•Recent technological advances in media, data, and methods have created a unique opportunity for marketers to better control to whom, when, and how much to discount.•To determine the optimal value ...and timing of the discount we model individual household purchase incidence and brand choice in response to the value and timing of a discount.•To select the customers who receive the discount we formulate a constrained multiple-knapsack model which picks the most valuable customers for a given marketing budget.•We illustrate the model using a Japanese dataset for customized temporal price-cut, a US dataset for customized temporal coupon and another US dataset for customized temporal discounts.
Customized temporal discounts are price cuts or coupons that are tailored by size, timing, and household to maximize profits to a retailer or manufacturer. The authors show how such discounts allow companies to optimize to whom, when, and how much to discount. Such a scheme allows firms to send just enough discounts just prior to the individual's purchase of a rival brand. To do so, the authors model household purchase timing and brand choice in response to discounts and use Bayesian estimation to obtain individual household parameters. They illustrate the model on a Japanese data set having price cuts, a US data set having coupons, and another US data set having discounts. They formulate the optimization task of customized temporal coupons as a constrained multiple-knapsack problem under a given budget. They use simulations of the empirical contexts to obtain optimal solutions and to assess improvement in profits relative to existing practice and alternate models in the literature. The proposed model yields increase in profits of 18–40 percent relative to a standard model that optimizes the value but not timing of discounts.
Context
Among adolescents and young adults (AYAs), cancer and its treatment can disturb body image in distinct ways compared to younger or older individuals.
Objective
Since AYA body image is not ...well understood, this study was designed to develop a conceptual framework for body image in AYAs with cancer.
Methods
Concept elicitation interviews were conducted with 36 AYA patients 10 adolescents (15–17 years), 12 emerging adults (18–25 years), 14 young adults (26–39 years) and health care providers (n = 36). The constant comparative method was used to analyze for themes and properties, with themes considered saturated if they were present and salient across participant sets.
Results
Twenty themes emerged from participant data. Three themes illustrate a shared understanding of patients' experience of body image: (1) physical changes produce shifts in identity and experience of self; (2) precancer body image shapes how the AYA experiences cancer‐related physical changes, and (3) changes to the body are upsetting. Nine themes were unique to patients while eight themes were unique to providers. Patient body image experiences were found to evolve over time, largely affected by concerns about how others view them. Providers appeared attuned to AYA patient body image but recognized that it is not systematically addressed with patients.
Conclusion
More striking than differences between patient groups is the consistency of themes that emerged. The conceptual framework of body image developed from these data offers an important step toward addressing body image concerns for AYA patients.
•Developed the Health Coaching Index to assess fidelity to practical coaching skills.•An interclass correlation among three coders of 0.81 showed excellent agreement.•Correlations with Roter ...Interaction Analysis System variables demonstrated validity.•The HCI may facilitate robust training of health coaches.
This study describes the development of the Health Coaching Index (HCI), an observational tool for assessing fidelity to implementing health coaching practical skills.
Initial HCI items were developed, adapted following cognitive interviews, and refined during coding training. Participants (n = 42) were trainees who completed a National Board for Health and Wellness Coaching (NBHWC)-approved training program and coached a standardized patient. Interrater reliability for the HCI was determined by calculating interclass correlations from ten videos coded by three raters. Construct validity was evaluated from 42 recordings using Spearman’s Rho between HCI and Roter Interaction Analysis System (RIAS) codes.
The interclass correlation (ICC) for HCI total score was 0.81, considered an excellent level of inter-rater agreement. Some significant correlations between HCI and RIAS codes supported construct validity (e.g., patient activation: Rho = 0.32; empathy: Rho = 0.36).
The HCI total score can reliably be used to assess fidelity to health coaching skills, and the HCI has construct validity similar to the RIAS as a measure of patient activation.
Adoption and further study of the HCI tool will allow for a more consistent implementation of health coaching skills, and may facilitate more robust training of health coaches for clinical practice and research.
We recruited 248 farmworker families with preschool-aged children in North Carolina and examined food security indicators over 24 months to identify food security patterns and examine the dynamic of ...change over time.
