Assessing intention of volunteers to develop their leadership: creation of an instrument using the theory of planned behavior

During the current tough economic times volunteers are playing an increasingly important role in making human services widely available and in building collaborative community partnerships. Volunteers are most likely to be productive, to be satisfied with their experience, and to sustain their volunteer service when the opportunities provided to them are aligned with their motives for volunteering, which may include building the kinds of knowledge, skills, and interpersonal awareness that are the cornerstones of leadership. Organizations that purposefully recognize, support, and develop their volunteers’ leadership potential generate positive outcomes not only for themselves and their volunteers, but also for the clients they serve, and for whole communities. Across the country more than 240 affiliates of the HandsOn Network (HON), the nation’s largest volunteer network, serve as clearinghouses for individuals seeking both long-term and short-term (episodic) volunteer opportunities, and for nonprofit agencies seeking volunteer services. In its commitment to civic engagement and innovative problem solving, HON is investigating opportunities and technologies for volunteer and community empowerment, and is actively engaged in the inquiry as to how best to serve volunteers who want to cultivate their leadership at every level. In partnership with HON, and using the Theory of Planned Behavior (Ajzen, 1991), an elicitation study was conducted as formative research to determine the most salient factors that predict volunteers’ intentions to develop their leadership via their attitudes toward leadership development, subjective norms regarding leadership development, and perceived behavioral control of leadership development. Themes derived from the elicitation study provided the content framework to create a survey tool, which was then administered in a pilot study to HON volunteers across the country. Content analysis of pilot study responses produced a solution in which items reflecting the respective theoretical constructs of the Theory of Planned Behavior separated with near-exact fit in a six-factor solution. This research resulted in the production of an instrument, the Volunteer Leadership Development Questionnaire (VLDQ), which can identify the factors influencing intentions of HON volunteers to express and develop their leadership. Recommendations are made for ongoing validation and refinement of the instrument

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo