The Helper-Therapy Principle Applied to Weight Management Specialists

One hundred twenty applicants to a weight management specialist training program were studied over a 33-month period. Following a nine-month training period, Specialists (N = 29; those leading at least one posttraining weight management group) were compared to Contact Controls (N = 31; persons participating in the weight management program, but not in the helper role) and No Contact Controls (N = 60; those not accepted into the training program and whose only contact with the program was for data collection purposes) in a test of the helper-therapy principle. The major question was, What are the long-term physical, psychological, and behavioral effects on overweight and formerly overweight individuals involved in helping other persons manage their weight? Data gathered at 12 and 24 months posttraining revealed few differences between the total group of specialists and persons in the two control groups. However, when the data were analyzed by the amount of commitment to the specialist role, it was found that the Higher Involved Specialists (N = 16; those who led two or more weight management groups in the year posttraining) were significantly more likely to lose additional weight (or maintain earlier weight losses), to be more consistent in their adherence to the eating and activity levels advocated by the program, to feel better about themselves and their bodies, and to maintain their levels of general well-being than control subjects or the Lesser Involved Specialists. These latter individuals (N = 13) were significantly the worse for having gone through specialist training, but not fully carrying out the specialist role

Validation of the shortened Perceived Medical Condition Self-Management Scale in patients with chronic disease

Self-efficacy, or perceived competence, has been identified as an important factor in self-management behaviors and health outcomes in patients with chronic disease. Measures of self-management self-efficacy are currently available for multiple forms of chronic disease. One established measure is the 8-item Perceived Medical Condition Self-Management Scale (PMCSMS). This study investigated the use of the PMCSMS in samples of patients with a chronic disease to develop an abbreviated version of the scale that could be more readily used in clinical contexts or in large population health cohort studies. The PMCSMS was administered as either a generic scale or as a disease-specific scale. The results of analyses using item response theory and classical test theory methods indicated that using 4 items of the scale resulted in similar internal consistency (α = .70-0.90) and temporal stability (test-retest r = .75 after 2 to 4 weeks) to the 8-item PMCSMS (r = .81 after 2 to 4 weeks). The 4 items selected had the greatest discriminability among participants (α parameters = 2.49-3.47). Scores from both versions also demonstrated similar correlations with related constructs such as health literacy (r = .13-0.29 vs. 0.14-0.27), self-rated health (r = .17-0.48 vs. 0.26-0.50), social support (r = .21-0.32 vs. 0.25-0.34), and medication adherence (r = .20-0.24 vs. 0.20-0.25). The results of this study indicate that 4-item PMCSMS scores are equally valid but more efficient, and have the potential to be beneficial for both research and clinical applications. (PsycINFO Database Recor

The environmental cost of misinformation: why the recommendation to use elevated temperatures for handwashing is problematic

Abstract Multiple government and health organizations recommend the use of warm or hot water in publications designed to educate the public on best practices for washing one's hands. This is despite research suggesting that the use of an elevated water temperature does not improve handwashing efficacy, but can cause hand irritation. There is reason to believe that the perception that warm or hot water is more effective at cleaning one's hands is pervasive, and may be one factor that is driving up unnecessary energy consumption and greenhouse gas emissions. We examine handwashing practices and beliefs about water temperature using a survey of 510 adults in the US. The survey included measures of handwashing frequency, duration, the proportion of time an elevated temperature was used and beliefs about water temperature and handwashing efficacy. We also estimate the energy consumed and resultant carbon dioxide equivalent emissions (CO2eq) in the US due to the use of elevated temperatures during handwashing. Participants used an elevated temperature 64% of the time, causing 6.3 million metric tons (MMt) of CO2eq, which is 0.1% of total annual emissions and 0.3% of commercial and residential sector emissions. Roughly 69% of the sample believed that elevated temperatures improve handwashing efficacy. Updating these beliefs could prevent 1 MMt of CO2eq annually, exceeding the total emissions from many industrial sources in the US including the lead and zinc industries. In addition to causing skin irritation, the recommendation to use an elevated temperature during handwashing contributes to another major threat to public health -climate change. Health and consumer protection organizations should consider advocating for the use of a 'comfortable' temperature rather than warm or hot water

Development and validation of the Diabetes Numeracy Test (DNT)

<p>Abstract</p> <p>Background</p> <p>Low literacy and numeracy skills are common. Adequate numeracy skills are crucial in the management of diabetes. Diabetes patients use numeracy skills to interpret glucose meters, administer medications, follow dietary guidelines and other tasks. Existing literacy scales may not be adequate to assess numeracy skills. This paper describes the development and psychometric properties of the Diabetes Numeracy Test (DNT), the first scale to specifically measure numeracy skills used in diabetes.</p> <p>Methods</p> <p>The items of the DNT were developed by an expert panel and refined using cognitive response interviews with potential respondents. The final version of the DNT (43 items) and other relevant measures were administered to a convenience sample of 398 patients with diabetes. Internal reliability was determined by the Kuder-Richardson coefficient (KR-20). An <it>a priori </it>hypothetical model was developed to determine construct validity. A shortened 15-item version, the DNT15, was created through split sample analysis.</p> <p>Results</p> <p>The DNT had excellent internal reliability (KR-20 = 0.95). The DNT was significantly correlated (p < 0.05) with education, income, literacy and math skills, and diabetes knowledge, supporting excellent construct validity. The mean score on the DNT was 61% and took an average of 33 minutes to complete. The DNT15 also had good internal reliability (KR-20 = 0.90 and 0.89). In split sample analysis, correlations of the DNT-15 with the full DNT in both sub-samples was high (rho = 0.96 and 0.97, respectively).</p> <p>Conclusion</p> <p>The DNT is a reliable and valid measure of diabetes related numeracy skills. An equally adequate but more time-efficient version of the DNT, the DNT15, can be used for research and clinical purposes to evaluate diabetes related numeracy.</p

Yoga for Risk Reduction of Metabolic Syndrome: Patient-Reported Outcomes from a Randomized Controlled Pilot Study

Lifestyle change is recommended as treatment for adults at risk for metabolic syndrome (MetS), although adoption of new behavioral patterns is limited. In addition, most existing lifestyle interventions do not address psychological stress or quality of life, both of which impact the burden of MetS. Yoga, a form of physical activity that incorporates psychological components (e.g., maintaining attention, relaxation), is a promising intervention for improving the burden of MetS. This randomized controlled trial assessed the feasibility and preliminary efficacy of a 12-week yoga program coupled with an evidence-based health education program (HED) compared to HED alone. A secondary, exploratory aim examined perceived stress, quality of life, and related psychological outcomes (mindfulness, perceived health competence, and mood). Sixty-seven adults at risk for MetS enrolled (mean age [SD]: 58 [10] years; 50% male; 79% non-Hispanic White). Preliminary results revealed significantly larger improvements in two quality of life domains (role-physical and general health perceptions) in the HED plus yoga group versus HED alone (ps<0.05). This is the first study that implemented lifestyle education along with yoga to evaluate the potential unique effects of yoga on participants at risk for MetS. A larger clinical trial is warranted to further investigate these promising patient-reported outcomes

Yoga for Risk Reduction of Metabolic Syndrome: Patient-Reported Outcomes from a Randomized Controlled Pilot Study

Lifestyle change is recommended as treatment for adults at risk for metabolic syndrome (MetS), although adoption of new behavioral patterns is limited. In addition, most existing lifestyle interventions do not address psychological stress or quality of life, both of which impact the burden of MetS. Yoga, a form of physical activity that incorporates psychological components (e.g., maintaining attention, relaxation), is a promising intervention for improving the burden of MetS. This randomized controlled trial assessed the feasibility and preliminary efficacy of a 12-week yoga program coupled with an evidence-based health education program (HED) compared to HED alone. A secondary, exploratory aim examined perceived stress, quality of life, and related psychological outcomes (mindfulness, perceived health competence, and mood). Sixty-seven adults at risk for MetS enrolled (mean age [SD]: 58 [10] years; 50% male; 79% non-Hispanic White). Preliminary results revealed significantly larger improvements in two quality of life domains (role-physical and general health perceptions) in the HED plus yoga group versus HED alone ( s &lt; 0.05). This is the first study that implemented lifestyle education along with yoga to evaluate the potential unique effects of yoga on participants at risk for MetS. A larger clinical trial is warranted to further investigate these promising patient-reported outcomes

The development of a brief version of the Santa Clara Strength of Religious Faith Questionnaire

The increasing interest between religiosity and health benefits has created the need for a brief, reliable, valid, and practical instrument to measure strength of religious faith. The purpose of this study is to develop a brief version of the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ). The SCSRFQ has been reduced from a ten-item questionnaire to a five-item scale, making it more suitable for administration to severely ill patients and for use in large-scale epidemiological studies. To create the brief version, 1584 participants completed the SCSRFQ. Results were evaluated for high correlation coefficients between individual item responses and the overall total 10 questions from the original scale. Items to be used in the abbreviated version were also selected on the basis of having moderate and centered means and high standard deviations. Thus, the items selected for the brief version generally correlated highly with the total score for the longer questionnaire and provided adequate variability. The reduced version, using questions 2, 4, 5, 8, and 10 of the original scale provides a \u3e 0.95 correlation with results from the longer version

Relationship between HIV stigma and self-isolation among people living with HIV in Tennessee.

HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood.Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior.Three main themes emerged regarding HIV stigma: (1) negative attitudes, fear of contagion, and misperceptions about transmission; (2) acts of discrimination by families, friends, health care providers, and within the workplace; and (3) participants' use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a person's HIV status made identifying enacted stigma with a quantitative scale difficult.Fear of discrimination resulted in participants isolating themselves from friends or experiences to avoid disclosure. Participant unwillingness to disclose their HIV status to friends and family could lead to an underestimation of enacted HIV stigma in quantitative scales