Panning for the gold in health research: Incorporating studies’ methodological quality in meta-analysis

Background: Systematic reviews now routinely assess methodological quality to gauge the validity of the included studies and of the synthesis as a whole. Although trends from higher quality studies should be clearer, it is uncertain how often meta-analyses incorporate methodological quality in models of study results either as predictors, or, more interestingly, in interactions with theoretical moderators.

Objective and methods: We survey 200 meta-analyses in three health promotion domains to examine when and how meta-analyses incorporate methodological quality.

Results: Although methodological quality assessments commonly appear in contemporary meta-analyses (usually as scales), they are rarely incorporated in analyses, and still more rarely analysed in interaction with theoretical determinants of the success of health promotions. The few meta-analyses (2.5%) that did include such an interaction analysis showed that moderator results remained significant in higher quality studies or were present only among higher quality studies. We describe how to model quality interactively with theoretically derived moderators and discuss strengths and weaknesses of this approach and in relation to current meta-analytic practice.

Conclusions: In large literatures exhibiting heterogeneous effects, meta-analyses can incorporate methodological quality and generate conclusions that enable greater confidence not only about the substantive phenomenon but also about the role that methodological quality itself plays.     

The relationship between employment quality and work-related well-being in the European Labor Force

In this article, data from the 2005 European Working Conditions Survey are used to examine the relationship between contemporary employment arrangements and the work-related well-being of European employees. By means of a Latent Class Cluster Analysis, several features of the employment conditions and relations characterizing jobs are combined in a typology of five employment arrangements: SER-like, instrumental, precarious unsustainable, precarious intensive and portfolio jobs. These job types show clear relationships with separate indicators of job satisfaction, perceived safety climate and the ability to stay in employment, as well as with an overall indicator for work-related well-being. The findings from this multifaceted approach towards employment quality raise questions about the long-term sustainability of highly flexible and de-standardized employment arrangements.     

A Video Recall Study of In‐session Changes in Sentiment Override

This study examines in‐session changes in sentiment override over the first three sessions of couple therapy. Couples viewed a video recording of therapy sessions immediately after each of the first three sessions and continuously rated their level of sentiment override. Ninety‐eight changes were randomly chosen for analysis. Three talk turns prior to each change was coded using the Family Relational Communication Control Coding System. Results show that changes in sentiment override occur frequently. Repeated incidents of communication control were related to negative change in sentiment override for females. Repeated incidents of being left out of the conversation were related to negative changes in sentiment override for females and positive changes for males.     

Emotional intelligence and health‐related quality of life in institutionalised Spanish older adults

This study explores the relationship between emotional intelligence (EI) and health‐related quality of life (HRQoL) in a sample of Spanish older adults who are institutionalised in long‐term care (LTC) facilities. One hundred fifteen institutionalised individuals (47.82% women; 88.3 ± 7.9 years) from southern Spain completed a set of questionnaires that included measures of EI, health and personality. Data were analysed via hierarchical regression. After controlling for personality and sociodemographic variables, the EI dimensions, emotional comprehension and emotional facilitation, accounted for part of the variance in several HRQoL facets. These dimensions could have an important role in the HRQoL of residents in LTC. Moreover, the use of a performance measure addresses the limitations of previous studies that have relied on self‐report measures. These aspects underscore the importance of the results of this study.     

A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

Intervention development and cultural adaptation research with diverse families

This article provides an introduction to the special issue on intervention development and cultural adaptation research with diverse families. The need for research on intervention development and on cultural adaptation of interventions is presented, followed by a discussion of frameworks on treatment development. Seven articles included in this special issue serve as examples of the stages of treatment and intervention development, and of the procedures employed in the cultural adaptation with diverse families. An overview of the seven articles is provided to illustrate the treatment development process and the use of pluralistic research methods. We conclude with a call to the field for creative and innovative intervention development research with diverse families to contribute to the body of evidence-based practice with these populations.     

The heart of the matter: a proposal for placing the self of the therapist at the center of family therapy research and training

As it faces the transition marked by the death or retirement of most of its first-generation founders, the field of family therapy finds itself still unable to answer the critical question of what it is that makes family therapy work. The two dominant approaches to answering this question, the common-factors perspective and the model-specific factors perspective, remain divided at this juncture by a fundamental difference of emphasis between the two. This article proposes a way of integrating the two perspectives via the hypothesis that therapists achieve maximum effectiveness by committing themselves to a family therapy model of proven efficacy whose underlying worldview closely matches their own personal worldview. The implications of this hypothesis for the training of family therapists are examined.     

Factors Moderating Children's Adjustment to Parental Separation: Findings From a Community Study in England

Research findings show that there is marked variability in children's response to parental separation, but few studies identify the sources of this variation. This prospective longitudinal study examines the factors modifying children's adjustment to parental separation in a community sample of 5,635 families in England. Children's behavioral/emotional problems were assessed when children were aged 47 and 81 months; marital quality, maternal depression, socioeconomic circumstances, and demographic variables were assessed prior to the separation from maternal report. Results indicated that 346 mothers separated from their partners in the 3-year period. Preseparation differences were found for measures of family process and parent risk factors, with effect sizes ranging from small to trivial. Parental separation was associated with a significant but modest increase in behavioral/emotional problems, independent of marital quality, maternal depression, socioeconomic circumstances, and demographic variables. Moderation analyses showed that children of cohabiting parents had a greater increase in adjustment problems following parental separation than children of married parents. Further research elucidating the factors that moderate children's adjustment to parental separation is needed to improve our understanding of who may most likely benefit from preventive interventions.     

Job-search strategies and reemployment quality: The impact of career adaptability

Past job-search research has focused on how hard unemployed people search for a job, but we still know little about the strategies that people use during their search and how we can predict the quality of the reemployment found. The first aim of this study was to predict the use of different job-search strategies via job-seekers' career adaptability. The second aim was to examine the impact of different job-search strategies on both the number of job-offers and the quality of the obtained job. In a two-wave study, 248 unemployed people indicated their career adaptability and the job-search strategies that they used. The use of a focused and exploratory strategy contributed to the number of job offers, whereas the use of an exploratory strategy reduced the quality of reemployment 8 months later. Moreover, career decision making and career confidence positively predicted reemployment quality. Implications for reemployment practice and further research are discussed.     

Investing in Success: Key Strategies for Building Quality in After-School Programs

This paper examines the relation between the implementation quality of after-school literacy activities and student reading gains. The data are from an evaluation of a multi-site after-school program in California in which continuous program quality improvement strategies were implemented to improve the delivery of a new balanced literacy program. Strategies included: (1) targeted staff training throughout the year, (2) regular observations and coaching of staff, and (3) the use of data to measure progress. Programs struggled to successfully implement these strategies early in the initiative, but gradually improved the quality and consistency of their use. Program quality, as measured through observations, also increased. Results suggested that the size of student reading gains were positively correlated with the quality of literacy programming provided by each instructor.