Ann A. O'Connell

A Brief Culturally Tailored Intervention for Puerto Ricans With Type 2 Diabetes

The information—motivation—behavioral skills (IMB) model of health behavior change informed the design of a brief, culturally tailored diabetes self-care intervention for Puerto Ricans with type 2 diabetes. Participants (n = 118) were recruited from an outpatient, primary care clinic at an urban hospital in the northeast United States. ANCOVA models evaluated intervention effects on food label reading, diet adherence, physical activity, and glycemic control (HbA1c). At follow-up, the intervention group was reading food labels and adhering to diet recommendations significantly more than the control group. Although the mean HbA1c values decreased in both groups (Intervention: 0.48% vs. Control: 0.27% absolute decrease), only the intervention group showed a significant improvement from baseline to follow-up (p < .008), corroborating improvements in diabetes self-care behaviors. Findings support the use of the IMB model to culturally tailor diabetes interventions and to enhance patients’ knowledge, motivation, and behavior skills needed for self-care.

The Dimensionality of Language Ability in Young Children

The purpose of this study was to empirically examine the dimensionality of language ability for young children (4-8 years) from prekindergarten to third grade (n = 915), theorizing that measures of vocabulary and grammar ability will represent a unitary trait across these ages, and to determine whether discourse skills represent an additional source of variance in language ability. Results demonstrated emergent dimensionality of language across development with distinct factors of vocabulary, grammar, and discourse skills by third grade, confirming that discourse skills are an important source of variance in childrens language ability and represent an important additional dimension to be accounted for in studying growth in language skills over the course of childhood.

Ability Grouping across Kindergarten Using an Early Childhood Longitudinal Study.

ABSTRACT Regardless of individual differences at kindergarten entry, schools have a mission to promote reading achievement for all students. Within-class ability grouping is an instructional strategy that has received attention for its potential benefits to students. The authors assessed the effects of within-class ability grouping on kindergarten reading growth by using data from the Early Childhood Longitudinal Study—Kindergarten Cohort. Results revealed that the frequency with which teachers used ability groups was positively associated with mean school gain in reading, suggesting that early literacy and reading improvement in kindergarten may be facilitated by the use of ability groups in reading.

Factors related to self-efficacy for use of condoms and birth control among women at risk for HIV infection.

ABSTRACT Many women who are at risk for HIV do not regularly use condoms, particularly with their main partners. In this paper we examine factors related to self-efficacy for condom use with main and other partners and self-efficacy for birth control in 2864 women interviewed in five urban high-risk communities. Limited social and economic resources, dependence on a main partner, and risk factors, including ex-changing sex for money or drugs and binge drinking, were found to be negatively related to self-efficacy. Segmentation analysis identified groups of women with low self-efficacy who should be the focus of preventive interventions.

Factors associated with perceptions of and decisional balance for condom use with main partner among women at risk for HIV infection.

ABSTRACT We examined factors associated with womens perceived advantages (pros), perceived disadvantages (cons), and decisional balance (standardized pros score minus standardized cons score) for condom use with main partner. Data from 1,938 young sexually active women who lived in five U.S. cities where the risk for human immunodeficiency virus is high were analyzed by using logistic, ordinal, and multiple linear regression analysis. For the pros scale of condom use, 27% of the women had low scores, and 33% had moderate scores. For the cons scale, 27% had moderate scores, and 5% had high scores. Of the total, 47% had a negative score on the decisional balance measure. Older age, living with a spouse or partner, or binge drinking was associated with lower pros scores and with a negative score on the decisional balance measure. Income from public assistance was associated with higher pros scores. Income from a spouse or partner or a history of sexually transmitted disease was associated with lower pros scores. Multiple sex partners or being at risk for HIV infection (based on perceptions of the main partners behaviors) was associated with higher cons scores. Income from a job was associated with a positive score on the decisional balance measure. Our analysis identified the characteristics of women who have low pros scores, high cons scores, and negative decisional balance scores. The regression results can inform our work in HIV prevention on whether to focus on the pros, the cons, or both to obtain positive decisional balance scores and increase condom use in situations that warrant protective behaviors.

Approaches to Academic Growth Assessment.

BACKGROUND There is much interest in assessing growth in student learning. Assessments of growth have important implications and affect many policy decisions at many levels. AIMS In the present article, we review some of the different approaches to measuring growth and examine the implications of their usage. SAMPLE Samples used in research on growth models typically include students enrolled in public schools that primarily serve kindergarten through the 12th grade. METHOD Definitions of growth and gain are reviewed, and five types of growth models are examined: (1) Student Gain Score Model, (2) The Covariate Adjustment Model, (3) The Student Percentile Gain Model - referred to as single-wave value-added models, (4) Univariate Value-Added Response Models, and (5) Multivariate Value-Added Response Models. RESULTS Modelling approaches are vastly different, whereas Student Gain Models are mathematically and conceptually simple, Multivariate Models are highly complex. CONCLUSION Educators assessing growth must make critical decisions about measurement. The type of instrument that is selected and the type of analytic techniques selected are of great importance. Growth must be considered from technical, pedagogical, and policy perspectives.