Participants in the Niños Sanos study, conducted 2011 to 2014, completed quarterly food security assessments. Based on responses to items in the US Household Food Security Survey Module, we identified different states of food security by using hidden Markov model analysis, and examined factors associated with different states. We delineated factors associated with changes in state by using mixed-effect ordinal logistic regression.
About half of the households (51%) consistently stayed in the most food-secure state. The least food-secure state was transient, with only 29% probability of this state for 2 consecutive quarters. Seasonal (vs migrant) work status, having immigration documents (vs not documented), and season predicted higher levels of food security.
Heterogeneity in food security among farmworker households calls for tailoring intervention strategies. The transiency and unpredictability of low food security suggest that access to safety-net programs could reduce low food security risk in this population.
This paper discusses the study of two interacting processes in which a feedback mechanism exists between the processes. The study was motivated by problems such as the circadian oscillation of gene ...expression where two interacting protein transcriptions form both negative and positive feedback loops with long delays to equilibrium. Traditionally, data of this type could be examined using autoregressive analysis. However, in circadian oscillation the order of an autoregressive model cannot be determined a priori. We propose a sparse multivariate autoregressive method that incorporates mixed linear effects into regression analysis, and uses a forward-backward greedy search algorithm to select non-zero entries in the regression coefficients, the number of which is constrained not to exceed a pre-specified number. A small simulation study provides preliminary evidence of the validity of the method. Besides the circadian oscillation example, an additional example of blood pressure variations using data from an intervention study is used to illustrate the method and the interpretation of the results obtained from the sparse matrix method. These applications demonstrate how sparse representation can be used for handling high dimensional variables that feature dynamic, reciprocal relationships.
Farmworker family members risk poor mental health due to stressors including poverty, relocation, and documentation status. This paper explores the relationship between farm-work related stressors ...and depressive symptoms in women of Latino farmworker families. 248 mothers of young children completed fixed-response interviews in Spanish. Measures included the Center for Epidemiologic Studies-Depression Scale, Migrant Farmworker Stress Inventory, and USDA Household Food Security Survey Module. Bivariate analyses indicated greater depressive symptoms with more economic hardship, more farm work-related stressors, greater age, and being unmarried. In multivariable logistic regression, economic hardship remained the only factor associated with depressive symptoms. Greater economic hardship, but not general farm work-related stress, is a main factor associated with depression in women of Latino farmworker families. Maternal depression can have consequences for both mothers and families. Mental health services for women in farmworker families should be targeted to those with the greatest economic challenges.
Peer relationships are especially relevant during adolescence and may contribute to sexuality-based disparities in substance use. This study uses social network analysis to examine how social ...networks may serve as risk or protective factors for sexual minority youth in the context of alcohol use.
Social network analysis was applied to 11th to 12th graders in three diverse high schools in a rural area of the Southeast United States. The network consists of 1,179 students, 607 of whom were participants in the study and nominated friends. Regression models were used to examine how potential predictors of alcohol use may function differently for sexual minority and majority students.
Approximately one fourth of students were classified as sexual minorities, inclusive of students who self-identified or reported any same-sex romantic attraction or sexual experience. These students did not use alcohol in greater amounts than students in the sexual majority. They received fewer incoming friendship nominations (p < .05) although a higher percentage of friendships were reciprocated (p < .05). They exhibited lower eigenvector centrality (p = .01), and their networks were less cohesive (p < .001). However, low centrality and low density did not predict greater alcohol consumption. Sexual minorities appeared to be influenced less strongly by peers' alcohol use, and friendships with sexual minorities further mitigated peer influence.
Sexual minorities occupied less prominent positions within their social networks. However, these network differences did not place sexual minorities at increased risk of alcohol use.
Abstract
Background
Increasing evidence shows that cognition and gait speed are associated and are important measures of health among older adults. However, previous studies have used different ...methods to assess these 2 outcomes and lack sufficient sample size to examine heterogeneity among subgroups. This study examined how the relationship between global cognitive function and gait speed are influenced by age, gender, and race utilizing an integrated data analysis approach.
