Constructing the Vulvar Pain Assessment Questionnaire Inventory

The goals of this program of research were to examine the link between self-reported vulvar pain and clinical diagnoses, and to create a user-friendly assessment tool to aid in that process. These goals were undertaken through a series of four empirical studies (Chapters 2-6): one archival study, two online studies, and one study conducted in a Women’s Health clinic. In Chapter 2, the link between self-report and clinical diagnosis was confirmed by extracting data from multiple studies conducted in the Sexual Health Research Laboratory over the course of several years. We demonstrated the accuracy of diagnosis based on multiple factors, and explored the varied gynecological presentation of different diagnostic groups. Chapter 3 was based on an online study designed to create the Vulvar Pain Assessment Questionnaire (VPAQ) inventory. Following the construct validation approach, a large pool of potential items was created to capture a broad selection of vulvar pain symptoms. Nearly 300 participants completed the entire item pool, and a series of factor analyses were utilized to narrow down the items and create scales/subscales. Relationships were computed among subscales and validated scales to establish convergent and discriminant validity. Chapters 4 and 5 were conducted in the Department of Obstetrics & Gynecology at Oregon Health & Science University. The brief screening version of the VPAQ was employed with patients of the Program in Vulvar Health at the Center for Women’s Health. The accuracy and usefulness of the VPAQscreen was determined from the perspective of patients as well as their health care providers, and the treatment-seeking experiences of patients was explored. Finally, a second online study was conducted to confirm the factor structure, internal consistency, and test-retest reliability of the VPAQ inventory. The results presented in these chapters confirm the link between targeted questions and accurate diagnoses, and provide a guideline that is useful and accessible for providers and patients.

Poverty Dynamics: Empirical Evidence for Canada (Working Paper 29)

Poverty (low income) dynamics are explored using tax filer data covering the period 1992 to 1996. The distributions of short-and long-term episodes are identified, and reveal substantial differences by sex and family type. Entry and exit models explore the relationships between poverty transitions and sex, family status and other personal and situational attributes. Duration effects on exiting and re-entering poverty are found to be important, and models including past poverty experiences point to strong "occurrence dependence" for poverty entry and incidence. Fixed-effect panel data models confirm the above, and reveal asymmetries in the impacts of household transitions on poverty.

Student Loans : Empirical Evidence and Policy Implications (Working Paper 7)

This paper first summarizes the results of an empirical investigation of borrowing and repayment patterns of post-secondary graduates, then addresses a number of related policy issues, including i) the need for further research to generate the information needed to fully evaluate the student loan system, ii) the advantages of extending the assistance available for those facing problems with their debt burdens in the post-schooling period, iii) the need to increase borrowing limits, iii) the efficiency and equity advantages of providing assistance to post-secondary students through loans rather than the grants which many have been calling for, and iii) a proposal for revitalising the cash-strapped post-secondary system with infusions from both federal and provincial governments and students themselves of equal parts, the latter facilitated by the appropriate changes in the loan system (higher limits and more support for those who run into trouble with repayment).

Student Loans : the Empirical Record (Working Paper 6)

Student loan programmes have been the target of a good deal of attention in recent years and one important set of concerns has focussed on the levels of borrowing and the associated debt loads. This paper presents the results of an empirical investigation of borrowing and repayment patterns of four recent cohorts of post-secondary graduates based on the National Graduates Survey (NGS) databases. The paper should be relevant to those interested in access to post-secondary education and the well-being of students, the financing of the higher education more generally, and a range of related issues.