Kimberly S. Canter

Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies ☆

Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations

A Systematic and Quantitative Review of Interventions to Facilitate School Reentry for Children With Chronic Health Conditions

OBJECTIVE To conduct as systematic and quantitative review of research on the effects of school reentry interventions for children with chronic health conditions. METHODS This analysis examined 2 primary outcomes: increasing illness- or injury-specific knowledge among teachers or healthy peers and enhancing positive attitudinal change toward an ill or injured child. A secondary analysis examined any change in the ill or injured childs global self-worth following the intervention. A random-effects model was used in all analyses, and effect sizes were analyzed using heterogeneity tests. RESULTS Larger effect sizes were found for increases in knowledge than for enhancing positive attitudinal changes (i.e., mean ES for knowledge: 0.84-0.88; mean ES for positive attitudinal change: 0.68), and larger effect sizes were found for teachers than for healthy peers in both analyses. Significant heterogeneity was found between groups (i.e., teachers vs. healthy peers) and within groups in both analyses. Results of the secondary analysis indicated a medium effect for improvements in global self-worth (i.e., mean ES = 0.24). CONCLUSIONS This analysis provides support for the effectiveness of school reentry interventions and highlights the critical need for more empirical work in this area.

Relationship Between Camp Attendance and Self-Perceptions in Children With Chronic Health Conditions: A Meta-Analysis

OBJECTIVE A meta-analysis examined the association between camp attendance and changes in self-perceptions in children with chronic health conditions. METHODS Studies using quantitative methods to assess changes in self-perceptions while attending camps designed for children with chronic health conditions were included in analyses. A random-effects model was used, and Cohens d was used to calculate effect sizes at both post-camp and follow-up. Some potential moderators of effects were examined (i.e., type of measure of self-perceptions, childrens chronic health condition, camp components). RESULTS 31 studies were included in the analyses. Children experienced small, but statistically significant, improvements in self-perceptions at both post-camp (d = .25, 95% CI [.16-.34]) and extended follow-up (d = .15, 95% CI [.05-.26]). This relationship was moderated by type of measure of self-perceptions and child health condition. CONCLUSIONS Camp attendance is associated with small improvements in self-perceptions for children with some chronic health conditions.

Measurement of Mealtime Behaviors in Rural Overweight Children: An Exploratory Factor Analysis of the Behavioral Pediatrics Feeding Assessment Scale

OBJECTIVE The current study presents results of an exploratory factor analysis (EFA) of the Behavioral Pediatric Feeding Assessment Scale (BPFAS) in a sample of rural children with overweight and obesity. Relationships between mealtime behavior and health outcomes are also explored. METHODS EFA was used to assess the fit of the BPFAS in a group of 160 treatment-seeking children (Mage = 9.11, SD = 1.77) living in rural Midwest communities. Correlations were also computed between factor scores and select health variables (child body mass index z-score and diet variables). RESULTS The EFA identified a 5-factor solution as the best fitting model (Tucker-Lewis Index = .96, root mean square error of approximation = .05), although several items (i.e., 7 of 25) did not load on any factor. 2 factors were correlated with health variables of interest. CONCLUSION Study results suggest that certain items on the BPFAS may not be appropriate for use with rural children with pediatric overweight or obesity. Implications for future research and practice are discussed.

Commentary: A Call to Action to Secure the Future of Pediatric Psychology—Resonating to the Points of Rozensky and Janicke (2012)

