Lingering Effects of COVID-19 Stressors on Mental Health and Alcohol Use in Middle Aged to Older Adults

Background

Older adults have faced not only health threats but grave mental health challenges since the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. Using factor analysis, this study is the first to identify the underlying dimensions of COVID-19-related stressors, then examine the relationship between these factors and mental health and alcohol use/misuse longitudinally in a middle aged to older adult sample in the United States.

Methods

As part of a long-term follow-up study, 921 survey participants completed measures of COVID-related stressors, psychological distress, and alcohol use/misuse in a 2020 survey. An exploratory factor analysis was conducted to examine the dimensionality of COVID-related stress. Regression models were utilized to examine relationships between the extracted factors and depression, anxiety, and alcohol-related outcomes measured approximately one year later, in 2021.

Results

Four dimensions of COVID-19 stressors were extracted, including 1) jobs, finances and loss of routine; 2) practical difficulties; 3) social worries and challenges; and 4) supply shortages. Practical difficulties were associated with higher depression at follow-up, while jobs, finances and loss of routine were associated with past 12 month frequency of intoxication at follow-up.

Conclusions

Challenges from the pandemic may have longer-term implications for mental health in older adults past the acute phase of the pandemic. It is important to allocate sufficient attention and resources to the prevention of late life depression and mental health as policymakers and health professionals continue to deal with the pandemic and future variants of the virus.

Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up

BACKGROUND

Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period.

METHODS

Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996-2007 and again in 2020-2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways.

RESULTS

Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up.

CONCLUSIONS

Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health.

How Scientists View Vaccine Hesitancy

This paper examines possible causes, consequences, and potential solutions for addressing vaccine hesitancy in the United States, focusing on the perspectives of academic scientists. By examining the experiences of scientists, who are arguably a critical community in US society, we gain deeper insights into how they understand the complexities of vaccine hesitancy and whether their insights and opinions converge with or diverge from the current literature. We present findings from a national survey of a representative sample of academic scientists from the fields of biology and public health regarding vaccine hesitancy and related topics. Empirical analysis using descriptive, bivariate, and multivariate analyses covers multiple topics, including vaccine controversy, trust in science, causes of vaccine hesitancy, preferred policy and regulatory approaches, risk perceptions, and scientists' ethics and perceived communication roles. The results highlight a diversity of opinions within the scientific community regarding how to improve science-society communication in regard to vaccines, including the need to be transparent and candid to the public about the risk of vaccines and their research.

U.S. Visa and Immigration Policy Challenges: Explanations for Faculty Perceptions and Intent to Leave

United States (US) immigration policies have increasingly focused on national security resulting in universities experiencing declines in international student applications, constraints on international scholar employment, and complications facilitating international research collaborations. The COVID-19 pandemic brought additional travel restrictions, embassy closures, and health and safety concerns that exacerbated these challenges. Science mobility is critical for science education, training, competitiveness, and innovation. Using a representative sample of US and foreign-born scientists in three STEM fields, we explore how recent visa and immigration policies have shaped research collaborations, work with students and postdoctoral scholars, and intentions to leave. We use descriptive statistics, analysis of variance, and logistic regression and find academic scientists report disruptions from visa and immigration policies; negative impacts of immigration policies on US higher education; negative effects on recruitment and retention of international trainees; and increased intentions to leave the US driven by negative perceptions of immigration policy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11162-023-09731-0.

The genome of a giant (trevally): Caranx ignobilis

Caranx ignobilis, commonly known as giant kingfish or giant trevally, is a large, reef-associated apex predator. It is a prized sportfish, targeted throughout its tropical and subtropical range in the Indian and Pacific Oceans. It also gained significant interest in aquaculture due to its unusual freshwater tolerance. Here, we present a draft assembly of the estimated 625.92 Mbp nuclear genome of a C. ignobilis individual from Hawaiian waters, which host a genetically distinct population. Our 97.4% BUSCO-complete assembly has a contig NG50 of 7.3 Mbp and a scaffold NG50 of 46.3 Mbp. Twenty-five of the 203 scaffolds contain 90% of the genome. We also present noisy, long-read DNA, Hi-C, and RNA-seq datasets, the latter containing eight distinct tissues and can help with annotations and studies of freshwater tolerance. Our genome assembly and its supporting data are valuable tools for ecological and comparative genomics studies of kingfishes and other carangoid fishes.

COVID-19 and gender inequity in science: Consistent harm over time

Stay-at-home-orders, online learning, and work from home policies are some of the responses governments, universities, and other institutions adopted to slow the spread of COVID-19. However, research shows these measures have increased pre-existing gender disparities in the workplace. The working conditions for women during the pandemic worsened due to increased family care responsibilities and unequal distribution of domestic labor. In the academy, working from home has resulted in reduced research time and increased teaching and family care responsibilities, with a larger proportion of that burden falling to women. We investigate the persistence of gender inequity among academic scientists resulting from university COVID-19 responses over time. We draw on two surveys administered in May 2020 and May 2021 to university-based biologists, biochemists, and civil and environmental engineers, to analyze how the pandemic response has disproportionately impacted women in academia and the endurance of those inequities. Results show significantly greater negative impacts from the pandemic on women’s research activities and work-life balance, compared to men. We conclude by discussing the implications of our results, and the need for the academy to better predict and adjust to the gender disparities its policies create.

Developing a short screener for acquiescent respondents

BACKGROUND

Acquiescent response style (ARS) refers to survey respondents' tendency to choose response categories agreeing to questions regardless of their content and is hypothesized as a stable respondent trait. While what underlies acquiescence is debatable, the effect of ARS on measurement is clear: bias through artificially increased agreement ratings. With certain population subgroups (e.g., racial/ethnic minorities in the U.S.) are associated with systemically higher ARS, it causes concerns for research involving those groups. For this reason, it may be necessary to classify respondents as acquiescers or a nonacquiescers, which allows independent analysis or accounting for this stylistic artifact. However, this classification is challenging, because ARS is latent, observed only as a by-product of collected data.

