Does Spaced Retrieval Therapy Help Improve Quality of Life for Individuals with Dementia?

Objective: The objective of this systematic EBM review is to determine “Does Spaced Retrieval Therapy Help Improve Quality of Life for Individuals with Dementia?” Study Design: A systemic review of three peer-reviewed randomized controlled trials (RCT) published in English between 2016-2017. Data Sources: All peer-reviewed articles were selected using PubMed. All articles were published in English and selected based on relevance to the clinical question. Exclusion criteria excluded studies with combined intervention methods. Outcome Measured: Assessment of instrumental activities of daily living (IADL) was determined using the IADL task score assessed by the recruiter. Improvement of hyperphagic behavior assessed by trained memory trainers determined by the Dementia Hyperphagic Behavior Scale. Results: All studies determined the efficacy of spaced retrieval therapy and its role in improving the quality of life of the participants with dementia. The RCT of Bourgeois et al. found that spaced retrieval therapy and trial and error learning (control) produced no significant difference, determining both learning methods capable of improving patient outcomes. The results of Kao et al. revealed that spaced retrieval therapy significantly improved hyperphagic behaviors lasting three months after completion of the program when compared to routine care (control). The Hsu et al. study determined that spaced retrieval therapy can decrease the severity of hyperphagic behaviors compared to routine care (control). Conclusion: All studies report spaced retrieval therapy is an acceptable tool capable to improve the quality of life for individuals living with dementia. These studies suggest behavioral and speech therapy (spaced retrieval) is effective enough to improve hyperphagic behavior and IADL. Future studies should be conducted to determine the longevity of new learned behaviors/activities as well as the minimum intervention period required for long-lasting benefit

The enemy within:designing a cell-based gameplay system for cancer education

This paper outlines the design and preliminary evaluation of The Enemy Within, a browser-based game produced to raise awareness of the nature of cancer as a progressive disease. Aimed at high school and young adult audiences, the ambition with the game is to make visible to players the myriad ways in which healthy cells can mutate and ultimately inherit hallmarks of cancer, whilst also demonstrating how both real-world behaviours and underlying genetics impact both positively and negatively on cell health

A Parent-Focused Intervention to Increase Parent Health Literacy and Healthy Lifestyle Choices for Young Children and Families.

Health literacy affects caregivers' ability to engage in preventive health care behaviors for themselves and their children. Studies suggest that health literacy among low income families needs improvement, and this possibly contributes to disparities in preventive health care rates. Additionally, parents and caregivers may not be able to provide or seek preventive health care for their children because of lack of knowledge and skills to do so effectively. This study designed and piloted an intervention that delivered to parents of young children, 1) health literacy information in an experiential manner, and 2) practical skills to engage their families in healthy lifestyle choices, with the decisions for healthy lifestyle choices being based on the health knowledge provided in the intervention. Specifically, the intervention focused on diet/nutrition, physical activity, sleep hygiene, parenting skills, and mental wellness. The intervention was successful at improving diet/nutrition knowledge at least one month post-intervention and more immediate changes were found for participants' overall beliefs about diet/nutrition, children's vegetable consumption, and parents' fruits and vegetable consumption. Immediate improvements were also found for factual knowledge about physical activity, sleep, and the relationship between mental health and stress. Additionally, the intervention was successful at improving general knowledge and beliefs about sleep, knowledge about the relationship between sleep and health, and knowledge about common childhood sleep problems at least one month post-intervention. The intervention also reduced participants' bedtime interactions with children that are indicative of sleep problems at least one month post-intervention. Future research should conceptualize the intervention as a multiple health behavior intervention and reflect this in the evaluation

Development and validation of assessments of adolescent health literacy: a Rasch measurement model approach.

BACKGROUND Health literacy (HL) is implicated in improved health decision-making and health promotion, and reduced racial, ethnic, and socioeconomic health disparities. Three major areas of HL include functional, interactive, and critical HL. HL skills develop throughout the lifespan as individuals' psychosocial and cognitive capacities develop and as they accumulate experiences with navigating health systems. Though adolescence is marked by increased involvement in health decision-making, most HL studies and measures of HL have focused on adults. Both the adult and adolescent HL literature are also limited by the paucity of validated test-based measures for assessing HL. The existing test-based validated HL measures for adolescents were originally designed for adults. However, adolescents are at an earlier phase of developing their HL skills (e.g., fewer experiences navigating the health system) compared to adults and measures originally designed for adults may assume prior knowledge that adolescents may lack therein underestimating adolescents' HL. This study developed and validated test-based assessments of adolescents' functional, interactive, and critical HL. METHODS Items were generated in an iterative process: focus groups with adolescents informed item content, cognitive interviews with adolescents and expert consultation established content and face validity of the initial items, and items were revised or removed where indicated. High school students (n = 355) completed a measurement battery including the revised HL items. The items were evaluated and validated using Rasch measurement models. RESULTS The final 6-item functional, 10-item interactive, and 7-item critical HL assessments and their composite (23 items) fit their respective Rasch models. Item-level invariance was established for gender (male vs. female), age (12-15-year-olds vs. 16-18-year-olds), and ethnicity in all assessments. The assessments had good convergent validity with an established measure of functional HL and scores on the assessments were positively related to reading instructions before taking medicine and questioning the truthfulness of health information found online. CONCLUSIONS These assessments are the first test-based measures of adolescents' interactive and critical HL, the first test-based measure of functional HL designed for adolescents, and the first composite test-based assessment of all three major areas of HL. These assessments should be used to inform strategies for improving adolescents' HL, decision-making, and behaviors

