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<p>We evaluated the comparability of influenza-related events self-reported by research participants and their outpatient medical records using data collected from the Hutterite Influenza Prevention Trial. We also explored the implications of using data on influenza symptoms from both data sources, independently and in combination, as predictors of laboratory-confirmed influenza. Self-report of influenza symptoms, physician-diagnosed otitis media and antibiotics prescribed at outpatient consultations was collected from trial participants. Similar data were also collected by fax requests for medical record information to the medical facilities. We found lower rates of self-reported prevalence for fever, sore throat, earache and otitis media and higher rates of antibiotic prescriptions compared to the medical records. Total agreements between self-report and medical report of symptoms varied between 61% and 88%. Negative agreement was considerably higher than positive agreement for each symptom, except cough. Self report of otitis media was a very specific measure (93%), but had lower sensitivity (47%). Positive predictive value was moderate at 64% but negative predictive value was good at 86%. Self-reported antibiotic prescription was a highly sensitive measure (98%), but had low specificity (50%). Positive predictive value was high at 91% but negative predictive value was modest at 65%. Fever (on its own) and combined with cough and/or sore throat were highly correlated with laboratory-confirmed influenza for all data sources. The ILI surveillance definition of fever and sore throat, based on combined symptoms by both medical records and self report, was the best predictor laboratory confirmed influenza.</p> / Doctor of Philosophy (PhD)

Physical activity improves health while combating the obesity epidemic. However, quantifying physical activity through self-report questionnaires or objective measures can provide varying results. The purposes of these studies were to determine if time, body mass index, or treatment assignment could affect the validity of physical activity measurements. The data were part of a larger physical activity promotion study conducted at the Miriam Hospital/Brown Medical School in Providence, Rhode Island and in communities in Southeastern Massachusetts from 2002 to 2005. In this trial, 280 women, with a mean age of 47.1 years, were randomly assigned to one of three intervention groups: Choose to Move (n=93), Jumpstart (n=95) and Wellness (n=92). A randomly selected sub sample of participants simultaneously wore an ActiGraph accelerometer and completed a 3-Day Physical Activity Recall questionnaire at baseline, 3 months and 12 months. Body mass index and treatment assignment were also used in-group comparisons. The results indicated that all components of time, BMI and treatment assignment influenced the accuracy of self-reported measurements when compared to objective accelerometer data. Additional research is essential to uncover the independent aspects considered influential to these physical activity measurements to enhance study design and participant outcomes in future trials. / Kinesiology

Excessive alcohol consumption is a widespread concern among many college campuses. Most of the data on the prevalence and adverse consequences associated with college drinking are gathered from self-report surveys, which require respondents to have a knowledge of standard drink sizes. Unfortunately, the reliability and validity of these data are questionable because college students are typically unable to define or pour standard drinks. Efforts to improve college students’ self-reported alcohol consumption are warranted. Some researchers suggest that we can improve self-reports of alcohol consumption by providing college students with feedback on the accuracy of their standard drink free-pours (White et al., 2005). However, the evidence supporting the use of feedback to improve the validity of self-report is limited by aggregate data, lack of repeated measures, evaluation of only one type of beer, and no evaluation of the effects of feedback on observable behavior (e.g., free-pour). The current study replicated White et al. (2005) using a single-case design and repeated measures to examine the effects of feedback on college students’ self-report as well as their free-pours. Results showed feedback improved the accuracy of college students’ free-pours of standard servings of beer containing 5% alcohol by volume (ABV); however, this skill did not generalize to pouring standard servings of a higher ABV (8%) beer. Unlike White et al. (2005), the feedback had little effect on college students’ self-reported alcohol consumption. Future researchers should use a similar single-case design to evaluate if feedback on various types of alcohol (such as beer, wine, and liquor) systematically affects college students’ self-reports. If so, this feedback could potentially be used as a method to improve the reliability or validity of college students’ self-reported alcohol consumption, and potentially lead to more accurate evaluations of alcohol reduction interventions.

Stereotype threat is the threat of confirming a negative stereotype about a group with which a person identifies. Researchers have found that stereotype threat can result in underperformance in multiple domains, shifts in social behavior, and shifts in assessed implicit attitudes, the likelihood of which increases as an individual's concern about the domain of interest increases. According to theory, this threat can be "alleviated",thereby diminishing or eliminating its impact. In this project, over the course of two experiments, the impact of stereotype threat and stereotype threat-alleviation on explicit self-report measures are examined. In experiment one, white college student participants were exposed (or not) to an on-line task intended to elicit race-based stereotype threat. Differences in reporting style (i.e., bias) between the two groups on self-reported measures of race-related attitudes were examined. It was hypothesized that the group exposed to stereotype threat would endorse lower racism and lower stereotypicality (i.e., stereotypic "White" behaviors, attitudes, adjectives, and beliefs). The data provided only partial support for the hypothesis - the threat group reported significantly less stereotypicality than the non threat group. However, the groups were not statistically different on measures of racism or race and social policy. In experiment two, again examining white college students who participated on-line, a stereotype threat-alleviation task was added, and whether this diminished or removed bias was examined. It was hypothesized the threat group would endorse lower stereotypicality and racism than the non threat group and the group receiving the threat alleviation task. The findings from study one did not replicate in study two. Instead, contrary to predictions, across measures of racism and stereotypicality, it was the non threat group that consistently showed the lowest scores. Potential explanations for these findings are offered, including the possibility of having eliciting stereotype threat, cognitive dissonance, or both for the threat and non threat groups via their filler task. Finally, implications for assessing, broaching, and reducing stereotype threat in clinical and research applications are also discussed. / Ph. D.

This research was designed to explore autobiographical memory in children, specifically, the personal events involved in memory and memory failures and to what extent children and adults realize what they have forgotten. Since previous research in this domain has focused mainly on adult's or children's ability to recall past events, few have ventured to investigate what underlies the process of forgetting for everyday events in parents and children, and if a link exists between the two. Survey data pertaining to self-reported memory failures along with information on the amount of interaction between parents and children was collected from parents and children at a local elementary school. The results showed that children and parents were more likely to report failure in prospective memory (forgetting to do something) than retrospective memory (forgetting something they already knew). Additionally, when asked what they thought had caused the failure, children were more likely to attribute the lapse to external distractions. Finally, the data showed that the degree of parent-child interaction was significantly related to the detail provided in a child's reported memory failures. The results are discussed in the context of developing a better understanding of, and suggest future avenues for, research in memory and memory failures in children, as well as understanding the relation between parent/child memory.

No / Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. STUDY OBJECTIVES: This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? METHOD: 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. RESULTS: 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. DISCUSSION: Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.