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Use of the Multidimensional Health Locus of Control to Predict Information-Seeking Behaviors and Health-Related Needs in Pregnant Women and Caregivers.
Holroyd LE, Anders S, Robinson JR, Jackson GP
(2017) AMIA Annu Symp Proc 2017: 902-911
MeSH Terms: Adult, Attitude to Health, Caregivers, Consumer Health Information, Female, Health Services Needs and Demand, Humans, Information Seeking Behavior, Internal-External Control, Male, Pregnancy, Pregnant Women, Socioeconomic Factors
Show Abstract · Added June 27, 2018
Pregnancy produces important health-related needs, and expectant families have turned to technologies to meet them. The ability to predict needs and technology preferences might aid in connecting families with resources. This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers. Internal MHLC scores were positively correlated with information-seeking behaviors, including website and patient portal use. Higher Chance scores were associated with decreased portal or pregnancy website use (p=0.002), with the exception of FitPregnancy.com (p=0.02). MHLC scores were not significantly correlated with number of health-related needs or whether needs were met. Individuals with needs about disease management had higher Powerful Others scores (p=0.01); those with questions about tests had lower Powerful Others scores (p=0.008). MHLC scores might be used to identify individuals less likely to seek information and to predict need types.
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13 MeSH Terms
Medication Nonadherence Before Hospitalization for Acute Cardiac Events.
Kripalani S, Goggins K, Nwosu S, Schildcrout J, Mixon AS, McNaughton C, McDougald Scott AM, Wallston KA, Vanderbilt Inpatient Cohort Study
(2015) J Health Commun 20 Suppl 2: 34-42
MeSH Terms: Acute Coronary Syndrome, Adult, Age Factors, Aged, Aged, 80 and over, Attitude to Health, Depression, Educational Status, Health Literacy, Heart Failure, Hospitalization, Hospitals, University, Humans, Medication Adherence, Middle Aged, Prospective Studies, Risk Factors, Self Report, Social Support, Tennessee
Show Abstract · Added April 6, 2017
Medication nonadherence increases the risk of hospitalization and poor outcomes, particularly among patients with cardiovascular disease. The purpose of this study was to examine characteristics associated with medication nonadherence among adults hospitalized for cardiovascular disease. Patients in the Vanderbilt Inpatient Cohort Study who were admitted for acute coronary syndrome or heart failure completed validated assessments of self-reported medication adherence (the Adherence to Refills and Medications Scale), demographic characteristics, health literacy, numeracy, social support, depressive symptoms, and health competence. We modeled the independent predictors of nonadherence before hospitalization, standardizing estimated effects by each predictor's interquartile range. Among 1,967 patients studied, 70.7% indicated at least some degree of medication nonadherence leading up to their hospitalization. Adherence was significantly lower among patients with lower health literacy (0.18-point change in adherence score per interquartile range change in health literacy), lower numeracy (0.28), lower health competence (0.30), and more depressive symptoms (0.52) and those of younger age, of non-White race, of male gender, or with less social support. Medication nonadherence in the period before hospitalization is more prevalent among patients with lower health literacy, numeracy, or other intervenable psychosocial factors. Addressing these factors in a coordinated care model may reduce hospitalization rates.
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20 MeSH Terms
Results of a novel screening tool measuring dietary sodium knowledge in patients with chronic kidney disease.
Wright Nunes JA, Anderson CA, Greene JH, Ikizler TA, Cavanaugh KL
(2015) BMC Nephrol 16: 42
MeSH Terms: Adult, Age Factors, Aged, Attitude to Health, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Logistic Models, Male, Mass Screening, Middle Aged, Odds Ratio, Renal Insufficiency, Chronic, Risk Assessment, Severity of Illness Index, Sex Factors, Sodium Chloride, Dietary, Surveys and Questionnaires
Show Abstract · Added August 4, 2015
BACKGROUND - Reducing dietary sodium has potential to benefit patients with chronic kidney disease (CKD). Little research is available defining dietary sodium knowledge gaps in patients with pre-dialysis CKD. We designed a brief screening tool to rapidly identify patient knowledge gaps related to dietary sodium for patients with CKD not yet on dialysis.
METHODS - A Short Sodium Knowledge Survey (SSKS) was developed and administered to patients with pre-dialysis CKD. We also asked patients if they received counseling on dietary sodium reduction and about recommended intake limits. We performed logistic regression to examine the association between sodium knowledge and patient characteristics. Characteristics of patients who answered all SSKS questions correctly were compared to those who did not.
RESULTS - One-hundred fifty-five patients were surveyed. The mean (SD) age was 56.6 (15.1) years, 84 (54%) were men, and 119 (77%) were white. Sixty-seven patients (43.2%) correctly identified their daily intake sodium limit. Fifty-eight (37.4%) were unable to answer all survey questions correctly. In analysis adjusted for age, sex, race, education, health literacy, CKD stage, self-reported hypertension and attendance in a kidney education class, women and patients of non-white race had lower odds of correctly answering survey questions (0.36 [0.16,0.81]; p = 0.01 women versus men and 0.33 [0.14,0.76]; p = 0.01 non-white versus white, respectively).
