Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions

Although there is a large and growing literature on tailored print health behavior change interventions, it is currently not known if or to what extent tailoring works. The current study provides a meta-analytic review of this literature, with a primary focus on the effects of tailoring. A comprehensive search strategy yielded 57 studies that met inclusion criteria. Those studies-which contained a cumulative N = 58,454-were subsequently meta-analyzed. The sample size-weighted mean effect size of the effects of tailoring on health behavior change was found to be r = .074. Variables that were found to significantly moderate the effect included (a) type of comparison condition, (b) health behavior, (c) type of participant population (both type of recruitment and country of sample), (d) type of print material, (e) number of intervention contacts, (f) length of follow-up, (g) number and type of theoretical concepts tailored on, and (h) whether demographics and/or behavior were tailored on. Implications of these results are discussed and future directions for research on tailored health messages and interventions are offered.     

Functional MRI of Language in Aphasia: A Review of the Literature and the Methodological Challenges

Animal analogue studies show that damaged adult brains reorganize to accommodate compromised functions. In the human arena, functional magnetic resonance imaging (fMRI) and other functional neuroimaging techniques have been used to study reorganization of language substrates in aphasia. The resulting controversy regarding whether the right or the left hemisphere supports language recovery and treatment progress must be reframed. A more appropriate question is when left-hemisphere mechanisms and when right-hemisphere mechanisms support recovery of language functions. Small lesions generally lead to good recoveries supported by left-hemisphere mechanisms. However, when too much language eloquent cortex is damaged, right-hemisphere structures may provide the better substrate for recovery of language. Some studies suggest that recovery is particularly supported by homologues of damaged left-hemisphere structures. Evidence also suggests that under some circumstances, activity in both the left and right hemispheres can interfere with recovery of function. Further research will be needed to address these issues. However, daunting methodological problems must be managed to maximize the yield of future fMRI research in aphasia, especially in the area of language production. In this review, we cover six challenges for imaging language functions in aphasia with fMRI, with an emphasis on language production: (1) selection of a baseline task, (2) structure of language production trials, (3) mitigation of motion-related artifacts, (4) the use of stimulus onset versus response onset in fMRI analyses, (5) use of trials with correct responses and errors in analyses, and (6) reliability and stability of fMRI images across sessions. However, this list of methodological challenges is not exhaustive. Once methodology is advanced, knowledge from conceptually driven fMRI studies can be used to develop theoretically driven, mechanism-based treatments that will result in more effective therapy and to identify the best patient candidates for specific treatments. While the promise of fMRI in the study of aphasia is great, there is much work to be done before this technique will be a useful clinical tool.     

Fatigue Impact Scale: Its validation in patients with chronic obstructive pulmonary disease

The aim of this study was to investigate the reliability and validity of the Fatigue Impact Scale (FIS) among patients with chronic obstructive pulmonary disease (COPD) and shorten the questionnaire. The empirically developed FIS, which comprised three subscales (cognitive, physical and psychosocial), was tested originally on Pipers' theoretical framework of subjective manifestations of fatigue, including behavioural, physical, emotional and cognitive expressions. The data analysed here consisted of responses from 296 patients with COPD who reported fatigue. The dimensionality of the FIS was examined using confirmatory factor analysis. A reduction of 15 items from the original FIS was made based on theory, modification indices and factor loadings. The results indicate that a nested-factor model with one general behavioural factor and three specific factors, physical, emotional and cognitive, shows acceptable fit. A modified version of 25 items, FIS-25 was developed. The original FIS and the FIS-25 were able to discriminate between patients with differing duration of fatigue. Test - retest correlations ranged from .70 to .85 for items and .94 for the total scale. Due to modification, the FIS-25 needs to be validated on a new group of patients with COPD.     

Composition of brain oscillations and their functions in the maintenance of auditory,visual and audio–visual speech percepts: an exploratory study

In the present exploratory study based on 7 subjects, we examined the composition of magnetoencephalographic (MEG) brain oscillations induced by the presentation of an auditory, visual, and audio-visual stimulus (a talking face) using an oddball paradigm. The composition of brain oscillations were assessed here by analyzing the probability-classification of short-term MEG spectral patterns. The probability index for particular brain oscillations being elicited was dependent on the type and the modality of the sensory percept. The maintenance of the integrated audio-visual percept was accompanied by the unique composition of distributed brain oscillations typical of auditory and visual modality, and the contribution of brain oscillations characteristic for visual modality was dominant. Oscillations around 20 Hz were characteristic for the maintenance of integrated audio-visual percept. Identifying the actual composition of brain oscillations allowed us (1) to distinguish two subjectively/consciously identical mental percepts, and (2) to characterize the types of brain functions involved in the maintenance of the multi-sensory percept.     

Use of Social Support: Gender and Personality Differences

Sex differences in social support have been explained in terms of gender differences in socialization and personality. The current research focused directly on the link between social support and gender variables. An adult, largely Caucasian sample of both sexes reported an experience in which they had received support, and were assessed on masculinity, femininity, nurturance, affiliation, autonomy, and self-confidence. The results revealed that gender, but not sex, was significantly correlated with patterns of social support. Femininity (in both sexes) was associated with seeking and receiving emotional support, and with seeking and receiving support from women. Masculinity (in both sexes) was linked only with receiving tangible support. These findings argue for the significance of femininity in promoting a more social form of well-being, and underscore the importance of studying gender directly rather than relying on sex as a proxy variable.     

