Linda G. Kimmel

Adult Science Learning from Local Television Newscasts

American adults learn about science and health from numerous sources including television. The Pew studies demonstrate that half of American adults watch a local television news show three times a week or more, making local television news the most widely used news medium. This study examines the impact of a program to increase the use of science and health stories in local newscasts. The results show substantial story recall and information retention. The analysis suggests that science and health stories in local television newscasts may either enhance viewers’ existing science/health schemas or foster the development of new schemas for less well-known constructs.

Physician-related factors involved in patient decisions to enroll onto cancer clinical trials.

The development of new cancer therapies requires additional, and more complex, clinical trials. But only approximately 3% to 5% of adult cancer patients participate in cancer clinical trials. This study seeks to identify and understand the attitudes of the public and cancer survivors toward health-related decisions and cancer clinical trials to identify the key factors that must be addressed to increase that percentage.

Assessing the Perceived Stress Scale for African American adults with asthma and low literacy

The Perceived Stress Scale (PSS) is a widely used measure of stress that has not been validated in asthma patients. The psychometric properties of the PSS were explored using confirmatory factor analysis and item response theory. Study 1 involved 312 ambulatory care patients with asthma who completed the PSS during a routine visit. Study 2 involved 247 community-dwelling adults with asthma who completed the PSS as a part of a larger asthma study. Four items showed acceptable psychometric performance across ethnic groups and literacy. The short PSS is a rapid, valid measure of subjective stress in diverse asthma populations.

Pathways to a STEMM Profession

The inadequate number of American young adults selecting a scientific or engineering profession continues to be a major national concern. Using data from the 23-year record of the Longitudinal Study of American Youth (LSAY) and working within the social learning paradigm, this analysis uses a set of 21 variables to predict young peoples employment in science, technology, engineering, mathematics, or medicine (STEMM) at ages 36 to 39. The LSAY is one of the longest and most intensive longitudinal studies of the impact of secondary education and postsecondary education conducted in the United States. Using a structural equation model, the study found that mathematics continues to be a primary gateway for STEMM professions, beginning with algebra track placement in grade eight and continuing through high school and college calculus courses. Home and family factors such as parent education and parent encouragement of science and mathematics during secondary school also enhanced the likelihood of entering a STEMM profession.

The burden of asthma in the Chicago community fifteen years after the availability of national asthma guidelines: The design and initial results from the CHIRAH study☆

Since the early 1990s, asthma burden has been recognized as a national public health concern in the United States [1]. The asthma burden has disproportionately affected persons of certain racial/ethnic backgrounds, principally African Americans [2] and those persons living in urban environments [3,4]. Concern about the growing problem of asthma has led to a number of national, state, and local efforts towards improving asthma outcomes and control [5,6,7,8]. No national effort toward asthma control has been more celebrated than the implementation of the National Heart, Lung and Blood Institutes National Asthma Education and Prevention Program (NAEPP). Initiated in 1989, to a large extent in response to the publics concern about the increased asthma prevalence and burden, the NAEPP set its first programmatic effort to the establishment of guidelines to improve asthma care [9]. Since the initial release of these guidelines in 1991, hundreds of thousands of copies have been distributed [10] and there have been countless efforts directed toward moving these guidelines into practice including continuing medical education (CME) programs, disease management programs, clinical performance measures, and research efforts. The NAEPP continues efforts in the establishment of national guidelines through a series of updates to the original guidelines, including the recent release of a major update in November 2007 [11,12]. While there continues to be numerous reports of progress of local implementation and health plan efforts, these reports have focused on changes in asthma processes of care or on outcomes limited primarily to health care utilization among selected, mostly health plan or practice-based samples. To date, there is a rather modest literature on community-wide population-based status of asthma burden and quality of care. The Chicago Initiative to Raise Asthma Health Equity (CHIRAH) is one of the NHLBI Centers of Excellence in Reducing Asthma Disparities. The core activity of the CHIRAH has been to conduct a community-based cohort study designed to characterize those factors that are contributing to racial/ethnic disparities with the purpose of identifying mutable factors that may provide the basis for new intervention strategies to eliminate these disparities. The CHIRAH project therefore provides a unique opportunity to report on a population-based understanding of the burden of asthma in a large urban environment known to have one of the highest asthma mortality rates in the US [13]. The purpose of this report is to examine the overall burden of asthma morbidity and treatment as seen from the perspective of this community-based study.

Do the Paths to STEMM Professions Differ by Gender

In this article we examine gender differences in factors related to science, technology, engineering, mathematics, and medicine (STEMM) education and employment between the ages of 36 and 39. Using data from the Longitudinal Study of American Youth, we identified a STEMM high school talent pool. We found early gender differences in interest in engineering, although we found no such differences in entry into a general STEMM undergraduate major. Throughout the course of the study, we developed and tested structural equation models. We discovered that there were no major gender differences in family encouragement or precollege educational experiences, except that high school boys were slightly more likely to take calculus in high school. There were no significant differences in entrance into medicine and other health professions, but there were substantial gender differences in earned engineering degrees and employment in engineering. The completion of a graduate or professional degree was a stronger predictor of female employment in a STEMM profession than for young men. Among young adults with academic qualifications for a STEMM profession, the presence of children 18 years of age or younger in the family made no difference in the likelihood of employment in a STEMM profession.

Obesity and asthma morbidity in a community-based adult cohort in a large Urban area: The chicago initiative to raise asthma health equity (CHIRAH)

Background. Urban minority populations experience increased rates of obesity and increased asthma prevalence and severity. Objective. The authors sought to determine whether obesity, as measured by body mass index (BMI), was associated with asthma quality of life or asthma-related emergency department (ED)/urgent care utilization in an urban, community-based sample of adults. Methods. This is a cross-sectional analysis of 352 adult subjects (age 30.9 ± 6.1, 77.8% females, forced expiratory volume in one second (FEV1)% predicted = 87.0% ± 18.5%) with physician-diagnosed asthma from a community-based Chicago cohort. Outcome variables included the Juniper Asthma Quality of Life Questionnaire (AQLQ) scores and health care utilization in the previous 12 months. Bivariate tests were used as appropriate to assess the relationship between BMI or obesity status and asthma outcome variables. Multivariate regression analyses were performed to predict asthma outcomes, controlling for demographics, income, depression score, and β-agonist use. Results. One hundred ninety-one (54.3%) adults were obese (BMI > 30 kg/m2). Participants with a higher BMI were older (p = .008), African American (p < .001), female (p = .002), or from lower income households (p = .002). BMI was inversely related to overall AQLQ scores (r = −.174, p = .001) as well as to individual domains. In multivariate models, BMI remained an independent predictor of AQLQ. Obese participants were more likely to have received ED/urgent care for asthma than nonobese subjects (odds ratio [OR] = 1.8, p = .036). Conclusions. In a community-based sample of urban asthmatic adults, obesity was related to worse asthma-specific quality of life and increased ED/urgent care utilization. However, compared to other variables measured such as depression, the contribution of obesity to lower AQLQ scores was relatively modest.

Measuring Cancer Clinical Trial Understanding

Researchers, practitioners, and participants in cancer clinical trials must have a clear understanding of clinical trials if participation in them is to be solicited ethically and effectively. A valid and reliable measure of cancer clinical trial understanding did not exist prior to a 2005 study conducted for the Coalition of Cooperative Cancer Groups. This report outlines a measure derived from that study, discusses the rationale for its component items, examines its psychometric properties, and demonstrates the relationship of this measure to the enrollment decision. Data from national samples of cancer survivors and the general public demonstrate the measures validity and reliability. Results are discussed as they relate to patient understanding of clinical trials, informed decision making, and health communication processes.

A 6-item brief measure for assessing perceived control of asthma in culturally diverse patients

BACKGROUND A concise yet accurate measurement tool is needed for use in research and practice in asthma self-management perceptions across culturally diverse patient populations. OBJECTIVES To evaluate the psychometric properties of the 11-item Perceived Control of Asthma Questionnaire (PCAQ) and to derive a brief, psychometrically sound, and culturally sensitive measure using item response theory. METHODS The PCAQ was administered as one of a battery of measures to 375 adults with asthma as part of an ongoing larger project studying asthma disparities. Analyses of differential item functioning (DIF) were conducted to detect the effects of sex, race/ethnicity, and health literacy on psychometric properties. RESULTS Forty-eight percent of the sample was non-Hispanic white and 44% was African American. The mean +/- SD age was 43.7 +/- 13.7 years. The derived 6-item version, with 5 DIF items not scored, correlated highly with its full version (r = 0.903; P < .001). CONCLUSIONS The 6-item PCAQ short form has the potential to maintain scale integrity while reducing administration time and lessening survey fatigue in studies using multiple questionnaires. DIF analyses also enabled us to understand the unique aspects of perceived asthma control in demographic groups most affected by asthma.

Pathways to STEMM Support Occupations

The preceding articles in this issue of the Peabody Journal of Education have focused on preparation for and entry into professional positions in science, technology, engineering, mathematics, and medicine (STEMM). This article shifts the focus from professional positions to STEMM support occupations, focusing on the preparation necessary for entrance into this alternate STEMM field. As a group, STEMM support occupations feature shorter periods of formal training for entry, lower requirements for advanced study, and more flexibility in regard to the timing and entry into the workforce. Many of the young adults who eventually entered a STEMM support occupation did not make that decision until later along the educational pathway than did students who became STEMM professionals. Beyond the general features of the support occupations, an initial analysis also points to important differences between support occupations related to medicine and support occupations related to other areas of science and technology.