Method
Data on cognition (Montreal Cognitive Assessment MoCA, Mini-Mental Status Examination MMSE, and Modified Mini-Mental State Examination 3MSE) and gait speed (range: 4–400 m) were acquired and harmonized from 25 research studies (n = 2802) of adults aged 50+ from the Wake Forest Older American Independence Center. Multilevel regression models examined the relationship between predicted values of global cognitive function (MoCA) and gait speed (4-m walk), including heterogeneity by age, race, and gender.
Results
Global cognitive function and gait speed exhibited a consistent positive relationship among whites with increasing age, while this was less consistent for African Americans. That is, there was a low correlation between global cognitive function and gait speed among African Americans aged 50–59, a positive correlation in their 60s and 70s, then a negative correlation thereafter.
Conclusion
Global cognition and gait speed exhibited a curvilinear U-shaped relationship among whites; however, the association becomes inverse in African Americans. More research is needed to understand this racial divergence and could aid in identifying interventions to maintain cognitive and gait abilities across subgroups.
Background
E5103 was a study designed to evaluate the efficacy and safety of bevacizumab. It was a negative trial for the end points of invasive disease–free survival and overall survival. The ...current work examines the tolerability of bevacizumab and other medication exposures with respect to clinical outcomes and patient‐reported outcomes (PROs).
Methods
Adverse events (AEs) collected from the Common Terminology Criteria for Adverse Events were summarized to form an AE profile at each treatment cycle. All‐grade and high‐grade events were separately analyzed. The change in the AE profile over the treatment cycle was delineated as distinct AE trajectory clusters. AE‐related and any‐reason early treatment discontinuations were treated as clinical outcome measures. PROs were measured with the Functional Assessment of Cancer Therapy–Breast + Lymphedema. The relationships between the AE trajectory and early treatment discontinuation as well as PROs were analyzed.
Results
More than half of all AEs (57.5%) were low‐grade. A cluster of patients with broad and mixed AE (all‐grade) trajectory grades was significantly associated with any‐reason early treatment discontinuation (odds ratio OR, 2.87; P = .01) as well as AE‐related discontinuation (OR, 4.14; P = .001). This cluster had the highest count of all‐grade AEs per cycle in comparison with other clusters. Another cluster of patients with primary neuropathic AEs in their trajectories had poorer physical well‐being in comparison with a trajectory of no or few AEs (P < .01). A high‐grade AE trajectory did not predict discontinuations.
Conclusions
A sustained and cumulative burden of across‐the‐board toxicities, which were not necessarily all recognized as high‐grade AEs, contributed to early treatment discontinuation. Patients with neuropathic all‐grade AEs may require additional attention for preventing deterioration in their physical well‐being.
In this secondary data analysis study of patients with breast cancer treated with bevacizumab and chemotherapy, cumulative multiple toxicities, even of low grades, are associated with early treatment discontinuation. Peripheral neuropathy is related to poor self‐reported physical well‐being, and this suggests additional care for patients exhibiting such toxicity.
The testlet response model is designed for handling items that are clustered, such as those embedded within the same reading passage. Although the testlet is a powerful tool for handling item ...clusters in educational and psychological testing, the interpretations of its item parameters, the conditional correlation between item pairs, and the testlet information function are not always clear. For example, the a-parameter in a testlet response model, which is sometimes referred to as the discrimination parameter and interpreted in the conventional way, is often directly compared to the a-parameter in standard item response models. In this article, it is argued that despite the deceptively similar forms of the a-parameters, such interpretation and comparison can be misleading. A marginalized version of the testlet model is introduced to derive quantities that are comparable to standard item response models. This mean (marginalization) of the function approach is contrasted with the temptingly simple but inappropriate function of the mean approach, in which the testlet effect is set to its mean of zero in respective equations for item response, correlation, and information functions. Testlet data collected from a science assessment within the National Assessment of Educational Progress are used to illustrate the subtle differences in the interpretations of the various response models.
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