Although illustrated medication instructions may improve medication management among vulnerable populations, little prior research has evaluated their use among Latinos. We conducted focus groups and interviews with Latino patients with diabetes at two safety net clinics in Tennessee to understand medication taking practices and perceptions of illustrated medication instructions. Patients reported confidence in being able to take medications, but demonstrated a lack of understanding of medication instructions. On further probing, they described several barriers to effective medication management rooted in poor communication. Patients expressed preference for illustrated medication instructions which could address several of the challenges raised by patients.
Adherence; communication; culture; health education; medication; patient satisfaction; qualitative methods
One-third of adults living with HIV/AIDS are over the age of 50. This study evaluated the structure of coping among 307 older adults living with HIV/AIDS. Participants completed 61 coping items and measures of anxiety, depression, loneliness, and coping self-efficacy. Exploratory factor analyses retained 40 coping items loading on five specific first order factors (Distancing Avoidance, Social Support Seeking, Self-Destructive Avoidance, Spiritual Coping, and Solution-Focused Coping) and two general second order factors (Active and Avoidant Coping). Factors demonstrated good reliability and validity. Results suggest that general coping factors should be considered with specific factors when measuring coping among older adults.
aging; coping; exploratory factor analysis; HIV/AIDS; older adults
This study investigated whether loneliness and cognitive processing explain the influence of negative (social constraints) and positive (emotional support) relationship qualities on cancer survivors’ distress. Participants were 195 cancer survivors who had undergone hematopoietic stem cell transplantation. Path analysis supported the hypothesis that loneliness and cognitive processing would mediate the association between social constraints and distress. Only loneliness mediated the association between emotional support and distress—an indirect effect significant only when support came from family and friends rather than a partner. Findings suggest that addressing social constraints may enhance cancer survivors’ adjustment.
hematopoietic stem cell transplantation; cancer survivorship; loneliness; psychological distress; social support; social constraints
Media coverage has emphasized human papillomavirus (HPV) as a vaccine-preventable, sexually transmitted virus causing cervical cancer. Appalachian undergraduate students (N = 309, 50% female) were surveyed on their knowledge of HPV; analyses of mental representations were similar to content analyses of media coverage of HPV, suggesting media cultivation. Semantic network analysis revealed linkages between vaccine, disease causation and prevention, women's centrality in the representations, and structural differences that varied between vaccinated women, unvaccinated women, and men. The findings provided insights into gaps in the public's understanding of HPV, potential stigmatization of those testing HPV+, and future challenges in vaccinating men.
human papillomavirus; semantic network analysis; belief systems; stigma; media coverage
This study investigated the psychosocial factors that influence psychological adjustment among women with genital herpes, while taking into account the physical factors. Women with herpes (N = 105, age 18–30) completed an on-line survey about factors related to their diagnosis and herpes-related quality of life. Perceived stigma, acceptance coping, denial coping, support from the Internet, and support from religious/spiritual figures accounted for 65.9 percent of the variance in quality of life scores. The findings reveal the importance of specific coping strategies and sources of support on psychological adjustment to herpes. Furthermore, a significant interaction between stigma and acceptance coping suggests a complex relationship between these two psychosocial factors that warrants future research.
coping; herpes; psychological adjustment; stigma; women
This study examined relations among indoor tanning frequency, symptoms of depression, anxiety, and obsessive-compulsive disorder, and substance use. A total of 421 college students (68% female) completed self-report measures on one occasion. Among men, indoor tanning was positively associated with symptoms of anxiety and obsessive-compulsive disorder, whereas indoor tanning was unrelated to these symptoms among women. Among women, indoor tanning was positively associated with the use of alcohol, tobacco, and other substances. Further research is needed to explore contextual and coping processes that may underlie these gender differences.
indoor tanning; skin cancer; depression; anxiety; substance use
This study examined the sources and frequency of, and dietary behavioral responses to, health-related social support and control in a racially/ethnically diverse sample of 1,361 adults with type 2 diabetes. Spouses were the most frequently reported sources of support/control for all racial/ethnic groups examined. Mexican Americans and Vietnamese Americans received more support/control compared to non-Hispanic whites. All types of social involvement were associated with good dietary behavior for Mexican Americans, whereas only support was associated with good dietary behavior for non-Hispanic whites. The findings underscore the importance of considering racial/ethnic differences in examining social network members’ involvement in chronic disease management.
