Factor, Concurrent and Predictive Validity of the Readiness to Change Questionnaire [Treatment Version] Among Non-Treatment-Seeking Individuals.

AIMS: This study assessed the factor, concurrent and predictive validity of the revised Readiness to Change Questionnaire [Treatment Version] (RCQ[TV]) among non-treatment-seeking individuals. METHODS: Non-treatment-seeking patients (Mage = 34.8, SD = 12.4) who screened positive for alcohol misuse were recruited from three urban Level I Trauma Centers and completed the RCQ[TV] (Heather et al. [(1999) Development of a treatment version of the Readiness to Change Questionnaire. Addict Res7, 63-83]). RESULTS: A confirmatory factor analysis supported the three-factor structure of the RCQ[TV]. Observed scores for precontemplation, contemplation and action demonstrated concurrent validity, as they were correlated with drinking and alcohol-related problems prior to baseline assessment. Finally, RCQ[TV] scores at baseline added to the predictability of an alcohol consumption composite score at a 3-month follow-up after controlling for baseline alcohol consumption and randomization to treatment arm. CONCLUSIONS: The results of the present study suggest that the RCQ[TV] has desirable psychometric properties and supports the use of the RCQ[TV] among non-treatment-seeking patients with alcohol misuse.

Brief Intervention Among Mexican-Origin Young Adults in the Emergency Department at the USA-Mexico Border: Examining the Role of Patient's Preferred Language of Intervention in Predicting Drinking Outcomes.

AIMS: Determine if the language in which brief intervention (BI) is delivered influences drinking outcomes among Mexican-origin young adults in the emergency department when controlling for ethnic matching. SHORT SUMMARY: Aim of study was to determine if a patient's preferred language of intervention influences drinking outcomes among Mexican-origin young adults in the emergency department. Results indicate no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. METHODS: This is a secondary data analysis on data from 310 patients randomized to receive a BI completed in Spanish (BI-S) or English (BI-E), with 3- and 12-month follow-up. Outcome measures of interest were drinking days per week, drinks per drinking day, maximum drinks in a day and negative consequences of drinking. RESULTS: There were no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. CONCLUSIONS: Reduced drinking outcomes following BI among Mexican-origin young adults in the emergency department may not have been due to the language used to deliver intervention. Thus, our results provide evidence that language of intervention is not a crucial factor to achieve cultural congruence. In addition, our findings suggest that receiving the intervention is beneficial regardless of language, thus, facilitating real-world implementation.

Coefficient α as a Measure of Test Score Reliability: Review of 3 Popular Misconceptions.

We discuss 3 popular misconceptions about Cronbach α or coefficient α, traditionally used in public health and the behavioral sciences as an index of test score reliability. We also review several other indices of test score reliability. We encourage researchers to thoughtfully consider the nature of their data and the options when choosing an index of reliability, and to clearly communicate this choice and its implications to their audiences.

Important considerations in conducting statistical mediation analyses.

An investigator wishes to examine mediation in a randomized control trial of the effectiveness of an intervention, which consists of a computerized decision aid for promoting colorectal cancer screening. Mediation is a naturally occurring process, and in any given instance, research investigators seek to ascertain whether it has occurred. In the case of a prevention intervention for a specific chain of events, mediation occurs (1) when the prevention intervention effects a change on a targeted intermediate condition: a mediator, for example, a person's intentions to get a colorectal screening examination; and (2) when, at a later point in time, this condition effects a change on a targeted outcome, for example, the actual behavior of getting a colorectal screening exam. Full mediation is said to occur when the effectiveness of the intervention on the targeted outcome only takes place through the intermediate condition and does not directly affect the targeted outcome. Partial mediation is said to occur when the intervention causes changes in both the intermediate condition and the targeted outcome. The assessment of mediation is important because conclusions about the efficacy of a public health intervention may depend on how these indirect influences are assessed.

Binational utilization and barriers to care among Mexican American border residents with diabetes.

OBJECTIVE: To assess whether U.S.-Mexico border residents with diabetes 1) experience greater barriers to medical care in the United States of America versus Mexico and 2) are more likely to seek care and medication in Mexico compared to border residents without diabetes. METHODS: A stratified two-stage randomized cross-sectional health survey was conducted in 2009 - 2010 among 1 002 Mexican American households. RESULTS: Diabetes rates were high (15.4%). Of those that had diabetes, most (86%) reported comorbidities. Compared to participants without diabetes, participants with diabetes had slightly greater difficulty paying US$ 25 (P = 0.002) or US$ 100 (P = 0.016) for medical care, and experienced greater transportation and language barriers (P = 0.011 and 0.014 respectively) to care in the United States, but were more likely to have a person/place to go for medical care and receive screenings. About one quarter of participants sought care or medications in Mexico. Younger age and having lived in Mexico were associated with seeking care in Mexico, but having diabetes was not. Multiple financial barriers were independently associated with approximately threefold-increased odds of going to Mexico for medical care or medication. Language barriers were associated with seeking care in Mexico. Being confused about arrangements for medical care and the perception of not always being treated with respect by medical care providers in the United States were both associated with seeking care and medication in Mexico (odds ratios ranging from 1.70 - 2.76). CONCLUSIONS: Reporting modifiable barriers to medical care was common among all participants and slightly more common among 1) those with diabetes and 2) those who sought care in Mexico. However, these are statistically independent phenomena; persons with diabetes were not more likely to use services in Mexico. Each set of issues (barriers facing those with diabetes, barriers related to use of services in Mexico) may occur side by side, and both present opportunities for improving access to care and disease management.

The influence of cognitive and affective components of the sentinel event on alcohol use following a brief intervention with trauma patients.

OBJECTIVE: Alcohol-related injury is a sentinel event, an unanticipated medical event that may prompt a re-evaluation of health behaviors, such as alcohol use. Few studies have examined the psychological components of the sentinel event that motivate behavior change. In the present study, we examined the influence of cognitive and affective components of an alcohol-related injury on changes in alcohol use following a brief intervention. METHOD: Injured patients (n = 411) who were drinking prior to their injury admission were recruited from three urban Level I trauma centers and randomized to receive brief advice or brief motivational intervention with or without a 1-month booster session. Assessments were completed at baseline and 3-, 6-, and 12-month follow-ups. Three groups were created based on endorsement (yes/no) of items assessing cognitive and affective components of the injury event: neither component, the cognitive component only, and both the cognitive and affective components. RESULTS: Mixed-effects models indicated that participants who endorsed both the cognitive and affective components had greater reductions in peak alcohol use from baseline to 3-month follow-up than those who did endorsed neither component. By contrast, participants who endorsed the cognitive component, but not the affective component, had greater increases in average drinks per week and percentage of days of heavy drinking from 3- to 12-month follow-ups than those who endorsed neither component. CONCLUSION: These results provide preliminary support for further consideration of an affective component of alcohol-related injuries that may motivate subsequent reductions in drinking following a sentinel event.

Discretizing continuous variables in nutrition and obesity research: a practice that needs to be cut short.

BACKGROUND/OBJECTIVES: Nutrition and obesity researchers often dichotomize or discretize continuous independent variables to conduct an analysis of variance to examine group differences. We describe consequences associated with dichotomizing and discretizing continuous variables using two cross-sectional studies related to nutrition. SUBJECTS/METHODS: Study 1 investigated the effects of health literacy and nutrition knowledge on nutrition label accuracy (n = 612). Study 2 investigated the effects of cognitive restraint and BMI on fruit and vegetable (F/V) intake (n = 586). We compare analytic approaches where continuous independent variables were either discretized/dichotomized or analyzed as continuous variables. RESULTS: In Study 1, dichotomization of health literacy and nutrition knowledge for 2 × 2 ANOVA revealed health literacy had an effect on nutrition label accuracy. Nutrition knowledge has an effect on nutrition label accuracy, but the health literacy by nutrition knowledge interaction was not significant. When analyzed using regression, the nutrition knowledge effect was significant. The simple effect of health literacy was also significant when health literacy equals zero. Finally, the quadratic effect of health literacy was negative and significant. In Study 2, dichotomization and discretization of cognitive restraint and BMI were used for three ANOVAs, which discretized BMI in three ways. For all ANOVAs, the BMI main effect for predicting fruit and vegetable intake was significant, the interaction between BMI and cognitive restraint was non-significant, and cognitive restraint was only significant when both variables were dichotomized. When analyzed using regression, the continuous mean-centered variables, and their interaction each significantly predicted F/V intake. CONCLUSIONS: Dichotomizing continuous independent variables resulted in distortions of effect sizes across studies, an inability to assess the quadratic effect of health literacy, and an inability to detect the moderating effect of BMI. We discourage researchers from dichotomizing and discretizing continuous independent variables and instead use multiple regression to examine relationships between continuous independent and dependent variables.

A brief report examining the stereotype content model with blind Americans.

PURPOSE/OBJECTIVE: The stereotype content model is a unifying theory of the makeup of stereotypes and their consequences on emotions and behaviors. There is a need to study this theory from the perspectives of those most affected by them-targets of stereotypes. RESEARCH METHOD/DESIGN: Blind adults (n = 264) living in the United States completed the stereotype content measure asking participants to rate the extent to which they believed members of wider society held certain beliefs about Blind persons. RESULTS: Confirmatory factor analyses showed good fit for the four-factor model of stereotype content: warmth, competence, status, and competition. CONCLUSIONS: This study confirms the stereotype content model and begins to extend the stereotype content model to be inclusive of the perspectives of those who are the targets of stereotypes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans.

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

Measurement Invariance of the Readiness to Change Questionnaire Among Injured Patients Who Received a Brief Intervention for Alcohol Use.

We tested measurement invariance of the Readiness to Change Questionnaire (RCQ) to evaluate its utility in assessing the stages of change in the context of brief intervention for alcohol use in opportunistic settings. Participants (N = 596) were patients admitted from three Level I trauma centers who were randomly assigned to one of three brief alcohol interventions. The RCQ was administered at baseline and 3-month follow-up. The RCQ was scalar invariant across biological sex and partially scalar invariant across race/ethnicity and alcohol use severity. Hispanic participants were higher on contemplation and action and Black participants were higher on action than White participants. Hazardous drinkers were lower in precontemplation and higher in contemplation and action than nonhazardous drinkers. The RCQ was scalar invariant across intervention conditions and time. Brief motivational intervention with a booster increased action from baseline to 3 month. These findings provide further support for the use of the RCQ.

A brief report of the prevalence of chronic and acute health conditions among blind American adults.

BACKGROUND: Prior research demonstrates disparities in the prevalence of certain chronic and acute health conditions among persons who are blind (PWB) compared to non-blind persons, such as diabetes and infectious diseases. However, a comprehensive understanding of the prevalence of chronic and acute health conditions among PWB is currently lacking. OBJECTIVE: The present study addressed this gap by examining the prevalence of chronic and acute conditions among blind persons, and examining differences by gender. METHODS: The present study surveyed 410 PWB residing in the U.S. about their health conditions and activities. Lifetime prevalence for eight chronic and six acute health conditions were estimated separately for men and women. Engagement in physical activity, regular use of medication, and satisfaction with health were also estimated. RESULTS: We found that men more often reported their health conditions interfered with daily activities compared to women, as well as higher prevalence of stroke and arthritis compared to women. CONCLUSION: The current study contributes information that is vital to understanding the burden of specific health conditions on this population and necessary to understand the extent to which this burden disproportionately affects PWB.

The psychometric properties of a version of the Treatment Self-Regulation Questionnaire for assessing motivations for responsible drinking.

OBJECTIVE: The aim of the present studies was to provide a psychometric evaluation of a version of the Treatment Self-Regulation Questionnaire (TSRQ) for assessing motivations derived from self-determination theory for responsible drinking among college students. Methods: A convenience sample of 308 college student drinkers (71.7% female) were recruited for Study 1 and a random sample of 192 college student drinkers (58.9% female) were recruited for Study 2. Participants completed the TSRQ and other self-report measures in both studies. Results: In Study 1, confirmatory factor analyses supported a revised four-factor structure of the TSRQ. In Study 2, correlation analyses generally provided support for the concurrent validity of the TSRQ subscales. Conclusion: The present studies provide some initial support for the TSRQ for assessing motivations for responsible drinking. Directions for future research and implications of a measure for assessing motivations for responsible drinking among college students are discussed.

Perspectives of Interactions with Healthcare Providers Among Patients Who Are Blind.

Healthcare providers' (HCPs) stereotypes about the incompetence of blind and low-vision patients may lead them to patronize blind patients, over-focus on impairments, and neglect the presenting problem. The content of perceived HCP stereotypes about blind patients in the clinical setting was examined from the patient perspective with seven focus groups, including a total of 42 individual participants. Most participants reported an interaction when their HCPs treated them as if they were incompetent, and discussed how perceived evaluations of their warmth and competence impacted whether their HCPs trusted and respected them. Participants also discussed their evaluations of their HCPs' warmth and competence, and how these evaluations impacted their trust and respect for the HCP. These results provide insight into blind patients' experiences interacting with their HCPs and can inform interventions to 1) help HCPs avoid stereotypic attitudes and 2) improve HCPs' comfort and abilities when working with patient with disabilities.

Measuring social problem solving using the Spanish version for Hispanics of the Social Problem Solving Inventory-Revised.

This study investigated the internal consistency, factor structure, and concurrent validity of the Social Problem Solving Inventory-Spanish Version for Hispanics (SPSI-R-Hispanic), a translation of the Social Problem Solving Inventory-Revised (SPSI-R; D'Zurilla, Nezu & Maydeu-Olivares, 2002), in a North American sample of 325 Spanish speaking Hispanics. The scales of the SPSI-R-Hispanic demonstrated good internal consistency reliability. The hypothesized factor model of the SPSI-R provided a good fit to the data. SPSI-R-Hispanic scores demonstrated concurrent validity in a multiple regression analysis, explaining 32% of incremental variability in psychological well-being scores. Gender differences were replicated, where men had higher positive problem orientation and rational problem solving scores and women had higher negative problem orientation scores.

Assessing measurement and predictive invariance of the Toronto Alexithymia Scale-20 in U.S. Anglo and U.S. Hispanic student samples.

We collected data from a predominately Anglo American student sample in the Southeastern United States and a predominately Hispanic student sample in the Southwestern United States. Along with an assessment of internal consistency reliability, we examined measurement invariance of the Toronto Alexithymia Scale-20 (TAS-20) using confirmatory factor analysis. We also assessed the predictive invariance of the TAS-20. Results indicate that 2 of the 3 TAS-20 subscales demonstrated satisfactory internal consistency reliability across samples. Items from the TAS-20 subscales demonstrated measurement invariance of the latent means. The relationship between 2 measures of emotional dysfunction and the TAS-20 also demonstrated slope and intercept invariance, indicating equivalent validity.

Protective behavioral strategies predict alcohol-related problems among injured patients following a brief intervention.

BACKGROUND: Alcohol protective behavioral strategies (PBS) have been proposed as mechanisms of change underlying interventions for reducing alcohol use and alcohol-related problems. Few studies have examined PBS use among non-college student populations and no study has examined PBS use among adult injured patients. The current study tested types of PBS as mediators of the effects of a brief motivational intervention (BMI) delivered in the trauma care setting on alcohol-related problems. METHOD: Secondary data analyses were conducted using data from a multisite randomized controlled trial of brief intervention in the trauma care setting. The current study used data from a subset of participants who reported having consumed alcohol at least once at 3-month follow-up (N = 324). Following a baseline assessment, participants were assigned to either brief advice (BA; n = 107), BMI (n = 119), or BMI with a telephone booster (BMI + B; n = 98). Participants completed measures of PBS at 3-month follow-up and of alcohol-related problems at baseline and 6-month follow-up. A multiple mediation model was conducted to simultaneously test the mediation effects of types of PBS. RESULTS: BMI and BMI + B relative to BA did not increase PBS use. However, more frequent use of certain types of PBS at 3-month follow-up were predictors of greater reductions in alcohol-related problems from baseline to 6-month follow-up. There were no statistically significant mediation effects. CONCLUSIONS: The present study suggests that PBS use reduces alcohol-related problems among trauma patients and implications for future studies are discussed.

A psychometric evaluation of the Protective Behavioral Strategies Scale-20 among internet samples of adult drinkers.

Protective behavioral strategies (PBS) are most commonly defined as behaviors that are used while drinking to reduce alcohol use and/or limit alcohol-related problems. Few studies have examined and quantified PBS use among non-college student populations. The purpose of the present two studies was to evaluate the psychometric properties of the Protective Behavioral Strategies Scale-20 (PBSS-20; Treloar, Martens, & McCarthy, 2015) among internet samples of adult drinkers. In the first study, we conducted an exploratory factor analysis of the PBSS-20 with a sample (n = 360) of adult drinkers who were recruited from Mechanical Turk. We then conducted a second study that recruited adult drinkers from Mechanical Turk and randomly split the data in half. With the first split-half sample (n = 339), we conducted a confirmatory factor analysis of the PBSS-20 and assessed the internal consistency and concurrent validity of the subscales. With the second split-half sample (n = 338), we tested measurement invariance across gender. The results support a three-factor structure of the PBSS-20 that is similar to what has been found among college students. However, six items were dropped and two Serious Harm Reduction items loaded best onto the Manner of Drinking factor. Furthermore, two subscales demonstrated adequate internal consistency and all three subscale were negatively associated with alcohol-related outcomes. Similar to college students, there was lack of measurement invariance across gender. We discuss the implications of the present findings in extending research on PBS to the more general population of U.S. adult drinkers.

A confirmatory factor analysis of the Attitudes Toward Lesbians and Gay Men (ATLG) measure.

The Attitudes Toward Lesbians and Gay men (ATLG; Herek, 1988) hypothesizes that individuals can have feelings of sexual prejudice toward gay men and lesbians. No research has confirmed the hypothesized factor structure of the ATLG. This study tested four possible factor structures for the ATLG. Results indicate that the hierarchical factor model provided a good description of the ATLG items. A measure of total sexual prejudice was derived. From the hierarchical structure, a measure representing the difference in sexual prejudice toward gay men and lesbians was also computed. Increased religious involvement and the etiology of homosexuality were statistical predictors of overall sexual prejudice, while decreased religious involvement and gender were statistical predictors of differential sexual prejudice toward gay men.

Undergraduate Research Participation Is Associated With Improved Student Outcomes at a Hispanic-Serving Institution.

Few scholars have comprehensively examined benefits of undergraduate research (UGR) participation for students at an institution campus-wide. In this study we examined benefits of UGR participation at a Hispanic-majority institution using National Survey of Student Engagement data. Generalized estimating equations were used to examine the influence of UGR participation on 5 student outcomes: gains in knowledge and skills, institutional support, overall satisfaction, grade point average, and student-faculty interaction. Results indicate that UGR participation is a robust positive predictor of all 5 outcomes. We provide insights into strategies for enhancing the beneficial impacts of UGR participation, especially for students from underrepresented groups.

Healthcare Use and Mammography Among Latinas With and Without Health Insurance Near the US-Mexico Border.

INTRODUCTION: Among Latinas, lacking health insurance and having lower levels of acculturation are associated with disparities in mammography screening. OBJECTIVE: We seek to investigate whether differences in lifetime mammography exist between Latina border residents by health insurance status and health care site (i.e., U.S. only or a combination of U.S. and Mexican health care). METHODS: Using data from the 2009 to 2010 Ecological Household Study on Latino Border Residents, mammography screening was examined among (n = 304) Latinas >40 years old. RESULTS: While more acculturated women were significantly (p < .05) more likely to report ever having a mammogram than less acculturated women, ever having a mammogram was not predicted by health care site or insurance status. CONCLUSION: Latinas who utilize multiple systems of care have lower levels of acculturation and health insurance, thus representing an especially vulnerable population for experiencing disparities in mammography screening.