37 research outputs found
A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics
Assessing adolescents’ perceived proficiency in critically evaluating nutrition information
Dynamic Treatment Regimes
In recent years, treatment and intervention scientists increasingly realize that individual heterogeneity in disorder severity, background characteristics and co-occurring problems translates into heterogeneity in response to various aspects of any treatment program. Accordingly, research in this area is shifting from the traditional “one-size-fits-all ” treatment to dynamic treatment regimes, which allow greater individualization in programming over time. A dynamic treatment regime is a sequence of decision rules that specify how the dosage and/or type of treatment should be adjusted through time in response to an individual’s changing needs, aiming to optimize the effectiveness of the program. In the chapter we review the Sequential Multiple Assignment Randomized Trials (SMART), which is an experimental design useful for the development of dynamic treatment regimes. We compare the SMART approach with other experimental approaches and discuss data analyses methods for constructing a high quality dynamic treatment regime as well as other secondary analyses. 1
Literacy and Health Outcomes: A Systematic Review of the Literature
OBJECTIVE: To review the relationship between literacy and health outcomes. DATA SOURCES: We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003. STUDY SELECTION: We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes. Two abstractors reviewed each study for inclusion and resolved disagreements by discussion. DATA EXTRACTION: One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry. The whole study team reconciled disagreements about information in evidence tables. Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality. DATA SYNTHESIS: We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report. Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources. Patients with low literacy were generally 1.5 to 3 times more likely to experience a given poor outcome. The average quality of the articles was fair to good. Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons. CONCLUSIONS: Low literacy is associated with several adverse health outcomes. Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions