PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-25 (210)
 

Clipboard (0)
None

Select a Filter Below

Journals
Year of Publication
more »
1.  Review and Meta-analysis of Couple-Oriented Interventions for Chronic Illness 
Background
Evidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and partner may enhance the efficacy of psychosocial or behavioral interventions for chronic illness.
Purpose
The purpose of this report is to present a cross-disease review of the characteristics and findings of studies evaluating couple-oriented interventions for chronic physical illness.
Methods
We conducted a qualitative review of 33 studies and meta-analyses for a subset of 25 studies.
Results
Identified studies focused on cancer, arthritis, cardiovascular disease, chronic pain, HIV, and Type 2 diabetes. Couple interventions had significant effects on patient depressive symptoms (d=0.18, p<0.01, k=20), marital functioning (d=0.17, p<0.01, k=18), and pain (d=0.19, p<0.01, k=14) and were more efficacious than either patient psychosocial intervention or usual care.
Conclusions
Couple-oriented interventions have small effects that may be strengthened by targeting partners’ influence on patient health behaviors and focusing on couples with high illness-related conflict, low partner support, or low overall marital quality. Directions for future research include assessment of outcomes for both patient and partner, comparison of couple interventions to evidence-based patient interventions, and evaluation of mechanisms of change.
doi:10.1007/s12160-010-9216-2
PMCID: PMC4101802  PMID: 20697859
Couples; Chronic illness; Intervention; Meta-analysis
2.  Predictors of Moderate-to-Vigorous Physical Activity (MVPA) in African American Young Adolescents 
Background
African American adolescents residing in the South are at increased risk for obesity and physical inactivity, yet our understanding of potential influences is limited.
Purpose
Using an ecological framework, this study explored multilevel predictors (individual, family, home, and neighborhood environment) of moderate-to-vigorous physical activity (MVPA) among 116 African American adolescents (ages 12–16).
Methods
Adolescents and their parents completed self-report surveys for hypothesized predictors. Youth physical activity was measured using accelerometry.
Results
In multiple regression models, decreased daily MVPA was associated with female sex (β=−24.27, p<0.0001). Family social support (β=1.07, p=0.004) and adolescent self efficacy for PA (β=6.89, p=0.054) were positively associated with daily MVPA.
Conclusions
Adolescent demographics along with family social support and self-efficacy influence younger African American adolescent physical activity. Further exploration of the complex interaction of multiple levels of influence is needed to develop appropriate interventions for this vulnerable group.
doi:10.1007/s12160-012-9437-7
PMCID: PMC4091819  PMID: 23334766
Physical activity; Adolescents; African American; Physical inactivity
3.  Victimization, Smoking, and Chronic Physical Health Problems Among Sexual Minority Women 
Background
Sexual minority women (SMW) have been shown to be at increased risk for abuse, smoking, and chronic physical health problems compared with heterosexual women. In the general population, abuse and smoking are associated with physical health problems. However, there has been little research on their associations among SMW.
Purpose
The current study examined a mediational model of abuse, smoking, and self-reported physical health conditions in a national sample of SMW.
Methods
Participants (N=1,224) were recruited via the Internet and completed measures of childhood trauma, adult sexual assault, smoking, body mass index, and chronic medical conditions.
Results
Structural equation modeling demonstrated that childhood abuse was associated with adult sexual assault, smoking, and physical health problems, but smoking was not a significant mediator.
Conclusions
The results highlight the impact of childhood abuse on physical health problems among SMW and the need to examine other health behaviors that may mediate this relation.
doi:10.1007/s12160-011-9289-6
PMCID: PMC4083397  PMID: 21735343
Lesbian; Bisexual; Physical health; Abuse; Smoking
4.  Exploring the Intergenerational Transmission of Illness Behavior: From Observations to Experimental Intervention 
Background
Functional abdominal pain (FAP) of childhood is characterized by, among other things, pain with no known physiological cause, and family patterns of related disorders have been reported.
Purpose
The purpose of this paper is to trace the development of one FAP research program and highlight some of its key findings from observations of interaction patterns to intervention studies designed to test outcomes of altering these patterns.
Methods
Studies summarized include observational and experimental research.
Results
Parental response to child pain behaviors appears to be a key factor in the development and maintenance of FAP, and intervention which includes targeting changes in parental responses can decrease reports of pain and other illness behaviors.
Conclusions
Research into FAP can provide valuable information for not only FAP and other unexplained pain conditions, but other medical conditions where environmental responses may play an important role in their etiology and maintenance.
doi:10.1007/s12160-010-9254-9
PMCID: PMC4041525  PMID: 21170690
Functional abdominal pain; Illness behavior; Intergenerational transmission
5.  The Case for Conscientiousness: Evidence and Implications for a Personality Trait Marker of Health and Longevity 
Purpose
Recent initiatives by major funding agencies have emphasized translational and personalized approaches (e.g., genetic testing) to health research and health management. While such directives are appropriate, and will likely produce tangible health benefits, we seek to highlight a confluence of several lines of research showing relations between the personality dimension of conscientiousness and a variety of health-related outcomes.
Methods
Using a modified health process model, we review the compelling evidence linking conscientiousness to health and disease processes, including longevity, diseases, morbidity-related risk factors, health-related psycho-physiological mechanisms, health-related behaviors, and social environmental factors related to health.
Conclusion
We argue the accumulated evidence supports greater integration of conscientiousness into public health, epidemiological, and medical research, with the ultimate aim of understanding how facilitating more optimal trait standing might foster better health.
doi:10.1007/s12160-012-9454-6
PMCID: PMC3604184  PMID: 23225322
Conscientiousness; health; public health
6.  Chronic Fatigue and Personality: A Twin Study of Causal Pathways and Shared Liabilities 
Background
The etiology of chronic fatigue syndrome (CFS) remains unknown. Personality traits influence well-being and may play a role in CFS and unexplained chronic fatigue.
Purpose
To examine the association of emotional instability and extraversion with chronic fatigue and CFS in a genetically informative sample.
Methods
We evaluated 245 twin pairs for two definitions of chronic fatigue. They completed the Neuroticism and Extraversion subscales of the NEO-FFI. Using a co-twin control design, we examined the association between personality and chronic fatigue.
Results
Higher emotional instability was associated with both definitions of chronic fatigue and was confounded by shared genetics. Lower extraversion was also associated with both definitions of fatigue, but was not confounded by familial factors.
Conclusions
Both emotional instability and extraversion are related to chronic fatigue and CFS. Whereas emotional instability and chronic fatigue are linked by shared genetic mechanisms, the relationship with extraversion may be causal and bi-directional.
doi:10.1007/s12160-012-9463-5
PMCID: PMC3643988  PMID: 23361410
chronic fatigue; personality; extraversion; neuroticism; twin; genetic
7.  Consistency and Timing of Marital Transitions and Survival During Midlife: the Role of Personality and Health Risk Behaviors 
Background
Marital status is associated with survival.
Purpose
The aims of this study are to evaluate marital history and timing on mortality during midlife, test the role of pre-marital personality, and quantify the role of health risk behaviors.
Methods
Cox proportional hazard models were run with varying classifications of marital history and sets of covariates.
Results
In fully adjusted models compared to the currently married, lifetime marital history predicts premature mortality with never married at 2.33 times risk of death and ever married at 1.64 risk of death. Midlife marital history shows that not having a partner during midlife (hazard ratio (HR)= 3.10 formerly married; HR=2.59 remaining single) has the highest risk of death. Controlling for personality and health risk behaviors reduces but does not eliminate the impact of marital status.
Conclusion
Consistency of marital status during midlife suggests that lack of a partner is associated with midlife mortality.
doi:10.1007/s12160-012-9457-3
PMCID: PMC3644000  PMID: 23299546
Marital history; Midlife mortality; Longitudinal study; UNC Alumni Heart Study
9.  Effects of Patient-Provider Race Concordance and Smoking Status on Lung Cancer Risk Perception Accuracy among African Americans 
Background
Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities.
Purpose
A controlled experiment assessed whether perceived physician race influenced African-American patients’ (n=127) risk perception accuracy following the provision of objective lung cancer risk information.
Methods
Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information.
Results
Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94)=4.02, p=.048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter.
Conclusions
The current study demonstrates that African-American patients’ perceptions of a doctor’s race are sufficient to independently impact their processing of lung cancer risk information.
doi:10.1007/s12160-013-9475-9
PMCID: PMC3644014  PMID: 23389688
lung cancer; risk perception; race concordance; smoking; virtual reality
10.  Interactive Influences of Ethnicity, Endothelin-1 Gene, and Everyday Discrimination Upon Nocturnal Ambulatory Blood Pressure 
Background
Everyday discrimination scale scores are associated with increased ambulatory blood pressure (BP), and reduced nocturnal dipping, and the ET-1/Lys198Asn polymorphism is associated with increased resting BP and exaggerated BP reactivity among African Americans compared to European Americans. Combined influences of these factors on BP control are unknown.
Purpose
This study tested the hypothesis of a three-way interaction between ethnicity, ET-1 carrier status and everyday discrimination upon ambulatory BP and nocturnal dipping.
Methods
Baseline laboratory anthropometrics and the everyday discrimination scale were completed by 351 (175 African American) young adult normotensives; followed by 24-hour ambulatory BP monitoring.
Results
For nocturnal dipping, multiple regression models controlling for age, sex, race, and BMI revealed significant three-way ET-1 x everyday discrimination x ethnicity interactions. Specifically, among African American ET-1 T-allele carriers, increases in everyday discrimination led to reduced nocturnal dipping.
Conclusions
African Americans that carry the ET1/Lys198Asn T-allele and report higher everyday discrimination scores may be at particular risk for reduced nocturnal dipping.
doi:10.1007/s12160-013-9472-z
PMCID: PMC3644019  PMID: 23436272
Nocturnal dipping; Everyday discrimination; ET-1 polymorphism; African American
11.  The impact of substance use, sexual trauma and intimate partner violence on sexual risk intervention outcomes in couples: A randomized trial 
Background
Few HIV prevention interventions focus on sexual risk reduction as mutual process determined by couple members, though risk behaviors are inter-dependent.
Purpose
This trial examined the impact of substance use, history of sexual trauma and intimate partner violence on sexual risk associated with participation in a risk reduction intervention.
Methods
HIV sero-concordant and -discordant multicultural couples in Miami, Florida (n = 216) were randomized to group (n = 112) or individual (n = 104) couple-based interventions.
Results
Group intervention participants increased condom use in couples in which women had a history of sexual trauma (F(2,221) = 3.39, p = .036) and by partners of alcohol users. History of sexual trauma was a determinant of conflict resolution, predicting negative communication and intimate partner violence.
Conclusions
Results emphasize the need for group sexual risk reduction interventions targeting sexual trauma, partner violence and substance use among HIV seroconcordant and discordant couples.
doi:10.1007/s12160-012-9455-5
PMCID: PMC3644024  PMID: 23208648
Couples; behavioral intervention; HIV; multicultural; sexual trauma; substance use; intimate partner violence
12.  Poor Decision Making Among Older Adults Is Related to Elevated Levels of Neuroticism 
Background
A well-studied index of reasoning and decision making is the Iowa Gambling Task (IGT). The IGT possesses many features important to medical decision making, such as weighing risks and benefits, dealing with unknown outcomes, and making decisions under uncertainty.
Purpose
There exists a great deal of individual variability on the IGT, particularly among older adults, and the present study examines the role of personality in IGT performance. We explored which of the five-factor model of personality traits were predictive of decision-making performance, after controlling for relevant demographic variables.
Methods
One hundred and fifty-two healthy cognitively intact adults (aged 26–85) were individually administered the IGT and the NEO Five-Factory Inventory.
Results
In the older adults, but not the younger, higher NEO neuroticism was associated with poorer IGT performance.
Conclusions
Our findings are discussed in the context of how stress may impact cognitive performance and cause dysfunction of neural systems in the brain important for decision making.
doi:10.1007/s12160-009-9094-7
PMCID: PMC4028129  PMID: 19350336
Neuroticism; Decision making; Aging; Frontal lobe; Personality; Stress
13.  Exploring the Role of the Built and Social Neighborhood Environment in Moderating Stress and Health 
Background
Health researchers have explored how different aspects of neighborhood characteristics contribute to health and well-being, but current understanding of built environment factors is limited.
Purpose
This study explores whether the association between stress and health varies by residential neighborhood, and if yes, whether built and social neighborhood environment characteristics act as moderators.
Methods
This study uses multilevel modeling and variables derived from geospatial data to explore the role of neighborhood environment in moderating the association of stress with health. Individual-level data (N=4,093) were drawn from residents of 45 neighborhoods within Philadelphia County, PA, collected as part of the 2006 Philadelphia Health Management Corporation's Household Health Survey.
Results
We find that the negative influence of high stress varied by neighborhood, that residential stability and affluence (social characteristics) attenuated the association of high stress with health, and that the presence of hazardous waste facilities (built environment characteristics) moderated health by enhancing the association with stress.
Conclusions
Our findings suggest that neighborhood environment has both direct and moderating associations with health, after adjusting for individual characteristics. The use of geospatial data could broaden the scope of stress–health research and advance knowledge by untangling the intertwined relationship between built and social environments, stress, and health. In particular, future studies should integrate built environment characteristics in health-related research; these characteristics are modifiable and can facilitate health promotion policies.
doi:10.1007/s12160-010-9175-7
PMCID: PMC4017772  PMID: 20300905
Stress; Health; Neighborhood environment; Philadelphia
14.  Co-Occurring Psychosocial Problems and HIV Risk Among Women Attending Drinking Venues in a South African Township: A Syndemic Approach 
Background
In South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied to understanding HIV risk among marginalized groups.
Purpose
To apply the syndemic framework to examine psychosocial problems that co-occur among women attending drinking venues in South Africa, and to test how the co-occurrence of these problems may exacerbate risk for HIV infection.
Method
560 women from a Cape Town township provided data on multiple psychosocial problems, including food insufficiency, depression, abuse experiences, problem drinking, and sexual behaviors.
Results
Bivariate associations among the syndemic factors showed a high degree of co-occurrence and regression analyses showed an additive effect of psychosocial problems on HIV risk behaviors.
Conclusions
These results demonstrate the utility of a syndemic framework to understand co-occurring psychosocial problems among women in South Africa. HIV prevention interventions should consider the compounding effects of psychosocial problems among women.
doi:10.1007/s12160-012-9420-3
PMCID: PMC3578969  PMID: 23054944
HIV risk; sexual risk behavior; syndemics; mental health; abuse; alcohol
15.  The Relation between Social Cohesion and Smoking Cessation among Black Smokers, and the Potential Role of Psychosocial Mediators 
Background
Social cohesion, the self-reported trust and connectedness between neighbors, may affect health behaviors via psychosocial mechanisms.
Purpose
Relations between individual perceptions of social cohesion and smoking cessation were examined among 397 Black treatment-seeking smokers.
Methods
Continuation ratio logit models examined the relation of social cohesion and biochemically-verified continuous smoking abstinence through 6 months post-quit. Indirect effects were examined in single mediator models using a nonparametric bootstrapping procedure. All analyses controlled for sociodemographics, tobacco dependence, and treatment.
Results
The total effect of social cohesion on continuous abstinence was non-significant (β=.05, p=.10). However, social cohesion was associated with social support, positive affect negative affect, and stress, which, in turn, were each associated with abstinence in adjusted models (ps<.05).
Conclusions
Results suggest that social cohesion may facilitate smoking cessation among Black smokers through desirable effects on psychosocial mechanisms that can result from living in a community with strong interpersonal connections.
doi:10.1007/s12160-012-9438-6
PMCID: PMC3587036  PMID: 23135831
social cohesion; neighborhood trust; smoking cessation; mediation
16.  Daily Spousal Influence on Physical Activity in Knee Osteoarthritis 
Background
Physical activity is critical for the management of knee osteoarthritis, and the spouse may play a role in encouraging or discouraging physical activity.
Purpose
To examine four types of spousal influence—spouses' daily activity, autonomy support, pressure, and persuasion--on the daily physical activity of adults living with knee osteoarthritis.
Methods
A total of 141 couples reported their daily experiences for 22 days using a handheld computer, and wore an accelerometer to measure moderate activity and steps.
Results
Spouses' autonomy support for patient physical activity, as well as their own level of activity, was concurrently associated with patients' greater daily moderate activity and steps. In addition, on days when male patients perceived that spouses exerted more pressure to be active, they spent less time in moderate activity.
Conclusions
Couple-oriented interventions for knee osteoarthritis should target physical activity in both partners and spousal strategies for helping patients stay active.
doi:10.1007/s12160-012-9442-x
PMCID: PMC3594506  PMID: 23161472
couples; physical activity; daily diary; arthritis; autonomy support; social control
17.  Healthy for Life: A Randomized Trial Examining Physical Activity Outcomes and Psychosocial Mediators 
Background
Researchers theorize that interventions increase physical activity by influencing key theory-based mediators (e.g., behavioral processes). However, few studies have been adequately powered to examine the importance of mediators.
Purpose
This study examined both physical activity behavior and psychosocial mediators in a randomized trial specifically powered to detect mediation.
Methods
Healthy, sedentary adults (n=448; 70% Caucasian, 87% women, mean age was 43) were randomly assigned to either a six-month print-based theory tailored physical activity intervention (n=224) or a six-month health/wellness contact control arm (n=224).
Results
The print intervention arm exhibited greater increases in physical activity than the control arm at six and 12 months (p<.05). Additionally, behavioral processes were found to be an important mediator of physical activity behavior.
Conclusions
It is important for researchers and practitioners to focus on increasing behavioral strategies for physical activity adoption. Future studies should examine other potential mediators of physical activity.
doi:10.1007/s12160-012-9439-5
PMCID: PMC3597765  PMID: 23229158
Exercise; Physical Activity; Mediators; Intervention Studies
18.  Accuracy of Weight Perception among Urban Early Adolescents with Uncontrolled Asthma and Their Caregivers 
Background
Obesity is associated with poor asthma outcomes; weight loss improves such outcomes. Inaccurate recognition of obesity may impede weight control.
Purpose
We examined perception of weight by early adolescents with uncontrolled asthma and their caregivers, and tested the relationship between medical visit frequency and accuracy of perceived weight status.
Methods
373 adolescents and their caregivers reported the adolescent’s height/weight and weight perception; caregivers reported healthcare utilization. We measured height/weight. Logistic regression modeled accuracy of weight perception.
Results
43.7% of the overweight/obese adolescents and caregivers accurately perceived weight status. BMI percentile (OR=1.19, CI=1.10–1.28) and total medical visits (OR=1.18, CI=1.05–1.33) were associated with higher accuracy in caregivers. Total medical visits (OR=0.84, CI=0.74–0.96) was associated with lower accuracy in adolescents.
Conclusions
Accurate perception of weight status was poor for overweight adolescents with uncontrolled asthma and their caregivers. Frequent medical visits were associated with improved caregivers’ but not adolescents’ perceptions.
doi:10.1007/s12160-012-9452-8
PMCID: PMC3602231  PMID: 23355113
asthma; obesity; perception; ethnic minority; inner-city; early adolescents
20.  Pathways Linking Socioeconomic Status and Postpartum Smoking Relapse 
Background
Low socioeconomic status (SES) exacerbates the high rate of smoking relapse in women following childbirth.
Purpose
This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse among women who quit smoking due to pregnancy.
Methods
Participants were 251 women enrolled in a randomized clinical trial of a new postpartum smoking relapse prevention intervention. Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach.
Results
Each of the hypothesized models were a good fit for the data. As hypothesized, SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress, reduced sense of agency, and increased craving for cigarettes. However, the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models.
Conclusions
Findings have implications for future interventions that aim to reduce postpartum relapse.
doi:10.1007/s12160-012-9434-x
PMCID: PMC3854787  PMID: 23086590
Smoking; Postpartum; Structural Equation Modeling; Relapse; Socioeconomic Status
21.  State and Trait Pain Catastrophizing and Emotional Health in Rheumatoid Arthritis 
Background
Pain catastrophizing is a powerful predictor of pain adaptation, and both stable and time-varying aspects may influence overall emotional well-being.
Purpose
Test the independent influences of state and trait pain catastrophizing on the relationship between daily intensity and negative affect, positive affect, and depressive symptoms.
Method
Daily diary data were collected for 30 days from a sample of 231 adults with a diagnosis of rheumatoid arthritis (RA).
Results
State pain catastrophizing accounted for a significant proportion of the relationship between daily pain and each of the 3 examined daily outcomes. Greater trait pain catastrophizing significantly increased the effect of state pain catastrophizing on the relationship between pain intensity and the outcome variables in cross-sectional and time-lagged models.
Conclusions
The results of the current study indicate that state pain catastrophizing plays a prominent role in the adaptation to daily pain fluctuations, particularly for those with a propensity to catastrophize.
doi:10.1007/s12160-012-9408-z
PMCID: PMC3547141  PMID: 22915012
pain catastrophizing; emotion; depression; chronic pain
22.  Physical Activity and Differential Methylation of Breast Cancer Genes Assayed from Saliva: A Preliminary Investigation 
Purpose
Individuals who exercise are at lower risk for breast cancer and have better post-diagnosis outcomes. The biological mechanisms behind this association are unclear, but DNA methylation has been suggested.
Methods
We developed a composite measure of DNA methylation across 45 CpG sites on genes selected a priori. We examined the association of this measure to self-reported physical activity and objectively measured cardiovascular fitness in a sample of healthy nonsmoking adults (n = 64) in an exercise promotion intervention.
Results
Individuals who were more physically fit and who exercised more minutes per week had lower levels of DNA methylation. Those who increased their minutes of physical activity over 12 months experienced decreases in DNA methylation.
Conclusions
DNA methylation may be a mechanism linking exercise and cancer incidence, and could serve as a biomarker for behavioral intervention trials. Studies with larger samples, objectively measured exercise, and more cancer-related markers are needed.
doi:10.1007/s12160-012-9411-4
PMCID: PMC3548059  PMID: 23054940
DNA methylation; breast cancer; fitness; physical activity; biomarker
23.  Using Google Street View to Audit the Built Environment: Inter-rater Reliability Results 
Background
Observational field audits are recommended for public health research to collect data on built environment characteristics. A reliable, standardized alternative to field audits that uses publicly available information could provide the ability to efficiently compare results across different study sites and time.
Purpose
This study aimed to assess inter-rater reliability of built environment audits conducted using Google Street View imagery.
Methods
In 2011, street segments from St. Louis and Indianapolis were geographically stratified to ensure representation of neighborhoods with different land use and socioeconomic characteristics in both cities. Inter-rater reliability was assessed using observed agreement and the prevalence-adjusted bias-adjusted kappa statistic (PABAK).
Results
The mean PABAK for all items was 0.84. Ninety-five percent of the items had substantial (PABAK≥0.60) or nearly perfect (PABAK≥0.80) agreement.
Conclusions
Using Google Street View imagery to audit the built environment is a reliable method for assessing characteristics of the built environment.
doi:10.1007/s12160-012-9419-9
PMCID: PMC3549312  PMID: 23054943
Physical activity; Measurement; Imagery
24.  Outcomes from a diabetes self-management intervention for Native Hawaiians and Pacific People: Partners in Care 
Background
Culturally-adapted interventions are needed to reduce diabetes-related morbidity and mortality among Native Hawaiian and Pacific People.
Purpose
To pilot test the effectiveness of a culturally-adapted diabetes self-management intervention.
Methods
Participants were randomly assigned in an unbalanced design to the Partners in Care intervention (n=48) or wait list control group (n=34). Assessments of hemoglobin A1c, understanding of diabetes self-management, performance of self-care activities, and diabetes-related distress were measured at baseline and 3 months (post intervention). Analysis of covariance was used to test between-group differences. The community steering committee and focus group data informed the cultural adaptation of the intervention.
Results
There were significant baseline adjusted differences at 3 months between the Partners in Care and wait list control group in intent-to-treat (p<0.001) and complete case analyses (p<0.0001) for A1c, understanding (p<0.0001), and performing diabetes self-management (p<0.0001).
Conclusions
A culturally-adapted diabetes self-management intervention of short duration was an effective approach to improving glycemic control among Native Hawaiian and Pacific Islanders.
doi:10.1007/s12160-012-9422-1
PMCID: PMC3556352  PMID: 23086589
Health disparities; Native Hawaiian and Pacific People; diabetes self-management; intervention; culturally adapted; randomized controlled trial; community-based; peer educators
25.  Worry about cancer progression and low perceived social support: Implications for quality of life among early-stage breast cancer patients 
Background
Worry about cancer progression and perceived social support can affect cancer survivors’ quality of life (QOL).
Methods
In 480 early-stage breast cancer survivors, we examined how worry about cancer progression and perceived social support six months after definitive surgery were associated with QOL (RAND 36-item Health Survey) at six-, 12-, and 24-month follow-up.
Results
At six months post-surgery, higher worry was associated with worse QOL for five of eight subscales. Lower social support was associated with worse QOL for four subscales. The negative effects of worry and limited social support dissipated for four subscales (worry) and two subscales (social support) by 12-month follow-up and for all subscales by 24-month follow-up. Social support at six months moderated the relationship between T2 worry and T4 emotional well-being; post-hoc tests did not clarify the nature of the interaction.
Conclusion
Early-stage breast cancer survivors who worry about cancer progression and/or have low social support may experience lower levels of QOL that can take several months to resolve.
doi:10.1007/s12160-012-9406-1
PMCID: PMC3561492  PMID: 22983622
quality of life; breast cancer; social support; worry; progression

Results 1-25 (210)