OBJECTIVES

To propose a screener that identifies respondents as acquiescers.

METHODS

With survey data collected for ARS research, various ARS classification methods were compared for validity as well as implementation practicality.

RESULTS

The majority of respondents was classified consistently into acquiescers or nonacquiescers under various classification methods.

CONCLUSIONS

We propose a method based on illogical responses given to two balanced, theoretically distant multi-item measurement scales as a screener.

Genome assembly of the roundjaw bonefish (Albula glossodonta), a vulnerable circumtropical sportfish

The roundjaw bonefish, Albula glossodonta, is the most widespread albulid in the Indo-Pacific and is vulnerable to extinction. We assembled the genome of a roundjaw bonefish from Hawai'i, USA, which will be instrumental for effective transboundary management and conservation when paired with population genomics datasets. The 1.05 gigabase pair (Gbp) contig-level assembly had a 4.75 megabase pair (Mbp) NG50 and a maximum contig length of 28.2 Mbp. Scaffolding yielded an LG50 of 20 and an NG50 of 14.49 Mbp, with the longest scaffold reaching 42.29 Mbp. The genome comprised 6.5% repetitive elements and was annotated with 28.3 K protein-coding genes. We then evaluated population genetic connectivity between six atolls in the Western Indian Ocean with 38,355 SNP loci across 66 A. glossodonta individuals. We discerned shallow population structure and observed genetic homogeneity between atolls in Seychelles and reduced gene flow between Seychelles and Mauritius. The South Equatorial Current might be the limiting mechanism of this reduced gene flow. The genome assembly will be useful for addressing taxonomic uncertainties of bonefishes globally.

Correction: COVID-19 and the academy: opinions and experiences of university-based scientists in the U.S

[This corrects the article DOI: 10.1057/s41599-021-00823-9.].

The Chicago Health and Life Experiences of Women Couples Study: Protocol for a Study of Stress, Hazardous Drinking, and Intimate Partner Aggression Among Sexual Minority Women and Their Partners

BACKGROUND

Large gaps exist in research on alcohol use and intimate partner aggression (IPA) among sexual minority women (SMW; eg, lesbian, bisexual). Dyadic research with SMW and their partners can illuminate how couple-level factors operate in conjunction with individual-level factors to shape well-being in this understudied and vulnerable population. Given the traditionally gendered lens with which women are primarily viewed as victims and men as perpetrators, understanding the dynamics of IPA in same-sex female couples can also advance research and practice related to IPA more generally.

OBJECTIVE

Guided by a recent extension of the minority stress model that includes relational (couple-level) sexual minority stress and the I-cubed theoretical perspective on IPA, we will collect individual and dyadic data to better characterize the links between hazardous drinking and IPA among SMW and their partners. First, this study aims to examine the associations among minority stress, hazardous drinking, and IPA in SMW and their partners. Minority stressors will be assessed as both individual and couple-level constructs, thus further extending the minority stress model. Second, we aim to examine potential mediators and moderators of the associations among minority stress, hazardous drinking, and IPA. Finally, we aim to test models guided by the I-cubed theoretical perspective that includes instigating (eg, relationship conflict), impelling (eg, negative affect and trait anger), and inhibiting (eg, relationship commitment and emotion regulation) or disinhibiting (eg, hazardous drinking) influences on IPA perpetration.

METHODS

This United States National Institutes of Health-funded project will draw from a large and diverse cohort of SMW currently enrolled in the Chicago Health and Life Experiences of Women (CHLEW) study-a 21-year longitudinal study of risk factors and consequences associated with SMW hazardous drinking. SMW currently enrolled in the CHLEW and their partners will be invited to participate in the CHLEW Couples Study. By analyzing dyadic data using actor-partner interdependence models, we will examine how each partner's minority stress, hazardous drinking, and IPA experiences are associated with both her own and her partner's minority stress, hazardous drinking, and IPA perpetration.

RESULTS

Data collection began in February 2021 and will likely continue through 2023. Initial results should be available by mid-2024.

CONCLUSIONS

The CHLEW Couples Study will fill important gaps in knowledge and provide the basis for future research aimed at clarifying the causal pathways linking hazardous drinking and IPA among SMW. This will support the development of culturally appropriate targeted individual and dyadic prevention and intervention strategies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28080.

The influence of minority stress on indicators of suicidality among lesbian, gay, bisexual and transgender adults in Thailand

WHAT IS KNOWN ON THE SUBJECT?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study examined rates and predictors of suicidality in Thai LGBT adults. Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past-year suicidal ideation, while socio-demographic and health-related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand. Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours. Standardized measures of sexual orientation and gender identity should be included in all patient intake forms. In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority-specific stressors should be used. Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing.

ABSTRACT

INTRODUCTION: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists.

AIM

To examine rates and predictors of suicidality among Thai LGBT adults (N = 411).

METHOD

Data collection was conducted via online and in-person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health-related factors, general and minority-specific stressors and suicidality were completed.

RESULTS

Thirty-nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12-month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤ .05, R² = 0.327). Past-year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p < .05, R²  = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R²  = 0.187).

DISCUSSION

General and minority-specific stressors negatively impacted suicidality among LGBT participants.

IMPLICATION FOR PRACTICE

Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals.

Alcohol use among sexual minority women: Methods used and lessons learned in the 20-Year Chicago Health and Life Experiences of Women Study

Background

Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated with high-risk/hazardous drinking among SMW. However, this research has almost exclusively used cross-sectional designs, limiting the ability to draw conclusions about processes through which sexual minority status affects alcohol use. Longitudinal designs, although very rare in research on alcohol use among SMW, are important for testing mediational mechanisms and necessary to understanding how changes in social determinants impact alcohol use.