social support; health-related social control; type 2 diabetes; chronic disease management; race/ethnicity
Long-term patterns of depression, and associations with health and function were examined among 1115 individuals with rheumatoid arthritis, using 18 years of panel data, summarized in 9653 interviews. Depression was defined by scores on the Geriatric Depression Scale (6 or above). Participants were classified, using cluster analysis, into three distinct patterns of depression over repeated assessments: nondepressed (65.8%), intermittent (25.2%), and chronic (9.0%). GEE analyses assessed outcomes over time as a function of patterns of depression; controlling for demographic and clinical factors. Results indicated that patterns of depression had significant adverse effects on health and function over time.
depression; rheumatoid arthritis
To provide a conceptual formulation for “research literacy” and preliminary evidence for the utility of the construct in enhancing knowledge of and ethical participation in research.
Examined the impact of a brief educational intervention on parents’ research knowledge and their research participation decisions.
Research-related knowledge was improved. Parents with greater knowledge were more comfortable with their research participation decisions. Enhanced understanding of child volition increased parents’ willingness to enroll their children in research.
The proposed research literacy model identifies methods to enhance population knowledge and appreciation of research, strengthening links between scientific advancement and health.
The ‘Southampton Initiative for Health’ (SIH) is a training intervention with Sure Start Children’s Centre staff designed to improve the diets and physical activity levels of women of child-bearing age. Training aims to help staff to support women in making changes to their lifestyles by improving three skills: reflection on current practice; asking ‘open discovery’ questions; and goal setting. The impact of the training on staff practice is being assessed. A before and after non-randomised controlled trial is being used to evaluate the effectiveness and cost-effectiveness of the intervention in improving women’s diets and increasing their physical activity levels.
diet; physical activity; reflexive practice; goal setting; self-efficacy; intervention, disadvantage
This study examined the properties of the Beck Depression Inventory-II (BDI-II) in a sample of 111 patients with chronic fatigue syndrome (CFS). Exploratory factor analysis identified two factors. The mean score for the Somatic-Affective factor was significantly higher than the Cognitive factor. Convergent and discriminant validity were assessed for BDI-II total score, the two factor scores, and the BDI for Primary Care (BDI-PC). The BDI-PC and Cognitive factor demonstrated superior validity. Results suggest patients endorse BDI-II somatic items that overlap with CFS symptoms at a high rate. Factor scores should be evaluated separately, or the BDI-PC should be utilized with this population.
Beck Depression Inventory-II; Beck Depression inventory for primary care; Chronic Fatigue Syndrome; depression; exploratory factor analysis
This study compared autonomous self-regulation and negative self-evaluative emotions as predictors of smoking behavior change in college student smokers (N=303) in a smoking cessation intervention study. Although the two constructs were moderately correlated, latent growth curve modeling revealed that only autonomous regulation, but not negative self-evaluative emotions, was negatively related to the number of days smoked. Results suggest that the two variables tap different aspects of motivation to change smoking behaviors, and that autonomous regulation predicts smoking behavior change better than negative self-evaluative emotions.
Autonomous self-regulation; Negative self-evaluative emotions; Self-determination theory; Smoking; College student
Research suggests communicating too much about one’s self within an online support group may amplify breast cancer patients’ focus on their own problems and exacerbate negative emotions while focusing on others may have the opposite effects. This study explored how pronoun usage within an online support group was associated with subsequent mental health outcomes. There were 286 patients recruited into the study who filled out the pre-test and 231 completed post-tests 4 months later with survey measures including breast cancer-related concerns and negative emotions. Messages were analyzed using a program counting first-person and relational pronouns. A positive relationship was found between use of first person pronouns and negative emotions.
Breast cancer; online support groups; pronouns; self focus; social support
to examine the relationships among non-conventional practices, adherence and immune functioning in individuals with HIV.
92 participants completed an interview on non-conventional practices (complementary and alternative medicines (CAM), psychosocial therapies, and religious practice). They also completed the Psychiatric Symptom Index and the AIDS Clinical Trials Group Adherence Follow-up Questionnaire. Medical chart reviews determined CD4 count and viral load.
Hierarchical logistic regressions revealed religious practice was associated with adherence and CAM was associated with viral load.
Participation in non-conventional practices in HIV populations may lead to positive health and health behaviors. Clinical implications are discussed.
complementary and alternative medicines; HIV; immune functioning; psychological distress psychosocial therapies; religious practice
We propose a model of symbolic social communication to explain the process whereby sociocultural identity mediates relationships among receivers, sources and messages to shape message effects. This exploratory study examines how two at-risk groups of African American men responded to various HIV prevention messages delivered by celebrity and professional sources. We interviewed 47 men from a homeless shelter and 50 male college students. Members of both groups were likely to select Johnson as the best person to deliver HIV prevention messages among a list of African American celebrity and professional sources. Results suggest the symbolic meanings embedded in celebrities and message topics are important and enduring influences on message effects. The images and ideas that a source represents are transferred to the advocated behavior, attitude or knowledge change and thus shape how messages are interpreted and received. Further understanding of how culture influences the effects of persuasive messages is critical for the improvement of health-communication campaigns.
celebrities; communication; HIV/AIDS; media; source credibility
Although brief alcohol interventions have proven effective in a variety of health care settings, the present article describes the development of the first brief intervention for heavy drinkers in dental practice. Elements of motivational interviewing and personalized normative feedback were incorporated in a 3- to 5-minute intervention delivered by dental hygienists. The intervention is guided by a one-page feedback report providing personalized normative feedback regarding the patient’s current oral health practices, their drinking in comparison to others, and oral cancer risk associated with current smoking and drinking. Future publications will present data regarding intervention effectiveness from an ongoing randomized trial.
alcohol; drinking behavior; heavy drinking; intervention; randomized controlled trial
Spouses often seek to influence the health behaviors of chronically ill partners, but little research has examined whether spouses find such involvement to be burdensome. The current study examined this question in a sample of 191 nondiabetic spouses whose partners had type 2 diabetes. Results revealed that spouses who attempted to exert more control over their partners’ dietary behavior experienced greater burden, particularly when their partners exhibited poor dietary adherence and reacted negatively to spouses’ involvement. The findings contribute to a sparse body of knowledge on how spouses are affected by efforts to influence their chronically ill partners’ disease management.
marriage; social control; chronic illness; type 2 diabetes; burden
Although it is commonly assumed that social support positively predicts health, the empirical evidence has been inconsistent. We argue that three moderating factors must be considered: (1) support-approving norms (cultural context); (2) support-requiring situations (stressful events); and (3) support-accepting personal style (low neuroticism). Our large-scale cross-cultural survey of Japanese and US adults found significant associations between perceived support and health. The association was more strongly evident among Japanese (from a support-approving cultural context) who reported high life stress (in a support-requiring situation). Moreover, the link between support and health was especially pronounced if these Japanese were low in neuroticism.
culture; neuroticism; social support; stress
Based upon Fredrickson’s Broaden-and-Build Theory of Positive Emotions, this study examined the role of expressing positive emotions in online support groups for women with breast cancer. Underserved women with breast cancer in rural Wisconsin and Detroit, Michigan were recruited from 2001 to 2003, and they were given access to online support groups. Both pretest and a 4-month posttest surveys were conducted with a sample of 231 women. Messages from 96 active participants were analyzed using a computerized text analysis program. Psychological benefits that occurred following the expression of positive emotions were greater among those who expressed more negative emotions.
Positive emotions; Emotional expression; Online support groups; Breast cancer
In this paper we present background, theoretical rationale, and pilot data on the development of an intervention designed to increase positive affect in people living with serious health-related stress. This proof-of-concept study demonstrated that a multiple-component positive affect intervention is feasible and acceptable for people newly diagnosed with HIV. Retention in the intervention and adherence to home practice were high. Participants reported significant increases in positive affect and significant decreases in negative affect. This positive affect intervention can serve as a template for programs to be developed to help people experiencing health-related and other types of life stress.
positive affect; stress; intervention; feasibility; chronic illness; HIV
Behavioral willingness is conceptualized as a pathway to behavior that is non-deliberative, yet traditional measures require thoughtful deliberation to complete. This study explored non-deliberative measures of alcohol-related willingness to complement recent work on marijuana-related willingness. The study also examined whether ads from a field-tested drug-and-alcohol prevention campaign may have operated by influencing alcohol-related willingness. Participants viewed campaign ads or consumer ads (control). Outcomes were reaction times to make speeded judgments about whether one would engage in risky alcohol-related behaviors. Results showed that campaign ads lowered willingness to play drinking games and (for males) to drive while intoxicated.