Failing to retain an adequate number of study participants in behavioral intervention trials poses a threat to interpretation of study results and its external validity. This qualitative investigation describes the retention strategies promoted by the recruitment and retention committee of the Behavior Change Consortium, a group of 15 university-based sites funded by the National Institutes of Health to implement studies targeted toward disease prevention through behavior change. During biannual meetings, focus groups were conducted with all sites to determine barriers encountered in retaining study participants and strategies employed to address these barriers. All of the retention strategies reported were combined into 8 thematic retention categories. Those categories perceived to be most effective for retaining study participants were summarized and consistencies noted among site populations across the life course (e.g., older adults, adults, children, and adolescents). Further, possible discrepancies between site populations of varying health statuses are discussed, and an ecological framework is proposed for use in future investigations on retention.
There is suggestive evidence that rates of major depression have risen markedly in the U.S. concurrent with the rise in obesity. The economic burden of depression, about $100 billion annually, is under-estimated if depression has a positive causal impact on obesity. If depression plays a causal role in increasing the prevalence of obesity, then policy interventions aimed at promoting mental health may also have the indirect benefits of promoting a healthy bodyweight. However, virtually the entire existing literature on the connection between the two conditions has examined merely whether they are significantly correlated, sometimes holding constant a limited set of demographic factors. This study utilizes multiple large-scale nationally-representative datasets to assess whether, and the extent to which, the positive association reflects a causal link from major depression to higher BMI and obesity. While contemporaneous effects are considered, the study primarily focuses on the effects of past and lifetime depression to bypass reverse causality and further assess the role of non-random selection on unobservable factors. There are expectedly no significant or substantial effects of current depression on BMI or overweight/obesity, given that BMI is a stock measure that changes relatively slowly over time. Results are also not supportive of a causal interpretation among males. However, among females, estimates indicate that past or lifetime diagnosis of major depression raises the probability of being overweight or obese by about seven percentage points. Results also suggest that this effect appears to plausibly operate through shifts in food consumption and physical activity. We estimate that this higher risk of overweight and obesity among females could potentially add about 10% (or $9.7 billion) to the estimated economic burden of depression.
The purpose of this study is to examine the implications of using different approaches to estimating the U.S. working-age population with disabilities. The approaches compared are the traditional work-activity limitation question, the Census Bureau's newer six-question sequence that does not include a work-activity limitation question, and the combination of the two. With data from the Current Population Survey and the American Community Survey, the authors demonstrate that using the work-limitation question or the six-question sequence alone results in an underestimate of the size of the working-age population with disabilities (assuming the International Classification of Disability, Health, and Functioning conceptualization of disabilities). Furthermore, the authors show that using the sample of the working-age population with disabilities identified by the six-question sequence will lead to biased estimates of key social policy success parameters; in particular, it will overestimate their employment rates and underestimate the share that are receiving Social Security Disability Insurance or Supplemental Security Income-Disabled Adults benefits relative to the broader sample that includes a work-limitation question and the six-question sequence.
The purpose of this study is to examine the effects of severe depression on the Test of Memory Malingering (TOMM). The present study examined whether 20 participants with high levels of depression, as measured by the Beck Depression Inventory 2nd Edition (BDI-II) and with current diagnoses of Major Depressive Disorder, would perform significantly worse on the TOMM than a control group. The results showed that the depressed and control groups did not have significant mean group differences on TOMM performance. Of the 20 depressed participants, only 2 on Trial 2 and 1 on the Retention Trial scored below the cutoff of 45, while none of the control participants performed in this range. The potential ameliorating effects of medications on the performance of the depressed group are discussed. The results indicate that the TOMM can be used with even severely depressed participants with only slight caution.
The Great Recession had the most severe impact on state tax revenues of any downturn since the Great Depression. We hypothesize that states with more progressive tax structures are more vulnerable to economic downturns, and that progressivity and income volatility may interact to amplify the recession's fiscal impact. We find that, while potential revenue exposure is greater in more progressive states, the most important source of variation was differences in income concentration and capital gains shares in the top 5 percent of taxpayers. Though the interaction between income volatility and high tax burdens at the top did produce large decreases in tax revenue in a few states, tax progressivity accounted for little of the overall interstate variation in revenue volatility. JEL codes: H24; H71
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