Health numeracy and cognitive decline in advanced age

ABSTRACT

The study aimed at investigating health numeracy in cognitively well performing healthy participants aged from 50 to 95 years as well as in participants with cognitive impairment, but no dementia (CIND). In cognitively well performing participants (n = 401), demographic variables and cognitive abilities (executive functions, reading comprehension, mental calculation, vocabulary) were associated with health numeracy. Older age, lower education, female gender as well as lower cognitive functions predicted low health numeracy. The effect of older age was partly mediated by executive functions and calculation abilities. Participants with CIND (n = 51) performed significantly lower than healthy controls in health numeracy. The findings suggest that cognitively well performing old individuals have difficulties in understanding health-related numerical information. The risk of misunderstanding health-related numerical information is increased in persons with CIND. As these population groups are frequently involved in health care decisions, particular attention has to be paid to providing numerical information in comprehensible form.     

Self‐Stigma,Mental Health Literacy,and Attitudes Toward Seeking Psychological Help

This study examined self‐stigma of seeking psychological help and mental health literacy as predictors of college students’ (N = 1,535) help‐seeking attitudes, with additional attention to psychological and demographic correlates. Results indicated that mental health literacy predicted help‐seeking attitudes above and beyond self‐stigma. Asian American race/ethnicity, male gender, current psychological distress, and help‐seeking history were also significant predictors. Implications for addressing mental health literacy and self‐stigma while attending to demographic and psychological variations in help seeking are discussed.     

Investigating Occupational Stress,Racial Identity,and Mentoring for African American Women in Health Care

This study examined the influence of racial identity and mentoring experiences on occupational stress among African American women in health care (N = 76). The women were surveyed about their occupational stress (role stress, psychological strain, and personal resources), racial identity, demographic information, and mentoring experiences. Results indicated that racial identity was negatively related to role stress and psychological strain, and level of education was closely related to personal resources. Mentoring was not found to have a significant impact on occupational stress as hypothesized. The implications for enhancing occupational satisfaction were discussed in relation to advocacy for career development professionals.     

Don't ask,don't tell: a systematic review of the extent to which participant characteristics are reported in social anxiety treatment studies

Background and Objectives: This study examined the extent to which social anxiety treatment studies report the demographic characteristics of their participants. One hundred and 56 treatment studies published in English between 2001 and 2012 articles were collected. Methods: Each study was evaluated on whether or not it reported information on gender, age, race, relationship status, education, socioeconomic status, sexual orientation, and disability and also the extent to which the racial composition of the sample was described. Results: The majority of studies reported information on age (96.2%) and gender (94.2%), but the percentage of studies that reported anything else is much lower: race (50.0%), education (42.3%), relationship status (37.8%), socioeconomic status (5.1%), disability (2.6%), and sexual orientation (1.3%). One third (34.0%) of studies reported the race of all participants in their samples, while the remaining reported no information or information for only a subset of participants (e.g. “mostly white”). Conclusions: Participants of social anxiety disorder treatment studies generally are not described beyond their age and gender. Standards for reporting participant characteristics of treatment studies (similar to standards for reporting the methodology of treatment studies) could improve clinical researchers’ and clinicians’ ability to evaluate the external validity of this body of work.     

Ecological Correlates of Family Functioning

Guided by ecological theory, we empirically explored how parents' psychological functioning, social relationships, and demographic characteristics related to family functioning. Our sample of 197 participants included both neglectful and control families. We found statistically significant associations between the predictor variables (i.e., maternal personal maturity, depression, stressful life events, social support, family of origin difficulties, education, income) and family functioning as rated by mothers, caseworkers familiar with the families, and observers who coded family interaction tasks. However, the exact pattern of significant associations differed as a function the rater of family health.     

Emotional Reactions to Health Status Changes and Emotional Well-Being Among HIV-Positive Persons with Limited Reading Literacy

People living with HIV-AIDS experience emotional distress in response to negative changes in their health status. The current study hypothesized that individuals with poorer health literacy skills would evidence greater emotional distress in response to negative changes in health status compared to persons with higher health literacy skills. HIV positive persons (N = 294) completed anonymous surveys that included measures of depression and social support and a subset of 98 participants completed two experimental vignettes depicting a person receiving test results showing an increase in HIV viral load (negative health changes) followed by a vignette suggesting decreased viral load (improved health changes). Responses to affective reactions and coping strategies indicated that persons with lower health literacy skills more strongly endorsed negative affective states and maladaptive coping strategies compared to persons with higher health literacy skills. In addition, lower health literacy was associated with greater symptoms of affective depression and poorer social support, whereas higher literacy was associated with greater negativistic thinking. Findings suggest the need for patient education and counseling regarding changes in health status among people living with HIV-AIDS, particularly persons with limited health literacy skills.     

