Group peer mentoring is effective for different demographic groups of biomedical research faculty: A controlled trial.

INTRODUCTION: Improved mentoring of midcareer researchers in medical schools has been identified as an important potential avenue for addressing low vitality and high burnout rates in faculty, and the scarcity of both underrepresented minority (URM) faculty and women in biomedical research. To address the need for widescale effective mentoring, we sought to determine whether a group peer mentoring intervention (C-Change Mentoring and Leadership Institute) for early midcareer research faculty was effective for different demographic groups in a controlled trial. METHODS AND MATERIALS: Thirty-five diverse early midcareer faculty and 70 propensity-matched (PM) control subjects matched to intervention subjects on a) study inclusion criteria; b) gender, race, and ethnicity, degree, rank, years of experience, publications, grants; and c) pretest survey outcome variables, participated in the intervention. The C-Change Participant Survey assessed vitality, self-efficacy in career advancement, research success, mentoring others, valuing diversity, cognitive empathy, and anti-sexism/anti-racism skills at pretest and intervention completion. Analysis using multiple regression models included outcome pretest values and indicator variables for intervention, gender, URM status, and MD vs. PhD. Hypotheses regarding differential effectiveness of the intervention by demographic group were tested by including cross-product terms between the demographic indicator variables and the intervention indicator. Missing data were addressed using chained equations to create 100 data sets. RESULTS AND DISCUSSION: The intervention participants had significantly higher (favorable) scores than PM controls for: self-assessed change in vitality; self-efficacy for career advancement, research, and mentoring others; cognitive empathy; and anti-sexism/racism skills. The benefits of the intervention were nearly identical across: gender, URM vs non-URM faculty, and degree MD/PhD, except vitality significantly increased for non-URM subjects, and not for URM faculty. Self-assessed change in vitality increased for URM and non-URM. CONCLUSION: The intervention worked successfully for enhancing vitality, self-efficacy and cross-cultural engagement across different demographic groups of biomedical research faculty.

Employee Cardiometabolic Risk Following a Cluster-Randomized Workplace Intervention From the Work, Family and Health Network, 2009-2013.

Objectives. To examine whether workplace interventions to increase workplace flexibility and supervisor support and decrease work-family conflict can reduce cardiometabolic risk. Methods. We randomly assigned employees from information technology (n = 555) and long-term care (n = 973) industries in the United States to the Work, Family and Health Network intervention or usual practice (we collected the data 2009-2013). We calculated a validated cardiometabolic risk score (CRS) based on resting blood pressure, HbA1c (glycated hemoglobin), HDL (high-density lipoprotein) and total cholesterol, height and weight (body mass index), and tobacco consumption. We compared changes in baseline CRS to 12-month follow-up. Results. There was no significant main effect on CRS associated with the intervention in either industry. However, significant interaction effects revealed that the intervention improved CRS at the 12-month follow-up among intervention participants in both industries with a higher baseline CRS. Age also moderated intervention effects: older employees had significantly larger reductions in CRS at 12 months than did younger employees. Conclusions. The intervention benefited employee health by reducing CRS equivalent to 5 to 10 years of age-related changes for those with a higher baseline CRS and for older employees. Trial Registration. ClinicalTrials.gov Identifier: NCT02050204. (Am J Public Health. 2023;113(12):1322-1331. https://doi.org/10.2105/AJPH.2023.307413).

Gates to retirement and gender differences: Macroeconomic conditions, job satisfaction, and age.

The different pathways out of the labor force have been the focus of many recent studies, yet not enough scholarly attention has been paid to the effect of country-level, individual, and job characteristics and their potentially different influence across genders. The current article examines the relationships between retirement decisions and macroeconomic conditions, personal characteristics, and job satisfaction, while focusing on gender differences. Data came from 16,337 respondents in 13 European countries that participated in the Survey of Health, Ageing and Retirement in Europe (SHARE). We find that the relative importance of macroeconomic conditions and job satisfaction differs by gender.