Aim

To describe the processes and lessons learned in conducting a 20-year longitudinal study focused on alcohol use among SMW.

Methods

The Chicago Health and Life Experiences of Women (CHLEW) study includes five waves of data collection (2000-present) with an age and racially/ethnically diverse sample of 815 SMW (ages 18-83) originally recruited in the Chicago Metropolitan Area in Illinois, a midwestern state in the United States (U.S.). Measures and focus have evolved over the course of the study.

Results

The CHLEW study is the longest-running and most comprehensive study of SMW's drinking in the U.S. or elsewhere. Findings reported in more than 50 published manuscripts have contributed to understanding variations in SMW's risk for hazardous/harmful drinking based on sexual identity, age, race/ethnicity, sex/gender of partner, and many other factors.

Conclusions

By describing the process used in conducting this long-term study, its major findings, and the lessons learned, we hope to encourage and support other researchers in conducting longitudinal research focused on SMW's health. Such research is critically important in understanding and ultimately eliminating sexual orientation-related health disparities.

COVID-19 and the academy: opinions and experiences of university-based scientists in the U.S

Much of the available evidence regarding COVID-19 effects on the scientific community in the U.S. is anecdotal and non-representative. We report findings from a based survey of university-based biologists, biochemists, and civil and environmental engineers regarding negative and positive COVID-19 impacts, respondent contributions to addressing the pandemic, and their opinions regarding COVID-19 research policies. The most common negative impact was university closures, cited by 93% of all scientists. Significant subgroup differences emerged, with higher proportions of women, assistant professors, and scientists at institutions located in COVID-19 "hotspot" counties reporting difficulties concentrating on research. Assistant professors additionally reported facing more unanticipated childcare responsibilities. Approximately half of the sample also reported one or more positive COVID-19 impacts, suggesting the importance of developing a better understanding of the complete range of impacts across all fields of science. Regarding COVID-19 relevant public policy, findings suggest divergence of opinion concerning surveillance technologies and the need to alter federal approval processes for new tests and vaccines.

A Community-Driven Probability Survey of Disadvantaged Populations in Chicago: Sinai Community Health Survey 2.0

BACKGROUND

Community-level health data are needed to identify and prioritize the most pressing health issues at the local level.

OBJECTIVES

To conduct a community-driven probability health survey of disadvantaged Chicago communities in 2015-2016.

METHODS

A safety-net hospital completed questionnaire development and dissemination in close partnership with a Community Advisory Committee (CAC), so the data captured accurately reflected community priorities.

LESSONS LEARNED

The final survey sample included 1,543 adult interviews and proxy reports for 394 children, well below our original recruitment goal. Although ideal for area probability sampling, face-to-face surveys are challenging given declining response rates. Nevertheless, these data provide representative community-level data that is otherwise unavailable.

CONCLUSIONS

Hyper-local data are especially critical for diverse and segregated cities such as Chicago. Lessons learned can be applied to future community surveys done by hospital systems, health departments, and community advocates to maximize the usefulness of findings.

Assessing the Quality of Published Surveys in Ophthalmology

PURPOSE

Surveys are an important research modality in ophthalmology, but their quality has not been rigorously assessed. This study evaluated the quality of published ophthalmic surveys.

METHODS

Three survey methodologists, three senior ophthalmologists, and two research assistants developed a survey evaluation instrument focused on survey development and testing; sampling frame; response bias; results reporting; and ethics. Two investigators used the instrument to assess the quality of all ophthalmic surveys that were published between January 1, 2018 and December 31, 2018; indexed in MEDLINE/PubMed, Embase, and/or Web of Science; contained the search terms "ophthalmology" and "survey" or "questionnaire" in the title and/or abstract; and were available in English.

RESULTS

The search identified 626 articles; 60 met the eligibility criteria and were assessed with the survey evaluation instrument. Most surveys (93%; 56/60) defined the study population; 48% (29/60) described how question items were chosen; 30% (18/60) provided the survey for review or described the questions in sufficient detail; 30% (18/60) were pre-tested or piloted; 25% (15/60) reported validity/clinical sensibility testing; 15% (9/60) described techniques used to assess non-response bias; and 63% (38/60) documented review by an institutional review board (IRB).

CONCLUSION

The quality of published ophthalmic surveys can be improved by focusing on survey development, pilot testing, non-response bias and institutional review board review. The survey evaluation instrument can help guide researchers in conducting quality ophthalmic surveys and assist journal editors in evaluating surveys submitted for publication.

The Influence of Item Characteristics on Acquiescence among Latino Survey Respondents

Acquiescence is often defined as the systematic selection of agreeable ("strongly agree") or affirmative ("yes") responses to survey items, regardless of item content or directionality. This definition implies that acquiescence is immune to item characteristics; however, the influence of item characteristics on acquiescence remains largely unexplored. We examined the influence of eight item characteristics on acquiescence in a telephone survey of 400 Latinos and non-Latino whites: qualified wording, mental comparisons, negated wording, unfamiliar terms, ambiguous wording, knowledge accessibility, item length, and polysyllabic wording. Negated and ambiguous wording was associated with reduced acquiescence for the full sample, as well as subsamples stratified by ethnicity and sociodemographic characteristics. This effect was strongest among younger, more educated, and non-Latino white respondents. No other item characteristics had a significant influence on respondent acquiescence. Findings from this study suggest that acquiescence may be affected by interactions between respondent and item characteristics.

