Student Perceptions of Value: A Qualitative Study of Student Experiences in the Communication Center

The goal of this study was to understand student experiences in and perceptions of a new communication center. Researchers conducted 22 semi-structured qualitative interviews with students who visited the communication center and conducted a thematic analysis of the interview transcripts. Overall, the findings suggest that students had positive experiences and indicated some areas for future development. The primary value of communication center lies in the knowledge and perceived credibility of the coaches. The communication center also serves as a unique site for addressing communication apprehension and helping students transfer communication skills to other contexts. To continue to develop, additional resources are needed to invest in coaches, space, and marketing in order to adequately serve the needs of all students

Coming unmoored: Disproportionate increases in obesity prevalence among young, disadvantaged white women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109980/1/oby20913.pd

Behavioral health coaching for rural-living older adults with diabetes and depression: an open pilot of the HOPE Study

BACKGROUND: Patients with diabetes are at increased risk for depression, compounding the burden of disease. When comorbid with diabetes, depression leads to poorer health outcomes and often complicates diabetes self-management. Unfortunately, treatment options for these complex patients are limited and comprehensive services are rarely available for patients in rural settings. METHODS: A small open trial was conducted to test the acceptability, feasibility and preliminary outcomes of a telephone-delivered coaching intervention for rural-dwelling older adults with uncontrolled diabetes and comorbid, clinically significant depressive symptoms. A total of eight older adults were enrolled in Healthy Outcomes through Patient Empowerment (HOPE), a 10-session (12-week), telephone-based coaching intervention. Primary study constructs included measures of diabetes control (Hemoglobin [Hb] A1c), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and diabetes-related distress (Problem Areas in Diabetes Scale [PAID]). Assessments were conducted at baseline, post-intervention, and 6-month follow-up. Acceptability and feasibility were evaluated using patient surveys, focused exit interviews, and session attendance data. RESULTS: Clinically significant improvements were realized post-intervention and at 6-month follow-up for outcomes related to diabetes and depression. Effect sizes using Cohen's d were determined post-intervention and at 6-month follow-up, respectively, for HbA1c (d=0.36; d=0.28), PHQ-9 (d=1.48; d=1.67, and PAID (d=1.50; d=1.06) scores. Among study participants, HbA1c improved from baseline by a mean (M) of 1.13 (SD=1.70) post-intervention and M=0.84 (SD=1.62) at 6 months. Depression scores, measured by the PHQ-9, improved from baseline by M=5.14 (SD=2.27) post-intervention and M=7.03 (SD=4.43) at 6-month follow-up. PAID scores also improved by M=17.68 (SD=10.7) post-intervention and M=20.42 (SD=20.66) from baseline to 6-month follow-up. Case examples are provided for additional context and to more fully articulate salient intervention concepts. CONCLUSION: Although preliminary, data from this small open trial suggest that HOPE holds the potential to improve both physical (diabetes) and emotional (diabetes distress, depression) health outcomes and that changes can be maintained over a 6-month time period. As envisioned by the authors, HOPE may function as an extension of traditional primary care for rural-dwelling older adults with multiple comorbidities. A future randomized clinical trial will test HOPE’s broader effectiveness with rural-dwelling older adults. TRIAL REGISTRATION: NCT0127471

Understanding strategies that promote minority participation in breast cancer clinical trials

Background: Despite the promising effectiveness of clinical trials on breast cancer prevention, treatment, and survival within communities of color, disparities in morbidity and/or mortality remain persistent. Improving minority participation in breast cancer clinical trials using culturally aligned strategies has the potential to improve cancer disparities for these communities. Objectives and methods: This dissertation aims to identify key strategies that promote diversity in breast cancer clinical trial participation using two studies: (1) a systematic review of the evidence was undertaken with the goal of better understanding the state of the current literature on the recruitment of minorities to breast cancer clinical trials. This review replicated for the years 2004–2012 the search strategy from a prior systematic review; and (2) a qualitative case study of patients, healthcare providers, and clinical trial staff at a breast center in Houston, Texas. Results: Study 1: The systematic review evaluated 34 studies: 20 studies examined methods for evaluating recruitment strategies; 9 studies examined effectiveness of recruitment strategies for improving minority participation in breast cancer clinical trials; and 5 studies examined the effect of provider attitudes on minority recruitment to breast cancer clinical trials. The included studies employed descriptive, qualitative, and quantitative study designs. Descriptive and qualitative studies looked at patients\u27 perspectives on methods for developing culturally tailored recruitment strategies and patients\u27 decision making processes related to trial participation. Studies that evaluated the effectiveness of recruitment strategies to promote minority participation in breast cancer clinical trials utilized comprehensive recruitment strategies that focused on education and outreach for patients and providers. Studies on the influence of providers\u27 attitudes and beliefs on minority recruitment focused on barriers and promoters of trial participation, and provider decision making in referring patients to clinical trials. Patient-Provider communication was the most common theme across all studies regardless of study design or population studied. For providers, lack awareness and time constraints were also influential factors in their decisions to refer minority patients to trials. Study 2: The results from the qualitative study were consistent with the strategies identified in the literature. The providers noted that patients\u27 experience was an important factor in achieving a high rate of minority participation in breast cancer clinical trials. Similarly, patients\u27 identified clear patient-centered communication, compassion, and interpersonal relationships with providers as significant influences in their ultimate decision to participate in trials at the breast center

Summer activities and vocabulary development. Relationships across middle childhood and adolescence

This paper examines the relation between children\u27s summer activities before fourth through sixth grade and their vocabulary knowledge in fifth grade and at age fifteen using the NICHD SECCYD dataset (N = 1,009). We used OLS regression and propensity score analyses to understand how children\u27s summer reading, library visits, participation in enrichment classes, and unsupervised time predicts their vocabulary knowledge. Propensity score matching and OLS analyses show that time spent reading predicts vocabulary during the following two years, and high levels of time allocated to reading across three or more summers in middle childhood predicts vocabulary knowledge at age 15. OLS analyses suggest a relationship between library visits and vocabulary knowledge. There is no short-term relationship between enrichment classes and vocabulary knowledge, although our OLS analysis demonstrated that consistent enrollment in summer enrichment classes over three years predicted improved vocabulary. Unsupervised time predicted poor vocabulary in both the short and long-term. (DIPF/Orig.

Is ignorance bliss? Depression, antidepressants and the diagnosis of Type 2 diabetes.

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107397/1/Mezuk Ignorance Bliss.pd