Two Essays on Econometric Modelling of Consumer Demand for Health Insurance and Financial Impact of Rural Hospital Closures

While distinct in their particular theme, the following two essays all have one unified goal. Their collective goal is to provide accurate estimates for important policy topics useful for policymakers and researchers. The first essay revisits the RAND HIE using a new matching method to address the potential insurance plan endogeneity. The resulting analysis finds small changes in demand elasticity for medical care but statistically significant improvement in smoking rates at the study exit. The second essay looks at the financial health impacts of rural hospital closures

Regional Economic Development Issues within the Information and Communications Technology (ICT) Industry

This exploratory research was initiated to develop a computer-based interview tool that would help determine the factors that companies in the information and communications technology (ICT) industry consider a problem in regards to the economic environment within a local study region. Topics included the labor market and community issues, including costs of doing business and quality-of-life questions. A computer-based process was employed in telephone interviews to solicit and record responses from executives in ICT-related companies for the 197 cases that are included in this study. Descriptive data are presented along with a first-order and a second-order factor analysis

The Impact of Time Perspective Latent Profiles on College Drinking: A Multidimensional Approach

Background- Zimbardo and Boyd\u27s1 time perspective, or the temporal framework individuals use to process information, has been shown to predict health behaviors such as alcohol use. Previous studies supported the predictive validity of individual dimensions of time perspective, with some dimensions acting as protective factors and others as risk factors. However, some studies produced findings contrary to the general body of literature. In addition, time perspective is a multidimensional construct, and the combination of perspectives may be more predictive than individual dimensions in isolation; consequently, multidimensional profiles are a more accurate measure of individual differences and more appropriate for predicting health behaviors. Objectives- The current study identified naturally occurring profiles of time perspective and examined their association with risky alcohol use. Methods- Data were collected from a college student sample (n = 431, mean age = 20.41 years) using an online survey. Time perspective profiles were identified using latent profile analysis. Results-Boot-strapped regression models identified a protective class that engaged in significantly less overall drinking (β= -0.254) as well as engaging in significantly less episodic high risk drinking (β = -0.274). There was also emerging evidence of a high risk time perspective profile that was linked to more overall drinking (β = 0.198) and engaging in more high risk drinking (β = 0.245), though these differences were not significant. Conclusions/Importance- These findings support examining time perspective in a multidimensional framework rather than individual dimensions in isolation. Implications include identifying students most in need of interventions, and tailoring interventions to target temporal framing in decision-making

Unplanned Drinking and Alcohol-Related Problems: A Preliminary Test of the Model of Unplanned Drinking Behavior

Much research links impulsivity with alcohol use and problems. In 2 studies, unplanned (or impulsive) drinking is assessed directly to determine whether it has direct effects on alcohol use and alcohol-related problems. In Study 1, we examined whether unplanned drinking serves as a proximal mediator of the effects of impulsivity-like traits on alcohol-related outcomes. With a sample of 211 college student drinkers, we found that the Unplanned Drinking Scale was significantly related to alcohol use, and perhaps more important, had a direct effect on alcohol-related problems even after controlling for frequency and quantity of alcohol use. Furthermore, unplanned drinking partially mediated the effects of negative urgency on alcohol-related problems. In Study 2, we examined whether unplanned drinking accounts for unique variance in alcohol-related outcomes when controlling for use of protective behavioral strategies. With a sample of 170 college students, we replicated the findings of Study 1 in that the Unplanned Drinking Scale had a significant direct effect on alcohol-related problems even after controlling for alcohol use; this effect was maintained when controlling for use of protective behavioral strategies. Limitations include the modest sample sizes and the cross-sectional design. Future directions for testing the Model of Unplanned Drinking Behavior are proposed

Personalized Boosters For a Computerized Intervention Targeting College Drinking: The Influence of Protective Behavioral Strategies

Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student drinkers at a southeastern public university, ages 18-24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2weeks post, and 4weeks post. Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking days, peak drinks, and associated blood alcohol concentration (BAC). Protective behavioral strategies (PBS) moderated this effect, with significant reductions for students low in PBS, but not students already highly engaged in PBS use. Conclusions: Easy dissemination and low cost make e-mailed boosters a very efficient way to promote student health

Hierarchical Linear Modeling of Drinking to Cope with Anxiety among College Students

Previous research has assumed that drinking motives (reasons for drinking) remain fairly stable over time (traits). The current study examines how drinking motives of college students may vary over time (states). Weekly measures were completed by 125 undergraduates at Old Dominion University, which examined how average levels of anxiety interacted with anxiety coping motives to influence drinking. Using Hierarchical Linear Modeling, it was found that anxiety coping motives were less predictive for participants with elevated average anxiety levels, as opposed to participants with normal to low anxiety levels. Implications and possible explanations are discussed. Research Mentor: Dr. James Henson, Department of Psycholog

Changes in Mental Health as a Predictor of Cannabis Coping Motives and Consequences: Examining the Impact of COVID-19 Among College Students

Objective: Cannabis use is common among college students and many students use cannabis to cope with negative affect. The COVID-19 pandemic was a particularly stressful time for college students. Subsequently, the present study compared college students who reported increases in anxiety/depression symptoms since COVID-19 stay at home orders to those who reported no change in anxiety/depression symptoms on cannabis coping motives, use frequency, and negative consequences. Specifically, we examined whether self-reported changes (i.e., group that indicated increases) in poor mental health during COVID-19 were associated with problematic cannabis use via higher cannabis coping motives. Method: College students (analytic n = 291) completed an online survey for research credit regarding their personal mental health, COVID-19 stressors, and cannabis use behaviors. Results: Individuals who reported increased depressive symptoms (57.4% of the current sample) due to COVID-19 (as compared to individuals whose depressive symptoms remained the same) reported significantly higher cannabis coping motives (d = .79) as well as more cannabis consequences (d = .37). Further, students who reported increased (61.5% of the current sample) anxiety symptoms (as compared to those whose anxiety symptoms stayed the same) also reported significantly higher cannabis coping motives (d = .47). Moreover, we found that students who reported an increase in depressive/anxiety symptoms reported more cannabis consequences via higher endorsement of cannabis coping motives while controlling for gender, cannabis use frequency, and past-week anxiety/depressive symptoms. Discussion: Providing resources for substance-free coping strategies to manage the mental health impact of COVID-19 may be extremely useful for this population