National Probability Sample Of Persons Research Articles

What Predicts Willingness to Participate in a Follow-up Panel Study among Respondents to a National Web/Mail Survey?

The American Family Health Study (AFHS) collected family health and fertility data from a national probability sample of persons aged 18–49 between September 2021 and May 2022, using web and mail exclusively. In July 2022, we surveyed AFHS respondents and gauged their willingness to become part of a national web panel that would create novel longitudinal data on these topics. We focus on predictors of willingness to participate, identifying the potential selection bias that this type of approach may introduce. We found that efforts of this type to create a national web panel may introduce potential selection bias in estimates based on the panel respondents, with individuals having higher socioeconomic status being more cooperative. Thus, alternative recruitment strategies and re-weighting of the subsample may be needed to further reduce selection bias. We present methodological implications of our results, limitations of our approach, and suggestions for further research on this topic.

Medical Clinic Characteristics and Access to Behavioral Health Services for Persons With HIV

Many persons with HIV do not receive needed behavioral health services. This study examined the impact of medical clinic characteristics on access to mental health and substance abuse care for persons with HIV. This was a longitudinal survey of patients and clinic directors participating in the HIV Cost and Services Utilization Study, a national probability sample of persons in care for HIV between 1996 and 1998 (N=2,031). Primary outcomes were receipt of outpatient mental health specialist care, outpatient substance abuse care, and abstinence from substance use in the past 30 days. After adjustment for patient characteristics, the likelihood of care by a mental health specialist was higher for patients in HIV specialty clinics (odds ratio [OR]=2.1, 95% confidence interval [CI]=1.2-3.5) and clinics with a combination of on-site case management and affiliated mental health care (OR=2.3, CI 1.3-4.4, for off-site affiliated care; OR=2.1, CI=1.2-3.7, for on-site care). Outpatient substance abuse care also was more likely for patients in clinics with on-site case management and affiliated substance abuse care (OR=4.3, CI=1.5-12.2, for off-site affiliated care; OR=3.2, CI=1.3-8.0, for on-site care). In a subgroup of persons reporting active substance use, care in clinics with on-site case management predicted 30-day abstinence from substances at follow-up (OR=1.7, CI=1.1-2.5). The organizational structure of medical clinics can have an important effect on use of mental health and substance abuse specialist care.

Male–female differences in the risk of progression from first use to dependence upon cannabis, cocaine, and alcohol

Introduction We extend prior reports about the risk of dependence on specific drugs by providing developmental-specific risk estimates for progression from first use to meeting criteria for DSM-III-R dependence upon cannabis, cocaine, or alcohol, as well as male–female differences. Methods The data are from the National Comorbidity Survey, with a national probability sample of persons 15–44 years old in the United States, which included many respondents who used cannabis, cocaine and alcohol on at least one occasion ( n = 3558, 1337, and 6149, for cannabis, cocaine, and alcohol, respectively). Survival analysis procedures provided cumulative risk estimates of progression from first use to dependence upon each drug. Results The estimated risk of cannabis dependence among male cannabis users was 1% in the first year after first use, and reached a peak at 4% per year 2 years later, before declining. In contrast, the estimated risk of cannabis dependence among female cannabis users remained at 1% per year for 3 years, without the peak. For both male and female cocaine users, the estimated risk for developing cocaine dependence was 5 to 6% within the first year after first use. Thereafter, the estimated risk declined from the peak value, with a somewhat faster decline for females in the next 3 years after first use. For alcohol, the estimated risk period extended for many years after the first drink, with female drinkers becoming alcohol dependent at a rate of about 1% per year; with somewhat higher risk for male drinkers. For both male and female drinkers, the period of risk for developing alcohol dependence extended for a span of more than 20 years since first use; for cannabis and cocaine, the estimated period of risk was much shorter. Comment There are male–female differences in the risk of becoming cannabis dependent during the first several years after initiation of cannabis use, less pronounced male–female differences for alcohol, and relatively smaller male–female differences for cocaine. These results should interest scientists whose focus is upon the origins of male–female differences in the occurrence of drug dependence.

Cohort comparisons: Social learning explanations for alcohol use among adolescents and older adults

Some researchers have suggested that theories of delinquency are appropriate to the study of deviant behavior among older adults. This study compares the relative effects of social learning variables on alcohol use and abuse by adolescents and older adults. Two sub-samples–aged 12–17 ( N = 17709) and aged 65 and older ( N = 2019)–were created from the 2002 National Household Survey of Drug Use and Health, a national probability sample of persons aged 12 and older in the United States. Data show that the frequency of alcohol use for adolescents is positively associated with personal approval of daily alcohol use and the number of peers who get drunk at least once a week, while older adult frequency is positively associated with personal approval of daily alcohol use and number of peers who use alcohol. Alcohol abuse by adolescents is correlated with personal approval of daily alcohol use, the number of peers who drink alcohol, and the number of peers who get drunk at least once a week. Among the older adult sub-sample only personal approval of daily alcohol use and number of peers who use alcohol is significantly associated with abuse. These findings provide evidence for the merits of applying social learning variables to understanding deviance among diverse age cohorts.

Short report: Migration among persons living with HIV

Data from the first national probability sample of persons with HIV, the HIV Cost of Services and Utilization Survey (HCSUS), are used to examine migration patterns among persons with HIV/AIDS in the USA. Persons with serious illness may choose to relocate to receive better care or support. This migration has implications for the distribution of resources. This study describes the frequency and reasons that persons with HIV move to different communities. An analytic file of 3014 respondents was obtained from the first national probability sample of persons with HIV/AIDS, the HCSUS. A migration section of the baseline questionnaire questioned respondents on their residential history. Persons were defined as movers if they moved across state lines or to a non-contiguous county after knowing they were HIV positive but before the HCSUS baseline interview. Forty percent of movers said that their HIV status was a very important factor in their decision to move. Although earlier studies of limited generalizability found movement among the HIV population from urban to rural counties, this study found only eight percent of HIV migration was from urban to rural counties, just slightly more than the migration from rural to urban counties. In addition, the vast majority of people who were moving were not moving to return home. Major factors in the decision to move included being near caregivers and being in a community with shared needs and interests. Significant numbers of persons also moved to obtain care from a physician knowledgeable in HIV treatment or to get away from discrimination. Financial assistance and the availability of Medicaid also played a prominent role in many decisions to move. Persons with HIV/AIDS are more likely to move than non-infected persons in the general population. Moreover, they are almost twice as likely to be moving out-of-state. Persons with HIV who move are similar to persons with HIV who do not move on most demographic characteristics including age, region of the country, and income.

HIV patients' experiences with inpatient and outpatient care: results of a national survey.

Little is known about HIV patients' care experiences. To assess HIV patients' experiences with inpatient and outpatient care, and to assess the relationship and relative influence of patient characteristics and site of care on care experiences. Cohort study. Patients with HIV receiving care outside of emergency rooms, prisons, or the military throughout the continental United States. One thousand seventy-four patients provided ratings of an inpatient stay and 2204 rated an outpatient visit; 818 patients provided evaluations of both inpatient and outpatient care. A national probability sample of persons in care for HIV from the HIV Cost and Services Utilization Study. Outcome variables were rates of problems with, and global ratings of, inpatient and outpatient care. Mean problem rates were 20.9% and 8.4% (lower score means fewer problems) for inpatient and outpatient care, respectively. On 9 of 10 of the individual inpatient report items, 15% or more of respondents reported problems. Global ratings of inpatient and outpatient care were 65.3 and 75.0 (0-100 scale, higher scores indicate better ratings), respectively. In multivariable models that controlled for site effects, the only patient characteristic that was consistently associated with problem rates and global ratings of care was mental health (P <0.0001 for both inpatient and outpatient care). Models including site effects explained two to four times as much variance as models excluding site effects. Inpatients with HIV reported higher problem rates with inpatient than outpatient care. Better provider-patient communication during inpatient stays is needed. For both inpatient and outpatient care, quality improvement efforts may be most productively focused on providers and processes of care at sites rather than on specific patient subgroups.

Delayed medical care after diagnosis in a US national probability sample of persons infected with human immunodeficiency virus.

To identify health care and patient factors associated with delayed initial medical care for human immunodeficiency virus (HIV) infection. Survey of a national probability sample of persons with HIV in care. Medical practices in the contiguous United States. Cohort A (N = 1540) was diagnosed by February 1993 and was in care within 3 years; cohort B (N = 1960) was diagnosed by February 1995 and was in care within 1 year of diagnosis. More than 3- or 6-month delay. Delay of more than 3 months occurred for 29% of cohort A (median, 1 year) and 17% of cohort B. Having a usual source of care at diagnosis reduced delay, with adjusted odds ratios (ORs) of 0.61 (95% confidence interval [CI], 0.48-0.77) in cohort A and 0. 70 (95% CI, 0.50-0.99) in cohort B. Medicaid coverage at diagnosis showed lower adjusted ORs of delay compared with private insurance (cohort A: adjusted OR, 0.52; 95% CI, 0.30-0.92; cohort B: adjusted OR, 0.48; 95% CI, 0.27-0.85). Compared with whites, Latinos had 53% and 95% higher adjusted ORs of delay (P<.05) in cohorts A and B, respectively, and African Americans had a higher adjusted OR in cohort A (1.56; 95% CI, 1.19-2.04). The health care factors showed similar effects on delay of greater than 6 months. Medicaid insurance and a usual source of care were protective against delay after HIV diagnosis. After full adjustment, delay was still greater for Latinos and, to a lesser extent, African Americans compared with whites.

Impact of psychiatric conditions on health-related quality of life in persons with HIV infection.

Little is known about the impact of comorbid psychiatric symptoms in persons with HIV. This study estimates the burden on health-related quality of life associated with comorbid psychiatric conditions in a nationally representative sample of persons with HIV. The authors conducted a multistage sampling of urban and rural areas to produce a national probability sample of persons with HIV receiving medical care in the contiguous United States (N=2,864). Subjects were screened for psychiatric conditions with the short form of the Composite International Diagnostic Interview. Heavy drinking was assessed on the basis of quantity and frequency of drinking. Health-related quality of life was rated with a 28-item instrument adapted from similar measures used in the Medical Outcomes Study. HIV subjects with a probable mood disorder diagnosis had significantly lower scores on health-related quality of life measures than did those without such symptoms. Diminished health-related quality of life was not associated with heavy drinking, and in drug users it was accounted for by presence of a comorbid mood disorder. Optimization of health-related quality of life is particularly important now that HIV is a chronic disease with the prospect of long-term survival. Comorbid psychiatric conditions may serve as markers for impaired functioning and well-being in persons with HIV. Inclusion of sufficient numbers of appropriately trained mental health professionals to identify and treat such conditions may reduce unnecessary utilization of other health services and improve health-related quality of life in persons with HIV infection.

Marital Quality: A Product of the Dyadic Environment or Individual Factors?

Using longitudinal datafrom a nationalprobability sample ofpersons maried in 1980, we attempted to ascertain whether stability in marital quality ratings is due to the dyadic properties of the relationship or to the personality or socialfactors brought by individuals to marriage. An analysis of marital quality with two successive partners coupled with data on marital quality over time with the same partner suggests that stability in marital quality is due largely to the dyadic perception of the relationship. However, some individuals carry personal traits from one marriage to the next that bear on marital quality. Little is known about the stability of marital quality across successive marriages. With an increase in the percent of all marriages involving a remarriage (currently around 40%) for one or both partners and the majority of divorced persons remarrying (Coleman & Ganong 1990) the question of whether the marital interaction patterns and evaluations experienced in the failed marriage carry over into the remarriage is an important substantive issue. Marital quality has been shown to have important effects on two domains of

Normal Hip and Knee Active Range of Motion: The Relationship to Age

Abnormal joint mobility is an important factor in movement dysfunction and physical disability. Because the decision to treat impaired joint mobility in an older individual may be influenced by assumptions concerning normal range of motion (ROM) at older ages, it is important to establish population-based normative values for hip and knee ROM by age, race, and sex. This study used data from the first National Health and Nutrition Examination Survey (NHANES 1), which involved a national probability sample of persons drawn from the civilian noninstitutionalized population of the United States. Goniometric measurements of hip and knee active range of motion (AROM) were obtained from a subset of the sample consisting of 1,892 subjects. This analysis was limited to the 1,313 white and 370 black subjects. Univariate statistics, weighted by the probability of selection into the sample, were calculated for 12 sex-race-age-group-specific categories. These normal AROM values for the hip and knee calculated from this population based sample were found to differ from estimates found in textbooks by as much as 18 degrees. With one exception, normal values for all motions were lower in the oldest age group than in the youngest age group. The differences in mean AROM were generally small, ranging from 3 to 5 degrees. Only in the case of hip extension did the difference in mean AROM between the youngest and the oldest age groups constitute a decline of more than 20% of the arc of motion. With the possible exception of hip extension, this study supports the conclusion that, at least to age 74 years, any substantial loss of joint mobility should be viewed as abnormal and not attributable to aging and therefore should be treated much as it would be in a younger individual.

Professor Robinson Responds

Professor Robinson Responds James C. Robinson CopyRight https://doi.org/10.2105/AJPH.80.1.89-a Published Online: October 07, 2011

Childlessness and Social Isolation among the Elderly

Data from a national probability sample of persons 65 and older are used to explore the relationship between number of living children and social isolation in old age. Two indicators of social isolation are employed: (1) whether respondent lives alone; and (2), for those living alone, whether social contacts with friends, neighbors, or relatives have occurred in the past day or two. For both measures, a substantial association between number of children and isolation is observed. Childlessness has a particularly powerful effect on the probability qf isolation, but this effect is strongly conditioned by the health and occupational class qf the elderly person.

Satisfaction with life among persons sixty-five years and older. A causal model.

A fully recursive path model heuristically depicting a causative chain between financial situation, health satisfaction, satisfaction with standard of living, satisfaction with family life, and satisfaction with life as a whole was examined. The model was evaluated via path analysis, with parallel analyses conducted for each sex. The data used in this analysis were collected from a national probability sample of persons aged 18 and over living in noninstitutional dwelling units. This present study includes only those persons 65 years and older (N = 301). The model was shown to be an effective predictor of satisfaction with life for each sex. Satisfaction with family was found to make the greatest single impact on life satisfaction. Moreover, the model was determined to be generally consistent throughout.

The Audience for National TV News Programs

Despite the vast amounts of data collected by TV ratings services, surprisingly little information about the composition of the audience for the evening newscasts of Huntley-Brinkley, Reynolds-Smith, or Walter Cronkite has come to light. The questions addressed in this article are rather mundane in nature, since there are more important questions about the impact of such programs in informing the public, increasing public concern about social issues, altering audience perceptions, and changing audience attitudes.' Nevertheless, consideration of these questions does bear on the likely effects of news programs and leads us to challenge certain other findings regarding the audience for television news. The data reported here come from television viewing diaries collected by the W. R. Simmons organization from a national probability sample of persons 18 years and older. The diaries were kept by 6,834 viewers for various two-week periods between October i2 and November 1i, 1969. These data offer unique advantages over alternative sources. First of all, the sample has a national probability base, but is over three times as large as those few previous studies of news viewing that were nationwide in scope. Second, considerable experience and care in collecting valid data on highly specific aspects of mass media use are built into the Simmons data gathering operation. Third, Simmons collects data on three media simultaneously; few organizations engaged in media research collect detailed data on more than one medium at a time. Finally, the data are collected by a commercial organization, a factor minimizing the likelihood that respondents would overreport their news behavior because it might be expected of them (as is to be feared when the focus of the survey is news and the respondent knows it). * The data reported here were analyzed for the Surgeon General's Advisory Committee on Television and Social Behavior, under the auspices of the National Institute of Mental Health. Further details will be contained in the final report of this committee. The author wishes to acknowledge the skillful guidance of Harold Israel of the Simmons organization in analysis of these data. tJohn P. Robinson is a Study Director at the Survey Research Center, University of Michigan.