The reliability and validity of a manual coding system for identifying emotion

Emotion focused coping and emotional expression have been identified as potential mediators of long-term adjustment to a cancer diagnosis. Tools for measuring emotional expression in text have not been well-validated, although there is an abundance of textual data that is available to help explore emotional expression and the relationship between emotional expression and outcome measures. The purpose of this dissertation was to develop a manual coding system of emotional expression that could be compared with current programs that have been used to evaluate emotional expression. Inter-rater reliability was found to be good with the use of the manually coded system of emotional expression between both trained and blinded coders. Sensitivity and specificity statistics compared the ability of a currently used text analysis program to predict both presence and absence of emotional expression. While excellent specificity and negative predictive value were found, the program demonstrated relatively good sensitivity and poor positive predictive value. There were not many notable differences found between manual coding and computerized coding in predicting change over time in regards to outcome measures. Replicating these findings on another sample is one area of future direction. Assessing the possibility of supplementing current content analysis programs to include the capability of attending to context is another important area of future direction

Thought Suppression Change in Cancer Patients and Survivors After Writing

Breast cancer is a debilitating and many times fatal disease that will affect approximately 215,990 women in the United States alone this year. Treatment for breast cancer can involve many physically and psychologically straining features. The illness perception theory states that individuals form illness representations to make sense of health threats and illness. These representations contain a number of individual, specific attributes about the illness identity, and cause, time-line, consequences of, and cure/control of the illness. Many women who have experienced breast cancer have also been found to be keeping their thoughts inside. Thought suppression has been linked to many negative consequences, such as anxiety and depression. To investigate, a writing paradigm was introduced to breast cancer patients as survivors. An expected link between expressive writing and a decrease in thought suppression was examined, yet not found to exist. Themes and case examples are provided

Understanding disparities in clinical trials for Native Hawaiian men

Understanding low rates of participation by minority populations in clinical trials is critical for reducing and eliminating disparities. We examined beliefs and attitudes of Native Hawaiian men related to illness and cancer to better understand their rates of participation in clinical trials. We conducted face-to-face interviews with Native Hawaiian key informants throughout the State of Hawai‘i using quota sampling methods to obtain a range of perspectives about attitudes towards health care seeking to provide insight into low clinical trials participation. Interviews were audio-taped, transcribed, and independently coded by researchers. Thematic analysis guided the extraction of relevant data from the discussions. Key informants (N=16) suggested the following beliefs and attitudes regarding clinical trials participation: 1) mistrust in the healthcare system, 2) external locus of control, 3) gender norms, and 4) the customary pono (righteousness, to make right) practice towards family/community to model and maintain good health, including participation in cancer clinical trials. Native Hawaiian men in this study expressed hesitation in the benefits of formalized health care. Many men described experiences of racism, inequity, and injustice associated their interactions with health care providers. These encounters were factors that influenced their healthcare practices and beliefs towards maintaining health and longevity

Preliminary Findings from a Pediatric Physical Activity Program for Children with Cancer

It is critical for pediatric patients diagnosed with cancer to engage in physical activity (PA) as it is associated with positive psychosocial outcomes and may improve physical function. However, physical activity opportunities for pediatric cancer patients are limited. PURPOSE: To test the feasibility and adherence of pediatric cancer patients to a virtual PA program. METHODS: Pediatric patients undergoing cancer treatment were referred to the Pediatric Physical Activity program (PePA) by the Children’s Hospital’s oncology team using rolling recruitment. The target sample size was 20-25 patients. Patients enrolled in an online 12-week PA intervention with similar-aged peers (2x/week, 60 min/session). Patients completed surveys which shared their hobbies and interests. They were given PA equipment (i.e., yoga ball, mat). Trained undergraduate Kinesiology students designed and delivered the PA lessons which included yoga, dancing, calisthenics and Pilates. PA duration (visual inspection of recorded sessions, system for observing fitness instruction time, SOFIT), intensity (wrist-based heart rate monitors) and focus group data were used to assess program feasibility. RESULTS: Nine patients enrolled in the study (5, 5-7 years-olds; 4, 13-16 year-olds). One patient from each group completed 95% and 79% of the 24 sessions, respectively. These 2 patients reported improved balance and enjoyment of the program. PA leaders led the 5-7-year-old and 13-16-year-old groups through 27.6±4.9 and 33.0±9.4 minutes of PA, respectively. Average PA intensity was 26±6% heart rate reserve (HRR) and varied based upon activity. Patients rated their perceived exertion (RPE) of the PA as 2-7 on a scale of 1-10. During the session, children aged 5-7 years and 13-16 years engaged in 14.6±9.1 and 27.2±14.4 minutes of fitness, respectively (SOFIT coding). Three-fourths through the program, the duration for the 5-7 year olds was reduced to 45 minutes to match energy levels. Patients and parent-proxies of the younger children reported that they liked the session duration and type of PA performed. CONCLUSION: PA intensity fell at the lower end of the recommended 30-45% HRR range for adult patients undergoing cancer treatment. Program adherence was difficult to achieve, but those who completed the program reported physical benefit

Engagement with a Social Networking Intervention for Cancer-Related Distress

BackgroundUnderstanding patterns and predictors of engagement could improve the efficacy of Internet interventions.PurposeThe purpose of the study was to characterize engagement in a multi-component Internet intervention for cancer survivors with distress.MethodsData were derived from 296 cancer survivors provided with access to the Internet intervention and included self-report measures and directly-measured engagement with each component of the intervention.ResultsOver 12 weeks, average total engagement was 7.3 h (sd = 11.7), and 42 % of participants spent >3 h on the website. Participants spent more time using social networking components than structured intervention content. Greater early and total engagement was associated with previous chemotherapy, being female, and being recruited via the Internet. Early engagement was associated with greater fatigue and more social constraints.ConclusionsFor many users, engagement with an Internet intervention was quite high. Reducing attrition and tailoring content to better meet the needs of those who do not engage should be a focus of future efforts

Perceived influence and college students’ diet and physical activity behaviors: an examination of ego-centric social networks

Abstract Background Obesity is partially a social phenomenon, with college students particularly vulnerable to changes in social networks and obesity-related behaviors. Currently, little is known about the structure of social networks among college students and their potential influence on diet and physical activity behaviors. The purpose of the study was to examine social influences impacting college students’ diet and physical activity behaviors, including sources of influence, comparisons between sources’ and students’ behaviors, and associations with meeting diet and physical activity recommendations. Methods Data was collected from 40 students attending college in Hawaii. Participants completed diet and physical activity questionnaires and a name generator. Participants rated nominees’ influence on their diet and physical activity behaviors as well as compared nominees' behaviors to their own. Descriptive statistics were used to look at perceptions of influence across network groups. Logistic regression models were used to examine associations between network variables and odds of meeting recommendations. Results A total of 325 nominations were made and included: family (n = 116), college friends (n = 104), high school friends (n = 87), and significant others (n = 18). Nearly half of participants were not from Hawaii. Significant others of non-Hawaii students were perceived to be the most influential (M(SD) = 9(1.07)) and high school friends the least influential (M(SD) = 1.31(.42)) network. Overall, perceived influence was highest for diet compared to physical activity, but varied based on comparisons with nominees’ behaviors. Significant others were most often perceived has having similar (44 %) or worse (39 %) eating behaviors than participants, and those with similar eating behaviors were perceived as most influential (M(SD) = 9.25(1.04)). Few associations were seen between network variables and odds of meeting recommendations. Conclusions Among the groups nominated, high school friends were perceived as least influential, especially among students who moved a long distance for college. Intervention strategies addressing perceived norms and using peer leaders may help promote physical activity among college students, while diet interventions may need to involve significant others in order to be successful. Testing of these types of intervention strategies and continued examination of social networks and their influences on diet and physical activity behaviors are needed

Diet and Physical Activity Intervention Strategies for College Students

Objectives: To understand perceived barriers in a diverse sample of college students and solicit their suggestions for interventions aimed at healthy eating, cooking and physical activity. Methods: Forty students (33% Asian American, 30% mixed ethnicity) were recruited. Six focus groups were audio-recorded, transcribed, and coded. Coding began with a priori codes, but allowed for additional codes to emerge. Analysis of questionnaires on participants' dietary and physical activity practices and behaviors provided context for qualitative findings. Results: Barriers included time, cost, facility quality, and intimidation. Tailoring towards a college student's lifestyle, inclusion of hands-on skill building, and online support and resources were suggested strategies. Conclusions: Findings provide direction for diet and physical activity interventions and policies aimed at college students

Engagement with a Social Networking Intervention for Cancer-Related Distress

BACKGROUND: Understanding patterns and predictors of engagement could improve the efficacy of Internet interventions. PURPOSE: The purpose of the study was to characterize engagement in a multi-component Internet intervention for cancer survivors with distress. METHODS: Data were derived from 296 cancer survivors provided with access to the Internet intervention and included self-report measures and directly-measured engagement with each component of the intervention. RESULTS: Over 12 weeks, average total engagement was 7.3 h (sd=11.7), and 42% of participants spent >3 h on the website. Participants spent more time using social networking components than structured intervention content. Greater early and total engagement was associated with previous chemotherapy, being female, and being recruited via the Internet. Early engagement was associated with greater fatigue and more social constraints. CONCLUSIONS: For many users, engagement with an Internet intervention was quite high. Reducing attrition and tailoring content to better meet the needs of those who do not engage should be a focus of future efforts