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This study tested the effects of two theory-based interventions to increase fruit and vegetable intake. Hypothesized intervention mediators included self-efficacy (SE), social support (SS), autonomous motivation (AM), and controlled motivation (CM). At baseline, 1,021 African American adults were recruited from 16 churches randomized to one comparison and two intervention groups: Group 1 (standard educational materials), Group 2 (culturally targeted materials), and Group 3 (culturally targeted materials and telephone-based motivational interviewing). A well-fitted model based on structural equation modeling--chi[superscript 2](df = 541, N = 353, 325) = 864.28, p less than 0.001, normed fit index = 0.96, nonnormed fit index = 0.98, comparative fit index = 0.98, root mean square error of approximation = 0.042--demonstrated that AM was both a significant mediator and moderator. In the subgroup with low baseline AM, AM mediated 17% of the effect of the Group 3 intervention on fruit and vegetable intake. Conversely, SS, SE, and CM were not significant mediators. Implications related to theory and intervention development are discussed. (Contains 2 tables and 2 figures.)

When identification of causal effects relies on untestable assumptions regarding nonidentified parameters, sensitivity of causal effect estimates is often questioned. For proper interpretation of causal effect estimates in this situation, deriving bounds on causal parameters or exploring the sensitivity of estimates to scientifically plausible alternative assumptions can be critical. In this article, the authors propose a practical way of bounding and sensitivity analysis, where multiple identifying assumptions are combined to construct tighter common bounds. In particular, the authors focus on the use of competing identifying assumptions that impose different restrictions on the same nonidentified parameter. Since these assumptions are connected through the same parameter, direct translation across them is possible. Based on this cross-translatability, various information in the data, carried by alternative assumptions, can be effectively combined to construct tighter bounds on causal effects. Flexibility of the suggested approach is demonstrated focusing on the estimation of the complier average causal effect (CACE) in a randomized job search intervention trial that suffers from noncompliance and subsequent missing outcomes. (Contains 3 tables and 4 figures.)

This randomized experimental study (N = 1,034) examines both the direct and the indirect effects of the Towards Working Life intervention on 2 components of adolescents' career preparation: preparedness for career choice and attitude toward career planning. The intervention comprised a 1-week workshop program, the proximal goals of which were to enhance 9th graders' career choice preparedness and attitude toward career planning. Participants were assessed at baseline and immediately after the intervention. The results showed that the intervention had directly improved the students' career choice preparedness, which in turn increased positive attitude toward career planning. Implications for both theory and practice are discussed. (Contains 2 tables and 2 figures.)

This study examines the mediating role of employment preparedness in improving employment, mental health, and construction of work-life goals among young vocational school graduates who participated in the School-to-Work effectiveness trial. The trial included a 1-week intervention program that focused on enhancing employment preparedness. In this trial, 416 graduates of secondary vocational institutes were randomized into a control and experimental group. All the study participants were assessed at baseline, immediately after the intervention, and 10 months later. The results showed that the School-to-Work intervention increased employment preparedness, which in turn increased employment at the 10-month follow-up. Furthermore, employment predicted work-life-related personal goals and lower financial strain, which in turn was associated with lower depressive symptoms. The implications for theory and practice are discussed.

This inquiry explores variables that predict elementary school students' fear of attending school due to school violence and their overall judgments of school violence as a problem. Using a nationally representative sample (Israel) of 5,472 elementary-school-aged children, this study tested the hypotheses that: (a) young students' personal fear of attending school due to violence, and (b) students' assessment of a school violence problem, are best understood as separate conceptual constructs. Structural equation modelling was used to test the proposed theoretical model for the sample as a whole and separately for across gender and for Arab and Jewish students. Student "fear" of attending school due to violence was related directly to experiences of personal victimization on school grounds by students and teachers. Children's judgments of their schools' overall "violence problem" were influenced directly by the school climate, risky peer-group behaviours, and personal victimization. The findings provide evidence that the proposed theoretical model applies across gender groups and for both Arab and Jewish students. Implications for policy, theory, and future research are highlighted.

A sample of 490 high school students from 81 schools in Michigan participated in an experiment in which they were randomly assigned to either a control or an experimental Web site. The experimental Web site provided exposure to educational material about the process of organ donation and organ transplantation. The control Web site provided educational material on methods to avoid the common cold. The pre- and post-tests of knowledge of issues related to organ donation and of attitude toward donation demonstrated statistically significant increases for the experimental group compared with the control group. A structural equation path model suggested that these increases in knowledge and pro-donation attitude mediated the effects of the experiment on contacting the Michigan donor registry. The increase in knowledge and in prodonation attitude increased the likelihood of contacting the registry. The potential for this and similar other Web interventions to enhance students' health education is discussed. (Contains 1 table and 3 figures.)

Examines an exploratory model of how variables in school settings affect school victimization and the consequences of victimization for junior high school students. The model presents ways in which school context and victimization affect students' fear of attending school and their assessment of school violence. Discusses gender and cultural differences, implications for social work practice, and recommendations for future research. (Contains 64 references, 4 figures, and 2 tables.) (GCP)

Vigor is a positive affect experienced at work. It refers to feelings of possessing physical strength, emotional energy, and cognitive liveliness. Accumulated evidence suggests that vigor has a protective effect on health, but the mechanisms of this link remain to be discovered. This study focused on sleep quality as one possible mechanism. We used a full-panel, longitudinal design to investigate the hypothesis that changes in vigor over time have inverse effects on insomnia and vice versa. The study was conducted on a multi-occupational sample of working adults (N = 1,414, 70 % men) at three time points (T1, T2, and T3), over a period of about 3 years. Vigor was assessed by the Shirom-Melamed Vigor Measure, while insomnia was assessed by the Brief Athens Insomnia Scale. Results of SEM-analyses, controlling for neuroticism, and other potential confounding variables, offered a strong support for the study hypotheses, indicating cross-lagged reciprocal inverse relationships between vigor and insomnia. The results suggest that vigor has a protective effect on sleep quality and that vigor might positively influence health through this pathway. Keywords Vigor * Insomnia * Longitudinal study * Positive affect * Sleep * Self-regulation, Introduction Current theory and accumulated evidence support the association of positive affects with improved states of physical health. From a theoretical viewpoint, the broaden-and-build model of positive emotions, frequently used [...]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1559-1816.2008.00369.x Byline: Arie Shirom (a2), Amiram Vinokur (b), Richard Price (b) Abstract: We investigated the additive and interactive effects of self-efficacy as a possible moderator of the effects of a job-search workshop on re-employment outcomes. We recruited 659 recently unemployed respondents and randomly assigned them to an experimental group invited to participate in the job-search workshop (n = 442), or a control group (n = 217). All respondents provided pretest data using self-administered questionnaires, and posttest data using questionnaires mailed to them 1 and 6 months after the workshop. No direct effects of the intervention on re-employment outcomes were found. The pretest-posttest change in self-efficacy interacted with the experimental condition to predict 3 re-employment outcomes. However, only 1 of the 3 moderating effects found supported our prior expectation in this regard. Author Affiliation: (a)Faculty of ManagementTel Aviv University (b)Michigan Prevention Research Center, Institute for Social ResearchUniversity of Michigan-Ann Arbor Article note: (2) Arie Shirom, Faculty of Management, Tel Aviv University, P.O. Box 39010, Tel Aviv 69978, Israel. E-mail: ashirom@post.tau.ac.il

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8519.2008.00642.x Byline: CHARLES KOWALSKI (1), STEVEN PENNELL (1), AMIRAM VINOKUR (1) Keywords: measurement; quality of life; clinical trials; outcome variables; ethics Abstract: ABSTRACT Following Bernheim, .sup.1 we examine aspects of 'felicitometrics,' .sup.2 the measurement of the 'quality' term in Quality of Life (QOL). Bernheim argued that overall QOL is best captured as the Gestalt .sup.3 of a global self-assessment and suggested that the Anamnestic Comparative Self Assessment (ACSA) approach, in which subjects' memories of the best and worst times of their lives are used to anchor a Visual Analog Scale (VAS), provided a serious answer to the serious question, 'How have you been?' Bernheim compares and contrasts the ACSA to multi-item questionnaire QOL instruments, such as the SF-36, concluding that the ACSA has a number of advantages. His discussion assumes that the use of QOL outcomes in clinical trials is both relevant and appropriate. In the present paper, we document the reasonableness of this latter assumption, .sup.4 contribute to the characterization of the similarities and differences between multi-item and individualized QOL instruments, and point to some other individualized instruments that may be used in clinical trial contexts. These 'other individualized instruments' differ from the ACSA in fundamental ways; but they are individualized in that the subject defines those areas in his/her life that are most important, and these may vary from subject-to-subject. Author Affiliation: (1)University of Michigan Article note: Charles Kowalski, University of Michigan - Dental School Ann Arbor MI 48109, United States. T: 734.763.3394, Email: chuckk@umich.edu

Chronic dialysis imposes ongoing stress on patients and staff and engenders recurring contact and long-term relationships. Thus, chronic dialysis units are opportune settings in which to investigate the impact of patients' relationships with staff on patient well-being. The authors designed the present study to examine the degree to which perceptions of open communication between patients and staff affect patient mental health. A one-year, two-wave longitudinal survey assessed patient (N = 109) perceptions of the interpersonal environment and mental health. Assessments included sharing personal reformation (open disclosure), assisting one another (helping), staff respect for patients (respect), and hierarchical patient--staff relations (formal staff authority). Cross-sectional and longitudinal regression analyses examined how these characteristics of the interpersonal environment relate to depression and subjective well-being among patients. Multivariate analysis showed that open disclosure correlated independently with lower levels of depression at baseline (N = 109) and a predicted significant decrease in depression over time (N = 64). Other interpersonal characteristics did not correlate with depression or subjective well-being at baseline or longitudinally. The interpersonal climate in chronic dialysis units influences patient well-being. Contrary to traditional views, open disclosure in patients' relationships with staff is not detrimental and contributes to well-being. KEY WORDS: chronic dialysis; depression; interpersonal relationships; mental health; professional boundaries, In the United States, nearly 450,000 individuals now undergo chronic dialysis, with more than 50,000 new patients appearing each year (United States Renal Data Service [USRDS], 2005). Complications are common, [...]

This study examined mechanisms of strain crossover within couples and the moderating role of gender. Data were collected at a time of military downsizing from a sample of 1,250 Russian army officers and their spouses. The authors tested a model that incorporated 3 mechanisms for the crossover of marital dissatisfaction among dual-earner couples. The model provided support for 2 suggested crossover mechanisms: direct reactions of crossover and indirect mediated effects through social undermining. Strong evidence was also provided for gender asymmetry in the crossover process. Marital dissatisfaction crossed over from husbands to wives but not vice versa, and social undermining behavior played a role in the process of crossover of marital dissatisfaction for husbands but not for wives.

Military personnel deployed to the Middle East included an unprecedented number of women, many of whom were mothers. Using a structural equation modeling approach, we examined the predictors of children's adjustment problems in data collected from a representative sample of 263 Air Force mothers 2 years after the Gulf War. Using a retrospective survey, we found that the main predictors of children's adjustment problems at the time of the war were mothers' difficulties in providing for the care of the children, mothers' deployment in the theater of the war (vs. deployment elsewhere), and degree of change in children's lives. Most important, war-related adjustment problems were not related to children's adjustment 2 years later, suggesting that the effects of maternal separation during the war were transient.

Using structural equation modeling analyses we examined the correlation in levels of depression symptoms within couples to determine whether the underlying mechanism is due to common stressors, empathic reactions, or crossover via social interaction. The analyses were based on two waves of data collection from a sample of 354 male Vietnam veterans, Era veterans (veterans who served elsewhere during the period of the Vietnam War), and nonveterans and from their wives or committed partners. The results demonstrated that the correlation in depression symptoms within couples is due primarily to common stressors and crossover via negative social interaction. Common stressful life events increase depression in both spouses, and this in turn increases social undermining, which further increases depression. KEY WORDS: crossover; stress transmission; stress; job loss; unemployment

Earlier analyses of the JOBS II intervention for unemployed job seekers demonstrated that the intervention facilitated reemployment, reduced depressive symptoms, and improved role and emotional functioning (A.D. Vinokur, R. H. Price, & Y. Schul, 1995). The present study focuses on mediational processes of the active ingredients targeted by the intervention. Structural equation modeling analysis demonstrated that an enhanced sense of mastery had mediating effects on reemployment, financial strain, and reduction in depressive symptoms. Another active ingredient, inoculation against setbacks, was shown to protect those who suffered the setback of losing a job after temporarily regaining one. The inoculation protected them from experiencing the high level of depressive symptoms that was typical of their counterparts in the control group.

The process linking unemployment and economic hardship to depression and marital or relationship satisfaction in couples was examined. Using structural equation modeling, the authors tested models in which financial strain and partners' symptoms of depression influence the behavioral exchange of the couples in terms of social support and social undermining and, in turn, the effects of support and undermining on relationship satisfaction and depressive symptoms. The analyses were based on longitudinal data from 815 recently unemployed job seekers and their spouses or partners. The results demonstrated that financial strain had significant effects on depressive symptoms of both partners, which in turn led the partner to withdraw social support and increase social undermining. Reduced supportive and increased undermining behaviors had additional adverse effects on satisfaction with the relationship and on depressive symptoms.

When life crises occur, significant others are thought to help alleviate distress and resolve practical problems. Yet life crises may overwhelm significant others, eroding their ability to provide effective support. The accuracy of these contrasting accounts of relationship functioning was evaluated in a study of 102 breast cancer patients and their significant others, interviewed at 4 and 10 months after diagnosis. Results largely confirmed the negative account of relationship functioning. Although significant others provided support in response to patients' physical impairment, they withdrew support in response to patients' emotional distress. Moreover, support from significant others did not alleviate patients' distress or promote physical recovery. These results reveal limits to the effectiveness of close relationships in times of severe stress.

Structural equation analyses were used to examine the impact of social support vs. social undermining (conflict) on mental health in longitudinal data from 1,087 recently unemployed respondents. The results demonstrated that social support and social undermining were not the opposite poles of the same factor, each having some impact independent of the other. Social undermining had statistically significant and strong adverse impact at each concurrent level of mental health. It also predicted improvement (but not a high level) in mental health in subsequent time waves. In contrast, social support had a significant beneficial impact on mental health only at Time 1. Compared with the volatile and extreme effects of social undermining, those of social support appear weaker but more stable. These findings are consistent with literature on the impact of life events (S. E. Taylor, 1991) and on marital interactions and satisfaction (J. M. Gottman & L. J. Krokoff, 1989).