Profiles of children\u27s social-emotional health at school entry and associated income, gender and language inequalities: a cross-sectional population-based study in British Columbia, Canada

OBJECTIVES: Early identification of distinct patterns of child social-emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural groupings of indicators of child vulnerability and strengths at a population level. The purpose of this study was to examine heterogeneity in the patterns of young children\u27s social and emotional health and investigate the extent to which sociodemographic characteristics were associated. DESIGN: Cross-sectional study based on a population-level cohort. SETTING: All kindergarten children attending public schools between 2004 and 2007 in British Columbia (BC), Canada. PARTICIPANTS: 35 818 kindergarten children (age of 5 years) with available linked data from the Early Development Instrument (EDI), BC Ministry of Health and BC Ministry of Education. OUTCOME MEASURE: We used latent profile analysis (LPA) to identify distinct profiles of social-emotional health according to children\u27s mean scores across eight social-emotional subscales on the EDI, a teacher-rated measure of children\u27s early development. Subscales measured children\u27s overall social competence, responsibility and respect, approaches to learning, readiness to explore, prosocial behaviour, anxiety, aggression and hyperactivity. RESULTS: Six social-emotional profiles were identified: (1) overall high social-emotional functioning, (2) inhibited-adaptive (3) uninhibited-adaptive, (4) inhibited-disengaged, (5) uninhibited-aggressive/hyperactive and (6) overall low social-emotional functioning. Boys, children with English as a second language (ESL) status and children with lower household income had higher odds of membership to the lower social-emotional functioning groups; however, this association was less negative among boys with ESL status. CONCLUSIONS: Over 40% of children exhibited some vulnerability in early social-emotional health, and profiles were associated with sociodemographic factors. Approximately 9% of children exhibited multiple co-occurring vulnerabilities. This study adds to our understanding of population-level distributions of children\u27s early social-emotional health and identifies profiles of strengths and vulnerabilities that can inform future intervention efforts

Is variety a spice of (an active) life?:Perceived variety, exercise behavior, and the mediating role of autonomous motivation

In this study, we examined whether perceived variety in exercise prospectively predicts unique variance in exercise behavior when examined alongside satisfaction of the three basic psychological needs (for competence, relatedness, and autonomy) embedded within self-determination theory (Ryan &amp; Deci, 2002), through the mediating role of autonomous and controlled motivation. A convenience sample of community adults (N = 363) completed online questionnaires twice over a 6-week period. The results of structural equation modeling showed perceived variety and satisfaction of the needs for competence and relatedness to be unique indirect positive predictors of exercise behavior (through autonomous motivation) 6 weeks later. In addition, satisfaction of the need for autonomy was found to negatively predict controlled motivation. Perceived variety in exercise complemented satisfaction of the needs for competence, relatedness, and autonomy in predicting motivation and (indirectly) exercise behavior, and may act as a salient mechanism in the prediction of autonomous motivation and behavior in exercise settings.</jats:p

Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics.</p> <p>Methods</p> <p>We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor.</p> <p>Results</p> <p>The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors–<it>Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy</it>, and <it>Negative Outcome Expectancy</it>. Competency and reported percent of patients who lose weight were most strongly associated with the <it>Physician Success/Self Efficacy </it>attitude factor. Greater skill in patient assessment was associated with less <it>Physician Discomfort/Bias</it>. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty.</p> <p>Conclusion</p> <p>Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.</p

Ordinal generalizability theory using an underlying latent variable framework

This dissertation introduces a method for estimating the variance components required in the use of generalizability theory (GT) with categorical ratings (e.g., ordinal variables). Traditionally, variance components in GT are estimated using statistical techniques that treat ordinal variables as continuous. This may lead to bias in the estimation of variance components and the resulting reliability coefficients (called G-coefficients). This dissertation demonstrates that variance components can be estimated using a structural equation modeling (SEM) technique called covariance structural modeling (CSM) of a polychoric or tetrachoric correlation matrix, which accounts for the metric of ordinal variables. The dissertation provides a proof of concept of this method, which will be called ordinal GT, using real data in the computation of a relative G-coefficient, and a simulation study presenting the relative merits of ordinal to conventional G-coefficients from ordinal data. The results demonstrate that ordinal GT is viable using CSM of the polychoric matrix of ordinal data. In addition, using a Monte Carlo simulation, the relative G-coefficients when ordinal data are naively treated as continuous are compared to when they are correctly treated as ordinal. The number of response categories, magnitude of the theoretical G-coefficient, and skewness of the item response distributions varied in experimental conditions for: (i) a two-facet crossed G-study design, and (ii) a one-facet partially nested G-study design. The results reveal that when ordinal data were treated as continuous, the empirical G-coefficients were consistently underestimates than their theoretical values. This was true regardless of the number of response categories, magnitude of the theoretical G-coefficient, and skewness. In contrast, the ordinal G-coefficients performed much better in all conditions. This dissertation shows that using CSM to model the polychoric correlation matrix provides better estimates of variance components in the GT of ordinal variables. It offers researchers a new statistical avenue for computing relative G-coefficients when using ordinal variables.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat