Background Questionnaire Research Articles

Survey of Health Literacy Among Japanese Outpatients with Mental Illness.

Low health literacy has been associated with adverse outcomes in health maintenance and the course of chronic physical illness. In particular, anxiety disorders can also affect one's physical health, causing issues including cardiovascular, respiratory, gastrointestinal and immune system disorders. However, there are no reports on physical health literacy among Japanese patients with mental illness. A patient background questionnaire, the Japanese version of the Ten-Item Personality Inventory, and the Japanese version of the Health Literacy Scale (HLS-EU-Q47; European Health Literacy Survey Questionnaire) were distributed face to face to 1000 psychiatric outpatients. A total of 785 valid responses including 211 patients with schizophrenia, 261 patients with mood disorders, and 234 patients with anxiety disorders were obtained by mail. Health literacy was "limited" in 52% of patients with schizophrenia, 51% of those with mood disorders, and 38% of those with anxiety disorders. Among patients with mood disorders, there were no differences between those with major depressive disorder and those with bipolar disorder. Anxiety disorders were associated with higher health literacy than schizophrenia and mood disorders (odds ratio (OR) 1.85, 95% confidence interval (95% CI) 1.07, 3.34), and in terms of personality, neuroticism (OR 0.85, 95% CI 0.75, 0.97) and openness (OR 0.85, 95% CI 0.74, 0.98) were associated with limited health literacy, while agreeableness (OR 1.36, 95% CI 1.18, 1.57) and extraversion OR 1.34, 95% CI 1.17, 1.52) were associated with higher health literacy. The results of this study indicate limited health literacy in patients with mental illness, in particular, limited health literacy in outpatients with schizophrenia and mood disorders. In addition, gender and some personality traits were associated with physical health literacy. Based on these results, physical health education should be individualized.

Rural cancer care delivery during the COVID-19 pandemic for patients with early-stage cancer.

e18566 Background: Cancer mortality rates remain substantially higher among rural populations. Rural-urban disparities in cancer outcomes are partly associated with care delivery challenges in rural areas, and the COVID-19 pandemic may have exacerbated these disparities. Care coordination (CC) is a critical component of patient-centered care; yet, rural patients experience significant CC-related challenges. In this study, we examined patient-reports of CC and time to treatment initiation (TTI) among rural patients with early-stage cancer. Methods: We conducted a cross-sectional survey with 51 patients with early-stage (I-III) cancer receiving active treatment at rural oncology practices between May 2021 and June 2022. Rural was defined using RUCA. Enrolled patients completed the background questionnaire and the Care Coordination Instrument (CCI). A validated instrument, the 29-item CCI assesses overall patient perceptions of CC and three domains of CC (Communication, Navigation, Operational). Items are rated on a 4-point Likert-scale. Data for the urban cohort were derived from historical data. General linear models (GLMs) were used to compare CCI scores between rural and urban patients. Results: The mean age of rural patients was 58.5 (range 24.0-84.0), and 64.7% were female. GI (39.2%) and breast (33.3%) were the most common cancer types. Median time from diagnosis to treatment initiation for rural patients was 61.0 days (IQR: 30.0-65.8), significantly longer compared to the pre-pandemic state registry data. 21.6% of rural patients reported delays in active treatment. Overall, there were no rural-urban differences on the overall perception of CC ( p > .05). However, rural patients reported significantly lower Communication scores ( p = .027). After adjusting for the effects of covariates, rural-urban differences on Communication remained significant ( p = .016). Item-level analyses revealed significant rural-urban differences in specific aspects of CC (e.g., physician-patient communication). CCI scores were not associated with TTI. Conclusions: Our findings indicate that rural patients with early-stage cancer experienced significant delays in treatment initiation during the pandemic, and there were notable differences in Communication aspects of CC between rural and urban patients. Interventions to improve TTI among rural patients are urgently needed to prevent potentially further exacerbating cancer health disparities.

Using Response Times for Joint Modeling of Careless Responding and Attentive Response Styles

Questionnaires are by far the most common tool for measuring noncognitive constructs in psychology and educational sciences. Response bias may pose an additional source of variation between respondents that threatens validity of conclusions drawn from questionnaire data. We present a mixture modeling approach that leverages response time data from computer-administered questionnaires for the joint identification and modeling of two commonly encountered response bias that, so far, have only been modeled separately—careless and insufficient effort responding and response styles (RS) in attentive answering. Using empirical data from the Programme for International Student Assessment 2015 background questionnaire and the case of extreme RS as an example, we illustrate how the proposed approach supports gaining a more nuanced understanding of response behavior as well as how neglecting either type of response bias may impact conclusions on respondents’ content trait levels as well as on their displayed response behavior. We further contrast the proposed approach against a more heuristic two-step procedure that first eliminates presumed careless respondents from the data and subsequently applies model-based approaches accommodating RS. To investigate the trustworthiness of results obtained in the empirical application, we conduct a parameter recovery study.

Documenting heritage language experience using questionnaires.

There exists a great degree of variability in the documentation of multilingual experience across different instruments. The present paper contributes to the "methods turn" and individual differences focus in (heritage) bilingualism by proposing a comprehensive online questionnaire building on existing questionnaires and the experience of using them to document heritage bilingualism: the Heritage Language Experience (HeLEx) online questionnaire. HeLEx is validated against and contrasted to an extended version of the Language and Social Background Questionnaire designed for heritage speakers (HSs), LSBQ-H. We compare data elicited with both questionnaires in turn from a group of Turkish HSs (n = 174, mean age=32). Our validation focuses on traditional language background variables, including language exposure and use, language proficiency, language dominance, as well as a more novel measure of language entropy. The analyses are based on a subset of key questions from each questionnaire that capture language experience for up to five languages, four modalities, and five social contexts. In a subsequent set of analyses, we explore the impact of different types of response scales, response mechanisms, and manners of variable derivation on the informativity of the data they can provide, in terms of the scope, granularity and distributional properties of the derived measures. Our results show that both HeLEx and LSBQ-H are successful at detecting the important distributional patterns in the data and reveal a number of advantages of HeLEx. In the discussion, we consider the impact of methodological choices regarding question phrasing, visual format, response options, and response mechanisms. We emphasize that these choices are not trivial and can affect the derived measures and subsequent analyses on the impact of individual differences on language acquisition and processing.

Evaluating gifted students’ perceptions of the characteristics of their effective teachers

Due to the special needs of gifted students, it is crucial that their teachers are carefully selected in order to give gifted students the greatest educational experience. The study involved 120 teachers from Saudi Arabia, Bahrain, and the United Arab Emirates along with 300 gifted students, both males (n = 144) and females (n = 156). Teachers of gifted students involved in the study were asked to complete the Preferred Teacher Characteristics Scale (PICS); additionally, teachers filled out a background questionnaire. While gifted students responded to three open-ended questions, The findings corroborated the idea that gifted students perform better in an environment where their teachers’ personalities are evident. This finding was in line with the preferences of teachers as measured by the PCIS scale, which revealed that students tended to value teachers more for their personal characteristics than for their professional ones. Many personal characteristics were highly regarded by the gifted students, who in this study believed they contributed to a teacher’s effectiveness. Personal integrity, tolerance, tenderness, friendliness, a sense of humor, and an openness to new experiences were among these characteristics.

In/directness in requests and refusals in EFL by multilinguals with L1 Hebrew or Arabic: A linguistic and textual perspective

This study investigated the linguistic and textual features characterizing direct and indirect speech act productions of requests and refusals in English by two multilingual populations: Arabic native speakers for whom English is their L3 and Hebrew is their L2, and Hebrew native speakers for whom English is their L2. Data were collected using a Discourse Completion Task and a background questionnaire. The findings revealed no statistical differences between the groups in the production of either the direct or the indirect mode of request and refusal: both groups preferred the indirect mode for requests and the direct mode for refusals. However, there were differences in the use of linguistic/textual features between direct and indirect requests/refusals within each language group, and differences in the use of features between the language groups within the directness mode. These findings are discussed in terms of cultural influences as well as differences in English proficiency levels.

Examining Perspectives of Latina Mothers and Speech-Language Pathologists Through Dyadic Interviews: Implications for Latine Children on the Autism Spectrum.

This qualitative pilot study explored cultural perspectives and needs of two bilingual (Spanish/English) Latina mothers with children on the autism spectrum in conversations with their children's speech-language pathologists (SLPs), one identifying as Mexican American and the other identifying as White American. Dyadic interviews were used to promote dialogue and learning opportunities for the participants. Two dyads (mothers and SLPs) participated, completing background questionnaires, dyadic interviews, and post-interview written reflections. Three main themes emerged from the qualitative analysis of the dyadic interviews: comunicación (communication), language, and challenge. Post-interview written reflections evidenced increased advocacy skills for the mothers and heightened awareness regarding communication style for the SLPs. The lived experiences revealed by all participants offer several implications: (a) the value of extended conversations between caregivers and service providers, (b) caregiver sacrifices, (c) the importance of cultural sensitivity for SLPs, and (d) positive outcomes from online learning for children on the autism spectrum.

Language athletes: Dual-language code-switchers exhibit inhibitory control advantages.

Recent studies have begun to examine bilingual cognition from more nuanced, experienced-based perspectives. The present study adds to this body of work by investigating the potential impact of code-switching on bilinguals' inhibitory control abilities. Crucially, our bilingual participants originated from a predominantly dual-language environment, the interactional context which is believed to require (and therefore, potentially train) cognitive control processes related to goal-monitoring and inhibition. As such, 266 French Canadian bilinguals completed an online experiment wherein they were asked to complete a domain-general (Flanker) and a language-specific (bilingual Stroop) inhibitory control task, as well as extensive demographic and language background questionnaires. Stepwise multiple regressions (including various potential demographic and linguistic predictors) were conducted on the participants' Flanker and Stroop effects. The results indicated that the bilinguals' propensity to code-switch consistently yielded significant positive (but unidirectional) inhibitory control effects: dual-language bilinguals who reported more habitual French-to-English switching exhibited better goal-monitoring and inhibition abilities. For the language-specific task, the analysis also revealed that frequent unintentional code-switching may mitigate these inhibition skills. As such, the findings demonstrate that dual-language code-switchers may experience inhibitory control benefits, but only when their switching is self-reportedly deliberate. We conclude that the bilinguals' interactional context is thus of primary importance, as the dual-language context is more conducive to intentional code-switching. Overall, the current study highlights the importance of considering individualistic language experience when it comes to examining potential bilingual executive functioning advantages.

Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8-17 years old: A study protocol.

It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8-17 years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8-17 years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.

Amylo-AFFECT-QOL, a self-reported questionnaire to assess health-related quality of life and to determine the prognosis in cardiac amyloidosis.

Self-reported questionnaires are useful for estimating the health-related quality of life (HR-QoL), impact of interventions, and prognosis. To our knowledge, no HR-QoL questionnaire has been developed for cardiac amyloidosis (CA). This study aimed to validate Amylo-AFFECT-QOL questionnaire to assess HR-QoL and its prognostic value in CA. A self-reported questionnaire, "Amylo-AFFECT" had been designed and validated for CA symptoms evaluation and screening by physicians. It was adapted here to assess HR-QoL (Amylo-AFFECT-QOL) and its prognostic value in CA. To validate the theoretical model, internal consistency and convergent validity were assessed, particularly correlations between Amylo-AFFECT-QOL and the HR-QoL Minnesota Living Heart Failure (MLHF) questionnaire. Amylo-AFFECT-QOL was completed by 515 patients, 425 of whom (82.5%) had CA. Wild-type and hereditary transthyretin amyloidosis (ATTRwt and ATTRv) and immunoglobulin light-chain amyloidosis (AL) were diagnosed in 47.8, 14.7, and 18.8% of cases, respectively. The best HR-QoL evaluation was obtained with five dimensions: "Heart failure," "Vascular dysautonomia," "Neuropathy," "Ear, gastrointestinal, and urinary dysautonomia," and "Skin or mucosal involvement." The global Amylo-AFFECT-QOL and MLHF scores showed significant positive correlations (rs = 0.72, p < 0.05). Patients with a final diagnosis of CA had a global Amylo-AFFECT-QOL score significantly higher than the control group composed by patients with other diagnoses (22.2 ± 13.6 vs. 16.2 ± 13.8, respectively, p-value < 0.01). According to the Amylo-AFFECT-QOL global results, ATTRv patients' QoL was more affected than AL patients' QoL or ATTRwt patients' QoL. Patients with a higher HR-QoL score had a greater risk of death or heart transplant after 1 year of follow-up (log-rank < 0.01). Amylo-AFFECT-QOL demonstrates good psychometric properties and is useful for quantifying HR-QoL and estimating CA prognosis. Its use may help to improve overall management of patients with CA.

Accounting for careless and insufficient effort responding in large-scale survey data—development, evaluation, and application of a screen-time-based weighting procedure

Careless and insufficient effort responding (C/IER) poses a major threat to the quality of large-scale survey data. Traditional indicator-based procedures for its detection are limited in that they are only sensitive to specific types of C/IER behavior, such as straight lining or rapid responding, rely on arbitrary threshold settings, and do not allow taking the uncertainty of C/IER classification into account. Overcoming these limitations, we develop a two-step screen-time-based weighting procedure for computer-administered surveys. The procedure allows considering the uncertainty in C/IER identification, is agnostic towards the specific types of C/IE response patterns, and can feasibly be integrated with common analysis workflows for large-scale survey data. In Step 1, we draw on mixture modeling to identify subcomponents of log screen time distributions presumably stemming from C/IER. In Step 2, the analysis model of choice is applied to item response data, with respondents’ posterior class probabilities being employed to downweigh response patterns according to their probability of stemming from C/IER. We illustrate the approach on a sample of more than 400,000 respondents being administered 48 scales of the PISA 2018 background questionnaire. We gather supporting validity evidence by investigating relationships between C/IER proportions and screen characteristics that entail higher cognitive burden, such as screen position and text length, relating identified C/IER proportions to other indicators of C/IER as well as by investigating rank-order consistency in C/IER behavior across screens. Finally, in a re-analysis of the PISA 2018 background questionnaire data, we investigate the impact of the C/IER adjustments on country-level comparisons.

Impacts of computer-assisted collaborative writing, collaborative prewriting, and individual writing on EFL learners’ performance and motivation

The present mixed-methods study aimed at investigating the effects of three writing conditions, including collaborative writing (CW), collaborative prewriting (CPW), and individual writing (IW), on the performance and motivation of 66 Iranian EFL learners in a computer-mediated communication (CMC) context. Data were obtained through a background questionnaire, writing motivation scale, participants’ writing performance on pretest and posttest, audio-recorded reflections, and semi-structured individual interviews. The quantitative data were analyzed using one-way ANOVA and paired-samples t-test, while the qualitative data were examined through a three-phase thematic analysis. Based on the obtained results, on the posttest, the CPW group significantly outperformed the IW group. No similar trend, however, was observed between CW and IW groups. In addition, as a result of collaborative writing and prewriting in a CMC context, the participants’ writing motivation significantly improved. Further findings as well as relevant pedagogical implications are discussed and future research avenues are outlined.

Dominance, Language Experience, and Increased Interaction Effects on the Development of Pragmatic Knowledge in Heritage Bilingual Children

Abstract We investigate whether dominance, language experience, and increased interaction have an effect on the development of heritage bilingual children’s knowledge of the discourse-pragmatic constraints guiding null and overt subjects. A group of child heritage bilinguals (n = 18, mean age = 5;5) and comparison groups of adults: Mexican Spanish monolinguals (n = 15), heritage bilinguals in the United States (n = 16), and English monolinguals in the United States (n = 16) completed a language background questionnaire, a portion of the Bilingual English-Spanish Assessment (BESA) in English and Spanish, a forced-choice task (FCT) in Spanish, and two acceptability judgment tasks (AJT s): one in English and one in Spanish. Results showed that heritage children and adults pattern similarly and differently from adult monolinguals. Increased interaction at home has a positive effect on accuracy in the pragmatic conditions that license null subjects in Spanish without affecting overt subject patterns in English, the dominant language.

Supporting Non-Native-English Speaking Graduate Students with Academic Writing Skills: A Case Study of the Explicit Instructional Use of Paraphrasing Guidelines writing frequently

In this study, we examined how the explicit instructional use of paraphrasing guidelines can help international graduate students who are non-native English speakers to paraphrase information in text sources. This case study involved 14 graduate students enrolled in an academic writing class at a university in the northwest United States. Data were collected through seven sources: a background questionnaire, video of instruction, pretest, posttest, student task documents, stimulated recall interviews, and teacher interviews, which together addressed the three research questions. The data show that the participants’ perceptions of using the guidelines were positive and that their paraphrases in the posttest had improved according to the guidelines. The study concludes that the use of the guidelines should be accompanied by meaningful support through explicit instruction and sufficient practice over time. The implications of this study include recommendations for paraphrasing instruction and future research.

Protocol for estimating the willingness-to-pay-based value for a quality-adjusted life year to aid health technology assessment in India: a cross-sectional study

IntroductionTo ensure that the evidence generated by health technology assessment (HTA) is translated to policy, it is important to generate a threshold value against which the outcomes of HTA studies...

Korean College Students’ Perceptions and Readiness Towards Online English Language Learning Courses

This study explores learners’ perceptions and readiness before and after online English courses, focusing on Korean EFL college students. One-hundred and eighty-four first-year college students were assigned to high-, intermediate-, or low-proficiency groups. A background questionnaire, the Online English Learning Perceptions (OELP) scale, the Online English Learning Readiness (OELR) scale, and a diagnostic assessment of English competence were utilized in this study. The results indicate that the students’ proficiency levels played a large role in determining their perceptions and their readiness towards online courses. High- and intermediate-proficiency learners showed greater outcomes than lower-proficiency learners in terms of adaptability, knowledge acquisition, and ease of loading in the OELP as well as their own self-directed learning, learner control, and motivation for learning, which were measured using the OELR. This study also reveals that all groups displayed significant improvement in terms of English competence after engaging in online courses. Based on the findings, the current study suggests pedagogical implications and possible instructional strategies teachers can use in online language classrooms.

Teaching irony in the Spanish/L2 classroom

This article presents an empirical study on the implementation in the Spanish/L2 classroom of a cognitive-based pedagogical material to teach irony building from previous research on irony detection in Spanish and English tweets (Author 1, 2019, in press). Participants were 87 intermediate and 82 advanced students from a North American university. Data were collected during a 75-minute classroom session following a pretest/posttest design to measure irony production and identification. A linguistic background and language use questionnaire was also administered prior to instruction. Quantitative data derived from the irony recognition tests were analysed through a scoring system. Mixed data from the irony production tests were codified to pinpoint learners’ ways of expressing irony using an analysis scheme based on Ruiz de Mendoza’s (2017) twofold category of irony. The results revealed a significant improvement after the intervention for students from the two proficiency levels. Advanced students were significantly better in the production task; however, no significant difference was found between the two groups in the irony recognition tasks. Our findings outline the impact and importance of explicitly teaching irony –a rather neglected aspect heretofore– already at lower levels to avoid misunderstandings in the L2 and enhance learners’ intercultural awareness and communicative competence.

Gender strategies in the perception and production of mixed nominal constructions by New Mexico Spanish-English bilinguals

This study investigated gender assignment strategies in mixed noun phrases containing a Spanish determiner and an English noun among Spanish-English bilinguals (n = 38) in New Mexico (U.S.A.). Previous research has reported different gender assignment strategies based on a preference for a default determiner, the gender of the translation equivalent, or shape-based cues from the other language. The present study consisted of (i) a language background questionnaire, (ii) a two-alternative forced-choice judgment task, and (iii) two director-matcher tasks: a forced-switch task and a spontaneous card game. The results of the judgment task indicate that participants preferred the gender of the translation equivalent, i.e., la window ‘the.FEM window’ following the gender of the Spanish noun la ventana. Results from the production tasks also show that participants produced both gender congruent and incongruent mixed NPs, with Late English bilinguals producing more congruent mixed NPs, similar to the translation equivalent strategy found in the judgment task. These findings differ from those found in naturalistic speech in other New Mexican communities, which display a preference for a masculine default strategy. We suggest that the nature of participants’ bilingual profile and the community norms (urban setting, heterogeneous and diverse language contact profiles) may play a key role in the observed code-switching patterns in mixed noun phrases.

Individual determinants of Mediterranean diet adherence among urban Lebanese adult residents

Purpose Many studies revealed positive health impacts of the Mediterranean diet (MedDiet), especially on metabolic disorders. Conversely, in Lebanon, recent information about determinants of adherence to the MedDiet are limited. This study aimed to examine the individual determinants of MedDiet adherence among adults in Lebanon. Design/methodology/approach A cross-sectional study was carried out during July 2021 among a convenient sample of 326 Lebanese adults. Data from participants were collected via an online survey developed by study researchers, composed of two well-structured questionnaires: a background questionnaire and a 14-item Mediterranean Diet Adherence Screener (14-MEDAS). Findings The mean MedDiet score in the total sample was 7.59 ± 2.22, reflecting moderate/fair MedDiet adherence. Consumption of fruits, vegetables, legumes and olive oil met the recommended MedDiet intake among most participants. Older age and having a regular routine of physical activity emerged as significant independent determinants of better MedDiet adherence. Originality/value Future public health interventions aiming at promoting MedDiet adherence shall target predominantly younger age groups of the Lebanese population and incorporate strategies to boost physical activity among target groups.

Complex transfer processes in multilingual language (L3/Ln) acquisition of Spanish past tenses: the role of non-native language (L2) transfer

ABSTRACT Research has shown that non-native background languages (L2s) can play an important role in the acquisition of an L3/Ln. However, only a few studies have focussed on positive transfer from an L2 to an L3/Ln in the context of multilingual language acquisition of Romance past tenses. The present study therefore analyses the acquisition of perfective/imperfective aspect in Spanish by 58 German-speaking multilingual learners with previous linguistic knowledge in two L2s (i.e. English and French). Data were elicited by means of a language background questionnaire, a c-test (for proficiency measures in Spanish), and three semantic interpretation tasks (used to determine the participants’ knowledge of aspect in the L2s and the target language). The findings indicate that the learners transfer the form-meaning-mappings established in (one of) their L2s, resulting in positive effects when form-meaning-mappings between the L2 and the target language(s) are similar.