Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes

The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors – lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients’ regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients’ regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = ?.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients’ regulatory focus and type of health behavior.     

Moderators and predictors of response to eating disorder risk factor reduction programs in collegiate female athletes

ObjectiveThe primary aim of this paper was to investigate moderators and predictors of response to two programs designed to reduce eating disorder risk factors in collegiate female athletes. This study served as an ancillary study to a parent trial that investigated the feasibility of an athlete modified cognitive dissonance-based program (AM-DBP) and an athlete modified healthy weight intervention program (AM-HWI).Design157 female collegiate athletes were randomized to either the AM-DBP or the AM-HWI program. Participants completed surveys at baseline, post-intervention, 6 weeks, and 1 year.MethodsAfter classifying sports as either lean or non-lean, we investigated if sport type acted as a moderator of program response to AM-DBP and AM-HWI using ANOVAs. Next, we examined whether baseline thin-ideal internalization, weight concern, shape concern, bulimic pathology, dietary restraint, and negative affect acted as predictors of changes in bulimic pathology using linear regression models.ResultsAthletes in non-lean sports who received AM-DBP showed more improvement in negative affect versus non-lean sport athletes in AM-HWI. Higher baseline scores of bulimic pathology predicted greater response in bulimic pathology to both programs at 6-weeks. In contrast, athletes with higher dietary restraint and negative affect baseline scores showed decreased response to both interventions at 6-weeks. Finally, athletes with higher baseline shape concern showed a decreased response to the AM-HWI intervention at the post intervention time point.ConclusionResults from the present study indicate that lean/non-lean sport may not play a strong role in determining response to efficacious programs. Further, factors such as pre-existing bulimic pathology, dietary restraint, negative affect, and shape concern may affect general response to intervention versus specific responses to specific interventions.     

Exploring the experience of adhering to a prescribed pre-surgical exercise program for patients with advanced rectal cancer: A phenomenological study

ObjectivesThe aim of this study was to explore the lived experience of patients with advanced rectal cancer as they attempted to adhere to a prescribed, hospital-based pre-surgical exercise program.Design/MethodsTen patients took part in three semi-structured in-depth interviews prior to (week 0), midway (week 3), and at completion (week 6) of the exercise program. Data were analysed using a phenomenological approach.ResultsMain themes that were deemed important for remaining enrolled in the program included: (1) building camaraderie and peer support, (2) experiencing a sense of structure and control, and (3) feeling safe and encouraged. Patients also reported engaging in further exercise outside the program and feeling motivated to continue exercising in the future.ConclusionsThis study shows the potential to integrate exercise prior to surgery as it was viewed as acceptable and feasible by patients with advanced rectal cancer. Moreover, it provides much needed information into the possible mechanisms that underpin patient's continued participation in exercise programs during treatment for advanced rectal cancer. Prescribed, hospital-based program should be implemented to promote opportunities for exercise and provide on-going supportive care options for patients awaiting surgery.     

Alcohol interlocks and prevention of drunk-driving recidivism

IntroductionAlcohol interlock programs (AIP) are aimed at preventing drunk-driving recidivism. They first appeared in Europe in the nineties.ObjectivesThe purpose of this study was investigate whether AIPs are effective in reducing recidivism and determine what factors of such programs contribute to their positive impact.MethodWe performed a follow-up of AIP participants (n = 175) and control participants (n = 234) for five years. Data such as blood alcohol concentration (BAC) at time of arrest, previous and subsequent violations (alcohol-related or other types) were collected from the official driver's license files. For self-evaluation and evaluation of the program (since November 2009 only), we used questionnaires based on two theoretical models: the Transtheoretical Model of Change (Prochaska & DiClemente, 1984) and the Diamond of Change Model from the DRUID project, build to explain which are the elements of driver rehabilitation training courses that favor behavioral modification (Bukasa et al., 2009).ResultsThe data obtained allowed us to describe these populations of alcohol-drinking offenders, for both the interlock program group and the control group. Two salient features were male proneness to alcohol-related violations and a very high BAC (between 1.5 and 2 g/l) among the majority of drivers who drink under the influence of alcohol. In terms of recidivism reduction, the interlock program was not clearly linked to a beneficial effect. An analysis of behavioral change among the AIP participants showed that consciousness raising took effect more quickly than did environmental reevaluation or reinforcement management.ConclusionsThe application of Prochaska et al.’s model to the follow-up of AIP programs would be more fruitful in the future if psychologists are involved in the program. As we have seen, medical/psychological monitoring may not have been strong enough in the program studied here.     

Effectiveness of peer-led dissonance-based eating disorder prevention groups: Results from two randomized pilot trials

ObjectiveThe present preliminary trials tested whether undergraduate peer leaders can effectively deliver a dissonance-based eating disorder prevention program, which could facilitate broad dissemination of this efficacious intervention.MethodIn Study 1, female undergraduates (N = 171) were randomized to peer-led groups, clinician-led groups, or an educational brochure control condition. In Study 2, which improved a design limitation of Study 1 by using completely parallel outcome measures across conditions, female undergraduates (N = 148) were randomized to either immediate peer-led groups or a waitlist control condition.ResultsIn Study 1, participants in peer- and clinician-led groups showed significantly greater pre–post reductions in risk factors and eating disorder symptoms than controls (M d = .64 and .98 respectively), though clinician- versus peer-led groups had higher attendance and competence ratings, and produced stronger effects at posttest (M d = .32) and at 1-year follow-up (M d = .26). In Study 2, participants in peer-led groups showed greater pre–post reductions in all outcomes than waitlist controls (M d = .75).ConclusionsResults provide novel evidence that dissonance-based eating disorder prevention groups led by undergraduate peers are feasible and produce greater reductions in eating disorder risk factors and symptoms than minimal-intervention control conditions, but indicate that effects are smaller for peer- versus clinician-led groups.     

An exploration of attitudes toward the use of patient incentives to support diabetes self-management

Objective: To improve our understanding of the potential of incentives to enhance diabetes self-management (type 1 and type 2) and to integrate incentives into a conceptual model of diabetes self-management over time.

Design: A qualitative analysis of in-depth individual interviews with 12 patients and 9 providers.

Main outcome measures: Influence of time on patients’ needs for diabetes self-management technologies and on the use of incentives to drive behavioural changes.

Results: Ten of the 12 participants with diabetes (83%) were interested in using financial incentives to improve their diabetes self-management. We found that incentives can play two key roles in diabetes self-management: guide the learning phase during the creation of habits; and serve as an acknowledgement of efforts made in the stable phase, when providers typically only focus on the patients’ failures at self-management.

Conclusion: Patients seem receptive to the idea of financial incentives, which have the potential to support diabetes self-management through either small monetary amounts or tangible rewards. Incentives hold promise for supporting behaviour changes, especially in early stages of diabetes, but they require careful planning to avoid the undesired consequence of decreased intrinsic motivation.     

The effectiveness of cognitive behavioral group intervention on depression and anxiety in patients with type II diabetes

IntroductionDepression and anxiety are important risk factors for diabetes and high blood pressure.ObjectiveThis study investigated the effectiveness of the Cognitive-Behavioral Group Intervention for Diabetes Disease (CBGI-DD) in reducing depression and anxiety in female patients with type 2 diabetes (T2D).MethodThe CBGI-DD program includes 12 weekly 2.5 h sessions, spread weekly over the course of 3 months. The present study was semi-experimental and controlled, with assessments at pre-test and post-test. It included diagnostic criteria for the diagnosis of T2D in the patient's medical records by a diabetes specialist. Participants (62 female volunteers aged 25 to 75 years) were randomly allocated to a control or test group. Both groups responded to the Second edition of the Beck Depression Inventory (BDI-II) and the Beck Anxiety Inventory (BAI) before (pretest) and immediately after the intervention (posttest). Participants in the test group received CBGI-DD (from April up to the end of September 2018) at Mashhad Diabetes Center. The control group received only medical care during this period.ResultsAn analysis of covariance showed that compared to the control group, the test group had a significant reduction in anxiety and depression from pre-test to post-test (p < 0.05). It was compared post-test scores between the two groups, controlling for pre-test scores.ConclusionThe CBGI-DD program seems to be effective in reducing anxiety and depression in female patients with T2D. However, further research exploring the potential for long-term improvements in depression and anxiety is needed.     