Overcoming Barriers to Sustaining Health Equity Interventions: Insights from the National Institutes of Health Centers for Population Health and Health Disparities

We conducted qualitative semi-structured telephone interviews with the directors of the 10 National Institutes of Health Centers for Population Health and Health Disparities (NIH/CPHHD) to identify factors that were associated with the sustainability of 19 interventions developed to address cancer disparities and 17 interventions developed to address cardiovascular disease disparities in the United States. Interview transcripts were analyzed using the constant comparative method of analysis to identify key themes and synthesize findings. Directors at NIH/CPHHD reported that barriers to sustainability included uncertainty about future funding and insufficient resources to build and maintain diverse stakeholder partnerships. Strategies that helped to overcome these barriers included developing and engaging community partnerships with health care systems; early pursuit of multiple funding sources; and investments in infrastructure to address the social determinants of health. Sustainability planning should be incorporated during the early stages of intervention development to facilitate maintenance of successful programs that address health disparities.

Measuring the Elusive Construct of Personalismo among Mexican American, Puerto Rican, and Cuban American Adults

Personalismo may have a broad influence on the well-being of U.S. Latinos by shaping social networks, and, in turn, access to information and resources. However, research on personalismo is currently constrained by the lack of a psychometrically sound measure of this cultural construct. This research used a mixed methods approach to develop a personalismo scale across three studies: a cognitive interviewing study with Mexican American adults (n=33); a cognitive interviewing study with non-Latino white, Mexican American, Puerto Rican, and Cuban American adults (n=61); and a psychometric telephone survey with Mexican American, Puerto Rican, and Cuban American adults (n=1,296). The final, 12-item scale had high internal consistency reliability and appears to be appropriate for use with Mexican American, Puerto Rican, and Cuban American adults. Significant differences emerged across Latino subgroups, with higher personalismo observed among Cuban Americans and female respondents, providing empirical evidence of cultural heterogeneity among U.S. Latino populations.

Why do Latino Survey Respondents Acquiesce? Respondent and Interviewer Characteristics as Determinants of Cultural Patterns of Acquiescence among Latino Survey Respondents

Research indicates that Latino survey respondents are more likely to acquiesce than non-Latino European Americans, thereby decreasing the potential for measurement invariance across cultural groups. In order to better understand what drives this culturally patterned response style, we examined the influence of respondent and interviewer characteristics on acquiescence. Data were obtained from a telephone survey of 400 Mexican American, Puerto Rican, Cuban American, and non-Latino European American respondents and a self-administered survey of 21 interviewers. Higher acquiescence was associated with several respondent characteristics: older age, lower education, stronger Latino cultural orientation, Spanish use, Latino ethnicity, and, among Latinos, Cuban American ethnicity. In contrast, acquiescence was not influenced by respondent-interviewer social distance, social deference, or interviewer characteristics (e.g., education, gender, acculturation, interviewer experience). These findings indicate that acquiescence differs across Latino ethnic subgroups and that respondent and language factors are more influential determinants of acquiescence than survey interviewers.

Validation of the Korean Parental Depression Literacy Scale

The aim of the present study was to validate the Korean American Parental Depression Literacy Scale (Parental D-Lit Scale), which was modified from Griffith's Depression Literacy Scale based on expert reviews, individual and focus group interviews, and a cross-sectional, self-administered survey. Survey participants included Korean American mothers (n = 107, 74.8%) and fathers (n = 36, 25.2%) of adolescent children. We examined reliability and validity using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and correlational and comparison analyses. The scale showed moderate reliability and validity (α = 0.72) and content validity (scale-level content validity index = 0.875). EFA resulted in a three-factor model, and CFA showed a close fit to the data (root mean square error of approximation = 0.056). Reliability indices indicated that total scale scores were more useful for examining depression literacy than subscale scores. Criterion validity was supported by statistically-significant correlations in the expected direction between depression literacy and other theoretically-related constructs, including attitudes towards mental health-care services (+), depression stigma (-), recognition of depression (+), and acculturation (+). The Parental D-Lit Scale scores showed statistically-significant mean differences between parents who identified depression in a vignette (mean = 18.3, standard deviation (SD) = 2.9) and those who did not (mean = 16.8, SD = 4.0), indicating the discriminant validity of the scale. The Parental D-Lit Scale shows promise for use by psychiatric/mental health nurses in assessing the effectiveness of educational and clinical interventions. Additional research should employ larger samples in various regions of the USA.

Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) Across English and Spanish-Speaking Hispanics/Latinos: Results From the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

The validity of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) has been examined in primarily non-Hispanics/Latinos with chronic illness. This study assessed the psychometric properties of the non-illness, expanded FACIT-Sp (FACIT-Sp-Ex) in 5,163 U.S. Hispanic/Latino adults. Measures were interviewer-administered in English or Spanish. Confirmatory factor analyses indicated four factors: Meaning, Peace, Faith, and Relational. The scale demonstrated measurement invariance across English and Spanish. Subscales displayed adequate internal and test-retest reliability. Scores were positively associated with Duke Religion Index (DUREL) subscales. When all subscales were entered in a single model, Meaning and Peace were inversely associated with depressive symptoms and positively associated with HRQOL. Faith was positively associated with depressive symptoms and inversely associated with HRQOL. Relational was not associated with any outcome. FACIT-Sp-Ex subscales were generally more strongly associated than DUREL subscales with well-being. The FACIT-Sp-Ex appears to be a valid measure of spiritual well-being in U.S. Hispanics/Latinos.

Effects of Regulatory Support Services on Institutional Review Board Turnaround Times

We evaluated how regulatory support services provided by University of Illinois at Chicago's Center for Clinical and Translational Science may reduce Institutional Review Board (IRB) turnaround times. IRB applications were categorized by receipt of any regulatory support and amount of support received. Turnaround time included total turnaround time, time for IRB review, and time for investigators to modify protocols. There were no differences in any turnaround times for supported versus nonsupported applications. However, for supported applications, those receiving more intensive support had total turnaround times 16.0 days ( SE 7.62, p < .05) faster than those receiving less intensive support. Receiving higher regulatory support may be associated with faster approval of IRB submissions.

