The need for financial education among Americans is often demonstrated with alarming rates of bankruptcy, high consumer debt levels, low savings rates, and other negative outcomes that may be the result of poor family financial management and low financial literacy levels. The collective response by public and private organizations to the accepted and often demonstrated need for financial education has been impressive in size and scope. This article provides an overview of the wide range of programs aimed at improving Americans’ financial literacy as well as a short review of the current evidence of the effectiveness of financial education programs. We advocate for the adoption of a comprehensive framework or approach to evaluation to assist those currently delivering, and planning to deliver, financial education and highlight some of the key challenges. A five‐tiered approach to program evaluation is described and outlined to provide a general framework to guide financial education evaluation.

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Communication is the critical process of diffusion of technological innovations, yet there is little research in the consumer behavior literature investigating how communication affects consumers' decision to adopt technological innovations. This paper examines the effects of communication source and modality on consumers' adoption of technological innovations using the 1999 University of Michigan's Survey of Consumers data. Specifically, a typology of communication sources and modality is presented, and the respective and interrelated influences of source and mode on consumers' adoption of electronic banking are examined. The results demonstrate that communication factors can serve as significant predictors of consumer adoption of technological innovations and that consumer preferences for communication source and modality vary for different segments of adopters. In addition, we find information gaps between consumer segments high and low in socioeconomic status. Finally, implications for the diffusion of technological innovations and future research directions are discussed. 1 vigorously communicating useful information, these consumers are not always able to recognize the full advantages of these technological innovations (Campbell 1999;Nuttall 1998). As Allen (1971) rightly put it, technology is also "consumer information" (p. 2), the flow of which must be planned and managed through appropriate communication processes in order to facilitate the adoption by potential customers.Rogers' Diffusion of Innovations Theory (1995) provides some conceptual guidance for understanding the adoption of products and services, and how technological innovation is proliferated across the consuming public (Gatignon and Robertson 1985). To date, the bulk of the diffusion studies in the consumer behavior literature have tilted heavily toward either individual predisposition (Hirschman 1980;Midgley and Dowling 1978) or innovation characteristics (Rogers 1995), as precursors of innovation adoption. It is important to note that communication is also a critical process factor for the diffusion of innovation (Mahajan, Muller, and Bass 1990). Yet, to date, consumer researchers have largely neglected the empirical study of communication in the diffusion process. Only a handful of studies have considered the notion that various types of communication can influence consumers' adoption of innovation (Mahajan, Muller, and Bass 1990;Mahajan, Muller, and Srivastava 1990).This paper considers the diffusion of technological innovation as it travels through multiple communication sources employing various communication modes. In this study, "sources" including mass media (i.e., one-way communication from corporations or government to consumers) and word of mouth (i.e., communications with family and friends), are coupled with one or both conversation and/or print "modes." While previous studies have not differentiated the effects of written and conversational communication, this study explicitly recognizes and investigates the differential impa...

To investigate the association between visit-to-visit variability in blood pressure and the incidence of dementia and its subtypes in a general population, we conducted a population-based retrospective cohort study using the Korean National Health Insurance System database. We identified 7 844 814 subjects without a history of any dementia who underwent ≥3 health examinations from 2005 to 2012 in the Korean National Health Insurance System cohort. Blood pressure variability (BPV) was measured using the variability independent of the mean, coefficient of variation, and SD. During the median follow-up of 6.2 years, there were 200 574 cases of all-cause dementia (2.8%), 165 112 cases of Alzheimer’s disease (2.1%), and 27 443 cases of vascular dementia (0.3%). There was a linear association between higher BPV and outcome measures. In the multivariable adjusted model, the hazard ratios and 95% CIs of all-cause dementia were 1.06 (1.04–1.07) for the highest quartile of variability independent of the mean of diastolic blood pressure only, 1.09 (1.08–1.11) for that of systolic blood pressure only, and 1.18 (1.16–1.19) for that of both systolic and diastolic blood pressure compared with subjects having no highest quartile for BPV. Consistent results were noted for Alzheimer’s disease and vascular dementia using other indices of variability and in various sensitivity and subgroup analyses. BPV is an independent predictor for developing dementia and its subtypes. A dose-response relationship was noted between higher BPV and dementia incidence. Reducing BPV may be a target for preventing dementia in the general population.

BackgroundThe aim of this study was to investigate whether anemia is associated with dementia incidence in the elderly.MethodsUsing the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) database, we identified 66-year-old subjects (n = 37,900) who were free of dementia and stroke. Anemia (hemoglobin < 12 g/dl for women and < 13 g/dl for men) and the severity of anemia (mild, moderate, or severe) were defined using World Health Organization criteria. The incidence of dementia was identified using International Classification of Diseases, Tenth Revision, dementia diagnosis codes (F00, F01, F02, F03, and G30) with prescription of an antidementia drug. Cox proportional hazards regression models were used to assess HRs for dementia incidence according to anemia.ResultsAfter adjusting for sex, baseline cognitive state, body mass index, smoking status, household income, disability, depression, hypertension, diabetes, and dyslipidemia, we found a significant association between anemia and dementia incidence (adjusted HR 1.24; 95% CI 1.02–1.51). The adjusted HRs for incidence of dementia according to the severity of anemia were 1.19 (95% CI 0.98–1.45) for those with mild anemia, 1.47 (95% CI 0.97–2.21) for those with moderate anemia, and 5.72 (95% CI 1.84–17.81) for those with severe anemia, showing a significant p value for trend (p = 0.003).ConclusionsAnemia is an independent risk factor for dementia incidence, with a marked increase of risk associated with severe anemia.Electronic supplementary materialThe online version of this article (doi:10.1186/s13195-017-0322-2) contains supplementary material, which is available to authorized users.

This paper investigates consumers' use of store-issued credit cards with particular attention to their function as an alternative payment and financing medium. Using 1998 Survey of Consumer Finances data, the researchers found that credit availability through bankcards is negatively correlated with consumers' use of store cards as a financing medium, suggesting the role of store cards as a supplementary credit line. A negative relationship is also found to exist between consumers' bankcard usage and their use of store cards for a transaction purpose, indicating that store cards function as a substitute payment medium. Consumers' usage of store cards varies according to function and is related to a number of variables, including the use of bank cards, credit history, attitude toward credit, income, education, and ethnicity.

We use two waves of a population based survey (the RAND American Life Panel) to investigate the relations between various evaluative and experienced well-being measures based on the English Longitudinal Study of Aging, the Gallup Wellbeing Index, and a 12-item hedonic well-being module of the Health and Retirement Study. In a randomized set-up we administered several versions of the survey with different response scales. Using factor analysis, we find that all evaluative measures load on the same factor, but the positive and negative experienced affect measures load on different factors. We find evidence of an effect of response scales on both the estimated number of underlying factors and their relations with demographics. We conclude that finer response scales allowing more nuanced answers offer more reliability. The relation of evaluative and experienced measures with demographics are very different; perhaps the most striking aspect is the lack of a consistent relation of experienced well-being measures with income, while evaluative well-being is strongly positively related with income.

Background and purpose The aim was to investigate whether female reproductive factors are associated with dementia. Methods In all, 4 696 633 post‐menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self‐administered questionnaire. Dementia was determined using dementia diagnosis codes and anti‐dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors. Results During a median follow‐up of 5.74 years, there were 212 227 new cases of all‐cause dementia (4.5%), 162 901 cases of Alzheimer’s disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03–1.16] for menarcheal age ≥17 years compared with menarcheal age 13–14 years, 0.79 (0.77–0.81) for menopausal age ≥55 years compared with menopausal age <40 years, and 0.81 (0.79–0.82) for fertility duration ≥40 years compared with fertility duration <30 years. Whilst being of parity one (HR 0.89, 95% CI 0.85–0.94) and breastfeeding <6 months (HR 0.92, 95% CI 0.88–0.95) was associated with lower risk of dementia, being of parity two or more (HR 1.04, 95% CI 0.99–1.05) and breastfeeding ≥12 months (HR 1.14, 95% CI 1.01–1.07) was associated with a higher risk of dementia than women without parity or breastfeeding history. Use of hormone replacement therapy and oral contraceptives independently reduced the dementia risk by 15% and 10%, respectively. Conclusions Female reproductive factors are independent risk factors for dementia incidence, with higher risk associated with shorter lifetime endogenous estrogen exposure.