The field of pediatric psychology has adjusted and adapted to fit the changing environment of healthcare and needs of children and their families over its history (Aylward, Bender, Graves, & Roberts, 2009). Although initially considered to have an overly narrow focus, pediatric psychology became novel and innovative in the 1960s and 1970s and ultimately developed into a creatively vibrant and productive force in research and practice in healthcare psychology. Although the field has achieved great accomplishments, there is the potential of stagnating or even being left behind if practitioners and researchers continue to exclusively maintain the ‘‘status quo’’ without further innovation. Therefore, current and rising professionals will need to focus their incredible intelligence and energies to move out of what are now the established routines and ways of doing ‘‘things’’ to become once again novel and innovative, responding to changes in health care. Rozensky and Janicke (2012) have contributed a significant vision for the future of pediatric psychology in a changing healthcare system. The significant points in this article are truly a call to action, a strategic plan as it were, for the field of practice and research in pediatric psychology. Rozensky and Janicke highlight several ripe and exciting opportunities for the field of pediatric psychology in terms of growth and expansion in light of current changes in the healthcare environment and in various other related fields and disciplines. In this commentary, we briefly attend to several of the issues raised by these visionaries as important areas for growth in the future of pediatric psychology. We have highlighted only a few of the major recommendations made by Rozensky and Janicke in order to provide the detailed discussion that each point warrants, and this selection should not be interpreted as an exhaustive list of the valuable points made in their discussion.

Self-reported emotion reactivity among early-adolescent girls: evidence for convergent and discriminant validity in an urban community sample

Emotion reactivity, measured via the self-report Emotion Reactivity Scale (ERS), has shown unique associations with different forms of psychopathology and suicidal thoughts and behaviors; however, this limited body of research has been conducted among adults and older adolescents of predominantly White/European ethnic backgrounds. The present study investigated the validity of ERS scores for measuring emotion reactivity among an urban community sample of middle-school-age girls. Participants (N = 93, ages 11-15, 76% African-American, 18% Latina) completed the ERS and measures of emotion coping, internalizing problems, proactive and reactive aggression, negative life events, and lifetime suicidal ideation and substance use. As hypothesized, ERS scores were significantly associated with internalizing problems, poor emotion coping, negative life events, reactive aggression, and suicidal ideation (evidence for convergent validity), but showed little to no association with proactive aggression or lifetime substance use (evidence for discriminant validity). A series of logistic regressions were conducted to further explore the associations among internalizing problems, emotion reactivity, and suicidal ideation. With depressive symptoms included in the model, emotion reactivity was no longer uniquely predictive of lifetime suicidal ideation, nor did it serve as a moderator of other associations. In conjunction with previous research, these findings offer further support for the construct validity and research utility of the ERS as a self-report measure of emotion reactivity in adolescents.

Historical Analysis: The Journal of Pediatric Psychology From 1976 to 2015

Objective To provide a historical analysis through the examination of trends in type of articles, content areas, and population groups across all issues of the Journal of Pediatric Psychology (JPP). Method All articles published in JPP between the years 1976-2015 were coded based on article type (e.g., original research, meta-analysis), content code (e.g., adherence, primary care), and population code (e.g., oncology, chronic and recurrent pain). Descriptive statistics were calculated. Results The overall top article types, content codes, and population codes are described as well as top codes for each decade. Overall, the majority of articles were classified as original research. Although some population and content codes varied over time, there were some areas that were consistently present throughout issues, including family systems, cognitive/intellectual functioning, pediatric oncology, and type 1 diabetes. Many topics selected for special issues and topics were consistent with top population and content codes. Conclusions Findings indicate that most top areas have consistently been present in JPP over the 39-year period. The current historical analysis highlights these patterns as well as serves as a historical record for JPP.

The role of health behaviors and food insecurity in predicting fruit and vegetable intake in low-income children

ABSTRACT Research supports the importance of adequate fruit and vegetable intake during childhood. The current study examines relationships between physical activity, sedentary behavior, sleep, food insecurity, and fruit and vegetable intake in a sample of low-income, elementary-aged children. 148 participants were recruited from several agencies serving low-income families in a large midwestern metropolitan area. A measurement model was specified to ensure good fit between the data and predictive model. A structural model was run and several significant findings emerged. Food insecurity significantly predicted vegetable intake (latent regression coefficient = −0.18, p < 0.05), such that children with higher food insecurity consumed fewer servings of vegetables. Physical activity also significantly predicted fruit intake (latent regression coefficient = 0.32, p < 0.01) and vegetable intake (latent regression coefficient = 0.26, p < 0.01), such that children who were more physically active consumed more servings of fruits and vegetables. Data indicate that children with high food insecurity consumed fewer vegetables, and that physical activity is significantly related to fruit and vegetable intake. Possible implications for public policy are discussed.