Perceptions of negative health-care experiences and self-reported health behavior change in three racial and ethnic groups

OBJECTIVES

Our two study objectives were: (1) to understand the relationship between the perception of a previous negative health-care experience and race/ethnicity, and how socio-demographic, access-to-health-care, and self-reported health variables modified this relationship; and (2) to assess how many behaviors participants reported changing as a result of experiencing a perceived negative health-care experience, which behaviors they changed, and if there were differences in patterns of change across racial/ethnic groups.

DESIGN

We conducted a cross-sectional survey of a convenience sample of 600 African-American, Mexican-Hispanic, and white adults in socioeconomically diverse neighborhoods in Chicago, IL. We used multivariable logistic regression to analyze the relationship between a perceived negative health-care experience in the last 5 years and race/ethnicity. We summed and then calculated the percentage of people who changed each of the 10 behaviors and evaluated whether or not there were differences in behavior change across racial/ethnic groups.

PRINCIPAL FINDINGS

More than 32% of participants reported a perceived negative health-care experience in the past 5 years. Participants who had a bachelor's degree or above (OR: 2.95, 95%CI: 1.01-8.63), avoided needed care due to cost (OR: 1.84, 95%CI: 1.11-3.06), or who reported fair/poor health (OR: 3.58, 95%CI: 1.66-7.80) had significantly increased odds of reporting a negative health-care experience. Of these people, 88% reported 'sometimes/always' changing at least one health-seeking behavior. There were no racial/ethnic differences in reporting negative experiences or in patterns of behavior change.

CONCLUSIONS

Race/ethnicity was not related to reporting a perceived negative health-care experience or reported patterns of behavior change in response to that experience. However, those who avoided care due to cost were more highly educated, or who indicated poorer health status reported having a negative experience more often. Our findings suggest that the perception of a previous negative experience may influence subsequent health-care-seeking behaviors.

Measures of economic advantage associated with HPV-positive head and neck cancers among non-Hispanic black and white males identified through the National Cancer Database

BACKGROUND

National trends show dramatic increases in the incidence of HPV-related head and neck squamous cell carcinomas (HNSCCs) among black and white males. Using cases identified through the National Cancer Data Base, we assessed factors associated with HPV 16- or 16/18 positive HNSCCs among non-Hispanic black and white males diagnosed in the U.S. between 2009 and 2013.

METHODS

This sample included 21,524 HNSCCs with known HPV status. Adjusted relative risks (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression.

RESULTS

Compared to those with HPV-negative tumors, male patients diagnosed with HPV-positive HNSCCs were non-Hispanic white, younger at diagnosis, lived in zip-code areas with higher median household income and higher educational attainment, had private health insurance and no reported comorbidities at diagnosis. Although the risk of HPV-positive HNSCCs increased with measures of higher area-level socioeconomic status, the effect was stronger for non-Hispanic black males (RR_Adjusted=1.76, 95% CI 1.49-2.09) than for whites (RR_Adjusted=1.12, 95% CI 1.08-1.16). The peak age for diagnosis of HPV-positive HNSCCs occurred in those diagnosed at 45-49 years (RR_Adjusted=1.57, 95% CI 1.42-1.73). Oropharyngeal tumors were strongly associated with HPV-positivity (RR_Adjusted=4.32, 95% CI 4.03-4.63). In the analysis restricted to oropharyngeal anatomic sites, similar patterns persisted.

CONCLUSION

In our analysis, measures of economic advantage were associated with an increased risk of HPV-positive HNSCCs. In order to develop effective interventions, greater understanding of the risk factors for HPV-positive HNSCCs is needed among both high-risk males and their healthcare providers.

Validating a Hazardous Drinking Index in a Sample of Sexual Minority Women: Reliability, Validity, and Predictive Accuracy

BACKGROUND

Although sexual minority women (SMW) are at increased risk of hazardous drinking (HD), efforts to validate HD measures have yet to focus on this population.

OBJECTIVES

Validation of a 13-item Hazardous Drinking Index (HDI) in a large sample of SMW.

METHODS

Data were from 700 adult SMW (age 18-82) enrolled in the Chicago Health and Life Experiences of Women study. Criterion measures included counts of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms, average daily and 30-day ethanol consumption, risky sexual behavior, and Diagnostic and Statistical Manual (DSM-IV) measures of alcohol abuse/dependence. Analyses included assessment of internal consistency, construction of receiver operating characteristic (ROC) curves to predict alcohol abuse/dependence, and correlations between HDI and criterion measures. We compared the psychometric properties (diagnostic accuracy and correlates of hazardous drinking) of the HDI to the commonly used CAGE instrument.

RESULTS

KR-20 reliability for the HDI was 0.80, compared to 0.74 for the CAGE. Predictive accuracy, as measured by the area under the receiver operating characteristic curve for alcohol abuse/dependence, was HDI: 0.89; CAGE: 0.84. The HDI evidenced the best predictive efficacy and tradeoff between sensitivity and specificity. Results supported the concurrent validity of the HDI measure.

CONCLUSIONS

The Hazardous Drinking Index is a reliable and valid measure of hazardous drinking for sexual minority women.

Components of Self-Rated Health among Adults: Analysis of Multiple Data Sources

Four data sources were used to examine competing interpretations of self-rated health measures: whether they are best classified as summary indicators of both physical and psychological health status, or merely as surrogate measures of physical health. Multiple regression analysis revealed that, within each data source, measures of physical health and depression were each independently associated with general health status ratings after six socio-demographic indicators (sex, race, age, education, income, and residence) were held constant. These results were confirmed using both cross-sectional and longitudinal models, and using several different indicators of physical health. They suggest that researchers should be cautious in interpreting global health ratings, as they contain significant information regarding the psychological, as well as physical, health status of respondents.

