Jennifer Rose

A Practical Guide to Calculating Cohen’s f2, a Measure of Local Effect Size, from PROC MIXED

Reporting effect sizes in scientific articles is increasingly widespread and encouraged by journals; however, choosing an effect size for analyses such as mixed-effects regression modeling and hierarchical linear modeling can be difficult. One relatively uncommon, but very informative, standardized measure of effect size is Cohen’s f2, which allows an evaluation of local effect size, i.e., one variable’s effect size within the context of a multivariate regression model. Unfortunately, this measure is often not readily accessible from commonly used software for repeated-measures or hierarchical data analysis. In this guide, we illustrate how to extract Cohen’s f2 for two variables within a mixed-effects regression model using PROC MIXED in SAS® software. Two examples of calculating Cohen’s f2 for different research questions are shown, using data from a longitudinal cohort study of smoking development in adolescents. This tutorial is designed to facilitate the calculation and reporting of effect sizes for single variables within mixed-effects multiple regression models, and is relevant for analyses of repeated-measures or hierarchical/multilevel data that are common in experimental psychology, observational research, and clinical or intervention studies.

Reproductive Health Care and Family Planning Needs Among Incarcerated Women

OBJECTIVES Women in correctional institutions have substantial reproductive health problems, yet they are underserved in receipt of reproductive health care. We assessed the level of risk for sexually transmitted diseases (STDs) and the reproductive health needs of 484 incarcerated women in Rhode Island to plan an intervention for women returning to the community. METHODS We used a 45-minute survey to assess medical histories, pregnancy and birth control use histories, current pregnancy intentions, substance use during the past 3 months, histories of childhood sexual abuse, and health attitudes and behaviors. RESULTS Participants had extremely high risks for STDs and pregnancy, which was characterized by inconsistent birth control (66.5%) and condom use (80.4%), multiple partners (38%), and a high prevalence of unplanned pregnancies (83.6%) and STDs (49%). Only 15.4% said it was not likely that they would have sexual relations with a man within 6 months after release. CONCLUSION Reproductive health services must be offered to incarcerated women. Such interventions will benefit the women, the criminal justice systems, and the communities to which the women will return.

Trajectories of smoking from adolescence to early adulthood and their psychosocial risk factors.

OBJECTIVE To explore patterns of persistence and change in smoking behavior as well as risk factors associated with the developmental course of smoking from age 13 to 25. DESIGN Data from the public use sample of the National Longitudinal Study of Adolescent Health (N = 5,789) were analyzed using semiparametric group-based modeling. MAIN OUTCOME MEASURES Smoking quantity-frequency in the past 30 days. RESULTS Six distinct smoking trajectories were identified: nonsmokers, experimenters, stable light smokers, quitters, late escalators, and stable high smokers. Baseline risk factors that were associated with greater likelihood of membership in all of the smoking trajectory groups compared with nonsmokers included alcohol use, deviance, peer smoking, and (with the exception of the late escalators) drug use. Deviance, peer smoking, and alcohol and drug use also distinguished the likelihood of membership among several of the 5 smoking trajectory groups. CONCLUSION The results add to basic etiologic research on developmental pathways of smoking in adolescence and young adulthood by providing evidence of heterogeneity in smoking behavior and prospectively linking different patterns of risk factors with the probability of trajectory group membership.

Trazodone For Sleep Disturbance After Alcohol Detoxification: A Double-Blind, Placebo-Controlled Trial

BACKGROUND Trazodone is a commonly prescribed off-label for sleep disturbance in alcohol-dependent patients, but its safety and efficacy for this indication is unknown. METHODS We conducted a randomized, double-blind, placebo-control trial of low-dose trazodone (50 to 150 mg at bedtime) for 12 weeks among 173 alcohol detoxification patients who reported current sleep disturbance on a validated measure of sleep quality or during prior periods of abstinence. Primary outcomes were the proportion of days abstinent and drinks per drinking day over 6-months; sleep quality was also assessed. RESULTS Urn randomization balanced baseline features among the 88 subjects who received trazodone and 85 who received placebo. The trazodone group experienced less improvement in the proportion of days abstinent during administration of study medication (mean change between baseline and 3 months: -0.12; 95% CI: -0.15 to -0.09), and an increase in the number of drinks per drinking day on cessation of the study medication (mean change between baseline and 6 months, 4.6; 95% CI: 2.1 to 7.1). Trazodone was associated with improved sleep quality during its administration (mean change on the Pittsburgh Sleep Quality Index between baseline and 3 months: -3.02; 95% CI: -3.38 to -2.67), but after it was stopped sleep quality equalized with placebo. CONCLUSIONS Trazodone, despite a short-term benefit on sleep quality, might impede improvements in alcohol consumption in the postdetoxification period and lead to increased drinking when stopped. Until further studies have established benefits and safety, routine initiation of trazodone for sleep disturbance cannot be recommended with confidence during the period after detoxification from alcoholism.