Workability and Requests for Flexible Work Arrangements Among Older Adults: The Role of a Time and Place Management Intervention.

This article investigates the effect of an intervention on the workability of older adults (i.e., the competence, health, and other mental and physical characteristics that workers need to meet the demands of their jobs). We used data from health care workers ( N = 437) who participated in a "time and place management" (TPM) intervention. Although related to flexible work options that aim to give workers more choice and control over the time and place of their work, TPM is conceptually distinct in that it focuses on the processes and guidelines necessary to the successful management of choice and control rather than the options alone. We focused on how the TPM intervention moderated the relationship between age and workability over time, with a particular focus on variation by baseline workability. Our results indicated that the intervention can benefit older workers with low workability.

Age Bias in the Workplace: Cultural Stereotypes and In-Group Favoritism.

Two key theoretical frameworks that explain why people might hold biases for or against a specific age group-cultural stereotypes and in-group favoritism-yield distinct and sometimes contradictory predictions. This study proposes a combined framework drawing on these two theories and then tests hypotheses based on this framework in the workplace context. Using survey data from U.S. employees of two pharmaceutical companies, we evaluated the extent to which respondents attributed characteristics related to innovation or change and reliable performance to other workers based on perceived relative age (the age of the target relative to the age of the respondent). The hypotheses that our combined framework generated were supported, but the results varied by type of characteristic as well as by age of the respondent. We conclude that the combined framework is more predictive of age bias in the workplace than either individual framework alone.

Physical, Cognitive, Social, and Emotional Mediators of Activity Involvement and Health in Later Life.

The current study tests the indirect effect of activity-related physical activity, cognitive activity, social interaction, and emotional exchange on the relationship between activity involvement and health (physical and emotional) in later life. Longitudinal data from the Health and Retirement Study (N = 5,442) were used to estimate a series of linear regression models. We found significant indirect effects for social interaction and benefit to others (emotional exchange) on emotional health (depressive symptoms) and indirect effects for use of body and benefit to others (physical) on physical health (frailty). The most potent indirect effect associated with emotional and physical health was experienced by those engaged in all four domains (use of body, use of mind, social interaction, and benefit to others). While effect sizes are small and results should be interpreted with caution, findings shed light on ways in which public health interventions aimed toward increasing role engagement in later life could be improved.

Across the continuum of satisfaction with work-family balance: Work hours, flexibility-fit, and work-family culture.

This study investigated the association between hours worked per week and satisfaction with work-family balance, using data from a 2007-2008 survey of employees nested within organizations. We tested hypotheses informed by the resource drain and resources-and-demands perspectives using quantile regression. We found that the negative association between hours worked per week and satisfaction with work-family balance was significantly stronger at the 25th percentile, as compared to at the 75th percentile, of satisfaction with work-family balance. Further, there was some evidence that perceived flexibility-fit (i.e., the fit between worker needs and flexible work options available) and supportive work-family culture attenuated the relationship between hours worked and satisfaction with work-family balance. The results suggest that analyses focusing on the average relationship between long work hours (such as those using ordinary least squares regression) and satisfaction with work-family balance may underestimate the importance of long work hours for workers with lower satisfaction levels.

Working in retirement: a brief report.

Despite the relatively large number of working retirees, very little research has focused specifically on their job experiences. This brief report aims to address this gap in the literature by examining what facets of workplace environment affect job satisfaction and engagement for people who are working in retirement. Data from the 2008 National Study of the Changing Workforce, a sample representative of United States workers, are used to compare workers aged 50 and above who consider themselves retired (N = 203) to those in the same age group who do not consider themselves retired (N = 936). Results suggest that although the economic security offered by the job is less important to job satisfaction and engagement among those who are working in retirement than it is for other older workers, their relationship with their supervisor may be more important. Implications of these findings are considered along with potential directions for future research.

Volunteer transitions among older adults: the role of human, social, and cultural capital in later life.

