51
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Pedro J, Fernandes J, Schmidt L, Costa ME, Martins MV. Mapping intentions to adopt fertility protective behaviours: the role of couple congruence and the importance of relationship and fertility awareness. HUM FERTIL 2022; 25:993-1002. [PMID: 34348572 DOI: 10.1080/14647273.2021.1960436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Several studies worldwide have shown that reproductive-aged people often have inadequate fertility awareness (FA). Since attitudes and health behaviours are influenced by the partner, there is a need for studies exploring the role of these influences on the individuals' adoption of fertility protective behaviours (FPB). This study explores the role of FA and relationship quality on couples' intention to adopt FPB. One hundred and twelve childless couples answered an online questionnaire about reproductive life plan, FA and intentions to adopt FPB. The results showed that couples were moderately congruent on their reproductive life plan. The female partners who reported higher female relationship quality and higher female willingness to undergo fertility treatments were more willing to adopt FPB. The male partners who had heightened FA also reported higher intention to adopt FPB. The influences of male and female FA, relationship quality and congruence on reproductive life plan were neither associated with couples' congruence on the intention to adopt FPB. Although the cross-sectional design restricts our ability to draw causal conclusions, these findings emphasize that future interventions should be targeted at couples and designed according to their expectations and reproductive desires.
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal.,Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
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52
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Ali T, McAvay G, Monin JK. Mealtime Behavior and Depressive Symptoms in Late-Life Marriage. GEROPSYCH 2022; 35:211-225. [PMID: 36777454 PMCID: PMC9912988 DOI: 10.1024/1662-9647/a000285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study examined whether one spouse's mealtime behaviors were associated with their own and their partner's depressive symptoms among older, married couples. We examined gender differences in these associations and tested marital satisfaction as a mediator of these associations. 101 couples self-reported mealtime behavior (number of meals, snacks, fast-food meals, and meals eaten alone), depressive symptoms, and marital satisfaction. Results of the Actor Partner Interdependence Model revealed a statistically significant actor effect of number of fast-food meals on depressive symptoms and a significant partner effect of number of fast-food meals and number of meals eaten alone on depressive symptoms. There were gender differences. Husbands' marital satisfaction mediated the effect of meals eaten alone on depressive symptoms. Wife's marital satisfaction mediated the effect of the husband's meals eaten alone, and wife's number of fast-food meals on the wife's depressive symptoms. Findings have implications for dyadic interventions to improve depressive symptoms.
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Affiliation(s)
- Talha Ali
- Department of Internal Medicine, Yale School of Medicine
| | - Gail McAvay
- Department of Internal Medicine, Yale School of Medicine
| | - Joan K. Monin
- Social and Behavioral Sciences, Yale School of Public Health
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53
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Curtis MG, Kogan S, Mitchell JW, Stephenson R. Dyadic effects of enacted stigma, internalized homophobia, and communal coping on depressive symptoms among cisgender sexual minority male couples. FAMILY PROCESS 2022; 61:1541-1558. [PMID: 34993953 DOI: 10.1111/famp.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
The present study investigated the dyadic direct and indirect effects of enacted stigma on depressive symptoms via internalized homophobia and whether communal coping moderated the effects of enacted stigma on internalized homophobia and depressive symptoms. Hypotheses were tested using actor-partner interdependence models with a sample of 543 cisgender sexual minority male couples. Results showed both partners' enacted stigma experiences were associated with elevated levels of internalized homophobia via actor and partner effects. Internalized homophobia was only associated with elevated depressive symptoms via actor effects. Indirect effects analysis suggested that internalized homophobia mediated the actor and partner influence of enacted stigma on depressive symptoms. Communal coping moderated the direct effects of enacted stigma on internalized homophobia and attenuated the conditional indirect actor and partner effects of enacted stigma on depressive symptoms. Findings underscore the role of intimate relationship processes in understanding the impacts of enacted stigma on depressive symptoms.
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Affiliation(s)
- Michael G Curtis
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Steven Kogan
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Jason W Mitchell
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, USA
| | - Rob Stephenson
- Department of Systems, Population and Leadership, University of Michigan, Ann Arbor, MI, USA
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54
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Dailey RM, Zhang Z, Kurlak R, Lloyd R, Burdick S. Romantic Partner Perspectives of the Relational Context of Weight Loss Support. HEALTH COMMUNICATION 2022; 37:1788-1797. [PMID: 33941002 DOI: 10.1080/10410236.2021.1920712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Much of the research on romantic partner support of weight loss takes the perspective of targets pursuing weight loss. This study, however, assesses the perspectives of the partners providing support, and specifically their perceptions of the relational context and their support strategy use. An MTurk sample of 283 partners of individuals trying to lose weight reported on relational context characteristics (i.e., having a team effort, opposing approaches, and imposition regarding the weight loss pursuits) and their use of encouragement, direct influence, and coercion. Analyses largely supported the hypotheses regarding the associations between the relational characteristics and strategy use. For example, higher team effort and lower opposing approaches about weight management were linked with more encouragement, and greater opposing approaches and imposition were associated with more coercion. Four relational weight loss climates based on the collective of these characteristics were also linked with strategy use. All associations were found after accounting for general relationship satisfaction as well as other control variables. Overall, the findings suggest that perceptions of the weight loss in the context of the relationship were connected to the strategies partners employed in helping targets achieve weight loss. Because strategies vary in effectiveness, understanding which relational characteristics, as well as which broader relational climates, facilitate partner strategy choice can ultimately help augment individuals' weight loss success.
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Affiliation(s)
- René M Dailey
- Department of Communication Studies, University of Texas at Austin
| | - Zhengyu Zhang
- Department of Communication Studies, Western Washington University
| | - Rebecca Kurlak
- Department of Communication Studies, University of Texas at Austin
| | - Rachel Lloyd
- Department of Communication Studies, University of Texas at Austin
| | - Suzanne Burdick
- Department of Communication Studies, University of Texas at Austin
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55
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Rasouli O, Øglænd IS, Reinfjell T, Eilertsen MEB. Protective and risk factors in the grieving process among cancer-bereaved parents: A qualitative study. DEATH STUDIES 2022; 47:881-890. [PMID: 36352505 DOI: 10.1080/07481187.2022.2142324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This Norwegian nationwide study explored cancer-bereaved parents' perceptions of protective and risk factors in their grieving process. A total of 162 parents answered two open-ended questions 2-8 years after their child's death due to cancer. Qualitative analysis revealed three main themes: memories of the child's illness and death, going forward in life, and relationships-a resource and a barrier. The results support the perspective of going forward in life and accepting grief as part of life, contrary to the notion of "getting over" or "detaching" from the deceased child. Social support is also crucial for cancer-bereaved parents.
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Affiliation(s)
- Omid Rasouli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingvild Svela Øglænd
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trude Reinfjell
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mary-Elizabeth Bradley Eilertsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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56
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Exploring motivation to quit and risk appraisals of hookah tobacco smoking for self and partner among a member of single and dual smoker couples. J Behav Med 2022:10.1007/s10865-022-00369-4. [DOI: 10.1007/s10865-022-00369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
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57
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Gil N, Fisher A, Beeken RJ, Pini S, Miller N, Buck C, Lally P, Conway R. The role of partner support for health behaviours in people living with and beyond cancer: A qualitative study. Psychooncology 2022; 31:1997-2006. [PMID: 36097392 PMCID: PMC9828063 DOI: 10.1002/pon.6032] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/16/2022] [Accepted: 09/05/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to qualitatively explore how partner support for health behaviours is perceived, received, and utilised in people living with and beyond cancer (LWBC). METHODS Semi-structured audio interviews were conducted with 24 participants, 15 men and nine women, living with and beyond breast, prostate, and colorectal cancer. Inductive and deductive Thematic Analysis was used to analyse the data. RESULTS Three key themes with six subthemes were identified relating to partner support for health behaviours: (1) Interdependence (Reciprocity, Overt Control, Influence & Motivation) (2) Concordance (Shared Attitudes & Health Beliefs, Shared Health Behaviour) and (3) Communal Coping (Communal Orientation towards Health and Decision Making, Co-operative Action in Health Behaviour). CONCLUSIONS Partner support plays a unique and significant role in the health behaviours of people LWBC. Partners play a collaborative role in managing health and facilitating health behaviours, while the high level of concordance in couples may represent a potential barrier to change via the reinforcement of maladaptive health beliefs and behaviours. IMPLICATIONS FOR CANCER SURVIVORS Overall, findings demonstrate that partners should be considered and included where possible when designing future behaviour change interventions for people LWBC.