Prevalence and predictors of sexually transmitted infection among newly incarcerated females.

Objectives: To examine demographic and behavioral characteristics in incarcerated women to determine which characteristics are associated with prevalent sexually transmitted infections (STIs). Study Design: A cross-sectional analysis of data of 205 women entering jail in Rhode Island was performed as part of a study evaluating a family planning program. Women were recruited near time of commitment, and inclusion was limited to women at risk for an unplanned pregnancy. Incarcerated women were interviewed by a research assistant for demographic information, psychosocial and behavioral characteristics. Self-collected vaginal swabs were tested for STIs, including Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction and Trichomonas vaginalis by InPouch culture. Relative risks (RRs) were estimated using Poisson regression. Results: Sixty-eight of 205 patients tested positive for an STI [33%; 95% confidence interval (CI) 27–40%]. Forty-five patients (26%) tested positive for T. vaginalis, 27 (14%) were positive for C. trachomatis, and 21 (11%) were positive for N. gonorrhoeae. On bivariate analysis, 6 or more sexual partners in the last year (RR 1.84; 95% CI 1.01–3.36), exchanging sex for drugs/money (RR 1.65; 95% CI 1.01–2.69), and homelessness (RR 1.82; 95% CI 1.07–3.09) were associated with STI. After adjustment for age, race/ethnicity, education, and other covariates, none of the factors was significantly associated with STI. Conclusions: The prevalence of STI in this jail population is high. Incarceration represents a unique opportunity to evaluate and treat this underserved population. Predictors of infection are limited and infection is common; therefore, routine screening should be considered in this population.

Nicotine dependence symptoms among recent onset adolescent smokers

The present study examined the prevalence of individual nicotine dependence symptoms among recent onset smokers across the continuum of nondaily and daily cigarette smoking behavior in a nationally representative sample of recent onset smokers from the National Surveys on Drug Use and Health (NSDUH). Rates of endorsement for 17 symptoms drawn primarily from the Nicotine Dependence Symptom Scale (Shiffman et al., 2004) were calculated for four levels of nondaily (smoked 1-3, 4-10, 11-20, or 21-29 days in the past 30 days) and daily (smoked 1, 2-5, 6-15, or >15 cigarettes per day in the past 30 days) smoking. Logistic and linear regression analyses with polynomial contrasts controlling for age, gender, length of exposure, and smoking quantity tested trends in symptom endorsement across levels of smoking. Significant linear and quadratic trends indicated that increasing rates of endorsement differed most between the lowest levels of nondaily and daily smoking. Results suggest that, for some, infrequent smoking may not represent benign experimentation. Recognizing early symptoms of nicotine dependence may assist in early identification and intervention of those at risk for heavier smoking in the future. Adolescents can be taught to recognize the early symptoms of nicotine dependence to increase awareness of the rapidity at which these symptoms may appear.

Risk factors for adolescent smoking: Parental smoking and the mediating role of nicotine dependence