Application of the bioecological model and health belief model to self-reported health risk behaviors of adolescents in the united states

Health risk behaviors are responsible for the majority of morbidity and mortality among adolescents. Researchers have identified three sources of risk-taking in adolescents – dispositional, ecological and biological. The Bioecological Model incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors by integrating the Bioecological Model with a more specific Health Belief Model. The relationship between risk perception and health risk behavior was also investigated as a first step in understanding adolescent decision-making using the Health Belief Model. Adolescents from a suburban Indiana area were asked to complete the Adolescent Health Risk Behavior Survey which assessed egocentrism, self-esteem, social norms, risk perceptions, and the incidence and prevalence of health endangering behaviors. Hierarchical linear regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain risk perception of health risk behaviors. Hierarchical logistic regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain health risk behaviors and to moderate the relationships between risk perception and health risk behaviors. Based on the results, it was confirmed that the Bioecological Model is important in understanding adolescent’s risk perception of health risk behaviors, and their self-reported health risk behaviors. It is also important in understanding the relationship between risk perception and health risk behaviors. Adolescent Variables, Microsystem, and Mesosystem were significant in predicting adolescent risk perception of all health risk behaviors examined, and self-reported smoking cigarette behavior and marijuana use. Adolescent variables and Microsystem were the only systems to predict adolescent self-reported alcohol use. The relationship between risk perception and reported smoking cigarette behavior was moderated by Adolescent Variables, Microsystem and Mesosystem, however for alcohol use the path was moderated by Adolescent Variables and for marijuana use the path was moderated by the Mesosytem. Results of this thesis imply the importance of considering the contribution of Bioecological Model variables when implementing prevention intervention programs specific to adolescent health risk behaviors

Psychosocial correlates in patterns of adolescent emotional eating and dietary consumption

Unhealthy eating behaviors, such as consumption of unhealthy diet and emotional eating, are common in adolescence and tend to co-occur. However, how these behaviors are patterned may vary among adolescents. This study identified patterns of dietary consumption and emotional eating behaviors in adolescents and examined the sociodemographic and psychosocial (e.g., self-efficacy beliefs and motivation) covariates associated with these eating patterns. Data were from the Family Life, Activity, Sun, Health and Eating study. Latent class analysis was used to estimate adolescent dietary patterns from dietary consumption (i.e., fruits, vegetables, sugar-sweetened beverages, junk food, etc.) and emotional eating variables (i.e., eating when feeling sad or anxious). The sample included 1,568 adolescents (Mean age = 14.48-years-old, 49% girls, 55% White). A four-class solution best fit the data (e.g., Bayesian Information Criteria [BIC] = 12263.568, three-class model BIC = 12271.622). Four unhealthy eating behavior patterns were identified: poor diet/high emotional eating, mixed diet/high emotional eating, poor diet/low emotional eating, and mixed diet/low emotional eating. Compared to the poor diet/high emotional eating group, the other groups were less likely to include older adolescents, girls, and adolescents who experienced food insecurity, and more likely to have higher self-efficacy for eating fruits and vegetables and limiting junk foods as well as motivation for consuming fruits and vegetables and limiting junk foods. Our findings highlight adolescents’ complex dietary patterns that include dietary consumption and emotional eating behaviors. Future studies should examine other potential dietary patterns that include emotional eating. Efforts to address unhealthy patterns of adolescents’ dietary consumption and emotional eating behaviors should be expanded

Safety, Efficacy, and Ill Intent: Examining COVID-19 Vaccine Perceptions among the New Undervaccinated Moveable Middle in a U.S. Cohort, October 2022

Individuals who received their primary vaccine series only (with no subsequent booster) may be a new type of “moveable middle” given their receipt of the original COVID-19 vaccination. One population within the moveable middle for whom tailored interventions may be needed is individuals with common mental disorders (CMD). The purpose of this paper is to understand the vaccine perceptions among this new moveable middle—the undervaccinated—and within the undervaccinated to examine the extent to which COVID-19 vaccine perceptions and motivations differ among those with and without symptoms of CMD. Using data from the CHASING COVID Cohort, we examine the relationship between vaccination status, CMD, and vaccine perceptions in the undervaccinated. Among 510 undervaccinated participants who had completed the primary vaccine series but were not boosted, the most common reasons for undervaccination focused on efficacy (not seeing a need for an additional dose, 42.4%; there not being enough evidence that a booster dose is effective, 26.5%; already having had COVID-19, 19.6%). Other concerns were related to safety (long-term side effects, 21.0%; short-term side effects, 17.6%) and logistics (plan to get a booster but haven’t had time yet, 18.8%). Overall, the greatest vaccine concerns (over 30%) for the undervaccinated focused on efficacy and safety issues. Symptoms of depression or anxiety were associated with lower levels of vaccine efficacy and greater safety concerns in adjusted models. The implications of our study are that campaigns that are hoping to maximize vaccination uptake should consider focusing on and emphasizing messaging on efficacy and safety issues

The invisible child: sibling experiences of growing up with a brother with severe haemophilia - an interpretative phenomenological analysis.

Introduction: Haemophilia is an inherited chronic condition that causes bleeding in the joints and soft tissue. Healthy siblings growing up in the family of a person with haemophilia can be affected socially and psychologically. Aim: To explore qualitatively the experiences of healthy siblings who grew up with a brother with severe haemophilia. Methods: 11 healthy siblings (10 female, 1 male) who grew up with a brother with severe haemophilia A were recruited via the Haemophilia Society UK. The verbatim transcripts of individual semi-structured interviews were analysed using interpretative phenomenological analysis (IPA). Results: Three themes were identified: lack of parental attention, negative social emotions, and carrier anxiety. Participants described having engaged in attention seeking behaviours because they felt they lacked parental attention. They also described the resentment, anger and frustration they felt about the effect their brothers’ haemophilia had on their lives. Female participants described the impact their carrier status or lack of it had on their lives. Conclusion: These findings could be translated into better advocacy and support for siblings through haemophilia centres. More research is also needed on how healthy siblings are affected by haemophilia, including studies guided by family systems theory.N/

Trends in Health Behavior Patterns Among U.S. Adults, 2003–2015

Background: Over the last two decades, considerable resources from U.S. federal and philanthropic entities were dedicated to improving preventive and reducing chronic disease risk behaviors. Purpose: Given the population health efforts to improve health behaviors in adults, this study explored how health behavior patterns shifted over the years by exploring multiple health behavior patterns. Methods: Data were obtained from the odd years between 2002 and 2016 Behavioral Risk Factor Surveillance System. Latent class analyses including fruit and vegetables, physical activity, cigarette smoking, and heavy and binge drinking were conducted for each year. Results: Three-class models best fit the data and were most interpretable. Each year included Healthy or Physically Active (preventive behaviors, no risk behaviors), Apathetic (no preventive/risk behaviors), and Binge-drinking groups. Gender and age consistently distinguished the Healthy/Physically Active groups from the Apathetic and Binge-drinking groups across the years. Conclusions: This study confirms health behavior clusters exist and have been stable across time. This is encouraging as trends have not gotten worse, but there is room for improvement. Repetition of the groups across years suggests that despite population-level interventions, a large segment of the U.S. population at risk for chronic diseases are not engaging in preventive health

Development and Validation of the Adolescent Media Health Literacy Scales: Rasch Measurement Model Approach

BackgroundHigh media use has been implicated in negative social and health outcomes among adolescents. Therefore, it is critical that adolescents develop skills to healthily engage with media content. Media health literacy (MHL), skills for assessing and responding to health-related media content, and potentially targetable moderators for the relationship between media use and health-related outcomes are understudied in adolescents. The lack of MHL assessment tools may have contributed to this research gap. ObjectiveThis study aimed to develop and validate test-based scales of adolescents’ MHL. MethodsThe items developed were vetted iteratively via community reviews and cognitive interviews to establish content and face validity. Adolescents (N=355) completed a questionnaire that included the revised MHL items. The scales (Recognition/Identification, Influence/Critical Analysis, and Action/Reaction) were validated using Rasch measurement models. Convergent validity was assessed by correlating the summed scores of the three scales with existing functional and internet-related health literacy measures. Criterion validity was assessed by modeling logistic regressions for predicting health literacy–related behaviors from each scale after controlling for demographics. Effect sizes were estimated, and a short form was also validated. ResultsThe final MHL scales (Recognition/Identification, Influence/Critical Analysis, and Action/Reaction) fit their Rasch models. The 9-item Recognition/Identification and 9-item Influence/Critical Analysis scales had good convergent validity with functional and internet-related health literacy measures and were positively related to reading instructions before taking medicines and questioning the truthfulness of health information found online. The 12-item MHL Scales-Short Form also had good convergent and criterion validity. However, convergent and criterion validity were not established for the 3-item Action/Reaction Scale. ConclusionsThe Recognition/Identification and Influence/Critical Analysis scales and the MHL Scales-Short Form may be used to determine the impact of MHL on media use and health outcome relationships and ultimately inform the development of interventions and policies to affect these relationships in multiple settings