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Voils, Corrine Ione

Overview:

Randomized trials of behavioral interventions; adherence to treatment regimens; spousal support in chronic disease management, mixed research synthesis; measurement of self-reported medication nonadherence 

Positions:

Professor in Medicine

Medicine, General Internal Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2001

Ph.D. — University of Kentucky at Lexington

Grants:

Increasing uptake of behavioral weight loss programs among primary care patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
April 07, 2015
End Date
March 31, 2020

Duke KURe Program

Administered By
Obstetrics and Gynecology, Urogynecology
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
August 01, 2013
End Date
July 31, 2018

Incentivizing behavior change skills to promote weight loss

Administered By
Medicine, General Internal Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 2015
End Date
April 30, 2018

Understanding recommendations for screening colonoscopy intervals

Administered By
Medicine, Gastroenterology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 15, 2013
End Date
May 31, 2017

Implementation, Adoption, and Utility of Family History in Diverse Care Settings

Administered By
Duke Center for Applied Genomics and Precision Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 16, 2013
End Date
April 30, 2017

Fragmentation of Medication Management in Medicare

Administered By
Medicine, General Internal Medicine
AwardedBy
Agency for Healthcare Research and Quality
Role
Co Investigator
Start Date
July 01, 2014
End Date
June 30, 2016

Family Structure, Informal Care and Long-term Care Insurance

Administered By
Medicine, General Internal Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 27, 2011
End Date
November 30, 2014

Adherence to Cancer Risk Management Among Unaffected BRCA1/2Mutation Carriers

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 05, 2011
End Date
June 30, 2014

The Continuity of Medication Management (COMM) Study

Administered By
Medicine, General Internal Medicine
AwardedBy
Agency for Healthcare Research and Quality
Role
Co Investigator
Start Date
September 30, 2010
End Date
September 29, 2012

Improving the Detection of Medication Nonadherence

Administered By
Medicine, General Internal Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
July 01, 2010
End Date
July 31, 2012

Barriers to Optimal Cardiovascular Medication Use in Diabetes and Renal Disease

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 25, 2006
End Date
August 31, 2011

Colorectal Cancer Screening Behavior in VA Population

Administered By
Medicine, General Internal Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
January 15, 2005
End Date
December 31, 2007
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Awards:

Research Career Scientist. Department of Veterans Affairs Health Services Research & Development Service.

Type
National
Awarded By
Department of Veterans Affairs Health Services Research & Development Service
Date
April 01, 2016

Publications:

Food preferences and weight change during low-fat and low-carbohydrate diets.

Understanding associations between food preferences and weight loss during various effective diets could inform efforts to personalize dietary recommendations and provide insight into weight loss mechanisms. We conducted a secondary analysis of data from a clinical trial in which participants were randomized to either a 'choice' arm, in which they were allowed to select between a low-fat diet (n = 44) or low-carbohydrate diet (n = 61), or to a 'no choice' arm, in which they were randomly assigned to a low-fat diet (n = 49) or low-carbohydrate diet (n = 53). All participants were provided 48 weeks of lifestyle counseling. Food preferences were measured at baseline and every 12 weeks thereafter with the Geiselman Food Preference Questionnaire. Participants were 73% male and 51% African American, with a mean age of 55. Baseline food preferences, including congruency of food preferences with diet, were not associated with weight outcomes. In the low-fat diet group, no associations were found between changes in food preferences and weight over time. In the low-carbohydrate diet group, increased preference for low-carbohydrate diet congruent foods from baseline to 12 weeks was associated with weight loss from 12 to 24 weeks. Additionally, weight loss from baseline to 12 weeks was associated with increased preference for low-carbohydrate diet congruent foods from 12 to 24 weeks. Results suggest that basing selection of low-carbohydrate diet or low-fat diet on food preferences is unlikely to influence weight loss. Congruency of food preferences and weight loss may influence each other early during a low-carbohydrate diet but not low-fat diet, possibly due to different features of these diets.NCT01152359.

Authors
McVay, MA; Voils, CI; Geiselman, PJ; Smith, VA; Coffman, CJ; Mayer, S; Yancy, WS
MLA Citation
McVay, MA, Voils, CI, Geiselman, PJ, Smith, VA, Coffman, CJ, Mayer, S, and Yancy, WS. "Food preferences and weight change during low-fat and low-carbohydrate diets." Appetite 103 (August 2016): 336-343.
Website
http://hdl.handle.net/10161/12380
PMID
27133551
Source
epmc
Published In
Appetite
Volume
103
Publish Date
2016
Start Page
336
End Page
343
DOI
10.1016/j.appet.2016.04.035

Adherence to Recommended Risk Management among Unaffected Women with a BRCA Mutation.

Identifying unaffected women with a BRCA mutation can have a significant individual and population health impact on morbidity and mortality if these women adhere to guidelines for managing cancer risk. But, little is known about whether such women are adherent to current guidelines. We conducted telephone surveys of 97 unaffected BRCA mutation carriers who had genetic counseling at least one year prior to the survey to assess adherence to current guidelines, factors associated with adherence, and common reasons for performing and not performing recommended risk management. More than half of participants reported being adherent with current risk management recommendations for breast cancer (69 %, n = 67), ovarian cancer (82 %, n = 74) and both cancers (66 %, n = 64). Older age (OR = 10.53, p = 0.001), white race (OR = 8.93, p = 0.019), higher breast cancer genetics knowledge (OR = 1.67, p = 0.030), higher cancer-specific distress (OR = 1.07, p = 0.002) and higher physical functioning (OR = 1.09, p = 0.009) were significantly associated with adherence to recommended risk management for both cancers. Responses to open-ended questions about reasons for performing and not performing risk management behaviors indicated that participants recognized the clinical utility of these behaviors. Younger individuals and those with lower physical functioning may require targeted interventions to improve adherence, perhaps in the setting of long-term follow-up at a multi-disciplinary hereditary cancer clinic.

Authors
Buchanan, AH; Voils, CI; Schildkraut, JM; Fine, C; Horick, NK; Marcom, PK; Wiggins, K; Skinner, CS
MLA Citation
Buchanan, AH, Voils, CI, Schildkraut, JM, Fine, C, Horick, NK, Marcom, PK, Wiggins, K, and Skinner, CS. "Adherence to Recommended Risk Management among Unaffected Women with a BRCA Mutation." Journal of genetic counseling (June 6, 2016).
PMID
27265406
Source
epmc
Published In
Journal of Genetic Counseling
Publish Date
2016

Understanding the Context for Long-Term Care Planning.

Evolving family structure and economic conditions may affect individuals' ability and willingness to plan for future long-term care (LTC) needs. We applied life course constructs to analyze focus group data from a study of family decision making about LTC insurance. Participants described how past exposure to caregiving motivated them to engage in LTC planning; in contrast, child rearing discouraged LTC planning. Perceived institutional and economic instability drove individuals to regard financial LTC planning as either a wise precaution or another risk. Perceived economic instability also shaped opinions that adult children are ill-equipped to support parents' LTC. Despite concerns about viability of social insurance programs, some participants described strategies to maximize gains from them. Changing norms around aging and family roles also affected expectations of an active older age, innovative LTC options, and limitations to adult children's involvement. Understanding life course context can inform policy efforts to encourage LTC planning.

Authors
Broyles, IH; Sperber, NR; Voils, CI; Konetzka, RT; Coe, NB; Van Houtven, CH
MLA Citation
Broyles, IH, Sperber, NR, Voils, CI, Konetzka, RT, Coe, NB, and Van Houtven, CH. "Understanding the Context for Long-Term Care Planning." Medical care research and review : MCRR 73.3 (June 2016): 349-368.
Website
http://hdl.handle.net/10161/11052
PMID
26553887
Source
epmc
Published In
Medical Care Research and Review
Volume
73
Issue
3
Publish Date
2016
Start Page
349
End Page
368
DOI
10.1177/1077558715614480

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study.

Less than 1% of severely obese US adults undergo bariatric surgery annually. It is critical to understand the factors that contribute to its utilization.To understand how primary care physicians (PCPs) make decisions regarding severe obesity treatment and bariatric surgery referral.Focus groups with PCPs practicing in small, medium, and large cities in Wisconsin.PCPs were asked to discuss prioritization of treatment for a severely obese patient with multiple co-morbidities and considerations regarding bariatric surgery referral. Focus group sessions were analyzed by using a directed approach to content analysis. A taxonomy of consensus codes was developed. Code summaries were created and representative quotes identified.Sixteen PCPs participated in 3 focus groups. Four treatment prioritization approaches were identified: (1) treat the disease that is easiest to address; (2) treat the disease that is perceived as the most dangerous; (3) let the patient set the agenda; and (4) address obesity first because it is the common denominator underlying other co-morbid conditions. Only the latter approach placed emphasis on obesity treatment. Five factors made PCPs hesitate to refer patients for bariatric surgery: (1) wanting to "do no harm"; (2) questioning the long-term effectiveness of bariatric surgery; (3) limited knowledge about bariatric surgery; (4) not wanting to recommend bariatric surgery too early; and (5) not knowing if insurance would cover bariatric surgery.Decision making by PCPs for severely obese patients seems to underprioritize obesity treatment and overestimate bariatric surgery risks. This could be addressed with PCP education and improvements in communication between PCPs and bariatric surgeons.

Authors
Funk, LM; Jolles, SA; Greenberg, CC; Schwarze, ML; Safdar, N; McVay, MA; Whittle, JC; Maciejewski, ML; Voils, CI
MLA Citation
Funk, LM, Jolles, SA, Greenberg, CC, Schwarze, ML, Safdar, N, McVay, MA, Whittle, JC, Maciejewski, ML, and Voils, CI. "Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study." Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 12.4 (May 2016): 893-901.
Website
http://hdl.handle.net/10161/12382
PMID
26948943
Source
epmc
Published In
Surgery for Obesity and Related Diseases
Volume
12
Issue
4
Publish Date
2016
Start Page
893
End Page
901
DOI
10.1016/j.soard.2015.11.028

Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

Authors
Sperber, NR; Andrews, SM; Voils, CI; Green, GL; Provenzale, D; Knight, S
MLA Citation
Sperber, NR, Andrews, SM, Voils, CI, Green, GL, Provenzale, D, and Knight, S. "Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration." Journal of personalized medicine 6.2 (January 2016).
Website
http://hdl.handle.net/10161/12381
PMID
27136589
Source
epmc
Published In
Journal of Personalized Medicine
Volume
6
Issue
2
Publish Date
2016
DOI
10.3390/jpm6020016

Does Type 2 Diabetes Genetic Testing and Counseling Reduce Modifiable Risk Factors? A Randomized Controlled Trial of Veterans.

We examined the clinical utility of supplementing type 2 diabetes mellitus (DM) risk counseling with DM genetic test results and counseling.In this randomized controlled trial, non-diabetic overweight/obese veteran outpatients aged 21 to 65 years received DM risk estimates for lifetime risk, family history, and fasting plasma glucose, followed by either genetic test results (CR+G; N = 303) or control eye disease counseling (CR+EYE; N = 298). All participants received brief lifestyle counseling encouraging weight loss to reduce the risk of DM.The mean age was 54 years, 53% of participants were black, and 80% were men. There was no difference between arms in weight (estimated mean difference between CR+G vs. CR+EYE at 3 months = 0.2 kg, 95% CI: -0.3 to 0.7; at 6 months = 0.4 kg, 95 % CI: -0.3 to 1.1), insulin resistance, perceived risk, or physical activity at 3 or 6 months. Calorie and fat intake were lower in the CR+G arm at 3 months (p's ≤ 0.05) but not at 6 months (p's > 0.20).Providing patients with genetic test results was not more effective in changing patient behavior to reduce the risk of DM compared to conventional risk counseling.ClinicalTrials.gov NCT01060540 http://clinicaltrials.gov/show/NCT01060540.

Authors
Voils, CI; Coffman, CJ; Grubber, JM; Edelman, D; Sadeghpour, A; Maciejewski, ML; Bolton, J; Cho, A; Ginsburg, GS; Yancy, WS
MLA Citation
Voils, CI, Coffman, CJ, Grubber, JM, Edelman, D, Sadeghpour, A, Maciejewski, ML, Bolton, J, Cho, A, Ginsburg, GS, and Yancy, WS. "Does Type 2 Diabetes Genetic Testing and Counseling Reduce Modifiable Risk Factors? A Randomized Controlled Trial of Veterans." Journal of general internal medicine 30.11 (November 2015): 1591-1598.
PMID
25876740
Source
epmc
Published In
Journal of General Internal Medicine
Volume
30
Issue
11
Publish Date
2015
Start Page
1591
End Page
1598
DOI
10.1007/s11606-015-3315-5

Effect of allowing choice of diet on weight loss--in response.

Authors
Yancy, WS; McVay, MA; Voils, CI
MLA Citation
Yancy, WS, McVay, MA, and Voils, CI. "Effect of allowing choice of diet on weight loss--in response." Annals of internal medicine 163.10 (November 2015): 805-806. (Letter)
PMID
26571246
Source
epmc
Published In
Annals of internal medicine
Volume
163
Issue
10
Publish Date
2015
Start Page
805
End Page
806
DOI
10.7326/l15-5159

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery: A Systematic Review.

Although bariatric surgery is the most cost-effective treatment for severe obesity, less than 1% of severely obese patients undergo it. Reasons for this low use are unclear.To identify patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery.The PubMed, PsycINFO, CINAHL, and Cochrane databases were searched for articles published from January 1, 1998, through December 31, 2014. Studies were eligible if they presented descriptive data regarding facilitators or barriers to bariatric surgery or if they reported statistical associations between patient or practitioner characteristics and referral to or receipt of bariatric surgery. Frequency effect sizes were calculated as the proportion of studies reporting a finding.Of the 7212 records identified in the initial search, 53 were included in full-text review. Nine studies met our inclusion criteria and were included in analyses. Of those, 4 included descriptive findings, 6 reported statistical associations, and 1 included both. One study included practitioners as participants, whereas 8 included patients. Four of 9 studies identified an association between female sex and a greater willingness to undergo bariatric surgery. Lack of knowledge about bariatric surgery was a barrier in 2 studies. Five of 9 cited patient concerns about the outcomes and safety of bariatric surgery as a barrier to undergoing it. Patients were more likely to pursue bariatric surgery when it was recommended by referring practitioners. Practitioners who believed that obesity treatment should be covered by insurance were more likely to recommend bariatric surgery.Limited patient and referring practitioner knowledge about the safety and effectiveness of bariatric surgery are important barriers to bariatric surgery use. Future efforts focused on improving knowledge and identification of the critical determinants of obesity treatment decision making from the practitioner and patient perspectives would have an important effect on public health.

Authors
Funk, LM; Jolles, S; Fischer, LE; Voils, CI
MLA Citation
Funk, LM, Jolles, S, Fischer, LE, and Voils, CI. "Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery: A Systematic Review." JAMA surgery 150.10 (October 2015): 999-1005. (Review)
PMID
26222655
Source
epmc
Published In
JAMA Surgery
Volume
150
Issue
10
Publish Date
2015
Start Page
999
End Page
1005
DOI
10.1001/jamasurg.2015.1250

A Comparison of Sleep Difficulties among Iraq/Afghanistan Theater Veterans with and without Mental Health Diagnoses.

Sleep disturbance is among the most common complaints of veterans and military personnel who deployed to the conflicts in Iraq and Afghanistan. A growing body of research has examined cross-sectional and longitudinal relationships between sleep disturbance and mental health symptoms and specific diagnoses in this population. However, prior research has not examined these relationships in terms of the presence or absence of any mental health diagnosis. The objective of the current study is to characterize the sleep complaints (sleep characteristics, sleep quality, insomnia symptoms, and distressing dreams and nightmares) of previously deployed military personnel in terms of the presence or absence of a mental health disorder, diagnosed using structured clinical diagnostic interviews.Participants (n = 1,238) were veterans and active duty military personnel serving in the military since September 11, 2001, and deployed at least once. Scale scores and item-level data from the Pittsburgh Sleep Quality Index (PSQI), the PSQI-Addendum, the Davidson Trauma Scale, and the Symptom Checklist-90 were used to compare sleep across mental health status (with/without mental health disorder).As expected, self-reported sleep impairments were worse among those meeting criteria for a mental health disorder. However, findings also revealed very poor sleep among those without a mental health diagnosis as well. Mean values for both groups were suggestive of short sleep duration, low sleep efficiency, long sleep onset latencies, poor sleep quality, frequent insomnia symptoms, and nightmare frequencies that are well above norms for the general population.Given the evidence for adverse mental and physical health sequelae of untreated sleep disturbance, increased attention to sleep in this population may serve as a primary prevention strategy.

Authors
Ulmer, CS; Van Voorhees, E; Germain, AE; Voils, CI; Beckham, JC
MLA Citation
Ulmer, CS, Van Voorhees, E, Germain, AE, Voils, CI, and Beckham, JC. "A Comparison of Sleep Difficulties among Iraq/Afghanistan Theater Veterans with and without Mental Health Diagnoses." Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 11.9 (September 2015): 995-1005.
PMID
26094928
Source
epmc
Published In
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Volume
11
Issue
9
Publish Date
2015
Start Page
995
End Page
1005
DOI
10.5664/jcsm.5012

Efficacy of Commercial Weight-Loss Programs.

Authors
Yancy, WS; Barton, AB; McVay, MA; Voils, CI
MLA Citation
Yancy, WS, Barton, AB, McVay, MA, and Voils, CI. "Efficacy of Commercial Weight-Loss Programs." Annals of internal medicine 163.5 (September 2015): 398-399. (Letter)
Website
http://hdl.handle.net/10161/11055
PMID
26322705
Source
epmc
Published In
Annals of internal medicine
Volume
163
Issue
5
Publish Date
2015
Start Page
398
End Page
399
DOI
10.7326/l15-5130-2

What constitutes quality of family experience at the end of life? Perspectives from family members of patients who died in the hospital.

Most palliative care efforts focus on assessing and improving the quality of life and quality of care for patients. Palliative care views the family as the unit of care; therefore, excellent comprehensive palliative care should also address the needs of the family and the caregiver(s). While the recent literature has offered detailed descriptions of caregiving needs in the home setting, it is crucial to describe the needs of family members who provide care for patients with advanced illness in an inpatient setting, where family members serve as the key intermediaries and decision makers. Therefore, we sought to define the relevant aspects of quality of experience for families of hospitalized patients.We convened a series of focus groups to identify the domains important for the quality of experience of dying patients' family members. Participants included bereaved family members of patients who had died at a Veterans Administration (VA) or private academic medical center. We conducted four in-depth follow-up interviews to probe for additional details and validate our interpretation of the focus group findings.Participants (n = 14) ranged in age from 46 to 83, with a mean of 62. All were female; 64% were Caucasian, 21% African American, and 14% did not report their ethnicity. Content analysis yielded 64 attributes of quality of family experience constituting eight domains: completion, symptom impact, decision making, preparation, relationship with healthcare providers, affirmation of the whole person, post-death care, and supportive services.Our data have implications for clinical guidance in assisting family members in the inpatient palliative setting, which often includes patient incapacity for communication and decision making. They suggest the importance of developing corresponding methods to assist families with the tasks involved with life completion, being prepared for a crisis and imminent death, and post-death care. Provider communications and relationships are central to the processes of meeting the clinical needs of family members. Our findings should inform the development of measures to assess family experience.

Authors
Steinhauser, KE; Voils, CI; Bosworth, H; Tulsky, JA
MLA Citation
Steinhauser, KE, Voils, CI, Bosworth, H, and Tulsky, JA. "What constitutes quality of family experience at the end of life? Perspectives from family members of patients who died in the hospital." Palliative & supportive care 13.4 (August 2015): 945-952.
PMID
25003541
Source
epmc
Published In
Palliative & Supportive Care
Volume
13
Issue
4
Publish Date
2015
Start Page
945
End Page
952
DOI
10.1017/s1478951514000807

Dietary and psych predictors of weight loss after gastric bypass.

BACKGROUND: Identifying severely obese patients who will succeed after bariatric surgery remains challenging. Although numerous studies have attempted to identify preoperative patient characteristics associated with weight loss, the roles of many dietary and psychological characteristics are unclear. The purpose of this study was to examine preoperative dietary and psychological predictors of successful weight loss after bariatric surgery. MATERIALS AND METHODS: This retrospective cohort study included all patients who underwent laparoscopic Roux-en-Y gastric bypass from September 2011-June 2013 at a single institution (n = 124). Patient demographics, comorbidities, dietary and psychological factors, and weight loss outcomes were extracted from the electronic medical record. Bivariate associations between these factors and successful weight loss (≥50% excess body weight) were examined. Factors significant at P ≤ 0.1 were included in a multivariate logistic regression model. RESULTS: On bivariate analysis, absence of either type 2 diabetes or hypertension, preoperative weight <270 lbs, no intentional past weight loss >50 lbs, no previous purging or family history of obesity, and no soda consumption preoperatively were associated with successful weight loss (P < 0.1). On multivariate analysis, successful weight loss was inversely associated with the presence of type 2 diabetes (odds ratio [OR], 0.22, 95% confidence interval [CI], 0.06-0.73), maximum intentional past weight loss >50 lbs (OR, 0.12 [95% CI, 0.04-0.43]), and decreasing soda consumption by >50% (OR, 0.27 [95% CI, 0.08-0.99]). CONCLUSIONS: Patients with type 2 diabetes mellitus, significant previous weight loss, and poor soda consumption habits are more likely to experience suboptimal weight loss after bariatric surgery. Additional preoperative counseling and close postoperative follow-up is warranted for these patients.

Authors
Fox, B; Chen, E; Suzo, A; Jolles, S; Greenberg, JA; Campos, GM; Voils, CI; Funk, LM
MLA Citation
Fox, B, Chen, E, Suzo, A, Jolles, S, Greenberg, JA, Campos, GM, Voils, CI, and Funk, LM. "Dietary and psych predictors of weight loss after gastric bypass." The Journal of surgical research 197.2 (August 2015): 283-290.
PMID
25940162
Source
epmc
Published In
Journal of Surgical Research
Volume
197
Issue
2
Publish Date
2015
Start Page
283
End Page
290
DOI
10.1016/j.jss.2015.04.019

Effects of provision of type 2 diabetes genetic risk feedback on patient perceptions of diabetes control and diet and physical activity self-efficacy.

We examined effects of providing type 2 diabetes genetic risk feedback on controllability perceptions.This is a secondary analysis of a randomized controlled trial in which overweight/obese Veterans Affairs patients without diabetes received conventional type 2 diabetes risk counseling that included either (1) personalized diabetes genetic risk feedback (genetic risk arm) or (2) eye disease counseling (comparison arm). Perceived diabetes control, and dietary and physical activity self-efficacy were compared between study arms, and between the comparison arm and each of 3 DNA-based genetic risk levels.Participants (N=531) were predominately male, middle-age, and African American. Immediately post-counseling, perceived diabetes control was higher for the genetic risk arm (risk levels combined) than the comparison arm (p=0.005). In analyses by genetic risk levels, low genetic risk participants reported higher perceived diabetes control than comparison participants (p=0.007). Immediately post-counseling, low genetic risk participants reported higher dietary self-efficacy in situations when mood is negative compared with controls(p=0.01). At 3 months, no differences in constructs were observed.Genetic risk feedback for diabetes has temporary effects on perceived controllability among patients with low genetic risk.Clinicians and other stakeholders should consider the limited effects on behavior change of diabetes genetic risk feedback.

Authors
McVay, MA; Beadles, C; Wu, R; Grubber, J; Coffman, CJ; Yancy, WS; Reiner, IL; Voils, CI
MLA Citation
McVay, MA, Beadles, C, Wu, R, Grubber, J, Coffman, CJ, Yancy, WS, Reiner, IL, and Voils, CI. "Effects of provision of type 2 diabetes genetic risk feedback on patient perceptions of diabetes control and diet and physical activity self-efficacy." Patient education and counseling (June 30, 2015).
PMID
26189166
Source
epmc
Published In
Patient Education and Counseling
Publish Date
2015

Effect of Allowing Choice of Diet on Weight Loss: A Randomized Trial.

Choosing a diet rather than being prescribed one could improve weight loss.To examine whether offering choice of diet improves weight loss.Double-randomized preference trial of choice between 2 diets (choice) versus random assignment to a diet (comparator) over 48 weeks. (ClinicalTrials.gov: NCT01152359).Outpatient clinic at a Veterans Affairs medical center.Outpatients with a body mass index of at least 30 kg/m2.Choice participants received information about their food preferences and 2 diet options (low-carbohydrate diet [LCD] or low-fat diet [LFD]) before choosing and were allowed to switch diets at 12 weeks. Comparator participants were randomly assigned to 1 diet for 48 weeks. Both groups received group and telephone counseling for 48 weeks.The primary outcome was weight at 48 weeks.Of 105 choice participants, 61 (58%) chose the LCD and 44 (42%) chose the LFD; 5 (3 on the LCD and 2 on the LFD) switched diets at 12 weeks, and 87 (83%) completed measurements at 48 weeks. Of 102 comparator participants, 53 (52%) were randomly assigned to the LCD and 49 (48%) were assigned to the LFD; 88 (86%) completed measurements. At 48 weeks, estimated mean weight loss was 5.7 kg (95% CI, 4.3 to 7.0 kg) in the choice group and 6.7 kg (CI, 5.4 to 8.0 kg) in the comparator group (mean difference, -1.1 kg [CI, -2.9 to 0.8 kg]; P = 0.26). Secondary outcomes of dietary adherence, physical activity, and weight-related quality of life were similar between groups at 48 weeks.Only 2 diet options were provided. Results from this sample of older veterans might not be generalizable to other populations.Contrary to expectations, the opportunity to choose a diet did not improve weight loss.

Authors
Yancy, WS; Mayer, SB; Coffman, CJ; Smith, VA; Kolotkin, RL; Geiselman, PJ; McVay, MA; Oddone, EZ; Voils, CI
MLA Citation
Yancy, WS, Mayer, SB, Coffman, CJ, Smith, VA, Kolotkin, RL, Geiselman, PJ, McVay, MA, Oddone, EZ, and Voils, CI. "Effect of Allowing Choice of Diet on Weight Loss: A Randomized Trial." Annals of internal medicine 162.12 (June 2015): 805-814.
PMID
26075751
Source
epmc
Published In
Annals of internal medicine
Volume
162
Issue
12
Publish Date
2015
Start Page
805
End Page
814
DOI
10.7326/m14-2358

SIMILARITY IN PATIENT AND SPOUSE OUTCOMES FROM A SPOUSE-ASSISTED LIFESTYLE INTERVENTION

Authors
King, HA; Coffman, CJ; McVay, MA; Jeffreys, AS; Voils, CI
MLA Citation
King, HA, Coffman, CJ, McVay, MA, Jeffreys, AS, and Voils, CI. "SIMILARITY IN PATIENT AND SPOUSE OUTCOMES FROM A SPOUSE-ASSISTED LIFESTYLE INTERVENTION." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S248-S248.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S248
End Page
S248

EVIDENCE-BASED STRATEGIES THAT IMPROVE RECRUITMENT, ADHERENCE, AND RETENTION OF RANDOMIZED TRIALS

Authors
Kiernan, M; Crane, MM; Voils, CI; Leahey, TM; Spring, B
MLA Citation
Kiernan, M, Crane, MM, Voils, CI, Leahey, TM, and Spring, B. "EVIDENCE-BASED STRATEGIES THAT IMPROVE RECRUITMENT, ADHERENCE, AND RETENTION OF RANDOMIZED TRIALS." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S42-S42.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S42
End Page
S42

PREDICTORS OF INITIATION OF A BEHAVIORAL WEIGHT LOSS INTERVENTION

Authors
Voils, CI
MLA Citation
Voils, CI. "PREDICTORS OF INITIATION OF A BEHAVIORAL WEIGHT LOSS INTERVENTION." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S43-S43.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S43
End Page
S43

IDENTIFYING FACTORS TO TARGET TO INCREASE INITIATION OF BEHAVIORAL WEIGHT LOSS TREATMENT

Authors
McVay, MA; Yancy, WS; Scott, CN; Allen, S; McSherry, WC; Voils, CI
MLA Citation
McVay, MA, Yancy, WS, Scott, CN, Allen, S, McSherry, WC, and Voils, CI. "IDENTIFYING FACTORS TO TARGET TO INCREASE INITIATION OF BEHAVIORAL WEIGHT LOSS TREATMENT." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S82-S82.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S82
End Page
S82

Prescriber continuity and medication adherence for complex patients.

BACKGROUND: Medication adherence is a critical aspect of managing cardiometabolic conditions, including diabetes, hypertension, dyslipidemia, and heart failure. Patients who have multiple cardiometabolic conditions and multiple prescribers may be at increased risk for nonadherence. OBJECTIVE: The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications to treat cardiometabolic conditions. METHODS: In this retrospective cohort study, 7933 veterans were identified with 1 to 4 cardiometabolic conditions. Refill adherence to oral medications for diabetes, hypertension, and dyslipidemia was measured using an administrative claims-based continuous multiple-interval gap (CMG) that estimates the percentage of days a patient did not possess medication. We dichotomized refill adherence for each condition as a CMG ≤20% for each year of analysis. Condition-specific logistic regression models estimated the relationship between refill adherence and number of cardiometabolic conditions and number of prescribers, controlling for demographic characteristics, other comorbidities, and a count of cardiometabolic drug classes used. RESULTS: Compared with patients with 1 prescriber, antihypertensive refill adherence was lower in patients seeing ≥4 prescribers (odds ratio [OR] = 0.69; 95% CI = 0.59-0.80), but the number of cardiometabolic conditions was not a significant predictor. Antidyslipidemia refill adherence was lower in patients seeing 3 prescribers (OR = 0.80; 95% CI = 0.70-0.92) or ≥4 prescribers (OR = 0.77; 95% CI = 0.64-0.91). Conversely, antidyslipidemia refill adherence improved with the number of cardiometabolic conditions, but differences were only statistically significant for ≥3 conditions (OR = 1.31; 95% CI = 1.09-1.57). In multivariate regression models, the number of conditions and number of prescribers were not significant predictors of refill adherence in the group of patients with diabetes. CONCLUSIONS: Effective management of care and medication regimens for complex patients remains an unresolved challenge, but these results suggest that medication refill adherence might be improved by minimizing the number of prescribers involved in a patient's care, at least for hypertension and dyslipidemia.

Authors
Hansen, RA; Voils, CI; Farley, JF; Powers, BJ; Sanders, LL; Sleath, B; Maciejewski, ML
MLA Citation
Hansen, RA, Voils, CI, Farley, JF, Powers, BJ, Sanders, LL, Sleath, B, and Maciejewski, ML. "Prescriber continuity and medication adherence for complex patients." The Annals of pharmacotherapy 49.3 (March 2015): 293-302.
PMID
25549627
Source
epmc
Published In
The Annals of pharmacotherapy
Volume
49
Issue
3
Publish Date
2015
Start Page
293
End Page
302
DOI
10.1177/1060028014563266

The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches.

BACKGROUND: Identifying pretreatment dietary habits that are associated with weight-loss intervention outcomes could help guide individuals' selection of weight-loss approach among competing options. A pretreatment factor that may influence weight-loss outcomes is macronutrient intake. METHODS: Overweight and obese Durham Veterans Affairs outpatients were randomised to a weight-loss intervention with a low-carbohydrate diet (n = 71) or orlistat medication therapy plus a low-fat diet (n = 73). Percentage fat, carbohydrate and protein intake prior to treatment were measured using 4-day food records. Linear mixed-effects models were used to determine whether pretreatment percentage macronutrient intake influenced weight trajectories and weight loss in each weight-loss condition. RESULTS: Participant's mean age was 53 years, baseline body mass index was 39.3 kg m(-2) and 72% were male. A higher pretreatment percentage carbohydrate intake was associated with less rapid initial weight loss (P = 0.02) and less rapid weight regain (P = 0.03) in the low-carbohydrate diet condition but was not associated with weight trajectories in the orlistat plus low-fat diet condition. In both conditions, a higher pretreatment percentage fat intake was associated with more rapid weight regain (P < 0.01). Pretreatment percentage protein intake was not associated with weight trajectories. None of the pretreatment macronutrients were associated with weight loss on study completion in either condition. CONCLUSIONS: Selection of a weight-loss approach on the basis of pretreatment macronutrient intake is unlikely to improve weight outcomes at the end of a 1-year treatment. However, pretreatment macronutrient intake may have implications for tailoring of interventions to slow weight regain after weight loss.

Authors
McVay, MA; Jeffreys, AS; King, HA; Olsen, MK; Voils, CI; Yancy, WS
MLA Citation
McVay, MA, Jeffreys, AS, King, HA, Olsen, MK, Voils, CI, and Yancy, WS. "The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches." J Hum Nutr Diet 28 Suppl 2 (February 2015): 16-23.
PMID
24251378
Source
pubmed
Published In
Journal of Human Nutrition & Dietetics
Volume
28 Suppl 2
Publish Date
2015
Start Page
16
End Page
23
DOI
10.1111/jhn.12188

The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches

© 2013 The British Dietetic Association Ltd.Background: Identifying pretreatment dietary habits that are associated with weight-loss intervention outcomes could help guide individuals' selection of weight-loss approach among competing options. A pretreatment factor that may influence weight-loss outcomes is macronutrient intake. Methods: Overweight and obese Durham Veterans Affairs outpatients were randomised to a weight-loss intervention with a low-carbohydrate diet (n = 71) or orlistat medication therapy plus a low-fat diet (n = 73). Percentage fat, carbohydrate and protein intake prior to treatment were measured using 4-day food records. Linear mixed-effects models were used to determine whether pretreatment percentage macronutrient intake influenced weight trajectories and weight loss in each weight-loss condition. Results: Participant's mean age was 53 years, baseline body mass index was 39.3 kg m-2 and 72% were male. A higher pretreatment percentage carbohydrate intake was associated with less rapid initial weight loss (P = 0.02) and less rapid weight regain (P = 0.03) in the low-carbohydrate diet condition but was not associated with weight trajectories in the orlistat plus low-fat diet condition. In both conditions, a higher pretreatment percentage fat intake was associated with more rapid weight regain (P < 0.01). Pretreatment percentage protein intake was not associated with weight trajectories. None of the pretreatment macronutrients were associated with weight loss on study completion in either condition. Conclusions: Selection of a weight-loss approach on the basis of pretreatment macronutrient intake is unlikely to improve weight outcomes at the end of a 1-year treatment. However, pretreatment macronutrient intake may have implications for tailoring of interventions to slow weight regain after weight loss.

Authors
Mcvay, MA; Jeffreys, AS; King, HA; Olsen, MK; Voils, CI; Yancy, WS
MLA Citation
Mcvay, MA, Jeffreys, AS, King, HA, Olsen, MK, Voils, CI, and Yancy, WS. "The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches." Journal of Human Nutrition and Dietetics 28.s2 (January 1, 2015): 16-23.
Source
scopus
Published In
Journal of Human Nutrition & Dietetics
Volume
28
Issue
s2
Publish Date
2015
Start Page
16
End Page
23
DOI
10.1111/jhn.12188

Dietary and psych predictors of weight loss after gastric bypass

© 2015 Elsevier Inc. All rights reserved.Background Identifying severely obese patients who will succeed after bariatric surgery remains challenging. Although numerous studies have attempted to identify preoperative patient characteristics associated with weight loss, the roles of many dietary and psychological characteristics are unclear. The purpose of this study was to examine preoperative dietary and psychological predictors of successful weight loss after bariatric surgery. Materials and methods This retrospective cohort study included all patients who underwent laparoscopic Roux-en-Y gastric bypass from September 2011-June 2013 at a single institution (n = 124). Patient demographics, comorbidities, dietary and psychological factors, and weight loss outcomes were extracted from the electronic medical record. Bivariate associations between these factors and successful weight loss (≥50% excess body weight) were examined. Factors significant at P ≤ 0.1 were included in a multivariate logistic regression model. Results On bivariate analysis, absence of either type 2 diabetes or hypertension, preoperative weight <270 lbs, no intentional past weight loss >50 lbs, no previous purging or family history of obesity, and no soda consumption preoperatively were associated with successful weight loss (P < 0.1). On multivariate analysis, successful weight loss was inversely associated with the presence of type 2 diabetes (odds ratio [OR], 0.22, 95% confidence interval [CI], 0.06-0.73), maximum intentional past weight loss >50 lbs (OR, 0.12 [95% CI, 0.04-0.43]), and decreasing soda consumption by >50% (OR, 0.27 [95% CI, 0.08-0.99]). Conclusions Patients with type 2 diabetes mellitus, significant previous weight loss, and poor soda consumption habits are more likely to experience suboptimal weight loss after bariatric surgery. Additional preoperative counseling and close postoperative follow-up is warranted for these patients.

Authors
Fox, B; Chen, E; Suzo, A; Jolles, S; Greenberg, JA; Campos, GM; Voils, CI; Funk, LM
MLA Citation
Fox, B, Chen, E, Suzo, A, Jolles, S, Greenberg, JA, Campos, GM, Voils, CI, and Funk, LM. "Dietary and psych predictors of weight loss after gastric bypass." Journal of Surgical Research 197.2 (January 1, 2015): 283-290.
Source
scopus
Published In
Journal of Surgical Research
Volume
197
Issue
2
Publish Date
2015
Start Page
283
End Page
290
DOI
10.1016/j.jss.2015.04.019

To the editor

Authors
Yancy, WS; Barton, AB; McVay, MA; Voils, CI
MLA Citation
Yancy, WS, Barton, AB, McVay, MA, and Voils, CI. "To the editor." Annals of Internal Medicine 163.5 (January 1, 2015): 398-399. (Letter)
Source
scopus
Published In
Annals of internal medicine
Volume
163
Issue
5
Publish Date
2015
Start Page
398
End Page
399

Effect of allowing choice of diet on weight loss: A randomized trial

© 2015 American College of Physicians.Background: Choosing a diet rather than being prescribed one could improve weight loss. Objective: To examine whether offering choice of diet improves weight loss. Design: Double-randomized preference trial of choice between 2 diets (choice) versus random assignment to a diet (comparator) over 48 weeks. (ClinicalTrials.gov: NCT01152359) Setting: Outpatient clinic at a Veterans Affairs medical center. Patients: Outpatients with a body mass index of at least 30 kg/m2. Intervention: Choice participants received information about their food preferences and 2 diet options (low-carbohydrate diet [LCD] or low-fat diet [LFD]) before choosing and were allowed to switch diets at 12 weeks. Comparator participants were randomly assigned to 1 diet for 48 weeks. Both groups received group and telephone counseling for 48 weeks. Measurements: The primary outcome was weight at 48 weeks. Results: Of 105 choice participants, 61 (58%) chose the LCD and 44 (42%) chose the LFD; 5 (3 on the LCD and 2 on the LFD) switched diets at 12 weeks, and 87 (83%) completed measurements at 48 weeks. Of 102 comparator participants, 53 (52%) were randomly assigned to the LCD and 49 (48%) were assigned to the LFD; 88 (86%) completed measurements. At 48 weeks, estimated mean weight loss was 5.7 kg (95% CI, 4.3 to 7.0 kg) in the choice group and 6.7 kg (CI, 5.4 to 8.0 kg) in the comparator group (mean difference, -1.1 kg [CI, -2.9 to 0.8 kg]; P = 0.26). Secondary outcomes of dietary adherence, physical activity, and weight-related quality of life were similar between groups at 48 weeks.

Authors
Yancy, WS; Mayer, SB; Coffman, CJ; Smith, VA; Kolotkin, RL; Geiselman, PJ; McVay, MA; Oddone, EZ; Voils, CI
MLA Citation
Yancy, WS, Mayer, SB, Coffman, CJ, Smith, VA, Kolotkin, RL, Geiselman, PJ, McVay, MA, Oddone, EZ, and Voils, CI. "Effect of allowing choice of diet on weight loss: A randomized trial." Annals of Internal Medicine 162.12 (January 1, 2015): 805-814.
Source
scopus
Published In
Annals of internal medicine
Volume
162
Issue
12
Publish Date
2015
Start Page
805
End Page
814
DOI
10.7326/M142358

In response

Authors
Yancy, WS; McVay, MA; Voils, CI
MLA Citation
Yancy, WS, McVay, MA, and Voils, CI. "In response." Annals of Internal Medicine 163.10 (January 1, 2015): 805-806. (Letter)
Website
http://hdl.handle.net/10161/11057
Source
scopus
Published In
Annals of internal medicine
Volume
163
Issue
10
Publish Date
2015
Start Page
805
End Page
806
DOI
10.7326/L155159

Extent and reasons for nonadherence to antihypertensive, cholesterol, and diabetes medications: the association with depressive symptom burden in a sample of American veterans.

OBJECTIVE: Persons with depressive symptoms generally have higher rates of medication nonadherence than persons without depressive symptoms. However, little is known about whether this association differs by comorbid medical condition or whether reasons for nonadherence differ by depressive symptoms or comorbid medical condition. METHODS: Self-reported extent of nonadherence, reasons for nonadherence, and depressive symptoms among 1,026 veterans prescribed medications for hypertension, dyslipidemia, and/or type 2 diabetes were assessed. RESULTS: In multivariable logistic regression adjusted for clinical and demographic factors, the odds of nonadherence were higher among participants with high depressive symptom burden for dyslipidemia (n=848; odds ratio [OR]: 1.42, P=0.03) but not hypertension (n=916; OR: 1.24, P=0.15), or type 2 diabetes (n=447; OR: 1.15, P=0.51). Among participants reporting nonadherence to antihypertensive and antilipemic medications, those with greater depressive symptom burden had greater odds of endorsing medication nonadherence reasons related to negative expectations and excessive economic burden. Neither extent of nonadherence nor reasons for nonadherence differed by depressive symptom burden among patients with diabetes. CONCLUSION: These findings suggest that clinicians may consider tailoring interventions to improve adherence to antihypertensive and antilipemic medications to specific medication concerns of participants with depressive symptoms.

Authors
Weidenbacher, HJ; Beadles, CA; Maciejewski, ML; Reeve, BB; Voils, CI
MLA Citation
Weidenbacher, HJ, Beadles, CA, Maciejewski, ML, Reeve, BB, and Voils, CI. "Extent and reasons for nonadherence to antihypertensive, cholesterol, and diabetes medications: the association with depressive symptom burden in a sample of American veterans." Patient preference and adherence 9 (January 2015): 327-336.
PMID
25759567
Source
epmc
Published In
Patient Preference and Adherence
Volume
9
Publish Date
2015
Start Page
327
End Page
336
DOI
10.2147/ppa.s74531

Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.

Spouse-assisted interventions can improve health behaviors, but mechanisms of action are unknown. This study evaluated mediators of dietary and physical activity outcomes during a spouse-assisted intervention to improve low-density lipoprotein cholesterol. This is a secondary analysis of data from a randomized controlled trial comparing usual care (n = 128) to a spouse-assisted lifestyle change intervention (n = 127) comprising nine monthly goal setting telephone calls to participants and support planning calls to spouses over 11 months. Structural equation modeling was used to examine if the intervention influenced the putative mediators of participant self-efficacy and perceived spousal support at 6 months (i.e. action test); if changes in putative mediators at 6 months were associated with changes in diet and physical activity outcomes at 11 months (i.e. conceptual test); and if treatment condition effects on outcomes at 11 months were mediated by its effects on the 6-month putative mediators (i.e. indirect effects test). Participants were 94.9% male, 64.9% white and were 61.3 years old on average. The action test showed that the intervention increased dietary self-efficacy (p < .001) and perceived spousal support for diet (p < .001) and physical activity (p < .01) at 6 months. The conceptual test showed that increases in participant physical activity self-efficacy at 6 months were associated with increases in physical activity frequency (p = .01) and duration (p = .04) at 11 months; other putative mediators were not associated with changes in outcomes at 11 months. The indirect effects tests did not support a mediating role for self-efficacy or perceived spousal support. Intervention-induced changes in spousal support and dietary self-efficacy did not translate into behavior change. Other mechanisms may be driving behavior change.

Authors
McVay, MA; King, HA; Jeffreys, AS; Coffman, CJ; Voils, CI
MLA Citation
McVay, MA, King, HA, Jeffreys, AS, Coffman, CJ, and Voils, CI. "Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention." Psychology, health & medicine 20.7 (January 2015): 753-766.
PMID
25774698
Source
epmc
Published In
Psychology, Health & Medicine
Volume
20
Issue
7
Publish Date
2015
Start Page
753
End Page
766
DOI
10.1080/13548506.2015.1020817

Development and validation of a cross-cultural knowledge, attitudes, and practices survey instrument for chronic kidney disease in a Swahili-speaking population.

Non-communicable diseases are a growing global burden, and structured surveys can identify critical gaps to address this epidemic. In sub-Saharan Africa, there are very few well-tested survey instruments measuring population attributes related to non-communicable diseases. To meet this need, we have developed and validated the first instrument evaluating knowledge, attitudes and practices pertaining to chronic kidney disease in a Swahili-speaking population.Between December 2013 and June 2014, we conducted a four-stage, mixed-methods study among adults from the general population of northern Tanzania. In stage 1, the survey instrument was constructed in English by a group of cross-cultural experts from multiple disciplines and through content analysis of focus group discussions to ensure local significance. Following translation, in stage 2, we piloted the survey through cognitive and structured interviews, and in stage 3, in order to obtain initial evidence of reliability and construct validity, we recruited and then administered the instrument to a random sample of 606 adults. In stage 4, we conducted analyses to establish test-retest reliability and known-groups validity which was informed by thematic analysis of the qualitative data in stages 1 and 2. The final version consisted of 25 items divided into three conceptual domains: knowledge, attitudes and practices. Each item demonstrated excellent test-retest reliability with established content and construct validity.We have developed a reliable and valid cross-cultural survey instrument designed to measure knowledge, attitudes and practices of chronic kidney disease in a Swahili-speaking population of Northern Tanzania. This instrument may be valuable for addressing gaps in non-communicable diseases care by understanding preferences regarding healthcare, formulating educational initiatives, and directing development of chronic disease management programs that incorporate chronic kidney disease across sub-Saharan Africa.

Authors
Stanifer, JW; Karia, F; Voils, CI; Turner, EL; Maro, V; Shimbi, D; Kilawe, H; Lazaro, M; Patel, UD
MLA Citation
Stanifer, JW, Karia, F, Voils, CI, Turner, EL, Maro, V, Shimbi, D, Kilawe, H, Lazaro, M, and Patel, UD. "Development and validation of a cross-cultural knowledge, attitudes, and practices survey instrument for chronic kidney disease in a Swahili-speaking population." PloS one 10.3 (January 2015): e0121722-.
PMID
25811781
Source
epmc
Published In
PloS one
Volume
10
Issue
3
Publish Date
2015
Start Page
e0121722
DOI
10.1371/journal.pone.0121722

Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol.

This study evaluated spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle intervention to reduce patient low-density lipoprotein cholesterol and improve patient health behaviors. Participants were 251 spouses of patients from the Durham Veterans Affairs Medical Center randomized to intervention or usual care. The intervention comprised 9 monthly telephone calls to patients and spouses. Outcomes were assessed at baseline, 6 and 11 months. At 11 months, there were no differences in spouse outcomes between intervention and usual care groups for moderate intensity physical activity (i.e., frequency, duration) or dietary intake (i.e., total calories, total fat, percentage of calories from total fat, saturated fat, percentage of calories from saturated fat, cholesterol, fiber). To improve spouse outcomes, couple interventions may need to include spouse behavior change goals and reciprocal support between patients and spouses and consider the need for improvement in spouse outcomes.

Authors
King, HA; Jeffreys, AS; McVay, MA; Coffman, CJ; Voils, CI
MLA Citation
King, HA, Jeffreys, AS, McVay, MA, Coffman, CJ, and Voils, CI. "Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol." Journal of behavioral medicine 37.6 (December 2014): 1102-1107.
PMID
24584818
Source
epmc
Published In
Journal of Behavioral Medicine
Volume
37
Issue
6
Publish Date
2014
Start Page
1102
End Page
1107
DOI
10.1007/s10865-014-9559-4

Approaches for informing optimal dose of behavioral interventions.

There is little guidance about to how select dose parameter values when designing behavioral interventions.The purpose of this study is to present approaches to inform intervention duration, frequency, and amount when (1) the investigator has no a priori expectation and is seeking a descriptive approach for identifying and narrowing the universe of dose values or (2) the investigator has an a priori expectation and is seeking validation of this expectation using an inferential approach.Strengths and weaknesses of various approaches are described and illustrated with examples.Descriptive approaches include retrospective analysis of data from randomized trials, assessment of perceived optimal dose via prospective surveys or interviews of key stakeholders, and assessment of target patient behavior via prospective, longitudinal, observational studies. Inferential approaches include nonrandomized, early-phase trials and randomized designs.By utilizing these approaches, researchers may more efficiently apply resources to identify the optimal values of dose parameters for behavioral interventions.

Authors
Voils, CI; King, HA; Maciejewski, ML; Allen, KD; Yancy, WS; Shaffer, JA
MLA Citation
Voils, CI, King, HA, Maciejewski, ML, Allen, KD, Yancy, WS, and Shaffer, JA. "Approaches for informing optimal dose of behavioral interventions." Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 48.3 (December 2014): 392-401. (Review)
PMID
24722964
Source
epmc
Published In
Annals of Behavioral Medicine
Volume
48
Issue
3
Publish Date
2014
Start Page
392
End Page
401
DOI
10.1007/s12160-014-9618-7

Validation of a measure of family experience of patients with serious illness: the QUAL-E (Fam).

Family members of seriously ill patients experience significant burden as they advocate with providers and participate in key decisions for loved ones. Most assessments focus on patient experience, yet family members' own quality of experience is central to comprehensive care.This study validated a measure of the quality of family experience, the QUAL-E (Fam), in palliative care.We enrolled family members of terminally ill patients admitted to general medicine services at two hospitals. Items were based on foundational work originally done for the patient instrument, QUAL-E, and interviews of family members of terminally ill patients. Cognitive interviewing was used to refine items, which then underwent formal testing factor analysis. In the first sample, we assessed factor structure. A subsequent sample established predictive validity and test-retest reliability.The initial item pool was reduced to a four-domain, 35-item scale and administered to the validation sample. Further analyses produced a final brief scale comprising 17 items, demonstrating appropriate convergent and divergent validity. Test-retest reliability demonstrated expected levels of stability in a highly changeable population. The scale provides an assessment of family experience and includes subscales assessing relationship with health care provider and completion. Additional scale items assess symptom experience and issues of preparation.The QUAL-E (Fam) is a companion instrument to the patient QUAL-E measure of quality of life at the end of life and is part of a package of assessment tools that can help evaluate the entire patient experience and contribute to quality care.

Authors
Steinhauser, KE; Voils, CI; Bosworth, HB; Tulsky, JA
MLA Citation
Steinhauser, KE, Voils, CI, Bosworth, HB, and Tulsky, JA. "Validation of a measure of family experience of patients with serious illness: the QUAL-E (Fam)." Journal of pain and symptom management 48.6 (December 2014): 1168-1181.
PMID
24858740
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
6
Publish Date
2014
Start Page
1168
End Page
1181
DOI
10.1016/j.jpainsymman.2014.04.006

Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention.

Individuals undertaking a weight loss effort have a choice among proven dietary approaches. Factors contributing to choice of either a low-fat/low-calorie diet or a low-carbohydrate diet, two of the most studied and popular dietary approaches, are unknown. The current study used data from participants randomized to the 'choice' arm of a trial examining whether being able to choose a diet regimen yields higher weight loss than being randomly assigned to a diet. At study entry, participants attended a group session during which they were provided tailored feedback indicating which diet was most consistent with their food preferences using the Geiselman Food Preference Questionnaire (FPQ), information about both diets, and example meals for each diet. One week later, they indicated which diet they chose to follow during the 48-week study, with the option of switching diets after 12 weeks. Of 105 choice arm participants, 44 (42%) chose the low-fat/low-calorie diet and 61 (58%) chose the low-carbohydrate diet. In bivariate analyses, diet choice was not associated with age, race, sex, education, BMI, or diabetes (all p > 0.05). Low-carbohydrate diet choice was associated with baseline higher percent fat intake (p = 0.007), lower percent carbohydrate intake (p = 0.02), and food preferences consistent with a low-carbohydrate diet according to FPQ (p < 0.0001). In a multivariable logistic regression model, only FPQ diet preference was associated with diet choice (p = 0.001). Reported reasons for diet choice were generally similar for those choosing either diet; however, concerns about negative health effects of the unselected diet was rated as more influential among participants selecting the low-fat diet. Only three low-carbohydrate and two low-fat diet participants switched diets at 12 weeks. Results suggest that when provided a choice between two popular weight loss dietary approaches, an individual's selection is likely influenced by baseline dietary intake pattern, and especially by his or her dietary preferences. Research is needed to determine if congruency between food preferences and dietary approach is associated with weight loss.