OBJECTIVES: We aim to understand how human, social, and cultural capitals are associated with the volunteer process, that is, engagement (starting), intensity (number of hours), and cessation (stopping), among older adults. METHOD: Data from the 2000 through 2008 Health and Retirement Study and the 2001 through 2009 Consumption and Activity Mail Survey provide a sample of 4,526 respondents. Random-effects pooled time series analyses incorporate not only the presence of various types of capital but also the quality of that capital. RESULTS: Human and cultural capitals were positively associated with increased volunteer involvement. Effects of social capital (relationships in the family, employment status, and the community) depended on the quality of the relationships, not necessarily on their presence alone. DISCUSSION: Results suggest that bolstering older adults' capitals, particularly among lower socioeconomic status groups, can increase volunteer engagement and intensity and reduce cessation. Additionally, a variety of organizational policies including respite programs for caregivers and employer policies allowing employees to reduce their work hours might indirectly affect participation rates and commitment. Potential pools of volunteers exist in families, workplaces, and religious organizations, but more research is necessary to identify how to recruit and retain individuals in social networks where volunteer participatory rates are low.

Stages of change and prenatal alcohol use.

This study evaluated stage of change as a predictor of alcohol use in a sample of 301 pregnant women who were either in the precontemplation (62%) or in the action (38%) stage of change in their first trimester. Stage of change distinguished between different patterns of alcohol consumption before and after pregnancy. Those in the precontemplation stage drank more per episode and more often before pregnancy than those in the action stage. The precontemplation group also had a significantly greater quantity of alcohol after pregnancy. However, stage of change did not directly predict subsequent prenatal alcohol use. Previous alcohol use, age, and education were the most significant predictors of prenatal drinks per drinking day. Temptation to drink alcohol was the best predictor of prenatal drinking frequency after study enrollment. Women in both stages of change reduced the quantity and the frequency of their alcohol consumption while pregnant and achieved comparable rates of abstinence.

Estimates of prenatal abstinence from alcohol: a matter of perspective.

Abstinence from alcohol has been recommended for both pregnant and pre-conceptional women. The purpose of this study is to compare self and partner reports of abstinence from alcohol in a sample of 253 pregnant women who were T-ACE (Tolerance, Annoy, Cut-down, Eye-opener) alcohol screen positive. Dyads' reports of the women's abstinence from alcohol before, during, and after pregnancy were compared. Based on their own self-report, less than 20% of the pregnant women were abstinent in their first trimester and about half were abstinent for the rest of their pregnancy. Partners significantly over-estimated the women's abstinence from alcohol at all points except in the post-partum period when the dyad had the highest rate of agreement (85.4%). Reasons for the discrepancies in the self and partner reports of prenatal abstinence, and how partners might influence such behavior remain speculative, but identify areas for future research and prevention.

Brief intervention for prenatal alcohol use: the role of drinking goal selection.

The behavioral problems and cognitive deficits resulting from even small amounts of prenatal alcohol exposure can be significant and enduring but completely preventable. The purpose of this study was to examine the impact of a prenatal drinking goal selected during a brief intervention for 115 pregnant women and their partners on subsequent consumption. Higher proportions of women having their first pregnancy chose abstinence as a goal over drinking reduction. Goal selection was highly predictive of subsequent drinking behavior. Interestingly, the participants who were abstinent at enrollment and who chose to remain abstinent had the highest rates of abstinence. In contrast, the women who chose cutting down on drinking were the least likely to drink less subsequently, despite recognizing more situations putting them at risk for drinking and identifying more alternatives to consumption. We conclude that goal choice in behavioral self-management of alcohol use by pregnant women is critical.

Identifying risk drinking in expectant fathers.

