scholarly journals Exploring the external validity of survey data with triangulation: A case study from the Norwegian Offender Mental Health and Addiction (NorMA) Study

2021 ◽  
pp. 263208432110612
Author(s):  
Nicoline Toresen Lokdam ◽  
Marianne Riksheim Stavseth ◽  
Anne Bukten

Objectives This paper demonstrates how to investigate the external validity of a study sample by triangulating survey and registry data, using data from the Norwegian Offender Mental Health and Addiction (NorMA) Study as a case. Methods We use survey data from the NorMA study ( n = 1495), including the NorMA cohort ( n = 733), and data from the Norwegian Prison Registry on all people imprisoned on 1 September 2013 ( n = 3386). Triangulation was performed by (1) comparing the NorMA cohort to those lost to follow-up ( n = 762), using survey data from the NorMA study. Secondly, we compared the NorMA cohort to the one-day population, using data from the Norwegian Prison Registry. We also stratified the one-day sample by possession of a Norwegian personal identification number (PIN). Results We found differences in birthplace, imprisonment and drug use between the NorMA cohort, lost to follow-up and the one-day population. Twenty-three percent of the one-day population did not have a Norwegian PIN. The NorMA cohort was more similar to those with a Norwegian PIN in the one-day population. Our triangulation demonstrates that 56–62% of the Norwegian prison population had an indication of drug use before imprisonment. Conclusions The NorMA cohort was overall representative of the one-day prison population holding a Norwegian PIN and less representative of prisoners without a Norwegian PIN. Using this method provides tangible inputs on the strengths and limitations of a study sample and can be a feasible method to investigate the external validity of survey data.

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Afona Chernet ◽  
Nicole Probst-Hensch ◽  
Véronique Sydow ◽  
Daniel H. Paris ◽  
Niklaus D. Labhardt

Abstract Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).


2016 ◽  
Vol 35 ◽  
pp. 47-54 ◽  
Author(s):  
T Cadman ◽  
J. Findon ◽  
H. Eklund ◽  
H. Hayward ◽  
D. Howley ◽  
...  

AbstractBackgroundADHD in childhood is associated with development of negative psychosocial and behavioural outcomes in adults. Yet, relatively little is known about which childhood and adulthood factors are predictive of these outcomes and could be targets for effective interventions. To date follow-up studies have largely used clinical samples from the United States with children ascertained at baseline using broad criteria for ADHD including all clinical subtypes or the use of DSM III criteria.AimsTo identify child and adult predictors of comorbid and psychosocial comorbid outcomes in ADHD in a UK sample of children with DSM-IV combined type ADHD.MethodOne hundred and eighteen adolescents and young adults diagnosed with DSM-IV combined type ADHD in childhood were followed for an average of 6 years. Comorbid mental health problems, drug and alcohol use and police contact were compared for those with persistent ADHD, sub-threshold ADHD and population norms taken from the Adult Psychiatric Morbidity Study 2007. Predictors included ADHD symptomology and gender.ResultsPersistent ADHD was associated with greater levels of anger, fatigue, sleep problems and anxiety compared to sub-threshold ADHD. Comorbid mental health problems were predicted by current symptoms of hyperactivity-impulsivity, but not by childhood ADHD severity. Both persistent and sub-threshold ADHD was associated with higher levels of drug use and police contact compared to population norms.ConclusionsYoung adults with a childhood diagnosis of ADHD showed increased rates of comorbid mental health problems, which were predicted by current levels of ADHD symptoms. This suggests the importance of the continuing treatment of ADHD throughout the transitional years and into adulthood. Drug use and police contact were more common in ADHD but were not predicted by ADHD severity in this sample.