How to use survey results

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Sexual Identity Mobility and Depressive Symptoms: A Longitudinal Analysis of Moderating Factors Among Sexual Minority Women

Sexual minority identity (bisexual, lesbian) is a known risk factor for depression in women. This study examined a facet of minority stress prevalent among women-sexual identity mobility-as an identity-related contributor to higher levels of depressive symptoms. We used three waves of data from the Chicago Health and Life Experiences of Women study, a longitudinal study of sexual minority women (N = 306). Random effects OLS regression models were constructed to examine the effect of sexual identity changes on depressive symptoms. We found that 25.6 % of the sample reported a sexual identity change between Wave I and Wave II, and 24.9 % reported a sexual identity change between Waves II and III. Women who reported a change in sexual identity also reported more depressive symptoms subsequent to identity change. This effect was moderated by the number of years participants had reported their baseline identity and by whether the participant had initiated a romantic relationship with a male partner.

The Utility of Debriefing Questions in a Household Survey on Drug Abuse

Since subjects are often uncomfortable disclosing sensitive information, questions gauging respondent reaction to survey questions about drug abuse may aid in the interpretation of responses. Such debriefing questions can be worded subjectively, i.e., asking subjects about their own reactions to questions, or projectively, i.e., asking subjects about their perceptions of the reactions of others to questions. Using data from a study employing both types of debriefing questions, we examined whether question wording made any difference. We evaluated the extent to which drug reporting was associated with respondent reaction to the survey and whether reactions varied by type of debriefing question. A factor analysis of debriefing questions appended to an experimental household survey on drug abuse yielded factors reflecting distinct subjective and projective dimensions. Analyses suggested that debriefing question wording does make a difference with respect to respondent reaction. Contrary to expectations, analyses suggested that those reporting drug use expressed less comfort on subjectively worded items and more comfort on projectively worded items. Subjects who self-administered their survey also reported lower levels of subjective comfort. The projective measures derived from analyses were associated with three demographic variables: Younger subjects reported higher levels of projective ease than older subjects. Those with some college reported higher levels of projective ease than those with the least amount of formal education. African-Americans reported lower levels of projective ease than White/Other subjects. Implications for the design, interpretation, and analysis of drug use surveys are considered.

Respondent Reactions to Sensitive Questions

We administered debriefing probes to gauge respondent discomfort in reaction to sensitive questions. These probes assessed respondents' own reactions to being asked to report on substance use (subjective discomfort), as well as their beliefs about the reaction of others (projective discomfort). We investigated whether a sample of men from the general population were more uncomfortable with questions about drug use than a sample of men who have sex with men (MSM) surveyed from the same city (Chicago). We also investigated whether those who disclosed drug use on the survey experienced higher levels of discomfort. Contrary to opinions often expressed as research ethics committee (REC) recommendations, questions about drug use do not generate much subjective discomfort. MSM did not differ from the general population with respect to subjective discomfort. General population males did, however, report higher levels of “drug specific” projective discomfort. Respondents disclosing recent drug use reported higher levels of subjective discomfort. Implications for the REC practice, researcher and REC education, and directions for future research are discussed.

Culture Moderates the Relation Between Perceived Stress, Social Support, and Mental and Physical Health

Cultural differences in the relations between perceived stress and mental and physical health, and the role of social support in buffering these relations, are examined in a survey of multiple U.S. cultural/ethnic groups. Findings from a health survey of N = 603 adults comprising approximately equal numbers of non-Hispanic Whites, Mexican Americans, Korean Americans, and African Americans show that perceived stress is negatively correlated with one’s perceived mental and physical health, in line with previous research. However, the role of social support in mitigating this relationship is culturally contingent. A buffering effect of social support on the relation between perceived stress and both mental and physical health was only observed for Mexican Americans, not for the other cultural/ethnic groups. These patterns are discussed in the context of research on differences in social help seeking among distinct types of collectivistic cultural groups. The findings are consistent with recent research on horizontal versus vertical collectivism that highlights the importance of sociability and benevolence in Latin American cultural contexts. The results affirm the importance of distinguishing between collectivistic cultures in understanding how social support may impact mental and physical health.

Longitudinal Associations among Discordant Sexual Orientation Dimensions and Hazardous Drinking in a Cohort of Sexual Minority Women

We examined differences between sexual minority women's (SMW's) sexual identity and sexual behavior or sexual attraction as potential contributors to hazardous drinking across a 10-year period. Data are from a longitudinal study examining drinking and drinking-related problems in a diverse, community-based sample of self-identified SMW (Wave 1: n = 447; Wave 2: n = 384; Wave 3: n = 354). Longitudinal cross-lagged models showed that SMW who report higher levels of identity-behavior or identity-attraction discordance may be at greater risk of concurrent and subsequent hazardous drinking. Results of multigroup models suggest that sexual orientation discordance is a more potent risk factor for risky drinking outcomes among SMW in older adulthood than in younger adulthood. Findings support that discordance between sexual orientation dimensions may contribute to hazardous drinking among SMW and provide evidence that cognitive-behavioral consistency is important for individuals expressing diverse and fluid sexual identities, attraction, and behavior.

Coming out in color: racial/ethnic differences in the relationship between level of sexual identity disclosure and depression among lesbians

Disclosing one's sexual minority identity, or "coming out," has varying effects on the mental health of lesbians. Previous research indicates a negative association between disclosure and depression. However, these findings are based on research with White lesbians. To date, there is a paucity of studies that examined how the relationship between disclosure and depression may differ by race/ethnicity among lesbians. To address this gap, we examined the relationship between disclosure and depression among African American (26.5%), Latina (19.7%), and White (53.8%) self-identified lesbians (N = 351) in 2 survey-interviews (∼ 3-years apart). Over 50% of the participants reported a history of lifetime depression at baseline and 35.9% reported depression at Time 2 (T2). Disclosure levels varied: 78.9% had disclosed to their mother, 58.4% to their father, and 83.3% to a sibling. The mean level for disclosure to nonfamily individuals was 6.29 (SD 2.64; range 0-9). Disclosure results varied by race/ethnicity showing African American lesbians (vs. White lesbians) were less likely to disclose to nonfamily individuals when controlling for covariates. Results for the relationship between disclosure and depression showed disclosure to either parent or sibling was not associated with depression for the total sample. Among Latinas only, disclosure to nonfamily individuals was associated with less depression. Additional research is needed to explore racial/ethnic differences in disclosure with certain individuals and to better understand the relation between disclosure and depression. Findings have implications for reducing overall rates of depression among lesbians living with multiple-minority identities.

