Postpartum depression (PPD) refers to the onset of depressive symptoms anytime within first year following the birth of a child. PPD affects approximately 10-20% of new mothers and often goes underdiagnosed and untreated. Left untreated, PPD can predispose women to more severe and frequent future depressive episodes. Literature suggests depression in mothers may have long-term negative effects on infants’ and children’s psychosocial development. The American Academy of Pediatrics (AAP) has identified pediatric primary care as the ideal location to screen and refer mothers possibly suffering from depression. Routinely assessing PPD in mothers during well-child checks is not only recommended, it is increasingly being considered a best practice standard. The AAP calls for further research to improve the feasibility of assessing and treating PPD in mothers in pediatric primary care. This paper is part of a larger study that will be evaluating the effectiveness of screening new mothers for PPD in pediatric primary care settings and providing a brief same day interventions. The current aims of this portion of the study will be to evaluate 1) referral results, and 2) mothers’ level of satisfaction with the protocol. Research assistants (RA) will approach mothers of infants, birth to 6 months of age in the waiting rooms of ETSU Pediatrics in Johnson City, TN. Mothers will be given a brief description of PPD, the study and will be asked to participate by signing a voluntary informed consent document. As part of the visit, nurses will distribute and score the Edinburg Postpartum Depression Scale (EPDS). Mothers scoring 9 or above will receive a brief educational brochure about PPD, a brief intervention and a one week follow-up phone call with an onsite behavioral health consultant (BCH) or social worker (SW). At mothers’ discretion, an appropriate outside referral to preferred provider will be made, if necessary. Approximately two weeks post- intervention, a satisfaction survey by phone will be administered by RAs. The survey will examine referral results (e.g., of high scores, what recommendations were made, did mothers follow through, treatments received, was there improvement in EPDS score) and the mothers’ level of satisfaction with the protocol (e.g., satisfaction with how protocol was handled by staff and how well mothers felt their needs were addressed). Satisfaction will be noted on a likert-scale ranging from 0 (no satisfaction) to 10 (very satisfied). Data is pending and collection will start during the first week of March showing EDPS uptake, referral results and mother satisfaction. Data is expected for approximately 60-100 new mothers.

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To date, the major emphasis in test and item evaluation has been directed toward statistical post-measures which rely heavily on data gathered from the administration of the instrument. These primarily summative techniques are limited, however, in that they are incapable of providing information about and item/test before it has been sent for field trials. This research presents a new direction in test and item analysis which, using test/item writing heuristics, provides a previously unavailable technology for instrument pre-analysis. The new field of "qualitative item and test pre-analysis" is proposed and described. The implications to the field are discussed in addition to specific suggestions for the use of this new technology. The design and creation of a base-case item and test pre-analysis expert system (ITAX) is also detailed, including the heuristics incorporated, implementation methodologies and limitations. The heuristics incorporated into the system include the detection of: two varieties of grammatical cues, negation/multiple negation, repetition of phrases within an options list, presence of too few options, inconsistent length of distractors, use of all- and none-of-the-above, repetition of significant words from the stem to the options, randomness of multiple choice answer placement, balance of true/false items and length of true/false items. A comprehensive reference to the system is also provided. / Master of Arts

Although formula scoring has been used since the early 1900s, it was not until 1975 that Frederic Lord offered the following potential psychometric justification for its use: If under formula-scoring directions an examinee omits only those items which would result in completely random guesses under number-right scoring directions, then the formula score will be a more efficient estimator of the examinee's standing on the trait measured. Whenever the number of omissions is greater than zero, the formula score will be more reliable than the number-right score. The purpose of this study was to test the premise that examinees omit only those items for which they have no knowledge when taking a test under formula-scoring directions. Several studies had been carried out previously to test this premise, and the design used in this study was a synthesis of the previous designs. Included in this study was an investigation of examinees' responses, under formula-scoring directions, to items that were constructed to be obscure. Also examinees responded to questions about their attitudes towards formula-scored tests and their strategies when taking formula-scored tests. Because of the results of the test of Lord's premise, also included in this study was a further investigation of omissiveness, the tendency to omit items under formula-scoring directions. Item difficulty and item omissions were examined relative to Lord's premise. A variable, called L for convenience, was computed for each item in order to find to what extent responses to test items support Lord's premise. Finally, the possibility of misinformation producing a counter effect to inappropriate omissions relative to Lord's premise was investigated. / Ph. D.

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published_or_final_version / Education / Master / Master of Education

published_or_final_version / Education / Master / Master of Education