Implementation of the Power to Prevent Diabetes Prevention Educational Curriculum Into Rural African American Communities: A Feasibility Study

The purpose of this study was to describe the feasibility of using a Community Based Participatory Research (CBPR) approach to implement the Power to Prevent (P2P) diabetes prevention education curriculum in rural African American (AA) settings

Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data

To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors

Self-Care Confidence Mediates the Relationship Between Perceived Social Support and Self-Care Maintenance in Adults With Heart Failure

Social support may be associated with HF self-care; however, the mechanisms are not well understood. We examine the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships

Family presence and participation during medical visits of heart failure patients: An analysis of survey and audiotaped communication data

OBJECTIVE: To describe the frequency, roles, and utility of family companion involvement in the care of patients with Heart Failure (HF) care and to examine the association between audiotaped patient, companion, and provider communication behaviors. METHODS: We collected survey data and audiotaped a single medical visit for 93 HF patients (36 brought a companion into the examination room) and their cardiology provider. Communication data was analyzed using the Roter Interaction Analysis System. RESULTS: There were 32% more positive rapport-building statements (p<.01) and almost three times as many social rapport-building statements (p<0.01) from patients and companions in accompanied visits versus unaccompanied patient visits. There were less psychosocial information giving statements in accompanied visits compared to unaccompanied patient visits (p<0.01.) Providers made 25% more biomedical information giving statements (p=0.04) and almost three times more social rapport-building statements (p<0.01) in accompanied visits. Providers asked fewer biomedical and psychosocial questions in accompanied versus unaccompanied visits. Providers made 16% fewer partnership-building statements in accompanied versus unaccompanied visits (p=0.01). CONCLUSIONS: Our findings are mixed regarding the benefits of accompaniment for facilitating patient-provider communication based on survey and audiotaped data. PRACTICE IMPLICATIONS: Strategies to enhance engagement during visits, such as pre-visit question prompt lists, may be beneficial

Self-Care Confidence Mediates the Relationship Between Perceived Social Support and Self-Care Maintenance in Adults With Heart Failure

BACKGROUND: Social support may be associated with HF self-care; however, the mechanisms are not well understood. We examine the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships. METHODS: Cross-sectional survey of HF patients seen in outpatient clinic settings. Our outcome (HF self-care maintenance and self-care management) and mediator (HF self-care confidence) variables were assessed using the Self-Care of Heart Failure Index. Perceived emotional/informational support assessed using the Medical Outcomes Study social support survey. We performed regression analyses to examine associations between perceived support and HF self-care behaviors. Mediation analysis was performed according to Baron & Kenny method. RESULTS: We surveyed 150 HF patients (mean age 61 yrs; 51% female; 43% African Americans). More emotional/informational support was associated with better self-care maintenance (β=0.13, p=0.04). More emotional/information support was associated with better self-care management (β= 0.23, p=0.04) in unadjusted, but not adjusted analysis (β= 0.20, p=0.10). Self-care confidence mediates the association between perceived support and self-care maintenance (percent change in β coefficient was 32%) and management (percent change in β coefficient was 20%). CONCLUSION: Perceived emotional/informational support is associated with better self-care maintenance and possibly better self-care management. Greater self-care confidence is one mediating mechanism