The effect of neighborhood disadvantage on the racial disparity in ovarian cancer-specific survival in a large hospital-based study in cook county, illinois

This paper examines the effect of neighborhood disadvantage on racial disparities in ovarian cancer-specific survival. Despite treatment advances for ovarian cancer, survival remains shorter for African-American compared to White women. Neighborhood disadvantage is implicated in racial disparities across a variety of health outcomes and may contribute to racial disparities in ovarian cancer-specific survival. Data were obtained from 581 women (100 African-American and 481 White) diagnosed with epithelial ovarian cancer between June 1, 1994, and December 31, 1998 in Cook County, IL, USA, which includes the city of Chicago. Neighborhood disadvantage score at the time of diagnosis was calculated for each woman based on Browning and Cagney’s index of concentrated disadvantage. Cox proportional hazard models measured the association of self-identified African-American race with ovarian cancer-specific survival after adjusting for age, tumor characteristics, surgical debulking, and neighborhood disadvantage. There was a statistically significant negative association (−0.645) between ovarian cancer-specific survival and neighborhood disadvantage (p = 0.008). After adjusting for age and tumor characteristics, African-American women were more likely than Whites to die of ovarian cancer (HR = 1.59, p = 0.003). After accounting for neighborhood disadvantage, this risk was attenuated (HR = 1.32, p = 0.10). These findings demonstrate that neighborhood disadvantage is associated with ovarian cancer-specific survival and may contribute to the racial disparity in survival.

Measuring Substance Use and Misuse via Survey Research: Unfinished Business

This article reviews unfinished business regarding the assessment of substance use behaviors by using survey research methodologies, a practice that dates back to the earliest years of this journal's publication. Six classes of unfinished business are considered including errors of sampling, coverage, non-response, measurement, processing, and ethics. It may be that there is more now that we do not know than when this work began some 50 years ago.

Evidence-Informed, Evidence not Used: A Pilot Study of a Sustained Flawed Process and Unfinished Business

An anonymous, online survey using a convenience sample of global researchers was implemented during 2013-2014 to explore the actual use or nonuse of their research outcomes in a range of interventions in the area of substance use and related disorders. Eighty-seven researchers from 19 countries responded. Based on their self-reports, the utilizability of their findings were either unknown to them or had no effects in terms of substance use treatment, prevention, policies, or professional education. Most respondents did believe, however, that their investigations had an influence on substance use research. The study's limitations are noted.

Sources of Interactional Problems in a Survey of Racial/Ethnic Discrimination

Cross-cultural variability in respondent processing of survey questions may bias results from multiethnic samples. We analyzed behavior codes, which identify difficulties in the interactions of respondents and interviewers, from a discrimination module contained within a field test of the 2007 California Health Interview Survey. In all, 553 (English) telephone interviews yielded 13,999 interactions involving 22 items. Multilevel logistic regression modeling revealed that respondent age and several item characteristics (response format, customized questions, length, and first item with new response format), but not race/ethnicity, were associated with interactional problems. These findings suggest that item function within a multi-cultural, albeit English language, survey may be largely influenced by question features, as opposed to respondent characteristics such as race/ethnicity.

Sources of Error in Substance Use Prevalence Surveys

Population-based estimates of substance use patterns have been regularly reported now for several decades. Concerns with the quality of the survey methodologies employed to produce those estimates date back almost as far. Those concerns have led to a considerable body of research specifically focused on understanding the nature and consequences of survey-based errors in substance use epidemiology. This paper reviews and summarizes that empirical research by organizing it within a total survey error model framework that considers multiple types of representation and measurement errors. Gaps in our knowledge of error sources in substance use surveys and areas needing future research are also identified.

Lifetime Victimization, Hazardous Drinking, and Depression Among Heterosexual and Sexual Minority Women

PURPOSE

Substantial research documents sexual-orientation-related mental health disparities, but relatively few studies have explored underlying causes of these disparities. The goals of this article were to (1) understand how differences in sexual identity and victimization experiences influence risk of hazardous drinking and depression, and (2) describe variations across sexual minority subgroups.

METHODS

We pooled data from the 2001 National Study of Health and Life Experiences of Women and the 2001 Chicago Health and Life Experiences of Women study to compare rates of victimization, hazardous drinking, and depression between heterosexual women and sexual minority women (SMW), and to test the relationship between the number of victimization experiences and the study outcomes in each of five sexual identity subgroups.

RESULTS

Rates of each of the major study variables varied substantially by sexual identity, with bisexual and mostly heterosexual women showing significantly higher risk than heterosexual women on one or both of the study outcomes. The number of victimization experiences explained some, but not all, of the risk of hazardous drinking and depression among SMW.

CONCLUSION

Although victimization plays an important role, sexual-minority-specific stressors, such as stigma and discrimination, likely also help explain substance use and mental health disparities among SMW.

