Publications

Journal Articles

1. Contraceptive Knowledge and Related Factors Among Male and Female U.S. Veterans of Reproductive Age

   E. Li, J. Rollison, M. Robbins, D. Shinnick, and S. A. Miner

   Contraception, 2026

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   Objectives
   This study aimed to examine associations of contraceptive knowledge among U.S. veterans of reproductive age, focusing on differences by sex, education, healthcare use, and primary source of contraceptive information. This study extends prior research by identifying factors associated with contraceptive knowledge in both males and female veterans.
   
   Study Design
   We analyzed data from a nationally representative 2025 survey of U.S. veterans aged 18–49 (n = 542). The survey included validated measures of contraceptive knowledge, healthcare use, and information sources. Survey-weighted linear regression models assessed associations between demographic factors, healthcare engagement, and knowledge scores, estimated overall and stratified by sex, adjusting for education.
   
   Results
   Male veterans scored significantly lower on contraceptive knowledge than female veterans (β = −2.83, p < 0.001, 95% CI [-4.14, -1.64]). Higher educational attainment was associated with greater knowledge (β = 1.6–2.8, p < 0.05, 95% CI [1.23, 4.37]). Any healthcare use in the past 12 months was associated with higher contraceptive knowledge, though this effect was only significant among males (β = 1.15, p = 0.04, 95% CI [0.04, 2.25]). Females who relied on the internet, social media, books/magazines, and personal contacts as their main source of contraceptive knowledge had lower knowledge scores (β = −4.8, p < 0.001, 95% CI [-7.01, -2.58]) than those who relied on healthcare providers.
   
   Conclusions
   While sex and education are important predictors of contraceptive knowledge, these findings indicate that higher health care engagement and reliance on providers as trusted sources of contraceptive information could improve contraceptive knowledge among veterans of reproductive age.
   
   Implications Statement
   Findings from this analysis highlight the need to build and strengthen contraceptive counseling, including counseling considerations for men. Enhancing routine, informed conversations about contraception could help close critical knowledge gaps in knowledge and promote equitable reproductive health decision-making among veterans.

2. Medicaid Home- and Community-Based Services Long-Term Care Expenditures: Evaluation of the Balancing Incentive Program

   B. Ghosh-Dastidar, M. W. Robbins, E. M. Friedman, N. Qureshi, and R. A. Shih

   Medical Care, 2026

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   Objective. The Balancing Incentive Program (BIP), legislated in the 2010 Affordable Care Act, offered states financial incentives to increase access to Medicaid home- and community-based services (HCBS). Despite the major infrastructure changes required by BIP, no evaluation to date has quantified the increase in spending attributable to BIP which is of concern to Medicaid HCBS policymakers, providers, and consumers. This is the first causal estimate of BIP’s effects including timing of implementation in each state, compared with a counterfactual.
   
   Design. Using state-level expenditure data, we estimated change in HCBS spending as percentage of LTSS spending in 17 BIP participant states compared with a counterfactual or synthetic control calculated as a weighted average of the outcome in 17 BIP eligible, non-participant states. Synthetic control weights were estimated using pre-BIP characteristics. To assess how BIP effects evolved over time, we estimated cumulative change in the outcome in multiple post-BIP years (2013, 2016 and 2019).
   
   Results. Our primary analysis indicates that cumulatively from FY 2013-2019, BIP states increased their HCBS spending as percentage of LTSS spending by an average of 5.2 percentage points (95% CI: 0.0, 9.8), compared with the synthetic control.
   
   Implications. Although many state-run programs have sought to increase HCBS access, our study’s causal estimate of BIP effects in 17 states, compared to 17 states that did not, represents a far more substantial growth than findings of prior studies.

3. A Demonstration of Propensity Score Weighting to Adjust a Social Media Nonprobability Sample Survey of Political Attitudes

   M. Pollard, M. W. Robbins, and M. G. Griswold

   Public Opinion Quarterly, 2026

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   Interest in using nonprobability online samples continues to grow despite concerns about selection bias. Many methods exist for adjusting nonprobability data so it may yield generalizable inferences. Here we investigate whether a propensity score weighting method can balance differences between a probability sample and a nonprobability sample of Twitter (now X) users to evaluate the feasibility of using social media data for producing generalizable inferences on public opinion. We fielded identical surveys to 2,001 probability-sampled respondents (June 30-July 22, 2022) and 949 Twitter users (March 1-July 13, 2022); final analytic sample sizes were 1,972 and 822, respectively. The nonprobability sample differed significantly in demographic characteristics (younger, lower income, higher educational attainment), and broadly endorsed significantly more liberal attitudes toward a range of political and policy issues than the probability sample. We show that the propensity score weighting procedure, using demographics, techno/psychographics, and political ideology, reconciles differences between the samples for 25 of the 27 attitudes assessed. The results demonstrate the feasibility and utility of the propensity score weighting procedure to replicate a probability sample with nonprobability social media data and add to the literature on the use of nonprobability samples to draw population-level inferences.

4. Exploring Contraceptive Care and Access Experiences of Veterans

   J. Rollison, S. A. Miner, E. Li, M. W. Robbins, D. Shinnick, and 1 more author

   RAND Health Quarterly, 2026

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   Although a significant amount of research has been done to examine access to contraceptive care, particularly among civilian women, there is significantly less understanding about the needs, preferences, and experiences of veteran men and women. The authors of this study conducted a mixed-methods study of men and women veterans’ access to, knowledge of, and use of contraception and contraceptive care.

5. Stay Tuned: Improving Sentiment Analysis and Stance Detection Using Large Language Models

   M. G. Griswold, M. W. Robbins, and M. Pollard

   Political Analysis, 2025

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   Sentiment analysis and stance detection are key tasks in text analysis, with applications ranging from understanding political opinions to tracking policy positions. Recent advances in large language models (LLMs) offer significant potential to enhance sentiment analysis techniques and to evolve them into the more nuanced task of detecting stances expressed toward specific subjects. In this study, we evaluate lexicon-based models, supervised models, and LLMs for stance detection using two corpuses of social media data—a large corpus of tweets posted by members of the U.S. Congress on Twitter and a smaller sample of tweets from general users—which both focus on opinions concerning presidential candidates during the 2020 election. We consider several fine-tuning strategies to improve performance—including cross-target tuning using an assumption of congressmembers’ stance based on party affiliation—and strategies for fine-tuning LLMs, including few shot and chain-of-thought prompting. Our findings demonstrate that: 1) LLMs can distinguish stance on a specific target even when multiple subjects are mentioned, 2) tuning leads to notable improvements over pretrained models, 3) cross-target tuning can provide a viable alternative to in-target tuning in some settings, and 4) complex prompting strategies lead to improvements over pretrained models but underperform tuning approaches.

6. The impact of drug possession decriminalization on arrests: A race-specific synthetic control analysis of Oregon’s Measure 110

   R. Neil, B. Ghosh Dastidar, B. Kilmer, M. W. Robbins, and K. Warren

   Journal of Quantitative Criminology, 2025

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   Objectives
   Racial disparities in arrests are a major concern, particularly when it comes to drug enforcement. In 2021, Oregon decriminalized the possession of controlled substances as part of Measure 110 (M-110), an unprecedented policy change in the United States. We estimate how M-110 affected five types of arrests, overall and by race.
   
   Methods
   National Incident-Based Reporting System data covering 3,642 police agencies from 43 states for 2018–2023 are combined with 2020 Census data. We extend a synthetic control methodology developed for micro-level data to test whether policy effects differ across groups and whether policies affect disparities, using permutation inference to quantify uncertainty.
   
   Results
   M-110 reduced drug possession arrest rates in Oregon for the overall population (67.8%) and for the three racial groups we focus on: Black (75.6%), Hispanic (77.5%); and White (66.2%), with the reduction being statistically significantly larger for Hispanic and Black than White individuals. M-110 reduced disorder arrest rates by 30.9% for Black individuals, which is statistically significantly different from zero and the White estimate. Black-White rate differences in drug possession arrests fell by 79.5% and in disorder arrests by 41.7%. In general, M-110 did not affect arrest rates for violent, property, or drug trafficking offenses.
   
   Conclusions
   M-110 reduced drug possession arrests while reducing Black-White rate differences. M-110 led to a decrease in disorder arrests for Black individuals, suggesting police did not substitute one arrest type for another for this population. Our method offers a new approach for examining heterogeneous policy effects and how policies affect disparities.

7. Resampling methods with multiply imputed data

   M. W. Robbins and L. Burgette

   Biometrika, 2025

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   Resampling techniques have become increasingly popular for estimation of uncertainty. However, data are often fraught with missing values that are commonly imputed to facilitate analysis. This article addresses the issue of using resampling methods such as a jackknife or bootstrap in conjunction with imputations that have been sampled stochastically, in the vein of multiple imputation. We derive the theory needed to illustrate two key points regarding the use of resampling methods in lieu of traditional combining rules. First, imputations should be independently generated multiple times within each replicate group of a jackknife or bootstrap. Second, the number of multiply imputed datasets per replicate group must dramatically exceed the number of replicate groups for a jackknife; however, this is not the case in a bootstrap approach. We also discuss bias-adjusted analogues of the jackknife and bootstrap that are argued to require fewer imputed datasets. A simulation study is provided to support these theoretical conclusions.

8. Quasi-experimental evaluations of border-enforcement measures

   M. W. Robbins, E. Treyger, and J. Chang

   Journal of Homeland Security and Emergency Management, 2025

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   In this article, we seek to establish a causal connection between border-enforcement actions or policies and metrics that might be used to measure relevant outcomes at the border. Applying quasi-experimental methods, we investigate the impact of surveillance technology on levels of U.S. Border Patrol apprehensions of unlawful border-crossers between ports of entry along the southwest border. Our analysis offers insights into some of the effects of surveillance technology and serves as a demonstration of concept for the usefulness of such statistical methods. The most robust finding is that deploying one type of technology – integrated fixed towers (IFTs) – is associated with decreased apprehension levels in the zones of deployment. Although we emphasize ambiguity in the meaning of the results and the uncertainty in statistical inference with relatively small numbers of deployments, we conclude that there is strong evidence that some migrants were deterred from crossing surveilled areas of the border. The results are more inconclusive for other surveillance assets, but there are suggestions that some may elevate apprehension levels, pointing to a boost to the U.S. Border Patrol’s situational awareness. Statistical methods both hold promise and have limitations for the study of the impact of border-enforcement measures beyond the analysis in this study. Although these methods cannot, on their own, yield clear answers in every case, they do have the potential to help policymakers understand and anticipate the impact and effectiveness of different border-enforcement measures.

9. Population displacement from Puerto Rico to U.S. states following Hurricane Maria

   M. W. Robbins

   Mathematical Population Studies, 2025

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   Population displacement from Puerto Rico to the United States following Hurricane Maria is considered and distinguished from ongoing outmigration from the island. Administrative data from two sources is used to estimate displacement with a capture-recapture method which, unlike existing estimates, excludes outmigration that occurs independent of the hurricane. The estimates are compared with preceding trends in outmigration from the US Census Bureau. The results show that nearly 90,000 individuals or about 2.7% of Puerto Ricans (95% CI: 2.5%, 2.9%) were displaced through May 2018. Displacement was highest (approximately 4.7%) from southeastern Puerto Rico where the hurricane made landfall and, counter to earlier outmigration patterns indicated by data from the American Community Survey, was comparatively low from the region near San Juan (4.0% pre-hurricane outmigration against 2.4% post-hurricane displacement). Displacement rates were higher in areas with higher levels of Federal Emergency Management Agency-certified damage to housing (3.3% in areas with high damage against 2.2% in areas with low damage) but did not consistently differ by indicators of socioeconomic disadvantage, including poverty and unemployment rates. Households’ intent to return indicates that those who will not return are more likely to be younger or be unemployed (86% of individuals under the age of 30 will not return, whereas 58% of individuals aged 65 and up will not return, and 84% of employed households will return, whereas 68% of unemployed ones will); these characteristics align with those commonly observed among outmigrants in the decade prior to the hurricane.

10. Understanding veterans in New York: A needs assessment of veterans recently separated from the military

    J. S. Ringel, J. Lejeune, J. Phillips, M. Robbins, M. A. Bradley, and 2 more authors

    RAND Health Quarterly, 2025

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    In this study, the authors present findings of a survey of recently discharged or separated veterans residing in New York state. The research evaluated (1) the mental and physical health of this cohort of veterans and (2) their access to, and experiences with, health care. The results offer critical information that can inform policy and practice changes to improve veterans’ awareness of, access to, and use of needed services.

11. Perceptions of mental health confidentiality policies and practices in the US military

    E. C. Wong, M. Waymouth, R. K. McBain, T. L. Schell, G. Hindmarch, and 6 more authors

    RAND Health Quarterly, 2025

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    This study assesses understanding and perceptions of mental health confidentiality policies and practices among service members, commanding officers, and mental health providers and whether these perceptions affect service members’ decisions to seek care. This analysis can inform policy and practices that aim to balance patient confidentiality with commanders’ responsibility for successful military operations and the protection of personnel.

12. Data fusion for predicting long-term program impacts

    M. W. Robbins, S. Bauhoff, and L. Burgette

    Statistics in Medicine, 2024

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    Policymakers often require information on programs’ long-term impacts that is not available when decisions are made. For example, while rigorous evidence from the Oregon Health Insurance Experiment (OHIE) shows that having health insurance influences short-term health and financial measures, the impact on long-term outcomes, such as mortality, will not be known for many years following the program’s implementation. We demonstrate how data fusion methods may be used address the problem of missing final outcomes and predict long-run impacts of interventions before the requisite data are available. We implement this method by concatenating data on an intervention (such as the OHIE) with auxiliary long-term data and then imputing missing long-term outcomes using short-term surrogate outcomes while approximating uncertainty with replication methods. We use simulations to examine the performance of the methodology and apply the method in a case study. Specifically, we fuse data on the OHIE with data from the National Longitudinal Mortality Study and estimate that being eligible to apply for subsidized health insurance will lead to a statistically significant improvement in long-term mortality.

13. Estimating generalized propensity scores with survey and attrition weighted data

    D. McCaffrey, B. A. Griffin, M. Robbins, Y. Chakraborti, D. Coffman, and 1 more author

    Statistics in Medicine, 2024

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    Prior work in causal inference has shown that using survey sampling weights in the propensity score estimation stage and the outcome model stage for binary treatments can result in a more robust estimator of the effect of the binary treatment being analyzed. However, to date, extending this work to continuous treatments and exposures has not been explored nor has consideration been given for how to handle attrition weights in the propensity score model. Nonetheless, generalized propensity score (GPS) analyses are being used for estimating continuous treatment effects on outcomes when researchers have observational data, and those data sets often have survey or attrition weights that need to be accounted for in the analysis. Here, we extend prior work and show with analytic results that using survey sampling or attrition weights in the GPS estimation stage and the outcome model stage for continuous treatments can result in a more robust estimator than one that does not. Simulation study results show that, although using weights in both estimation stages is sufficient for robust estimation, it is not necessary and unbiased estimation is possible in some cases under various approaches to using weights in estimation. Analysts do not know if the conditions of our simulation studies hold, so use of weights in both estimation stages might provide insurance for reducing potential bias. We discuss the implications of our results in the context of an empirical example.

14. Joint imputation of general data

    M. Robbins

    Journal of Survey Statistics and Methodology, 2024

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    High-dimensional complex survey data of general structures (e.g., containing continuous, binary, categorical, and ordinal variables), such as the US Department of Defense’s Health-Related Behaviors Survey (HRBS), often confound procedures designed to impute any missing survey data. Imputation by fully conditional specification (FCS) is often considered the state of the art for such datasets due to its generality and flexibility. However, FCS procedures contain a theoretical flaw that is exposed by HRBS data—HRBS imputations created with FCS are shown to diverge across iterations of Markov Chain Monte Carlo. Imputation by joint modeling lacks this flaw; however, current joint modeling procedures are neither general nor flexible enough to handle HRBS data. As such, we introduce an algorithm that efficiently and flexibly applies multiple imputation by joint modeling in data of general structures. This procedure draws imputations from a latent joint multivariate normal model that underpins the generally structured data and models the latent data via a sequence of conditional linear models, the predictors of which can be specified by the user. We perform rigorous evaluations of HRBS imputations created with the new algorithm and show that they are convergent and of high quality. Lastly, simulations verify that the proposed method performs well compared to existing algorithms including FCS.

15. The quality of occupational healthcare for carpal tunnel syndrome, healthcare expenditures, and disability outcomes: A prospective observational study

    T. Nuckols, M. Dworsky, C. Conlon, M. Robbins, D. Benner, and 4 more authors

    Muscle and Nerve, 2023

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    Introduction/aims
    In prior work, higher quality care for work-associated carpal tunnel syndrome (CTS) was associated with improved symptoms, functional status, and overall health. We sought to examine whether quality of care is associated with healthcare expenditures or disability.
    
    Methods
    Among 343 adults with workers’ compensation claims for CTS, we created patient-level aggregate quality scores for underuse (not receiving highly beneficial care) and overuse (receiving care for which risks exceed benefits). We assessed whether each aggregate quality score (0%–100%, 100% = better care) was associated with healthcare expenditures (18-mo expenditures, any anticipated need for future expenditures) or disability (days on temporary disability, permanent impairment rating at 18 mo).
    
    Results
    Mean aggregate quality scores were 77.8% (standard deviation [SD] 16.5%) for underuse and 89.2% (SD 11.0%) for overuse. An underuse score of 100% was associated with higher risk-adjusted 18-mo expenditures ($3672; 95% confidence interval [CI] $324 to $7021) but not with future expenditures (−0.07 percentage points; 95% CI −0.48 to 0.34), relative to a score of 0%. An overuse score of 100% was associated with lower 18-mo expenditures (−$4549, 95% CI −$8792 to −$306) and a modestly lower likelihood of future expenditures (−0.62 percentage points, 95% CI −1.23 to −0.02). Quality of care was not associated with disability.
    
    Discussion
    Improving quality of care could increase or lower short-term healthcare expenditures, depending on how often care is currently underused or overused. Future research is needed on quality of care in varied workers’ compensation contexts, as well as effective and economical strategies for improving quality.

16. Home health agency adoption of quality improvement interventions and association with performance

    K. D. Shetty, M. W. Robbins, D. Saliba, K. N. Campbell, and C. L. Damberg

    Journal of the American Geriatrics Society, 2021

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    Background
    The Centers for Medicare & Medicaid Services (CMS) Home Health Quality Reporting Program (HHQRP) uses performance measurement to spur improvements in home health agencies’ (HHAs’) quality of care. We examined quality improvement (QI) activities HHAs reported making to improve on HHQRP quality measures, and whether reported QI activities were associated with better measure performance.
    
    Methods
    We used responses (N = 1052) from a Web- and mail-based survey of a stratified random sample of HHAs included in CMS Home Health Compare in October 2019. We estimated national adoption rates for 27 possible QI activities related to organizational culture, health information technology, care process redesign, provider incentives, provider training, changes to staffing responsibilities, performance monitoring, and measure-specific QI initiatives and technical assistance. We used multivariate linear regression to examine the associations between HHA characteristics and QI adoption, and between QI adoption and CMS Home Health Quality of Patient Care Star Rating.
    
    Results
    HHAs reported implementing an average of 16 QI activities (interquartile range 11–19 activities). Larger HHA size was associated with adopting 1.6 additional QI activities (p < 0.001). HHAs with higher proportions of disabled, black, or Hispanic patients adopted QI activities at similar or higher rates as other HHAs. Of the 27 QI activities, 23 were considered helpful by more than 80% of adopting HHAs. Compared with adopting 44% of QI activities (10th percentile among HHAs), adopting 89% of QI activities (90th percentile) was associated with a 0.4-star higher Star Rating (95% confidence interval 0.2–0.6).
    
    Conclusions
    HHAs report implementing a significant number of QI activities in response to CMS measurement programs; implementation of a greater number of activities is associated with better performance on publicly reported measures. To guide future HHA QI investments, work is needed to identify the optimal combination of QI activities and the specific QI activities that yield the greatest performance improvements.

17. Actions to improve quality: Results from a national hospital survey

    K. D. Shetty, M. W. Robbins, A. Tolpadi, K. N. Campbell, A. M. Clancy, and 4 more authors

    The American Journal of Managed Care, 2021

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    Objectives:
    CMS measures and reports hospital performance to drive quality improvement (QI), but information on actions that hospitals have taken in response to quality measurement is lacking. We aimed to develop national estimates of QI actions undertaken by hospitals and to explore their relationship to performance on CMS quality measures.
    
    Study Design:
    Nationally representative cross-sectional survey of acute care hospitals in 2016 (n = 1313 respondents; 64% response rate).
    
    Methods:
    We assessed 23 possible QI changes. Using multivariate linear regression, we estimated the relationship between reported QI changes and performance on composite measures derived from 26 Hospital Inpatient Quality Reporting Program measures (scaled 0-100), controlling for case mix and facility characteristics.
    
    Results:
    Hospitals reported implementing a mean of 17 QI changes (median [interquartile range], 17 [15-20]). Large hospitals reported significantly higher adoption rates than small hospitals for 18 QI changes. Most hospitals that reported making QI changes (63%-96% for the 23 changes) responded that the specific change made helped improve performance. In multivariate regression analyses, adoption of 92% of QI changes (90th percentile among hospitals), compared with adoption of 50% of QI changes (10th percentile), was associated with a 2.3-point higher overall performance score (95% CI, 0.7-4.0) and higher process (8.7 points; 95% CI, 5.7-11.7) and patient experience (3.0 points; 95% CI, 0.1-5.9) composite scores.
    
    Conclusions: Hospitals reported widespread adoption of QI changes in response to CMS quality measurement and reporting. Higher QI adoption rates were associated with modestly higher process, patient experience, and overall performance composite scores.

18. Blending of probability and convenience samples as applied to a survey of military caregivers

    M. W. Robbins, B. Ghosh-Dastidar, and R. Ramchand

    Journal of Survey Statistics and Methodology, 2021

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    Probability samples are the preferred method for providing inferences that are generalizable to a larger population. However, in many cases, this approach is unlikely to yield a sample size large enough to produce precise inferences. Our goal here is to improve the efficiency of inferences from a probability sample by combining (or blending) it with a nonprobability sample, which is (by itself) potentially fraught with selection biases that would compromise the generalizability of results. We develop novel methods of statistical weighting that may be used for this purpose. Specifically, we make a distinction between weights that can be used to make the two samples representative of the population individually (disjoint blending) and those that make only the combined sample representative (simultaneous blending). Our focus is on weights constructed using propensity scores, but consideration is also given to calibration weighting. We include simulation studies that, among other illustrations, show the gain in precision provided by the convenience sample is lower in circumstances where the outcome is strongly related to the auxiliary variables used to align the samples. Motivating the exposition is a survey of military caregivers; our interest is focused on unpaid caregivers of wounded, ill, or injured US servicemembers and veterans who served following September 11, 2001. Our work serves not only to illustrate the proper execution of blending but also to caution the reader with respect to its dangers, as invoking a nonprobability sample may not yield substantial improvements in precision when assumptions are valid and may induce biases in the event that they are not.

19. Associations between a zero tolerance BAC law and traffic crashes and fatalities: Insights from a novel synthetic control method

    S. Davenport, M. Robbins, M. Cerda, A. Riveral, and B. Kilmer

    Addiction, 2021

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    Background and aims
    Debates regarding lowering the blood alcohol concentration (BAC) limit for drivers are intensifying in the United States and other countries, and the World Health Organization recommends that the limit for adults should be 0.05%. In January 2016, Uruguay implemented a law setting a zero BAC limit for all drivers. This study aimed to assess the effect of this policy on the frequency of moderate/severe injury and fatal traffic crashes.
    
    Design
    A quasi-experimental study in which a synthetic control model was used with controls consisting of local areas in Chile as the counterfactual for outcomes in Uruguay, matched across population counts and pre-intervention period outcomes. Sensitivity analyses were also conducted.
    
    Setting
    Uruguay and Chile.
    
    Cases
    Panel data with crash counts by outcome per locality-month (2013–2017).
    
    Intervention and comparator
    A zero blood alcohol concentration law implemented on 9 January 2016 in Uruguay, alongside a continued 0.03 g/dl BAC threshold in Chile.
    
    Measurements
    Per-capita moderate/severe injury (i.e. moderate or severe), severe injury and fatal crashes (2013–2017).
    
    Findings
    Our base synthetic control model results suggested a reduction in fatal crashes at 12 months [20.9%; P-value = 0.018, 95% confidence interval (CI) = −0.340, −0.061]. Moderate/severe injury crashes did not decrease significantly (10.2%, P = 0.312, 95% CI = −0.282, 0.075). The estimated effect at 24 months was smaller and with larger confidence intervals for fatal crashes (14%; P = 0.048, 95% CI = −0.246, −0.026) and largely unchanged for moderate/severe injury crashes (−9.4%, P = 0.302, 95% CI = −0.248, 0.058). Difference-in-differences analyses yielded similar results. As a sensitivity test, a synthetic control model relying on an inferior treatment–control match pre-intervention (measured by mean squared error) yielded similar-sized differences that were not statistically significant.
    
    Conclusions
    Implementation of a law setting a zero blood alcohol concentration threshold for all drivers in Uruguay appears to have resulted in a reduction in fatal crashes during the following 12 and 24 months.

20. Nonparametric estimation of population average dose-response curves using entropy balancing weights for continuous exposures

    B. G. Vegetabile, B. A. Griffin, D. Coffman, M. Cefalu, M. W. Robbins, and 1 more author

    Health Services and Outcomes Research Methodology, 2021

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    Weighted estimators are commonly used for estimating exposure effects in observational settings to establish causal relations. These estimators have a long history of development when the exposure of interest is binary and where the weights are typically functions of an estimated propensity score. Recent developments in optimization-based estimators for constructing weights in binary exposure settings, such as those based on entropy balancing, have shown more promise in estimating treatment effects than those methods that focus on the direct estimation of the propensity score using likelihood-based methods. This paper explores recent developments of entropy balancing methods to continuous exposure settings and the estimation of population dose-response curves using nonparametric estimation combined with entropy balancing weights, focusing on factors that would be important to applied researchers in medical or health services research. The methods developed here are applied to data from a study assessing the effect of non-randomized components of an evidence-based substance use treatment program on emotional and substance use clinical outcomes.

21. microsynth: Synthetic control methods with micro- and meso-level data in R

    M. W. Robbins and S. Davenport

    Journal of Statistical Software, 2021

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    The R package microsynth has been developed for implementation of the synthetic control methodology for comparative case studies involving micro- or meso-level data. The methodology implemented within microsynth is designed to assess the efficacy of a treatment or intervention within a well-defined geographic region that is itself a composite of several smaller regions (where data are available at the more granular level for comparison regions as well). The effect of the intervention on one or more time-varying outcomes is evaluated by determining a synthetic control region that resembles the treatment region across pre-intervention values of the outcome(s) and time-invariant covariates and that is a weighted composite of many untreated comparison regions. The microsynth procedure includes functionality that enables its user to (1) calculate weights for synthetic control, (2) tabulate results for statistical inferences, and (3) create time series plots of outcomes for treatment and synthetic control. In this article, microsynth is described in detail and its application is illustrated using data from a drug market intervention in Seattle, WA.

22. The effect of incentives and mode of contact on the successful recruitment of teachers into survey panels

    M. W. Robbins and J. Hawes-Dawson

    Survey Practice, 2020

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    This article discusses an experiment run at the beginning of an effort to substantially enlarge the RAND American Teacher Panel, a nationally representative sample of K-12 public school teachers. Ten strategies were evaluated. We considered different modes of contact (FedEx vs. US Postal Service [USPS]), contingency status of incentives (pre- vs. promised incentive), amounts of incentive ($2, $10, $40, or $60), and types of incentive (cash, check, gift card, electronic). Strategies were compared in terms of response rate and cost effectiveness. Our study yielded several findings that should advance the literature: The use of FedEx clearly outperforms USPS, and the use of a moderate preincentive ($10) outperforms much larger promised incentives (up to $60) with respect to both responsiveness and cost-effectiveness. In addition, cash and check seem preferable to gift cards. Finally, we assess the potential for nonresponse bias by comparing enrollees to nonresponders across a variety of demographic characteristics for each strategy.

23. Nursing home responses to performance-based accountability: Results of a national survey

    K. D. Shetty, A. Tolpadi, M. W. Robbins, E. A. Taylor, K. Campbell, and 1 more author

    Journal of the American Geriatrics Society, 2020

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    OBJECTIVES
    The Centers for Medicare & Medicaid Services (CMS) Nursing Home Quality Initiative aims to improve quality through performance measurement. We describe quality improvement (QI) changes that skilled nursing facilities (SNFs) reported making in response to CMS performance measurements and whether reported QI changes were associated with better performance on CMS performance measures.
    
    DESIGN
    Nationally representative survey.
    
    SETTING
    A total of 15,475 SNFs that reported quality performance on Nursing Home Compare in 2016.
    
    PARTICIPANTS
    A total of 1,182 SNFs (58% of random sample of 2,045 SNFs).
    
    MEASUREMENTS
    Adoption of 22 possible QI changes, grouped into seven categories (organizational culture, health information technology, care process redesign, provider incentives, changes to staffing responsibilities, performance monitoring, and measure-specific QI initiatives and technical assistance); performance on the CMS Nursing Home Compare Five-Star Quality Rating System’s quality measure rating.
    
    RESULTS
    SNFs reported making an average of 13 QI changes (interquartile range = 11-16 changes). SNFs mostly commonly reported becoming a learning organization (87%) and providing training to staff on QI strategies (87%). After controlling for patient and facility characteristics, larger SNFs were more likely to obtain assistance on measure reporting from QI organizations and use provider champions than smaller SNFs by 14 and 11 percentage points, respectively. Rural SNFs and SNFs with higher proportions of disabled, black, or Hispanic residents adopted QI changes at similar rates as other SNFs. Of the 22 QI changes, 20 were considered at least somewhat helpful by more than 80% of adopting SNFs. Implementation of all 22 QI changes (vs no changes) was associated with a .48-star higher quality measure rating (95% confidence interval = .003-.98 stars; P = .05).
    
    CONCLUSION
    In response to CMS measurement programs, SNFs reported making substantial QI investments that were associated with better performance on CMS quality measures. To guide future SNF investments in QI, work is needed to identify the QI changes that yield the greatest performance improvements.

24. The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures

    K. D. Shetty, M. Robbins, D. Aragaki, A. Basu, C. Conlon, and 4 more authors

    Muscle & Nerve, 2020

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    Introduction
    The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures.
    
    Methods
    We evaluated test quality among 338 adults with workers’ compensation claims for carpal tunnel syndrome. Using simulations, we examined how it influences the appropriateness of surgery. Using regression, we evaluated associations with symptoms and functional limitations (Boston Carpal Tunnel Questionnaire), overall health (12-item Short Form Health Survey version 2), actual receipt of surgery, and expenditures.
    
    Results
    In simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). In regression analyses, patients with the highest quality tests had larger declines in symptoms (−0.50 point; 95% confidence interval [CI], −0.89 to −0.12) and functional impairment (−0.42 point; 95% CI, −0.78 to −0.06) than patients with the lowest quality tests. Test quality was not associated with overall health, actual receipt of surgery, or expenditures.
    
    Discussion
    Test quality is pivotal to determining surgical appropriateness and associated with meaningful differences in symptoms and function.

25. Quality of electrodiagnostic testing for carpal tunnel syndrome: Adherence to quality measures

    D. Aragaki, A. Basu, C. Conlon, K. S. Shetty, M. Robbins, and 2 more authors

    Muscle & Nerve, 2020

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    Introduction
    Research has shown that quality of health-care services is often suboptimal. Little is known about the quality of electrodiagnostic testing.
    
    Methods
    We prospectively recruited 477 adults with workers’ compensation claims for carpal tunnel syndrome (CTS) from 30 occupational health clinics and evaluated whether electrodiagnostic testing adhered to five process-oriented quality measures.
    
    Results
    Among patients who had surgery for CTS, nearly all underwent recommended preoperative electrodiagnostic testing (measure #1, 170 of 174, 97.7%). Most electrodiagnostic tests included essential components (measure #2, 295 of 379, 77.8%). However, few reports documented skin temperature (measure #3, 93 of 379, 24.5%) and criteria were seldom met for interpreting test findings as consistent with CTS (measure #4, 41 of 284, 14.4%) or “severe” CTS (measure #5, 8 of 46, 17.4%).
    
    Discussion
    Most patients underwent testing before surgery, but test quality was often suboptimal. This work lays the groundwork for future efforts to monitor and improve the quality of electrodiagnostic testing for CTS.

26. A fully flexible changepoint test for regression models with stationary errors

    M. W. Robbins

    Statistica Sinica, 2020

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    Temporal discontinuities in time series represent one of the classic problems of time series. Such discontinuities are often analyzed by detecting changes at specific times in the parameters governing a regression model fit to the series. The regression framework examined here contains three classes of predictors: functional form, seasonal, and stochastic. Regression errors are allowed to observe a general stationary structure. Methods are proposed that provide the analyst with full flexibility in selecting which set of regression parameters are allowed to change under the alternative hypothesis. Here, we also examine several mathematical complications that arise in the development of such procedures. A simulation study illustrates the efficacy of the proposed methodology, where a test statistic based on the residuals from an ARMA model is shown to perform most favorably. The methods are applied to a carbon dioxide time series measured at Mauna Loa Observatory, where a shift in the seasonal variations is detected (in addition to a known shift in trend), and to a series of monthly temperatures at Barrow, Alaska, where only a shift in trend is found.

27. Robust estimation of the effect of neighborhood socioeconomic status on cognitive function

    M. W. Robbins, B. A. Griffin, R. A. Shih, and M. E. Slaughter

    Statistics in Medicine, 2020

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    The fundamental difficulty of establishing causal relationships between an exposure and an outcome in observational data involves disentangling causality from confounding factors. This problem underlies much of neighborhoods research, which abounds with studies that consider associations between neighborhood characteristics and health outcomes in longitudinal data. Such analyses are confounded by selection issues; individuals with above average health outcomes (or associated characteristics) may self-select into advantaged neighborhoods. Techniques commonly used to assess causal inferences in observational longitudinal data, such as inverse probability of treatment weighting (IPTW), may be inappropriate in neighborhoods data due to unique characteristics of such data. We advance the IPTW toolkit by introducing a procedure based on a multivariate kernel density function which is more appropriate for neighborhoods data. The proposed weighting method is applied in conjunction with a marginal structural model. Our empirical analyses use longitudinal data from the Health and Retirement Study; our exposure of interest is an index of neighborhood socioeconomic status (NSES), and we examine its influence on cognitive function. Our findings illustrate the importance of the choice of method for IPTW—the comparison weighting methods provide poor balance across the set of covariates (which is not the case for our preferred procedure) and yield misleading results when applied in the outcomes models. The utility of the multivariate kernel is also validated via simulation. In addition, our findings emphasize the importance of IPTW—controlling for covariates within a regression without IPTW indicates that NSES affects cognition, whereas IPTW-weighted models fail to show a statistically significant effect.

28. Evaluation of the Strength Aptitude Test and other fitness tests to qualify Air Force recruits for physically demanding specialties

    S. M. Robson, S. Pezard, M. C. Lytell, C. S. Sims, J. Boon, and 11 more authors

    RAND Health Quarterly, 2019

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    The Air Force uses the Strength Aptitude Test (SAT) to determine whether recruits meet the fitness levels needed to perform the duties of various Air Force specialties with physical strength requirements. However, the SAT was developed in the early 1980s and has not been revalidated since then. In the interim, the duties associated with many Air Force Specialty Code classifications may have changed, and new ones have been added. These changes require a reevaluation of the SAT’s utility and effectiveness for qualifying recruits into these specialties. This study evaluates the status and validity of the SAT in a series of studies and summarizes the studies RAND has completed independently and one study conducted in conjunction with HumRRO, which provided the additional data necessary to develop some courses of action for the Air Force to follow to ensure airmen can meet job-related physical requirements.

29. A cheap trick to improve the power of a conservative hypothesis test

    T. J. Fisher and M. W. Robbins

    The American Statistician, 2019

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    Critical values and p-values of statistical hypothesis tests are often derived using asymptotic approximations of sampling distributions. However, this sometimes results in tests that are conservative (i.e., understate the frequency of an incorrectly rejected null hypothesis by employing too stringent of a threshold for rejection). Although computationally rigorous options (e.g., the bootstrap) are available for such situations, we illustrate that simple transformations can be used to improve both the size and power of such tests. Using a logarithmic transformation, we show that the transformed statistic is asymptotically equivalent to its untransformed analogue under the null hypothesis and is divergent from the untransformed version under the alternative (yielding a potentially substantial increase in power). The transformation is applied to several easily-accessible statistical hypothesis tests, a few of which are taught in introductory statistics courses. With theoretical arguments and simulations, we illustrate that the log transformation is preferable to other forms of correction (such as statistics that use a multiplier). Finally, we illustrate application of the method to a well-known dataset. Supplementary materials for this article are available online.

30. A comparison of strategies for recruiting teachers into survey panels

    M. W. Robbins, G. Grimm, B. Stecher, and V. D. Opfer

    SAGE Open, 2018

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    We examine a range of options for recruiting teachers into a nationally representative survey panel. Recruitment strategies considered include a telephone-based approach and the use of promised incentives and pre-incentives of varying amounts and forms. Using a randomized experiment, we evaluate the effectiveness of five separate recruitment strategies and conduct a cost-benefit analysis. Our preferred strategy is one that uses a US$10 gift card as pre-incentive (it yielded a 27% rate of successful recruitment at a cost of US$78 per recruited teacher). Statistical comparisons indicate that no other technique was superior to this strategy in terms of recruitment rate or cost-effectiveness. Efforts at refusal conversion after the initial approach were mostly ineffective. A comparison across demographic type characteristics of enrolled panelists and nonrespondents shows no substantial differences for any recruitment strategy considered. Hence, the potential for recruitment-level nonresponse to induce large bias into findings from surveys administered to the panel is minimal.

31. Delivering clinical practice guideline-concordant care for PTSD and major depression in military treatment facilities

    K. A. Hepner, C. Farris, C. M. Farmer, P. O. Iyiewuare, T. Tanielian, and 4 more authors

    RAND Health Quarterly, 2018

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    This article describes the psychological health workforce at military treatment facilities, examines the extent to which care is consistent with clinical practice guidelines, and identifies facilitators and barriers to providing this care.

32. Quality of care and patient-reported outcomes among adults with work-associated carpal tunnel syndrome: A prospective observational study

    T. Nuckols, C. Conlon, M. Robbins, M. Dworsky, J. Lai, and 5 more authors

    Muscle and Nerve, 2018

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    Introduction:
    Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes.
    
    Methods:
    This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians’ adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF-12v2) at recruitment and at 18 months.
    
    Results:
    Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (−0.18, 95% confidence interval [CI] −0.32 to −0.05), BCTQ Functional Status scores (−0.21, 95% CI −0.34 to −0.08), and SF12-v2 Physical Component scores (1.75, 95% CI 0.33–3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks.
    
    Discussion:
    Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management.

33. An improved measure for lack of fit in time series models

    T. J. Fisher and M. W. Robbins

    Statistica Sinica, 2018

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    The correlation structure of time series is of fundamental importance in diagnostic procedures. The squared autocorrelation function of the residuals of a fitted model is generally used as a measure of the goodness-of-fit; multivariate analogues are available for vector time series. As an alternative, we propose a logarithmic transformation of the determinant of a constructed Toeplitz matrix containing the typical measure of correlation. We show that the proposed measure is asymptotically more powerful than the typical measure of correlation (when used with or without the Ljung-Box correction) in the detection of a variety of residual dependence structures. The proposed method is shown to have utility when applied in conjunction with a host of methods used to diagnose the fit of strong and weak autoregressive moving average models and generalized autoregressive conditional heteroskedastic models. A simulation study demonstrates the effectiveness of the proposed method and illustrates its improvement over the existent procedures.

34. Implementing the Drug Market Intervention across multiple sites

    J. Saunders, M. Robbins, and A. Ober

    Criminology & Public Policy, 2017

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    In 2012, the editors of CPP published an exchange about the Drug Market Intervention (DMI) in High Point, NC, concluding that it may be a promising approach to crime control but questioning whether it could be implemented across different settings. In this effectiveness study, we followed a cohort of seven sites that participated in a Bureau of Justice Assistance–sponsored DMI training to assess implementation and outcomes. Three sites were not able to implement, and implementation fidelity varied across the four sites that did implement. Of the four sites that held at least one call-in, only one was successful at reducing overall and drug crime (by 28% and 56%, respectively). This works out to an implementation rate of 57% with an average overall crime reduction of 16% (treatment-on-the-treated) or 4% (intent-to-treat). The results of this study demonstrate the importance of replication and the careful study of implementation fidelity prior to wide dissemination.

35. Provider type and management of common visits in primary care

    D. W. Roblin, H. Liu, L. F. Cromwell, M. Robbins, B. E. Robinson, and 2 more authors

    American Journal of Managed Care, 2017

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    Objectives:
    Debate continues on whether nurse practitioners (NPs) and physician assistants (PAs) are more likely to order ancillary services, or order more costly services among alternatives, than primary care physicians (PCPs). We compared prescription medication and diagnostic service orders associated with NP/PA versus PCP visits for management of neck or back (N/B) pain or acute respiratory infection (ARI).
    
    Study Design:
    Retrospective, observational study of visits from January 2006 through March 2008 in the adult primary care practice of Kaiser Permanente in Atlanta, Georgia.
    
    Methods:
    Data were obtained from electronic health records. NP/PA and PCP visits for N/B pain or ARI were propensity score matched on patient age, gender, and comorbidities.
    
    Results:
    On propensity score-matched N/B pain visits (n = 6724), NP/PAs were less likely than PCPs to order a computed tomography (CT)/magnetic resonance image (MRI) scan (2.1% vs 3.3%, respectively) or narcotic analgesic (26.9% vs 28.5%) and more likely to order a nonnarcotic analgesic (13.5% vs 8.5%) or muscle relaxant (45.8% vs 42.5%) (all P ≤.05). On propensity score-matched ARI visits (n = 24,190), NP/PAs were more likely than PCPs to order any antibiotic medication (73.7% vs 65.8%), but less likely to order an x-ray (6.3% vs 8.6%), broad-spectrum antibiotic (41.5% vs 42.5%), or rapid strep test (6.3% vs 9.7%) (all P ≤.05).
    
    Conclusions:
    In the multidisciplinary primary care practice of this health maintenance organization, NP/PAs attending visits for N/B pain or ARI were less likely than PCPs to order advanced diagnostic radiology imaging services, to prescribe narcotic analgesics, and/or to prescribe broad-spectrum antibiotics.

36. A framework for synthetic control methods with high dimensional, micro-level data: Evaluating a neighborhood-specific crime intervention

    M. W. Robbins, J. Saunders, and B. Kilmer

    Journal of the American Statistical Association, 2017

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    The synthetic control method is an increasingly popular tool for analysis of program efficacy. Here, it is applied to a neighborhood-specific crime intervention in Roanoke, VA, and several novel contributions are made to the synthetic control toolkit. We examine high-dimensional data at a granular level (the treated area has several cases, a large number of untreated comparison cases, and multiple outcome measures). Calibration is used to develop weights that exactly match the synthetic control to the treated region across several outcomes and time periods. Further, we illustrate the importance of adjusting the estimated effect of treatment for the design effect implicit within the weights. A permutation procedure is proposed wherein countless placebo areas can be constructed, enabling estimation of p-values under a robust set of assumptions. An omnibus statistic is introduced that is used to jointly test for the presence of an intervention effect across multiple outcomes and post-intervention time periods. Analyses indicate that the Roanoke crime intervention did decrease crime levels, but the estimated effect of the intervention is not as statistically significant as it would have been had less rigorous approaches been used. Supplementary materials for this article are available online.

37. Quality of care for work-associated carpal tunnel syndrome

    T. Nuckols, C. Conlon, M. Robbins, M. Dworsky, J. Lai, and 5 more authors

    Journal of Occupational and Environmental Medicine, 2017

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    Objective:
    To evaluate the quality of care provided to individuals with workers’ compensation claims related to Carpal tunnel syndrome (CTS) and identify patient characteristics associated with receiving better care.
    
    Methods:
    We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects’ medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality.
    
    Results:
    Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
    
    Conclusions:
    Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones.

38. The impact of using mid-level providers in face-to-face primary care on health care utilization

    H. Liu, M. Robbins, A. Mehrotra, D. Auerbach, B. E. Robinson, and 2 more authors

    Medical Care, 2017

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    Background:
    There has been concern that greater use of nurse practitioners (NP) and physician assistants (PA) in face-to-face primary care may increase utilization and spending.
    
    Objective:
    To evaluate a natural experiment within Kaiser Permanente in Georgia in the use of NP/PA in primary care.
    
    Study Design:
    From 2006 through early 2008 (the preperiod), each NP or PA was paired with a physician to manage a patient panel. In early 2008, NPs and PAs were removed from all face-to-face primary care. Using the 2006–2010 data, we applied a difference-in-differences analytic approach at the clinic level due to patient triage between a NP/PA and a physician. Clinics were classified into 3 different groups based on the percentage of visits by NP/PA during the preperiod: high (over 20% in-person primary care visits attended by NP/PAs), medium (5%–20%), and low (<5%) NP/PA model clinics.
    
    Measures:
    Referrals to specialist physicians; emergency department visits and inpatient admissions; and advanced diagnostic imaging services.
    
    Results:
    Compared with the low NP/PA model, the high NP/PA model and the medium NP/PA model were associated with 4.9% and 5.1% fewer specialist referrals, respectively (P<0.05 for both estimates); the high NP/PA model and the medium NP/PA model also showed fewer hospitalizations and emergency department visits and fewer advanced diagnostic imaging services, but none of these was statistically significant.
    
    Conclusions:
    We find no evidence to support concerns that under a physician’s supervision, NPs and PAs increase utilization and spending.

39. Assessing the value of high quality care for work-associated carpal tunnel syndrome in a large integrated healthcare system: Study design

    C. Conlon, S. Asch, M. Hanson, A. Avins, B. Levitan, and 6 more authors

    The Permanente Journal, 2016

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    Context
    Little is known about quality of care for occupational health disorders, although it may affect worker health and workers’ compensation costs. Carpal tunnel syndrome (CTS) is a common work-associated condition that causes substantial disability.
    
    Objective
    To describe the design of a study that is assessing quality of care for work-associated CTS and associations with clinical outcomes and costs.
    
    Design
    Prospective observational study of 477 individuals with new workers’ compensation claims for CTS without acute trauma who were treated at 30 occupational health clinics from 2011 to 2013 and followed for 18 months.
    
    Main Outcome Measures
    Timing of key clinical events, adherence to 45 quality measures, changes in scores on the Boston Carpal Tunnel Questionnaire and 12-item Short Form Health Survey Version 2 (SF-12v2), and costs associated with medical care and disability.
    
    Results
    Two hundred sixty-seven subjects (56%) received a diagnosis of CTS and had claims filed around the first visit to occupational health, 104 (22%) received a diagnosis before that visit and claim, and 98 (21%) received a diagnosis or had claims filed after that visit. One hundred seventy-eight (37%) subjects had time off work, which started around the time of surgery in 147 (83%) cases and lasted a median of 41 days (interquartile range = 42 days).
    
    Conclusions
    The timing of diagnosis varied, but time off work was generally short and related to surgery. If associations of quality of care with key medical, economic, and quality-of-life outcomes are identified for work-associated CTS, systematic efforts to evaluate and improve quality of medical care for this condition are warranted.

40. A general regression changepoint test for time series data

    M. W. Robbins, C. M. Gallagher, and R. B. Lund

    Journal of the American Statistical Association, 2016

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    This article develops a test for a single changepoint in a general setting that allows for correlated time series regression errors, a seasonal cycle, time-varying regression factors, and covariate information. Within, a changepoint statistic is constructed from likelihood ratio principles and its asymptotic distribution is derived. The asymptotic distribution of the changepoint statistic is shown to be invariant of the seasonal cycle and the covariates should the latter obey some simple limit laws; however, the limit distribution depends on any time-varying factors. A new test based on ARMA residuals is developed and is shown to have favorable properties with finite samples. Driving our work is a changepoint analysis of the Mauna Loa record of monthly carbon dioxide concentrations. This series has a pronounced seasonal cycle, a nonlinear trend, heavily correlated regression errors, and covariate information in the form of climate oscillations. In the end, we find a prominent changepoint in the early 1990s, often attributed to the eruption of Mount Pinatubo, which cannot be explained by covariates. Supplementary materials for this article are available online.

41. Cross-correlation matrices for tests of independence and causality between two multivariate time series

    M. W. Robbins and T. J. Fisher

    Journal of Business and Economic Statistics, 2015

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    An often-studied problem in time series analysis is that of testing for the independence of two (potentially multivariate) time series. Toeplitz matrices have demonstrated utility for the related setting of time series goodness-of-fit testing—ergo, herein, we extend those concepts by defining a nontrivial block Toeplitz matrix for use in the setting of independence testing. We propose test statistics based on the trace of the square of the matrix and determinant of the matrix; these statistics are connected to one another as well as known statistics previously proposed in the literature. Furthermore, the log of the determinant is argued to relate to a likelihood ratio test and is proven to be more powerful than other tests that are asymptotically equivalent under the null hypothesis. Additionally, matrix-based tests are presented for the purpose of inferring the location or direction of the causality existing between the two series. A simulation study is provided to explore the efficacy of the proposed methodology—the methods are shown to offer improvement over existing techniques, which include the famous Granger causality test. Finally, data examples involving U.S. inflation, trade volume, and exchange rates are given. Supplementary materials for this article are available online.

42. The utility of nonparametric transformations for imputation of survey data

    M. W. Robbins

    Journal of Official Statistics, 2014

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    Missing values present a prevalent problem in the analysis of establishment survey data. Multivariate imputation algorithms (which are used to fill in missing observations) tend to have the common limitation that imputations for continuous variables are sampled from Gaussian distributions. This limitation is addressed here through the use of robust marginal transformations. Specifically, kernel-density and empirical distribution-type transformations are discussed and are shown to have favorable properties when used for imputation of complex survey data. Although such techniques have wide applicability (i.e., they may be easily applied in conjunction with a wide array of imputation techniques), the proposed methodology is applied here with an algorithm for imputation in the USDA’s Agricultural Resource Management Survey. Data analysis and simulation results are used to illustrate the specific advantages of the robust methods when compared to the fully parametric techniques and to other relevant techniques such as predictive mean matching. To summarize, transformations based upon parametric densities are shown to distort several data characteristics in circumstances where the parametric model is ill fit; however, no circumstances are found in which the transformations based upon parametric models outperform the nonparametric transformations. As a result, the transformation based upon the empirical distribution (which is the most computationally efficient) is recommended over the other transformation procedures in practice.

43. Direct payments, cash rents, land values, and the effects of imputation in U.S. farm-level data

    M. W. Robbins and T. K. White

    Agricultural and Resource Economics Review, 2014

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    Research using the Agricultural Resource Management Survey (ARMS) and other data shows that direct government payments to farmers increase rents and the price of land. However, some ARMS data is imputed and does not account for relationships between payments and other variables. We investigate various imputation methods and benefits gained from a method with a wide scope rather than a parsimonious range of variables. Using our method, we estimate that an additional dollar of direct payment increases land value about $2.69 more per acre than ARMS imputation methods and that our imputations (using an exhaustive iterative sequential regression) outperform other methods and/or smaller models.

44. Causal inference using mixture models: A word of caution

    M. W. Robbins and C. M. Setodji

    Medical Care, 2014

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45. Hidden heroes: America’s military caregivers—Executive summary

    R. Ramchand, T. Tanielian, M. Fisher, C. A. Vaughan, T. E. Trail, and 5 more authors

    RAND Health Quarterly, 2014

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    This article distills a longer report, Hidden Heroes: America’s Military Caregivers. It describes the magnitude of military caregiving in the United States, identifies gaps in support services, and offers recommendations.

46. Changepoint detection in climatic time series with long-term trends

    C. Gallagher, R. B. Lund, and M. W. Robbins

    Journal of Climate, 2013

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    Climate time series often have artificial shifts induced by instrumentation changes, station relocations, observer changes, etc. Climate time series also often exhibit long-term trends. Much of the recent literature has focused on identifying the structural breakpoint time(s) of climate time series—the so-called changepoint problem. Unfortunately, application of rudimentary mean-shift changepoint tests to scenarios with trends often leads to the erroneous conclusion that a mean shift occurred near the series’ center. This paper examines this problem in detail, constructing some simple homogeneity tests for series with trends. The asymptotic distribution of the proposed statistic is derived; en route, an attempt is made to unify the asymptotic properties of the changepoint methods used in today’s climate literature. The tests presented here are linked to the ubiquitous t test. Application is made to two temperature records: 1) the continental United States record and 2) a local record from Jacksonville, Illinois.

47. Imputation in high dimensional economic data as applied to the Agricultural Resource Management Survey

    M. W. Robbins, S. K. Ghosh, and J. D. Habiger

    Journal of the American Statistical Association, 2013

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    In this article, we consider imputation in the USDA’s Agricultural Resource Management Survey (ARMS) data, which is a complex, high-dimensional economic dataset. We develop a robust joint model for ARMS data, which requires that variables are transformed using a suitable class of marginal densities (e.g., skew normal family). We assume that the transformed variables may be linked through a Gaussian copula, which enables construction of the joint model via a sequence of conditional linear models. We also discuss the criteria used to select the predictors for each conditional model. For the purpose of developing an imputation method that is conducive to these model assumptions, we propose a regression-based technique that allows for flexibility in the selection of conditional models while providing a valid joint distribution. In this procedure, labeled as iterative sequential regression (ISR), parameter estimates and imputations are obtained using a Markov chain Monte Carlo sampling method. Finally, we apply the proposed method to the full ARMS data, and we present a thorough data analysis that serves to gauge the appropriateness of the resulting imputations. Our results demonstrate the effectiveness of the proposed algorithm and illustrate the specific deficiencies of existing methods. Supplementary materials for this article are available online.

48. Changepoint detection in daily precipitation data

    C. M. Gallagher, R. B. Lund, and M. W. Robbins

    Environmetrics, 2012

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    This paper introduces a method to identify an undocumented changepoint time in a daily precipitation series. A two-state Markov chain is used to induce dependence in the precipitation amounts; our dynamics allow for seasonality in the daily observations, a structure inherent to many nonequatorial region series. No current precipitation changepoint techniques exist that consider day-to-day dependencies, the zero support set aspect (the fact that most measurements are zero), and the periodic dynamics of the problem. The test statistic is constructed by applying cumulative sum methods to a strategically devised set of one-step-ahead prediction residuals. The methods are robust to distributional assumptions, requiring only seasonal mean and transition probability estimators. Simulations are presented that demonstrate the efficacy of the methods; application to two daily precipitation series is made.

49. Mean shift testing in correlated data

    M. W. Robbins, C. M. Gallagher, R. B. Lund, and A. Aue

    Journal of Time Series Analysis, 2011

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    Several tests for detecting mean shifts at an unknown time in stationary time series have been proposed, including cumulative sum (CUSUM), Gaussian likelihood ratio (LR), maximum of F(Fmax) and extreme value statistics. This article reviews these tests, connects them with theoretical results, and compares their finite sample performance via simulation. We propose an adjusted CUSUM statistic which is closely related to the LR test and which links all tests. We find that tests based on CUSUMing estimated one-step-ahead prediction residuals from a fitted autoregressive moving average perform well in general and that the LR and Fmax tests (which induce substantial computational complexities) offer only a slight increase in power over the adjusted CUSUM test. We also conclude that CUSUM procedures work slightly better when the changepoint time is located near the centre of the data, but the adjusted CUSUM methods are preferable when the changepoint lies closer to the beginning or end of the data record. Finally, an application is presented to demonstrate the importance of the choice of method.

50. Farm commodity payments and imputation in the Agricultural Resource Management Survey

    M. W. Robbins and T. K. White

    American Journal of Agricultural Economics, 2011

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51. Changepoints in the North Atlantic tropical cyclone record

    M. W. Robbins, R. B. Lund, C. M. Gallagher, and Q. Lu

    Journal of the American Statistical Association, 2011

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    This article examines the North Atlantic tropical cyclone record for statistical discontinuities (changepoints). This is a controversial area and indeed, our end conclusions are opposite of those made in Dr. Kelvin Droegemeier’s July 28, 2009 Senate testimonial. The methods developed here should help rigorize the debate. Elaborating, we develop a level-α test for a changepoint in a categorical data sequence sampled from a multinomial distribution. The proposed test statistic is the maximum of correlated Pearson chi-square statistics. This test statistic is linked to cumulative sum statistics and its null hypothesis asymptotic distribution is derived in terms of the supremum of squared Brownian bridges. The methods are used to identify changes in the tropical cyclone record in the North Atlantic Basin over the period 1851–2008. We find changepoints in both the storm frequencies and their strengths (wind speeds). The changepoint in wind speed is not found with standard cumulative sum mean shift changepoint methods, hence providing a dataset where categorical probabilities shift but means do not. While some of the identified shifts can be attributed to changes in data collection techniques, the hotly debated changepoint in cyclone frequency circa 1995 also appears to be significant.

Book Chapters

1. A statistical analysis of North Atlantic tropical cyclone changes

   T. J. Fisher, R. B. Lund, and M. W. Robbins

   In Quantitative Approaches to Evaluating Climate Change Impacts, 2020

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Technical Reports

1. Exploring Contraceptive Care and Access Experiences of Veterans

   J. Rollison, S. A. Miner, E. Li, M. Robbins, D. Shinnick, and 1 more author

   Oct 2025

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   Practical access to contraceptive care and the ability to choose care that meets one’s needs and preferences are important for an individual’s health and well-being in the United States. Although a significant amount of research has been done to examine access to contraceptive care, particularly among civilian women, there is significantly less understanding about the needs, preferences, and experiences of veteran men and women. We conducted a mixed-methods study of men and women veterans’ access to, knowledge of, and use of contraception and contraceptive care.

2. Benchmarking the Transportation Security Administration’s Covert Index Testing Program

   J. C. Chang, M. W. Robbins, V. Barrer, and N. Maslov

   Apr 2025

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   The Transportation Security Administration (TSA) conducts various covert testing programs as one of many ways to ensure the effectiveness of TSA’s workforce, operations, and programs. One such program is TSA Inspection’s Red Team Index Division’s (RTID’s) covert testing program, or the Index testing program, which is carefully directed and conducted from TSA headquarters. Index testing involves teams of detailed supervisory transportation security officers, detailed security training instructors, and inspection transportation security specialists who attempt to covertly bring standardized threat items in carry-on baggage, on their person, or in checked baggage through checkpoints into secure areas at commercial airports. The program is intended to produce quality testing data suitable for a national-level analysis.
   Considering the importance of Index testing to the security of commercial aviation, the U.S. Department of Homeland Security (DHS) Science and Technology Directorate (S&T), in consultation with RTID, asked a research team from the Homeland Security Operational Analysis Center (HSOAC) to benchmark Index testing against other testing analogues (covert or overt, and for different purposes) to see whether the program conforms to some industry quality management standards or best practices.
   The findings and recommendations presented in this report are based on a literature review, interviews, and the HSOAC team’s experience with Index testing. From the literature review and interviews, we were unable to find a direct analogue to Index testing. The existing programs that we identified lacked the resources required to run many replications of a test scenario and perform rigorous statistical analyses. However, we were able to find some standards in the literature that are applicable to Index testing. Using subjective determination, we observed that most of these standards are currently implemented in Index testing but that the implementation status for a handful of standards is unclear (i.e., either they were not implemented or we were unable to assert with confidence that the standard is implemented). We made recommendations on whether RTID should consider new steps toward implementing these standards. We then isolated aspects of Index testing that appear to be untouched by existing standards (because of the unique nature of the program) and proposed some relevant new standards that RTID might consider to fill those gaps.

3. Perceptions of Mental Health Confidentiality Policies and Practices in the U.S. Military

   E. C. Wong, M. Waymouth, R. K. McBain, T. L. Schell, G. Hindmarch, and 6 more authors

   Dec 2024

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   The Office of the Secretary of Defense contracted with the RAND Corporation to examine the potential impact of existing U.S. military mental health confidentiality policies on service members seeking assistance for mental health issues. RAND was tasked with conducting a multimethods investigation involving key-stakeholder interviews with military mental health providers, commanding officers, and enlisted service members, as well as conducting a survey of the active component regarding knowledge, understanding, and practices associated with mental health confidentiality policies in the military. This report provides findings from all data collection efforts and is intended for Office of the Secretary of Defense personnel who are responsible for psychological health treatment policies and practices.

4. Understanding Veterans in New York: A Needs Assessment of Veterans Recently Separated from the Military

   J. S. Ringel, J. Lejeune, J. Phillips, M. Robbins, M. A. Bradley, and 2 more authors

   Oct 2024

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   This report presents the findings of a survey of recently discharged or separated service members residing in New York state. The study aimed to assess veterans’ needs by understanding the health and well-being of recently discharged or separated veterans, identifying barriers to accessing services, and learning about their experiences with health care provided through the Department of Veterans Affairs (VA). The results offer critical information that can inform policy and practice changes to improve awareness of, access to, and use of needed services among veterans living in New York.

5. America’s Post-9/11 Military and Veteran Caregivers

   M. W. Robbins, R. Ramchand, G. Swabe, and K. Hyde

   Sep 2024

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   In 2024, RAND published America’s Military and Veteran Caregivers: Hidden Heroes Emerging from the Shadows. The authors of that report presented data from the 2023 RAND Caregiving Survey; produced new estimates of the number of adults caregiving in the United States today; investigated how those caring for wounded, ill, and injured service members and veterans compare with those caring for civilians and with non-caregivers; and shared insights on the potential impacts of caregiving on caregivers’ health, their economic security, and their families’ well-being. In this related report, the authors provide estimates specific to caregivers providing care to service members and veterans who served in the U.S. military after September 11, 2001. To produce valid and more-precise estimates for this population, the authors employed a statistical technique blending data from the probability-based 2023 RAND Caregiving Survey with two convenience samples of caregivers.

6. Interactive Pardee RAND Food-Energy-Water Security Index

   H. H. Willis, D. G. Groves, J. S. Ringel, Z. Mao, S. Efron, and 3 more authors

   Jan 2024

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7. Pardee RAND Food-Energy-Water Index: Updates as of 2023

   Z. H. Tariq, H. H. Willis, and M. W. Robbins

   Oct 2023

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8. Public Perceptions of Artificial Intelligence for Homeland Security

   B. Boudreaux, D. Yeung, R. Steratore, T. Goode, N. Kalra, and 6 more authors

   Mar 2024

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   To ensure that the U.S. Department of Homeland Security (DHS) can effectively integrate artificial intelligence (AI) into its missions, the department must evaluate the public’s perceptions of DHS use of AI. In this study, researchers used a nationally representative survey to evaluate the American public’s views of DHS use of AI. The insights and recommendations from this study will help DHS officials and other key stakeholders understand and integrate public perception into technology deployments.

9. 2018 Department of Defense Health Related Behaviors Survey (HRBS): Results for the Reserve Component

   S. O. Meadows, C. C. Engel, R. L. Collins, R. L. Beckman, J. Breslau, and 13 more authors

   Apr 2021

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   The Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense’s flagship survey for understanding the health, health-related behaviors, and well-being of service members. Originally implemented to assess substance use (i.e., illicit drugs, alcohol, and tobacco), the survey now includes content areas—such as mental and physical health, sexual behavior, and postdeployment problems—that may affect force readiness or the ability to meet the demands of military life. The HRBS is intended to supplement administrative data already collected by the armed forces.
   
   In 2016, the Defense Health Agency asked the RAND Corporation to review previous iterations of the HRBS, update survey content, administer a revised version of the survey, and analyze data from the resulting 2018 HRBS. The 2018 HRBS included U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard personnel in both the active and reserve components, and this report details the survey methodology and results for the reserve component. A separate report details the survey methodology and results for the active component. No expertise in health, health-related behaviors, or health care is required to read this report. However, this report might be of most use to individuals who provide direct care related to the health and health-related behaviors of active-duty service members or who are responsible for making related policy decisions.

10. 2018 Department of Defense Health Related Behaviors Survey (HRBS): Results for the Active Component

    S. O. Meadows, C. C. Engel, R. L. Collins, R. L. Beckman, J. Breslau, and 13 more authors

    Apr 2021

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    The Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense’s flagship survey for understanding the health, health-related behaviors, and well-being of service members. Originally implemented to assess substance use (i.e., illicit drugs, alcohol, and tobacco), the survey now includes additional content areas—such as mental and physical health, sexual behavior, and postdeployment problems—that could affect force readiness or the ability to meet the demands of military life. The HRBS is intended to supplement administrative data already collected by the armed forces.
    
    In 2016, the Defense Health Agency asked the RAND Corporation to review previous iterations of the HRBS, update survey content, administer a revised version of the survey, and analyze data from the resulting 2018 HRBS. The 2018 HRBS included U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard personnel in both the active and reserve components, and this report details the survey methodology and results for the active component. A separate report details the survey methodology and results for the reserve component. No expertise in health, health-related behaviors, or health care is required to read this report. However, it may be of most use to individuals who provide direct care related to the health and health-related behaviors of active component service members or who are responsible for making related policy decisions.

11. Community Planning and Capacity Building in Puerto Rico after Hurricane Maria: Pre-Disaster Conditions, Hurricane Damage, and Courses of Action

    V. L. Towe, E. L. Petrun Sayers, E. W. Chan, A. Y. Kim, A. Tom, and 6 more authors

    Sep 2020

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    On August 8, 2018, the government of Puerto Rico submitted to Congress its economic and disaster recovery plan, as required by the Bipartisan Budget Act of 2018. Under contract with the Federal Emergency Management Agency (FEMA), the Homeland Security Operational Analysis Center (HSOAC) provided substantial support in developing the plan by soliciting and integrating inputs from a wide variety of stakeholders, contributing analysis where needed, and assisting with drafting the plan. The plan included an overview of damage and needs, courses of action (COAs) to meet those needs, costs of the COAs, and potential funding mechanisms for those costs.
    
    This detailed volume, released by HSOAC, is intended to support federal agencies evaluating and funding recovery actions for the Community Planning and Capacity Building (CPCB) sector. The purpose of this document is to provide decisionmakers greater detail on the conditions in Puerto Rico prior to the 2017 hurricane season, impact from Hurricanes Irma and Maria, COAs that were identified to help the sector (and, more broadly, Puerto Rico) recover in a resilient manner, potential funding mechanisms, and considerations for implementers as they move forward. HSOAC plans to release similar detailed volumes for other sectors engaged as part of recovery planning.
    
    This document will likely also be of interest to other stakeholders funding or implementing recovery activities in Puerto Rico, including commonwealth and local agencies, nongovernmental organizations, and the private sector. Furthermore, this body of material contributes to the larger literature about disaster recovery and resilience and may be of interest to other communities planning for or recovering from similar disasters.

12. Modeling the Impact of Border-Enforcement Measures

    E. Treyger, M. W. Robbins, J. Chang, and S. Tanverakul

    May 2020

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    This report presents the results of a project conducted under the title "Human Migration Modeling." The goal of this project was to explore the use of statistical modeling methods to estimate the effects of border-enforcement measures—such as technology, infrastructure, and personnel—on outcomes relevant to border security. As a result of consultations with stakeholders within U.S. Customs and Border Protection, the project focused on a subset of stationary surveillance technology, investigating the effects of the deployment of such technology assets on U.S. Border Patrol apprehensions of unlawful migrants between ports of entry along the southwest border. The project employed quasi-experimental statistical methods that are commonly used in socialscience research to evaluate the effects of various interventions (such as policy changes).
    
    This report presents the results of our analysis and the lessons we extracted from it for the broader goal of assessing the potential that statistical modeling holds for improving the evidence base relevant to border-enforcement policies and operations. Through the reported analysis and its implications, we aspired to advance the understanding of the impact or effectiveness of border-enforcement measures. The report should be of interest to both operational commanders and policymakers within the U.S. Department of Homeland Security (DHS), particularly within Customs and Border Protection. The report demonstrates a mode of analysis that yields evidence relevant to investment decisions, operational decisions, and planning within DHS. It should also be of interest to other policy and academic researchers, as well as the broader community of experts engaged in immigration enforcement and border security policy.

13. RAND American Educator Panels (AEP) Technical Description

    M. Robbins and D. Grant

    Mar 2020

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    This report describes the methodology behind the RAND American Educator Panels, which consist of the American School Leader Panel and the American Teacher Panel. It provides detailed information on the panels, the multiple phases and waves of recruitment used to create the panels, weighting, and variance estimation.

14. Medicare’s Ground Ambulance Data Collection System: Sampling and Instrument Considerations and Recommendations

    A. Mulcahy, K. Becker, J. Cantor, S. Ashwood, J. Ringel, and 12 more authors

    Jul 2019

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15. Evaluation of the Strength Aptitude Test and Other Fitness Tests to Qualify Air Force Recruits for Physically Demanding Specialties

    S. M. Robson, S. Pezard, M. C. Lytell, C. S. Sims, J. Boon, and 7 more authors

    Aug 2018

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    The Air Force uses the Strength Aptitude Test (SAT) to determine whether recruits meet the fitness levels needed to perform the duties of various Air Force specialties with physical strength requirements. However, the SAT was developed in the early 1980s and has not been revalidated since then. In the interim, the duties associated with many Air Force Specialty Code (AFSC) classifications have changed, and new ones have been added. This report evaluates the status and validity of the SAT in a series of studies and builds upon previous RAND research on the SAT (Sims et al., 2014). It also suggests alternative strategies for developing SAT requirements that accurately reflect the physical demands of Air Force jobs while minimizing adverse effects on job opportunities for women.

16. Military Mental Health: Provider Perspectives on Treating PTSD and Depression

    K. A. Hepner, C. Farris, C. M. Farmer, P. O. Iyiewuare, T. Tanielian, and 4 more authors

    Apr 2017

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    The Military Health System (MHS) plays a critical role in maintaining a physically and psychologically healthy force. Ensuring the quality and availability of programs and services targeting two of the most common mental health conditions diagnosed and treated in the MHS—posttraumatic stress disorder (PTSD) and depression—is a key contributor to this goal. This research brief provides data on various aspects of the MHS capacity to treat PTSD and depression.

17. Delivering Clinical Practice Guideline–Concordant Care for PTSD and Major Depression in Military Treatment Facilities

    K. A. Hepner, C. Farris, C. M. Farmer, P. O. Iyiewuare, T. Tanielian, and 4 more authors

    Jan 2017

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    The U.S. Department of Defense (DoD) strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to meeting this goal. Given the rates of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) among U.S. service members, attention has been directed to ensuring the quality and availability of programs and services targeting these and other psychological health conditions. Understanding the capacity of the MHS and its providers to deliver high-quality care for PTSD and MDD is an important step in support of future efforts to improve care across the MHS.
    
    DoD’s Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) asked the RAND Corporation to conduct an assessment of the capacity of the MHS to deliver evidence-based care for PTSD and MDD and to recommend areas in which the MHS could focus its efforts to continuously improve the quality of care provided to all service members. This document is the final report on the results of that study. Specifically, this report (1) provides an overview of the psychological health (PH) workforce at military treatment facilities (MTFs), (2) describes the extent to which PH providers within MTFs report delivering guideline-concordant care for PTSD and MDD, (3) identifies facilitators and barriers to providing this care, and (4) provides recommendations to increase the use and monitoring of guideline-concordant care for PTSD and MDD. It complements other RAND studies that have examined administrative data and medical records of service members diagnosed with PTSD or depression to assess the types of care they actually received.

18. What Supports Do Teachers Need to Help Students Meet Common Core State Standards for English Language Arts and Literacy? Findings from the American Teacher and School Leader Panels

    J. H. Kaufman, L. S. Hamilton, B. M. Stecher, S. Naftel, M. Robbins, and 4 more authors

    Dec 2016

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    New state standards for what students should learn in English language arts and literacy (ELA/literacy)—including Common Core State Standards (CCSS) and standards adapted from CCSS have changed expectations for what teachers should know and be able to do in their classrooms. However, policymakers and school leaders have insufficient evidence about whether teachers are prepared to address CCSS in their classrooms and what additional professional development (PD) opportunities teachers may need to do so. In this short report, we present teachers’ self-reports about their capacity to implement CCSS, as well as the PD opportunities they have received and their needs for additional professional learning. We specifically focus on teachers who reported that they are expected to address state ELA/literacy standards in their instruction. These findings are intended to provide guidance to both states and districts seeking ways to best support educators and help students meet state standards.

19. What Supports Do Teachers Need to Help Students Meet Common Core State Standards for Mathematics? A RAND Brief with Findings from the American Teacher and School Leader Panels

    L. S. Hamilton, J. H. Kaufman, B. M. Stecher, S. Naftel, M. Robbins, and 4 more authors

    Oct 2016

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    Mathematics teachers across the United States have been working to adjust their instruction in response to states’ adoption of the Common Core State Standards for Mathematics (CCSS-M) or other standards adapted from CCSS-M. In this report, we document the extent to which U.S. teachers are expected to address new mathematics standards in their instruction, teachers’ familiarity with these standards, the professional development (PD) opportunities that teachers report receiving, and the PD opportunities they feel they need to help them implement standards effectively.
    
    Our findings draw on RAND’s American Teacher Panel (ATP) and American School Leader Panel (ASLP). The ATP and ASLP are new survey tools that take the pulse of the nation’s educators on key issues of education policy and practice through periodic surveys of a representative sample of teachers and principals across the United States. Through these unique panels, RAND collects accurate, longitudinal data regarding educators’ perspectives on and implementation of major federal, state, and district policies put in place over the past several years, including those related to standards, assessment, and evaluation.

20. What Are Teachers’ and School Leaders’ Major Concerns About New K–12 State Tests? Findings from the American Teacher and American School Leader Panels

    J. H. Kaufman, L. S. Hamilton, B. M. Stecher, S. Naftel, M. Robbins, and 4 more authors

    Oct 2016

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    Many states have recently made major changes to their K–12 student testing programs. The media have reported growing dissatisfaction with the amount of testing happening in schools and the use of tests for high-stakes decisionmaking about schools, principals, and teachers. However, there is little systematically gathered information on the perspectives of U.S. educators who have firsthand knowledge about testing and its effects on teaching and learning. In this report, we share U.S. principals’ and teachers’ main concerns about testing, drawing upon new survey tools for understanding educators’ perspectives on the implementation of major education policies: RAND’s American Teacher Panel (ATP) and American School Leader Panel (ASLP). The ATP and ASLP take the pulse of the nation’s educators on key issues of educational policy and practice through periodic surveys of a representative sample of teachers and principals across the United States. This report focuses on educator perspectives about state testing programs; upcoming reports will also address teacher capacity and the supports provided to teachers to implement standards and assessments.

21. Promotion Benchmarks for Senior Officers with Joint and Acquisition Service

    A. A. Robbert, T. Terry, P. Emslie, and M. Robbins

    Sep 2016

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    The Goldwater–Nichols Department of Defense Reorganization Act of 1986 (Pub. L. 99-433, 1986; codified at 10 U.S.C. § 662) established objectives for promotion of officers with service in joint assignments. Congress intended the objectives to ensure that officers assigned to joint service were comparable in quality to officers serving in various capacities within the military services. The Office of the Secretary of Defense and the Joint Staff monitor achievement of the objectives using reports of promotion outcomes compiled in accordance with instructions they provide to the services.
    
    An earlier RAND Corporation study of joint officer management (Harrell et al., 1996) noted that "the comparative [Goldwater–Nichols] promotion statistics are complex and hard to comprehend... and may not represent a true picture of compliance with Goldwater–Nichols objectives" (p. 22). Some of the concerns raised in that study still exist; the objective of this study is to address those and others that have been identified. Like in that previous study, we analyzed whether the current statutory and policy objectives are working as intended, identified concerns with the calculation methodologies used to determine compliance, and developed suitable alternatives. Additionally, we addressed how Acquisition Corps officers are compared with line and equivalent officers in the same service, as prescribed in the Defense Acquisition Workforce Improvement Act (Pub. L. 101-510, 1990, Title XII). Service reports regarding joint service and Acquisition Corps promotion comparisons are compiled under a common set of instructions.
    
    Our approach relied heavily on digital data provided by the services and augmented by the Defense Manpower Data Center to confirm the services’ promotion outcome reporting procedures and to determine how the reports would appear under alternative policies and reporting instructions.

22. Ready to Serve: Community-Based Provider Capacity to Deliver Culturally Competent, Quality Mental Health Care to Veterans and Their Families

    T. Tanielian, C. Farris, C. Epley, C. M. Farmer, E. Robinson, and 3 more authors

    Nov 2014

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    RAND’s study was designed to assess the potential performance of the system of care for service members, veterans, and their families, with a particular focus on community-based, civilian providers. This study specifically addresses the potential readiness of mental health providers working in community settings to deliver culturally competent, high-quality care to service members, veterans, and their families. This study builds upon previous studies examining similar issues for providers working within VA and DoD settings, as well as two studies of civilian providers. We explore provider capabilities, attitudes, and behaviors as they relate to providing high-quality and culturally appropriate care, and we examine what factors may predict their readiness to deliver such care. Understanding the skills and training of mental health providers from non-DoD and non-VA settings who are potentially delivering care to service members, veterans, and families will help inform expectations about what types of care these beneficiaries may experience within civilian settings and the extent to which that care is of a high quality. Such information can also help direct future training efforts designed to ensure that providers are ready, capable, and willing to address the mental health needs of our nations’ veterans and their families. The following sections provide additional information about our approach, findings, and the implications from this research.

23. Key Facts and Statistics from the RAND Military Caregivers Study

    R. Ramchand, T. Tanielian, M. Fisher, C. Vaughan, T. Trail, and 5 more authors

    Apr 2014

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    This presentation slide deck offers key facts and statistics from the RAND Military Caregivers study. The results of the study are fully documented in Ramchand R, Tanielian T, et al., Hidden Heroes: America’s Military Caregivers, RAND Corporation, 2014. These charts and figures are offered in both Microsoft PowerPoint and .PDF formats for ease of insertion into other presentation slide decks.

24. Hidden Heroes: America’s Military Caregivers

    R. Ramchand, T. Tanielian, M. Fisher, C. Vaughan, T. Trail, and 5 more authors

    Mar 2014

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    After a decade of war, supporting returning service members, veterans, and their families remains a national priority. Addressing the treatment and recovery needs of those who have been wounded, ill, or injured has been a special area of focus. This most recent cohort of wounded, ill, and injured veterans—those who served after September 2001–benefited from improved battlefield medicine and rehabilitative services that allowed them to return to their homes and communities much more rapidly than cohorts before them. In their recovery and reintegration, many of these veterans are aided by the support and assistance of nonprofessional or informal caregivers: individuals who provide a broad range of care and assistance with activities of daily living, such as bathing, dressing, and eating, and who help them relearn basic skills, arrange and take them to medical appointments, manage their finances, and care for their children.
    
    While much has been written about the role of caregiving for the elderly and chronically ill and for children with special needs, little is known about the population of those who care for military personnel and veterans, referred to as "military caregivers" in this report. An earlier RAND report, Military Caregivers: Cornerstones of Support for Our Nation’s Wounded, Ill, and Injured Veterans (Tanielian et al., 2013), summarized the scant literature on this group and outlined the need for continued research to understand the characteristics and needs of this population. This report summarizes the results of a two-part study designed to describe the magnitude of military caregiving in the United States today, as well as to identify gaps in the array of programs, policies, and initiatives designed to support military caregivers. The findings from this study will be of interest to policy and program officials within the agencies and organizations that sponsor and implement caregiver support programs.

25. Military Caregivers: Who Are They? And Who Is Supporting Them?

    R. Ramchand, T. Tanielian, M. Fisher, C. Vaughan, T. Trail, and 5 more authors

    Mar 2014

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    More than 2.5 million U.S. service members have been deployed to Afghanistan and Iraq since 2001. Their wartime experiences have led to a sharp increase in the number of veterans living with disabilities. Many veterans of these and earlier conflicts rely for their day-to-day needs on care provided by family or friends. These informal caregivers, whom we term military caregivers, provide a range of indispensable services, saving the nation millions of dollars in health and long-term care costs. RAND researchers estimate that there are 5.5 million military caregivers in the United States today. To improve the nation’s understanding of this little-studied group and the programs and services available to them, we set out to describe who these caregivers are, the burden of care that they bear, their support needs, the constellation of programs and other resources that exist to support them, and areas where additional support is needed.

Manuals

1. gerbil: Generalized Efficient Regression-Based Imputation with Latent Processes

   M. Robbins, P. Lima, and M. Griswold

   Mar 2023

   R package version 0.1.9

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2. microsynth: Synthetic Control Methods with Micro- And Meso-Level Data

   M. Robbins and S. Davenport

   Mar 2025

   R package version 2.0.51

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