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Affiliation(s)
- Natalie Gil
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Abigail Fisher
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Rebecca J. Beeken
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Simon Pini
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Natalie Miller
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Caroline Buck
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Phillippa Lally
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Rana Conway
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
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58
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Ukai T, Tabuchi T, Iso H. The impact of spousal behavior changes on smoking, drinking and physical activity: The longitudinal survey of middle-aged and elderly persons in Japan. Prev Med 2022; 164:107293. [PMID: 36208818 DOI: 10.1016/j.ypmed.2022.107293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/19/2022] [Accepted: 10/02/2022] [Indexed: 10/31/2022]
Abstract
The purpose of this study is to assess how one spouse's behavior change can influence their partner's successful behavior changes in smoking, drinking and physical activity. We used data from 10-wave prospective annual surveys of 9417 married couples (discrete-time person-years = 118,876) aged 50-59 years in the Longitudinal Survey of Middle-aged and Elderly Persons in Japan. A logistic generalized estimating equation model with discrete-time design was used among individuals who smoked at baseline to examine the impact of their spouse's health behaviors (i.e. quit smoking, stable non-smoker, or started smoking in reference to stable smoker) on changes in their own behavior (quitting smoking) which lasted one year or more. Similarly, reducing alcohol intake and starting physical activity were individually analyzed. Partners of spouses who had quit smoking had higher odds of quitting smoking themselves than partners of spouses who were stable smokers. The multivariable odds ratios[95%CI] in men and women were 1.94[1.23-3.07] and 2.89[1.81-4.52]. An association was found in partners of spouses who had been stable non-smokers (OR:1.64[1.33-2.03] and 2.20[1.66-2.94]), but not after spouses had started smoking (OR:1.29[0.71-2.36] and 1.27[0.54-2.99]). Similar associations were found for reducing alcohol intake and starting physical activity although for physical activity, the association was still found after the spouse had become physically inactive. Couples affect each other's health behaviors. Both male and female participants had higher odds of adopting positive health behavior changes if these changes had previously been made by their spouse.
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Affiliation(s)
- Tomohiko Ukai
- Division of Public Health, Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan.
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Public Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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59
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Bhushan NL, Musara P, Hartmann M, Stoner MCD, Shah SR, Nabukeera J, Rukundo I, Mutero P, Lewis MA, Piper J, Shapley‐Quinn MK, Etima J, Minnis AM. Making the Case for Joint Decision-Making in Future Multipurpose Prevention Technology (MPT) Choice: Qualitative Findings on MPT Attribute Preferences from the CUPID Study (MTN-045). J Int AIDS Soc 2022; 25:e26024. [PMID: 36254362 PMCID: PMC9577116 DOI: 10.1002/jia2.26024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/21/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Young women in sub‐Saharan Africa account for two‐thirds of all new HIV infections and face high rates of unintended pregnancy. Multipurpose prevention technologies (MPTs) are promising products under development that are designed to simultaneously prevent HIV and unintended pregnancy. Since MPTs will be used in the context of sexual relationships, ensuring acceptability and use requires understanding the role of male partners in MPT use decision‐making. Methods This paper draws on qualitative data from 39 couples enrolled in the Microbicide Trials Network (MTN) 045 study, conducted in 2019–2020. Partners completed a discrete choice experiment (DCE), first separately and then jointly, to measure preferences for future MPT attributes and then completed a qualitative interview. We also draw on quantitative data from interviewer observation about who dominated the decision‐making process during the joint DCE. Content analysis was used to examine (1) how couples made decisions on existing non‐MPT HIV and pregnancy prevention products; (2) how couples made decisions on future ideal‐MPT product during the DCE; and (3) how these decision‐making processes varied by decision‐making dominance (10 male, 10 female and 19 equal) and interview type (19 joint and 20 separate). Results Existing non‐MPT product decisions focused on trust between partners and product attributes, while future ideal‐MPT product decisions exclusively focused on product attributes. Across existing and future products, preferences for product attributes varied by gender. Male partners were most concerned with limiting side effects impacting sexual pleasure, female partners were most concerned with limiting side effects causing physical symptoms and both were concerned with the return to fertility. Across all dominance and interview types, couples reported making decisions together and female partners were often able to negotiate with male partners for their preferred product or set of product attributes. Conclusions Research activities in this study provided an opportunity for couples to openly present their product attribute preferences to their partner, learn about their partner's attribute preferences, negotiate for their ideal set of attributes and ultimately choose attributes that benefited the couple without disempowering the female partner. Future research should focus on the utility of couple‐based decision‐making aids or similar tools for facilitating joint MPT decision‐making.
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Affiliation(s)
| | - Petina Musara
- Clinical Trials Research CentreUniversity of ZimbabweHarareZimbabwe
| | | | | | - Shweta R. Shah
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Josephine Nabukeera
- Makerere University ‐ Johns Hopkins University Research Collaboration (MU‐JHU)KampalaUganda
| | - Ivan Rukundo
- Makerere University ‐ Johns Hopkins University Research Collaboration (MU‐JHU)KampalaUganda
| | - Prisca Mutero
- Clinical Trials Research CentreUniversity of ZimbabweHarareZimbabwe
| | - Megan A. Lewis
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Jeanna Piper
- National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | | | - Juliane Etima
- Makerere University ‐ Johns Hopkins University Research Collaboration (MU‐JHU)KampalaUganda
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60
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Veenstra CM, Ellis KR, Abrahamse P, Ward KC, Morris AM, Hawley ST. A dyadic survey study of partner engagement in and patient receipt of guideline-recommended colorectal cancer surveillance. BMC Cancer 2022; 22:1060. [PMID: 36229796 PMCID: PMC9559022 DOI: 10.1186/s12885-022-10131-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background We investigated whether partner (spouse or intimate partner) engagement in colorectal cancer (CRC) surveillance is associated with patient receipt of surveillance. Methods From 2019 to 2020 we surveyed Stage III CRC survivors diagnosed 2014–2018 at an academic cancer center, a community oncology practice and the Georgia SEER registry, and their partners. Partner engagement was measured across 3 domains: Informed about; Involved in; and Aware of patient preferences around surveillance. We evaluated bivariate associations between domains of partner engagement and independent partner variables. Analysis of variance and multivariable logistic regression were used to compare domains of engagement with patient-reported receipt of surveillance. Results 501 patients responded (51% response rate); 428 had partners. 311 partners responded (73% response rate). Partners were engaged across all domains. Engagement varied by sociodemographics. Greater partner involvement was associated with decreased odds of receipt of composite surveillance (OR 0.67, 95% CI 0.48–0.93) and trended towards significance for decreased odds of receipt of endoscopy (OR 0.60, 95% CI 0.34–1.03) and CEA (OR 0.75, 95% CI 0.55–1.04). Greater partner awareness was associated with increased odds of patients’ receipt of endoscopy (OR 2.18, 95% CI 1.15–4.12) and trended towards significance for increased odds of receipt of composite surveillance (OR 1.30, 95% CI 0.91–2.04). Conclusion Partners are engaged (informed, involved, and aware) in CRC surveillance. Future research to develop dyadic interventions that capitalize on the positive aspects of partner engagement may help partners effectively engage in surveillance to improve patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10131-3.
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Affiliation(s)
- Christine M Veenstra
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA.
| | - Katrina R Ellis
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
| | - Paul Abrahamse
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
| | | | | | - Sarah T Hawley
- University of Michigan, 300 North Ingalls, NIB, Room 3A22, 48109, Ann Arbor, MI, USA
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61
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Belus JM, van Heerden A, van Rooyen H, Bradley VD, Magidson JF, Hines AC, Barnabas RV. Supporting Treatment for Anti-Retroviral Therapy (START) Together: Protocol for a pilot, randomized, couple-based intervention to promote women's ART adherence and men's engagement in HIV care in KwaZulu-Natal, South Africa. Contemp Clin Trials Commun 2022; 29:100970. [PMID: 36105267 PMCID: PMC9464877 DOI: 10.1016/j.conctc.2022.100970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 07/08/2022] [Accepted: 08/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background South Africa currently has the greatest number of people with HIV globally. The country has not yet met its 95-95-95 goals, with different gaps in the HIV care cascade for women and men. This paper reports on a protocol to pilot test a couple-based intervention designed to improve women's antiretroviral therapy (ART) adherence and men's engagement in care in heterosexual couples living in the Vulindlela area of KwaZulu-Natal, South Africa. Study goals are two-fold: (1) assess the acceptability, feasibility, and fidelity of the experimental intervention, START Together, and (2) collect efficacy data on START Together for women's ART adherence, men's engagement in HIV care, and the couple's relationship functioning. Methods Women (N = 20) who were not engaged with ART adherence (defined via self-reported ART difficulties, record of missed clinic visits, or viral non-suppression) are the target patients; male partners are not required to know or disclose their HIV status to be part of the study. Couples are randomized 1:1 to the experimental treatment (START Together) or treatment as usual (referrals to the local clinic to support ART adherence or any other HIV-related care). START Together is a 5-session intervention based in cognitive-behavioral couple therapy, which is a skill-based intervention focusing on communication and problem-solving skills, and Life Steps, a problem-solving intervention identifying barriers and solutions to medication adherence. Couples are assessed at baseline, post-treatment (8 weeks post-randomization), and follow-up (12 weeks post-randomization). Conclusion This study will provide preliminary implementation and efficacy data on whether this novel approach has potential to improve women and men's HIV and healthcare-related needs.