Alienation Among the Visually Impaired: Some Important Predictors

We evaluated the effectiveness of a nondiet approach designed to reduce restrained eating behaviors and improve self-acceptance and self-esteem. This approach also encourages participants to address eating and exercise behavior separately. Subjects were Conoco employees who participated in the Wellness Department's Eat For L.I.F.E. (Long-term change; Image of self; Fun; Enjoyment of eating) program and completed pre-participation and 3-year follow-up questionnaires (N = 79). Pre- and postsurvey data were used to assess participants eating behavior, dieting behavior, self-acceptance, self-esteem, level of physical activity, and demographic information. Mastery of the internally directed eating style was assessed during the program at 3 months, at the conclusion of the 6-month program, and at the 3-year follow-up. Analysis of variance indicated that Eat For L.I.F.E. participants were able to significantly decrease their restrained eating behavior and increase self-acceptance, self-esteem, and level of physical activity. Participants also were able to adopt many aspects of the nonrestrained, internally directed eating style and decrease their frequency of weighing-in behavior. These results indicate that strategies fostering internally directed eating behaviors may be more centrally related to an individual's well-being than programs supporting externally directed eating behaviors.     

Exercise video games are associated with more positive affective response,which predicts physical activity adherence

BackgroundA more positive affective valence during exercise is predictive of adherence to physical activity programs. This study examines the relationship between affective response during exercise and longer-term maintenance of physical activity among individuals using exercise video games (EVGs) and standard modalities of physical activity (i.e., walking, cycling).MethodsHealthy adults (mean age 45.4, SD = 14.5) were randomly assigned to a 12-week supervised, thrice weekly program of EVGs (n = 93) or Standard exercise (n = 96), and were assessed for affect immediately before, at the mid-point, and immediately after one exercise session per week. Participation in moderate-to-vigorous physical activity (MVPA) was conducted at end of treatment (EOT) and 6-month follow up.ResultsEVG participants reported more positive affective valence during exercise compared to Standard participants (b = 0.63, SE = 0.08, p < .001), and perceived less exertion (b = 0.52, SE = 0.36, p = .04) compared to Standard participants. For both groups, a more positive affective valence during exercise was significantly predictive of continued physical activity at 6-months (b = 6.64, SE = 2.50, p = .01). EVG participants also showed a significant chronic effect such that week-to-week there were improvements in affect prior to exercise and this effect was significantly associated with greater MPVA at EOT and follow-up (b = 21.96, SE = 10.10, p = .03 at EOT). Among Standard participants no significant chronic effect was seen over time.ConclusionsEVGs may provide an effective means of promoting more positive shifts in affective valence both during, and in anticipation of, physical activity that encourages longer-term participation.     

The role of additional information in the compliance,satisfaction, psychological,and emotion responses of non-surgical patients with low back pain: An exploratory investigation

Abstract

Noncompliance and the psychological and emotional states of patients with low back pain are major concerns for health professionals. The current study evaluated whether amount of information available to patients enhanced compliance to a medical regimen and whether it reduced negative emotions in patients with low back pain. Forty-five orthopaedic non-surgical patients with low back pain were randomly assigned to one of three information presentation conditions: 1) Standard, 2) Pre-examination, and 3) Post-examination. Patients were also separated by compensation and noncompensation within each information group. Patients completed questionnaires at their initial visit and at their follow-up which evaluated their: levels of compliance to a prescribed treatment program, psychological, and emotional states. Results indicated that some patients benefitted from receiving additional information as the Pre-examination and Post-examination groups demonstrated superior comprehension and recall as well as higher levels of compliance to a physical therapy program. In addition, compensation patients complained of more negative psychological and emotional behaviors in comparison to noncompensation patients. Implications of the research and future research considerations were discussed.     

The effectiveness of a proactive coping intervention targeting self-management in diabetes patients

Objective: The study’s aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention’s effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.

Design/outcome measures: A total of 141 type 2 diabetes patients were included in the intervention. The intervention employed a 5-step approach to target proactive coping skills. Psychological (e.g. proactive coping and self-efficacy) and behavioural variables (e.g. self-care, diet and physical activity) were assessed at baseline (T1), after the initial phase of the intervention (T2), after the booster phase (T3) and at follow-up (T4), comprising a total period of 15 months. Medical variables were assessed at T1 and T4.

Results: Employing piecewise Latent Growth Curve Modelling, results showed that participants improved on all psychological and behavioural variables during the initial phase and maintained these improvements over 12 months. The booster phase yielded no further improvements. Mixed findings were obtained on medical outcomes.

Conclusion: The original intervention is effective, but the added value of the booster sessions is uncertain.     

The effect of belief in weight controllability on anti-fat attitudes: An experimental manipulation

IntroductionAnti-fat attitudes reflect a type of discrimination on the basis of body weight and are one of the last accepted types of social stigma.ObjectiveTo evaluate the effect of exposure to priming messages about the causes of obesity on attitudes toward fat people.MethodParticipants (n = 580, M age = 22.19, 64.1% female) were randomly assigned to one of three possible conditions and then provided responses on three AFA subscales: Dislike, Fear of fat, and Willpower.ResultsPriming participants with messages confirming/challenging the weight controllability belief was associated with higher/lower levels on Willpower respectively compared to the control group. Unexpectedly, participants in both confirming and challenging groups showed significantly higher scores on Fear of fat. No differences were found on scores indicating Dislike.ConclusionThe current findings emphasize the effect of exposure to information about the causes of obesity on weight controllability beliefs.     

The Conners Parent Rating Scale: Psychometric properties in typically developing 4- to 12-year-old Belgian French-speaking children

IntroductionThe Conners Parent Rating Scale – 48 items (CPRS) is one of the most widely used behavioral scales in clinical and research settings with children.ObjectiveThe principal aim of this study was to validate the five-factor structure of the French version of the CPRS in 4- to 12-year-old Belgian French-speaking children. Secondly, a sample of children with Attention Deficit and Hyperactivity Disorder (ADHD) was assessed and their ADHD CPRS profile was examined.MethodsA total of 382 typically developing children from 4 to 12 years old were included in this study. Furthermore, 15 children (aged 6 to 12 years old) diagnosed with ADHD participated in this study.ResultsConfirmatory factor analysis shows that the CPRS presents good psychometric properties and has a factor structure similar to the original version. Furthermore, the CPRS shows high rates of sensitivity and specificity when the ADHD and control group scores are compared.ConclusionsThis study confirms the original five-factor structure of the CPRS when used with French-speaking children. Our results highlight the fact that the CPRS is a reliable measure of parental perception of their children's disruptive behaviors, and encourage the use of culturally adapted normative data for 4- to 12-year-old children.     

Effects of an early reading intervention based on grapho-syllabic decoding and fluency training in French elementary schools

IntroductionStudies conducted in recent decades have led to the development of instructional interventions to help prevent or eliminate a large proportion of reading difficulties. However, few experiments have been conducted in French schools.ObjectiveAims for this research were to create, implement and evaluate a remediation program for French students with reading difficulties up to the end of elementary school.MethodThis paper examines the effects of a decoding-skills and fluency-based intervention on 133 struggling readers in second- to fifth-grade. Depending on the nature of their reading difficulties, students were given a year-long training based either on grapho-syllabic conversion — focusing on syllable units, rather than phonemic units, is considered a promising way of helping French-speaking beginning readers — or on repeated reading techniques, used to improve fluency.ResultsIncreases in written-word identification scores were greater for students who followed the program than they were for a control group of 184 students with reading difficulties who did not follow the program.ConclusionThe results show that programs combining early evaluation of written-word identification abilities followed by a year-long series of remediation sessions focusing on specific difficulties can help students progress in written-word identification. However, further research is needed to examine why our program was less effective with children from disadvantaged (“éducation prioritaire”) areas.     

Fathers as Intervention Agents for Their Children with Developmental Disabilities

ABSTRACT

Parent training aimed at aiding children to overcome social and behavioral problems is an area that has continued to gain attention and support. Very little of the current research has been with developmentally disabled children, the focus of this study. Additionally, for most parent training programs, “parents” actually refers to mothers. In this study three fathers and their developmentally disabled children, who ranged in age from 2 years 10 months to 4 years 5 months, were studied. A multiple baseline across fathers' behaviors was utilized for participants to evaluate effects of parent training on fathers' target behaviors. Child compliance and inappropriate behaviors were also addressed. Parent training resulted in desirable changes on a range of target behaviors. The implications of these findings are discussed.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

Preliminary examination of a couple-based eating disorder prevention program

The purpose of the current study was to investigate a new dissonance-based prevention program that is based on the dual pathway model of eating disorders within the context of an individual's romantic relationship. A total of 209 dating couples participated in a couple-based prevention program or an assessment-only condition and completed measures of body dissatisfaction, thin-ideal internalization, disordered eating, negative affect, and relationship satisfaction at two time points (approximately one week apart) and approximately half of the sample completed 1-month follow-up measures. The prevention program significantly reduced several key risk factors for eating disorders such as environmental pressures to be thin, internalization of the thin and athletic ideals, state body dissatisfaction, and actual-ideal body discrepancy. Initial support was found for the inclusion of couples in eating disorder prevention programs as a successful way of addressing the thin ideal and its detrimental effects for women.     

Misinformation effect and centrality

Introduction and objectivesThe two objectives of this study are to examine the effects of the introduction of post-event information (correct and incorrect) on the memory of the central and peripheral aspects of a given situation and to determine the effects of this additional information on the level of confidence claimed by the participants regarding their reported memories.MethodOne hour and a half after watching a film, the participants were presented with three types of information, by means of open questions: leading, misleading and neutral. One week later, they carried out a recognition task, during which they had to assess to what extent they were sure of their answers.ResultsWhile the memory of the event was more accurate concerning the central aspects of the event than the peripheral elements, the misinformation effect appeared only in the central condition. In addition, following the presentation of incorrect information, the participants were more certain of their answers related to the central aspects.ConclusionThese results highlight the importance of taking into account the centrality factor in studies about the misinformation phenomenon.     

The pathway to accepting derogatory ingroup norms: The roles of compartmentalization and legitimacy

ObjectivesThe current experiment was conducted among ice hockey fans, and brings together theories of intergroup relations and self and identity literature. It investigated if perceiving strong norms in favor of derogating against fans of outgroup teams, and engaging in these behaviors oneself, leads to an increased compartmentalization of these behaviors (i.e., such that they are restricted to a particular compartment within the self). This association was expected to be especially strong when derogatory behaviors are portrayed as illegitimate. We also explored whether this compartmentalization then flows on to vitality as a well-being indicator.Method and designIce hockey fans supporting a diversity of NHL teams were recruited (N = 116). The legitimacy of the derogatory behaviors was manipulated by making salient either: that these behaviors have harmful consequences for outgroup members (illegitimate condition) vs. that such behaviors can benefit the ingroup (legitimate condition).ResultsThe expected mediated model was supported among the entire sample. The association between engaging in the derogatory behaviors and their compartmentalization in the self was also moderated by the experimental manipulation: While participants in the illegitimate condition reported a positive link between engaging in these behaviors and their compartmentalization, participants in the legitimate condition did not show a significant association between these variables, suggesting no need for them to restrict these behaviors within themselves.ConclusionsResults are discussed in light of normative approaches, intergroup theories, and the self.