Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure.

The purpose of this study was to understand how the real relationship (RR) relates to important process and outcome variables from both the clients' and therapists' perspectives. Using a sample of 31 therapist/client dyads at a university counseling center, the authors examined the RR at the 3rd session of therapy and at termination. The results revealed that client adult attachment avoidance was negatively correlated with client RR, while client adult attachment anxiety was uncorrelated. Therapists' ratings of negative transference were negatively correlated with therapist-rated RR and were uncorrelated with client-rated RR. Hierarchical linear modeling analyses were conducted to predict postintervention outcome from client and therapist perceptions of the RR. Therapists' ratings of the RR accounted for a significant amount of variance in client posttreatment symptoms while controlling pretreatment symptoms. Client-rated RR total scores and client and therapist 3rd-session alliance scores were not significant predictors of postsymptom ratings. Implications of the usefulness of measuring the RR in psychotherapy are discussed, as are recommendations for future study.

Chicago, IL; Sacramento, CA; Silver Spring, MD; and Durham, NC, capturing a sociodemographically diverse sample with specific attention to ensuring inclusion of Hispanic, African-American, and elderly participants. Of 1774 people recruited, 75% participated: 961 took part in a deliberative method and 377 participants comprised the RMO control group. To assess effectiveness of the deliberative methods overall and of individual methods, we evaluated whether mean pre-post changes on a knowledge and attitude survey were statistically different from the RMO control using ANCOVA. In addition, we calculated mean scores capturing participant views of the impact and value of deliberation. Participating in deliberation increased participants' knowledge of evidence and comparative effectiveness research and shifted participants' attitudes regarding the role of evidence in decision-making. When comparing each deliberative method to the RMO control group, all four deliberative methods resulted in statistically significant change on at least one knowledge or attitude measure. These findings were underscored by self-reports that the experience affected participants' opinions. Public deliberation offers unique potential for those seeking informed input on complex, values-laden topics affecting broad public constituencies.

OBJECTIVES: Involving stakeholders in research helps ensure that research is relevant and responsive to stakeholder needs while improving the quality of the research. This research was conducted as part of AHRQ's Community Forum project which was charged with identifying emerging strategies and state of the art methods for engaging stakeholders. METHODS: We developed a conceptual framework for stakeholder engagement that informed this literature scan and assisted in organizing findings. The scan included a search of peer-reviewed literature, using academic databases as well as an Internet search of grey literature and Web sites. Our final review included 23 peer-reviewed articles, 15 grey literature documents, and 43 Web sites related to stakeholder engagement. To supplement our scan, we conducted 11 interviews with individuals experienced in the field of stakeholder engagement. Our technical experts also suggested organizations and Web sites to explore in our literature review. RESULTS: We identified many promising methods of involving stakeholders in research. One example is using online collaborative platforms to enable interactions between an organization and its stakeholders through a virtual space. These allow users to share information, work together, and provide feedback to stakeholders about how their input is being used. Other examples include product development challenges, utilizing existing online communities, and grassroots community organizing. Selected recommended practices from our review include gaining trust of stakeholders before involvement and maintaining throughout; selecting stakeholders for whom the decision or research has important consequences; and educating stakeholders on their roles, their responsibilities, and the topics being discussed. A limitation to our findings is that there are limited evaluation data measuring outcome effectiveness of these methods. CONCLUSIONS: Stakeholder involvement is critical to health care research. This presentation will highlight selected effective and creative approaches to stakeholder engagement. OBJECTIVES:To analyze the profile of care for sexually transmitted infections (STIs) in health centers in border areas of Central America. METHODS: A crosssectional study in a sample of 3357 people received medical care for some STIs in 13 health centers in border areas of Central America, during 2007-2010. Doctors were trained and supplied medicines, condoms and HIV testing (basic package of health care). The sample of users was characterized according to sociodemographic variables and the associated factors with the probability of receiving the basic package of care for STIs were analyzed using additive probit regression models. RESULTS: Of the total users, 66% had 25 to 59 years old, and 93% of users were women. The most frequently diagnosed STI were Candidiasis, Bacterial Vaginosis, Trichomoniasis, Gonorrhea and Syphilis. 60% of prescriptions for these STIs were adhered to the international recommendations. 53.1 % of users received only medicines, 5.8 ...

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