measured-response

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"Br J Health Psychol"

These PubMed results were generated on 2006/03/27

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Reductions in Depressed Mood and Denial Coping During Cognitive Behavioral Stress Management With HIV-Positive Gay Men Treated With HAART.

Ann Behav Med. 2006 Apr;31(2):155-64

Authors: Carrico AW, Antoni MH, Duran RE, Ironson G, Penedo F, Fletcher MA, Klimas N, Schneiderman N

Background: Stress management interventions for HIV-positive persons have been designed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression. Purpose: We examined the efficacy of a cognitive behavioral stress management (CBSM) intervention in combination with medication adherence training (MAT) in 130 gay and bisexual men living with HIV infection. Methods: Participants were randomized to either a 10-week CBSM+MAT intervention (n = 76) or a MAT-only condition (n = 54). Measures of self-reported adherence, active cognitive coping (i.e., acceptance and positive reinterpretation), avoidant coping (i.e., denial and behavioral disengagement), and depressed mood were examined over the 10-week intervention period. Results: Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period, but no changes in active cognitive coping or self-reported adherence were observed. Using path analysis, greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks. We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period. Conclusions: Although denial may be an effective means of distress reduction in the short term, reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term. CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping.

PMID: 16542130 [PubMed - in process]

Cancer-specific self-efficacy and psychosocial and functional adaptation to early stage breast cancer.

Ann Behav Med. 2006 Apr;31(2):145-54

Authors: Manne SL, Ostroff JS, Norton TR, Fox K, Grana G, Goldstein L

Background: Although self-efficacy is considered a key psychological resource in adapting to chronic physical illness, this construct has received less attention among individuals coping with cancer. Purpose: To examine changes in cancer self-efficacy over time among women with early stage breast cancer and associations between task-specific domains of self-efficacy and specific psychological, relationship, and functional outcomes. Methods: Ninety-five women diagnosed with early stage breast cancer completed surveys postsurgery and 1 year later. Results: Cancer-related self-efficacy was relatively stable over 1 year, with only 2 domains of efficacy-(a) Activity Management and (b) Self-Satisfaction-evidencing significant increases over the 1-year time period. Cross-sectional findings were relatively consistent with predictions and suggested that specific domains of self-efficacy were more strongly related to relevant domains of adaptation. Longitudinal findings were not as consistent with the domain-specificity hypothesis but did suggest several predictive associations between self-efficacy and outcomes. Personal Management self-efficacy was associated with higher relationship satisfaction, higher Communication Self-Efficacy was associated with less functional impairment, and higher Affective Management self-efficacy was associated with higher self-esteem 1 year later. Conclusions: Specific domains of cancer-related self-efficacy are most closely related to relevant areas of adaptation when considered cross-sectionally, but further study is needed to clarify the nature of these relationships over time.

PMID: 16542129 [PubMed - in process]

Gender and acculturation influences on physical activity in latino adults.

Ann Behav Med. 2006 Apr;31(2):138-44

Authors: Marquez DX, McAuley E

Background: Studies examining physical activity levels have used samples primarily composed of non-Latino Whites and have focused on leisure time physical activity (LTPA). Additionally, few studies have investigated differences in physical activity between Latino men and Latina women, or the relationship between acculturation and activity. Purpose: To examine the subjective and objective physical activity of Latinos and gender differences in physical activity and the extent to which LTPA and non-LTPA were predictive of overall accelerometer physical activity. An additional objective was to examine the relationship between acculturation and different types of physical activity. Methods: Data were obtained from 155 Latinos (n = 86 female, n = 69 male). Comparisons were made between Latino men and women. Results: Latino men participated in significantly greater occupational and overall objective and subjective physical activity than Latina women; however, women participated in greater household activity. Regression analyses demonstrated that recreational, occupational, and household activity were significant predictors of overall accelerometer physical activity for the complete sample. Among women, recreational and household activity were significant predictors; however, overall accelerometer physical activity was not significantly predicted in men. Additionally, it was demonstrated that acculturation was related to occupational activity, but not to recreational activity. Conclusions: These results suggest that gender differences in physical activity are present among Latinos and that acculturation may be a correlate of various types of physical activity.

PMID: 16542128 [PubMed - in process]

Outcomes of a multifaceted physical activity regimen as part of a diabetes self-management intervention.

Ann Behav Med. 2006 Apr;31(2):128-37

Authors: King DK, Estabrooks PA, Strycker LA, Toobert DJ, Bull SS, Glasgow RE

Background: Physical activity (PA) is important for management of diabetes, yet practical interventions that achieve sustained behavior change are rare. Purpose: The goals of this research were to evaluate the effectiveness of a multifaceted PA intervention for people with type 2 diabetes that emphasized participant choice in activity selection. Baseline activity patterns were examined to determine whether they predicted changes in PA at 2 months. Methods: Three hundred thirty-five participants were recruited from 42 primary care physicians and then randomized to either a computer-assisted, tailored self-management intervention (N = 174) or health risk appraisal with feedback control (N = 161). Primary outcome measures included the Community Healthy Activities Model Program for Seniors Questionnaire, diet, and psychosocial assessments at baseline and 2 months. Results: For 301 participants who completed the 2-month follow-up, the intervention significantly improved all PA (p < .01) and moderate PA (metabolic equivalents > 3.0, p < 01) relative to controls. Baseline cluster analyses grouped participant activity patterns into three categories. At 2 months, cluster assignment differentially predicted change in calories expended in moderate, rote, sport, and lifestyle PA. Conclusions: A computer-assisted, multifaceted approach to PA demonstrated improvement after 2 months. The results suggest that individuals are capable of adjusting their activity patterns to maximize their PA.

PMID: 16542127 [PubMed - in process]

Effects of social stressors on cardiovascular reactivity in black and white women.

Ann Behav Med. 2006 Apr;31(2):120-7

Authors: Lepore SJ, Revenson TA, Weinberger SL, Weston P, Frisina PG, Robertson R, Portillo MM, Jones H, Cross W

Background: Behavioral scientists have theorized that perceived racism in social interactions may account for some of the observed disparities in coronary heart disease between Black and White Americans. Purpose: The objective was to examine whether racial stress influences cardiovascular reactivity, a risk factor for cardiovascular disease. Methods: We measured cardiovascular responses in Black and White women (n = 80) as they talked about 3 hypothetical scenarios: (a) being accused of shoplifting (racial stressor), (b) experiencing airport delays (nonracial stressor), and (c) giving a campus tour (control). Results: Relative to White women, Black women had significantly greater mean diastolic blood pressure reactivity (3.81 vs. 0.25 mmHg; p < .05) in response to the racial stressor than in response to the nonracial stressor. Black women exhibited significantly lower heart rate during recovery following the racial stressor than during recovery following the nonracial stressor (-0.37 beats/min vs. 0.86 beats/min; p < .001). Among Black women, those who explicitly made race attributions during the racial stressor had greater systolic but not diastolic blood pressure reactivity than those who did not make racial attributions (8.32 mmHg vs. 2.17 mmHg; p < .05). Conclusions: These findings suggest that perceived racism in social interactions may contribute to increased physiological stress for Black women.

PMID: 16542126 [PubMed - in process]

Socioeconomic status, psychosocial processes, and perceived health: an interpersonal perspective.

Ann Behav Med. 2006 Apr;31(2):109-19

Authors: Gallo LC, Smith TW, Cox CM

Background: Psychosocial variables, including stress, emotions, and social factors, may contribute to the association between socioeconomic status (SES) and health. Concepts and methods from interpersonal theory (1) could provide a useful framework for research concerning the roles of psychosocial factors in socioeconomic health disparities. Purpose: We examined the association between SES and psychosocial processes captured by the interpersonal circumplex and tested the degree to which circumplex ratings explained the association between SES and perceived health. Methods: San Diego community residents (N = 304; 51% male; 34% Latino; 50% White; 20% Black; 6.8% Asian/Asian American; 2.9% another ethnicity) completed a circumplex-based assessment of several social contexts (home, work, and community), the SF-12 measure of perceived health, and questions concerning demographic characteristics. Results: Multilevel models revealed that individuals with lower SES described their social worlds as more hostile and less friendly compared with their higher SES counterparts. Furthermore, lower SES was associated with perceptions of exposure to more dominant or controlling behavior from others, compared with higher SES. Appraisals of hostility versus friendliness, in particular, helped explain the inverse association between SES and some aspects of perceived health. Conclusions: Applications of interpersonal theory may be useful in efforts to understand the roles of psychosocial factors in SES-related health disparities.

PMID: 16542125 [PubMed - in process]

Construct validity of physical activity and sedentary behaviors staging measures for adolescents.

Ann Behav Med. 2006 Apr;31(2):186-93

Authors: Hagler AS, Calfas KJ, Norman GJ, Sallis JF, Patrick K

Purpose: To evaluate the construct validity of physical activity (PA) and sedentary behaviors (SB) staging measures for adolescents that incorporate the current national recommendations. Method: The Progressive Aerobic Cardiovascular Endurance Run, Actigraph accelerometer, and self-reported hours of TV viewing served as criterion measures. Participants were 878 adolescents (M age = 12.74, 53.6% girls, 39.9% non-White). Results: The PA staging measure had mixed evidence of convergent validity and strong evidence of divergent validity. The SB staging measure had strong and generalized evidence of convergent validity but weak evidence of divergent validity, which could be related to inaccurate assumptions about the relation of SB to PA and fitness. Results were generally in the expected direction and provide preliminary evidence for the construct validity and generalizability of both staging measures. However, more research is warranted to validate the staging measures with Actigraph-measured PA and sedentary time. Effect sizes (eta(2) values) ranged from small to large (.02-.63). Conclusion: PA and SB stage-of-change measures that are congruent with current national recommendations and appropriate for use among adolescents were partially supported for their construct validity.

PMID: 16542134 [PubMed - in process]

Reducing Obesity Indicators Through Brief Physical Activity Counseling (PACE) in Italian Primary Care Settings.

Ann Behav Med. 2006 Apr;31(2):179-85

Authors: Bolognesi M, Nigg CR, Massarini M, Lippke S

Background: There is an alarming prevalence of obesity and sedentariness in Western countries. An ideal context for health promotion and preventive medicine seems to be the setting of primary care provided by the general practitioner (GP). Purpose: Therefore, this study evaluated the impact of GPs' brief physical activity counseling for overweight and obese patients. Methods: Individuals recruited during routine physician visits were randomly split into an experimental (n = 48) group that received the Patient-centered Assessment and Counseling for Exercise (PACE) protocol, and a usual-care control (n = 48) group. Body mass index (BMI) and abdominal girth were assessed as objective biometrical parameters. Patients in the experimental group self-reported their readiness for physical activity and self-efficacy. Results: The experimental group had significantly better BMI and abdominal girth compared with the control group after a 5- to 6-month follow-up. Furthermore, the experimental group progressed in their stage of physical activity readiness and increased their self-efficacy. Conclusions: The GPs' counseling for physical activity using the PACE protocol influenced mediators and biometrical outcomes in an Italian primary care context.

PMID: 16542133 [PubMed - in process]

Health-related quality of life and patient reports about care outcomes in a multidisciplinary hospital intervention.

Ann Behav Med. 2006 Apr;31(2):173-8

Authors: Hays RD, Eastwood JA, Kotlerman J, Spritzer KL, Ettner SL, Cowan M

Background: Patient perceptions of care and health-related quality of life (HRQOL) are important outcomes for hospitalized patients. Purpose: This study examined patient experiences with hospital care and HRQOL in individuals hospitalized at a west coast teaching hospital. Methods: We assessed patient experiences with care and HRQOL using interviews with 1,207 hospitalized, general medicine patients participating in a multidisciplinary provider team intervention at a large academic medical center. Patient outcome variables included the Picker dimensions of hospital care (Continuity and Transition, Coordination of Care, Emotional Support, Information and Education, Involvement of Family and Friends, Physical Comfort, Respect for Patient Preferences, Overall Impression), the Health Utilities Index Mark 3 (HUI-3), and the SF-12 physical (PCS-12) and mental health (MCS-12) summary scores. Results: Patients randomized to a multidisciplinary intervention reported higher emotional support (b = 3.32), t(903) = 2.01, p =.044, and physical comfort (b = 3.49), t(863) = 2.25, p = .025, from health care providers than did the control group, but these effects became nonsignificant after adjusting for multiple comparisons. The HUI-3, PCS-12, and MCS-12 summary scores improved significantly from baseline to the 30-day, ts(943, 919, 860) = 4.94, 2.20, and 5.31, ps < .0001, = .03, and < .0001, respectively, and the 4-month follow-ups, ts(871, 919, 943) = 7.25, 8.68, and 8.08, ps < .001, < .001, and < .0001, respectively, but change on these measures did not differ between intervention and control patients. Baseline health was significantly associated with patient evaluations of hospital care, but patient evaluations did not predict future health. Conclusions: There were no differences in reports and ratings of hospital care or HRQOL between the control and the intervention groups. Hence, the behavioral changes in hospital staff in the intervention group had no effect on patient-reported outcomes. Mental health at baseline was predictive of patient evaluations of the hospitalization, but evaluations of care were not associated with subsequent HRQOL. Thus, it may be important to adjust patient evaluations of hospital care for case-mix differences in health.

PMID: 16542132 [PubMed - in process]

Pain and wound healing in surgical patients.

Ann Behav Med. 2006 Apr;31(2):165-72

Authors: McGuire L, Heffner K, Glaser R, Needleman B, Malarkey W, Dickinson S, Lemeshow S, Cook C, Muscarella P, Melvin WS, Ellison EC, Kiecolt-Glaser JK

Background: Human and animal laboratory studies have shown that stress delays healing of standardized punch biopsy wounds. Purpose: This 5-week prospective study of 17 women who underwent elective gastric bypass surgery addressed the association between postsurgical pain intensity and subsequent healing of a standard 2.0-mm punch biopsy wound. Methods: Participants were assessed 1 week before surgery, within 3 hr before surgery, 1 to 3 days postsurgery, and at weekly intervals for 4 weeks following surgery. Results: Patient ratings of greater acute postsurgical pain, averaged over Days 1 and 2 postsurgery, and greater persistent postsurgical pain, averaged over 4 weekly postsurgery pain ratings, were significantly associated with subsequent delayed healing of the punch biopsy wound. Presence of depressive symptoms on the day of surgery, pre-existing persistent pain, and medical complications following initial discharge from the hospital were not related to wound healing. Depressive symptoms on the day of surgery and pre-existing persistent pain did predict persistent postsurgical pain intensity. Conclusions: These findings extend the previous laboratory models of wound healing to a surgical population, providing the first evidence that pain plays an important role in postsurgery wound healing, a key variable in postsurgical recovery.

PMID: 16542131 [PubMed - in process]

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Using participatory action research to build a priority setting process in a Canadian Regional Health Authority.

Soc Sci Med. 2006 Mar 13;

Authors: Patten S, Mitton C, Donaldson C

Due to resource scarcity, every health system worldwide must decide what services to fund, and conversely, what services not to fund. In order to institute and refine a macro-level priority setting framework within a large, urban health authority in Alberta, Canada, researchers and decision makers together embarked on a participatory action research (PAR) project. The focus of this paper is the PAR process in this context, including reflections from PAR participants about the contribution of the research methodology to their own practice as health care managers and clinicians. The use of qualitative research in health economics-in this case, to refine the application of a macro-level priority setting model-is a relatively new advancement. PAR proved to be an appropriate and helpful approach to introducing a theoretically driven model of macro-level priority setting within a large, complex health organization. However, it is important that support for the change is sustained as long as necessary to embed the new practices into the organization.

PMID: 16540221 [PubMed - as supplied by publisher]

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European public acceptance of euthanasia: Socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries.

Soc Sci Med. 2006 Mar 11;

Authors: Cohen J, Marcoux I, Bilsen J, Deboosere P, van der Wal G, Deliens L

In many European countries, the last decade has been marked by an increasing debate about the acceptability and regulation of euthanasia and other end-of-life decisions in medical practice. Growing public sensibility to a 'right to die' for terminally ill patients has been one of the main constituents of these debates. Within this context, we sought to describe and compare acceptance of euthanasia among the general public in 33 European countries. We used the European Values Study data of 1999-2000 with a total of 41125 respondents (63% response rate) in 33 European countries. The main outcome measure concerned the acceptance of euthanasia (defined as 'terminating the life of the incurably sick', rated on a scale from 1 to 10). Results showed that the acceptance of euthanasia tended to be high in some countries (e.g. the Netherlands, Denmark, France, Sweden), while a markedly low acceptance was found in others (e.g. Romania, Malta and Turkey). A multivariate ordinal regression showed that weaker religious belief was the most important factor associated with a higher acceptance; however, there were also socio-demographic differences: younger cohorts, people from non-manual social classes, and people with a higher educational level tended to have a higher acceptance of euthanasia. While religious belief, socio-demographic factors, and also moral values (i.e. the belief in the right to self-determination) could largely explain the differences between countries, our findings suggest that perceptions regarding euthanasia are probably also influenced by national traditions and history (e.g. Germany). Thus, we demonstrated clear cross-national differences with regard to the acceptance of euthanasia, which can serve as an important basis for further debate and research in the specific countries.

PMID: 16537097 [PubMed - as supplied by publisher]

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Vaccination for Group B Streptococcus during pregnancy: Attitudes and concerns of women and health care providers.

Soc Sci Med. 2006 Mar 15;

Authors: Patten S, Vollman AR, Manning SD, Mucenski M, Vidakovich J, Davies HD

Group B Streptococcus (GBS) is the leading infectious cause of neonatal morbidity and mortality. Although intrapartum antibiotic prophylaxis (IAP) strategies are effective in preventing GBS transmission from mothers to newborns, there are growing concerns about adverse effects, and the development of antibiotic resistance. GBS vaccines targeting the most virulent neonatal disease serotypes are currently under development and may be used during pregnancy. The objective of this study was to explore the key issues and concerns that would be associated with GBS vaccination during pregnancy from the perspectives of pregnant women and health care providers. Twenty-two women and 25 health care professionals in Alberta, Canada participated in 10 focus groups, each group ranging from 2 to 20 participants. Valuable information emerged from the focus groups about the factors that would affect acceptance of a maternal GBS vaccine. This information will be essential for health systems to consider in the introduction, promotion and delivery of such a vaccine. The data may help optimize education about GBS and a putative vaccine to pregnant women.

PMID: 16545514 [PubMed - as supplied by publisher]