Inpatient rehabilitation volume and functional outcomes in stroke, lower extremity fracture, and lower extremity joint replacement

Background:It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Objectives:Assess associations between facility volumes and 2 patient-centered outcomes in the 3 most common diagnostic groups in inpatient rehabilitation. Research Design:We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the United States. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Measures:Discharge functional status (FIM instrument) and probability of home discharge. Results:Facility-level factors accounted for 6%–15% of the variance in discharge FIM total scores and 3%–5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (P<0.01) associations with discharge functional status in all 3 diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Conclusions:Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all 3 diagnostic groups. Patients with these conditions can be treated locally rather than at higher volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions.

A comparison of the genetic and clinical profile of men that respond and do not respond to the immediate antihypertensive effects of aerobic exercise

We compared the genetic and clinical profile of men who lower and do not lower blood pressure (BP) after acute aerobic exercise. Volunteers were 45 men (Mean ± SEM, 43.5 ± 1.5 yr) with high BP (145.7 ± 1.5/85.7 ± 1.1 mmHg). They completed three experiments: nonexercise control and two cycle exercise sessions at 40% and 60% peak oxygen consumption, and were then instrumented to an ambulatory BP monitor. Logistic regression determined the genetic and clinical profile of men who lowered BP after exercise (responders [ExR n = 36]); and those who did not (nonresponders [ExNR n = 9]). ExR had higher C-reactive protein (CRP), high-density lipoprotein (HDL), the metabolic syndrome, family history of hypertension, more renin-angiotensin system (RAS) common alleles, and α-adducin Trp460 and endothelial nitric oxide synthase (ENOS) C786 risk alleles. ExNR had lower CRP and HDL, did not have the metabolic syndrome and a family history of hypertension, had more RAS risk alleles, and had the α-adducin Gly460Gly and ENOS T786T genotypes. This model had a sensitivity of 97.1%, specificity of 75.0%, and accounted for 46.3%–74.4% of the BP response. These results suggest genetic and clinical information may eventually be used to characterize people who do and do not respond to exercise as antihypertensive therapy.

Understanding Risk for Reading Difficulties in Children With Language Impairment

Purpose The purpose of this study was to retrospectively examine the preschool language and early literacy skills of kindergarten good and poor readers, and to determine the extent to which these skills predict reading status. Method Participants were 136 children with language impairment enrolled in early childhood special education classrooms. On the basis of performance on a word recognition task given in kindergarten, children were classified as either good or poor readers. Comparisons were made across these 2 groups on a number of language and early literacy measures administered in preschool, and logistic regression was used to determine the best predictors of kindergarten reading status. Results Twenty-seven percent of the sample met criterion for poor reading in kindergarten. These children differed from good readers on most of the skills measured in preschool. The best predictors of kindergarten reading status were oral language, alphabet knowledge, and print concept knowledge. Presence of comorbid disabilities was not a significant predictor. Classification accuracy was good overall. Conclusion Results suggest that risk of reading difficulty for children with language impairment can be reliably estimated in preschool, prior to the onset of formal reading instruction. Measures of both language and early literacy skills are important for identifying which children are likely to develop later reading difficulties.

Teacher-child relationships and classroom-learning behaviours of children with developmental language disorders: Teacher-child relationships and classroom-learning behaviours of children with DLDs

BACKGROUND Children with developmental language disorders (DLDs) often struggle with classroom behaviour. No study has examined whether positive teacher-child relationships may act as a protective factor for children with DLDs in that these serve to enhance childrens important classroom-learning behaviours. AIMS To examine the association between the quality of teacher-child relationships and teacher-rated classroom-learning behaviours of children with DLDs in both preschool and kindergarten. METHODS & PROCEDURES Longitudinal data were collected on 191 preschoolers (mean = 42.4 months of age, SD = 11.6 months) with DLDs in special education classrooms during preschool and in kindergarten. Teacher-child relationship quality was assessed in preschool, and childrens classroom-learning behaviours were measured in preschool and kindergarten. Regression models were used to examine the relationship between teacher-child relationship quality and childrens concurrent and future classroom-learning behaviours. OUTCOMES & RESULTS Positive teacher-child relationship quality in preschool was associated with better classroom-learning behaviours in preschool and kindergarten for children with DLDs. Preschool teacher-child relationship quality characterized by low levels of conflict and high levels of closeness was associated with positive classroom-learning behaviours during preschool. Teacher-child conflict but not closeness was predictive of childrens classroom-learning behaviours in kindergarten. CONCLUSIONS & IMPLICATIONS These results suggest that the quality of the teacher-child relationship for children with DLDs during preschool is associated within their learning-related behaviours in the classroom both concurrently and in the subsequent year. Findings suggest that teacher-child relationships should be explored as a mechanism for improving the learning-related behaviours of children with DLDs.