The Frequency and Perceived Impact of Engaging in In-Person and Cyber Unwanted Pursuit after Relationship Break-Up among College Men and Women

The present study examined the extent of cyber and in-person unwanted pursuit behaviors (UPBs) reported by undergraduate men and women who pursued former partners and the pursuer’s perceptions of the impact of their pursuit on their targets. Among a sample of 1167 undergraduates (66.8 % women; 95.4 % heterosexual) approximately 80 % of men and women reported engaging in UPBs toward former partners, with cyber pursuit endorsed by a subset of those who engaged in in-person UPBs. Despite few gender differences in overall pursuit, men endorsed engaging in a number of specific behaviors more than did women. Most UPBs did receive responses from targets, and pursuers generally did not perceive their behaviors as annoying, threatening, or frightening. Women perceived that targets had more negative responses to UPBs, particularly to threatening or violent pursuit, and men perceived more positive or neutral responses overall. Minor UPBs were associated with relationship reconciliation among women and men, whereas severe UPBs were associated with reconciliation among men only. Results suggest that pursuers likely underestimate the impact of their behaviors on targets and that pursuers’ efforts, even severe and threatening, are often reinforced, particularly for men who pursue. Universities must be aware of UPBs and provide prevention programs specific to healthy relationship dissolution and pursuit. Provision of corrective information regarding the impact of severe and threatening pursuit may assist in reducing these behaviors.     

A mixed-methods process evaluation of a goal management intervention for patients with polyarthritis

Process evaluations of newly developed interventions are necessary to identify effective and less effective intervention components. First aim of this study was to identify key components of a psychosocial goal management intervention from the perspective of participants, and second aim was to evaluate the intervention’s fidelity. A mixed-methods approach was applied to 24 interviews with participants post-intervention and 16 audio recordings of random training sessions. Participants experienced three key components: (1) the content, in which specific exercises helped to raise awareness and (intention to) change goal management behaviour, (2) person-focused approach, specifically, the nurse as trainer and personal fit of the approach, and (3) social mechanisms, including facilitating group processes and interpersonal processes. Adherence to the protocol by the trainers was high, while differences were found in the degree to which they were able to apply the intended collaborative approach and psychological communication skills. The applied design provided valuable insights into the processes that took place. Both the effects experienced by participants in relationship to the content, approach and social mechanisms as well as the strengths and weaknesses found with regard to fidelity provide insights that can inform the development and implementation of person-focused interventions.     

Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial

Objective: Nonadherence reduces glaucoma treatment efficacy. Motivational interviewing (MI) is a well-studied adherence intervention, but has not been tested in glaucoma. Reminder interventions also may improve adherence.

Design: 201 patients with glaucoma or ocular hypertension were urn-randomised to receive MI delivered by an ophthalmic technician (OT), usual care or a minimal behavioural intervention (reminder calls).

Main Outcome Measures: Outcomes included electronic monitoring with Medication Event Monitoring System (MEMS) bottles, two self-report adherence measures, patient satisfaction and clinical outcomes. Multilevel modelling was used to test differences in MEMS results by group over time; ANCOVA was used to compare groups on other measures.

Results: Reminder calls increased adherence compared to usual care based on MEMS, p = .005, and self-report, p = .04. MI had a nonsignificant effect but produced higher satisfaction than reminder calls, p = .007. Treatment fidelity was high on most measures, with observable differences in behaviour between groups. All groups had high baseline adherence that limited opportunities for change.

Conclusion: Reminder calls, but not MI, led to better adherence than usual care. Although a large literature supports MI, reminder calls might be a cost-effective intervention for patients with high baseline adherence. Replication is needed with less adherent participants.     

Conscious Motivations of Adolescent Visual Artists and Creative Writers: Similarities and Differences

This exploratory study was designed to expand the field’s understanding of talented adolescent visual artists and creative writers and their conscious motivations for engaging in these creative activities. Accordingly, 233 talented high school visual arts (n = 151) and creative writing (n = 82) students were asked to rate the degree to which they believed their creative activities were motivated by each of a wide range of possible motivations. The students in both fields reported being very strongly motivated by the opportunities their activities provided them to use their imaginations, feel free, sense that they were being their “true” selves, regulate their emotions, capture moments in time, deepen their self-understanding, express themselves, improve their skills, and enhance their self-esteem. Some of these motivations correspond closely to those highlighted by theories of intrinsic motivation, competence motivation, and self-actualization, several are similar to those which have been reported by professional artists and writers, and some suggest that the students may have derived important psychological benefits from their creative activities. Theoretically plausible differences between the motivational profiles of the visual and creative writing students were identified and discussed.     

Blaming the Victim: University Student Attitudes Toward Bullying

Numerous studies have examined adolescent attitudes toward bullying, but limited research has explored college students’ attitudes toward victims of bullying. Using data collected from three southern universities (n = 1,135), the current research investigates demographic, experiential, and behavioral factors that are likely to influence whether university students attribute blame to bullying victims. Findings indicate that most university students report prosocial attitudes toward bullying. Victim blaming and minimizing attitudes were most common among males, heterosexuals, and those with a history of prior bullying perpetration during junior high or high school. Individuals reporting a higher frequency of drug use were significantly more likely to support victim blaming attitudes, and those who engaged in more frequent alcohol use were significantly more likely to minimize bullying.