BACKGROUND Parental smoking and early-emerging nicotine dependence symptoms are well-documented risk factors for adolescent smoking. However, very little is known about the mediating pathways through which these risk factors may act, or whether parental smoking may cause or signal early-emerging nicotine dependence symptoms. METHODS Data were drawn from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study. Adolescents who had smoked under 100 cigarettes in their lifetime (n=594; low-exposure group) and adolescents who had smoked over 100 cigarettes, but fewer than 5 cigarettes per day (n=152) were included in the analyses. Path analysis was performed on longitudinal data to investigate the association between parental smoking and smoking frequency at the 48 months follow-up, both directly and through mediating variables of smoking frequency, smoking quantity, and nicotine dependence. RESULTS Fathers smoking was associated with higher adolescent nicotine dependence scores at the baseline assessment wave. Structural equation modeling revealed that mothers smoking at baseline was associated with adolescents smoking frequency at the 48-month follow-up, and its effect was partially mediated by both smoking frequency and nicotine dependence among low-exposure adolescent smokers. CONCLUSIONS Parental smoking is a risk factor for future smoking in low-exposure adolescent smokers, above and beyond the risks posed by smoking behavior and nicotine dependence. Moreover, parental smoking is associated with early-onset nicotine dependence in low-exposure adolescent smokers. As an easily measureable risk factor, parent smoking status can be used to identify and intervene with novice adolescent smokers who are at high risk for chronic smoking behavior.

Transitions to Regular Smoking and Nicotine Dependence in the Adolescent National Comorbidity Survey (NCS-A)

ObjectiveThis study aims to investigate the occurrence of nicotine dependence following the achievement of previous smoking milestones (initiation, weekly, and daily smoking).MethodAnalyses are based on data from The National Comorbidity Survey-Adolescent, a nationally representative face-to-face survey of 10,123 adolescents (age 13–17) conducted between 2001 and 2004.ResultsAmong adolescents who had ever smoked (36.0%), 40.7% reached weekly smoking levels and 32.8% had reached daily smoking. Approximately one in five adolescents who had ever smoked (19.6%) met criteria for nicotine dependence. An earlier age of smoking initiation, a shorter time since the onset of smoking and faster transitions among smoking milestones were independently associated with the onset of daily smoking and nicotine dependence.ConclusionsThese findings shed new light on the course of smoking and nicotine dependence during adolescence by demonstrating a rapid transition across smoking stages for those most at risk for the development of chronic and dependent use.

Improving Birth Control Service Utilization By Offering Services Prerelease Vs Postincarceration

OBJECTIVES We examined whether incarcerated women would substantially increase birth control initiation if contraceptive services were available within the prison compared with after their release back into the community. METHODS During phase 1 of the study, a nurse educator met with women at the Rhode Island Adult Correctional Institute and offered them referrals for contraceptive services at a community health clinic after their release. During phase 2, contraceptive services were offered to women during their incarceration. RESULTS The majority of the participants (77.5%) reported a desire to initiate use of birth control methods. Within 4 weeks of their release, 4.4% of phase 1 participants initiated use of a contraceptive method, compared with 39.1% of phase 2 participants (odds ratio [OR]=14.6; 95% confidence interval [CI]=5.5, 38.8). CONCLUSIONS Provision of contraceptive services to women during their incarceration is feasible and greatly increases birth control initiation compared to providing services only in the community.

Elementary neurocognitive function, learning potential and everyday life skills in schizophrenia: What is their relationship?

Few studies have investigated the relationships between static, elementary neurocognitive functions, dynamic measures of learning potential and functional status in schizophrenia, despite the putative role of learning potential in models of the relationship between static neurocognitive function and functional status (e.g., Green et al., 2000). The current study sought to clarify these relationships. One-hundred and twenty-five outpatients with schizophrenia were administered the California Verbal Learning Test-II (CVLT-II), as an index of learning potential, along with measures of sustained attention, verbal prose recall, working memory, problem-solving and processing speed, and a capacity measure of everyday life skills (Study 1). A subset of 48 outpatients with schizophrenia who were impaired on the Wisconsin Card Sorting Test (WCST) were also administered a test-train-test version of the WCST as a second measure of learning potential (Study 2). As expected, several static, elementary neurocognitive measures were linked to measures of everyday life skills in both samples. There was no evidence, however, that either measure of learning potential contributed unique variance beyond that explained by elementary cognitive skill to measures of everyday life skills. Learning potential was also tested as a mediator and moderator of the relationship between static neurocognitive function and measures of everyday life skills. Neither learning potential measure mediated the relationship between static measures of neurocognition and everyday life skills. Learning potential, as measured by the CVLT-II, was found to moderate the relationship of processing speed and everyday life skills. Taken together, these findings raise questions as to the explanatory value of measures of learning potential as predictors of functional status in schizophrenia.