Authors
McVay, MA; Voils, CI; Coffman, CJ; Geiselman, PJ; Kolotkin, RL; Mayer, SB; Smith, VA; Gaillard, L; Turner, MJ; Yancy, WS
MLA Citation
McVay, MA, Voils, CI, Coffman, CJ, Geiselman, PJ, Kolotkin, RL, Mayer, SB, Smith, VA, Gaillard, L, Turner, MJ, and Yancy, WS. "Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention." Appetite 83 (December 2014): 117-124.
PMID
25149197
Source
epmc
Published In
Appetite
Volume
83
Publish Date
2014
Start Page
117
End Page
124
DOI
10.1016/j.appet.2014.08.023

Corrigendum to "Weight loss intervention for young adults using mobile technology: Design and rationale of a randomized controlled trial - Cell phone Intervention for You (CITY)" [Contemp Clin Trials 37/2 (2014) 333-341].

Authors
Batch, BC; Tyson, C; Bagwell, J; Corsino, L; Intille, S; Lin, PH; Lazenka, T; Bennett, G; Bosworth, HB; Voils, C; Grambow, S; Sutton, A; Bordogna, R; Pangborn, M; Schwager, J; Pilewski, K; Caccia, C; Burroughs, J; Svetkey, LP
MLA Citation
Batch, BC, Tyson, C, Bagwell, J, Corsino, L, Intille, S, Lin, PH, Lazenka, T, Bennett, G, Bosworth, HB, Voils, C, Grambow, S, Sutton, A, Bordogna, R, Pangborn, M, Schwager, J, Pilewski, K, Caccia, C, Burroughs, J, and Svetkey, LP. "Corrigendum to "Weight loss intervention for young adults using mobile technology: Design and rationale of a randomized controlled trial - Cell phone Intervention for You (CITY)" [Contemp Clin Trials 37/2 (2014) 333-341]." Contemporary clinical trials 39.2 (November 2014): 351-.
PMID
25488046
Source
epmc
Published In
Contemporary Clinical Trials
Volume
39
Issue
2
Publish Date
2014
Start Page
351
DOI
10.1016/j.cct.2014.10.001

Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.

Patients with multiple chronic conditions often have multiple prescribers, which has been associated with greater health care utilization and medication nonadherence in claims-based analyses. This qualitative study was conducted to understand the reasons why patients have increasing numbers of prescribers of medications and to understand patient perspectives on advantages and disadvantages of having multiple prescribers, including effects on medication supply.This qualitative study involved three focus groups comprising 23 outpatients from a single Veterans Affairs (VA) Medical Center with at least one chronic cardiometabolic condition (hypertension, diabetes, dyslipidemia, or congestive heart failure). Participants were asked about their experiences, including perceived of advantages and disadvantages, of having multiple prescribers of cardiometabolic medications. Conventional content analysis was used to analyze the data.Multiple prescribers arose through referrals and patients actively seeking non-VA prescribers (primary care and/or specialist) to maximize timeliness and access to medications, provide access to medications not on the VA formulary, and minimize out-of-pocket costs. Patients seeking non-VA care had to coordinate own their care by sharing prescriptions and test results to their prescribers within and outside VA.Prescribing physicians should engage in open dialogue with patients to create a shared understanding of patient and provider goals and priorities for chronic disease medications.

Authors
Voils, CI; Sleath, B; Maciejewski, ML
MLA Citation
Voils, CI, Sleath, B, and Maciejewski, ML. "Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population." BMC health services research 14 (October 25, 2014): 490-.
PMID
25344128
Source
epmc
Published In
BMC Health Services Research
Volume
14
Publish Date
2014
Start Page
490
DOI
10.1186/s12913-014-0490-8

How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions?

Long-term care (LTC) poses a significant strain on public health insurance financing. In response, there is policy interest in bolstering the private long-term care insurance (LTCI) market. Although families are central to LTC provision, their role in LTCI demand remains unclear. The purpose of this study was to obtain in-depth information concerning: (a) How do older parents evaluate the need for LTCI, (b) what role do adult children play? and (c) How do families communicate about parents' LTC preferences and plans, including LTCI purchase?We conducted focus groups with older parents and adult children in diverse markets. Two groups were conducted with older parents who had purchased LTCI and two with parents who had not purchased LTCI. Four groups were conducted with adult children, mixed as to whether their parents had purchased LTCI. Probes were informed by published reasons for purchasing or not purchasing LTCI. We analyzed transcriptions using directed content analysis and constant comparative method.Older parents valued autonomy for themselves and their children. Older parent purchasers regarded LTCI as supporting this value while nonpurchasers perceived limitations. Adult children described unstated expectations that they would care for their parents. Though discussions between parents and children about LTCI were rare, successful influence occurred when children appealed to shared values, specifically avoiding burden and remaining home.Messages that emphasize autonomy over LTC decisions and interventions that start the LTC conversation among families, with attention to shared values, could increase private LTCI uptake.

Authors
Sperber, NR; Voils, CI; Coe, NB; Konetzka, RT; Boles, J; Van Houtven, CH
MLA Citation
Sperber, NR, Voils, CI, Coe, NB, Konetzka, RT, Boles, J, and Van Houtven, CH. "How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions?." The Gerontologist (September 10, 2014).
PMID
25209446
Source
epmc
Published In
The Gerontologist
Publish Date
2014
DOI
10.1093/geront/gnu082

Patient complexity, prescriber continuity and acute care.

Authors
Maciejewski, ML; Voils, CI
MLA Citation
Maciejewski, ML, and Voils, CI. "Patient complexity, prescriber continuity and acute care." Journal of general internal medicine 29.9 (September 2014): 1225-. (Letter)
PMID
24957382
Source
epmc
Published In
Journal of General Internal Medicine
Volume
29
Issue
9
Publish Date
2014
Start Page
1225
DOI
10.1007/s11606-014-2937-3

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. Previously, we created a conceptual model that distinguishes behavior initiation from maintenance. This model was used to generate Maintenance After Initiation of Nutrition TrAINing (MAINTAIN), an intervention to enhance weight loss maintenance following initiation. The effectiveness of MAINTAIN is being evaluated in an ongoing trial, the rationale and procedures of which are reported herein.Veterans aged ≤ 75 with body mass index ≥ 30 kg/m(2) participate in a 16-week, group-based weight loss program. Participants who lose ≥ 4 kg by the end of 16 weeks (target n = 230) are randomized 1:1 to receive (a) usual care for 56 weeks or (b) MAINTAIN, a theoretically-informed weight loss maintenance intervention for 40 weeks, followed by 16 weeks of no intervention contact. MAINTAIN involves 3 in-person group visits that transition to 8 individualized telephone calls with decreasing contact frequency. MAINTAIN focuses on satisfaction with outcomes, weight self-monitoring, relapse prevention, and social support. We hypothesize that, compared to usual care, MAINTAIN will result in at least 3.5 kg less regain and better relative levels of caloric intake and physical activity over 56 weeks, and that it will be cost-effective.If effective, MAINTAIN could serve as a model for redesigning existing weight loss programs.NCT01357551.

Authors
Voils, CI; Gierisch, JM; Olsen, MK; Maciejewski, ML; Grubber, J; McVay, MA; Strauss, JL; Bolton, J; Gaillard, L; Strawbridge, E; Yancy, WS
MLA Citation
Voils, CI, Gierisch, JM, Olsen, MK, Maciejewski, ML, Grubber, J, McVay, MA, Strauss, JL, Bolton, J, Gaillard, L, Strawbridge, E, and Yancy, WS. "Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study." Contemporary clinical trials 39.1 (September 2014): 95-105.
PMID
25117805
Source
epmc
Published In
Contemporary Clinical Trials
Volume
39
Issue
1
Publish Date
2014
Start Page
95
End Page
105
DOI
10.1016/j.cct.2014.08.002

Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept.

Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without intervention. We posit that health behavior initiation and maintenance require separate psychological processes and skills. To determine the value of operationalizing maintenance as a process separate from initiation, we conducted a pilot study of a telephone-delivered intervention to assist people in transitioning from behavior initiation to maintenance. Participants were 20 veterans who had initiated lifestyle changes during a randomized controlled trial of a cholesterol reduction intervention. After completing the randomized controlled trial, these participants were enrolled in the pilot maintenance intervention, which involved three monthly telephone calls from a nurse interventionist focusing on behavioral maintenance skills. To evaluate the feasibility and acceptability of this intervention, we assessed recruitment and retention rates as well as 4-month pre-post changes in health behaviors and associated psychological processes. We also conducted individual interviews with participants after study completion. Although not powered to detect significant changes, there was evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes. Participants accepted the intervention and desired ongoing contact to maintain accountability. This pilot maintenance intervention warrants further evaluation in a randomized controlled trial.

Authors
Voils, CI; Gierisch, JM; Yancy, WS; Sandelowski, M; Smith, R; Bolton, J; Strauss, JL
MLA Citation
Voils, CI, Gierisch, JM, Yancy, WS, Sandelowski, M, Smith, R, Bolton, J, and Strauss, JL. "Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept." Health Educ Behav 41.3 (June 2014): 325-336.
PMID
24347145
Source
pubmed
Published In
Health Education & Behavior
Volume
41
Issue
3
Publish Date
2014
Start Page
325
End Page
336
DOI
10.1177/1090198113515242

Systematic review and metasummary of attitudes toward research in emergency medical conditions.

Emergency departments are challenging research settings, where truly informed consent can be difficult to obtain. A deeper understanding of emergency medical patients' opinions about research is needed. We conducted a systematic review and meta-summary of quantitative and qualitative studies on which values, attitudes, or beliefs of emergent medical research participants influence research participation. We included studies of adults that investigated opinions toward emergency medicine research participation. We excluded studies focused on the association between demographics or consent document features and participation and those focused on non-emergency research. In August 2011, we searched the following databases: MEDLINE, EMBASE, Google Scholar, Scirus, PsycINFO, AgeLine and Global Health. Titles, abstracts and then full manuscripts were independently evaluated by two reviewers. Disagreements were resolved by consensus and adjudicated by a third author. Studies were evaluated for bias using standardised scores. We report themes associated with participation or refusal. Our initial search produced over 1800 articles. A total of 44 articles were extracted for full-manuscript analysis, and 14 were retained based on our eligibility criteria. Among factors favouring participation, altruism and personal health benefit had the highest frequency. Mistrust of researchers, feeling like a 'guinea pig' and risk were leading factors favouring refusal. Many studies noted limitations of informed consent processes in emergent conditions. We conclude that highlighting the benefits to the participant and society, mitigating risk and increasing public trust may increase research participation in emergency medical research. New methods for conducting informed consent in such studies are needed.

Authors
Limkakeng, AT; de Oliveira, LL; Moreira, T; Phadtare, A; Garcia Rodrigues, C; Hocker, MB; McKinney, R; Voils, CI; Pietrobon, R
MLA Citation
Limkakeng, AT, de Oliveira, LL, Moreira, T, Phadtare, A, Garcia Rodrigues, C, Hocker, MB, McKinney, R, Voils, CI, and Pietrobon, R. "Systematic review and metasummary of attitudes toward research in emergency medical conditions." J Med Ethics 40.6 (June 2014): 401-408. (Review)
Website
http://hdl.handle.net/10161/12533
PMID
23665997
Source
pubmed
Published In
Journal of medical ethics
Volume
40
Issue
6
Publish Date
2014
Start Page
401
End Page
408
DOI
10.1136/medethics-2012-101147

Obesity-related health status changes and weight-loss treatment utilization.

BACKGROUND: Behavioral weight-loss treatment can improve health, yet it is underutilized. Factors leading to initiation of weight-loss treatment are not well characterized. In particular, it is unknown whether changes in obesity-related health status contribute to weight-loss treatment initiation. PURPOSE: To determine if recent weight change or diagnosis of an obesity-related comorbidity was associated with utilization of a behavioral weight-loss program in an integrated healthcare setting. METHODS: In a retrospective cohort study of 45,272 Veterans Affairs (VA) patients with BMI >30, logistic regression was used to examine whether recent weight change or obesity-related comorbidities newly diagnosed in the past 6 months were associated with initiation of a VA behavioral weight management program (called MOVE!) in 2010 or sustained MOVE! use (eight or more sessions). Weight change in prior year was categorized as >3% weight loss; weight stable (<3% change); or weight gain of 3%-4.9%, 5%-9.9%, or ≥10%. Data were analyzed in 2013. RESULTS: Patients were 91% male, 68% white, and had a mean age of 58 years. Patients were more likely to initiate treatment if they had ≥3% weight gain (3%-4.9%: OR=1.64, 95% CI=1.52, 1.77; 5%-9.9%: OR=1.99, 95% CI=1.84, 2.16; ≥10%: OR=2.68, 95% CI=2.32, 3.10) or were newly diagnosed with any obesity-related comorbidity (ORs: 2.14-3.59). Weight change and new comorbidity diagnoses were not associated, however, with sustained MOVE! use. CONCLUSIONS: Adverse obesity-related health events were associated with initiation of behavioral weight-loss treatment offered in an integrated healthcare setting.

Authors
McVay, MA; Yancy, WS; Vijan, S; Van Scoyoc, L; Neelon, B; Voils, CI; Maciejewski, ML
MLA Citation
McVay, MA, Yancy, WS, Vijan, S, Van Scoyoc, L, Neelon, B, Voils, CI, and Maciejewski, ML. "Obesity-related health status changes and weight-loss treatment utilization." American journal of preventive medicine 46.5 (May 2014): 465-472.
PMID
24745636
Source
epmc
Published In
American Journal of Preventive Medicine
Volume
46
Issue
5
Publish Date
2014
Start Page
465
End Page
472
DOI
10.1016/j.amepre.2013.11.018

The intersection of patient complexity, prescriber continuity and acute care utilization.

BACKGROUND: Care continuity is considered a critical characteristic of high-performing health systems. Few studies have examined the continuity of medication management of complex patients, who often have multiple providers and complex medication regimens. PURPOSE: The purpose of this study was to characterize patient factors associated with having more prescribers and the association between number of prescribers and acute care utilization. DESIGN AND SUBJECTS: A retrospective cohort study was conducted of 7,933 Veterans with one to four cardiometabolic conditions (diabetes, hypertension, hyperlipidemia or congestive heart failure) and prescribed medications for these conditions in 2008. MAIN MEASURES: The association between number of cardiometabolic conditions and prescribers was modeled using Poisson regression. The number of cardiometabolic conditions and number of prescribers were modeled to predict probability of inpatient admission, probability of emergency room (ER) visits, and number of ER visits among ER users. Demographic characteristics, number of cardiometabolic medications and comorbidities were included as covariates in all models. KEY RESULTS: Patients had more prescribers if they had more cardiometabolic conditions (p < 0.001). The adjusted odds of an ER visit increased with the number of prescribers (two prescribers, Odds Ratio (OR) = 1.16; three prescribers, OR = 1.21; 4+ prescribers, OR = 1.39), but not with the number of conditions. Among ER users, the number of ER visits was neither associated with the number of prescribers nor the number of conditions. The adjusted odds of an inpatient admission increased with the number of prescribers (two prescribers, OR = 1.27; three prescribers, OR = 1.30; 4+ prescribers, OR = 1.34), but not with the number of conditions. CONCLUSIONS: Having more prescribers was associated with greater healthcare utilization for complex patients, despite adjustment for the number of conditions and medications. The number of prescribers may be an appropriate target for reducing acute care utilization by complex patients.

Authors
Maciejewski, ML; Powers, BJ; Sanders, LL; Farley, JF; Hansen, RA; Sleath, B; Voils, CI
MLA Citation
Maciejewski, ML, Powers, BJ, Sanders, LL, Farley, JF, Hansen, RA, Sleath, B, and Voils, CI. "The intersection of patient complexity, prescriber continuity and acute care utilization." J Gen Intern Med 29.4 (April 2014): 594-601.
PMID
24408277
Source
pubmed
Published In
Journal of General Internal Medicine
Volume
29
Issue
4
Publish Date
2014
Start Page
594
End Page
601
DOI
10.1007/s11606-013-2746-0

EFFECTIVENESS OF INTERNET AND DVD DECISION AIDS FOR PATIENTS WITH HIP AND KNEE OSTEOARTHRITIS

Authors
Allen, KD; Sanders, L; Olsen, M; Bowlby, L; Katz, JN; III, MRC; Powers, BJ; Sperber, NR; Voils, CI; Williams, JW
MLA Citation
Allen, KD, Sanders, L, Olsen, M, Bowlby, L, Katz, JN, III, MRC, Powers, BJ, Sperber, NR, Voils, CI, and Williams, JW. "EFFECTIVENESS OF INTERNET AND DVD DECISION AIDS FOR PATIENTS WITH HIP AND KNEE OSTEOARTHRITIS." April 2014.
Source
wos-lite
Published In
Osteoarthritis and Cartilage
Volume
22
Publish Date
2014
Start Page
S203
End Page
S203

Community-based HCV screening: Knowledge and attitudes in a high risk urban population

Background: In an attempt to curtail the rising morbidity and mortality from undiagnosed HCV (hepatitis C virus) in the United States, screening guidelines have been expanded to high-risk individuals and persons born 1945-1965. Community-based screening may be one strategy in which to reach such persons; however, the acceptance of HCV testing, when many high-risk individuals may not have access to HCV specific medications, remains unknown.Methods: We set out to assess attitudes about HCV screening and knowledge about HCV disease at several community-based testing sites that serve high-risk populations. This assessment was paired with a brief HCV educational intervention, followed by post-education evaluation.Results: Participants (n = 140) were surveyed at five sites; two homeless shelters, two drug rehabilitation centers, and a women's "drop-in" center. Personal acceptance of HCV testing was almost unanimous, and 90% of participants reported that they would still want to be tested even if they were unable to receive HCV treatment. Baseline hepatitis C knowledge was poor; however, the brief educational intervention significantly improved knowledge and increased acceptability of testing when medical access issues were explicitly stated.Conclusions: Despite inconsistencies in access to care and treatment, high-risk communities want to know their HCV status. Though baseline HCV knowledge was poor in this population, a brief on-site educational intervention improved both knowledge and acceptability of HCV testing and care. These data support the establishment of programs that utilize community-based screening, and also provide initial evidence for acceptance of the implementation of the recently expanded screening guidelines among marginalized communities. © 2014 Norton et al.; licensee BioMed Central Ltd.

Authors
Norton, BL; Voils, CI; Timberlake, SH; Hecker, EJ; Goswami, ND; Huffman, KM; Landgraf, A; Naggie, S; Stout, JE
MLA Citation
Norton, BL, Voils, CI, Timberlake, SH, Hecker, EJ, Goswami, ND, Huffman, KM, Landgraf, A, Naggie, S, and Stout, JE. "Community-based HCV screening: Knowledge and attitudes in a high risk urban population." BMC Infectious Diseases 14.1 (March 10, 2014).
Source
scopus
Published In
BMC Infectious Diseases
Volume
14
Issue
1
Publish Date
2014
DOI
10.1186/1471-2334-14-74

Posttraumatic stress disorder and medication nonadherence in patients with uncontrolled hypertension.

Authors
Kronish, IM; Lin, JJ; Cohen, BE; Voils, CI; Edmondson, D
MLA Citation
Kronish, IM, Lin, JJ, Cohen, BE, Voils, CI, and Edmondson, D. "Posttraumatic stress disorder and medication nonadherence in patients with uncontrolled hypertension." JAMA Intern Med 174.3 (March 2014): 468-470.
PMID
24296721
Source
pubmed
Published In
JAMA Internal Medicine
Volume
174
Issue
3
Publish Date
2014
Start Page
468
End Page
470
DOI
10.1001/jamainternmed.2013.12881

Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial - Cell Phone Intervention for You (CITY).

The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population.To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to 3) a usual care, advice-only control condition.A total of 365 community-dwelling overweight/obese adults aged 18-35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 24 [corrected] months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014.If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. ClinicalTrial.gov: NCT01092364.

Authors
Batch, BC; Tyson, C; Bagwell, J; Corsino, L; Intille, S; Lin, PH; Lazenka, T; Bennett, G; Bosworth, HB; Voils, C; Grambow, S; Sutton, A; Bordogna, R; Pangborn, M; Schwager, J; Pilewski, K; Caccia, C; Burroughs, J; Svetkey, LP
MLA Citation
Batch, BC, Tyson, C, Bagwell, J, Corsino, L, Intille, S, Lin, PH, Lazenka, T, Bennett, G, Bosworth, HB, Voils, C, Grambow, S, Sutton, A, Bordogna, R, Pangborn, M, Schwager, J, Pilewski, K, Caccia, C, Burroughs, J, and Svetkey, LP. "Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial - Cell Phone Intervention for You (CITY)." Contemporary clinical trials 37.2 (March 2014): 333-341.
Website
http://hdl.handle.net/10161/10732
PMID
24462568
Source
epmc
Published In
Contemporary Clinical Trials
Volume
37
Issue
2
Publish Date
2014
Start Page
333
End Page
341
DOI
10.1016/j.cct.2014.01.003

Community-based HCV screening: knowledge and attitudes in a high risk urban population.

In an attempt to curtail the rising morbidity and mortality from undiagnosed HCV (hepatitis C virus) in the United States, screening guidelines have been expanded to high-risk individuals and persons born 1945-1965. Community-based screening may be one strategy in which to reach such persons; however, the acceptance of HCV testing, when many high-risk individuals may not have access to HCV specific medications, remains unknown.We set out to assess attitudes about HCV screening and knowledge about HCV disease at several community-based testing sites that serve high-risk populations. This assessment was paired with a brief HCV educational intervention, followed by post-education evaluation.Participants (n = 140) were surveyed at five sites; two homeless shelters, two drug rehabilitation centers, and a women's "drop-in" center. Personal acceptance of HCV testing was almost unanimous, and 90% of participants reported that they would still want to be tested even if they were unable to receive HCV treatment. Baseline hepatitis C knowledge was poor; however, the brief educational intervention significantly improved knowledge and increased acceptability of testing when medical access issues were explicitly stated.Despite inconsistencies in access to care and treatment, high-risk communities want to know their HCV status. Though baseline HCV knowledge was poor in this population, a brief on-site educational intervention improved both knowledge and acceptability of HCV testing and care. These data support the establishment of programs that utilize community-based screening, and also provide initial evidence for acceptance of the implementation of the recently expanded screening guidelines among marginalized communities.

Authors
Norton, BL; Voils, CI; Timberlake, SH; Hecker, EJ; Goswami, ND; Huffman, KM; Landgraf, A; Naggie, S; Stout, JE
MLA Citation
Norton, BL, Voils, CI, Timberlake, SH, Hecker, EJ, Goswami, ND, Huffman, KM, Landgraf, A, Naggie, S, and Stout, JE. "Community-based HCV screening: knowledge and attitudes in a high risk urban population." BMC infectious diseases 14 (February 10, 2014): 74-.
Website
http://hdl.handle.net/10161/11641
PMID
24512462
Source
epmc
Published In
BMC Infectious Diseases
Volume
14
Publish Date
2014
Start Page
74
DOI
10.1186/1471-2334-14-74

The intersection of patient complexity, prescriber continuity and acute care utilization

BACKGROUND: Care continuity is considered a critical characteristic of high-performing health systems. Few studies have examined the continuity of medication management of complex patients, who often have multiple providers and complex medication regimens. PURPOSE: The purpose of this study was to characterize patient factors associated with having more prescribers and the association between number of prescribers and acute care utilization. DESIGN AND SUBJECTS: A retrospective cohort study was conducted of 7,933 Veterans with one to four cardiometabolic conditions (diabetes, hypertension, hyperlipidemia or congestive heart failure) and prescribed medications for these conditions in 2008. MAIN MEASURES: The association between number of cardiometabolic conditions and prescribers was modeled using Poisson regression. The number of cardiometabolic conditions and number of prescribers were modeled to predict probability of inpatient admission, probability of emergency room (ER) visits, and number of ER visits among ER users. Demographic characteristics, number of cardiometabolic medications and comorbidities were included as covariates in all models. KEY RESULTS: Patients had more prescribers if they had more cardiometabolic conditions (p<0.001). The adjusted odds of an ER visit increased with the number of prescribers (two prescribers, Odds Ratio (OR)=1.16; three prescribers, OR=1.21; 4+ prescribers, OR=1.39), but not with the number of conditions. Among ER users, the number of ER visits was neither associated with the number of prescribers nor the number of conditions. The adjusted odds of an inpatient admission increased with the number of prescribers (two prescribers, OR=1.27; three prescribers, OR=1.30; 4+ prescribers, OR=1.34), but not with the number of conditions. CONCLUSIONS: Having more prescribers was associated with greater healthcare utilization for complex patients, despite adjustment for the number of conditions and medications. The number of prescribers may be an appropriate target for reducing acute care utilization by complex patients. © 2014 Society of General Internal Medicine.

Authors
Maciejewski, ML; Powers, BJ; Sanders, LL; Farley, JF; Hansen, RA; Sleath, B; Voils, CI
MLA Citation
Maciejewski, ML, Powers, BJ, Sanders, LL, Farley, JF, Hansen, RA, Sleath, B, and Voils, CI. "The intersection of patient complexity, prescriber continuity and acute care utilization." Journal of General Internal Medicine 29.4 (January 1, 2014): 594-601.
Source
scopus
Published In
Journal of General Internal Medicine
Volume
29
Issue
4
Publish Date
2014
Start Page
594
End Page
601
DOI
10.1007/s11606-013-2746-0

Systematic review and metasummary of attitudes toward research in emergency medical conditions

Emergency departments are challenging research settings, where truly informed consent can be difficult to obtain. A deeper understanding of emergency medical patients' opinions about research is needed. We conducted a systematic review and meta-summary of quantitative and qualitative studies on which values, attitudes, or beliefs of emergent medical research participants influence research participation. We included studies of adults that investigated opinions toward emergency medicine research participation. We excluded studies focused on the association between demographics or consent document features and participation and those focused on non-emergency research. In August 2011, we searched the following databases: MEDLINE, EMBASE, Google Scholar, Scirus, PsycINFO, AgeLine and Global Health. Titles, abstracts and then full manuscripts were independently evaluated by two reviewers. Disagreements were resolved by consensus and adjudicated by a third author. Studies were evaluated for bias using standardised scores. We report themes associated with participation or refusal. Our initial search produced over 1800 articles. A total of 44 articles were extracted for full-manuscript analysis, and 14 were retained based on our eligibility criteria. Among factors favouring participation, altruism and personal health benefit had the highest frequency. Mistrust of researchers, feeling like a 'guinea pig' and risk were leading factors favouring refusal. Many studies noted limitations of informed consent processes in emergent conditions. We conclude that highlighting the benefits to the participant and society, mitigating risk and increasing public trust may increase research participation in emergency medical research. New methods for conducting informed consent in such studies are needed.

Authors
Limkakeng, AT; de Oliveira, LLH; Moreira, T; Phadtare, A; Rodrigues, CG; Hocker, MB; McKinney, R; Voils, CI; Pietrobon, R
MLA Citation
Limkakeng, AT, de Oliveira, LLH, Moreira, T, Phadtare, A, Rodrigues, CG, Hocker, MB, McKinney, R, Voils, CI, and Pietrobon, R. "Systematic review and metasummary of attitudes toward research in emergency medical conditions." Journal of Medical Ethics 40.6 (January 1, 2014): 401-408.
Website
http://hdl.handle.net/10161/10308
Source
scopus
Published In
Journal of medical ethics
Volume
40
Issue
6
Publish Date
2014
Start Page
401
End Page
408
DOI
10.1136/medethics-2012-101147

Patient complexity, prescriber continuity and acute care

Authors
Maciejewski, ML; Voils, CI
MLA Citation
Maciejewski, ML, and Voils, CI. "Patient complexity, prescriber continuity and acute care." Journal of General Internal Medicine 29.9 (January 1, 2014): 1225-. (Letter)
Source
scopus
Published In
Journal of General Internal Medicine
Volume
29
Issue
9
Publish Date
2014
Start Page
1225
DOI
10.1007/s11606-014-2937-3

Validation of a measure of family experience of patients with serious illness: The QUAL-E (fam)

© 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.Context Family members of seriously ill patients experience significant burden as they advocate with providers and participate in key decisions for loved ones. Most assessments focus on patient experience, yet family members' own quality of experience is central to comprehensive care. Objectives This study validated a measure of the quality of family experience, the QUAL-E (Fam), in palliative care. Methods We enrolled family members of terminally ill patients admitted to general medicine services at two hospitals. Items were based on foundational work originally done for the patient instrument, QUAL-E, and interviews of family members of terminally ill patients. Cognitive interviewing was used to refine items, which then underwent formal testing factor analysis. In the first sample, we assessed factor structure. A subsequent sample established predictive validity and test-retest reliability. Results The initial item pool was reduced to a four-domain, 35-item scale and administered to the validation sample. Further analyses produced a final brief scale comprising 17 items, demonstrating appropriate convergent and divergent validity. Test-retest reliability demonstrated expected levels of stability in a highly changeable population. The scale provides an assessment of family experience and includes subscales assessing relationship with health care provider and completion. Additional scale items assess symptom experience and issues of preparation. Conclusion The QUAL-E (Fam) is a companion instrument to the patient QUAL-E measure of quality of life at the end of life and is part of a package of assessment tools that can help evaluate the entire patient experience and contribute to quality care.

Authors
Steinhauser, KE; Voils, CI; Bosworth, HB; Tulsky, JA
MLA Citation
Steinhauser, KE, Voils, CI, Bosworth, HB, and Tulsky, JA. "Validation of a measure of family experience of patients with serious illness: The QUAL-E (fam)." Journal of Pain and Symptom Management 48.6 (January 1, 2014): 1168-1181.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
6
Publish Date
2014
Start Page
1168
End Page
1181
DOI
10.1016/j.jpainsymman.2014.04.006

Physician perceptions on colonoscopy quality: results of a national survey of gastroenterologists.

Background. Quality indicators for colonoscopy have been developed, but the uptake of these metrics into practice is uncertain. Our aims were to assess physician perceptions regarding colonoscopy quality measurement and to quantify the perceived impact of quality measurement on clinical practice. Methods. We conducted in-person interviews with 15 gastroenterologists about their perceptions regarding colonoscopy quality. Results from these interviews informed the development of a 34-question web-based survey that was emailed to 1,500 randomlyselected members of the American College of Gastroenterology. Results. 160 invitations were undeliverable, and 167 out of 1340 invited physicians (12.5%) participated in the survey. Respondents and nonrespondents did not differ in age, sex, practice setting, or years since training. 38.8% of respondents receive feedback on their colonoscopy quality. The majority of respondents agreed with the use of completion rate (90%) and adenoma detection rate (83%) as quality indicators but there was less enthusiasm for withdrawal time (61%). 24% of respondents reported usually or always removing diminutive polyps solely to increase their adenoma detection rate, and 20% reported prolonging their procedure time to meet withdrawal time standards. Conclusions. A minority of respondents receives feedback on the quality of their colonoscopy. Interventions to increase continuous quality improvement in colonoscopy screening are needed.

Authors
Gellad, ZF; Voils, CI; Lin, L; Provenzale, D
MLA Citation
Gellad, ZF, Voils, CI, Lin, L, and Provenzale, D. "Physician perceptions on colonoscopy quality: results of a national survey of gastroenterologists." Gastroenterology research and practice 2014 (January 2014): 510494-.
PMID
24734039
Source
epmc
Published In
Gastroenterology Research and Practice
Volume
2014
Publish Date
2014
Start Page
510494
DOI
10.1155/2014/510494

Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions.

Little is known about weekly variability in medication nonadherence both between and within persons.To characterize medication nonadherence across repeated, closely spaced occasions.This prospective cohort study comprised four unannounced telephone assessment occasions, each separated by approximately 2 weeks. On each occasion, adult outpatients taking at least a single antihypertensive medication completed a measure of extent of, and reasons for, nonadherence.Two hundred and sixty-one participants completed 871 (83%) of 1,044 occasions. Nonadherence was reported on 152 (17.5%) of 871 occasions by 93 (36%) of 261 participants. The most commonly endorsed reasons for nonadherence were forgetting (39.5%), being busy (23.7%), and traveling (19.7%). Among 219 participants completing at least three occasions, 50% of the variability in extent of nonadherence was a result of within-person fluctuations, and 50% was a result of between-person differences.Interventions to reduce nonadherence should be informed by variability in the extent of nonadherence and specific reasons for nonadherence.

Authors
Voils, CI; King, HA; Neelon, B; Hoyle, RH; Reeve, BB; Maciejewski, ML; Yancy, WS
MLA Citation
Voils, CI, King, HA, Neelon, B, Hoyle, RH, Reeve, BB, Maciejewski, ML, and Yancy, WS. "Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions." Patient preference and adherence 8 (January 2014): 643-650.
PMID
24855340
Source
epmc
Published In
Patient Preference and Adherence
Volume
8
Publish Date
2014
Start Page
643
End Page
650
DOI
10.2147/ppa.s60715

Continuity of medication management and continuity of care: Conceptual and operational considerations.

Continuity of care is considered foundational to high-quality care. Traditional continuity of care constructs may adequately characterize care quality in general populations, but may merit reconceptualization for patients with multiple chronic conditions. Specifically, interactions between multiple chronic condition patients and providers involve complex medication management; therefore care continuity measurement may be more relevant if focused on the provider subset who prescribes essential medications for chronic conditions-a construct we call continuity of medication management. Our objective was to explore conceptual distinctions between continuity of medication management and continuity of care, survey existing evidence in this area, and discuss implications of our findings for future research and intervention development.In this topical review, we discuss conceptual distinctions between continuity of medication management and continuity of care, review the limited continuity of medication management-related empirical evidence, and discuss implications for future research and interventions.Continuity of medication management represents a potential conceptual and measurement advance by reflecting interpersonal continuity and management continuity, and may provide a means of identifying patients at high-risk of adverse events. Empirical evidence also establishes support for continuity of medication management as a meaningful measure of care continuity. Finally, continuity of medication management may also be a potential target for future intervention to improve care delivery among multiple chronic condition patients.If continuity of medication management is validated in diverse populations, correlated with patient outcomes, and responsive to change, then it may be an important target for improving the health and health care of multiple chronic condition patients.

Authors
Beadles, CA; Voils, CI; Crowley, MJ; Farley, JF; Maciejewski, ML
MLA Citation
Beadles, CA, Voils, CI, Crowley, MJ, Farley, JF, and Maciejewski, ML. "Continuity of medication management and continuity of care: Conceptual and operational considerations." SAGE open medicine 2 (January 2014): 2050312114559261-. (Review)
PMID
26770750
Source
epmc
Published In
SAGE Open Medicine
Volume
2
Publish Date
2014
Start Page
2050312114559261
DOI
10.1177/2050312114559261

Approaches for Informing Optimal Dose of Behavioral Interventions

© 2014, The Society of Behavioral Medicine (outside the USA).Purpose: The purpose of this study is to present approaches to inform intervention duration, frequency, and amount when (1) the investigator has no a priori expectation and is seeking a descriptive approach for identifying and narrowing the universe of dose values or (2) the investigator has an a priori expectation and is seeking validation of this expectation using an inferential approach.Background: There is little guidance about to how select dose parameter values when designing behavioral interventions.Methods: Strengths and weaknesses of various approaches are described and illustrated with examples.Results: Descriptive approaches include retrospective analysis of data from randomized trials, assessment of perceived optimal dose via prospective surveys or interviews of key stakeholders, and assessment of target patient behavior via prospective, longitudinal, observational studies. Inferential approaches include nonrandomized, early-phase trials and randomized designs.Conclusions: By utilizing these approaches, researchers may more efficiently apply resources to identify the optimal values of dose parameters for behavioral interventions.

Authors
Voils, CI; King, HA; Maciejewski, ML; Allen, KD; Yancy, WS; Shaffer, JA
MLA Citation
Voils, CI, King, HA, Maciejewski, ML, Allen, KD, Yancy, WS, and Shaffer, JA. "Approaches for Informing Optimal Dose of Behavioral Interventions." Annals of Behavioral Medicine 48.3 (2014): 392-401.
Source
scival
Published In
Annals of Behavioral Medicine
Volume
48
Issue
3
Publish Date
2014
Start Page
392
End Page
401
DOI
10.1007/s12160-014-9618-7

Correlates of daily leisure-time physical activity in a community sample: Narrow personality traits and practical barriers.

OBJECTIVE: Previous studies examining correlates of leisure time physical activity (LTPA) have identified personality factors that are correlated with LTPA and practical factors that impede LTPA. The purpose of the present study was to test how several narrow traits predict daily reports of LTPA and to test whether traits that predict LTPA moderate the effects of practical barriers. METHODS: 1192 participants completed baseline measures of personality, then reported their LTPA and several situational and environmental factors daily for 25 days. We used generalized estimating equations to measure how personality traits, practical barriers, and interactions between these factors affected (1) the odds of engaging in LTPA and (2) the duration of daily LTPA. RESULTS: Higher standing on Activity and Discipline and lower standing on Assertiveness predicted greater odds of engaging in LTPA and longer duration of LTPA, and higher standing on Aesthetics predicted shorter duration of LTPA. Poor weather conditions and less leisure time were associated with less LTPA, and effects of these barriers were generally greater among participants 30 and older. In participants older than 30, poor weather was associated with less LTPA among those with lower standing on Activity but was not associated with LTPA among those high in Activity. Despite Discipline's overall positive association with LTPA, less leisure time and less routineness were greater barriers for those high in Discipline. CONCLUSIONS: Assessing narrow personality traits could help target LTPA interventions to individual patients' needs and could help identify important new personality dynamics that affect LTPA.

Authors
Gallagher, P; Yancy, WS; Denissen, JJ; Kühnel, A; Voils, CI
MLA Citation
Gallagher, P, Yancy, WS, Denissen, JJ, Kühnel, A, and Voils, CI. "Correlates of daily leisure-time physical activity in a community sample: Narrow personality traits and practical barriers." Health Psychol 32.12 (December 2013): 1227-1235.
PMID
23025299
Source
pubmed
Published In
Health Psychology
Volume
32
Issue
12
Publish Date
2013
Start Page
1227
End Page
1235
DOI
10.1037/a0029956

HOW DO FAMILY DYNAMICS INFLUENCE LONG-TERM CARE INSURANCE (LTCI) PURCHASE DECISIONS?

Authors
Sperber, N; Voils, CI; Coe, NB; Konetzka, R; Boles, J; Van Houtven, CH
MLA Citation
Sperber, N, Voils, CI, Coe, NB, Konetzka, R, Boles, J, and Van Houtven, CH. "HOW DO FAMILY DYNAMICS INFLUENCE LONG-TERM CARE INSURANCE (LTCI) PURCHASE DECISIONS?." November 2013.
Source
wos-lite
Published In
The Gerontologist
Volume
53
Publish Date
2013
Start Page
555
End Page
555

Nonadherence to medications.

Authors
Voils, CI; Maciejewski, ML
MLA Citation
Voils, CI, and Maciejewski, ML. "Nonadherence to medications." JAMA 310.14 (October 9, 2013): 1505-. (Letter)
PMID
24104381
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
310
Issue
14
Publish Date
2013
Start Page
1505
DOI
10.1001/jama.2013.277302

Recruitment and retention rates in behavioral trials involving patients and a support person: a systematic review.

BACKGROUND: Recruitment and retention challenges impede the study of behavioral interventions among patient-support person dyads. PURPOSE: The aim of the study was to characterize recruitment and retention rates of behavioral interventions involving dyads. METHODS: Using PRISMA guidelines and with the guidance of a medical librarian, we searched Medline, EMBASE, Cochrane Controlled Trials, PsycInfo, and CINAHL from inception until July 2011. Eligible articles involved RCTs of behavioral interventions targeting adult patients with a non-psychiatric illness and a support person. Sample and study characteristics, recruitment and retention strategies, and recruitment and retention rates were abstracted in duplicate. Quality of reporting was determined on a 5-point scale. Due to the heterogeneity in data reporting and missing data, a narrative synthesis was undertaken. RESULTS: 53 unique studies involving 8081 dyads were included. 9 studies were ascertained to have a "high quality" of reporting. A majority of the studies did not report target sample size, time to complete recruitment, and sample sizes at each follow-up time point. Strategies employed to recruit support persons were rarely reported. 16 studies did not report the number of dyads screened. The mean recruitment rate was 51.2% (range: 4.3%-95.4%), and mean retention rate was 77.5% (range: 36%-100%). CONCLUSIONS: Details regarding recruitment and retention methodology were sparse in these interventions. Where available, data suggests that resources need to be devoted towards recruitment of sample but that retention rates are generally adequate.

Authors
Trivedi, RB; Szarka, JG; Beaver, K; Brousseau, K; Nevins, E; Yancy, WS; Slade, A; Voils, CI
MLA Citation
Trivedi, RB, Szarka, JG, Beaver, K, Brousseau, K, Nevins, E, Yancy, WS, Slade, A, and Voils, CI. "Recruitment and retention rates in behavioral trials involving patients and a support person: a systematic review." Contemp Clin Trials 36.1 (September 2013): 307-318. (Review)
PMID
23916918
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
36
Issue
1
Publish Date
2013
Start Page
307
End Page
318
DOI
10.1016/j.cct.2013.07.009

Spousal support in a behavior change intervention for cholesterol management.

OBJECTIVE: To evaluate spousal involvement in a nurse-led intervention for patients with high cholesterol in which patients set health goals and spouses learned support strategies. METHODS: Qualitative interviews were conducted with 29 patients and 26 spouses who received the intervention during a trial. Interviews were stratified by patient LDL-C change (better, same, worse). Coded text was content analyzed, and organized into thematic matrices, with columns indicating individuals (spouse or patient) and rows indicating dyads. RESULTS: Patients and spouses reported no drawbacks to spousal involvement; some patients whose LDL-C did not improve wanted more focus on spouse health. Spouses said that the nurse's expertise and interest were helpful and they were better able to communicate with patients about health. Although the program helped couples work together, spouses with better or same LDL-C talked more about functioning as a unit, whereas those whose partners had worse LDL-C talked more about functioning as individuals. CONCLUSION: Although the spousal role was accepted, there were variations in level of involvement. More active spousal involvement might relate to better patient outcomes. For less involved spouses, more focus on their health may improve commitment or involvement. PRACTICE IMPLICATIONS: These findings can inform ways to generate spousal support in future trials.

Authors
Sperber, NR; Sandelowski, M; Voils, CI
MLA Citation
Sperber, NR, Sandelowski, M, and Voils, CI. "Spousal support in a behavior change intervention for cholesterol management." Patient Educ Couns 92.1 (July 2013): 121-126.
PMID
23541217
Source
pubmed
Published In
Patient Education and Counseling
Volume
92
Issue
1
Publish Date
2013
Start Page
121
End Page
126
DOI
10.1016/j.pec.2013.02.015

Recruiting young adults into a weight loss trial: report of protocol development and recruitment results.

Obesity has spread to all segments of the U.S. population. Young adults, aged 18-35 years, are rarely represented in clinical weight loss trials. We conducted a qualitative study to identify factors that may facilitate recruitment of young adults into a weight loss intervention trial. Participants were 33 adults aged 18-35 years with BMI ≥25 kg/m(2). Six group discussions were conducted using the nominal group technique. Health, social image, and "self" factors such as emotions, self-esteem, and confidence were reported as reasons to pursue weight loss. Physical activity, dietary intake, social support, medical intervention, and taking control (e.g. being motivated) were perceived as the best weight loss strategies. Incentives, positive outcomes, education, convenience, and social support were endorsed as reasons young adults would consider participating in a weight loss study. Incentives, advertisement, emphasizing benefits, and convenience were endorsed as ways to recruit young adults. These results informed the Cellphone Intervention for You (CITY) marketing and advertising, including message framing and advertising avenues. Implications for recruitment methods are discussed.

Authors
Corsino, L; Lin, PH; Batch, BC; Intille, S; Grambow, SC; Bosworth, HB; Bennett, GG; Tyson, C; Svetkey, LP; Voils, CI
MLA Citation
Corsino, L, Lin, PH, Batch, BC, Intille, S, Grambow, SC, Bosworth, HB, Bennett, GG, Tyson, C, Svetkey, LP, and Voils, CI. "Recruiting young adults into a weight loss trial: report of protocol development and recruitment results." Contemp Clin Trials 35.2 (July 2013): 1-7.
Website
http://hdl.handle.net/10161/10735
PMID
23591327
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
35
Issue
2
Publish Date
2013
Start Page
1
End Page
7
DOI
10.1016/j.cct.2013.04.002

Clinical practice variation in the management of diminutive colorectal polyps: results of a national survey of gastroenterologists.

OBJECTIVES: We investigated physician beliefs and behaviors regarding diminutive colorectal polyps and the contribution of these beliefs to variable detection rates. METHODS: One hundred sixty-seven members of the American College of Gastroenterology took a Web-based survey. We compared respondents and nonrespondents using demographic and practice information from the American Medical Association Physician Masterfile. RESULTS: Respondents varied in their definition of diminutive polyps. Respondents acknowledged leaving diminutive polyps in place during colonoscopy in various scenarios. Years in practice, confidence in endoscopic histologic diagnosis, and never having seen advanced histology in a diminutive polyp were predictive of leaving polyps in place. The majority of respondents were at least somewhat agreeable to leaving diminutive polyps in place if guidelines endorsed this practice. CONCLUSIONS: Gastroenterologists vary in their removal of diminutive polyps. The results have implications for the interpretation and management of variable polyp detection rates.

Authors
Gellad, ZF; Voils, CI; Lin, L; Provenzale, D
MLA Citation
Gellad, ZF, Voils, CI, Lin, L, and Provenzale, D. "Clinical practice variation in the management of diminutive colorectal polyps: results of a national survey of gastroenterologists." Am J Gastroenterol 108.6 (June 2013): 873-878.
PMID
23735908
Source
pubmed
Published In
The American Journal of Gastroenterology (Elsevier)
Volume
108
Issue
6
Publish Date
2013
Start Page
873
End Page
878
DOI
10.1038/ajg.2012.316

Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice.

A variety of diet approaches achieve moderate weight loss in many individuals. Yet, most diet interventions fail to achieve meaningful weight loss in more than a few individuals, likely due to inadequate adherence to the diet. It is widely conjectured that targeting the diet to an individual's food preferences will enhance adherence, thereby improving weight loss. This article describes the design considerations of a study protocol aimed at testing this hypothesis. The study is a 2-arm randomized trial recruiting 216 medical outpatients with BMI ≥30 kg/m(2) followed for 48 weeks. Participants in the experimental arm (Choice) select from two of the most widely studied diets for weight loss, a low-carbohydrate, calorie-unrestricted diet (LCD) or a low-fat, reduced-calorie diet (LFD). The participant's choice is informed by results from a validated food preference questionnaire and a discussion of diet options with trained personnel. Choice participants are given the option to switch to the other diet after three months, if desired. Participants in the Control arm are randomly assigned to follow one of the two diets for the duration of follow-up. The primary outcome is weight assessed every 2-4 weeks for 48 weeks. Secondary outcomes include adherence to diet by food frequency questionnaire and obesity-specific health-related quality of life. If assisting patients to choose their diet enhances adherence and increases weight loss, the results will support the provision of diet options to patients who desire weight loss, and bring us one step closer to remediating the obesity epidemic faced by our healthcare systems.

Authors
Yancy, WS; Coffman, CJ; Geiselman, PJ; Kolotkin, RL; Almirall, D; Oddone, EZ; Mayer, SB; Gaillard, LA; Turner, M; Smith, VA; Voils, CI
MLA Citation
Yancy, WS, Coffman, CJ, Geiselman, PJ, Kolotkin, RL, Almirall, D, Oddone, EZ, Mayer, SB, Gaillard, LA, Turner, M, Smith, VA, and Voils, CI. "Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice." Contemp Clin Trials 35.1 (May 2013): 106-116.
PMID
23506974
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
35
Issue
1
Publish Date
2013
Start Page
106
End Page
116
DOI
10.1016/j.cct.2013.03.002

In response.

Authors
Voils, CI; Maciejewski, ML; Hoyle, RH; Reeve, BB; Gallagher, MP; Bryson, CL; Yancy, WS
MLA Citation
Voils, CI, Maciejewski, ML, Hoyle, RH, Reeve, BB, Gallagher, MP, Bryson, CL, and Yancy, WS. "In response." Med Care 51.5 (May 2013): 468-469. (Letter)
PMID
23552432
Source
pubmed
Published In
Medical Care
Volume
51
Issue
5
Publish Date
2013
Start Page
468
End Page
469
DOI
10.1097/MLR.0b013e31828fadbf

Uptake of Web-based clinical resources from the MacArthur Initiative on Depression and Primary Care.

This study assessed the usability and desired enhancements for the MacArthur Foundation's Depression and Primary Care (MDPC) Web site to determine if resources for integrated depression care that are disseminated through the Web site are incorporated into routine clinical care. Since its launch in 2003, more than 20,000 users registered as members of the MDPC website to read and download depression care resources. Subjects were randomly selected from MDPC Web site users who had previously downloaded the depression toolkit. Web-based survey, which was administered anonymously, included the following domains: (1) socio-demographic data, (2) confidence in managing depression (3) Web site content and design features, (4) desired enhancements to Web site and content, (5) use of resources downloaded from the Web site, and (6) importance of depression care resources. Of the 3,478 randomly selected participants, 666 (19.1%) responded. Web site content was rated "good" or "excellent" for screening and diagnosis (84.3%), treatment (69.8%), patient education (66.2%), and care management (66.9%). The Patient Health Questionnaire-9 (PHQ-9) was rated "very useful" by 68.3%; 47.1% reported using it in at least 25% of encounters with patients who are depressed. PHQ-9 use was significantly associated with higher self-confidence in managing depression (P = 0.05). Evidence-based resources for depression care can be disseminated effectively through a dedicated Web site and may help clinicians incorporate effective care models into routine practice.

Authors
Han, C; Voils, CI; Williams, JW
MLA Citation
Han, C, Voils, CI, and Williams, JW. "Uptake of Web-based clinical resources from the MacArthur Initiative on Depression and Primary Care." Community Ment Health J 49.2 (April 2013): 166-171.
PMID
22038376
Source
pubmed
Published In
Community Mental Health Journal
Volume
49
Issue
2
Publish Date
2013
Start Page
166
End Page
171
DOI
10.1007/s10597-011-9461-2

Determinants of a subject's decision to participate in clinical anesthesia research.

BACKGROUND: A top priority for research studies is to ensure that potential participants receive adequate information to make a truly informed decision. Understanding patient experiences with the recruitment process may identify areas for improvement in the consent process. We examined which factors were associated with the decision to consent in a clinical research study. METHODS: Patients scheduled for elective surgery were asked to complete a questionnaire about the consent process, immediately after being approached to participate in an anesthesia-related research study. Sociodemographic characteristics, preoperative levels of anxiety and depression, medical comorbidities, factors that may affect decision to participate in a research study, and study design features were collected. A multivariable logistic regression model was estimated to identify factors associated with providing consent. Performance of the prediction model was assessed using the receiver operating characteristic curve. Internal validity was assessed by a bootstrap analysis. RESULTS: In all, 282 participants completed the questionnaire. Of those, 179 (63%) had consented to participate in research, and 103 (37%) had declined to participate. In the multivariable logistic regression model, the odds of providing consent were higher for males (odds ratio [OR] [95% confidence interval]=2.49 [1.29-4.79]) and for patients with higher levels of patient comfort (OR=1.84 [1.22-2.78]). The odds of providing consent were lower for protocols that require additional testing (OR=0.15 [0.06-0.39]) and patients with higher levels of concern about blood sampling (OR=0.70 [0.54-0.90]) or worry about study risks (OR=0.72 [0.55-0.95]). Bootstrap analysis revealed a stable model with high internal validity. CONCLUSIONS: The 2 strongest predictors of consent were male gender and comfort; predictors of refusal were protocol type that requires additional testing, greater concern about blood sampling and study risks, and lower overall patient comfort with the study. These patient and study characteristics may inform modification of the consent process for clinical research studies and facilitate the development of more accurate enrollment projections and strategies.

Authors
Balajonda, N; Bisanar, TL; Mathew, JP; Pang, H; Voils, CI
MLA Citation
Balajonda, N, Bisanar, TL, Mathew, JP, Pang, H, and Voils, CI. "Determinants of a subject's decision to participate in clinical anesthesia research." Anesth Analg 116.2 (February 2013): 448-454.
PMID
23302987
Source
pubmed
Published In
Anesthesia and Analgesia
Volume
116
Issue
2
Publish Date
2013
Start Page
448
End Page
454
DOI
10.1213/ANE.0b013e318277dd7d

A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol.

OBJECTIVE: This randomized controlled trial evaluated the effectiveness of a telephone-delivered, spouse-assisted lifestyle intervention to reduce patient LDL-C. METHOD: From 2007 to 2010, 255 outpatients with LDL-C>76 mg/dL and their spouses from the Durham Veterans Affairs Medical Center were randomized to intervention or usual care. The intervention comprised nine monthly goal-setting telephone calls to patients and support planning calls to spouses. Outcomes were assessed at 11 months. RESULTS: Patients were 95% male and 65% White. LDL-C did not differ between groups (mean difference = 2.3 mg/dL, 95% CI = -3.6, 8.3, p = 0.44), nor did the odds of meeting goal LDL-C (OR = 0.95, 95% CI = 0.6, 1.7; p = 0.87). Intakes of calories (p = 0.03), total fat (p = 0.02), and saturated fat (p = 0.02) were lower for the intervention group. Cholesterol and fiber intake did not differ between groups (p = 0.11 and 0.26, respectively). The estimated rate of moderate intensity physical activity per week was 20% higher in the intervention group (IRR = 1.2, 95% CI = 1.0, 1.5, p = 0.06). Most participants did not experience a change in cholesterol medication usage during the study period in the intervention (71.7%) and usual care (78.9%) groups. CONCLUSION: This intervention might be an adjunct to usual primary care to improve adherence to lifestyle behaviors.

Authors
Voils, CI; Coffman, CJ; Yancy, WS; Weinberger, M; Jeffreys, AS; Datta, S; Kovac, S; McKenzie, J; Smith, R; Bosworth, HB
MLA Citation
Voils, CI, Coffman, CJ, Yancy, WS, Weinberger, M, Jeffreys, AS, Datta, S, Kovac, S, McKenzie, J, Smith, R, and Bosworth, HB. "A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol." Prev Med 56.1 (January 2013): 46-52.
PMID
23146744
Source
pubmed
Published In
Preventive Medicine
Volume
56
Issue
1
Publish Date
2013
Start Page
46
End Page
52
DOI
10.1016/j.ypmed.2012.11.001

Patient self-efficacy and spouse perception of spousal support are associated with lower patient weight: baseline results from a spousal support behavioral intervention.

Obesity and related chronic illnesses are leading causes of death and excessive health care costs, necessitating identification of factors that can help patients achieve and maintain healthy weight. Greater self-efficacy and perceived spousal support in patients have been associated with successful weight management. The current study also assesses self-efficacy and perceived support in spouses and whether these factors are related to patient weight. At baseline of a spousal support trial, patients and spouses (N = 255 couples) each completed measures of self-efficacy and spousal support for their own exercise and healthy eating behaviors. We fit a multivariable regression model to examine the relationship between these factors and patient weight. Patients were 95% males and 65% Whites, with average age of 61 years (SD = 12) and weight of 212 lbs (SD = 42). Spouses were 64% Whites, with average age of 59 years (SD = 12). Factors associated with lower patient weight were older patient age (estimate = -0.8 lbs, p < .01), normal blood pressure (estimate = -17.6 lbs, p < .01), higher patient self-efficacy for eating healthy (estimate = -3.8 lbs, p = .02), and spouse greater perceived support for eating healthy (estimate = -10.0 lbs, p = .03). Future research should explore the causal pathways between perceived support and health outcomes to establish whether patient support behaviors could be a point of intervention for weight management.

Authors
Gallagher, P; Yancy, WS; Jeffreys, AS; Coffman, CJ; Weinberger, M; Bosworth, HB; Voils, CI
MLA Citation
Gallagher, P, Yancy, WS, Jeffreys, AS, Coffman, CJ, Weinberger, M, Bosworth, HB, and Voils, CI. "Patient self-efficacy and spouse perception of spousal support are associated with lower patient weight: baseline results from a spousal support behavioral intervention." Psychol Health Med 18.2 (2013): 175-181.
PMID
22963235
Source
pubmed
Published In
Psychology, Health & Medicine
Volume
18
Issue
2
Publish Date
2013
Start Page
175
End Page
181
DOI
10.1080/13548506.2012.715176

A randomized controlled trial to evaluate the effectiveness of CouPLES: A spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol

Objective: This randomized controlled trial evaluated the effectiveness of a telephone-delivered, spouse-assisted lifestyle intervention to reduce patient LDL-C. Method: From 2007 to 2010, 255 outpatients with LDL-C>76. mg/dL and their spouses from the Durham Veterans Affairs Medical Center were randomized to intervention or usual care. The intervention comprised nine monthly goal-setting telephone calls to patients and support planning calls to spouses. Outcomes were assessed at 11. months. Results: Patients were 95% male and 65% White. LDL-C did not differ between groups (mean difference=2.3 mg/dL, 95% CI=-3.6, 8.3, p=0.44), nor did the odds of meeting goal LDL-C (OR=0.95, 95% CI=0.6, 1.7; p=0.87). Intakes of calories (p=0.03), total fat (p=0.02), and saturated fat (p=0.02) were lower for the intervention group. Cholesterol and fiber intake did not differ between groups (p=0.11 and 0.26, respectively). The estimated rate of moderate intensity physical activity per week was 20% higher in the intervention group (IRR=1.2, 95% CI=1.0, 1.5, p=0.06). Most participants did not experience a change in cholesterol medication usage during the study period in the intervention (71.7%) and usual care (78.9%) groups. Conclusion: This intervention might be an adjunct to usual primary care to improve adherence to lifestyle behaviors. © 2012.

Authors
Voils, CI; Coffman, CJ; Yancy, WS; Weinberger, M; Jeffreys, AS; Datta, S; Kovac, S; McKenzie, J; Smith, R; Bosworth, HB
MLA Citation
Voils, CI, Coffman, CJ, Yancy, WS, Weinberger, M, Jeffreys, AS, Datta, S, Kovac, S, McKenzie, J, Smith, R, and Bosworth, HB. "A randomized controlled trial to evaluate the effectiveness of CouPLES: A spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol." Preventive Medicine 56.1 (2013): 46-52.
Source
scival
Published In
Preventive Medicine
Volume
56
Issue
1
Publish Date
2013
Start Page
46
End Page
52
DOI
10.1016/j.ypmed.2012.11.001

Determinants of a subject's decision to participate in clinical anesthesia research

BACKGROUND: A top priority for research studies is to ensure that potential participants receive adequate information to make a truly informed decision. Understanding patient experiences with the recruitment process may identify areas for improvement in the consent process. We examined which factors were associated with the decision to consent in a clinical research study. METHODS:: Patients scheduled for elective surgery were asked to complete a questionnaire about the consent process, immediately after being approached to participate in an anesthesia-related research study. Sociodemographic characteristics, preoperative levels of anxiety and depression, medical comorbidities, factors that may affect decision to participate in a research study, and study design features were collected. A multivariable logistic regression model was estimated to identify factors associated with providing consent. Performance of the prediction model was assessed using the receiver operating characteristic curve. Internal validity was assessed by a bootstrap analysis. RESULTS:: In all, 282 participants completed the questionnaire. Of those, 179 (63%) had consented to participate in research, and 103 (37%) had declined to participate. In the multivariable logistic regression model, the odds of providing consent were higher for males (odds ratio [OR] [95% confidence interval] = 2.49 [1.29-4.79]) and for patients with higher levels of patient comfort (OR = 1.84 [1.22-2.78]). The odds of providing consent were lower for protocols that require additional testing (OR = 0.15 [0.06-0.39]) and patients with higher levels of concern about blood sampling (OR = 0.70 [0.54-0.90]) or worry about study risks (OR = 0.72 [0.55-0.95]). Bootstrap analysis revealed a stable model with high internal validity. CONCLUSIONS:: The 2 strongest predictors of consent were male gender and comfort; predictors of refusal were protocol type that requires additional testing, greater concern about blood sampling and study risks, and lower overall patient comfort with the study. These patient and study characteristics may inform modification of the consent process for clinical research studies and facilitate the development of more accurate enrollment projections and strategies. Copyright © 2013 International Anesthesia Research Society.

Authors
Balajonda, N; Bisanar, TL; Mathew, JP; Pang, H; Voils, CI
MLA Citation
Balajonda, N, Bisanar, TL, Mathew, JP, Pang, H, and Voils, CI. "Determinants of a subject's decision to participate in clinical anesthesia research." Anesthesia and Analgesia 116.2 (2013): 448-454.
Source
scival
Published In
Anesthesia and Analgesia
Volume
116
Issue
2
Publish Date
2013
Start Page
448
End Page
454
DOI
10.1213/ANE.0b013e318277dd7d

In response

Authors
Voils, CI; MacIejewski, ML; Hoyle, RH; Reeve, BB; Gallagher, MP; Bryson, CL; Yancy, WS
MLA Citation
Voils, CI, MacIejewski, ML, Hoyle, RH, Reeve, BB, Gallagher, MP, Bryson, CL, and Yancy, WS. "In response." Medical Care 51.5 (2013): 468-469.
Source
scival
Published In
Medical Care
Volume
51
Issue
5
Publish Date
2013
Start Page
468
End Page
469
DOI
10.1097/MLR.0b013e31828fadbf

Uptake of web-based clinical resources from the macarthur initiative on depression and primary care

This study assessed the usability and desired enhancements for the MacArthur Foundation's Depression and Primary Care (MDPC) Web site to determine if resources for integrated depression care that are disseminated through the Web site are incorporated into routine clinical care. Since its launch in 2003, more than 20,000 users registered as members of the MDPC website to read and download depression care resources. Subjects were randomly selected from MDPC Web site users who had previously downloaded the depression toolkit. Web-based survey, which was administered anonymously, included the following domains: (1) socio-demographic data, (2) confidence in managing depression (3) Web site content and design features, (4) desired enhancements to Web site and content, (5) use of resources downloaded from the Web site, and (6) importance of depression care resources. Of the 3,478 randomly selected participants, 666 (19.1%) responded. Web site content was rated "good" or "excellent" for screening and diagnosis (84.3%), treatment (69.8%), patient education (66.2%), and care management (66.9%). The Patient Health Questionnaire-9 (PHQ-9) was rated "very useful" by 68.3%; 47.1% reported using it in at least 25% of encounters with patients who are depressed. PHQ-9 use was significantly associated with higher self-confidence in managing depression (P = 0.05). Evidence-based resources for depression care can be disseminated effectively through a dedicated Web site and may help clinicians incorporate effective care models into routine practice. © 2013 Springer Science+Business Media, LLC (Outside the USA).

Authors
Han, C; Voils, CI; Jr, JWW
MLA Citation
Han, C, Voils, CI, and Jr, JWW. "Uptake of web-based clinical resources from the macarthur initiative on depression and primary care." Community Mental Health Journal 49.2 (2013): 166-171.
Source
scival
Published In
Community Mental Health Journal
Volume
49
Issue
2
Publish Date
2013
Start Page
166
End Page
171
DOI
10.1007/s10597-011-9461-2

Spousal support in a behavior change intervention for cholesterol management

Objective: To evaluate spousal involvement in a nurse-led intervention for patients with high cholesterol in which patients set health goals and spouses learned support strategies. Methods: Qualitative interviews were conducted with 29 patients and 26 spouses who received the intervention during a trial. Interviews were stratified by patient LDL-C change (better, same, worse). Coded text was content analyzed, and organized into thematic matrices, with columns indicating individuals (spouse or patient) and rows indicating dyads. Results: Patients and spouses reported no drawbacks to spousal involvement; some patients whose LDL-C did not improve wanted more focus on spouse health. Spouses said that the nurse's expertise and interest were helpful and they were better able to communicate with patients about health. Although the program helped couples work together, spouses with better or same LDL-C talked more about functioning as a unit, whereas those whose partners had worse LDL-C talked more about functioning as individuals. Conclusion: Although the spousal role was accepted, there were variations in level of involvement. More active spousal involvement might relate to better patient outcomes. For less involved spouses, more focus on their health may improve commitment or involvement. Practice implications: These findings can inform ways to generate spousal support in future trials. © 2013 .

Authors
Sperber, NR; Sandelowski, M; Voils, CI
MLA Citation
Sperber, NR, Sandelowski, M, and Voils, CI. "Spousal support in a behavior change intervention for cholesterol management." Patient Education and Counseling 92.1 (2013): 121-126.
Source
scival
Published In
Patient Education and Counseling
Volume
92
Issue
1
Publish Date
2013
Start Page
121
End Page
126
DOI
10.1016/j.pec.2013.02.015

Clinical utility of genetic risk testing in primary care: The example of Type 2 diabetes

Genetic advances in Type 2 diabetes (T2D) have led to the discovery and validation of multiple markers for this complex disease. Despite low predictive value of current T2D markers beyond clinical risk factors and family history, researchers are exploring the clinical utility and outcomes of implementation in practice, and testing is available via direct-to-consumer markets. Clinical utility research demonstrates high hypothetical utility to patients for motivating behavior change and potentially reducing risk. However, trials to date have not demonstrated improvements in behavioral and clinical outcomes over and above counseling based on traditional risk factors. Ongoing research in T2D genetics and associated risk-prediction models is necessary to refine genetic risk pathways, algorithms for risk prediction and use of this information in clinical care. Further research is also needed to explore care models and support interventions that address the needs of personalized risk information and sustainable preventive behaviors to reduce the rising prevalence of T2D. © 2013 Future Medicine Ltd.

Authors
Vorderstrasse, AA; Cho, A; Voils, CI; Orlando, LA; Ginsburg, GS
MLA Citation
Vorderstrasse, AA, Cho, A, Voils, CI, Orlando, LA, and Ginsburg, GS. "Clinical utility of genetic risk testing in primary care: The example of Type 2 diabetes." Personalized Medicine 10.6 (2013): 549-563.
Source
scival
Published In
Personalized medicine
Volume
10
Issue
6
Publish Date
2013
Start Page
549
End Page
563
DOI
10.2217/pme.13.47

Initial validation of a self-report measure of the extent of and reasons for medication nonadherence.

BACKGROUND: Self-report measures of medication nonadherence confound the extent of and reasons for medication nonadherence. Each construct is assessed with a different type of psychometric model, which dictates how to establish reliability and validity. OBJECTIVES: To evaluate the psychometric properties of a self-report measure of medication nonadherence that assesses separately the extent of nonadherence and reasons for nonadherence. RESEARCH DESIGN: Cross-sectional survey involving the new measure and comparison measures to establish convergent, discriminant, and predictive validity. The new measure was readministered 2-21 days later. SUBJECTS: A total of 202 veterans with treated hypertension were recruited from the Durham Veterans Affairs Medical Center. MEASURES: A new self-report measure assessed the extent of nonadherence and reasons for nonadherence. Comparison measures included self-reported medication self-efficacy, beliefs about medications, impression management, conscientiousness, habit strength, and an existing nonadherence measure. RESULTS: Three items assessing the extent of nonadherence produced reliable scores for this sample, α = 0.84 (95% confidence interval, 0.80-0.87). Correlations with comparison measures provided evidence of convergent and discriminant validity. Correlations with systolic ( r = 0.27, P < 0.0001) and diastolic (r = 0.27, P < 0.0001) blood pressure provided evidence of predictive validity. Reasons for nonadherence were assessed with 21 independent items. Intraclass correlations were 0.58 for the extent score and ranged from 0.07 to 0.64 for the reasons. CONCLUSIONS: The dual conceptualization of medication nonadherence allowed a stronger evaluation of the reliability and validity than was previously possible with measures that confounded these 2 constructs. Measurement of self-reported nonadherence consistent with psychometric principles will enable reliable, valid evaluation of interventions to reduce nonadherence.

Authors
Voils, CI; Maciejewski, ML; Hoyle, RH; Reeve, BB; Gallagher, P; Bryson, CL; Yancy, WS
MLA Citation
Voils, CI, Maciejewski, ML, Hoyle, RH, Reeve, BB, Gallagher, P, Bryson, CL, and Yancy, WS. "Initial validation of a self-report measure of the extent of and reasons for medication nonadherence." Med Care 50.12 (December 2012): 1013-1019.
PMID
22922431
Source
pubmed
Published In
Medical Care
Volume
50
Issue
12
Publish Date
2012
Start Page
1013
End Page
1019
DOI
10.1097/MLR.0b013e318269e121

Informing the dosing of interventions in randomized trials.

Dosing is potentially the most important decision that must be made when building or refining behavioral interventions. In this paper, we propose standardized terminology and reporting of dosing information, which would inform intervention development, refinement for dissemination, and systematic reviews of dose-response relationships. Dosing of interventions may be characterized by duration, frequency, and amount. To illustrate the value of operationalizing these three parameters to evaluate dose-response relationships, 31 published reports of behavioral interventions to increase adherence to antiretroviral therapy (ART) were reviewed. The ART literature was characterized by under-reporting of dosing parameters, heterogeneity in dosing schedules, and heterogeneity in type of control group, which complicate analysis of dose-response relationships in systematic review and determination of the optimal dose for intervention dissemination. Improved reporting of the three dosing parameters and comparison of intended to actual delivery can inform the identification of the most effective intervention doses and the efficient implementation of efficacious interventions in clinical practice.

Authors
Voils, CI; Chang, Y; Crandell, J; Leeman, J; Sandelowski, M; Maciejewski, ML
MLA Citation
Voils, CI, Chang, Y, Crandell, J, Leeman, J, Sandelowski, M, and Maciejewski, ML. "Informing the dosing of interventions in randomized trials." Contemp Clin Trials 33.6 (November 2012): 1225-1230. (Review)
PMID
22841930
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
33
Issue
6
Publish Date
2012
Start Page
1225
End Page
1230
DOI
10.1016/j.cct.2012.07.011

Mapping the Mixed Methods-Mixed Research Synthesis Terrain.

Mixed methods-mixed research synthesis is a form of systematic review in which the findings of qualitative and quantitative studies are integrated via qualitative and/or quantitative methods. Although methodological advances have been made, efforts to differentiate research synthesis methods have been too focused on methods and not focused enough on the defining logics of research synthesis-each of which may be operationalized in different ways-or on the research findings themselves that are targeted for synthesis. The conduct of mixed methods-mixed research synthesis studies may more usefully be understood in terms of the logics of aggregation and configuration. Neither logic is preferable to the other nor tied exclusively to any one method or to any one side of the qualitative/quantitative binary.

Authors
Sandelowski, M; Voils, CI; Leeman, J; Crandell, JL
MLA Citation
Sandelowski, M, Voils, CI, Leeman, J, and Crandell, JL. "Mapping the Mixed Methods-Mixed Research Synthesis Terrain." J Mix Methods Res 6.4 (October 2012): 317-331.
PMID
23066379
Source
pubmed
Published In
Journal of Mixed Methods Research
Volume
6
Issue
4
Publish Date
2012
Start Page
317
End Page
331
DOI
10.1177/1558689811427913

Age and sex differences in prospective effects of health goals and motivations on daily leisure-time physical activity.

OBJECTIVE: To examine relationships between health goals, types of motivation for those goals, and daily leisure-time physical activity (LTPA), and whether these relationships differ by age or sex. METHODS: From 2005 to 2008, 710 participants in and around Berlin, Germany provided life goals and motivational attributes of those goals at baseline, then reported LTPA daily for 25 days. RESULTS: Having (vs. not having) a goal of physical health predicted higher odds of engaging in LTPA for younger but not older participants (under age 30; OR=1.26, p=0.048), and was not related to duration of LTPA episodes. Effect of intrinsic motivation for the health goal differed by sex: for females, higher intrinsic motivation predicted higher odds of LTPA (OR=1.19, p=0.001), but was not related to duration. For males, higher intrinsic motivation predicted lower LTPA odds marginally (OR=0.70, p=0.054) but predicted longer duration (estimate=18.27 min, p<0.001). More approach motivation for the health goal predicted longer duration of LTPA episodes (0.67 min, p=0.022). CONCLUSIONS: One size does not fit all in LTPA intervention design. Future research should identify the mechanisms by which health goals and motivations affect health behavior.

Authors
Gallagher, P; Yancy, WS; Swartout, K; Denissen, JJ; Kühnel, A; Voils, CI
MLA Citation
Gallagher, P, Yancy, WS, Swartout, K, Denissen, JJ, Kühnel, A, and Voils, CI. "Age and sex differences in prospective effects of health goals and motivations on daily leisure-time physical activity." Prev Med 55.4 (October 2012): 322-324.
PMID
22846505
Source
pubmed
Published In
Preventive Medicine
Volume
55
Issue
4
Publish Date
2012
Start Page
322
End Page
324
DOI
10.1016/j.ypmed.2012.07.017

Understanding gastroenterologist adherence to polyp surveillance guidelines.

Authors
Shah, TU; Voils, CI; McNeil, R; Wu, R; Fisher, DA
MLA Citation
Shah, TU, Voils, CI, McNeil, R, Wu, R, and Fisher, DA. "Understanding gastroenterologist adherence to polyp surveillance guidelines." Am J Gastroenterol 107.9 (September 2012): 1283-1287.
PMID
22951869
Source
pubmed
Published In
The American Journal of Gastroenterology (Elsevier)
Volume
107
Issue
9
Publish Date
2012
Start Page
1283
End Page
1287
DOI
10.1038/ajg.2012.59

Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial.

BACKGROUND: We describe the study design, procedures, and development of the risk counseling protocol used in a randomized controlled trial to evaluate the impact of genetic testing for diabetes mellitus (DM) on psychological, health behavior, and clinical outcomes. METHODS/DESIGN: Eligible patients are aged 21 to 65 years with body mass index (BMI) ≥27 kg/m(2) and no prior diagnosis of DM. At baseline, conventional DM risk factors are assessed, and blood is drawn for possible genetic testing. Participants are randomized to receive conventional risk counseling for DM with eye disease counseling or with genetic test results. The counseling protocol was pilot tested to identify an acceptable graphical format for conveying risk estimates and match the length of the eye disease to genetic counseling. Risk estimates are presented with a vertical bar graph denoting risk level with colors and descriptors. After receiving either genetic counseling regarding risk for DM or control counseling on eye disease, brief lifestyle counseling for prevention of DM is provided to all participants. DISCUSSION: A standardized risk counseling protocol is being used in a randomized trial of 600 participants. Results of this trial will inform policy about whether risk counseling should include genetic counseling. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01060540.

Authors
Voils, CI; Coffman, CJ; Edelman, D; Maciejewski, ML; Grubber, JM; Sadeghpour, A; Cho, A; McKenzie, J; Blanpain, F; Scheuner, M; Sandelowski, M; Gallagher, MP; Ginsburg, GS; Yancy, WS
MLA Citation
Voils, CI, Coffman, CJ, Edelman, D, Maciejewski, ML, Grubber, JM, Sadeghpour, A, Cho, A, McKenzie, J, Blanpain, F, Scheuner, M, Sandelowski, M, Gallagher, MP, Ginsburg, GS, and Yancy, WS. "Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial. (Published online)" Trials 13 (August 1, 2012): 121-.
PMID
22852560
Source
pubmed
Published In
Trials
Volume
13
Publish Date
2012
Start Page
121
DOI
10.1186/1745-6215-13-121

DEVELOPING A THEORETICALLY INFORMED MEASURE TO DETECT AND ADDRESS SELF-REPORTED MEDICATION NONADHERENCE

Authors
Voils, CI; Maciejewski, M; Hoyle, R; Reeve, B; Gallagher, P; Yancy, W
MLA Citation
Voils, CI, Maciejewski, M, Hoyle, R, Reeve, B, Gallagher, P, and Yancy, W. "DEVELOPING A THEORETICALLY INFORMED MEASURE TO DETECT AND ADDRESS SELF-REPORTED MEDICATION NONADHERENCE." ANNALS OF BEHAVIORAL MEDICINE 43 (April 2012): S178-S178.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
43
Publish Date
2012
Start Page
S178
End Page
S178

CORRELATES OF LEISURE TIME PHYSICAL ACTIVITY IN A ONE-MONTH DAILY DIARY STUDY: PRACTICAL BARRIERS AND NARROW PERSONALITY TRAITS

Authors
Gallagher, P; Yancy, WS; Denissen, JJ; Kuehnel, A; Voils, CI
MLA Citation
Gallagher, P, Yancy, WS, Denissen, JJ, Kuehnel, A, and Voils, CI. "CORRELATES OF LEISURE TIME PHYSICAL ACTIVITY IN A ONE-MONTH DAILY DIARY STUDY: PRACTICAL BARRIERS AND NARROW PERSONALITY TRAITS." ANNALS OF BEHAVIORAL MEDICINE 43 (April 2012): S122-S122.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
43
Publish Date
2012
Start Page
S122
End Page
S122

Bayesian Approaches to the Synthesis of Qualitative and Quantitative Research Findings

The Bayesian statistical framework naturally combines information from different sources, making it especially applicable to mixed research synthesis. We illustrate three different Bayesian approaches to the synthesis of qualitative and quantitative research findings to address the research question "Which factors are associated with HIV antiretroviral medication adherence?" Although all three approaches were designed to incorporate information from both types of studies, they use this information in different ways. The assumptions, advantages, and disadvantages of each approach are discussed. © 2012 John Wiley & Sons, Ltd..

Authors
Crandell, JL; Voils, CI; Sandelowski, M
MLA Citation
Crandell, JL, Voils, CI, and Sandelowski, M. "Bayesian Approaches to the Synthesis of Qualitative and Quantitative Research Findings." (February 16, 2012): 137-159. (Chapter)
Source
scopus
Publish Date
2012
Start Page
137
End Page
159
DOI
10.1002/9781119959847.ch7

An organizing framework for informal caregiver interventions: detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts.

BACKGROUND: Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected by an intervention. In so doing, we characterize what has been measured in the published literature to date and what should be measured in future studies to enable comparisons across interventions and across time. METHODS: Our data set comprises 121 reports of caregiver interventions conducted in the United States and published between 2000 and 2009. We extracted information on variables that have been examined as primary and secondary outcomes. These variables were grouped into categories, which then informed the organizing framework. We calculated the frequency with which the interventions examined each framework component to identify areas about which we have the most knowledge and under-studied areas that deserve attention in future research. RESULTS: The framework stipulates that caregiver interventions seek to change caregiving activities, which in turn affect caregiver and care recipient outcomes. The most frequently assessed variables have been caregiver psychological outcomes (especially depression and burden) and care recipient physical and health care use outcomes. CONCLUSIONS: Based on the organizing framework, we make three key recommendations to guide interventions and inform research and policy. First, all intervention studies should assess quality and/or quantity of caregiving activities to help understand to what extent and how well the intervention worked. Second, intervention studies should assess a broad range of caregiver and care recipient outcomes, including considering whether expanding to economic status and health care use of the caregiver can be accommodated, to ease subsequent economic evaluations of caregiving. Third, intervention studies should measure a common set of outcomes to facilitate cross-time and cross-study comparisons of effectiveness.

Authors
Van Houtven, CH; Voils, CI; Weinberger, M
MLA Citation
Van Houtven, CH, Voils, CI, and Weinberger, M. "An organizing framework for informal caregiver interventions: detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts. (Published online)" BMC Geriatr 11 (November 22, 2011): 77-. (Review)
PMID
22107600
Source
pubmed
Published In
BMC Geriatrics
Volume
11
Publish Date
2011
Start Page
77
DOI
10.1186/1471-2318-11-77

A mixed-methods approach to synthesizing evidence on mediators of intervention effects.

Greater understanding of the mechanisms (mediators) by which behavioral-change interventions work is critical to developing theory and refining interventions. Although systematic reviews have been advocated as a method for exploring mediators, this is rarely done. One challenge is that intervention researchers typically test only two paths of the mediational model: the effect of the intervention on mediators and on outcomes. The authors addressed this challenge by drawing information not only from intervention studies but also from observational studies that provide data on associations between potential mediators and outcomes. They also reviewed qualitative studies of participants' perceptions of why and how interventions worked. Using data from intervention (n = 37) and quantitative observational studies (n = 55), the authors conducted a meta-analysis of the mediation effects of eight variables. Qualitative findings (n = 6) contributed to more in-depth explanations for findings. The methods used have potential to contribute to understanding of core mechanisms of behavioral-change interventions.

Authors
Leeman, J; Chang, Y; Voils, CI; Crandell, JL; Sandelowski, M
MLA Citation
Leeman, J, Chang, Y, Voils, CI, Crandell, JL, and Sandelowski, M. "A mixed-methods approach to synthesizing evidence on mediators of intervention effects." West J Nurs Res 33.7 (November 2011): 870-900. (Review)
PMID
21415244
Source
pubmed
Published In
Western Journal of Nursing Research
Volume
33
Issue
7
Publish Date
2011
Start Page
870
End Page
900
DOI
10.1177/0193945911402365

Continuity of antipsychotic medication management for Medicaid patients with schizophrenia.

OBJECTIVE: The purpose of this study was to examine whether medication refill behavior varies by the number of prescribers of antipsychotic medication a patient has. METHODS: A total of 7,868 patients with schizophrenia were identified from North Carolina Medicaid records for the period 2001-2003. Medication switching and adherence outcomes in 2003 were constructed from Medicaid pharmacy claims. Adherence was categorized into four levels (nonadherence, partial adherence, full adherence, or excess filler). Patients were stratified into four groups on the basis of the number of providers who prescribed antipsychotics in 2002 (one prescriber, two prescribers, three prescribers, or four or more prescribers). Medication switching was modeled via logistic regression, and the four-level adherence outcome was modeled via ordered logistic regression, with both regressions controlling for the number of prescribers, age, gender, race, and comorbidity. Medication switching in 2003 was also controlled for in the adherence regression. Predicted probabilities of being in the four adherence groups were estimated to examine the impact of the number of prescribers on adherence. RESULTS: Fifty-seven percent of Medicaid patients with schizophrenia had one prescriber for antipsychotic medication, 29% had two prescribers, 10% had three prescribers, and 4% had four or more prescribers in 2002. Patients with more prescribers were significantly more likely than patients with one prescriber to switch medications (p<.01 for patients with three prescribers) and to be either fully adherent or excess fillers (p<.001). CONCLUSIONS: Patients with schizophrenia who received medication from multiple prescribers frequently changed medications and filled prescriptions too soon. Care coordination, such as with medical homes, may be effective in improving medication use in this vulnerable population.

Authors
Farley, JF; Wang, CC; Hansen, RA; Voils, CI; Maciejewski, ML
MLA Citation
Farley, JF, Wang, CC, Hansen, RA, Voils, CI, and Maciejewski, ML. "Continuity of antipsychotic medication management for Medicaid patients with schizophrenia." Psychiatr Serv 62.7 (July 2011): 747-752.
PMID
21724787
Source
pubmed
Published In
Psychiatric Services
Volume
62
Issue
7
Publish Date
2011
Start Page
747
End Page
752
DOI
10.1176/ps.62.7.pss6207_0747

The trials and tribulations of enrolling couples in a randomized, controlled trial: a self-management program for hyperlipidemia as a model.

OBJECTIVE: Capitalizing on spousal support may enhance the effectiveness of interventions for chronic disease management. However, couples-based interventions present logistical challenges. We describe our experience and lessons learned while recruiting couples into the Couples Partnering for Lipid-Enhancing Strategies (CouPLES) trial. METHODS: This trial seeks to reduce serum low-density lipoprotein cholesterol levels using a couples-based intervention designed to help patients engage in self-management behaviors. We proposed enrolling 250 couples over 13 months. RESULTS: Due to practical challenges that we encountered, recruitment and enrollment lasted 21 months. Those challenges included: travel to study site; effectively marketing the study; participant burden; and establishing eligibility criteria. By modifying our protocol to address these challenges, the recruitment rate increased from 12 to 33%. CONCLUSION: In the absence of trials identifying the most effective recruitment strategies, investigators may need to experiment, amending their protocol intermittently until target enrollment numbers are reached. The lessons we present may help researchers conducting couples-based interventions develop more effective protocols. PRACTICE IMPLICATIONS: To achieve target enrollment numbers, researchers conducting couples-based interventions should consider minimizing travel to the study site; carefully crafting recruitment materials; budgeting more for participant incentives and staff effort; and limiting exclusion criteria. These practices may also enhance retention.

Authors
Voils, CI; Yancy, WS; Weinberger, M; Bolton, J; Coffman, CJ; Jeffreys, A; Oddone, EZ; Bosworth, HB
MLA Citation
Voils, CI, Yancy, WS, Weinberger, M, Bolton, J, Coffman, CJ, Jeffreys, A, Oddone, EZ, and Bosworth, HB. "The trials and tribulations of enrolling couples in a randomized, controlled trial: a self-management program for hyperlipidemia as a model." Patient Educ Couns 84.1 (July 2011): 33-40.
PMID
20599337
Source
pubmed
Published In
Patient Education and Counseling
Volume
84
Issue
1
Publish Date
2011
Start Page
33
End Page
40
DOI
10.1016/j.pec.2010.06.005

Combining adjusted and unadjusted findings in mixed research synthesis.

RATIONALE, AIMS AND OBJECTIVES: Finding ways to incorporate disparate types of evidence into research syntheses has the potential to build a better evidence base for clinical practice and policy. Yet conducting such mixed research synthesis studies is challenging. Researchers have to determine whether and how to use adjusted and unadjusted quantitative findings in combination with each other and with qualitative findings. METHODS: Among quantitative findings, adjustment for confounding, either via study design or statistical analysis, can be a considerable source of heterogeneity. Yet there is no consensus about the best way to synthesize findings resulting from different methods for addressing confounding. When synthesizing qualitative and quantitative findings, additional considerations include determining whether findings are amenable to synthesis by aggregation or configuration, which, in turn, depends on the degree of interpretive transformation of findings. RESULTS: Qualitative survey findings appear similar in form to unadjusted or minimally adjusted quantitative findings and, when addressing the same relationship, can be summed. More interpreted qualitative findings appear similar in form to adjusted findings found in, for example, structural equation models specifying the relationship among a host of latent variables. An option for synthesis of conceptually similar models is reciprocal translation. CONCLUSIONS: These decisions will ultimately be judged on the meaningfulness of their results to practice or policy.

Authors
Voils, CI; Crandell, JL; Chang, Y; Leeman, J; Sandelowski, M
MLA Citation
Voils, CI, Crandell, JL, Chang, Y, Leeman, J, and Sandelowski, M. "Combining adjusted and unadjusted findings in mixed research synthesis." J Eval Clin Pract 17.3 (June 2011): 429-434.
PMID
21040243
Source
pubmed
Published In
Journal of Evaluation in Clinical Practice
Volume
17
Issue
3
Publish Date
2011
Start Page
429
End Page
434
DOI
10.1111/j.1365-2753.2010.01444.x

Bayesian data augmentation methods for the synthesis of qualitative and quantitative research findings.

The possible utility of Bayesian methods for the synthesis of qualitative and quantitative research has been repeatedly suggested but insufficiently investigated. In this project, we developed and used a Bayesian method for synthesis, with the goal of identifying factors that influence adherence to HIV medication regimens. We investigated the effect of 10 factors on adherence. Recognizing that not all factors were examined in all studies, we considered standard methods for dealing with missing data and chose a Bayesian data augmentation method. We were able to summarize, rank, and compare the effects of each of the 10 factors on medication adherence. This is a promising methodological development in the synthesis of qualitative and quantitative research.

Authors
Crandell, JL; Voils, CI; Chang, Y; Sandelowski, M
MLA Citation
Crandell, JL, Voils, CI, Chang, Y, and Sandelowski, M. "Bayesian data augmentation methods for the synthesis of qualitative and quantitative research findings." Qual Quant 45.3 (April 2011): 653-669.
PMID
21572970
Source
pubmed
Published In
Quality & Quantity
Volume
45
Issue
3
Publish Date
2011
Start Page
653
End Page
669
DOI
10.1007/s11135-010-9375-z

THE RELATIONSHIP BETWEEN PATIENT AND SPOUSE PSYCHOSOCIAL FACTORS AND PATIENT WEIGHT: BASELINE RESULTS FROM THE COUPLES PARTNERING FOR LIPID ENHANCING STRATEGIES (COUPLES) TRIAL

Authors
Gallagher, P; Yancy, WS; Weinberger, M; Coffman, CJ; Jeffreys, A; Bosworth, HB; Bolton, J; Slade, A; Smith, R; Steward, N; Voils, CI
MLA Citation
Gallagher, P, Yancy, WS, Weinberger, M, Coffman, CJ, Jeffreys, A, Bosworth, HB, Bolton, J, Slade, A, Smith, R, Steward, N, and Voils, CI. "THE RELATIONSHIP BETWEEN PATIENT AND SPOUSE PSYCHOSOCIAL FACTORS AND PATIENT WEIGHT: BASELINE RESULTS FROM THE COUPLES PARTNERING FOR LIPID ENHANCING STRATEGIES (COUPLES) TRIAL." April 2011.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
41
Publish Date
2011
Start Page
S205
End Page
S205

OUTCOMES FROM THE COUPLES PARTNERING FOR LIPID ENHANCING STRATEGIES (COUPLES) TRIAL

Authors
Voils, CI; Yancy, WS; Coffman, C; Weinberger, M; Jeffreys, A; McKenzie, J; Bosworth, H
MLA Citation
Voils, CI, Yancy, WS, Coffman, C, Weinberger, M, Jeffreys, A, McKenzie, J, and Bosworth, H. "OUTCOMES FROM THE COUPLES PARTNERING FOR LIPID ENHANCING STRATEGIES (COUPLES) TRIAL." April 2011.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
41
Publish Date
2011
Start Page
S204
End Page
S204

Improving the measurement of self-reported medication nonadherence.

OBJECTIVE: Medication nonadherence is a significant clinical problem in chronic disease management. Self-report measures have inadequate reliability and poor distributional properties. We demonstrate how two fundamental measurement issues have limited the usefulness of self-reported medication nonadherence measures and offer recommendations for improving measurement. STUDY DESIGN AND METHODS: We reviewed existing self-report measures of medication nonadherence in the context of hypertension, one of the most common chronic conditions in which medication nonadherence is a paramount concern. We evaluated these measures with regard to two issues: (1) conflation of causal indicators (which give rise to a latent construct) and effect indicators (which are determined by a latent construct), and (2) a lack of evidence regarding the stability of nonadherence over time. RESULTS: Nonadherence measurement could be improved by using effect indicators to assess the extent of nonadherence and causal indicators to assess reasons for nonadherence. Moreover, nonadherence should be assessed longitudinally, so that recent developments in statistical modeling can illuminate the extent to which medication nonadherence is transient vs. stable. CONCLUSION: Attention to these measurement issues can improve the assessment of self-reported nonadherence, thereby allowing more accurate conclusions to be drawn about medication-taking behavior and informing the development of improved interventions that target medication nonadherence.

Authors
Voils, CI; Hoyle, RH; Thorpe, CT; Maciejewski, ML; Yancy, WS
MLA Citation
Voils, CI, Hoyle, RH, Thorpe, CT, Maciejewski, ML, and Yancy, WS. "Improving the measurement of self-reported medication nonadherence." J Clin Epidemiol 64.3 (March 2011): 250-254.
PMID
21194887
Source
pubmed
Published In
Journal of Clinical Epidemiology
Volume
64
Issue
3
Publish Date
2011
Start Page
250
End Page
254
DOI
10.1016/j.jclinepi.2010.07.014

Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties.

Authors
Voils, CI; Yancy, WS
MLA Citation
Voils, CI, and Yancy, WS. "Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties." J Clin Epidemiol 64.3 (March 2011): 340-341. (Letter)
PMID
21255718
Source
pubmed
Published In
Journal of Clinical Epidemiology
Volume
64
Issue
3
Publish Date
2011
Start Page
340
End Page
341
DOI
10.1016/j.jclinepi.2009.11.022

Improving the measurement of self-reported medication nonadherence: Response to authors

Authors
Voils, CI; Hoyle, RH; Thorpe, CT; MacIejewski, ML; Jr, WSY
MLA Citation
Voils, CI, Hoyle, RH, Thorpe, CT, MacIejewski, ML, and Jr, WSY. "Improving the measurement of self-reported medication nonadherence: Response to authors." Journal of Clinical Epidemiology 64.3 (2011): 258-261.
Source
scival
Published In
Journal of Clinical Epidemiology
Volume
64
Issue
3
Publish Date
2011
Start Page
258
End Page
261
DOI
10.1016/j.jclinepi.2010.02.023

Comparison of two self-rating instruments for medication adherence in hypertension revealed insufficient psychometric properties - Final response

Authors
Voils, CI; Jr, WSY
MLA Citation
Voils, CI, and Jr, WSY. "Comparison of two self-rating instruments for medication adherence in hypertension revealed insufficient psychometric properties - Final response." Journal of Clinical Epidemiology 64.3 (2011): 342--.
Source
scival
Published In
Journal of Clinical Epidemiology
Volume
64
Issue
3
Publish Date
2011
Start Page
342-
DOI
10.1016/j.jclinepi.2010.10.008

Improving dietary adherence

Of the many challenges clinicians face, those associated with unhealthy diet practices may be the most widespread and the most difficult to address and overcome. This is because everyone has performed the ritual of eating (and drinking) more frequently and for longer than any other health habit. Food and drink are associated with a number of factors that can make adherence to a new diet regimen quite challenging, including a person's sense of comfort and pleasure, underlying physiology, social interactions, ethnic and family traditions, and cravings. © 2010 Springer Science+Business Media, LLC.

Authors
Yancy, WS; Voils, CI
MLA Citation
Yancy, WS, and Voils, CI. "Improving dietary adherence." Improving Patient Treatment Adherence: A Clinician's Guide. December 1, 2010. 39-67.
Source
scopus
Publish Date
2010
Start Page
39
End Page
67
DOI
10.1007/978-1-4419-5866-2_3

Implementation of antiretroviral therapy adherence interventions: a realist synthesis of evidence.

AIM: This paper is a report of a synthesis of evidence on implementation of interventions to improve adherence to antiretroviral therapy. BACKGROUND: Evidence on efficacy must be supplemented with evidence on how interventions were implemented in practice and on how that implementation varied across populations and settings. DATA SOURCES: Sixty-one reports were reviewed of studies conducted in the United States of America in the period 2001 to December 2008. Fifty-two reports were included in the final analysis: 37 reporting the effects of interventions and 15 reporting intervention feasibility, acceptability, or fidelity. REVIEW METHODS: An adaptation of Pawson's realist synthesis method was used, whereby a provisional explanatory model and associated list of propositions are developed from an initial review of literature. This model is successively refined to the point at which it best explains empirical findings from the reports reviewed. RESULTS: The final explanatory model suggests that individuals with HIV will be more likely to enroll in interventions that protect their confidentiality, to attend when scheduling is responsive to their needs, and both to attend and continue with an intervention when they develop a strong, one-to-one relationship with the intervener. Participants who have limited prior experience with antiretroviral therapy will be more likely to continue with an intervention than those who are more experienced. Dropout rates are likely to be higher when interventions are integrated into existing delivery systems than when offered as stand-alone interventions. CONCLUSION: The explanatory model developed in this study is intended to provide guidance to clinicians and researchers on the points in the implementation chain that require strengthening.

Authors
Leeman, J; Chang, YK; Lee, EJ; Voils, CI; Crandell, J; Sandelowski, M
MLA Citation
Leeman, J, Chang, YK, Lee, EJ, Voils, CI, Crandell, J, and Sandelowski, M. "Implementation of antiretroviral therapy adherence interventions: a realist synthesis of evidence." J Adv Nurs 66.9 (September 2010): 1915-1930. (Review)
PMID
20707822
Source
pubmed
Published In
Journal of Advanced Nursing
Volume
66
Issue
9
Publish Date
2010
Start Page
1915
End Page
1930
DOI
10.1111/j.1365-2648.2010.05360.x

Hypertension Improvement Project (HIP) Latino: results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults.

OBJECTIVES: To assess the feasibility of a culturally tailored behavioral intervention for improving hypertension-related health behaviors in Hispanic/Latino adults. DESIGN: Feasibility pilot study in a community health center and a Latino organization in Durham, North Carolina. INTERVENTION: The culturally adapted behavioral intervention consisted of six weekly group sessions incorporating motivational interviewing techniques. Goals included weight loss if overweight, adoption of the Dietary Approaches to Stop Hypertension dietary pattern, and increased physical activity. Participants were also encouraged to monitor their daily intake of fruits, vegetables, dairy and fat, and to record physical activity. Cultural adaptations included conducting the study in familiar places, using Spanish-speaking interventionist, culturally appropriate food choices, and physical activity. MAIN OUTCOMES: Systolic blood pressure (BP), weight, body mass index (BMI), exercise, and dietary pattern were measured at baseline and at 6 weeks follow-up. Qualitative evaluations of the recruitment process and the intervention were also conducted. RESULTS: There were 64 potential participants identified via healthcare provider referrals (33%), printed media (23%), and direct contact (44%). Seventeen participants completed the intervention and had main outcome data available. Participants 'strongly agreed/agreed' that the group sessions provided them with the tools they needed to achieve weight loss, BP control, and the possibility of sustaining the lifestyle changes after completing the intervention. At the end of the intervention, all physiological, diet, and exercise outcomes were more favorable, with the exception of fat. After 6 weeks, systolic BP decreased an average of -10.4+/-10.6 mmHg, weight decreased 1.5+/-3.2 lbs, BMI decreased 0.3+/-0.5, and physical activity increased 40 minutes per week. CONCLUSION: Our findings suggest that lifestyle interventions for preventing and treating hypertension are feasible and potentially effective in the Hispanic/Latino population.

Authors
Rocha-Goldberg, MDELP; Corsino, L; Batch, B; Voils, CI; Thorpe, CT; Bosworth, HB; Svetkey, LP
MLA Citation
Rocha-Goldberg, MDELP, Corsino, L, Batch, B, Voils, CI, Thorpe, CT, Bosworth, HB, and Svetkey, LP. "Hypertension Improvement Project (HIP) Latino: results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults." Ethn Health 15.3 (June 2010): 269-282.
PMID
20379894
Source
pubmed
Published In
Ethnicity & Health
Volume
15
Issue
3
Publish Date
2010
Start Page
269
End Page
282
DOI
10.1080/13557851003674997

Comparison of pain measures among patients with osteoarthritis.

UNLABELLED: This study compared recalled average pain, assessed at the end of the day, with the average of real-time pain ratings recorded throughout the day among patients with osteoarthritis (OA). Participants (N = 157) with hand, hip, or knee OA completed electronic pain diaries on 1 weekend day and 1 weekday. Diaries included at least 7 pain ratings per day, immediately after waking and every 2 hours following, using a visual analog scale (VAS) scored as 1 to 100 (scores not seen by participants). At the end of each diary day, participants rated their average pain that day on the same VAS. Pearson correlations examined associations between recalled average pain and the average of real-time pain ratings that day. Mixed models, including interaction terms, examined whether associations between recalled and actual average pain ratings differed according to the following patient characteristics: joint site, age, race, gender, study enrollment site, and pain catastrophizing. Correlations between recalled and actual average pain ratings were r = .88 for weekdays and r = .86 for weekends (P < .0001). In mixed models, there were no significant interaction terms for any patient characteristics. In summary, patients with OA accurately recalled their average pain over a 1-day period, and this did not differ according to any patient characteristics examined. PERSPECTIVE: This study showed that patients with OA accurately recalled their average pain over a single-day period, and this did not differ according to patient characteristics. Results of this study indicate that end-of-day recall is a practical and valid method for assessing patients' average pain during a day.

Authors
Allen, KD; Coffman, CJ; Golightly, YM; Stechuchak, KM; Voils, CI; Keefe, FJ
MLA Citation
Allen, KD, Coffman, CJ, Golightly, YM, Stechuchak, KM, Voils, CI, and Keefe, FJ. "Comparison of pain measures among patients with osteoarthritis." J Pain 11.6 (June 2010): 522-527.
PMID
20096640
Source
pubmed
Published In
Journal of Pain
Volume
11
Issue
6
Publish Date
2010
Start Page
522
End Page
527
DOI
10.1016/j.jpain.2009.09.007

THE RELATIONSHIP BETWEEN SPOUSAL SUPPORT FOR EXERCISE AND DIET BEHAVIORS

Authors
Voils, CI; Yancy, W; Weinberger, M; Coffman, C; Bolton, J; Jeffreys, A; Oddone, E; Bosworth, H
MLA Citation
Voils, CI, Yancy, W, Weinberger, M, Coffman, C, Bolton, J, Jeffreys, A, Oddone, E, and Bosworth, H. "THE RELATIONSHIP BETWEEN SPOUSAL SUPPORT FOR EXERCISE AND DIET BEHAVIORS." April 2010.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
39
Publish Date
2010
Start Page
13
End Page
13

Fertility patients' views about frozen embryo disposition: results of a multi-institutional U.S. survey.

OBJECTIVE: To describe fertility patients' preferences for disposition of cryopreserved embryos and determine factors important to these preferences. DESIGN: Cross-sectional survey conducted between June 2006 and July 2007. SETTING: Nine geographically diverse U.S. fertility clinics. PATIENT(S): 1020 fertility patients with cryopreserved embryos. INTERVENTION(S): Self-administered questionnaire. MAIN OUTCOME MEASURE(S): Likelihood of selecting each of five conventional embryo disposition options: store for reproduction, thaw and discard, donate to another couple, freeze indefinitely, and donate for research; likelihood of selecting each of two alternative options identified in previous research: placement of embryos in the woman's body at an infertile time, or a disposal ceremony; importance of each of 26 considerations to disposition decisions; and views on the embryo's moral status. RESULT(S): We found that 54% of respondents with cryopreserved embryos were very likely to use them for reproduction, 21% were very likely to donate for research, 7% or fewer were very likely to choose any other option. Respondents who ascribed high importance to concerns about the health or well-being of the embryo, fetus, or future child were more likely to thaw and discard embryos or freeze them indefinitely. CONCLUSION(S): Fertility patients frequently prefer disposition options that are not available to them or find the available options unacceptable. Restructuring and standardizing the informed consent process and ensuring availability of all disposition options may benefit patients, facilitate disposition decisions, and address problems of long-term storage.

Authors
Lyerly, AD; Steinhauser, K; Voils, C; Namey, E; Alexander, C; Bankowski, B; Cook-Deegan, R; Dodson, WC; Gates, E; Jungheim, ES; McGovern, PG; Myers, ER; Osborn, B; Schlaff, W; Sugarman, J; Tulsky, JA; Walmer, D; Faden, RR; Wallach, E
MLA Citation
Lyerly, AD, Steinhauser, K, Voils, C, Namey, E, Alexander, C, Bankowski, B, Cook-Deegan, R, Dodson, WC, Gates, E, Jungheim, ES, McGovern, PG, Myers, ER, Osborn, B, Schlaff, W, Sugarman, J, Tulsky, JA, Walmer, D, Faden, RR, and Wallach, E. "Fertility patients' views about frozen embryo disposition: results of a multi-institutional U.S. survey." Fertil Steril 93.2 (February 2010): 499-509.
PMID
19061998
Source
pubmed
Published In
Fertility and Sterility
Volume
93
Issue
2
Publish Date
2010
Start Page
499
End Page
509
DOI
10.1016/j.fertnstert.2008.10.015

Transforming verbal counts in reports of qualitative descriptive studies into numbers.

Reports of qualitative studies typically do not offer much information on the numbers of respondents linked to any one finding. This information may be especially useful in reports of basic, or minimally interpretive, qualitative descriptive studies focused on surveying a range of experiences in a target domain, and its lack may limit the ability to synthesize the results of such studies with quantitative results in systematic reviews. Accordingly, the authors illustrate strategies for deriving plausible ranges of respondents expressing a finding in a set of reports of basic qualitative descriptive studies on antiretroviral adherence and suggest how the results might be used. These strategies have limitations and are never appropriate for use with findings from interpretive qualitative studies. Yet they offer a temporary workaround for preserving and maximizing the value of information from basic qualitative descriptive studies for systematic reviews. They show also why quantitizing is never simply quantitative.

Authors
Chang, Y; Voils, CI; Sandelowski, M; Hasselblad, V; Crandell, JL
MLA Citation
Chang, Y, Voils, CI, Sandelowski, M, Hasselblad, V, and Crandell, JL. "Transforming verbal counts in reports of qualitative descriptive studies into numbers." West J Nurs Res 31.7 (November 2009): 837-852.
PMID
19448052
Source
pubmed
Published In
Western Journal of Nursing Research
Volume
31
Issue
7
Publish Date
2009
Start Page
837
End Page
852
DOI
10.1177/0193945909334434

A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence.

OBJECTIVES: Bayesian meta-analysis is a frequently cited but very little-used method for synthesizing qualitative and quantitative research findings. The only example published to date used qualitative data to generate an informative prior probability and quantitative data to generate the likelihood. We developed a method to incorporate both qualitative and quantitative evidence in the likelihood in a Bayesian synthesis of evidence about the relationship between regimen complexity and medication adherence. METHODS: Data were from 11 qualitative and six quantitative studies. We updated two different non-informative prior distributions with qualitative and quantitative findings to find the posterior distribution for the probabilities that a more complex regimen was associated with lower adherence and that a less complex regimen was associated with greater adherence. RESULTS: The posterior mode for the qualitative findings regarding more complex regimen and lesser adherence (using the uniform prior with Jeffreys' prior yielding highly similar estimates) was 0.588 (95% credible set limits 0.519, 0.663) and for the quantitative findings was 0.224 (0.203, 0.245); due to non-overlapping credible sets, we did not combine them. The posterior mode for the qualitative findings regarding less complex regimen and greater adherence was 0.288 (0.214, 0.441) and for the quantitative findings was 0.272 (0.118, 0.437); the combined estimate was 0.299 (0.267, 0.334). CONCLUSIONS: The utility of Bayesian methods for synthesizing qualitative and quantitative research findings at the participant level may depend on the nature of the relationship being synthesized and on how well the findings are represented in the individual reports.

Authors
Voils, C; Hassselblad, V; Crandell, J; Chang, Y; Lee, E; Sandelowski, M
MLA Citation
Voils, C, Hassselblad, V, Crandell, J, Chang, Y, Lee, E, and Sandelowski, M. "A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence." J Health Serv Res Policy 14.4 (October 2009): 226-233.
PMID
19770121
Source
pubmed
Published In
Journal of Health Services Research & Policy
Volume
14
Issue
4
Publish Date
2009
Start Page
226
End Page
233
DOI
10.1258/jhsrp.2009.008186

A systematic review comparing antiretroviral adherence descriptive and intervention studies conducted in the USA.

We examined the extent to which studies aimed at testing interventions to improve antiretroviral adherence have targeted the facilitators of and barriers known to affect adherence. Of the 88 reports reviewed, 41 were reports of descriptive studies conducted with US HIV-positive women and 47 were reports of intervention studies conducted with US HIV-positive persons. We extracted from the descriptive studies all findings addressing any factor linked to antiretroviral adherence and from the intervention studies, information on the nature of the intervention, the adherence problem targeted, the persons targeted for the intervention, and the intervention outcomes desired. We discerned congruence between the prominence of substance abuse as a factor identified in the descriptive studies as a barrier to adherence and its prominence as the problem most addressed in those reports of intervention studies that specified the problems targeted for intervention. We also discerned congruence between the prominence of family and provider support as factors identified in the descriptive studies as facilitators of adherence and the presence of social support as an intervention component and outcome variable. Less discernible in the reports of intervention studies was specific attention to other factors prominent in the descriptive studies, which may be due to the complex nature of the problem, individualistic and rationalist slant of interventions, or simply the ways interventions were presented. Our review raises issues about niche standardization and intervention tailoring, targeting, and fidelity.

Authors
Sandelowski, M; Voils, CI; Chang, Y; Lee, EJ
MLA Citation
Sandelowski, M, Voils, CI, Chang, Y, and Lee, EJ. "A systematic review comparing antiretroviral adherence descriptive and intervention studies conducted in the USA." AIDS Care 21.8 (August 2009): 953-966. (Review)
PMID
20024751
Source
pubmed
Published In
AIDS Care
Volume
21
Issue
8
Publish Date
2009
Start Page
953
End Page
966
DOI
10.1080/09540120802626212

On Quantitizing.

Quantitizing, commonly understood to refer to the numerical translation, transformation, or conversion of qualitative data, has become a staple of mixed methods research. Typically glossed are the foundational assumptions, judgments, and compromises involved in converting disparate data sets into each other and whether such conversions advance inquiry. Among these assumptions are that qualitative and quantitative data constitute two kinds of data, that quantitizing constitutes a unidirectional process essentially different from qualitizing, and that counting is an unambiguous process. Among the judgments are deciding what and how to count. Among the compromises are balancing numerical precision with narrative complexity. The standpoints of "conditional complementarity," "critical remediation," and "analytic alternation" clarify the added value of converting qualitative data into quantitative form.

Authors
Sandelowski, M; Voils, CI; Knafl, G
MLA Citation
Sandelowski, M, Voils, CI, and Knafl, G. "On Quantitizing." J Mix Methods Res 3.3 (July 1, 2009): 208-222.
PMID
19865603
Source
pubmed
Published In
Journal of Mixed Methods Research
Volume
3
Issue
3
Publish Date
2009
Start Page
208
End Page
222
DOI
10.1177/1558689809334210

Validation of a questionnaire to assess self-reported colorectal cancer screening status using face-to-face administration.

PURPOSE: The aim of this study was to assess the accuracy of a National Cancer Institute (NCI)-developed colorectal cancer screening questionnaire. METHODS: We conducted 36 cognitive interviews and made iterative changes to the questionnaire to improve comprehension. The revised questionnaire was administered face-to-face to 201 participants. The primary outcome was agreement between questionnaire responses and medical records for whether or not a participant was up-to-date for any colorectal cancer screening test. RESULTS: Comprehension of descriptions and questions was generally good; however, the barium enema description required several revisions. The sensitivity of the questionnaire for up-to-date screening status was 94%, specificity 63%, and concordance 88%. CONCLUSIONS: The modified questionnaire was highly sensitive for determining if a person was up-to-date for any colorectal cancer screening test, although the specificity was low. Given the difficulty of obtaining all relevant records, self-report using this questionnaire is a reasonable option for identifying people who have undergone testing.

Authors
Fisher, DA; Voils, CI; Coffman, CJ; Grubber, JM; Dudley, TK; Vernon, SW; Bond, JH; Provenzale, D
MLA Citation
Fisher, DA, Voils, CI, Coffman, CJ, Grubber, JM, Dudley, TK, Vernon, SW, Bond, JH, and Provenzale, D. "Validation of a questionnaire to assess self-reported colorectal cancer screening status using face-to-face administration." Dig Dis Sci 54.6 (June 2009): 1297-1306.
PMID
18726152
Source
pubmed
Published In
Digestive Diseases and Sciences
Volume
54
Issue
6
Publish Date
2009
Start Page
1297
End Page
1306
DOI
10.1007/s10620-008-0471-z

Gender, race/ethnicity, and social class in research reports on stigma in HIV-positive women.

The layering of HIV-related stigma with stigmas associated with gender, race, and class poses a methodological challenge to those seeking to understand and, thereby, to minimize its negative effects. In this meta-study of 32 reports of studies of stigma conducted with HIV-positive women, we found that gender was hardly addressed despite the all-female composition of samples. Neither sexual orientation nor social class received much notice. Race was the dominant category addressed, most notably in reports featuring women in only one race/ethnic group. The relative absence of attention to these categories as cultural performances suggests the recurring assumption that sample inclusiveness automatically implies the inclusion of gender, race, and class, which is itself a cultural performance.

Authors
Sandelowski, M; Barroso, J; Voils, CI
MLA Citation
Sandelowski, M, Barroso, J, and Voils, CI. "Gender, race/ethnicity, and social class in research reports on stigma in HIV-positive women." Health Care Women Int 30.4 (April 2009): 273-288. (Review)
PMID
19255883
Source
pubmed
Published In
Health Care for Women International
Volume
30
Issue
4
Publish Date
2009
Start Page
273
End Page
288
DOI
10.1080/07399330802694880

Study protocol: Couples Partnering for Lipid Enhancing Strategies (CouPLES) - a randomized, controlled trial.

BACKGROUND: Almost 50% of Americans have elevated low-density lipoprotein cholesterol (LDL-C). The behaviors required to lower LDL-C levels may be difficult to adhere to if they are inconsistent with spouses' health practices, and, alternatively, may be enhanced by enlisting support from the spouse. This trial extends previous trials by requiring spouse enrollment, teaching spouses how to provide emotional and instrumental support, allowing patients to decide which component of the intervention they would like to receive, and having patients determine their own goals and action plans. METHODS: Veteran outpatients with above-goal LDL-C (N = 250) and their spouses are randomized, as a couple, to receive printed education materials only or the materials plus an 11-month, nurse-delivered, telephone-based intervention. The intervention contains four modules: medication adherence, diet, exercise, and patient-physician communication. Patients decide which modules they complete and in which order; modules may be repeated or omitted. Telephone calls are to patients and spouses separately and occur monthly. During each patient telephone call, patients' progress is reviewed, and patients create goals and action plans for the upcoming month. During spouse telephone calls, which occur within one week of patient calls, spouses are informed of patients' goals and action plans and devise strategies to increase emotional and instrumental support.The primary outcome is patients' LDL-C, measured at baseline, 6 months, and 11 months. Linear mixed models will be used to test the primary hypothesis that an 11-month, telephone-based patient-spouse intervention will result in a greater reduction in LDL-C as compared to printed education materials. Various process measures, including social support, self-efficacy, medication adherence, dietary behavior, and exercise, are also assessed to explain any change, or lack thereof, in LDL-C. DISCUSSION: Given the social context in which self-management occurs, interventions that teach spouses to provide instrumental and emotional support may help patients initiate and adhere to behaviors that lower their LDL-C levels. Moreover, allowing patients to retain autonomy by deciding which behaviors they would like to change and how may improve adherence and clinical outcomes. TRIAL REGISTRATION: The ClinicalTrials.gov registration number is NCT00321789.

Authors
Voils, CI; Yancy, WS; Kovac, S; Coffman, CJ; Weinberger, M; Oddone, EZ; Jeffreys, A; Datta, S; Bosworth, HB
MLA Citation
Voils, CI, Yancy, WS, Kovac, S, Coffman, CJ, Weinberger, M, Oddone, EZ, Jeffreys, A, Datta, S, and Bosworth, HB. "Study protocol: Couples Partnering for Lipid Enhancing Strategies (CouPLES) - a randomized, controlled trial. (Published online)" Trials 10 (February 6, 2009): 10-.
PMID
19200384
Source
pubmed
Published In
Trials
Volume
10
Publish Date
2009
Start Page
10
DOI
10.1186/1745-6215-10-10

"Distorted into clarity": a methodological case study illustrating the paradox of systematic review.

Systematic review is typically viewed in the health sciences as the most objective--that is, rigorous, transparent, and reproducible--method for summarizing the results of research. Yet, recent scholarship has shown systematic review to involve feats of interpretation producing less certain, albeit valuable, results. We found this to be the case when we tried to overcome the resistance to synthesis of a set of qualitative and quantitative findings on stigma in HIV-positive women. These findings were difficult to combine largely because of fuzzy conceptualizations of stigma and the volume of unique quantitative findings. Our encounter with findings resistant to synthesis heightened our awareness of the extent to which all systematic reviews are accomplished by practices that paradoxically "distort [research findings] into clarity."

Authors
Sandelowski, M; Voils, CI; Barroso, J; Lee, EJ
MLA Citation
Sandelowski, M, Voils, CI, Barroso, J, and Lee, EJ. ""Distorted into clarity": a methodological case study illustrating the paradox of systematic review." Res Nurs Health 31.5 (October 2008): 454-465. (Review)
PMID
18324678
Source
pubmed
Published In
Research in Nursing & Health
Volume
31
Issue
5
Publish Date
2008
Start Page
454
End Page
465
DOI
10.1002/nur.20278

Barriers to the practice of evidence-based urology.

PURPOSE: We investigated urologist perceptions of barriers to implementing evidence-based medicine in clinical practice. MATERIALS AND METHODS: In April 2005 an Internet survey was conducted to assess American Urological Association member attitudes toward evidence-based medicine. This analysis presents the responses to an open-ended question about perceived barriers to implementing evidence-based clinical practice in urology. Two raters developed a coding scheme with 5 main categories of evidence concerns, system level factors, physician factors, patient factors and other barriers. Each rater independently assigned a category to each response. Discrepancies were resolved by consensus. RESULTS: A total of 365 participants (72%) responded to the open-ended question, each providing up to 4 codable responses. Of the group 53% cited concerns about the evidence including the lack thereof, low quality, limited applicability and biased presentation. In addition, 37% reported system level factors such as issues of reimbursement, fear of litigation, problems with implementation, interference/bias by third parties, and expectations and attitudes of other providers as important issues. Physician factors and patient factors were further cited by 28% and 9%, respectively. In terms of the legitimacy of evidence-based medicine 9% expressed skepticism whereas 5% of respondents indicated that they saw no barriers to implementing evidence-based medicine in urology. CONCLUSIONS: Efforts to promote evidence-based medicine in urology should focus not only on the generation of high quality clinical research but also on its unbiased reporting and timely dissemination. Concerted efforts should be made to reduce system level factors that hinder the implementation of evidence-based care.

Authors
Scales, CD; Voils, CI; Fesperman, SF; Sur, RL; Kübler, H; Preminger, GM; Dahm, P
MLA Citation
Scales, CD, Voils, CI, Fesperman, SF, Sur, RL, Kübler, H, Preminger, GM, and Dahm, P. "Barriers to the practice of evidence-based urology." J Urol 179.6 (June 2008): 2345-2349.
PMID
18423732
Source
pubmed
Published In
The Journal of Urology
Volume
179
Issue
6
Publish Date
2008
Start Page
2345
End Page
2349
DOI
10.1016/j.juro.2008.01.109

Prevalence and predictors of fecal occult blood testing after colonoscopy

Authors
Fisher, DA; Grubber, J; Coffman, CJ; Voils, CI; Vernon, SW; Provenzale, D
MLA Citation
Fisher, DA, Grubber, J, Coffman, CJ, Voils, CI, Vernon, SW, and Provenzale, D. "Prevalence and predictors of fecal occult blood testing after colonoscopy." April 2008.
Source
wos-lite
Published In
Gastroenterology
Volume
134
Issue
4
Publish Date
2008
Start Page
A160
End Page
A160

Do patients know why they had a colonoscopy?

Authors
Fisher, DA; Grubber, J; Coffman, CJ; Voils, CI; Vernon, SW; Provenzale, D
MLA Citation
Fisher, DA, Grubber, J, Coffman, CJ, Voils, CI, Vernon, SW, and Provenzale, D. "Do patients know why they had a colonoscopy?." April 2008.
Source
wos-lite
Published In
Gastroenterology
Volume
134
Issue
4
Publish Date
2008
Start Page
A317
End Page
A317

Selective adherence to antihypertensive medications as a patient-driven means to preserving sexual potency.

OBJECTIVE: To describe hypertensive patients' experiences with sexual side effects and their consequences for antihypertensive medication adherence. METHODS: Data were from a study conducted to identify facilitators of and barriers to adherence to blood pressure-lowering regimens. Participants were 38 married and unmarried veterans with a diagnosis of hypertension and 13 female spouses. Eight patient and four spouse focus groups were conducted. A directed approach to content analysis was used to determine the facilitators of and barriers to adherence. For this report, all discussion concerning the topic of sexual relations was extracted. RESULTS: Male patients viewed sexual intercourse as a high priority and felt that a lack of sexual intercourse was unnatural. They pursued strategies to preserve their potency, including discontinuing or selectively adhering to their medications and obtaining treatments for impotence. In contrast, spouses felt that sexual intercourse was a low priority and that a lack of sexual intercourse was natural. They discouraged their husbands from seeking treatments for impotence. CONCLUSION: Although the primary study was not designed to explore issues of sexual function, the issue emerged spontaneously in the majority of discussions, indicating that sexuality is important in this context for both male patients and their spouses. Physicians should address sexual side effects of antihypertensive medications with patients, ideally involving spouses.

Authors
Voils, CI; Sandelowski, M; Dahm, P; Blouin, R; Bosworth, HB; Oddone, EZ; Steinhauser, KE
MLA Citation
Voils, CI, Sandelowski, M, Dahm, P, Blouin, R, Bosworth, HB, Oddone, EZ, and Steinhauser, KE. "Selective adherence to antihypertensive medications as a patient-driven means to preserving sexual potency. (Published online)" Patient Prefer Adherence 2 (February 2, 2008): 201-206.
PMID
19920964
Source
pubmed
Published In
Patient Preference and Adherence
Volume
2
Publish Date
2008
Start Page
201
End Page
206

The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults.

OBJECTIVE: To examine the contribution of medication adherence to 12-month depression scores in the context of other psychosocial and clinical predictors of depression in a sample of older adults treated for depression. METHODS: Secondary analysis of a prospective cohort study involving 241 older patients undergoing depression treatment using a standardized algorithm. Depression was measured at baseline and 12-months post-baseline. Baseline predictor variables included antidepressant adherence, barriers to antidepressant adherence, four domains of social support, basic and instrumental activities of daily living (BADLs and IADLs), and clinical factors including past history of depression and medical comorbidities. RESULTS: Nearly 28% of patients reported being nonadherent with their antidepressant medication. In bivariate analyses, greater antidepressant medication nonadherence, more medication barriers, poorer subjective social support, less non-family interaction, greater BADL and IADL limitations, poor self-rated health, higher baseline depression scores, and not having diabetes were related to higher 12-month depression scores. In multivariable analyses, greater medication nonadherence, not having diabetes, poorer subjective social support, greater BADL limitations, and higher baseline depression scores were related to higher 12-month depression scores. CONCLUSION: Interventions should be directed toward improving antidepressant adherence and modifiable psychosocial variables.

Authors
Bosworth, HB; Voils, CI; Potter, GG; Steffens, DC
MLA Citation
Bosworth, HB, Voils, CI, Potter, GG, and Steffens, DC. "The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults." Int J Geriatr Psychiatry 23.2 (February 2008): 129-134.
PMID
17563920
Source
pubmed
Published In
International Journal of Geriatric Psychiatry
Volume
23
Issue
2
Publish Date
2008
Start Page
129
End Page
134
DOI
10.1002/gps.1852

Identifying depressed older adults in primary care: a secondary analysis of a multisite randomized controlled trial.

OBJECTIVE: To determine whether a subset of depressive symptoms could be identified to facilitate diagnosis of depression in older adults in primary care. METHOD: Secondary analysis was conducted on 898 participants aged 60 years or older with major depressive disorder and/or dysthymic disorder (according to DSM-IV criteria) who participated in the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) study, a multisite, randomized trial of collaborative care for depression (recruitment from July 1999 to August 2001). Linear regression was used to identify a core subset of depressive symptoms associated with decreased social, physical, and mental functioning. The sensitivity and specificity, adjusting for selection bias, were evaluated for these symptoms. The sensitivity and specificity of a second subset of 4 depressive symptoms previously validated in a midlife sample was also evaluated. RESULTS: Psychomotor changes, fatigue, and suicidal ideation were associated with decreased functioning and served as the core set of symptoms. Adjusting for selection bias, the sensitivity of these 3 symptoms was 0.012 and specificity 0.994. The sensitivity of the 4 symptoms previously validated in a midlife sample was 0.019 and specificity was 0.997. CONCLUSION: We identified 3 depression symptoms that were highly specific for major depressive disorder in older adults. However, these symptoms and a previously identified subset were too insensitive for accurate diagnosis. Therefore, we recommend a full assessment of DSM-IV depression criteria for accurate diagnosis.

Authors
Voils, CI; Olsen, MK; Williams, JW; Impact Study Investigators,
MLA Citation
Voils, CI, Olsen, MK, Williams, JW, and Impact Study Investigators, . "Identifying depressed older adults in primary care: a secondary analysis of a multisite randomized controlled trial." Prim Care Companion J Clin Psychiatry 10.1 (2008): 9-14.
PMID
18311416
Source
pubmed
Published In
Primary care companion to the Journal of clinical psychiatry
Volume
10
Issue
1
Publish Date
2008
Start Page
9
End Page
14

Making Sense of Qualitative and Quantitative Findings in Mixed Research Synthesis Studies.

The synthesis of qualitative and quantitative research findings is increasingly promoted, but many of the conceptual and methodological issues it raises have yet to be fully understood and resolved. In this article, we describe how we handled issues encountered in efforts to synthesize the findings in forty-two reports of studies of antiretroviral adherence in HIV-positive women in the course of an ongoing study to develop methods to synthesize qualitative and quantitative research findings in common domains of health-related research. Working with these reports underscored the importance of looking past method claims and ideals and directly at the findings themselves, differentiating between aggregative syntheses in which findings are assimilated and interpretive syntheses in which they are configured, and understanding the judgments involved in designating relationships between findings as confirmatory, divergent, or complementary.

Authors
Voils, CI; Sandelowski, M; Barroso, J; Hasselblad, V
MLA Citation
Voils, CI, Sandelowski, M, Barroso, J, and Hasselblad, V. "Making Sense of Qualitative and Quantitative Findings in Mixed Research Synthesis Studies." Field methods 20.1 (2008): 3-25.
PMID
18677415
Source
pubmed
Published In
Field Methods
Volume
20
Issue
1
Publish Date
2008
Start Page
3
End Page
25
DOI
10.1177/1525822X07307463

Five-year trajectories of social networks and social support in older adults with major depression.

BACKGROUND: Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual levels over five years. METHODS: The sample consisted of 339 initially depressed adults aged 59 or older (M = 69 years) enrolled in a naturalistic study of depression. Measures of social ties, including social network size, frequency of interaction, instrumental support, and subjective support, were administered at baseline and yearly for five years. RESULTS: Latent growth curve models were estimated for each aspect of social ties. On average, social network size and frequency of interaction were low at baseline and remained stable over time, whereas subjective and instrumental support were high at baseline yet increased over time. There was significant variation in the direction and rate of change over time, which was not predicted by demographic or clinical factors. CONCLUSIONS: Because increasing social networks may be ineffective and may not be possible for a portion of people who already receive maximal support, interventions to increase social support may only work for a portion of older depressed adults.

Authors
Voils, CI; Allaire, JC; Olsen, MK; Steffens, DC; Hoyle, RH; Bosworth, HB
MLA Citation
Voils, CI, Allaire, JC, Olsen, MK, Steffens, DC, Hoyle, RH, and Bosworth, HB. "Five-year trajectories of social networks and social support in older adults with major depression." Int Psychogeriatr 19.6 (December 2007): 1110-1124.
PMID
17433120
Source
pubmed
Published In
International psychogeriatrics / IPA
Volume
19
Issue
6
Publish Date
2007
Start Page
1110
End Page
1124
DOI
10.1017/S1041610207005303

INTEGRATING QUALITATIVE AND QUANTITATIVE RESEARCH FINDINGS

Authors
Voils, CI; Sandelowski, M; Barroso, J; Hasselblad, V
MLA Citation
Voils, CI, Sandelowski, M, Barroso, J, and Hasselblad, V. "INTEGRATING QUALITATIVE AND QUANTITATIVE RESEARCH FINDINGS." ANNALS OF BEHAVIORAL MEDICINE 33 (December 2007): S147-S147.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
33
Publish Date
2007
Start Page
S147
End Page
S147

In or out? Methodological considerations for including and excluding findings from a meta-analysis of predictors of antiretroviral adherence in HIV-positive women.

AIM: This paper is a discussion detailing the decisions concerning whether to include or exclude findings from a meta-analysis of report of quantitative studies of antiretroviral adherence in HIV-positive women. BACKGROUND: Publication constraints and the absence of reflexivity as a criterion for validity in, and reporting of, quantitative research preclude detailing the many judgements made in the course of a meta-analysis. Yet, such an accounting would assist researchers better to address the unique challenges to meta-analysis presented by the bodies of research they have targeted for review, and to show the subjectivity, albeit disciplined, that characterizes the meta-analytic process. DATA SOURCES: Data were 29 published and unpublished studies on antiretroviral adherence in HIV-positive women of any race/ethnicity, class, or nationality living in the United States of America. The studies were retrieved between June 2005 and January 2006 using 40 databases. REVIEW METHODS: Findings were included if they met the statistical assumptions of meta-analysis, including: (1) normal distribution of observations; (2) homogeneity of variances; and (3) independence of observations. RESULTS: Relevant studies and findings were excluded because of issues related to differences in study design, different operationalizations of dependent and independent variables, multiple cuts from common longitudinal data sets, and presentation of unadjusted and adjusted findings. These reasons led to the exclusion of 73% of unadjusted relationships and 87% of adjusted relationships from our data set, leaving few findings to synthesize. CONCLUSION: Decisions made during research synthesis studies may result in more information losses than gains, thereby obliging researchers to find ways to preserve findings that are potentially valuable for practice.

Authors
Voils, CI; Barroso, J; Hasselblad, V; Sandelowski, M
MLA Citation
Voils, CI, Barroso, J, Hasselblad, V, and Sandelowski, M. "In or out? Methodological considerations for including and excluding findings from a meta-analysis of predictors of antiretroviral adherence in HIV-positive women." J Adv Nurs 59.2 (July 2007): 163-177. (Review)
PMID
17543011
Source
pubmed
Published In
Journal of Advanced Nursing
Volume
59
Issue
2
Publish Date
2007
Start Page
163
End Page
177
DOI
10.1111/j.1365-2648.2007.04289.x

Does participatory decision making improve hypertension self-care behaviors and outcomes?

This study examined patients' perceptions of their providers' participatory decision making (PDM) style and hypertension self-care behaviors and outcomes. Five hundred fifty-four veterans with hypertension enrolled in the Veterans' Study to Improve the Control of Hypertension rated providers' PDM styles using a validated 3-item instrument. Behaviors assessed included presence of a home blood pressure monitor, monitoring frequency, and self-reported antihypertensive medication adherence. Overall, veterans with hypertension rated providers as highly participatory. In adjusted analyses, a lower PDM score was associated with decreased odds of having a home monitor (odds ratio, 0.90 per 10-point decrement in PDM score; 95% confidence interval, 0.83-0.98) but not with monitoring frequency, adherence, or blood pressure control. Providers' involvement of patients in decision making, reflected in ratings of PDM style, may be important to securing patients' participation in their own care, but alone this factor seems insufficient. No relationship between PDM score and blood pressure control was observed.

Authors
Cho, AH; Voils, CI; Yancy, WS; Oddone, EZ; Bosworth, HB
MLA Citation
Cho, AH, Voils, CI, Yancy, WS, Oddone, EZ, and Bosworth, HB. "Does participatory decision making improve hypertension self-care behaviors and outcomes?." J Clin Hypertens (Greenwich) 9.5 (May 2007): 330-336.
PMID
17485968
Source
pubmed
Published In
Journal of Clinical Hypertension
Volume
9
Issue
5
Publish Date
2007
Start Page
330
End Page
336

Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings.

The new imperative in the health disciplines to be more methodologically inclusive has generated a growing interest in mixed research synthesis, or the integration of qualitative and quantitative research findings. Qualitative metasummary is a quantitatively oriented aggregation of qualitative findings originally developed to accommodate the distinctive features of qualitative surveys. Yet these findings are similar in form and mode of production to the descriptive findings researchers often present in addition to the results of bivariate and multivariable analyses. Qualitative metasummary, which includes the extraction, grouping, and formatting of findings, and the calculation of frequency and intensity effect sizes, can be used to produce mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings.

Authors
Sandelowski, M; Barroso, J; Voils, CI
MLA Citation
Sandelowski, M, Barroso, J, and Voils, CI. "Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings." Res Nurs Health 30.1 (February 2007): 99-111. (Review)
PMID
17243111
Source
pubmed
Published In
Research in Nursing & Health
Volume
30
Issue
1
Publish Date
2007
Start Page
99
End Page
111
DOI
10.1002/nur.20176

Comparability work and the management of difference in research synthesis studies.

The new imperative to be more methodologically inclusive has generated a burgeoning interest in synthesizing the findings of qualitative and quantitative studies, or mixed research synthesis. Yet, the very diversity seen to define the mixed research synthesis enterprise is also considered to defy it as it intensifies the problem of comparing the seemingly incomparable to enable the combination of the seemingly uncombinable. We propose here that the research synthesis enterprise, in general, and the mixed research synthesis enterprise, in particular, entail comparability work whereby reviewers impose similarity and difference on the studies to be reviewed. The very study diversity requiring management does not exist a priori but rather is itself an outcome of comparability work already done whereby judgments have been made about what constitutes methodological and topical diversity and uniformity. Conceiving the research synthesis process as defined by comparability work moves the backstage interpretive work of systematic review to center stage and, thereby, sets a new stage for addressing the methodological issues involved. These issues are explored by reference to the synthesis of empirical studies of antiretroviral adherence in HIV-positive women in the US.

Authors
Sandelowski, M; Voils, CI; Barroso, J
MLA Citation
Sandelowski, M, Voils, CI, and Barroso, J. "Comparability work and the management of difference in research synthesis studies." Soc Sci Med 64.1 (January 2007): 236-247.
PMID
17029691
Source
pubmed
Published In
Social Science & Medicine
Volume
64
Issue
1
Publish Date
2007
Start Page
236
End Page
247
DOI
10.1016/j.socscimed.2006.08.041

Research results have expiration dates: ensuring timely systematic reviews.

Time and timeliness are key issues in appraising and ensuring the clinical relevance of systematic reviews. Time considerations entering the systematic review process include the history of the clinical problem, disease, or treatment that is the target of the review, and the history of the research conducted to address it. These considerations guide: (i) formulation of the research problems and questions; (ii) setting of parameters for the search and retrieval of studies; (iii) determination of inclusion and exclusion criteria; (iv) appraisal of the clinical relevance of findings; (v) selection of the findings that will be synthesized; and (vi) interpretation of the results of that synthesis.

Authors
Barroso, J; Sandelowski, M; Voils, CI
MLA Citation
Barroso, J, Sandelowski, M, and Voils, CI. "Research results have expiration dates: ensuring timely systematic reviews." J Eval Clin Pract 12.4 (August 2006): 454-462.
PMID
16907690
Source
pubmed
Published In
Journal of Evaluation in Clinical Practice
Volume
12
Issue
4
Publish Date
2006
Start Page
454
End Page
462
DOI
10.1111/j.1365-2753.2006.00729.x

"Are you at peace?": one item to probe spiritual concerns at the end of life.

BACKGROUND: Physicians may question their role in probing patients' spiritual distress and the practicality of addressing such issues in the time-limited clinical encounter. Yet, patients' spirituality often influences treatment choices during a course of serious illness. A practical, evidence-based approach to discussing spiritual concerns in a scope suitable to a physician-patient relationship may improve the quality of the clinical encounter. METHODS: Analysis of the construct of being "at peace" using a sample of patients with advanced cancer, congestive heart failure, or chronic obstructive pulmonary disease. Descriptive statistics were used to compare response distributions among patient subgroups. Construct validity of the concept of being "at peace" was evaluated by examining Spearman rank correlations between the item and existing spirituality and quality-of-life subscales. RESULTS: Variation in patient responses was not explained by demographic categories or diagnosis, indicating broad applicability across patients. Construct validity showed that feeling at peace was strongly correlated with emotional and spiritual well-being. It was equally correlated with faith and purpose subscales, indicating applicability to traditional and nontraditional definitions of spirituality. CONCLUSIONS: Asking patients about the extent to which they are at peace offers a brief gateway to assessing spiritual concerns. Although these issues may be heightened at the end of life, research suggests they influence medical decision making throughout a lifetime of care.

Authors
Steinhauser, KE; Voils, CI; Clipp, EC; Bosworth, HB; Christakis, NA; Tulsky, JA
MLA Citation
Steinhauser, KE, Voils, CI, Clipp, EC, Bosworth, HB, Christakis, NA, and Tulsky, JA. ""Are you at peace?": one item to probe spiritual concerns at the end of life." Arch Intern Med 166.1 (January 9, 2006): 101-105.
PMID
16401817
Source
pubmed
Published In
Archives of internal medicine
Volume
166
Issue
1
Publish Date
2006
Start Page
101
End Page
105
DOI
10.1001/archinte.166.1.101

Racial differences in blood pressure control: potential explanatory factors.

PURPOSE: Poor blood pressure control remains a common problem that contributes to significant cardiovascular morbidity and mortality, particularly among African Americans. We explored antihypertensive medication adherence and other factors that may explain racial differences in blood pressure control. METHODS: Baseline data were obtained from the Veteran's Study to Improve The Control of Hypertension, a randomized controlled trial designed to improve blood pressure control. Clinical, demographic, and psychosocial factors relating to blood pressure control were examined. RESULTS: A total of 569 patients who were African American (41%) or white (59%) were enrolled in the study. African Americans were more likely to have inadequate baseline blood pressure control than whites (63% vs 50%; odds ratio = 1.70; 95% confidence interval [CI] 1.20-2.41). Among 20 factors related to blood pressure control, African Americans also had a higher odds ratio of being nonadherent to their medication, being more functionally illiterate, and having a family member with hypertension compared with whites. Compared with whites, African Americans also were more likely to perceive high blood pressure as serious and to experience the side effect of increased urination compared with whites. Adjusting for these differences reduced the odds ratio of African Americans having adequate blood pressure control to 1.59 (95% confidence interval 1.09-2.29). CONCLUSIONS: In this sample of hypertensive patients who have good access to health care and medication benefits, African Americans continued to have lower levels of blood pressure control despite considering more than 20 factors related to blood pressure control. Interventions designed to improve medication adherence need to take race into account. Patients' self-reports of failure to take medications provide an opportunity for clinicians to explore reasons for medication nonadherence, thereby improving adherence and potentially blood pressure control.

Authors
Bosworth, HB; Dudley, T; Olsen, MK; Voils, CI; Powers, B; Goldstein, MK; Oddone, EZ
MLA Citation
Bosworth, HB, Dudley, T, Olsen, MK, Voils, CI, Powers, B, Goldstein, MK, and Oddone, EZ. "Racial differences in blood pressure control: potential explanatory factors." Am J Med 119.1 (January 2006): 70.e9-70.15.
PMID
16431192
Source
pubmed
Published In
American Journal of Medicine
Volume
119
Issue
1
Publish Date
2006
Start Page
70.e9
End Page
70.15
DOI
10.1016/j.amjmed.2005.08.019

Racial differences in health concern.

An understanding of racial differences in risk-related affect may help explain racial differences in health behaviors and outcomes and provide additional opportunities for intervention. In phone interviews with a random community sample of 197 whites, 155 blacks and 163 Latinos, we assessed concern that respondents' health would be hurt by their diet, an inability to exercise, an inability to follow a doctor's recommendations and disease. A multivariate analysis of variance with follow-up profile analysis revealed that whites were less concerned than blacks and Latinos about an inability to follow their doctors' recommendations (ps < 0.01). There were no racial differences in the other health concern variables. Interventions to inform blacks and Latinos about their health risks must strike a balance between creating enough health concern to encourage health behavior but not so much that it interferes with health-promoting behaviors.

Authors
Voils, CI; Oddone, EZ; Weinfurt, KP; Friedman, JY; Bright, CM; Schulman, KA; Bosworth, HB
MLA Citation
Voils, CI, Oddone, EZ, Weinfurt, KP, Friedman, JY, Bright, CM, Schulman, KA, and Bosworth, HB. "Racial differences in health concern." J Natl Med Assoc 98.1 (January 2006): 36-42.
PMID
16532976
Source
pubmed
Published In
Journal of the National Medical Association
Volume
98
Issue
1
Publish Date
2006
Start Page
36
End Page
42

Defining and Designing Mixed Research Synthesis Studies.

Mixed research synthesis is the latest addition to the repertoires of mixed methods research and systematic review. Mixed research synthesis requires that the problems generated by the methodological diversity within and between qualitative and quantitative studies be resolved. Three basic research designs accommodate this diversity, including the segregated, integrated, and contingent designs. Much work remains to be done before mixed research synthesis can secure its place in the repertoires of mixed methods research and systematic review, but the effort is well worth it as it has the potential to enhance both the significance and utility for practice of the many qualitative and quantitative studies constituting shared domains of research.

Authors
Sandelowski, M; Voils, CI; Barroso, J
MLA Citation
Sandelowski, M, Voils, CI, and Barroso, J. "Defining and Designing Mixed Research Synthesis Studies." Res Sch 13.1 (2006): 29-.
PMID
20098638
Source
pubmed
Published In
Research in the Schools
Volume
13
Issue
1
Publish Date
2006
Start Page
29

Office measurements usually overestimate BP

Authors
Kim, JW; Bosworth, HB; Voils, CI
MLA Citation
Kim, JW, Bosworth, HB, and Voils, CI. "Office measurements usually overestimate BP." December 2005.
Source
wos-lite
Published In
Cleveland Clinic Journal of Medicine
Volume
72
Issue
12
Publish Date
2005
Start Page
1148
End Page
1148

Theoretical models to understand treatment adherence

Authors
Bosworth, HB; Voils, CI
MLA Citation
Bosworth, HB, and Voils, CI. "Theoretical models to understand treatment adherence." (August 21, 2005): 13-46. (Chapter)
Source
scopus
Publish Date
2005
Start Page
13
End Page
46
DOI
10.4324/9781410615626

Perceived discrimination and reported delay of pharmacy prescriptions and medical tests.

BACKGROUND: Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE: Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN: Cross-sectional, observational study. PARTICIPANTS: A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS: A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS: The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS: A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays.

Authors
Van Houtven, CH; Voils, CI; Oddone, EZ; Weinfurt, KP; Friedman, JY; Schulman, KA; Bosworth, HB
MLA Citation
Van Houtven, CH, Voils, CI, Oddone, EZ, Weinfurt, KP, Friedman, JY, Schulman, KA, and Bosworth, HB. "Perceived discrimination and reported delay of pharmacy prescriptions and medical tests." J Gen Intern Med 20.7 (July 2005): 578-583.
PMID
16050850
Source
pubmed
Published In
Journal of General Internal Medicine
Volume
20
Issue
7
Publish Date
2005
Start Page
578
End Page
583
DOI
10.1111/j.1525-1497.2005.0123.x

How well do clinic-based blood pressure measurements agree with the mercury standard?

BACKGROUND: Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement. OBJECTIVE: To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP. DESIGN: Prospective reliability study. PATIENTS: One hundred patients with an International Classification of Diseases-9th edition code for hypertension were enrolled. MEASURES: Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records. RESULTS: Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to 0.86). Overall, clinic-based readings overestimated the mercury readings, with a mean overestimation of 8.3 mmHg for SBP and 7.1 mmHg for DBP. Based on the clinic-based measure, 21% of patients were misdiagnosed with uncontrolled hypertension. CONCLUSIONS: Health professionals should be aware of this potential difference when utilizing clinic-based BP values for making treatment decisions and/or assessing quality of care.

Authors
Kim, JW; Bosworth, HB; Voils, CI; Olsen, M; Dudley, T; Gribbin, M; Adams, M; Oddone, EZ
MLA Citation
Kim, JW, Bosworth, HB, Voils, CI, Olsen, M, Dudley, T, Gribbin, M, Adams, M, and Oddone, EZ. "How well do clinic-based blood pressure measurements agree with the mercury standard?." J Gen Intern Med 20.7 (July 2005): 647-649.
PMID
16050862
Source
pubmed
Published In
Journal of General Internal Medicine
Volume
20
Issue
7
Publish Date
2005
Start Page
647
End Page
649
DOI
10.1111/j.1525-1497.2005.0105.x

Social support and locus of control as predictors of adherence to antidepressant medication in an elderly population.

OBJECTIVE: The authors examined whether social support and locus of control (LOC), either individually or jointly, would be associated with subsequent self-reported medication adherence and treatment barriers in a sample of depressed elderly patients. METHODS: A group of 85 elderly patients with major depression was enrolled in the Mental Health Clinical Research Center for the Study of Depression in Later Life at Duke University and treated with a standardized algorithm. During the course of the study, participants completed measures of social support and internal locus of control (LOC). A little more than 1 year later, they completed general measures of medication adherence and treatment barriers. RESULTS: Increasing subjective and instrumental social support and non-family interaction were associated with greater adherence among patients high in internal LOC but not among patients low in internal LOC. Less instrumental social support was associated with more treatment barriers among patients low in internal LOC but not among patients high in internal LOC. CONCLUSION: The relationship between social support and antidepressant medication adherence is moderated by beliefs about control over one's illness.

Authors
Voils, CI; Steffens, DC; Flint, EP; Bosworth, HB
MLA Citation
Voils, CI, Steffens, DC, Flint, EP, and Bosworth, HB. "Social support and locus of control as predictors of adherence to antidepressant medication in an elderly population." Am J Geriatr Psychiatry 13.2 (February 2005): 157-165.
PMID
15703325
Source
pubmed
Published In
American Journal of Geriatric Psychiatry
Volume
13
Issue
2
Publish Date
2005
Start Page
157
End Page
165
DOI
10.1176/appi.ajgp.13.2.157

For the patient. Who trusts healthcare institutions? Results from a community-based sample.

Authors
Voils, CI; Oddone, EZ; Weinfurt, KP; Friedman, JY; Schulman, KA; Bosworth, HB
MLA Citation
Voils, CI, Oddone, EZ, Weinfurt, KP, Friedman, JY, Schulman, KA, and Bosworth, HB. "For the patient. Who trusts healthcare institutions? Results from a community-based sample." Ethn Dis 15.1 (2005): 150-.
PMID
15720061
Source
pubmed
Published In
Ethnicity & disease
Volume
15
Issue
1
Publish Date
2005
Start Page
150

Who trusts healthcare institutions? Results from a community-based sample.

OBJECTIVE: The goal of this research was to examine racial differences in trust in various healthcare institutions. METHOD: In telephone interviews, 195 Whites, 183 Blacks, and 171 Latinos from Durham, NC indicated how often they trust various institutions (community doctors, local hospitals, county health department, insurance companies, and state and federal government) to do what is best for patients. RESULTS: In bivariate analyses, trust in various healthcare institutions was associated with race; Whites and Latinos trusted physicians more often than Blacks, and Latinos trusted the health department, insurance companies, and both government entities more often than Whites and Blacks (Ps < .01). In adjusted analyses controlling for marital status, financial status, and education, race was still associated with trust. Whites trusted physicians more often than Blacks, and Latinos trusted insurance companies, the state government, and the federal government more often than Whites and Blacks (Ps < .01). CONCLUSIONS: Racial differences in trust of healthcare institutions vary by institution type. Future studies of trust and interventions designed to improve trust must account for race and target institution differences.

Authors
Voils, CI; Oddone, EZ; Weinfurt, KP; Friedman, JY; Schulman, KA; Bosworth, HB
MLA Citation
Voils, CI, Oddone, EZ, Weinfurt, KP, Friedman, JY, Schulman, KA, and Bosworth, HB. "Who trusts healthcare institutions? Results from a community-based sample." Ethn Dis 15.1 (2005): 97-103.
PMID
15720055
Source
pubmed
Published In
Ethnicity & disease
Volume
15
Issue
1
Publish Date
2005
Start Page
97
End Page
103

Overcoming clinical inertia: A visit-specific scale for measuring quality in hypertension care

• Objective: To develop a valid, reproducible scale that quantifies a provider's reaction to uncontrolled blood pressure. • Design: Retrospective chart review. • Setting and participants: 70 patients with hypertension who were treated with antihypertensive medication at the Durham Veterans Affairs Medical Center primary care clinic. • Methods: Three raters blinded to each other's assessments rated each patient visit using the hypertension quality of care scale. This scale includes 4 categories reflecting the extent of provider recognition of elevated blood pressure and action to lower it (0: blood pressure not recorded at visit; 1: blood pressure not controlled, not mentioned in the medical record, and nothing further done; 2: blood pressure not controlled, mentioned in the medical record, but nothing further done; 3: blood pressure not controlled and the provider acted in some manner to lower it). • Results: Providers failed to recognize or act on inadequately controlled blood pressure at 48% of visits. The average frequency of scores for all raters was 2.9% (no blood pressure recorded), 30.5% (blood pressure recorded but not mentioned), 14.3% (blood pressure recorded, provider recognized elevation, but no action), and 25.3% (provider acted to lower blood pressure); blood pressure was adequately controlled in 27.1% of patients. Inter-rater agreement was excellent (Kendall's W = 0.92). Scale scores were moderately related to the extent of systolic blood pressure elevation (r = 0.29, averaged across raters). • Conclusion: The scale demonstrated excellent interrater agreement and moderate correlation with elevation in systolic blood pressure. The scale could be used to measure the effectiveness of interventions designed to prompt providers to respond to inadequately controlled hypertension.

Authors
Henderson, W; Bosworth, HB; Voils, CI; Dudley, TK; McCant, FA; Gentry, PW; Oddone, EZ
MLA Citation
Henderson, W, Bosworth, HB, Voils, CI, Dudley, TK, McCant, FA, Gentry, PW, and Oddone, EZ. "Overcoming clinical inertia: A visit-specific scale for measuring quality in hypertension care." Journal of Clinical Outcomes Management 12.3 (2005): 147-150.
Source
scival
Published In
Journal of Clinical Outcomes Management
Volume
12
Issue
3
Publish Date
2005
Start Page
147
End Page
150

Impact of functional support on health-related quality of life in patients with colorectal cancer.

BACKGROUND: It has been shown that social integration and the availability of social support influence quality of life. However, little is known about the relation between social support and mental and physical health in patients with colorectal cancer. In the current study, the authors examined the effects of social network size, as well as emotional and instrumental support, on health-related quality of life (HRQOL) in patients with colorectal cancer. METHODS: Six hundred thirty-six veterans with colorectal cancer were asked to complete a telephone interview, which included a measure of social support (the Berkman-Syme Index) and the Medical Outcomes Study Short Form 12-Item Survey. Mean physical composite scale (PCS) and mental composite scale (MCS) scores were compared across groups. RESULTS: No difference in mean PCS or MCS scores was found between patients who had larger social networks and patients who had smaller social networks. The availability of emotional and instrumental support was associated with higher MCS scores, whereas the availability of instrumental support was associated with lower PCS scores. CONCLUSIONS: Irrespective of network size, the availability of emotional support and instrumental support had an impact on HRQOL in patients with colorectal cancer. More emphasis needs to be placed on understanding how various types of social support, individually and collectively, influence physical and mental health in patients with colorectal cancer.

Authors
Sultan, S; Fisher, DA; Voils, CI; Kinney, AY; Sandler, RS; Provenzale, D
MLA Citation
Sultan, S, Fisher, DA, Voils, CI, Kinney, AY, Sandler, RS, and Provenzale, D. "Impact of functional support on health-related quality of life in patients with colorectal cancer." Cancer 101.12 (December 15, 2004): 2737-2743.
PMID
15536617
Source
pubmed
Published In
Cancer
Volume
101
Issue
12
Publish Date
2004
Start Page
2737
End Page
2743
DOI
10.1002/cncr.20699

Measuring quality of life at the end of life: validation of the QUAL-E.

OBJECTIVES: To validate the QUAL-E, a new measure of quality of life at the end of life. METHODS: We conducted a cross-sectional study to assess the instrument's psychometric properties, including the QUAL-E's associations with existing measures, evaluation of robustness across diverse sample groups, and stability over time. The study was conducted at the VA and Duke University Medical Centers, Durham, North Carolina, in 248 patients with stage IV cancer, congestive heart failure with ejection fraction < or = 20%, chronic obstructive pulmonary disease with FEV1 < or = 1.0 1, or dialysis-dependent end stage renal disease. The main outcome measures included QUAL-E and five comparison measures: FACIT quality of life measure, Missoula-VITAS Quality of Life Index, FACIT-SP spirituality measures, Participatory Decision Making Scale (MOS), and Duke EPESE social support scales. RESULTS: QUAL-E analyses confirmed a four-domain structure (25 items): life completion (alpha = 0.80), symptoms impact (alpha = 0.87), relationship with health care provider (alpha = 0.71), and preparation for end of life (alpha = 0.68). Convergent and discriminant validity were demonstrated with multiple comparison measures. Test-retest reliability assessment showed stable scores over a 1-week period. SIGNIFICANCE OF RESULTS: The QUAL-E, a brief measure of quality of life at the end of life, demonstrates acceptable validity and reliability, is easy to administer, performs consistently across diverse demographic and disease groups, and is acceptable to seriously ill patients. It is offered as a new instrument to assist in the evaluation of the quality and effectiveness of interventions targeting improved care at the end of life.

Authors
Steinhauser, KE; Clipp, EC; Bosworth, HB; McNeilly, M; Christakis, NA; Voils, CI; Tulsky, JA
MLA Citation
Steinhauser, KE, Clipp, EC, Bosworth, HB, McNeilly, M, Christakis, NA, Voils, CI, and Tulsky, JA. "Measuring quality of life at the end of life: validation of the QUAL-E." Palliat Support Care 2.1 (March 2004): 3-14.
PMID
16594230
Source
pubmed
Published In
Palliative & Supportive Care
Volume
2
Issue
1
Publish Date
2004
Start Page
3
End Page
14

Putting the brakes on prejudice: on the development and operation of cues for control.

A model concerning the establishment and operation of cues for control was developed and tested to understand how control can be exerted over (automatic) prejudiced responses. Cues for control are stimuli that are associated with prejudiced responses and the aversive consequences of those responses (e.g., guilt). In Experiments 1 and 2, 3 events critical to the establishment of cues occurred: behavioral inhibition, the experience of guilt, and retrospective reflection. In Experiment 3, the presentation of already-established cues for control did, as expected, produce behavioral inhibition. In Experiment 4, participants were provided with an experience in which cues could be established. Later presentation of those cues in a different task resulted in behavioral inhibition and less racially biased responses.

Authors
Monteith, MJ; Ashburn-Nardo, L; Voils, CI; Czopp, AM
MLA Citation
Monteith, MJ, Ashburn-Nardo, L, Voils, CI, and Czopp, AM. "Putting the brakes on prejudice: on the development and operation of cues for control." J Pers Soc Psychol 83.5 (November 2002): 1029-1050.
PMID
12416910
Source
pubmed
Published In
Journal of Personality and Social Psychology
Volume
83
Issue
5
Publish Date
2002
Start Page
1029
End Page
1050

Implicit associations as the seeds of intergroup bias: how easily do they take root?

Three experiments provided evidence that intergroup bias occurs automatically under minimal conditions, using the Implicit Association Test (IAT). In Experiment 1, participants more readily paired in-group names with pleasant words and out-group names with unpleasant words, even when they were experienced only with the in-group and had no preconceptions about the out-group. Participants in Experiment 2 likewise showed an automatic bias favoring the in-group, even when in-group/out-group exemplars were completely unfamiliar and identifiable only with the use of a heuristic. In Experiment 3, participants displayed a pro-in-group IAT bias following a minimal group manipulation. Taken together, the results demonstrate the ease with which intergroup bias emerges even in unlikely conditions.

Authors
Ashburn-Nardo, L; Voils, CI; Monteith, MJ
MLA Citation
Ashburn-Nardo, L, Voils, CI, and Monteith, MJ. "Implicit associations as the seeds of intergroup bias: how easily do they take root?." J Pers Soc Psychol 81.5 (November 2001): 789-799.
PMID
11708557
Source
pubmed
Published In
Journal of Personality and Social Psychology
Volume
81
Issue
5
Publish Date
2001
Start Page
789
End Page
799

Taking a look underground: Detecting, interpreting, and reacting to implicit racial biases

Participants were given the opportunity to gain insight into their implicit racial biases by completing the Implicit Association Test (IAT, Greenwald, McGhee, & Schwartz, 1998). We examined participants' detection of their implicit racial biases, and their interpretation of and reactions to such biases. Further, we examined the potential moderating role of proneness to prejudice-related discrepancies. Results revealed strong implicit racial biases that were moderately related to explicit prejudice but unrelated to proneness to discrepancies. The majority of participants detected this bias, and they felt guilty about it to the extent that they attributed the bias to race-related factors. Participants with smaller discrepancies were more prone to misattribute their IAT bias to nonracial factors and not feeling guilty. These latter findings suggest that people who typically experience success at avoiding prejudiced responses might, paradoxically, be least likely to detect subtle racial biases when they do occur.

Authors
Monteith, MJ; Voils, CI; Ashburn-Nardo, L
MLA Citation
Monteith, MJ, Voils, CI, and Ashburn-Nardo, L. "Taking a look underground: Detecting, interpreting, and reacting to implicit racial biases." Social Cognition 19.4 (2001): 395-417.
Source
scival
Published In
Social Cognition
Volume
19
Issue
4
Publish Date
2001
Start Page
395
End Page
417
DOI
10.1521/soco.19.4.395.20759

Effects of culture and processing goals on the activation and binding of trait concepts

Two studies compared spontaneous trait use by Latinos and Anglo-Americans, with trait-implying behaviors equated over cultures on their intentional trait implications. In Study 1, only Anglos showed activation of trait concepts on a lexical decision task. In Study 2, with the more complex stimuli set, Anglos showed greater binding (linkage) of trait concepts and/or behaviors to the actors performing the behaviors. Results were consistent with the more frequent use of trait terms by Euro-Americans than by those from collectivist cultures, especially in open-ended self-descriptions and causal explanations, and illustrate the value of investigating activation and binding as two separable stages of spontaneous trait inference. The results also show that spontaneous inferences can reveal cultural differences that intentional inferences do not.

Authors
Zárate, MA; Uleman, JS; Voils, CI
MLA Citation
Zárate, MA, Uleman, JS, and Voils, CI. "Effects of culture and processing goals on the activation and binding of trait concepts." Social Cognition 19.3 (2001): 295-323.
Source
scival
Published In
Social Cognition
Volume
19
Issue
3
Publish Date
2001
Start Page
295
End Page
323
DOI
10.1521/soco.19.3.295.21469

Exerting control over prejudiced responses

Authors
Monteith, MJ; Voils, CI
MLA Citation
Monteith, MJ, and Voils, CI. "Exerting control over prejudiced responses." 2001.
Source
wos-lite
Published In
COGNITIVE SOCIAL PSYCHOLOGY
Publish Date
2001
Start Page
375
End Page
388

Proneness to prejudiced responses: toward understanding the authenticity of self-reported discrepancies.

Three studies investigated the authenticity of prejudice-related discrepancies. A comprehensive discrepancy questionnaire was developed (Study 1), which yielded small as well as large discrepancy scores. Study 2 indicated that discrepancy scores were stable, and personality could not account for the relation between discrepancies and their affective consequences. In Study 3, low-prejudice participants responded to jokes about Blacks under high or low distraction. Behavioral validation for self-reported discrepancies was found, such that participants with larger discrepancies evaluated the jokes more favorably under high than low distraction, but participants with smaller discrepancies provided equally unfavorable evaluations in both distraction conditions. Implications for understanding people's abilities to avoid potentially prejudiced responses and their self-insight into such abilities are discussed.

Authors
Monteith, MJ; Voils, CI
MLA Citation
Monteith, MJ, and Voils, CI. "Proneness to prejudiced responses: toward understanding the authenticity of self-reported discrepancies." J Pers Soc Psychol 75.4 (October 1998): 901-916.
PMID
9825527
Source
pubmed
Published In
Journal of Personality and Social Psychology
Volume
75
Issue
4
Publish Date
1998
Start Page
901
End Page
916
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