We present the Stata commands [R] probitfe and [R] logitfe, which estimate probit and logit panel data models with individual and/or time unobserved effects. Fixed effect panel data methods that estimate the unobserved effects can be severely biased because of the incidental parameter problem (Neyman and Scott, 1948). We tackle this problem by using the analytical and jackknife bias corrections derived in Fernandez-Val and Weidner (2016) for panels where the two dimensions (N and T ) are moderately large. We illustrate the commands with an empirical application to international trade and a Monte Carlo simulation calibrated to this application.Keywords: st0001, probit, logit, panel, fixed effects, bias corrections, incidental parameter problem c yyyy StataCorp LP st00011. The expressions of V β , B β , and D β for probit and logit models are given in the Appendix. 2. The expressions of V δ , B δ , and D δ for probit and logit models are given in the Appendix.
Objectives: Distressing physical symptoms (e.g., back pain, nausea), many of which lack medical explanation, are a common cause for medical help seeking. However, racial/ethnic and educational differences may complicate identification and explanation of such symptoms, potentially contributing to clinician misdiagnosis and patient dissatisfaction. To better understand this issue, we examined racial/ethnic differences in general physical symptoms (GPS) and, more specifically, medically unexplained physical symptoms (MUPS) and whether differences varied by race/ethnicity and educational attainment. Method: A sample of 4,864 Latino, Asian, and non-Latino White community respondents (54% female; average age of 41 years) self-reported their GPS. Two experts then rated whether endorsed symptoms were likely to have a medical basis. We assessed the associations of GPS and MUPS with race/ethnicity, age, gender, educational attainment, chronic physical conditions, and past-year psychiatric diagnoses. Results: Asian respondents reported significantly fewer GPS than non-Latino Whites, and both Asian and Latino respondents endorsed significantly fewer MUPS than non-Latino Whites. When nativity and language were each included as covariates, racial/ethnic differences in GPS count were no longer observed; however, observed differences in MUPS count remained. Educational attainment did not demonstrate a significant relationship with either GPS or MUPS. Although comorbid mental health diagnoses were significantly related to both GPS and MUPS, age, gender, and comorbid physical conditions were the only significant predictors of GPS. Conclusions: Results from this study question existing stereotypical views of racial/ethnic differences in somatization and suggest that educational attainment does not significantly contribute to reported physical symptoms—with or without medical explanation.
Racial/ethnic concordance between patients and providers concerning the quality of care has received interest over past decades yielding mixed results. Patients seem to prefer clinicians of their own race/ ethnicity, but empirical studies have found small or inconsistent effects on the quality of care. Research on the impact of racial/ethnic concordance and treatment duration appears to suggest that racial/ethnic concordance is associated with retention and completion; however, exactly why racial/ethnic concordance improves treatment length remains unexplored. On the other side, the quality of working alliance is a wellestablished common factor underlying effective treatments. In this study, we examined the interaction between patient-provider racial/ethnic concordance, length of treatment in the therapeutic dyad, and working alliance as evaluated by both patients themselves and objective raters. The study included 312 Psychological Services
Patient activation involves patients' ability and motivation to communicate about their health and health care. Research has demonstrated that clinician or patient interventions may improve patient activation. This study explored the degree to which clinician and patient interventions affected both patient activation and symptoms of depression and anxiety in a racially and ethnically diverse clinical sample. Methods: Data were from a randomized clinical trial that included 312 patients and 74 clinicians from 13 Massachusetts community-and hospital-based outpatient behavioral health clinics. Patients completed measures of patient activation and depression and anxiety symptoms. Secondary data analyses were conducted to examine the effect of patient and clinician interventions (DECIDE-PA and DECIDE-PC, respectively) on depression and anxiety symptoms and patient activation. A multilevel, mixed-effects simultaneous-equation model was estimated to assess the relationship between the interventions, changes in patients' symptoms, and patient activation.Results: Clinicians' greater intervention dosage (i.e., more completed DECIDE-PC training sessions) was associated with patients' decreased anxiety symptoms, but associations with patient activation or depression symptoms were not significant. The effect of clinician training dosage on anxiety symptoms was stronger when patients and clinicians were not of the same race-ethnicity. The reduction in patients' anxiety symptoms appeared to increase patient activation.Conclusions: Clinician interventions designed to boost patient-clinician communication and the therapeutic alliance may serve to lessen patients' anxiety and may ultimately improve patient activation.
Objective: Older adults of color face systemic obstacles in seeking mental health care. Unaddressed late-life mental health issues can challenge independent living and increase disability and mortality risk. This study examined factors associated with mental health service use among community-dwelling older adults. Method: This cross-sectional analysis used data from the Positive Minds-Strong Bodies trial ( N= 1,013). Results: Higher anxiety, depressive, and posttraumatic stress disorder (PTSD) symptoms increased odds of service use (odds ratio [OR] = 1.05–2.11). Asian and Latinx, but not Black, older adults had lower odds of service use than Whites (OR = 0.15–0.35). Yet Asian and Latinx older adults with higher anxiety and depression symptoms and Asians with at least one PTSD symptom had higher odds of service use than Whites with the same symptomatology (OR = 1.16–2.88). Conclusion: White older adults might be more likely to seek mental health care at lower levels of need, while Asian and Latinx older adults might seek services when they perceive greater need.
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