2018 ◽  
Vol 62 (11) ◽  
pp. 1562-1585 ◽  
Author(s):  
Cindy Brooks Dollar ◽  
Joshua A. Hendrix

Research consistently finds that men use all types of drugs more frequently and extensively than women. However, the misuse of prescription tranquilizers provides an exception. Recent research has found that women are more likely to misuse tranquilizers than men, yet few efforts have been made to systematically understand why this is the case and whether there are gendered factors that might help explain their misuse. Building on general strain theory and other scholarship concerning the links between psychological strain, mental–emotional health, and illicit drug use, we employed a mixed-methods design to investigate the interrelationships between gender, mental health, and tranquilizer misuse. Using data from the 2010 National Survey of Drug Use and Health, we examined tranquilizer misuse among women using various social, demographic, and health-related characteristics. Following this, we drew on nine in-depth interviews with adult women aged 21 to 69 years who reported a history of misusing tranquilizers. The quantitative data reveal that the odds of tranquilizer misuse are nearly two times higher for each unit increase on the poor mental health scale. Whereas being married increases the risk of misuse, having young children is associated with a decreased risk. Our analysis of the interview data reveals three main themes, related to tranquilizer access, reasons for misuse, and shame related to misuse. The interviews clearly uncover tranquilizer misuse as an attempt by women to manage competing demands between their work and home lives, and more specifically as a means of promoting success in both devotions. We conclude by arguing that women’s misuse of tranquilizers is a gendered behavior in response to gender-specific strains, which in turn reproduces gendering as an institution as well as in individual lives. The implications of these findings for general strain theory are also discussed.


2019 ◽  
Vol 74 (1) ◽  
pp. 48-56 ◽  
Author(s):  
J Mark Noordzij ◽  
Marielle A Beenackers ◽  
Joost Oude Groeniger ◽  
Frank J Van Lenthe

BackgroundUrban green spaces have been linked to different health benefits, but longitudinal studies on the effect of green spaces on mental health are sparse and evidence often inconclusive. Our objective was to study the effect of changes in green spaces in the residential environment on changes in mental health using data with 10 years of follow-up (2004–2014).MethodsData from 3175 Dutch adults were linked to accessibility and availability measures of green spaces at three time points (2004/2011/2014). Mental health was measured with the Mental Health Inventory-5. Fixed effects analyses were performed to assess the effect of changes in green spaces on mental health.ResultsCross-sectional analysis of baseline data showed significant associations between Euclidean distances to the nearest green space and mental health, with an increase of 100 m correlating with a lower mental health score of approximately 0.5 (95% CI −0.87 to −0.12) on a 0–100 scale. Fixed effects models showed no evidence for associations between changes in green spaces and changes in mental health both for the entire sample as well as for those that did not relocate during follow-up.ConclusionsDespite observed cross-sectional correlations between the accessibility of green space in the residential environment and mental health, no evidence was found for an association between changes in green spaces and changes in mental health. If mental health and green spaces are indeed causally linked, then changes in green spaces in the Eindhoven area between 2004 and 2014 are not enough to produce a significant effect.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12035-e12035
Author(s):  
Giuliano Santos Borges ◽  
Evandro De Azambuja ◽  
Rodrigo Rovere ◽  
Paulo Henrique Colchon ◽  
Marcos Cesar Staak Junior

e12035 Background: Internet-available programme Adjuvant! Online is widely regarded as one of the best tools to estimate prognosis as well as benefit of adjuvant therapy in breast cancer. Methods: It is a retrospective cohort study, with a post hoc analysis with 214 patients of three different Brazilian services in which were measured the year overall and disease free survivals in a follow up of three years, and the same endpoints were estimated on a 10 year basis by the Adjuvant! Online programme. Results: See table. Conclusions: Our study shows interesting trends in breast cancer survival, even though the number of patients accrued may not be enough to have full external validity. We conclude that the OS and DFS rates in our sample compared to the one calculated by the Adjuvant! Online programme display agreement, following the same pattern, considering different periods of follow up (much longer in the internet tool). The only group which had poor concordance was the group of younger patients (i.e., under 40), even though it was the least represented group in our sample. Nevertheless, it can be suggested that the programme underestimates the usually bad prognosis in these cases, as broadly documented in medical literature. Our study shows interesting trends in breast cancer survival, even though the number of patients accrued may not be enough to have full external validity. [Table: see text]


Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 672
Author(s):  
Özge Azman ◽  
Elvira Mauz ◽  
Matthias Reitzle ◽  
Raimund Geene ◽  
Heike Hölling ◽  
...  

Few studies from Germany have investigated the associations between parenting style and children’s and adolescents’ health. Little attention has been directed to whether these associations vary with familial socioeconomic or migration status. The aim of this analysis was to investigate the association between parenting style and the mental health of children and adolescents aged 11–17 years using data from the KiGGS cohort study (second follow-up). We calculated mean Strengths and Difficulties Questionnaire (SDQ) total difficulties scores stratified by parenting style (authoritative, permissive, demanding–controlling, emotional distancing). Linear regression analyses adjusted for age, gender, socioeconomic status, migration status, and family status were performed. We also analyzed moderating effects of socioeconomic and migrations status on associations between parenting style and SDQ scores. There were only small differences between the permissive and the authoritative parenting styles. Significantly higher mean scores were observed for the demanding–controlling and emotional distancing styles for both the mother and father. These associations persisted after full adjustment and did not vary by socioeconomic or migration status. Parenting behavior is an important predictor of children’s and adolescents’ mental health. The promotion of good relationships within families and improving parenting skills offer promising approaches for health promotion in young people.


2020 ◽  
Author(s):  
Harriet Fisher ◽  
Sarah Harding ◽  
Sarah Bell ◽  
Lauren Copeland ◽  
Rhiannon Evans ◽  
...  

Abstract Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprised a Mental Health First Aid (MHFA) training package to at least 16 percent of staff, a short mental health awareness session to all teachers, and development of a staff peer-support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings regarding the extent of uptake and fidelity of the intervention, drawn from a wider process evaluation reported elsewhere. Methods: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. Results: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the two-day standard MHFA training course, and a further 146 (11.1%) staff completed the one-day MHFA for Schools and Colleges training. In seven (58.3%) schools the required eight percent of staff completed the MHFA training packages. A one-hour mental health awareness raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer-support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study at the outset. Teachers reported limited use of the peer support service during follow-up. At the one year follow up, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership. Conclusion: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031151 ◽  
Author(s):  
Karin A Wasmann ◽  
Pieta Wijsman ◽  
Susan van Dieren ◽  
Willem Bemelman ◽  
Christianne Buskens

ObjectiveRandomised controlled trials (RCT) are the gold standard to provide unbiased data. However, when patients have a treatment preference, randomisation may influence participation and outcomes (eg, external and internal validity). The aim of this study was to assess the influence of patients’ preference in RCTs by analysing partially randomised patient preference trials (RPPT); an RCT and preference cohort combined.DesignSystematic review and meta-analyses.Data sourcesMEDLINE, Embase, PsycINFO and the Cochrane Library.Eligibility criteria for selecting studiesRPPTs published between January 2005 and October 2018 reporting on allocation of patients to randomised and preference cohorts were included.Data extraction and synthesisTwo independent reviewers extracted data. The main outcomes were the difference in external validity (participation and baseline characteristics) and internal validity (lost to follow-up, crossover and the primary outcome) between the randomised and the preference cohort within each RPPT, compared in a meta-regression using a Wald test. Risk of bias was not assessed, as no quality assessment for RPPTs has yet been developed.ResultsIn total, 117 of 3734 identified articles met screening criteria and 44 were eligible (24 873 patients). The participation rate in RPPTs was >95% in 14 trials (range: 48%–100%) and the randomisation refusal rate was >50% in 26 trials (range: 19%–99%). Higher education, female, older age, race and prior experience with one treatment arm were characteristics of patients declining randomisation. The lost to follow-up and cross-over rate were significantly higher in the randomised cohort compared with the preference cohort. Following the meta-analysis, the reported primary outcomes were comparable between both cohorts of the RPPTs, mean difference 0.093 (95% CI −0.178 to 0.364, p=0.502).ConclusionsPatients’ preference led to a substantial proportion of a specific patient group refusing randomisation, while it did not influence the primary outcome within an RPPT. Therefore, RPPTs could increase external validity without compromising the internal validity compared with RCTs.PROSPERO registration numberCRD42019094438.


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