CONCLUSIONS - Our survey provides a mechanism to quickly identify dietary sodium knowledge gaps in patients with CKD. Women and patients of non-white race may have knowledge barriers impeding adherence to sodium reduction advice.
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19 MeSH Terms
Predictors of health care system and physician distrust in hospitalized cardiac patients.
Gupta C, Bell SP, Schildcrout JS, Fletcher S, Goggins KM, Kripalani S, Vanderbilt Inpatient Cohort Study (VICS)
(2014) J Health Commun 19 Suppl 2: 44-60
MeSH Terms: Acute Coronary Syndrome, Adaptation, Psychological, Adult, Aged, Attitude to Health, Female, Health Literacy, Heart Failure, Humans, Inpatients, Male, Middle Aged, Multivariate Analysis, Physician-Patient Relations, Prospective Studies, Social Support, Trust
Show Abstract · Added January 20, 2015
Trusting relationships among patients, physicians, and the health care system is important in encouraging self-care behaviors in cardiovascular patients. This study aimed to assess the prevalence of health care system and physician distrust in this population, compare the 2 forms of distrust, and describe the demographic, socioeconomic, and psychosocial predictors of high distrust. A total of 1,232 hospitalized adults with acute coronary syndrome or heart failure were enrolled in a prospective, observational study assessing health care system distrust and physician distrust. High health care system distrust (35%) was observed across the population, with lower levels of interpersonal physician distrust (16%). In a multivariate analysis, poor social support and coping skills were strong predictors of both health care system (p=.026, p=.003) and physician distrust (p<.001, p=.006). Individuals with low or marginal health literacy had a higher likelihood of physician distrust (p<.001), but no relation was found between health literacy and health care system distrust. In conclusion, distrust is common among acutely ill cardiac patients. Those with low social support and low coping skills are more distrusting of physicians and the health care system.
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17 MeSH Terms
Health literacy, numeracy, and other characteristics associated with hospitalized patients' preferences for involvement in decision making.
Goggins KM, Wallston KA, Nwosu S, Schildcrout JS, Castel L, Kripalani S, Vanderbilt Inpatient Cohort Study (VICS)
(2014) J Health Commun 19 Suppl 2: 29-43
MeSH Terms: Adult, Aged, Attitude to Health, Cardiovascular Diseases, Educational Status, Female, Health Literacy, Humans, Inpatients, Male, Mathematical Concepts, Middle Aged, Multivariate Analysis, Patient Participation, Patient Preference, Prospective Studies, Sex Factors, Social Support, Trust
Show Abstract · Added January 20, 2015
Little research has examined the association of health literacy and numeracy with patients' preferred involvement in the problem-solving and decision-making process in the hospital. Using a sample of 1,249 patients hospitalized with cardiovascular disease from the Vanderbilt Inpatient Cohort Study (VICS), we assessed patients' preferred level of involvement using responses to two scenarios of differing symptom severity from the Problem-Solving Decision-Making Scale. Using multivariable modeling, we determined the relationship of health literacy, subjective numeracy, and other patient characteristics with preferences for involvement in decisions, and how this differed by scenario. The authors found that patients with higher levels of health literacy desired more participation in the problem-solving and decision-making process, as did patients with higher subjective numeracy skills, greater educational attainment, female gender, less perceived social support, or greater health care system distrust (p<.05 for each predictor in multivariable models). Patients also preferred to participate more in the decision-making process when the hypothetical symptom they were experiencing was less severe (i.e., they deferred more to their physician when the hypothetical symptom was more severe). These findings underscore the role that patient characteristics, especially health literacy and numeracy, play in decisional preferences among hospitalized patients.
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19 MeSH Terms
Good cop, bad cop: quality of parental involvement in type 1 diabetes management in youth.
Young MT, Lord JH, Patel NJ, Gruhn MA, Jaser SS
(2014) Curr Diab Rep 14: 546
MeSH Terms: Adaptation, Psychological, Adolescent, Adolescent Behavior, Attitude to Health, Blood Glucose, Blood Glucose Self-Monitoring, Conflict (Psychology), Diabetes Mellitus, Type 1, Diet, Diabetic, Exercise, Glycated Hemoglobin A, Health Knowledge, Attitudes, Practice, Humans, Insulin, Medication Adherence, Monitoring, Physiologic, Parent-Child Relations, Parents, Self Care
Show Abstract · Added March 11, 2015
Sustained parental involvement in diabetes management has been generally advised to counteract the deteriorating adherence and glycemic control often seen during adolescence, yet until recently, little attention has been given to the optimal amount, type, and quality of parental involvement to promote the best health outcomes for adolescents with type 1 diabetes (T1D). This review synthesizes research regarding the involvement of caregivers-primarily mothers and fathers-of youth with T1D, with a focus on biopsychosocial outcomes. The recent literature on parental involvement in diabetes management highlights a shift in focus from not only amount but also the types (e.g., monitoring, problem-solving) and quality (e.g., warm, critical) of involvement in both mothers and fathers. We provide recommendations for ways that both parents can remain involved to facilitate greater collaboration in shared direct and indirect responsibility for diabetes care and improve outcomes in youth with T1D.
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19 MeSH Terms
Faith leaders' comfort implementing an HIV prevention curriculum in a faith setting.
Pichon LC, Griffith DM, Campbell B, Allen JO, Williams TT, Addo AY
(2012) J Health Care Poor Underserved 23: 1253-65
MeSH Terms: African Continental Ancestry Group, Attitude to Health, Curriculum, Female, HIV Infections, Humans, Male, Michigan, Pilot Projects, Religion, Sexuality, Surveys and Questionnaires
Show Abstract · Added March 27, 2014
YOUR Blessed Health (YBH) is a faith-based HIV prevention pilot program designed to increase faith-based organizations' capacity to address HIV/AIDS among African American congregations. Faith leaders (e.g., pastors, pastors' spouses) were trained to deliver youth and adult HIV education sessions. Perceptions of comfort with discussing 11 sexual health topics were assessed after program implementation. Twenty-nine faith leaders self-reported their comfort discussing sexual behaviors, sexual communication, and sexual abuse. Overall, faith leaders were comfortable discussing these sexual health topics; however, denominational and leadership role differences were found. These findings suggest African American faith leaders are willing to lead faith-based HIV prevention efforts, but that consideration of denominational differences and organizational roles in faith-based health promotion programs is critical.
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12 MeSH Terms
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
Williams SE, Rothman RL, Offit PA, Schaffner W, Sullivan M, Edwards KM
(2013) Acad Pediatr 13: 475-80
MeSH Terms: Adult, Attitude to Health, Female, Humans, Male, Parents, Patient Acceptance of Health Care, Pilot Projects, Vaccination
Show Abstract · Added May 28, 2014
OBJECTIVE - A cluster randomized trial was performed to evaluate an educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents.
METHODS - Two primary care sites were randomized to provide families with either usual care or an intervention (video and written information) for vaccine-hesitant parents. Eligible parents included those presenting for their child's 2-week well-child visit with performance on the Parent Attitudes about Childhood Vaccines (PACV) survey suggesting vaccine hesitancy (score ≥25). Enrollees completed PACV surveys at the 2-month well-child visit and vaccination status at 12 weeks of age was assessed. The primary outcome was the difference in PACV scores obtained at enrollment and 2 months between the 2 groups. The proportion of on-time vaccination was also compared at 12 weeks.
RESULTS - A total of 454 parents were approached, and 369 (81.3%) participated; 132 had PACV scores of ≥25 and were enrolled, 67 in the control group (mean PACV score 37) and 55 in the intervention group (mean PACV score 40). Two-month PACV surveys were completed by 108 (∼90%) of enrollees. Parents in the intervention group had a significant decrease in PACV score at 2 months compared to control (median difference 6.7, P = .049); this remained significant after adjustment for baseline PACV score, race/ethnicity, and income (P = .044). There was no difference in the on-time receipt of vaccines between groups at 12 weeks.
CONCLUSIONS - A brief educational intervention for vaccine-hesitant parents was associated with a modest but significant increase in measured parental attitudes toward vaccines.
Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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9 MeSH Terms
The health of African American men: implications for research and practice.
Jack L, Griffith DM
(2013) Am J Mens Health 7: 5S-7S
MeSH Terms: African Americans, Attitude to Health, Cultural Characteristics, Health Status, Health Status Disparities, Humans, Male, Men's Health, United States
Added March 7, 2014
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9 MeSH Terms
Relationship between physical inactivity and health characteristics among participants in an employee-wellness program.
Birdee GS, Byrne DW, McGown PW, Rothman RL, Rolando LA, Holmes MC, Yarbrough MI
(2013) J Occup Environ Med 55: 514-9
MeSH Terms: Absenteeism, Adolescent, Adult, Age Factors, Attitude to Health, Cardiovascular Diseases, Community Participation, Female, Health Behavior, Health Promotion, Health Status, Humans, Male, Middle Aged, Motor Activity, Obesity, Occupational Health, Sedentary Behavior, Sex Factors, Surveys and Questionnaires, Young Adult
Show Abstract · Added December 10, 2013
OBJECTIVE - To characterize factors associated with physical inactivity among employees with access to workplace wellness program.
METHODS - We examined data on physical inactivity, defined as exercise less than once a week, from the 2010 health risk assessment completed by employees at a major academic institution (N = 16,976).
RESULTS - Among employees, 18% of individuals reported physical activity less than once a week. Individuals who were physically inactive as compared with physically active reported higher prevalence of cardiovascular diseases (adjusted odds ratio [AOR], 1.36 [1.23 to 1.51]), fair or poor health status (AOR, 3.52 [2.97 to 4.17]), and absenteeism from work (AOR, 1.59 [1.41 to 1.79]). Overall, physically inactive employees as compared with physically active employees reported more interest in health education programs.
CONCLUSION - Future research is needed to address barriers to physical inactivity to improve employee wellness and potentially lower health utility costs.
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21 MeSH Terms