Psychometric Evaluation and Normative Data for the Depression, Anxiety, and Stress Scales-21 (DASS-21) in a Nonclinical Sample of U.S. AdultsSinclair, Samuel Justin; Siefert, Caleb J.; Slavin-Mulford, Jenelle M.; Stein, Michelle B.; Renna, Megan; Blais, Mark A.
doi: 10.1177/0163278711424282pmid: 22008979
Health care professionals are coming under increased pressure to empirically monitor patient outcomes across settings as a means of improving clinical practice. Within the psychiatric and primary care communities, many have begun utilizing brief psychometric measures of psychological functioning to accomplish these goals. The purpose of this study was to evaluate the psychometric properties and clinical utility of the Depression, Anxiety, and Stress Scales—21-item version (DASS-21), and contribute normative data to facilitate interpretation using a sample of U.S. adults (N = 503). Item-scale convergence was generally supported, although assumptions of item-scale divergence were not met. Only 86%, 50%, and 43% of Depression, Anxiety, and Stress items, respectively, correlated significantly greater with their hypothesized scales than other scales. Internal consistency reliability was acceptable for all scales and comparable to existing research (αs = .91, .80, and .84 for Depression, Anxiety, and Stress, respectively). Scale-level correlations were greater than what has been reported elsewhere (range of rs = .68 to .73), and principal components analysis supported the extraction of only one component accounting for 47% of the item-level variance. However, confirmatory factor analysis (CFA) favored a three-factor structure when compared to a one-factor model. The implications for the health care professions are discussed.
Contrasting Case Definitions for Chronic Fatigue Syndrome, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Myalgic EncephalomyelitisJason, Leonard A.; Brown, Abigail; Clyne, Erin; Bartgis, Lindsey; Evans, Meredyth; Brown, Molly
doi: 10.1177/0163278711424281pmid: 22158691
This article uses data from patients recruited using the 1994 case definition of chronic fatigue syndrome (CFS) to contrast those meeting criteria for the Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS) Canadian case definition with those that did not meet these criteria. The study also contrasts those meeting criteria for Myalgic Encephalomyelitis (ME) based on criteria from Ramsay and other theorists with those that did not meet the ME criteria. The ME/CFS case definition criteria identified a subset of patients with more functional impairments and physical, mental, and cognitive problems than the subset not meeting these criteria. The ME subset had more functional impairments, and more severe physical and cognitive symptoms than the subset not meeting ME criteria. When applied to a population meeting the 1994 CFS case definition, both ME/CFS and ME criteria appear to select a more severe subset of patients.
Initial Evaluation of a Smoking Cessation Program Incorporating Physical Activity Promotion to Greek Adults in Antismoking ClinicsHassandra, Mary; Kofou, Georgia; Zourbanos, Nikos; Gratsani, Stamatia; Zisi, Vassiliki; Theodorakis, Yiannis
doi: 10.1177/0163278712445202pmid: 22582342
The purpose of this study was to evaluate an initial application of a smoking cessation program that integrated the promotion of physical activity (PA) as a cessation aid to Greek adults in antismoking clinics. From an initial pool of 50, 12 men and 28 women from Central Greece completed the program, and 18 of them succeeded in quitting for 1 year after the program. Additionally, after the program, they increased their PA. Suggestions for future applications of the program are further discussed.
The Relationship of Point-of-Sale Tobacco Advertising and Neighborhood Characteristics to Underage Sales of TobaccoWidome, Rachel; Brock, Betsy; Noble, Petra; Forster, Jean L.
doi: 10.1177/0163278712447624pmid: 22615496
Our objective was to determine how point-of-sale tobacco marketing may relate to sales to minors. The authors used data from a 2007 cross-sectional study of the retail tobacco marketing environments in the St. Paul, MN metropolitan area matched with a database of age-of-sale compliance checks (random, covert test purchases by a minor, coordinated by law enforcement) of tobacco retailers and U.S. Census data to test whether certain characteristics of advertising or neighborhoods were associated with compliance check failure. The authors found that tobacco stores were the most likely type of store to fail compliance checks (44% failure), supermarkets were least likely (3%). Aside from a marginally significant association with Hispanic population proportion, there was no other association between either store advertising characteristics or neighborhood demographics and stores’ compliance check failure. Though our findings were null, the relationship between advertising and real youth sales may be more nuanced as compliance checks do not perfectly simulate the way youth attempt to purchase cigarettes.
Mapping Structural Influences on Sex and HIV Education in Church and Secular Schools in ZimbabweMpofu, Elias; Mutepfa, Magen Mhaka; Hallfors, Denise Dion
doi: 10.1177/0163278712443962pmid: 22582341
The authors used state-of-the-art concept mapping approaches to examine structural institutional effects of church and secular high schools on the types of sexual and HIV-prevention education messages transmitted to learners in Zimbabwe. Participants were school teachers (n = 26), school counselors (n = 28), and pastors involved in student pastoral care (n = 14; males = 27, females = 41). They reported on messages perceived to influence sexual decisions of learners in their school setting. The self-report data were clustered into message types using concept mapping and contrasted for consistency of content and structure both between and within type of school. The authors also engaged in curriculum document study with member checks in the participant schools to determine convergence of the evidence on school-type effects of the messages transmitted to students. Church schools prioritized faith-informed sexual and HIV-prevention messages, whereas both types of schools prioritized Life skills education and a future focus. Secular schools prioritized sex and HIV messages in the context of community norms. Facts about HIV and AIDS were relatively underemphasized by church schools. The implicit knowledge values that differentiate types of schools influence learner access to information important for their sexual decisions.
“This Clinic Is Number One”Watermeyer, Jennifer
doi: 10.1177/0163278712445472pmid: 22615495
HIV/AIDS has significantly affected health care practices. The need for high adherence and regular clinic visits places pressure on health care providers and patients. Poor quality of care has been described in many contexts, but some clinics have achieved excellent treatment results. Using a success case approach, this study aimed to understand factors which contribute to successful care at a South African pediatric HIV/AIDS clinic with documented high patient adherence and follow-up rates. Data included over 50 hours of ethnographic observations and interviews with a total of 35 clinic staff and caregivers. Thematic analysis highlighted strong congruence between caregiver and staff perceptions. Factors which seemed to contribute to successful care included organizational routines, staff–patient relationships, communication, teamwork, leadership, job commitment, caregivers’ negative experiences at other clinics, and faith in the “life-saving” care at this clinic. Results suggest the need for all factors to be present in order to promote quality of care. Recommendations for other clinic settings are discussed.