BACKGROUND: Identification of risk drinking in expectant fathers may be helpful as an important part of efforts to minimize maternal alcohol use, and as an opportunity to inform them about a problematic practice during a critical developmental stage for the couple. The purpose of this study was to evaluate the T-ACE screening questionnaire, which asks about tolerance to alcohol, being annoyed by other's comments about drinking, attempts to cut down, and having a drink first thing in the morning ("eye-opener"), in the male partners of pregnant women who themselves were T-ACE positive. METHODS: Two hundred fifty-four male partners were asked to complete the T-ACE embedded in a health survey, the Alcohol Use Disorders Identification Test (AUDIT), and other questions about their alcohol use in the past 30 days when their pregnant partners had a median gestation of 11.5 weeks (T1). After delivery, male partners again completed the T-ACE and quantity-frequency questions (T2). The predictive ability of the T-ACE and AUDIT was compared, using risk drinking (>4 drinks/day or >14 drinks/week) as the criterion standard. RESULTS: A substantial minority of male partners had risk drinking, 31 percent at T1 and 25 percent at T2. Although the AUDIT was better than the T-ACE as an independent predictor of risk drinking, the latter was most accurate when the tolerance threshold exceeded 2 drinks, the same established for pregnant women. The sensitivity (T1= 84.6%, T2= 82.8%) and specificity (T1= 43.8%, T2= 51.1%) of the T-ACE at this threshold compared favorably with those of the AUDIT at the standard cut point of 8. CONCLUSIONS: The T-ACE may be a practical way for clinicians to identify risk drinking in both pregnant women and expectant fathers.

Problem drinking in women evaluated for infertility.

Clinicians may wish to use the T-ACE, a screening instrument for prenatal risk drinking, for their infertile patients. Twenty-eight T-ACE negative and 23 T-ACE positive women presenting to an academic infertility clinic completed two interviews about their drinking. The 23 T-ACE positive participants were also randomized to receive a brief intervention. The T-ACE distinguished between heavier and lighter patterns of alcohol use in this sample. Moreover, it appeared that although the average quantity of alcohol consumed per drinking day was unchanged, the overall mean percentage of days drinking declined significantly from the time of enrollment to follow-up in all groups.

Alcohol use by pregnant women: partners, knowledge, and other predictors.

OBJECTIVE: The impact of a couple's knowledge about healthy pregnancy habits involving alcohol and substance use was assessed in the context of other factors previously identified to predict prenatal alcohol consumption in a sample of 254 pregnant women and their male partners. METHOD: Couples were asked to assess independently a series of statements (true or false) describing the consequences of prenatal substance exposure, while also providing information about their own drinking. RESULTS: Although the couples demonstrated good knowledge of healthy habits during pregnancy, they did not agree when the element of chance was considered. Median household income was more highly predictive of a pregnant woman's knowledge score than her partner's score. In turn, the subject's knowledge of healthy pregnancy habits as manifested in the assessment score had only a weak relationship with prenatal alcohol consumption. Previous alcohol use by the pregnant woman was the strongest predictor of prenatal alcohol use. CONCLUSIONS: Because previous alcohol consumption use by the pregnant woman was the strongest predictor of prenatal alcohol use, the importance of its accurate identification is emphasized. Although pending further investigation, knowledge about healthy pregnancy behaviors may exert greater impact if it is shared by a pregnant woman and her partner.

Social support and prenatal alcohol use.

BACKGROUND: Lack of social support during pregnancy may be associated with the prenatal use of alcohol. The purpose of this study is to evaluate the degree, predictors, and consequences of social support in a cohort of 200 pregnant women who scored 2 or more on the T-ACE, a 4-item screening questionnaire for prenatal drinking. METHODS: The pregnant women completed the Maternal Social Support Index (MSSI). Their partners completed the same measure, which was modified to reflect their status as the biological fathers. RESULTS: Despite having similar overall MSSI scores, there was only slight to fair agreement on the level of support received by the pregnant women for most daily tasks when their responses were compared with their partners. Predictors of increased maternal social support included the woman's being married and having more education and a more prestigious job than her partner. Social support was not predictive of either subsequent prenatal alcohol use or newborn birth weight. CONCLUSIONS: Regardless of social support, previous, prepregnancy, and early pregnancy drinking were the most predictive factors for subsequent prenatal alcohol consumption in this sample, underscoring the importance of screening pregnant women for drinking.

