Self-selection Of Participants Research Articles

Correction for Self-Selection in Breast Cancer Screening. Comment on Dibden et al. Worldwide Review and Meta-Analysis of Cohort Studies Measuring the Effect of Mammography Screening Programmes on Incidence-Based Breast Cancer Mortality. Cancers 2020, 12, 976.

Observational studies of cancer screening are subject to bias associated with the self-selection of screening participants for whom the underlying probability of cancer death may be different from those who do not participate. Dibden et al. reviewed data on mortality reduction from 27 observational studies of mammography screening expressed in terms of relative risk for women who were screened versus not screened. Results were given, both unadjusted and after application of a correction for self-selection. The correction was based on a constant (1.17)-the ratio of risks of death in screening non-attenders versus those not invited, derived from a Swedish study. For some of the studies this correction had a large effect in diminishing the measured mortality benefit associated with screening. In particular, application to The Pan-Canadian Study of Mammography Screening, a study whose authors had previously tested for and found no evidence of self-selection bias, caused the estimated benefit to decrease from 40% to 10%. The appropriateness of applying a correction based on a constant to a population whose healthcare environment and screening participation rates are very different from those from which it was derived is questionable.

The moral deliberation pathway in veterinary practice: a qualitative study.

Veterinarians may face various ethical decisions and potential moral conflicts in clinical practice. The ethical decision-making process often leads to a satisfying resolution. However, when such a process is accompanied by a perceived inability to act according to a person's values, it can lead to psychological distress that characterises moral distress. Theoretical models in professions such as nursing attempt to explain the evolution of moral conflict into moral distress. In veterinary professionals, a model has been proposed to explain this pathway (the moral deliberation pathway). However, empirical data are still lacking on whether veterinary clinicians experience a moral deliberation pathway as hypothesised. Using thematic analysis, this qualitative study investigates veterinary clinicians' experiences with moral distress and aims to explain the moral deliberation pathway in these veterinarians. The results suggest that veterinarians' experiences with moral distress follow a deliberation process that can be explained by the proposed moral deliberation pathway. Experiencing a moral conflict leads to moral stress, then either to moral distress or resolution into moral comfort. Self-selection of participants and possible recollection bias may have biased the findings. The empirical data provided by this study can inform future research and intervention strategies to identify, measure and manage moral distress in the veterinary context.

Sexual communication patterns in couples with vulvodynia-a case-control behavioral observation study.

Sexual communication is a common target in psychological treatments for vulvodynia, and associations with sexual function and distress, as well as pain intensity, have been demonstrated. However, structured observations of the communication patterns of couples with vulvodynia are lacking, as these are needed to guide treatment efforts. To explore (1) the sexual communication patterns in couples with vulvodynia in terms of observed communication quality (operationalized as validating and invalidating responses), self-reported sexual assertiveness, and self-disclosure and (2) associations between sexual communication quality and pain intensity. In a case-control design with within- and between-group comparisons, 62 couples engaged in videotaped discussions about their sexual relationship. Trained coders assessed the discussions by rating sexual communication (validation and invalidation) according to a structured behavioral coding scheme. Group differences in sexual communication quality were examined with parametric and nonparametric tests. Dyadic associations among observed communication quality, self-rated sexual assertiveness, and self-disclosure were examined within the actor-partner interdependence model. Multiple regression was used to test the predictive value of partners' validation/invalidation on the pain intensity of the women with vulvodynia. Observed communication quality (ie, validation and invalidation), self-reported sexual assertiveness, self-disclosure, and pain intensity. Partners of women with vulvodynia were more invalidating toward their partners than those of women without pain. There were no significant differences in validating/invalidating communication between women in the 2 groups or in validation between partners. Partners' validating communication were significantly associated with women's lower pain intensity. The sexual communication patterns differed between couples with and without vulvodynia, and the associations between validating/invalidating responses and sexual assertiveness were stronger in the vulvodynia group than in the group without pain. Results on validation/invalidation and self-disclosure were inconclusive. The results indicate a need to direct treatment interventions toward couples' sexual communication quality (ie, levels of validation and invalidation). Strengths include systematic behavioral coding and dyadic analyses. Limitations include the cross-sectional design and self-selection of participants. This study demonstrated sexual communication patterns specific to couples with vulvodynia, and we conclude that validation and invalidation are important components of the sexual communication of couples with vulvodynia as they relate to sexual assertiveness, women's self-disclosure, and pain intensity.

Recruiting research participants for transport research: Reflections from studies on autonomous vehicles in the UK

Much research is dependent on the willingness of participants to give up their time – whether renumerated or not – and engage with the activities we have designed such as interviews, surveys, writing diaries, and taking photos. We talk about social research being dependent on ‘self-selection’, but we say less about what happens when the people with whom we wish to engage do not agree to do so; when we are unable to get the insights we need to answer our research questions or respond to our research aims. In this Viewpoint, we discuss three interconnected methodological themes: locating and accessing participants, participant self-selection and identification in the context of the research, and topical fatigue. We discuss these themes in relation to recent developments in transport and the rise of autonomous vehicles in particular.

Enhanced feedback interventions to promote evidence-based blood transfusion guidance and reduce unnecessary use of blood components: the AFFINITIE research programme including two cluster factorial RCTs

Enhanced feedback interventions to promote evidence-based blood transfusion guidance and reduce unnecessary use of blood components: the AFFINITIE research programme including two cluster factorial RCTs

Co-developing Local Feminist “Conceptual Vocabularies” While Strengthening Activism Through Critical Consciousness Raising with South Africa’s Mine and Farm Women

ABSTRACT This article is a reflection on five feminist schools, popular education platforms, convened between 2017 and 2019 with two women’s groups organising in the platinum mines in Marikana, North West and commercial farms in uMgungundlovu in Kwa Zulu-Natal in South Africa. The first part of the article looks at the background to the feminist schools and reflects on the composition of the groups, the self-selection of participants who attended the feminist schools, the co-development of a flexible curriculum and the non-hierachical dialogical learning methodology employed. The second part hones in on the use of local languages and how they enriched our conversations and encouraged full participation. Here we also highlight some of the translation challenges we experienced when dialoguing and drawing from concepts central in feminist theory, analysis and critique, e.g. patriarchy, power, gender. To resolve the challenges, direct translations did not work; we thus used multiple local concepts, and layered these with local expressions that the women felt were close proximates. We argue in this paper that to strengthen activist movements there is a need to think through our “pedagogy of mobilisation” and to co-develop local feminist registers and grammars and “conceptual vocabularies”. We thus make a case for the development and refinement of indigenous feminist theories/concepts that are locally grounded but outward-looking, drawing from and in conversation with local languages, realities and activists. We hope this paper adds to debates on feminist popular education and pedagogical questions in feminist activism.

Estimate of exposure to SARS-CoV-2 and performance of high-risk interventions by European anaesthesiologists: A Pan-European cross-sectional survey.

Estimate of exposure to SARS-CoV-2 and performance of high-risk interventions by European anaesthesiologists: A Pan-European cross-sectional survey.

Technology-Assisted Self-Selection of Candidates for Nonprescription Statin Therapy

BackgroundAlthough statins reduce cardiovascular morbidity and mortality, only about one-half of eligible patients receive treatment. Safe and appropriate consumer access to statins could have a significant positive public health impact. ObjectivesThis study compares the concordance between a participant and clinician assessment of eligibility for statin therapy using a technology-assisted approach. MethodsA total of 500 participants, 83 with limited literacy, completed an at-home Web-based application to assess appropriateness for treatment with rosuvastatin 5 mg. The Web application is designed to assess eligibility for a moderate-intensity statin based on current guidelines and deny access to individuals with contraindications to rosuvastatin. Subsequently, participants visited a research site where clinicians, blinded to the information the participant entered, performed an independent Web application assessment. The Web application is programmed for 1 of 3 rosuvastatin treatment outcomes: “OK to use,” “not right for you,” or “ask a doctor.” The primary endpoint was the percent of participants whose self-selected eligibility for nonprescription rosuvastatin was concordant with clinician assessment. ResultsFor the primary endpoint, participant selection for statin therapy was concordant with clinician selection in 481 (96.2%) of 500 participants (95% confidence interval: 94.1%-97.7%), of whom 23 (4.6%) were deemed appropriate and 458 (91.6%) were deemed inappropriate for treatment. Discordance was due to incorrect self-selection (“OK to use”) in 3 cases, incorrect rejection (“not right for you”) in 14 cases and an incorrect “ask a doctor” outcome in 2 cases. ConclusionsThe use of a technology-assisted approach to consumer self-selection for statin therapy resulted in participant self-selection that showed substantial agreement with clinician selection.

Assessing the Risk and Outcome of COVID-19 in Patients with Psoriasis or Psoriatic Arthritis on Biologic Treatment: A Critical Appraisal of the Quality of the Published Evidence

The need to rapidly spread information about the risk of COVID-19 in patients with psoriasis and psoriatic arthritis on biologics may have hampered the methodological rigor in published literature. We analyzed the quality of papers dealing with the risk and outcomes of COVID-19 in patients with psoriasis and psoriatic arthritis receiving biologic therapies. The Newcastle-Ottawa Scale was used to estimate the quality of the published studies. Moreover, to better contextualize results, specific internal and external validity items were further considered, that is, case definition, modality of COVID-19 assessment, evidence for self-selection of participants, percentage of dropout/nonparticipants, and sample size calculation. A total of 25 of 141 papers were selected. The median Newcastle-Ottawa Scale score was 47% for psoriasis and 44% for psoriatic arthritis, indicating an overall high risk of bias. A total of 37% of psoriasis and 44% of psoriatic arthritis studies included patients with suspected COVID-19 without a positive swab. No studies provided a formal sample size calculation. A significant risk of bias in all the published papers was found. Major issues to be considered in future studies are reduction of ascertainment bias, better consideration of nonresponse or participation bias, and provision of formal statistical power calculation.

Self-selection bias in estimating the determinants of landowners' Re-enrollment decisions in forest incentive programs

Despite increasing attention in recent years, only a limited number of studies have investigated the determinants of landowner re-enrollment intentions in conservation incentive programs. However, none of these studies controlled for the potential self-selection of participants. The concern for a self-selection bias is policy relevant because researchers and policymakers investigate the determinants of re-enrollment not only to predict the retention rate of participants but also to promote the long-term success of conservation programs. This paper uses data on eligible landowners, consisting of both participants and non-participants, from a forest incentive program in Japan to examine the determinants of the participants' re-enrollment decision, controlling for a rich set of observable landowner attributes, and conditioning on the unobserved participants' attributes which are identified by modeling the re-enrollment decision jointly with the decision to participate. The empirical results indicate that the unconditional marginal effects from the separate re-enrollment model are biased by selection and underestimate the effects by between 12% and 48%. The results also show that the observable factors that attract landowners to participate also tend to encourage participants to remain in the program. This implies that interventions directed at increasing initial participation are also likely to increase re-enrollment.

Measuring institutional transformation: a multifaceted assessment of a new faculty development program

PurposeThis study aims to understand the extent to which a faculty development program that includes a week-long course design experience followed by sustained support changes new faculty's perceptions, beliefs and teaching practices. The authors employed the teacher professional knowledge and skill (TPK&S) framework and characteristics of effective educational development interventions to drive the program development, implementation and assessment.Design/methodology/approachThis study utilized a mixed methods approach. Data sources include pre-/mid-/post-program responses to a validated survey, pre-/post-program course syllabi analyzed using a validated rubric and pre-/post-classroom observations collected using the Classroom Observation Protocol for Undergraduate STEM (COPUS) instrument.FindingsFindings indicate transformative effects for participants' beliefs about their teaching and changes to their instructional practices. Significant and practical effects were observed across different portions of the program for increases in participants' self-efficacy, endorsement of a conceptual change approach toward teaching and perceptions of institutional support. Participants produced more learning-focused syllabi and many moved toward more student-centered instructional approaches in their teaching practices.Research limitations/implicationsDue to the voluntary nature of the new faculty development program, this study may have been limited by participant self-selection bias and differential sample sizes for the study's individual measures. Future research should consider designs which maximize faculty participation in measurement across all data sources.Originality/valueThis study addresses shortcomings in prior studies which utilized limited data sources to measure intervention impact and answers the call for more rigorous research to obtain a more complete picture of instructional development in higher education.

Selection effects on dishonest behavior

AbstractIn many situations people behave ethically, while elsewhere dishonesty reigns. Studies of the determinants of unethical behavior often use random assignment of participants in various conditions to identify contextual or psychological factors influencing dishonesty. However, in many real-world contexts, people deliberately choose or avoid specific environments. In three experiments (total N = 2,124) enabling self-selection of participants in two similar tasks, one of which allowed for cheating, we found that participants who chose the task where they could lie for financial gain reported a higher number of correct predictions than those who were assigned it at random. Introduction of financial costs for entering the cheating-allowing task led to a decrease in interest in the task; however, it also led to more intense cheating. An intervention aimed to discourage participants from choosing the cheating-enabling environment based on social norm information did not have the expected effect; on the contrary, it backfired. In summary, the results suggest that people low in moral character are likely to eventually dominate cheating-enabling environments, where they then cheat extensively. Interventions trying to limit the preference of this environment may not have the expected effect as they could lead to the selection of the worst fraudsters.