Correlates of satisfaction with body function and body appearance in middle- and older aged adults: The activity counseling trial (ACT)

Abstract

This study examined the dimensional structure and correlates of body satisfaction among middle-aged and older adult men (n = 471) and women (n = 383) who were participants in the Activity Counseling Trial. Correlates were grouped as (1) fitness parameters, (2) demographic characteristics, and (3) components of subjective well-being. Factor analyses demonstrated that body function and body appearance were independent components of satisfaction in this population. Body composition and cardiorespiratory fitness were directly related to satisfaction with body appearance; however, satisfaction with body function was most strongly related in expected directions to measures of subjective well-being. Age was positively related to both measures of body satisfaction, whereas data on race revealed that blacks were more satisfied with their body appearance and function than whites. The observed relationships for body satisfaction suggest that older adults may value body function more than body appearance. Furthermore, the associations of race and age with body satisfaction have important implications for intervention research.     

The Effects of Library User-Education Programmes on the Information-Seeking Behaviour of Brisbane College of Theology Students

ABSTRACT

An increasing proportion of students entering the Brisbane College of Theology (BCT) are adult learners and engaged in theological education for general academic purposes or personal enrichment. In meeting the needs of these students, the user-education programmes conducted by the BCT Libraries endeavour to address the Australian Information Literacy Standards.¹ The literature reveals that information literacy is learned through experience primarily shaped by both librarians and faculty. This case study, which uses an adaptation of Biggs' model of presage, process, and product, looks at the information search process from the perspective of one theological library. As a phenomenographic study, it examines the interconnected theories of students' experience, perception, approach, and learning outcomes in the information search process. It will be shown here that user-education programmes and mediation with the librarian significantly influence the information-seeking behaviour of students.     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.     

Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress

Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants (n = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

The Winding Paths of the Lonesome Cowboy: Evidence for Mutual Influences Between Personality,Subjective Health,and Loneliness

Prior research demonstrated influences of personality traits and their development on later status of subjective health and loneliness. In the present study, we intended to extend these findings by examining mutual influences between health‐related characteristics and personality traits and their development over time. German adults were assessed at two time points across 15 years (N_T1 = 654, N_T2 = 271; M_age at Time 1 = 24.39, SD = 3.69). Data were analyzed with multivariate structural equation models and a multivariate latent change model. Neuroticism was found to predict later levels and the development of subjective health and loneliness. While subjective health likewise predicted later levels of Neuroticism, loneliness was found to be predictive of later levels as well as the development of Neuroticism, Extraversion, and Conscientiousness. Correlated changes indicated that developing a socially more desirable personality is associated with slower declines in subjective health and slower increases in loneliness. The findings indicate that characteristics related to an individual's health are reciprocally associated with personality traits. Thus, the study adds to the understanding of the development of personality and health‐related characteristics.     

Relationships among motor skill,perceived self-competence,fitness, and physical activity in young adults

PurposeThis large-scale, exploratory study sought to examine the associations between motor skill proficiency (MSP), perceived self-competence (PC), physical fitness (PF), and self-reported physical activity (PA) to assess the assumption that relationships among these variables found in childhood and adolescence persist into young-adulthood. Specifically, predictors of PF and PA were assessed. Additionally, the contributions body mass index (BMI) and gender made to these relationships, as well as that of process- versus product-oriented motor skills data, were studied. Finally, how these relationships differed by gender was explored.MethodsParticipants’ (n = 448) MSP was assessed using select measures from the TGMD-2 and the BOT-2, while PF was evaluated using the FitnessGram. Participants also completed surveys to assess PC (SPPCS), PA (past-week MAQ), and demographic information. Height and weight were collected to calculate BMI.ResultsModels predicting physical fitness had good fit to the observed data, with perceived athletic competence, locomotor skill, upper-limb coordination, BMI, and gender accounting for about 75% (R² = 0.748) of aerobic PF variance and about 48% (R² = 0.476) of variance in push-up performances. About 18% (R² = 0.178) of variance in curl-up performances was predicted by perceived athletic competence, locomotor skill, upper-limb coordination, and PA. The PA model demonstrated weaker predictive power, with only about 10% (R² = 0.097) of variance explained. When considering male and female models separately, female models demonstrated better fit when predicting all PF and PA outcome variables. BMI and gender operated as significant predictors to differing degrees across the various models.ConclusionsThere is compelling evidence to believe relationships found among MSP, PC, PF, and PA in childhood and adolescence also exist in early adulthood. However, differences in the roles of gender and physical fitness versus physical activity are likely to exist.     

Decomposing the within-person and between-person sources of variation in physical activity-cognition associations for low-active older adults

Abstract

Objectives: To examine within-person and between-person sources of variation in the relationship between physical activity and cognition in older adults participating in a walking program. To explore whether demographic, health and fitness variables, and their interactions with activity, are significant predictors of cognition.

Design: Brief longitudinal burst design.

Participants: 118 participants (91 females, mean age?=?72.81?+ 5.24 years).

Main Outcome Measures: Cognition, self-reported moderate-to-vigorous walking and self-reported moderate-to-vigorous physical activity were assessed at baseline and 6, 9, 12 and 16 weeks follow-up. Attendance at weekly walks was also recorded.

Results: Within-persons, changes in physical activity were related to select measures of executive functioning, with increased activity predictive of better cognition (three of four cognitive functions, p<.05). Between-persons, activity was also associated with cognition (two of four cognitive functions, p<.05). Younger age and higher education were related to better cognition. Interactions of demographic, health, and fitness variables with changes in within-person activity were generally non-significant.

Conclusion: The results highlight the importance of distinguishing within- from between-person effects in longitudinal analyses of the association between physical activity and cognition. This stringent within-person test of association underscores the potential value of simple physical activity interventions for improving cognitive function.     

A little shot of humility: Intellectual humility predicts vaccination attitudes and intention to vaccinate against COVID-19

Vaccinations remain a critical, albeit surprisingly controversial, health behavior, especially with the promise of widely available COVID-19 vaccine. Intellectual humility, a virtue characterized by nonjudgmental recognition of one's own intellectual fallibility, may counter rigidity associated with anti-vaccination attitudes and help promote vaccine-related behaviors. This study investigated whether intellectual humility is related to anti-vaccination attitudes and intentions to vaccinate against COVID-19, and whether intellectual humility can predict unique variance in these outcomes beyond participant demographic and personal factors. Participants (N = 351, 57.23% male, mean age = 37.41 years, SD = 11.51) completed a multidimensional measure for intellectual humility, the anti-vaccination attitudes (VAX) scale, and a two-item COVID-19 vaccination intention scale. Bivariate correlations demonstrated that intellectual humility was negatively related with anti-vaccination attitudes overall, r(349) = −.46, p < .001, and positively related to intentions to vaccinate against COVID-19, r(349) = .20, p < .001. Hierarchical multiple regression revealed that intellectual humility predicted all four types anti-vaccination attitudes, overall anti-vaccination attitudes, and COVID-19 vaccination intentions above and beyond demographic and personal factors (i.e., sex, race/ethnicity, age, education, socioeconomic status, and political orientation), ΔR² between .08 and .18, ps < .001. These results bolster intellectual humility as a malleable psychological factor to consider in efforts to combat anti-vaccination attitudes and promote COVID-19 vaccination uptake.     

How does education lead to healthier behaviours? Testing the mediational roles of perceived control,health literacy and social support

Abstract

Objectives: Educational attainment is increasingly recognised as a unique dimension of socioeconomic status (SES) and a powerful determinant of health behaviour—and thus physical health and mortality. However, very little is known about the specific pathways through which education influences these health behaviours. Design: The present study used a nationally representative US survey to test three potential psychosocial pathways (perceived control, health literacy and social support) through which education might influence intake of fruits and vegetables (FV), physical activity (PA) and sedentary behaviour (SB), controlling for other aspects of SES (income, health insurance status) and demographics (age, gender, race/ethnicity). Results: Both aspects of perceived control (locus of control, cancer fatalism) mediated the impact of education on FV and PA while only locus of control mediated the impact of education on SB. Further, only one aspect of health literacy (ability to understand recommendations) mediated education’s effect on any health behaviour (FV). Social support did not mediate any of the effects of education on health behaviors. Conclusion: Future work explicitly assessing and testing these mediational pathways is needed to better understand how education influences people’s health behaviours throughout their lives.     

The Perception of Mechanical Vibration: III. The Frequency Function

Three studies of male and female undergraduates examined the effects of incidental orienting tasks on the free recall of concrete nouns. In Experiments 1 (between-Ss design N = 53) and 2 (within-Ss design N = 54) semantic orienting tasks resulted in recall that was equal to or higher than recall following intentional learning. Nonsemantic orienting tasks produced poorest recall. In Experiment 3 (N = 59), Ss performed a word recognition task between two free-recall trials. The target and distractor words were either acoustically, orthographically, or semantically related or were unrelated to each other. On the second free-recall trial, recall was highest for target words that had been paired with semantically related distractors. The results of the three experiments add to the growing support for a levels-of-processing model of memory.     

Preferences for Online Mental Health Services Among Australian and Indian Samples: A Cross-Cultural Comparison

Online mental health services provide a point-of-access to mental healthcare that may otherwise be unavailable or limited, particularly in developing countries. Nevertheless, there is a lack of research into individual differences between those who prefer online mental health services and those who prefer traditional in-person services, and whether these differences vary as a function of culture. This study investigated differences in preferences for online or in-person mental health services on e-health literacy, age, education level, and comfort using the internet in a general community sample recruited from Australia and India. A total of 487 participants (31.6% male; mean age?=?33.55, SD?=?12.20, range 18–78), 297 Australians and 190 Indians, completed an online or paper-and-pencil survey. A significant negative relationship between age and e-health literacy was found with younger ages associated with higher e-health literacy. Furthermore, e-health literacy scores were significantly higher for the Australian sample. Age, e-health literacy, country-of-residence, education level, and comfort in using the internet did not predict mental health service preference. The results suggest that preference for in-person or online mental healthcare is independent of demographic and cultural factors and indicate that online mental health services may be acceptable to Indian health service consumers.     

Motivational,volitional and multiple goal predictors of walking in people with type 2 diabetes

BackgroundType 2 diabetes is a major public health problem. Effective diabetes self-management involves people engaging in multiple health behaviours, including physical activity. Walking is an effective, accessible and inexpensive form of physical activity, yet many people with Type 2 diabetes do not meet recommended levels. The present study aimed to: 1) identify demographic, motivational and volitional factors predictive of walking in people with Type 2 diabetes mellitus, and 2) test whether accounting for the perceived impact of other goal pursuits (goal facilitation and goal conflict) improved the prediction of walking.MethodsA theory-based cross-sectional study using the Health Action Process Approach was conducted in adults with Type 2 diabetes across Scotland. Assuming a 50% response rate 1000 questionnaires were mailed to achieve the target sample size (N = 500). Demographic information was collected, and intentional (outcome expectations, social support, risk perceptions), motivational (intention, self-efficacy), volitional (action planning, action control) and multiple goal (goal conflict, goal facilitation) factors were assessed as predictors of physical activity in general and walking specifically.ResultsThe final sample comprised 411 respondents. The majority (60%) were non-adherent to physical activity recommendations. Of 411 respondents, 356 provided walking data. Body Mass Index and age were the only demographic and anthropometric factors predictive of walking (overall R² = 0.04). When motivational factors were added, intention and self-efficacy added to the prediction (overall R² = 0.07). When volitional factors were added, only action control was predictive of walking (overall R² = 0.08). Finally, goal facilitation explained an additional 7% variance in walking when added to the model (final overall R² = 0.15).ConclusionThere was low adherence with physical activity recommendations in general and walking in particular. When testing predictors of motivational, volitional and competing goal constructs together, action control and goal facilitation emerged as predictors of walking. Future research should consider how walking can be embedded synergistically alongside other goal pursuits and how action control may help to ensure that they are pursued.     

Mental Health in Information Work

Abstract

The attention paid to problems related to mental health of employees in organizations is growing. Although the stress literature is huge and varied, most of the empirical studies are done in traditional work environments in which information technology and computers are of little importance. The recent increasing use of information technology has created a growing number of information processing work environments. The work in those work environments is typically done with data and can be characterized as “mental” work. The general hypothesis in this paper is that people doing mental work relate the perception of their work to mental health. More specifically, this paper describes the relationship between work-related factors and mental health among employees in a typical information processing environment: an insurance company. First, we discuss the concept of mental health. Next, we summarize the results of a number of studies on the determinants of mental health in information work. The results of our study indicate that work and health perception has a greater impact on mental health than work characteristics, personality, and activities outside work. Work perception, health perception, and mental health can be considered as one factor, although there are minor differences between subgroups in the population. In the discussion we try to integrate the findings into a general model of mental health related to work.