can be judged within a larger effort to prepare people for personal emergencies or large-scale disasters.

Psychometric evaluation of the Functional Analytic Psychotherapy Intimacy Scale in obsessive-compulsive and related disorders

Functional Analytic Psychotherapy (FAP) is a contextual behavioral therapy that targets specific ideographic behaviors related to interpersonal functioning and intimacy. There is a scarcity of measures specifically focused on behavioral measurement of intimacy as well as limited studies that examine intimacy in obsessive-compulsive and related disorders (OCRDs). Leonard and colleagues (2014) created the Functional Analytic Psychotherapy Intimacy Scale (FAPIS). The purpose of this study was to investigate the validity of the FAPIS in evaluating those with OCRDs. The FAPIS and other measures of intimacy were administered to 549 nonreferred adults endorsing OCRD symptoms. Several confirmatory factor analyses were conducted to assess the best fitting factor structure, and convergent validity and divergent validity were also assessed. Given the psychometric properties of the FAPIS in this sample, future research may be helpful in assessing if the FAPIS would be beneficial in measuring change related to intimacy when working with people with OCRDs.

Validating Drug Court Collaboration Instrument: Differences in Model Adherence Between Adult and Juvenile Drug Courts

Drug courts aim to significantly address drug abuse and drug-related criminality. However, the effectiveness of drug courts varies from court to court. The variation of success demands insights regarding what is going on inside the "black box" of drug court practices. Therefore, it is necessary to evaluate to what extent drug courts are operated in adherence with guiding principles and strategies. Using a national sample and validated measures, the current article examines the "black boxes" of adult and juvenile drug courts across the country. We found that, in general, adult drug courts face less model adherence challenges in comparison with juvenile courts, which may, in part, explain why adult drug courts perform better than juvenile drug courts overall.

Pharmacokinetics-based adherence measures for antiretroviral therapy in HIV-infected Kenyan children

BACKGROUND

Traditional medication adherence measures do not account for the pharmacokinetic (PK) properties of the drugs, potentially misrepresenting true therapeutic exposure.

METHODS

In a population of HIV-infected Kenyan children on antiretroviral therapy including nevirapine (NVP), we used a one-compartment model with previously established PK parameters and Medication Event Monitoring Systems (MEMS®)-recorded dosing times to estimate the mean plasma concentration of NVP (Cp) in individual patients during 1 month of follow-up. Intended NVP concentration (Cp') was calculated under a perfectly followed dosing regimen and frequency. The ratio between the two (R = Cp/Cp') characterized the patient's NVP exposure as compared to intended level. Smaller R values indicated poorer adherence. We validated R by evaluating its association with MEMS®-defined adherence, CD4%, and spot-check NVP plasma concentrations assessed at 1 month.

RESULTS

In data from 152 children (82 female), children were mean age 7.7 years (range 1.5-14.9) and on NVP an average of 2.2 years. Mean MEMS® adherence was 79%. The mean value of R was 1.11 (SD 0.37). R was positively associated with MEMS® adherence (p < 0.0001), and lower-than-median R values were significantly associated with lower NVP drug concentrations (p = 0.0018) and lower CD4% (p = 0.0178), confirming a smaller R value showed poorer adherence.

CONCLUSION

The proposed adherence measures, R, captured patient drug-taking behaviours and PK properties.

Indentation Measurements to Validate Dynamic Elasticity Imaging Methods

We describe macro-indentation techniques for estimating the elastic modulus of soft hydrogels. Our study describes (a) conditions under which quasi-static indentation can validate dynamic shear-wave imaging estimates and (b) how each of these techniques uniquely biases modulus estimates as they couple to the sample geometry. Harmonic shear waves between 25 and 400 Hz were imaged using ultrasonic Doppler and optical coherence tomography methods to estimate shear dispersion. From the shear-wave speed of sound, average elastic moduli of homogeneous samples were estimated. These results are compared directly with macroscopic indentation measurements measured two ways. One set of measurements applied Hertzian theory to the loading phase of the force-displacement curves using samples treated to minimize surface adhesion forces. A second set of measurements applied Johnson-Kendall-Roberts theory to the unloading phase of the force-displacement curve when surface adhesions were significant. All measurements were made using gelatin hydrogel samples of different sizes and concentrations. Agreement within 5% among elastic modulus estimates was achieved for a range of experimental conditions. Consequently, a simple quasi-static indentation measurement using a common gel can provide elastic modulus measurements that help validate dynamic shear-wave imaging estimates.

Caregiving in severe mental illness: the psychometric properties of the Involvement Evaluation Questionnaire in Portugal

BACKGROUND

Despite the achievements of previous research, caregiving assessments in severe mental illness should be crossculturally validated in order to define risk groups or to evaluate family work. This study reports on the psychometric properties of the European version of the Involvement Evaluation Questionnaire (IEQ-EU) in Portugal.

METHODS

A Portuguese translation of the IEQ-EU was developed according to the 'European Psychiatric Services: Inputs Linked to Outcome Domains and Needs' (EPSILON) group guidelines. We then studied 194 caregivers who were related to patients with schizophrenia spectrum disorders in psychiatric outpatient services. All relatives were assessed using the IEQ-EU. In order to describe the corresponding patients' sample, the majority (n = 162) was evaluated with the World Health Organization Disability Assessment Schedule (WHO-DAS II); 108 patients were also assessed with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF).

RESULTS

The factor structure of the Portuguese version of the questionnaire was similar to the original; internal consistency was good, with Cronbach's α ranging from 0.71 to 0.87 in the IEQ-EU scales (total score and domains: tension, supervision, worrying, urging); test-retest reliability yielded intraclass correlation coefficients (ICCs) from 0.80 to 0.94, concerning the same scores. Ecological validity was confirmed. Most caregiving consequences were reported on the worrying domain of the IEQ-EU.

CONCLUSIONS

Validity and reliability of the Portuguese IEQ-EU translation were established. Specifically the four IEQ-EU subscale domains seem to be valid in Portugal.