Papers by Catherine Zimmer
Science of The Total Environment
Translational behavioral medicine, Jan 17, 2018
The WHO recommends antiretroviral therapy (ART) initiation immediately after HIV diagnosis. When ... more The WHO recommends antiretroviral therapy (ART) initiation immediately after HIV diagnosis. When HIV services are fragmented and poorly coordinated, initiation of ART can be delayed. MEASURE Evaluation conducted an organizational network intervention in Addis Ababa, Ethiopia, which increased referral network density and client satisfaction in the intervention versus control networks. The objective of our study was to extend the parent study by assessing effects of network density on the speed of ART initiation and adherence to ART. Measures of client-time since HIV diagnosis, use of ART, satisfaction with HIV-related services, and adherence were obtained from cross-sectional interviews with female service recipients with HIV/AIDS at baseline (T1, 402) and at 18-month follow-up (T2, 524) and compared between network sites. We used weighted least squares estimation with probit regression techniques in a structural equation modeling framework for analyses. On average at follow-up, clie...
Journal of Health Communication, Feb 14, 2012
Arthritis researchers have thoroughly documented a powerful relationship between years of educati... more Arthritis researchers have thoroughly documented a powerful relationship between years of education and health outcomes, but they have not documented the role of literacy. The authors examined the associations between literacy and arthritis health status measures. Participants were recruited from southeastern urban and rural areas. Rapid Estimate of Adult Literacy in Medicine, which provides an estimate of reading level in less than 3 minutes, was administered to 447 participants at baseline in 2 community-based randomized controlled trials of lifestyle interventions designed for aging sedentary adults with arthritis. Those who read below ninth grade were considered to have low literacy. Among the 447 study participants, the median sample age was 69 years. A majority of the participants were women (86%), Caucasian (80%), overweight or obese (72%). Of all participants, 20% had low literacy. Significantly more African Americans (54%) than Caucasians (12%) had low literacy levels (p < .001). Individuals with low literacy did not have significantly worse disability or arthritis symptoms than individuals with adequate literacy (all ps > .05). Among our study participants, 1 in 5 had low literacy, but literacy was not associated with health status in this population.
ABSTRACT Background/Question/Methods Developmental tempo axes (i.e., large-small body size contin... more ABSTRACT Background/Question/Methods Developmental tempo axes (i.e., large-small body size continuum, slow-fast paced continuum, life-style continuum, slow-quick return leaf economics spectrum) are theoretical constructs used to represent underlying biological processes that cause organism’s traits to covary (e.g., organism’s with larger body sizes have lower metabolic rates). Because developmental tempo axes determine how organisms influence and respond to the environment, they are increasingly used to identify hosts that contribute disproportionately more to pathogen transmission (i.e., highly competent hosts). Despite a formal theoretical language on developmental tempo axes, researchers have used a variety of conventional statistical methods to quantify them, namely univariate models, principal component analyses, and exploratory factor analysis. Here, we used structural equation modeling methods to investigate the relative ability of these conventional statistical methods to 1) map formal theoretical language on developmental tempo axes and 2) to measure these latent biological processes. We first developed a meta-model to map formal theoretical language. We used our meta-model to derive a causal model specific to mammalian life history traits (e.g., adult body size, litter size, gestation length, neonate body size). We then compared our causal model’s structure and statistical results to conventional methods’ causal structures and statistical results. Results/Conclusions The meta-model highlighted that current theory hypothesizes the existence of two independent processes that influence functional traits. The primary developmental tempo process is associated with somatic effort (i.e., the large-small body size continuum; the slow-quick return leaf economics spectrum). For example, building a larger body requires a longer lifespan. The secondary developmental tempo process influences traits via constraints that operate independent of body size (i.e., the slow-fast paced continuum; the life-style continuum). For example, independent of body size, allocating resources towards reducing mortality can reduce reproductive output. Disease ecologists have largely ignored the secondary process or have conflated the primary process with the secondary process. Comparison of our causal model’s structure to causal structures assumed by conventional statistical methods revealed that the later mis-specify the causal relationships assumed by theory and, therefore, potentially incorrectly estimate developmental tempo axes. These results suggest that conventional methods may produce statistical results that jeopardize disease ecologist’s ability to predict the identity of highly competent hosts.
ABSTRACT The objective of this cross-sectional study was to examine the relationship between raci... more ABSTRACT The objective of this cross-sectional study was to examine the relationship between racial residential segregation and physical activity among older African American church members living in the Southeastern, United States. Using the concept of therapeutic landscapes, quantitative and qualitative methods were conducted with participants from a cancer screening and physical activity intervention. Counts of parks and recreational facilities within a 1-mile buffer of participants were measured and hypothesized to be a potential mediator between racial residential segregation and physical activity. Using multilevel regression models, analyses were conducted on 472 participants from 3 urban counties in NC. A 10% increase in the proportion of African Americans residing in a neighborhood was associated with approximately 8 more minutes of physical activity. Participants living in neighborhoods with a greater proportion of African American residents were 81% less likely to meet physical activity recommendations. To understand the perception of the neighborhood environment on physical activity, 12 participants residing in predominantly African American neighborhoods were interviewed. Themes that emerged related to participants' physical activity and their neighborhood, included feelings of safety, physical appearance of neighborhood, knowing your neighbors, and neighborhood opportunities for physical activity. The Southeastern, US has a historical and social context, which may operate differently to impact physical activity among older African Americans, as compared to other regions of the U.S. Examining this relationship closer may help to illuminate which aspects of racially segregated neighborhoods create an environment for physical activity and may lead to the design of effective interventions for this population.
Social Forces, Jun 1, 1998
Psychiatric Services, Oct 7, 2014
The authors examined the relationship between violent acts and threats by persons with serious me... more The authors examined the relationship between violent acts and threats by persons with serious mental illness, the size and composition of their social networks, and characteristics of the social support they received. A group of 169 respondents with serious mental illness and 59 of their significant others were interviewed using structured and semi-structured protocols to elicit data on demographic characteristics, clinical characteristics, characteristics of respondents' social networks and of the social support they received, and perceptions of threat within the social network. Data on acts and threats of violence by respondents over an 18-month period were collected from self-reports by respondents and significant others and from hospital and court records. Fifty-six respondents either threatened violence or committed a violent act during the study period. Respondents with a diagnosis of schizophrenia were more likely to commit violent acts but were not more likely to threaten violence than were respondents with other diagnoses. Respondents in larger networks, those with networks composed primarily of relatives, and those who lived with unrelated persons were more likely to threaten violence. Financial dependence on family was associated with more violent threats and acts. Respondents who perceived hostility from others were more likely to engage in violent threats and acts, and those with confused thinking were less likely to act or threaten violence. More than half of the targets of violence were respondents' relatives, particularly mothers living with a respondent. Respondents who were violent perceived their significant others as threatening but did not perceive themselves as being threatening in return. The interpersonal and social contexts of respondents and their perceptions of these contexts are important considerations in assessing risk for violence by persons with mental illness. Mothers who live with an adult offspring with schizophrenia may be at increased risk for being a target of violence. Violence by persons with psychiatric disorders may be linked to their perceptions and experience of being threatened by others.
International Journal of Human Resource Management, Feb 18, 2011
Abstract A comparative study of Malaysian and Australian managers used the Carson and Bedeian mul... more Abstract A comparative study of Malaysian and Australian managers used the Carson and Bedeian multidimensional career commitment measure and the individualism-collectivism scale developed by Singelis et al. (1995) in a survey to test the hypothesis that career commitment is likely ...
Issues in mental health nursing, 2015
Research on stress-related health outcomes in African-American women often neglects "network... more Research on stress-related health outcomes in African-American women often neglects "network-stress": stress related to events that occur to family, friends, or loved ones. Data from the African-American Women's Well-Being Study were analyzed to examine self-stress and network-stress for occurrence, perceived stressfulness, and association with symptoms of psychological distress. Women reported a higher number of network-stress events compared with self-stress events. Occurrences of network-stress were perceived as undesirable and bothersome as self-stress. Both types of stress were significantly associated with psychological distress symptoms. Including network-stress may provide a more complete picture of the stress experiences of African-American women.
Longitudinal Research with Latent Variables, 2010
Autoregressive cross-lagged models and latent growth curve models are frequently applied to longi... more Autoregressive cross-lagged models and latent growth curve models are frequently applied to longitudinal or panel data. Though often presented as distinct and sometimes competing methods, the Autoregressive Latent Trajectory (ALT) model (Bollen and Curran, 2004) combines the primary features of each into a single model. This chapter: (1) presents the ALT model, (2) describes the situations when this model is
Psychiatry, 1997
This paper examines links between violent behavior, type and severity of psychopathology, substan... more This paper examines links between violent behavior, type and severity of psychopathology, substance abuse comorbidity, and community mental health treatment, using matched data from two surveys: the National Institute of Mental Health Epidemiologic Catchment Area project and the Triangle Mental Health Survey (a North Carolina study of adults with severe and persistent mental illness). Multivariate logistic regression analysis was used to model the risk of violent acts attributable to three domains of independent variables: sociodemographic characteristics, clinical diagnoses and symptomatology, and mental health services utilization. Findings include: (1) Symptom severity was significantly greater in the clinically-selected sample than in the community survey of respondents with comparable diagnoses who self-reported using mental health services; (2) Violence risk was related to psychoticism/agitation in a curvilinear form; (3) In a multivariable model, violence was significantly as...
Hospital & community psychiatry, 1994
The authors examined the relationship between violent acts and threats by persons with serious me... more The authors examined the relationship between violent acts and threats by persons with serious mental illness, the size and composition of their social networks, and characteristics of the social support they received. A group of 169 respondents with serious mental illness and 59 of their significant others were interviewed using structured and semi-structured protocols to elicit data on demographic characteristics, clinical characteristics, characteristics of respondents' social networks and of the social support they received, and perceptions of threat within the social network. Data on acts and threats of violence by respondents over an 18-month period were collected from self-reports by respondents and significant others and from hospital and court records. Fifty-six respondents either threatened violence or committed a violent act during the study period. Respondents with a diagnosis of schizophrenia were more likely to commit violent acts but were not more likely to threat...
Journal of Psychosocial Oncology, 2015
Purpose: Adaptation is an ongoing, cognitive process with continuous appraisal of the cancer expe... more Purpose: Adaptation is an ongoing, cognitive process with continuous appraisal of the cancer experience by the survivor. This exploratory study tested a path model examining the personal (demographic, disease, and psychosocial) characteristics associated with quality of life (QOL) and whether or not adaptation to living with cancer may mediate these effects. Methods: This study employed path analysis to estimate adaptation to cancer. A cross sectional sample of NHL survivors (N=750) was used to test the model. Eligible participants were >18 years, at least two years post-diagnosis, and living with or without active disease. Results: 68% of the variance was accounted for in QOL. The strongest effect (-0.596) was direct by negative adaptation, approximately three times that of positive adaptation (0.193). The strongest demographic total effects on QOL were age and social support; <65 years of age had better QOL and better adaptation compared to those >65. Of the disease characteristics, comorbidity score had the strongest direct effect on QOL; each additional comorbidity was associated with a 0.309 standard deviation decline on QOL. There were no fully mediated effects through positive adaptation alone. Our exploratory findings support the coexistence of positive and negative adaptations perception as mediators of personal characteristics of the cancer experience. Negative adaptation can affect QOL in a positive way. Cancer survivorship is simultaneously shaped by both positive and negative adaptation with future research and implications for practice aimed at improving QOL.
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Papers by Catherine Zimmer