Validation of interpersonal support evaluation list-12 (ISEL-12) scores among English- and Spanish-speaking Hispanics/Latinos from the HCHS/SOL Sociocultural Ancillary Study

The Interpersonal Support Evaluation List-12 (ISEL-12; Cohen, Mermelstein, Kamarck, & Hoberman, 1985) is broadly employed as a short-form measure of the traditional ISEL, which measures functional (i.e., perceived) social support. The ISEL-12 can be scored by summing the items to create an overall social support score; three subscale scores representing appraisal, belonging, and tangible social support have also been proposed. Despite extensive use, studies of the psychometric properties of ISEL-12 scores have been limited, particularly among Hispanics/Latinos, the largest and fastest growing ethnic group in the United States. The current study investigated the reliability and structural and convergent validity of ISEL-12 scores using data from 5,313 Hispanics/Latinos who participated in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Participants completed measures in English or Spanish and identified their ancestry as Dominican, Central American, Cuban, Mexican, Puerto Rican, or South American. Cronbach's alphas suggested adequate internal consistency for the total score for all languages and ancestry groups; coefficients for the subscale scores were not acceptable. Confirmatory factor analyses revealed that the one-factor and three-factor models fit the data equally well. Results from multigroup confirmatory factor analyses supported a similar one-factor structure with equivalent response patterns and variances between language groups and ancestry groups. Convergent validity analyses suggested that the total social support score related to scores of social network integration, life engagement, perceived stress, and negative affect (depression, anxiety) in the expected directions.

Emotional risks to respondents in survey research

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents.

Survey mode and asking about future intentions did not impact self-reported colorectal cancer screening accuracy

BACKGROUND

Self-reported colorectal cancer (CRC) screening behavior is often subject to over-reporting bias. We examined how the inclusion of a future intention to screen item (viz. asking about future intentions to get screened before asking about past screening) and mode of survey administration impacted the accuracy of self-reported CRC screening.

METHODS

The target population was men and women between 49 and 85 years of age who lived in Olmsted County, MN, for at least 10 years at the time of the study. Eligible residents were randomized into four groups representing the presence or absence the future intention to screen item in the questionnaire and administration mode (mail vs. telephone). A total of 3,638 cases were available for analysis with 914, 838, 956, and 930 in the mail/future intention, mail/no future intention, telephone/future intention, and telephone/no future intention conditions, respectively. False positives were defined as self-reporting being screened among those with no documented history of screening in medical records and false negatives as not self-reporting screening among those with history of screening.

RESULTS

Comparing false positive and false negative reporting rates for each specific screening test among the responders at the bivariate level, regardless of mode, there were no statistically significant differences by the presence or absence of a preceding future intention question. When considering all tests combined, the percentage of false negatives within the telephone mode was slightly higher for those with the future intention question (6.7% vs 4.2%, p = 0.04). Multivariate models that considered the independent impact of the future intention question and mode, affirmed the results observed at the bivariate level. However, individuals in the telephone arm (compared to mail) were slightly (though not significantly) more likely to report a false positive (36.4% vs 31.8%, OR = 1.11, p = 0.55).

CONCLUSION

It may be that in the context of a questionnaire that is clearly focused on CRC and with specific descriptions of the various CRC screening tests, certain design features such as including intention to screen items or mode of administration will have very little impact on the accuracy of self-reported CRC screening.

Studying alcohol use prior to sexual intercourse among female sex workers in eastern Indonesia

Researching female sex workers (FSWs) in Indonesia, where commercial sex tends to be hidden or undercover, is challenging but possible. This is even more challenging when it involves investigation of sensitive behaviors, such as their alcohol use, a known disinhibitor to risk behavior. The adoption of effective strategies is needed to increase response rates and improve data quality. This article describes procedures used to research FSWs' alcohol use during commercial sex in the Eastern part of Indonesia. Challenges, lessons learned, and recommendations for best practices are discussed.

Condom Use Among Men Who Have Sex With Men and Male-to-Female Transgenders in Jakarta, Indonesia

This article examined differences in condom use during anal intercourse among men who have sex with men (MSM) and male-to-female transgender women in Jakarta, Indonesia. A cross-sectional design, structured interviews, and hierarchical linear modeling were used to examine condom use among MSM recruited from entertainment places (EPs; e.g., discotheques/dance clubs/karaoke bars), massage parlors (MPs), and among transgender women who congregated and/or sought sexual partners on streets/parks (S/P). The sample consisted of 91, 97, and 114 of MSM-EP, MSM-MP, and transgender-S/P, respectively. Respondents reported on 641 unique sexual partner encounters, which were "nested" within 302 respondents. Reported condom use was high, 66%, 84%, and 83% for MSM-EP, MSM-MP, and transgender-S/P, respectively, and varied across type of respondent. At the individual level, depressive symptoms and history of physical abuse during childhood and adulthood were associated with lower condom use (p < .05). By contrast, having a higher level of education was associated with more condom use (p < .05). At the partner level, condom use was associated with type of partners and the use of club drugs before sex. HIV-prevention efforts should take into account the multilevel determinants of condom use within these populations.

Enhancing Surveys of Health Care Professionals

Surveys involving health care providers are characterized by low and declining response rates (RRs), and researchers have utilized various strategies to increase survey RRs among health professionals. Based on 48 studies with 156 subgroups of within-study conditions, a multilevel meta-regression analysis was conducted to summarize the effects of different strategies employed in surveys of health professionals. An estimated overall survey RR among health professionals was 0.53 with a significant downward trend during the last half century. Of the variables that were examined, mode of data collection, incentives, and number of follow-up attempts were all found to be significantly related to RR. The mail survey mode was more effective in improving RR, compared to the online or web survey mode. Relative to the non-incentive subgroups, subgroups receiving monetary incentives were more likely to respond, while nonmonetary incentive groups were not significantly different from non-incentive groups. When number of follow-ups was considered, the one or two attempts of follow-up were found to be effective in increasing survey RR among health professionals. Having noted challenges associated with surveying health professionals, researchers must make every effort to improve access to their target population by implementing appropriate incentive- and design-based strategies demonstrated to improve participation rates.

Hazardous drinking, depression, and anxiety among sexual-minority women: self-medication or impaired functioning?

OBJECTIVE

Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women.

METHOD

Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study.

RESULTS

Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression.

CONCLUSIONS

Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood.