The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

Primary care providers (PCPs) offered input regarding the incorporation of a family health history (FHH) risk assessment tool into a community health care system (CHCS). Sixteen PCPs participated in one of three focus groups. Perceived impediments included the lack of standard screening guidelines, effective screening tests, genetic counseling resources, and services for high-risk patients. The PCPs were concerned about their level of expertise, the cost of preventive health care, and genetic discrimination. They also were concerned about the use of a FHH tool by oncologists within the CHCS because of communication gaps between oncologists and PCPs, lack of clarity regarding follow-up and legal liability, and reimbursement issues. To integrate a FHH tool into a CHCS, PCPs will need consultation and referral services, evidence-based recommendations, and "just-in-time" educational resources. Oncologists who use the tool will need to develop a streamlined communication system with PCPs, establish clearly defined roles, and ensure patient follow-up.     

Can we disregard the whole model? Omnibus non-inferiority testing for R2 in multi-variable linear regression and in ANOVA

Determining a lack of association between an outcome variable and a number of different explanatory variables is frequently necessary in order to disregard a proposed model (i.e., to confirm the lack of a meaningful association between an outcome and predictors). Despite this, the literature rarely offers information about, or technical recommendations concerning, the appropriate statistical methodology to be used to accomplish this task. This paper introduces non-inferiority tests for ANOVA and linear regression analyses, which correspond to the standard widely used F test for and R², respectively. A simulation study is conducted to examine the Type I error rates and statistical power of the tests, and a comparison is made with an alternative Bayesian testing approach. The results indicate that the proposed non-inferiority test is a potentially useful tool for ‘testing the null’.     

Stability in cognition across early childhood. A developmental cascade

Children confront the formidable task of assimilating information in the environment and accommodating their cognitive structures to that information. Developmental science is concerned equally with two distinctive features of these processes: children's group mean level of performance through time and the standing of individual children through time. Prevailing opinion since the inception of the mental-measurement movement has been that individual development is unstable-that individual children change unpredictably in their abilities. We report results of a large-scale controlled, multivariate, prospective, microgenetic, 4-year longitudinal study that reveals a statistically significant cascade of species-typical cognitive abilities from infancy to childhood. Infancy is a recognizable starting point of life; we find that to a small but significant degree, infancy also represents a setting point in the life of the individual.     

Maternal responsiveness to young children at three ages: longitudinal analysis of a multidimensional, modular, and specific parenting construct

Responsiveness defines the prompt, contingent, and appropriate reactions parents display to their children in the context of everyday exchanges. Maternal responsiveness occupies a theoretically central position in developmental science and possesses meaningful predictive validity over diverse domains of children's development, yet basic psychometric features of maternal responsiveness are still poorly understood. In this prospective longitudinal study, the authors examined structure, individual variation, and continuity of multiple dimensions of responsiveness in 40 mothers to their infants' activities at 10, 14, and 21 months during natural home-based play interactions. Both age-general and age-specific patterns emerged in maternal responding. The study's developmental results support the multidimensionality, modularity, and specificity of this central parenting construct.     

THE ATTITUDES TOWARD WOMEN SCALE AND ATTITUDE CHANGE IN COLLEGE STUDENTS

To determine cohort changes in gender-role attitudes, responses to the 15-item form of the Attitudes Toward Women Scale (AWS; Spence & Helmreich, 1972a, 1978) were compared for students at the same university tested in 1972, 1976, 1980, and 1992. In both males and females, members of the 1992 cohort were the most egalitarian, and members of the 1972 cohort were the least egalitarian. In all groups, women were significantly less traditional in their attitudes than men. As has been found in previous studies, detailed analyses of the data from the 1992 cohort revealed that the scale was unifactorial, but that the score distributions were skewed. There was also some indication of ceiling effects at the egalitarian end of the scale, particularly in women. The implications of these latter results for the usefulness of the AWS in current research were explored.