Risk during pregnancy--self-report versus medical record.

OBJECTIVE: This study was undertaken to compare the frequencies with which physicians and patients report medical and behavioral risk factors during pregnancy, with particular attention to identification of women at risk for prenatal alcohol use. STUDY DESIGN: The sample included 278 women, drawn from a randomized trial of T-ACE (alcohol screening questionnaire) positive pregnant women receiving obstetric care. Medical records and participants' self-reports were available for comparison. RESULTS: Physicians identified only 10.8% of women recognized as at risk for alcohol consumption by the T-ACE screening measure. In contrast, the physicians' records were more inclusive for medical risk factors than the participant's self-reports. Physicians were significantly more likely to correctly identify nonwhite participants as being at risk for prenatal alcohol use (odds ratio = 3.59, P = .026), compared with their white counterparts. CONCLUSION: Self-report on the T-ACE questionnaire is more effective than medical records in identifying women at risk for prenatal alcohol use.

Brief intervention for prenatal alcohol use: a randomized trial.

OBJECTIVE: To test the effectiveness of a brief intervention in the reduction of prenatal alcohol consumption by women when a partner is included. METHODS: Randomized trial of a single session brief intervention given by the study nurse or principal investigator for 304 pregnant women and their partners. The women had positive T-ACE (Tolerance, Annoyed, Cut down, Eye-opener, an alcohol screening test) results and were at risk for alcohol consumption while pregnant. All completed initial diagnostic and postpartum interviews. RESULTS: Fewer than 20% of participants (median 11.5 weeks of gestation) were abstinent at study enrollment, averaging more than 1.5 drinks per episode. Nearly 30% had 2 or more drinks at a time while pregnant. Prenatal alcohol use declined in both the treatment and control groups after study enrollment, based on a 95% follow-up rate. Factors associated with increased prenatal alcohol use after randomization included more years of education, extent of previous alcohol consumption, and temptation to drink in social situations. Brief interventions for prenatal alcohol reduced subsequent consumption most significantly for the women with the highest consumption initially (regression coefficient, b = -0.163, standard error (b) = 0.063, P < .01). Moreover, the effects of the brief intervention were significantly enhanced when a partner participated (b = -0.932, standard error (b) = 0.468), P < .05). CONCLUSION: Pregnant women with the highest levels of alcohol use reduced their drinking most after a brief intervention that included their partners. Recommendations include consistent screening for prenatal alcohol use followed by diagnostic assessment when indicated, and if confirmed by other studies, a patient-partner brief intervention for the heaviest drinkers.

Psychosocial function after hematopoietic stem cell transplantation.

The authors report on a prospective cohort study of patients with chronic myelogenous leukemia undergoing allogeneic hematopoietic stem cell transplantation. The purpose was to evaluate the progression of quality of life and mood, as well as patterns of alcohol consumption, a behavior with potential adverse health consequences. Of the 84 subjects who completed serial measures and other interviews at admission for hematopoietic stem cell transplantation and 6-month follow-up, 75 provided data 12 months later The main findings of this study were that quality of life improves, measures of depressive symptoms decline, and patients drink less alcohol overall. Time was the most important variable accounting for these changes.

Race, gender, and the retirement decisions of people ages 60 to 80: prospects for age integration in employment.

UNLABELLED: Demographic projections have prompted concerns about the potential economic burden of an aging population. This article, drawing on the 1998 Health and Retirement Study, explores ways in which race, gender, and age moderate the effects of various factors on labor force participation among people ages 60 to 80. Key findings center on health, education, and non-wage income. First, the effect of low non-wage income is weaker at older ages due to higher levels of functional disability. Second, the effect of low education is stronger for women, who perceive their chances of finding employment as low. Third, the effect of health is weaker for blacks, as they are less likely to find steady employment regardless of health. POLICY IMPLICATIONS: Employer flexibility in number of hours worked might make sense for workers close to retirement age, while job search and training programs might be preferable for workers past the typical retirement age.