A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’ project

• Ketamine infusion causes an initial ‘high’, enhanced perception, and dissociation. • People may have a reduction in or removal of suicidal ideation & depression symptoms. • People can experience an increase in motivation, socialisation, and activity. • The treatment environment affects ketamine experience. • People who have experience of ketamine for depression advocate the treatment. There has been a lack of in-depth interviews investigating patient experience of ketamine treatment for depression. We examined participants’ pathways to receiving ketamine infusion to treat their depression, and their responses to, lived experiences of, and attitudes towards ketamine treatment. Qualitative methods were used to conduct in-depth interviews with 13 patients (6 male; 7 female) diagnosed with treatment resistant depression (TRD) with experience of receiving ketamine treatment for depression. Interpretative phenomenological analysis (IPA) was employed. For the majority of participants ketamine infusion causes a reported initial ‘high’, enhanced perception, and dissociative experience; followed by a lifting of mood and a reduction in or removal of suicidal ideation and depression symptoms lasting around 3–6 days. This leads to a reported increase in motivation, socialisation, and activity. All participants valued the therapeutic alliance with clinicians which enhanced the treatment experience and all advocated treatment access for those with depression who have not responded to other treatments. Small numbers, purposive sample, participant self-selection, and single site recruitment limit generalisability. Ketamine for depression can have many beneficial effects, and it is potentially life-transforming for some. Ketamine may be a source of hope for patients for whom other treatments have not been effective. For some, ketamine is not tolerated or does not have anti-depressive effects. Further qualitative in-depth exploration of patient experience and consideration of how ketamine depression treatment access can be appropriately made available are warranted.

Effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): Results of a pragmatic randomized controlled trial

BackgroundMajor Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions. MethodsThis two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1. ResultsA small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low. LimitationsResults are limited to green professions and representativeness might be restricted by self-selection of participants. ConclusionDepression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates. Trial RegistrationGerman Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

A randomized trial of brief web-based prevention of unhealthy alcohol use: Participant self-selection compared to a male young adult source population

BackgroundHow much a randomized controlled trial (RCT) sample is representative of or differs from its source population is a challenging question, with major implications for generalizability of results. It is particularly crucial for freely-available web-based interventions tested in RCTs since they are designed to reach broad populations and could increase health disparities if they fail to reach the more vulnerable individuals. We assessed the representativeness of a sample of participants in a primary/secondary prevention web-based brief intervention RCT in relation to its source population. Then we compared those recruited to those not recruited in the RCT. MethodsThere is a mandatory army recruitment process in Switzerland at age 19 for men. Between August 2010 and July 2011, 12,564 men (source population) attended two recruitment centers and were asked to answer a screening questionnaire on alcohol use. Among 11,819 (94.1%) who completed it, 7027 (59.5%) agreed to participate in a longitudinal cohort study with regular assessments. In 2012, these participants were invited to a web-based brief intervention RCT. Participation was not dependent on the presence or quantity of alcohol use. We assessed the representativeness of the RCT sample in relation to the source population and compared participants recruited/not recruited in the RCT with respect to education level and alcohol use. ResultsThe RCT sample differed from the source population: individuals 20 and over were significantly less represented (34.3% vs 37.9%, p = 0.006), as were those with lower education level (58.6% vs 63.0%, p = 0.0009). The prevalence of any alcohol use was higher in the RCT population (92.3% vs 90.6%, p = 0.03) but unhealthy alcohol use was less represented (37.1% vs 43.2%, p < 0.0001). Differences on alcohol use measures and education were similarly found when those recruited in the RCT were compared to those who were not, including in a multivariable model, showing independent associations between less unhealthy alcohol use and higher education and recruitment in the RCT. ConclusionsRCT participants differed from other members of the source population, with those participating in the RCT having higher prevalence of any alcohol use but lower levels of consumption and lower prevalence of indicators of unhealthy alcohol use. Individuals with higher education were overrepresented in the RCT sample. Selection bias may exist at both ends of the drinking spectrum and individuals with some indicators of greater vulnerability were less likely to participate. Results of web-based studies may not adequately generalize to the general population.Trial registration: The trial was registered at current controlled trials: ISRCTN55991918.

Enclave deliberation and social movement mobilization: the DDays in Occupy Central

ABSTRACTScholars have called for a synergy between studies of deliberative democracy and social movements for their mutual enhancement. The existing literature generally applies the principle of deliberation to evaluate social movements, but few studies have examined the corresponding practice of deliberative democracy within a movement. The Occupy Central (OCLP) campaign in Hong Kong is a rare case in which the organizers incorporated Deliberation Days into a social movement; however, participant self-selection turned it into an instance of ‘enclave deliberation’. This paper studies the impact of enclave deliberation on social movements based on the case of the OCLP campaign and argues that enclave deliberation can be a powerful tool for mobilization, particularly for gaining public support and for recruiting core participants. However, the coherence and support of the movement can decline when enclave deliberation is used to make decisions for the general public, because enclave deliberation incorporates only a small spectrum of like-minded participants who might not seriously engage with opposing views. The findings of this study imply that enclave deliberation could facilitate mobilization, but it has its inherent limitations for decision-making in a movement. Given the selective nature of social movements, deliberation within social movements is likely to be enclave deliberation in most cases. This study thus has significant implications for the practice of deliberation in social movements in other contexts.

A self-defeating interpersonal style predicts depression over and above the Big 5 personality trait constructs

Three hundred and fifty-three adult participants completed self-report measures assessing depression, the putative “Big 5” personality factors, socially desirable responding, and a new scale intended to measure the propensity to engage in a self-defeating interpersonal style of behavior (the SELF-DISS; Atkinson & Vernon, 2018). Our goals were to see whether SELF-DISS scores would significantly predict depression and whether they would do so over and above the proposed “Big 5” trait constructs using online recruitment of participants from the general population at large. The recruitment method, although expeditious, necessarily resulted in the self-selection of participants, thereby raising the possibility that some sampling bias may have been incorporated into the study. Nevertheless, the results obtained clearly supported both predictions.

In the Name of the Law: Legal Frames and the Ending of the Occupy Movement in Hong Kong

The Hong Kong government made tactical use of legal instruments to end the Occupy Movement in 2014, yet there were divergent responses to the injunctions at the two main protest sites. Through a within-case comparison, this study argues that diverging legal frames explain the different reactions at the two sites. Law, as a constitutive symbol of certain collective action frames, constructs the boundaries of a movement and creates expectations among protesters regarding how to address legal instruments. The protesters in Admiralty tended to adhere to a law-abiding frame that required them to respect and obey the law when confronted with legal tactics. In contrast, the framing contest and self-selection of participants made activists in Mongkok susceptible to a law-defying frame that disposed them to resist the actions of law enforcement authorities. This study sheds light on the conditions under which protesters will obey the law.

Predicting enrollment in two randomized controlled trials of nonpharmacologic interventions for youth with primary mood disorders

BackgroundAs recruitment and retention are often challenging in randomized controlled trials (RCTs), this study sought to identify predictors of participation (i.e., trial enrollment). MethodThese analyses identified predictors of enrollment among 119 youth, ages 7–14, with a primary mood disorder, who screened eligible for the Omega-3 and Therapy pilot studies; 95 (79.8%) actually participated in the treatment. ResultsYouth who received some form of travel assistance (16.0%) almost uniformly enrolled in the treatment portion of the RCT. Youth who lived further away from the study site (p = .047) or whose primary caregiver never married (p = .01) were less likely to enroll. Of note, socioeconomic status (SES) variables (parent education and child insurance status) did not significantly predict enrollment, suggesting that study incentives or accommodations may have adequately addressed barriers commonly associated with SES. LimitationsDue to the fairly high trial enrollment rate (approximately 80%), there likely was limited power to detect some differences between groups. Generalizability may be limited to youth with a primary mood disorder diagnosis. ConclusionsDespite retaining a large proportion of the youth who screened eligible, participant self-selection is a limitation of any RCT. A silent inclusion criterion of any RCT is willingness to be randomized.

After-School and Informal STEM Projects: the Effect of Participant Self-Selection

This research represents an unforeseen outcome of the authors’ National Science Foundation Innovation Technology Experiences for Students and Teachers (ITEST) program grant in science education. The grant itself focused on the use of serious educational games (SEGs) in the science classroom, both during and after school, to teach science content and affect student perceptions of science and technology. This study consists of a Bayesian artificial neural network analysis, using the preintervention measures of affect, interest, personality, and cognitive ability, in members of both the treatment and comparison groups to generate the probabilities that students would opt into the treatment group or choose not to participate. It appears, from this sample and the sampling methods of other related studies within the field, that despite sometimes profound results from technology interventions in science, interventions are affecting only those who already have a strong interest in STEM due to the manner in which participants are recruited.