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Affiliation(s)
- Jennifer M Belus
- Swiss Tropical and Public Health Institute, Department of Medicine, Allschwil, 4123, Switzerland.,University of Basel, Basel, Switzerland.,University of Maryland, Department of Psychology, College Park, MD, 20742, USA
| | - Alastair van Heerden
- Human and Social Development, Human Sciences Research Council, Pietermaritzburg, South Africa.,SAMRC/WITS Developmental Pathways for Health Research Unit Department of Paediatrics, Faculty of Health Science, University of the Witwatersrand, South Africa
| | - Heidi van Rooyen
- SAMRC/WITS Developmental Pathways for Health Research Unit Department of Paediatrics, Faculty of Health Science, University of the Witwatersrand, South Africa.,The Impact Centre, Human Sciences Research Council, Durban, South Africa
| | - Valerie D Bradley
- University of Maryland, Department of Psychology, College Park, MD, 20742, USA
| | - Jessica F Magidson
- University of Maryland, Department of Psychology, College Park, MD, 20742, USA
| | - Abigail C Hines
- University of Maryland, Department of Psychology, College Park, MD, 20742, USA
| | - Ruanne V Barnabas
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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62
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Dailey RM, Lloyd R, Burdick S, Zhang Z, Kurlak R. Romantic partner undermining of weight loss: Links between overweight individuals' weight management efforts and perceptions of their partner's undermining motivations and behaviors. J Health Psychol 2022; 28:583-596. [PMID: 36124728 DOI: 10.1177/13591053221123842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated romantic partners' undermining of weight management (i.e. hindrance of weight loss efforts) and how perceived motivations behind undermining were associated with weight loss progress. Data from 241 overweight individuals currently cohabiting with a romantic partner and trying to lose weight revealed two overarching undermining factors (i.e. verbal criticism/complaint, behavioral interference) and six perceived motivations (e.g. partner believed weight loss was unnecessary, partner relational fears, weight loss was an imposition on partner). Path modeling showed both undermining behaviors were negatively associated with weight management. Yet, only certain motivations (e.g. imposition on partner, weight loss was unnecessary) were linked to weight management, either directly or indirectly, through undermining. Specifically, whereas criticism/complaint mediated the associations between these motivations and weight management, interference only mediated the association between imposition and weight management. Findings are discussed in terms of the theoretical and practical value of distinguishing undermining behaviors and their underlying motivations.
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63
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Miller HN, Voils CI, Cronin KA, Jeanes E, Hawley J, Porter LS, Adler RR, Sharp W, Pabich S, Gavin KL, Lewis MA, Johnson HM, Yancy WS, Gray KE, Shaw RJ. A Method to Deliver Automated and Tailored Intervention Content: 24-month Clinical Trial. JMIR Form Res 2022; 6:e38262. [PMID: 36066936 PMCID: PMC9490532 DOI: 10.2196/38262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/28/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background
The use of digital technologies and software allows for new opportunities to communicate and engage with research participants over time. When software is coupled with automation, we can engage with research participants in a reliable and affordable manner. Research Electronic Data Capture (REDCap), a browser-based software, has the capability to send automated text messages. This feature can be used to automate delivery of tailored intervention content to research participants in interventions, offering the potential to reduce costs and improve accessibility and scalability.
Objective
This study aimed to describe the development and use of 2 REDCap databases to deliver automated intervention content and communication to index participants and their partners (dyads) in a 2-arm, 24-month weight management trial, Partner2Lose.
Methods
Partner2Lose randomized individuals with overweight or obesity and cohabitating with a partner to a weight management intervention alone or with their partner. Two databases were developed to correspond to 2 study phases: one for weight loss initiation and one for weight loss maintenance and reminders. The weight loss initiation database was programmed to send participants (in both arms) and their partners (partner-assisted arm) tailored text messages during months 1-6 of the intervention to reinforce class content and support goal achievement. The weight maintenance and reminder database was programmed to send maintenance-related text messages to each participant (both arms) and their partners (partner-assisted arm) during months 7-18. It was also programmed to send text messages to all participants and partners over the course of the 24-month trial to remind them of group classes, dietary recall and physical activity tracking for assessments, and measurement visits. All text messages were delivered via Twilio and were unidirectional.
Results
Five cohorts, comprising 231 couples, were consented and randomized in the Partner2Lose trial. The databases will send 53,518 automated, tailored text messages during the trial, significantly reducing the need for staff to send and manage intervention content over 24 months. The cost of text messaging will be approximately US $450. Thus far, there is a 0.004% known error rate in text message delivery.
Conclusions
Our trial automated the delivery of tailored intervention content and communication using REDCap. The approach described provides a framework that can be used in future behavioral health interventions to create an accessible, reliable, and affordable method for intervention delivery and engagement that requires minimal trial-specific resources and personnel time.
Trial Registration
ClinicalTrials.gov NCT03801174; https://clinicaltrials.gov/ct2/show/NCT03801174?term=NCT03801174
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Affiliation(s)
- Hailey N Miller
- School of Nursing, Duke University, North Carolina, NC, United States
- Duke Global Digital Health Science Center, Duke University, Durham, NC, United States
| | - Corrine I Voils
- Department of Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, United States
- William S Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Kate A Cronin
- William S Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Elizabeth Jeanes
- William S Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Jeffrey Hawley
- Duke Office of Clinical Research, School of Medicine, Duke University, Durham, NC, United States
| | - Laura S Porter
- School of Nursing, Duke University, North Carolina, NC, United States
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Rachel R Adler
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, United States
| | - Whitney Sharp
- Department of Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Samantha Pabich
- William S Middleton Memorial Veterans Hospital, Madison, WI, United States
- Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Kara L Gavin
- Department of Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, United States
- William S Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Megan A Lewis
- RTI International, Research Triangle Park, NC, United States
| | - Heather M Johnson
- Division of Cardiology, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States
- Christine E Lynn Women's Health & Wellness Institute/Baptist Health South Florida, Boca Raton, FL, United States
| | - William S Yancy
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Kristen E Gray
- Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States
| | - Ryan J Shaw
- School of Nursing, Duke University, North Carolina, NC, United States
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64
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Kim Y, Tian X, Solomon DH. Coping with COVID-19 at the community level: Testing the predictors and outcomes of communal coping. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2790-2807. [PMID: 35032396 PMCID: PMC9015577 DOI: 10.1002/jcop.22797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic is a socially shared health issue that has had profound impacts on all aspects of community life and requires collaborative coping responses. Drawn from the extended theoretical model of communal coping, we examined (a) factors that promote community members' communal coping and (b) the influence of communal coping on perceived stress and positive adaptation in the context of COVID-19. An empirical test based on the survey of participants (N = 257) living in the state of New York showed that strong community identity, but not the length of residency in the same community and integrated connectedness to communication resources of the community, was positively associated with communal coping orientation. Having a higher communal coping orientation was not related to perceived stress, but it was positively related to engagement in COVID-19 preventive behaviors. The implications of these findings for understanding communal coping at the community level and future directions are discussed.
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Affiliation(s)
- Youllee Kim
- Department of Communication StudiesUniversity of DenverDenverColoradoUSA
| | - Xi Tian
- Department of Communication StudiesHong Kong Baptist UniversityKowloon TongHong Kong
| | - Denise H. Solomon
- Department of Communication Arts & SciencesThe Pennsylvania State UniversityState CollegePennsylvaniaUSA
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65
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McMahon JM, Simmons J, Braksmajer A, LeBlanc N. HIV-serodifferent couples' perspectives and practices regarding HIV prevention strategies: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000620. [PMID: 36962775 PMCID: PMC10022221 DOI: 10.1371/journal.pgph.0000620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022]
Abstract
A substantial proportion of heterosexually acquired HIV infections in the U.S. occur between partners in primary relationships characterized by mixed HIV status. The U.S. Centers for Disease Control and Prevention have issued guidelines prioritizing HIV-serodifferent couples for primary HIV prevention, including treatment-as-prevention and pre-exposure prophylaxis (PrEP). Yet, very little research has been conducted to understand the perspectives and practices of HIV-serodifferent couples regarding HIV prevention strategies in the U.S. To help fill this gap, we conducted a mixed methods study with 27 mostly Black/African American and Latinx HIV-serodifferent heterosexual couples residing in New York City to explore their knowledge, attitudes, practices, and perspectives regarding combination HIV prevention, including condoms, PrEP and viral control. All couples expressed the desire to maintain viral suppression in the HIV-positive partner, which was not always achieved. There was considerable heterogeneity in the use of HIV prevention methods by couples; and several patterns emerged that were largely driven by gender and relationship dynamics. Female partners, in particular, expressed high levels of anxiety around transmission of HIV and thus desired multiple methods of protection. Healthcare providers should consider couples' psychosocial well-being, relationship quality, and other motivational factors when helping to tailor HIV preventative care for mixed-status couples.
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Affiliation(s)
- James M. McMahon
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Janie Simmons
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Amy Braksmajer
- Department of Sociology, State University of New York at Geneseo, Geneseo, New York, United States of America
| | - Natalie LeBlanc
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
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66
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Leblanc NM, Mitchell JW, Bond KT, Juarez Cuellar A, Vil NMS, McMahon J. Perspectives on a Couples-Based, e-Health HIV Prevention Toolkit Intervention: A Qualitative Dyadic Study with Black, Heterosexual Couples in New York State. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2625-2640. [PMID: 35639220 PMCID: PMC10688541 DOI: 10.1007/s10508-021-02270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 05/11/2023]
Abstract
Web-based technology provides an unparalleled opportunity to increase access and uptake of couples-based HIV prevention interventions. e-Health HIV prevention interventions for US Black heterosexual couples have largely been understudied. To address this gap, we applied the Assessment Phase of the ADAPT-ITT Framework to investigate Black heterosexual couples' perspectives on an existing e-Health, couples-based HIV prevention intervention. Applying a qualitative descriptive approach, joint dyadic interviews were conducted with 28 Black heterosexual couples from three jurisdictions in New York State. Content dyadic analysis revealed three descriptive categories: perspectives of the toolkit intervention (sub-codes: perceived relevance, reactions to core components), recommendations to enhance intervention relevancy (sub-codes: tailoring to relationship type, adding new content), and lasting intervention considerations (sub-codes: toolkit usability and language use). Overall, couples found the toolkit intervention content and usability acceptable and reflected on its potential to build sexual and relationship health. Couples recommended to enhance toolkit adaptability for varied couple's motivation and types re-consider terms like sexual agreements, and include content to facilitate communication regarding sensitive topics (e.g., childhood sexual trauma, co-parenting, family planning) and other issues that may have more relevance to the experience of US Black persons (i.e., wealth building).
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Affiliation(s)
- Natalie M Leblanc
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Keosha T Bond
- City College of New York, CUNY School of Medicine, New York City, NY, USA
| | | | - Noelle M St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
| | - James McMahon
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA
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67
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Zhao J, Guan Y, McBride CM. A systematic review of theory-informed strategies used in interventions fostering family genetic risk communication. PATIENT EDUCATION AND COUNSELING 2022; 105:1953-1962. [PMID: 35304074 PMCID: PMC9203975 DOI: 10.1016/j.pec.2022.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Inherited risk is a family issue. Identifying family members who carry a pathogenic genetic variant that increases risk of cancers and other chronic diseases can be lifesaving for those affected. OBJECTIVE The research questions are: (1) which family communication frameworks have been applied, (2) how do intervention strategies employed map to these theories, and (3) to what extent were families receptive to these strategies and communication increased? METHODS Manuscripts published between January 2010 and August 2020 were searched in three databases: PubMed, PsycINFO, and Web of Science. RESULTS Nine intervention trials were identified. All interventions were evaluated in clinical genetic counseling contexts using at least one individual-level strategy (e.g. increase knowledge). Only three focused on dyadic conversations such as preparing for relatives' information needs. CONCLUSIONS This systematic review posed the question whether theoretically based approaches have been applied to foster family genetic risk communication. Greater attention needs to be paid to the utilization of dyadic level and family system level theories to guide intervention developments. PRACTICAL IMPLICATIONS We conclude by calling for accelerating and broadening the development of interventions to enable family communication about inherited risk that are theory-based, incorporate family-systems thinking, and are conducted outside of specialty clinic settings.
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Affiliation(s)
- Jingsong Zhao
- Department of Behavioral, Social and Health Education Sciences, Emory University, GA, USA.
| | - Yue Guan
- Department of Behavioral, Social and Health Education Sciences, Emory University, GA, USA
| | - Colleen M McBride
- Department of Behavioral, Social and Health Education Sciences, Emory University, GA, USA
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68
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Couple Efficacy and Communal Coping for HIV Prevention Among Kenyan Pregnant Couples. AIDS Behav 2022; 26:2135-2147. [PMID: 35122576 DOI: 10.1007/s10461-021-03559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/01/2022]
Abstract
Involving both partners of a couple in HIV prevention can improve maternal and child health outcomes in sub-Saharan Africa. Using data from 96 couples, we explored the actor and partner effects of perceived relationship dynamics on a couple's confidence and ability to reduce HIV risk together. Perceived relationship quality altered perceived confidence and ability to reduce HIV threat. One's own ability to confidently act together with their spouse appeared to be stronger for husbands than wives with respect to relationship commitment. A partner's confidence to communicate with their spouse about HIV risk reduction appeared to be stronger from husbands to wives for relationship satisfaction and trust. Gender differences in perceived relationship quality and effects on communal coping may exist and requires further study for applicability in intervention development in this setting. Efficacious couple-oriented interventions for HIV prevention should incorporate evidence on how partners mutually influence each other's health beliefs and behaviors.
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69
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Metheny N, Stephenson R, Darbes LA, Chavanduka TMD, Essack Z, van Rooyen H. Correlates of Substance Misuse, Transactional Sex, and Depressive Symptomatology Among Partnered Gay, Bisexual and Other Men Who Have Sex with Men in South Africa and Namibia. AIDS Behav 2022; 26:2003-2014. [PMID: 34997385 DOI: 10.1007/s10461-021-03549-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
Despite having some of the world's highest rates of HIV, there is a lack of knowledge on correlates of transmission risk among gay, bisexual and other men who have sex with men in Southern Africa. There is even less known about the factors that shape HIV risk in male-male couples. Using data from Together Tomorrow, a study of partnered GBMSM in South Africa and Namibia, this study assessed the individual and dyadic correlates of three major HIV risk factors in this population: substance misuse, transactional sex, and depressive symptomatology. Data were collected during November 2016-March 2017 via a quantitative survey conducted with 140 partnered MSM (70 couples) in Windohoek, Keetmanshoop, Walvis Bay, and Swakopmund, Namibia and 300 partnered MSM (150 couples) in Pietermaritzburg and Durban, KwaZulu-Natal, South Africa for a total sample size of 440 partnered MSM (220 couples). Results of multilevel modeling analyses show several significant factors present in partnered GBMSM that differ from studies of single GBMSM, with intimate partner violence being a significant correlate across all three risk factors. Future interventions should consider dyadic approaches and integrate IPV prevention and mitigation efforts to reduce HIV in this population as part of a multisectoral approach. To reduce rates of HIV in partnered GBMSM in Namibia and South Africa multilevel, multisectoral work is needed in policy, social norms change, and relationship-focused dyadic interventions to reduce the social and structural stigma facing male couples.
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Affiliation(s)
- Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, FL, 33146, USA.
| | - Rob Stephenson
- University of Michigan School of Nursing, Ann Arbor, MI, USA
- University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, USA
| | - Lynae A Darbes
- University of Michigan School of Nursing, Ann Arbor, MI, USA
- University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, USA
| | - Tanaka M D Chavanduka
- University of Michigan School of Nursing, Ann Arbor, MI, USA
- University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, USA
| | - Zaynab Essack
- Human Sciences Research Council of South Africa, Pretoria, Gauteng, South Africa
- School of Law, University of KwaZulu-Natal, KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Heidi van Rooyen
- Human Sciences Research Council of South Africa, Pretoria, Gauteng, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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70
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Burke W, Hovick SR, Jordan E, Ni H, Kinnamon DD, Hershberger RE. Communal Coping as a Strategy to Enhance Family Engagement in Dilated Cardiomyopathy. Circ Genom Precis Med 2022; 15:e003541. [DOI: 10.1161/circgen.121.003541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Assuring that relatives are informed about a genetic diagnosis and have appropriate medical follow-up can be challenging. We hypothesize that communal coping (CC)—an approach in which a group views a stressor (such as a new genetic diagnosis) as our problem, versus my or your problem, and takes joint action to address it—can help families to address this challenge. A better understanding of CC could also inform counseling interventions to promote CC and family follow-up.
Methods:
In the Dilated Cardiomyopathy (DCM) PM study (Precision Medicine), living first-degree relatives of DCM probands were invited to undergo clinical screening; 31% of these did so. This research program offers the opportunity to determine the frequency of CC in DCM families, assess whether CC attitudes and actions occurred more commonly among families in which family members participated, and conduct prospective follow-up to evaluate family coping and counseling needs over time.
Results:
The proposed studies will provide evidence about the frequency of CC attitudes and actions among DCM families, assess the association of CC with increased family follow-up, and identify counseling needs related to family follow-up.
Conclusions:
The DCM PM study offers an opportunity to test the hypothesis that CC contributes to increased family follow-up and generate evidence to inform counseling interventions to encourage such follow-up.
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Affiliation(s)
- Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle (W.B.)
| | - Shelly R. Hovick
- School of Communication, Ohio State University, Columbus (S.R.H.)
| | - Elizabeth Jordan
- Department of Internal Medicine, Division of Human Genetics (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
- Davis Heart and Lung Research Institute (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
| | - Hanyu Ni
- Department of Internal Medicine, Division of Human Genetics (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
- Davis Heart and Lung Research Institute (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
| | - Daniel D. Kinnamon
- Department of Internal Medicine, Division of Human Genetics (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
- Davis Heart and Lung Research Institute (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
| | - Ray E. Hershberger
- Department of Internal Medicine, Division of Human Genetics (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
- Davis Heart and Lung Research Institute (E.J., H.N., D.D.K., R.E.H.), Ohio State University Wexner Medical Center, Columbus
- Department of Internal Medicine, Division of Cardiovascular Medicine (R.E.H.), Ohio State University Wexner Medical Center, Columbus
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71
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Conroy AA, McKenna S, Ruark A, Neilands TB, Spinelli M, Gandhi M. Relationship Dynamics are Associated with Self-Reported Adherence but not an Objective Adherence Measure in Malawi. AIDS Behav 2022; 26:3551-3562. [PMID: 35507094 DOI: 10.1007/s10461-022-03636-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 12/01/2022]
Abstract
Couple relationships can be leveraged to improve adherence to antiretroviral therapy (ART), but few studies have identified relationship factors to target in interventions in sub-Saharan Africa. We conducted a cross-sectional study with 211 couples in southern Malawi with at least one partner on ART to test for associations between ART adherence and relationship dynamics (intimacy, trust, relationship satisfaction, unity, commitment, and partner support). We measured ART adherence through subjective measures (patient and partner reports) and an objective measure (ART drug levels in hair) and hypothesized that more positive relationship dynamics (e.g., higher intimacy) would be associated with better adherence. Multi-level logistic and linear regression models were used to evaluate study hypotheses, controlling for the clustering of individuals within couples. High levels of adherence were found by all three measures. Unity, satisfaction, and partner support were associated with higher patient and partner reports of adherence, and additional relationship dynamics (intimacy, trust) were associated with higher partner reported adherence. No associations were found between relationship dynamics and drug levels in hair, although drug levels were high overall. Future studies should perform longitudinal assessments of relationship dynamics and objective metrics of adherence, and examine these associations in populations with lower adherence levels such as young women or individuals starting ART.
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Affiliation(s)
- Amy A Conroy
- Division of Prevention Sciences, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA.
- Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA.
| | | | - Allison Ruark
- Department of Applied Health Sciences, Wheaton College, Wheaton, IL, USA
| | - Torsten B Neilands
- Division of Prevention Sciences, Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Matthew Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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72
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Milton K, Poole K, Cross A, Gasson S, Gokal K, Lyons K, Pulsford R, Jones A. 'People don't get cancer, families do': Co-development of a social physical activity intervention for people recently affected by a cancer diagnosis. Eur J Cancer Care (Engl) 2022; 31:e13573. [PMID: 35285105 PMCID: PMC9285961 DOI: 10.1111/ecc.13573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/20/2021] [Accepted: 03/02/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This research took a co-design approach to develop a social intervention to support people affected by a cancer diagnosis to be physically active. METHODS We conducted semi-structured interviews with five key stakeholder groups: (1) adults with a recent breast or prostate cancer diagnosis; (2) family and friends of cancer patients; (3) healthcare professionals; (4) physical activity providers; and (5) cancer charity representatives. Inductive content analysis was used to identify themes in the data. We then worked with a subset of participants to co-develop the intervention. RESULTS Participants welcomed the idea of a social approach to a physical activity intervention. Input was received on the timing and format of delivery, how to communicate about physical activity to cancer patients and their family and friends and the types of physical activity that would be appropriate. Our findings suggest that interventions need to be flexible in terms of timing and delivery and offer a wide range of physical activity options. These findings directly informed the co-development of 'All Together Active'. CONCLUSION All Together Active is designed to support cancer patients and their family and friends to be active throughout treatment and beyond, benefiting their physical and mental health.
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Affiliation(s)
- Karen Milton
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Karen Poole
- School of Health SciencesUniversity of SurreySurreyUK
| | | | - Sophie Gasson
- School of Health SciencesUniversity of SurreySurreyUK
| | - Kajal Gokal
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Karen Lyons
- Connell School of NursingBoston CollegeNewtonMassachusettsUSA
| | - Richard Pulsford
- Sport and Health SciencesUniversity of Exeter, St Luke's CampusExeterUK
| | - Andy Jones
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
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73
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Conroy AA, Leddy AM, Darbes LA, Neilands TB, Mkandawire J, Stephenson R. Bidirectional Violence Is Associated with Poor Engagement in HIV Care and Treatment in Malawian Couples. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4258-NP4277. [PMID: 32946327 PMCID: PMC7969480 DOI: 10.1177/0886260520959632] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Growing evidence suggests that intimate partner violence (IPV) is a barrier to engagement in HIV care. Bidirectional IPV-being both a perpetrator and victim-may be the most common pattern of IPV, yet no research has examined its effect on engagement in care, which could identify couples in most need of interventions. Married couples (N = 211) with at least one partner on antiretroviral therapy were recruited from HIV clinic waiting rooms in Zomba, Malawi. Partners completed separate surveys on physical, sexual, and emotional IPV, medication adherence, and appointment attendance. We created categorical variables indicating no violence, perpetrator-only, victim-only, and bidirectional violence. Generalized estimating equation regression models tested for associations between IPV and engagement in care. The bidirectional pattern represented 25.4%, 35.5%, and 34.0% of all physical, sexual, and emotional IPV. Physical IPV victimization-only (adjusted odds ratio [AOR]: 0.28, 95% confidence interval [CI]: 0.08, 0.92) was associated with lower adherence, but the association was stronger for bidirectional physical IPV (AOR: 0.10, 95% CI: 0.02, 0.51). Bidirectional sexual IPV was also associated with lower adherence (AOR: 0.14, 95% CI: 0.02, 0.80). Bidirectional physical IPV (AOR: 4.04, 94% CI: 1.35, 12.14) and emotional IPV (AOR: 3.78, 95% CI: 1.78, 8.05) were associated with missing 1+ appointment. Interventions to address the health effects of bidirectional IPV, which may be greater than victim-only or perpetrator-only IPV, should intervene with both partners to break cycles of violence. Couple-based interventions may be a viable option by intervening on both partners' trauma and aggression simultaneously.
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Affiliation(s)
- Amy A. Conroy
- University of California San Francisco, San Francisco, CA, USA
| | - Anna M. Leddy
- University of California San Francisco, San Francisco, CA, USA
| | - Lynae A. Darbes
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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74
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Jolidon V. Gender inequality and mammography screening: Does living with a partner improve women's mammography uptake? Soc Sci Med 2022; 298:114875. [PMID: 35276623 DOI: 10.1016/j.socscimed.2022.114875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/29/2022] [Accepted: 02/27/2022] [Indexed: 11/19/2022]
Abstract
Macrolevel gender inequality is defined as the unequal distribution of power and resources between men and women shaped by macrolevel social structures and institutions. An emerging line of health research is emphasising its negative consequences on women's health and healthcare access. The present study examines how gender inequality contexts affect women's mammography screening uptake. It adopts a macrosociological and institutionalist approach on preventive healthcare use and compares women who live with a partner with those who do not. This is the first study to test the effect of macrolevel gender inequality on mammography uptake across the 26 Swiss cantons (i.e. regions). The Swiss cantons' autonomy to manage their political and healthcare systems, as provided by the federal system, offers an ideal setting for the comparative analysis of macrolevel factors. Data on 9724 women aged 50-70 from the Swiss Health Interview Survey (waves 2007, 2012 and 2017) is analysed. Multilevel logistic models estimate two canton-level indicators of gender inequality, the gender gaps in time use and full-time employment, and their association with mammography uptake, controlling for women's socioeconomic and demographic characteristics, health status and healthcare use. Cross-level interactions assess how these indicators moderate the mammography uptake of women living with and without a partner. Results show that in cantons with higher gender inequality, women have a lower probability of mammography uptake. Women who live with a partner have a higher mammography uptake than those who do not. However, this advantage is moderated by canton-level gender inequality, namely, women who live with a partner in more gender unequal cantons have a lower mammography uptake than their counterparts who reside in more gender equal cantons. Results support the hypothesis that macrolevel gender inequality moderates women's preventive healthcare uptake, from an institutionalist approach.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, 40 Bd du Pont-d'Arve, 1205, Genève, Switzerland.
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75
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Johnson MJ, Darbes LA, Hosegood V, Johnson MO, Fritz K, Ngubane T, van Rooyen H, McGrath N. Social Influence and Uptake of Couples HIV Testing and Counselling in KwaZulu-Natal, South Africa. AIDS Behav 2022; 26:764-774. [PMID: 34417920 PMCID: PMC8840905 DOI: 10.1007/s10461-021-03435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
Social influences may create a barrier to couples HIV testing and counselling (CHTC) uptake in sub-Saharan Africa. This secondary analysis of data collected in the 'Uthando Lwethu' randomised controlled trial used discrete-time survival models to evaluate the association between within-couple average 'peer support' score and uptake of CHTC by the end of nine months' follow-up. Peer support was conceptualised by self-rated strength of agreement with two statements describing friendships outside of the primary partnership. Eighty-eight couples (26.9%) took up CHTC. Results tended towards a dichotomous trend in models adjusted only for trial arm, with uptake significantly less likely amongst couples in the higher of four peer support score categories (OR 0.34, 95% CI 0.18, 0.68 [7-10 points]; OR 0.53, 95% CI 0.28, 0.99 [≥ 11 points]). A similar trend remained in the final multivariable model, but was no longer significant (AOR 0.59, 95% CI 0.25, 1.42 [7-10 points]; AOR 0.88, 95% CI 0.36, 2.10 [≥ 11 points]). Accounting for social influences in the design of couples-focused interventions may increase their success.
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Affiliation(s)
- Matthew J. Johnson
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Mailpoint 95, Tremona Road, Southampton, SO16 6YD UK
- NIHR ARC Wessex Data Science Hub, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - Lynae A. Darbes
- Center for AIDS Prevention Studies, Division of Prevention Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA USA
- Department of Health Behavior and Biological Sciences, Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, USA
| | - Victoria Hosegood
- Department of Social Statistics and Demography, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Mallory O. Johnson
- Center for AIDS Prevention Studies, Division of Prevention Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Katherine Fritz
- International Center for Research on Women, Washington, DC USA
| | | | - Heidi van Rooyen
- Human Sciences Research Council, Durban, South Africa
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nuala McGrath
- Department of Social Statistics and Demography, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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76
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Lee HJ, Kim B. “Till Death Do Us Part”, Dying Matters, Beyond the Individual: Advance Care Planning Patterns Among Older Couples. J Aging Health 2022; 34:858-869. [DOI: 10.1177/08982643211068555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective We examined the formal and informal advance care planning (ACP) patterns of older couples and determined how these patterns are associated with individual and spousal characteristics. Methods Using data from the 2014 and 2016 Health and Retirement Study, we performed latent class analysis to identify ACP patterns and multinomial regression models to describe characteristics of older couples ( N = 2195 couples). Results We identified four ACP patterns: high engaging couple (47%); high engaging husband—low engaging wife (11%); high engaging wife—low engaging husband (11%); and low engaging couple (31%). High engaging couples were more likely to be older, educated, and financially better off, whereas high ACP engagement in discordant ACP patterns was associated with health and wives’ constraints. Discussion A couple-based approach was recommended to promote the merits of ACP where spouses were older, had limited resources, or where one or both partners were suffering from poor health.
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Affiliation(s)
- Hyo Jung Lee
- Department of Sociology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Bon Kim
- Department of Human Ecology & Welfare, Jeju National University, Jeju, South Korea
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77
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Hampanda K, Pelowich K, Chi BH, Darbes LA, Turan JM, Mutale W, Abuogi L. A Systematic Review of Behavioral Couples-Based Interventions Targeting Prevention of Mother-to-Child Transmission in Low- and Middle-Income Countries. AIDS Behav 2022; 26:443-456. [PMID: 34415489 DOI: 10.1007/s10461-021-03401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 02/04/2023]
Abstract
There is increasing focus in HIV prevention and treatment on couples-based approaches. No systematic review has synthesized prospective behavioral couples-based HIV trials targeting prevention of mother-to-child transmission (PMTCT) outcomes in low- and middle-income countries (LMICs). We systematically reviewed published abstracts and articles reporting prospective comparative evaluations of behavioral couples-based HIV interventions delivered during pregnancy to both members of a self-identified heterosexual couple in LMICs following PRISMA. Citations, abstracts, and full texts were double screened for eligibility. References meeting eligibility criteria underwent double data abstraction, quality appraisal, and qualitative synthesis. We identified 295 unique publications. Of these, 5 randomized trials were deemed eligible and synthesized. Studies were conducted in 3 different African countries using three overarching intervention approaches: home-based; group workshops; and faith-based. Studies included various PMTCT outcome measures. We found evidence that behavioral couples-based approaches around the time of pregnancy can positively affect HIV testing among pregnant women and their male partners, infant HIV prophylaxis use, and HIV-free infant survival. The effects on other PMTCT outcomes were not well supported. There was a low to moderate risk of bias among the included studies. Few couples-based PMTCT interventions have been tested in LMICs. Of the interventions we located, workshops/group education and home-based couple counseling and testing were most commonly used to promote PMTCT. Research is needed on the role of relationship dynamics within such interventions and whether couples-based approaches during pregnancy can extend to health outcomes across the PMTCT continuum of care.
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78
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Sohail M, Long DM, Batey DS, Mugavero MJ, Ojesina AI, Levitan EB. Partnership status and time to viral suppression and sustained viral suppression among newly diagnosed heterosexual people with HIV. Int J STD AIDS 2022; 33:347-354. [PMID: 35085052 DOI: 10.1177/09564624211065227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies examining the role of partnership on HIV care outcomes have primarily focused on the men who have sex with men population in the United States, leaving a gap in the literature on this phenomenon among the heterosexual persons with HIV (PWH). This study examined association between partnership around diagnosis (married, unmarried-partnered, and un-partnered) with time to viral suppression (TVS) and sustained viral suppression (SVS) in newly diagnosed heterosexual PWH from a HIV clinic in Birmingham, Alabama. METHODS TVS [time to first viral load (VL) <200 copies/ml] was measured using VLs from 12 months following diagnosis using Kaplan-Meier and proportional hazard model for interval censoring (n=153) to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). SVS was measured using VLs for 12 months after first VS using logistic regression model (n=137) to calculate odds ratios (ORs) and 95% CIs. Models were adjusted for confounding demographics and clinical characteristics. RESULTS The study population comprised of 77% Black, 57% male, and 46% aged 31-49 years; 24% were married, 35% unmarried-partnered, and 41% un-partnered. The median TVS (days) was 57 for married, 73 for unmarried-partnered, and 75 for un-partnered. Compared to un-partnered individuals, unmarried-partnered had similar, whereas married had 69% higher [HR (95% CI): 1.69 (1.02, 2.78)] hazard of TVS. Compared to un-partnered, unmarried-partnered and married individuals had similar odds of achieving SVS. CONCLUSION Married, newly diagnosed, heterosexual PWH had faster TVS than un-partnered individuals suggesting that intimate partners may help achieve HIV care goals.
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Affiliation(s)
- Maira Sohail
- Department of Epidemiology, 48653The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Dustin M Long
- Department of Biostatistics, 48653The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - D Scott Batey
- Department of Social Work, 200297The University of Alabama at Birmingham College of Arts and Sciences, Birmingham, AL, USA
| | - Michael J Mugavero
- 9967The University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Akinyemi I Ojesina
- Department of Epidemiology, 48653The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Emily B Levitan
- Department of Epidemiology, 48653The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
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79
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Starks TJ, Bosco SC, Doyle KM, Revenson TA. Partners' Consensus About Joint Effort and COVID-19 Prevention Among Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:217-230. [PMID: 34155577 PMCID: PMC8216588 DOI: 10.1007/s10508-021-02063-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 05/07/2023]
Abstract
The current study examined the relevance of relationship functioning to partners' agreement or consensus about joint effort surrounding COVID-19 prevention. Interdependence theory has been widely used to understand how relationship partners influence health behavior, including how sexual minority male (SMM) couples regulate HIV risk. Couples with better relationship functioning tend to be more successful at negotiating joint (shared) goals and subsequently accomplishing them. The study recruited 134 cis-male, SARS-CoV-2 negative adults in relationships with cis-male partners from phone-based social networking applications. Participants completed an online survey assessing relationship functioning (Perceived Relationship Components Questionnaire), COVID-19 prevention behaviors, and risk perceptions. Partners' consensus around joint COVID-19 prevention effort was assessed using an adapted version of the Preferences for Sexual Health Outcomes scale. Path analyses indicated that consensus for joint prevention effort predicted social distancing (B = 0.23; p = .001) and the number of other COVID-19 prevention behaviors engaged in (B = 0.17; p = .003) above and beyond perceived risk and relationship functioning. Relationship satisfaction predicted higher levels of consensus for joint COVID-19 prevention effort (B = 0.40; p = .029). Findings suggest that the theoretical foundations of successful HIV prevention interventions that utilize joint goal formation may generalize to the prediction of COVID-19 prevention behavior and may be leveraged to mitigate the risk of SARS-CoV-2 infection among SMM in relationships. Interventions that overlook the potential for dyadic regulation of health behavior may miss opportunities to capitalize on shared coping resources and fail to address relational barriers to prevention.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, 10065, USA.
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
| | - Stephen C Bosco
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Kendell M Doyle
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Tracey A Revenson
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, 10065, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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80
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Lamarche VM, Rolison JJ. Hand-in-hand in the golden years: Cognitive interdependence, partner involvement in retirement planning, and the transition into retirement. PLoS One 2021; 16:e0261251. [PMID: 34965266 PMCID: PMC8716039 DOI: 10.1371/journal.pone.0261251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
This research examined the influence of cognitive interdependence-a mental state reflecting a collective representation of the self-in-relationship-on the anticipation for and experiences with the transition into retirement. Among soon-to-be retirees (Study 1), greater cognitive interdependence was associated with seeing partners as more instrumental to one's goals both pre- and post-retirement, anticipating greater goal alignment post-retirement, and having directly involved partners in retirement planning to a greater extent than those relatively lower in cognitive interdependence. Among recent retirees (Study 2), retrospective cognitive interdependence was associated with post-retirement goal alignment and goal instrumentality, and the extent to which they believed they had directly involved their partners in retirement planning. However, it was post-retirement goal alignment that was associated with greater ease of retirement and subjective well-being. Finally, soon-to-be retirees relatively high in cognitive interdependence responded to concerns about their retirement (i.e., goal discordance and high retirement ambivalence) by wanting to involve their partners in their retirement plans to a greater extent (Study 3). These studies highlight the importance of romantic partners across the lifespan, and how partners might influence retirement planning, the transition to retirement, and well-being among recent retirees.
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Affiliation(s)
- Veronica M. Lamarche
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
- * E-mail:
| | - Jonathan J. Rolison
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
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81
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Lipkus IM, Sanders C, Mays D. Influencing Perceptions of Harm of Waterpipe Tobacco Smoking Among One Member of Couples Who Use Waterpipe. Nicotine Tob Res 2021; 24:1071-1078. [PMID: 34953166 PMCID: PMC9199946 DOI: 10.1093/ntr/ntab261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/11/2021] [Accepted: 12/24/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) often occurs socially, increasing health risks for the smoker and others through secondhand smoke effects. While messages on WTS harms enhance perceived risks for self, whether these messages elevate perceived risks for others, such as one's romantic partner who engages in WTS, is unclear. We tested this idea by surveying one member of dual-smoking couples who engages in WTS. AIMS AND METHODS As part of an online study, we enrolled adults ages 18-30 who engaged in WTS and were in a committed relationship of at least 6 months whose partner engaged in WTS. Participants were randomized to a control arm or to one of two arms consisting of watching a brief video on health harms or overcoming myths about WTS, respectively. Outcomes were perceived harms and measures of desire and probability of quitting for self and partner. RESULTS Participants (N = 238) who watched either video, compared with participants who did not watch a video, reported greater perceived health risks for self and partner and that their own WTS harmed their partner. Participants who watched either video reported a greater desire to quit for themselves, perceived that their partner had a greater desire to quit, and reported a higher likelihood of quitting together in the next 6 months. CONCLUSIONS Brief videos containing risk-based messaging increase young adult waterpipe tobacco smokers' perceived harms and desire to quit for self and partner. This can be a useful strategy to motivate cessation in couples who engage in WTS. IMPLICATIONS This study shows for the first time that at least among one member of dual-smoking couples who engages in WTS, brief videos on harms of WTS influences perceived harms and motivation to quit for the self and one's partner. This can be a useful strategy to promote cessation.
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Affiliation(s)
- Isaac M Lipkus
- Corresponding Author: Isaac M. Lipkus, PhD, Duke University School of Nursing, 307 Trent Dr., Durham, NC 27710, USA. Telephone: 919-668-2348; Fax: (919)-681-8899;
| | | | - Darren Mays
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, Ohio State University College of Medicine, Columbus, OH, USA
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82
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Huelsnitz CO, Jones RE, Simpson JA, Joyal-Desmarais K, Standen EC, Auster-Gussman LA, Rothman AJ. The Dyadic Health Influence Model. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2021; 26:3-34. [PMID: 34873983 DOI: 10.1177/10888683211054897] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Relationship partners affect one another's health outcomes through their health behaviors, yet how this occurs is not well understood. To fill this gap, we present the Dyadic Health Influence Model (DHIM). The DHIM identifies three routes through which a person (the agent) can impact the health beliefs and behavior of their partner (the target). An agent may (a) model health behaviors and shape the shared environment, (b) enact behaviors that promote their relationship, and/or (c) employ strategies to intentionally influence the target's health behavior. A central premise of the DHIM is that agents act based on their beliefs about their partner's health and their relationship. In turn, their actions have consequences not only for targets' health behavior but also for their relationship. We review theoretical and empirical research that provides initial support for the routes and offer testable predictions at the intersection of health behavior change research and relationship science.
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Affiliation(s)
| | | | | | - Keven Joyal-Desmarais
- Concordia University, Montreal, Quebec, Canada.,Montreal Behavioural Medicine Centre, Quebec, Canada
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83
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Basinger ED, Hartsell H. Communal Coping and Self-Care in Black and White Individuals Living with Type 2 Diabetes. HEALTH COMMUNICATION 2021; 36:1961-1969. [PMID: 32844697 DOI: 10.1080/10410236.2020.1808408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Type 2 diabetes mellitus is both prevalent and profoundly impactful, and how people cope with the illness is related to a variety of individual and relational outcomes. The goal of this investigation was to test the logic of the recently extended Theoretical Model of Communal Coping (TMCC), a communication theory that argues that race (in this study, Black and White) moderates the relationship between communal coping and disease-related outcomes (i.e., glucose, diet, and exercise self-care). In general, survey data from 348 participants (n = 224 Black participants, n = 124 White participants) revealed that although communal coping was directly and positively related to self-care, the relationship between communal coping and self-care was stronger for Black participants than White participants. The results of the study have implications for the TMCC and for researchers, families managing type 2 diabetes, and healthcare practitioners.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Haley Hartsell
- Department of Communication Studies, University of North Carolina at Charlotte
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84
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Morton K, Mhlakwaphalwa T, Msimango L, van Heerden A, Ngubane T, Joseph P, Ngcobo N, Feng Z, Hosegood V, van Rooyen H, McGrath N. Optimising a couples-focused intervention to increase couples' HIV testing and counselling using the person-based approach: a qualitative study in Kwa-Zulu Natal, South Africa. BMJ Open 2021; 11:e047408. [PMID: 34853099 PMCID: PMC8638156 DOI: 10.1136/bmjopen-2020-047408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This qualitative study explored how to optimise a couples-focused intervention to promote couples HIV testing and counselling (CHTC). SETTING Community setting in Kwa-Zulu Natal, South Africa. PARTICIPANTS Qualitative interviews were conducted with 20 couples who had participated in a couples-focused intervention and five staff members delivering the intervention. Partners were interviewed individually by researchers of the same gender. INTERVENTION A couples-focused intervention comprised of two group sessions and four couples counselling sessions was previously shown to significantly increase uptake to CHTC in Kwa-Zulu Natal, South Africa. However, more than half of couples participating in the intervention still chose not to test together during follow-up. ANALYSIS The transcripts were analysed using the table of changes from the person-based approach. Proposed optimisations were discussed with a community group to ensure the intervention was as persuasive and acceptable as possible. RESULTS Many couples found it challenging to discuss CHTC with their partner due to an implied lack of trust. Optimisations to the intervention were identified to increase readiness to discuss CHTC, including education about serodiscordance, discussions about CHTC by peer mentors and open discussion of personal barriers to CHTC during couples' counselling sessions. Additional training for staff in open questioning techniques could help them feel more comfortable to explore couples' perceived barriers to CHTC, rather than advising couples to test. A logic model was developed to show anticipated mechanisms through which the optimised intervention would increase uptake to CHTC, including increasing knowledge, increasing positive outcome beliefs and managing negative emotions. CONCLUSIONS In-depth qualitative research informed optimisations to a couples-focused intervention for further evaluation in South Africa to encourage uptake to CHTC. Suggestions are made for optimal methods to gain open feedback on intervention experiences where participants may be reluctant to share negative views.
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Affiliation(s)
| | - Tembeka Mhlakwaphalwa
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Lindani Msimango
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Alastair van Heerden
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
- School of Clinical Medicine, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
| | - Thulani Ngubane
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Philip Joseph
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Nathi Ngcobo
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
| | - Z Feng
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Victoria Hosegood
- Department of Social Statistics and Demography, Faculty of Social Sciences, University of Southampton, Southampton, UK
| | - Heidi van Rooyen
- Human Sciences Research Council, Sweetwaters, Pietermaritzburg, KwaZulu-Natal, South Africa
- University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Nuala McGrath
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- Department of Social Statistics & Demography, Faculty of Social Sciences, University of Southampton, Southampton, UK
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85
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Reaney M, Gladwin T, Churchill S. Information about foot care provided to people with diabetes with or without their partners: Impact on recommended foot care behavior. Appl Psychol Health Well Being 2021; 14:465-482. [PMID: 34761530 DOI: 10.1111/aphw.12314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many people with diabetes will develop foot ulcers. To reduce risk, it is recommended that the feet are protected against harm and checked daily. Spouses can help people with diabetes care for their feet. METHODS A randomized parallel arm design compared information sheets given to participants with diabetes and their spouses (dyad group; n = 64) to an information sheet given only to participants with diabetes (individual group; n = 69). The self-reported number of days that the participant with diabetes' feet were (1) checked for problems and (2) protected against problems occurring (by the person with diabetes and/or the spouse) were summed for the week after receiving the information sheet. ANCOVAs tested the effects of group. RESULTS Frequency of foot detection behavior (Participant + Spouse) was significantly higher in the dyad group compared with the individual group. This was not the case for foot protection behavior (Participant + Spouse). Findings revealed greater levels of spousal support (for both protection and detection behavior) in the dyad group compared to the individual group. CONCLUSIONS Clinical recommendations and advice on foot care delivered both to people with diabetes and their spouses can encourage greater foot care than if delivered to the patient alone.
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Affiliation(s)
- Matthew Reaney
- Institute of Education, Health, and Social Sciences, University of Chichester, Chichester, UK
| | - Thomas Gladwin
- Institute of Education, Health, and Social Sciences, University of Chichester, Chichester, UK.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Institute for Lifecourse Development, University of Greenwich, London, UK
| | - Susan Churchill
- Institute of Education, Health, and Social Sciences, University of Chichester, Chichester, UK
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86
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Manne S, Kashy DA, Pagoto S, Peterson SK, Heckman CJ, Gallo J, Berger A, Buller DB, Kulik A, Frederick S, Pesanelli M. Family Attitudes and Communication about Sun Protection and Sun Protection Practices among Young Adult Melanoma Survivors and Their Family Members. JOURNAL OF HEALTH COMMUNICATION 2021; 26:781-791. [PMID: 34844521 PMCID: PMC9270718 DOI: 10.1080/10810730.2021.2008552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Young melanoma survivors and their family are at increased risk for developing melanoma, but seldom engage in sun protection behaviors. Little is known about the role of family factors in sun protection. Our goals were: 1) examine correspondence between survivors and family sun protection, individual attitudes, and family attitudes and communication about risk-reducing behaviors, and; 2) evaluate the mediating role of family attitudes and communication in the association between individual sun protection attitudes and behavior. Measures of individual attitudes, family attitudes and communication, and sun protection behaviors were completed by 529 participants. Multilevel modeling assessed family correspondence in sun-related attitudes and behaviors and mediation. Families had varying levels of shared attitudes and behaviors, with higher correspondence for family norms. Survivors reported stronger family norms, greater family benefits, and more discussion than siblings. For both sexes, family discussion was associated with higher sun protection. For women only, more favorable attitudes were associated with sun protection partly because women discussed sun protection with family and held stronger norms. Because families' attitudes and practices correspond, family-focused interventions may prove effective. Among females, increasing risk awareness and sunscreen efficacy and overcoming barriers may foster enhanced normative standards, communication about, and engagement in sun protection.
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Affiliation(s)
- Sharon Manne
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Susan K Peterson
- Department of Behavioral Science, Division of of Cancer Prevention and Population Sciences, University of Texas Md Anderson Cancer Center, USA
| | - Carolyn J Heckman
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | - Joseph Gallo
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | - Adam Berger
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | | | - Alexandria Kulik
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | - Sara Frederick
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
| | - Morgan Pesanelli
- Department of Medicine, Behavioral Sciences Section, Rutgers Cancer Institute of New Jersey, USA
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87
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Potter S, Röcke C, Gerstorf D, Brose A, Kolodziejczak K, Hoppmann C, Ram N, Drewelies J. Partner Pain and Affect in the Daily Lives of Older Couples. J Gerontol B Psychol Sci Soc Sci 2021; 77:1197-1209. [PMID: 34653253 DOI: 10.1093/geronb/gbab188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The susceptibility of older adults' affect to fluctuations in their own health (within-person health sensitivity) indicates how they handle everyday health challenges. In old age, affective well-being is often increasingly influenced by close others, yet it is unknown whether older adults' affect is additionally susceptible to fluctuations in their spouse's health (within-partnership health sensitivity) and the extent to which age and relationship satisfaction moderate such associations. METHODS Parallel sets of multi-level actor-partner interdependence models are applied to self-reported health (feelings of pain/discomfort) and positive and negative affect, obtained 6 times a day over 7 consecutive days from two independent samples, the Berlin Couple Dynamics Study (N= 87 couples; Mage= 75 years; M relationship length= 46 years) and the Socio-Economic Panel Couple Dynamics Study (N= 151 couples; Mage= 72 years; M relationship length= 47 years). RESULTS Husbands and wives had lower positive affect and higher negative affect in moments when they reported more pain (within-person health sensitivity) and when their respective spouse reported more pain (within-partnership health sensitivity). Tests for moderation suggest that within-person, but not within-partnership, health sensitivity is lower at older ages and higher with more satisfying relationships. DISCUSSION These findings empirically illustrate lifespan notions that close relationships shape time-varying health-affect links and thus underscore the theoretical and practical utility of examining social contextual antecedents of older adults' everyday affective well-being.
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Affiliation(s)
- Sophie Potter
- Humboldt University Berlin.,Max Planck Institute for Human Development
| | | | - Denis Gerstorf
- Humboldt University Berlin.,German Institute for Economic Research (DIW Berlin)
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88
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Conroy AA, Ruark A, Neilands TB, Darbes LA, Johnson MO, Tan JY, Mkandawire J. Development and Validation of the Couple Sexual Satisfaction Scale for HIV and Sexual Health Research. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3297-3311. [PMID: 34609644 DOI: 10.1007/s10508-021-02098-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Sexual satisfaction is an important dimension of relationship quality with implications for sexual and reproductive health (SRH), and HIV prevention, care, and treatment. We developed and validated the Couple Sexual Satisfaction Scale (CSSS) with heterosexual couples in sub-Saharan Africa. Using data from qualitative interviews with 94 partnered women and men in Swaziland and Malawi, we generated a 22-item scale and administered it to 211 couples with at least one partner living with HIV in Malawi. We performed an exploratory factor analysis (EFA) to identify and confirmatory factor analysis (CFA) to test the factor structure. To assess validity, we tested for associations between the CSSS and relationship quality, consistent condom use, and intimate partner violence (IPV) using generalized estimating equations. The EFA yielded two factors, general sexual satisfaction (13-item CSSS-Gen subscale, e.g., "I am satisfied with the sweetness of sex in our relationship") and HIV-specific sexual satisfaction (4-item CSSS-HIV subscale, e.g., "My appetite for sex has gone down due to HIV"), accounting for 78% of the shared variance. The CFA supported the two-factor solution: χ2(118) = 203.60; CFI = 0.909; SRMR = 0.057; RMSEA = 0.058. Participants with higher CSSS-Gen scores reported higher coital frequency and relationship quality (intimacy, trust, unity, equality, relationship satisfaction, commitment, partner social support), and less consistent condom use, physical IPV, and emotional IPV. Participants with higher CSSS-HIV scores reported higher coital frequency and relationship quality (trust, partner support), and less consistent condom use, and sexual IPV. The CSSS demonstrated good psychometric properties and provides new opportunities to study sexual reproductive health and HIV-related health behaviors among couples in sub-Saharan Africa.
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Affiliation(s)
- Amy A Conroy
- Center for AIDS Prevention Studies, Division of Prevention Sciences, University of California, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
| | - Allison Ruark
- Department of Medicine, Brown University, Providence, RI, USA
- Ukwanda Centre for Rural Health, Department of Global Health, Faculty of Medicine and Health Sciences,, Stellenbosch University, Stellenbosch, South Africa
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Division of Prevention Sciences, University of California, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA
| | - Lynae A Darbes
- Department of Health Behavior and Biological Sciences, Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Mallory O Johnson
- Center for AIDS Prevention Studies, Division of Prevention Sciences, University of California, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA
| | - Judy Y Tan
- Center for AIDS Prevention Studies, Division of Prevention Sciences, University of California, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA
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89
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Law WK, Yaremych HE, Ferrer RA, Richardson E, Wu YP, Turbitt E. Decision-making about genetic health information among family dyads: a systematic literature review. Health Psychol Rev 2021; 16:412-429. [PMID: 34546151 DOI: 10.1080/17437199.2021.1980083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Decisions involving two individuals (i.e., dyadic decision-making) have been increasingly studied in healthcare research. There is evidence of bi-directional influences in decision-making processes among spousal, provider-patient and parent-child dyads. Genetic information can directly impact biologically related individuals. Thus, it is important to understand dyadic decision-making about genetic health information among family members. This systematic literature review aimed to identify literature examining decision-making among family dyads. Peer-reviewed publications were included if they reported quantitative empirical research on dyadic decision-making about genetic information, published between January 1998 and August 2020 and written in English. The search was conducted in 6 databases and returned 3167 articles, of which 15 met the inclusion criteria. Most studies were in the context of cancer genetic testing (n = 8) or reproductive testing or screening (n = 5). Studies reported two broad categories of decisions with dyadic influence: undergoing screening or testing (n = 10) and sharing information with family (n = 5). Factors were correlated between dyads such as attitudes, knowledge, behaviors and psychological wellbeing. Emerging evidence shows that dyad members influence each other when making decisions about receiving or sharing genetic information. Our findings emphasize the importance of considering both members of a dyad in intervention design and clinical interactions.
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Affiliation(s)
- Wai Ki Law
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia
| | - Haley E Yaremych
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA.,Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, Bethesda, MD, USA
| | - Ebony Richardson
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia
| | - Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Erin Turbitt
- The Discipline of Genetic Counselling, The University of Technology Sydney, Ultimo, Australia.,Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
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90
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Thompson T, Ketcher D, Gray TF, Kent EE. The Dyadic Cancer Outcomes Framework: A general framework of the effects of cancer on patients and informal caregivers. Soc Sci Med 2021; 287:114357. [PMID: 34500320 DOI: 10.1016/j.socscimed.2021.114357] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 01/22/2023]
Abstract
It is widely acknowledged that cancer affects not only patients but also their friends and family members who provide informal, and typically unpaid, care. Given the dual impact that cancer often has on patients and their informal caregivers (i.e., family members, partners, or friends), an expanded dyadic framework that encompasses a range of health and psychosocial outcomes and includes primary caregivers with a range of relationships to the patients is critically needed. Moreover, an emphasis on the role of social and contextual factors may help the framework resonate with a broader range of patient-caregiver relationships and allow for the development of more effective dyadic interventions. This article describes the development of the Dyadic Cancer Outcomes Framework, which was created to guide future research and intervention development. Using an iterative process, we conducted a conceptual review of currently used dyadic and/or caregiving models and frameworks and developed our own novel dyadic framework. Our novel Dyadic Cancer Outcomes Framework highlights individual- and dyad-level predictors and outcomes, as well as incorporating the disease trajectory and the social context. This framework can be used in conjunction with statistical approaches including the Actor Partner Interdependence Model to evaluate outcomes for different kinds of partner-caregiver dyads. This flexible framework can be used to guide intervention development and evaluation for cancer patients and their primary caregivers, with the ultimate goal of improving health, psychosocial, and relationship outcomes for both patients and caregivers. Future research will provide valuable information about the framework's effectiveness for this purpose.
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Affiliation(s)
- Tess Thompson
- Washington University in St. Louis, Brown School of Social Work, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Dana Ketcher
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Institute, Boston, MA, USA; Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, USA
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91
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Postpartum dietary and physical activity-related beliefs and behaviors among women with recent gestational diabetes mellitus: a qualitative study from Singapore. BMC Pregnancy Childbirth 2021; 21:612. [PMID: 34493247 PMCID: PMC8424799 DOI: 10.1186/s12884-021-04089-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/29/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A woman with a history of GDM has at least seven-fold increased lifetime risk of developing type 2 diabetes mellitus (T2DM), compared to women who have normoglycemic pregnancies. Postpartum lifestyle modification has been shown to reduce postpartum weight retention and prevent the progression to T2DM. The aim of this study was to explore the postpartum dietary and physical activity-related beliefs and behaviors among women in Singapore who had GDM in their most recent pregnancies. METHODS Semi-structured in-depth interviews were conducted with 14 women, who were up to four months postpartum and had GDM in their most recent pregnancies. Interview data were analyzed using thematic analysis. RESULTS Three themes were identified in the analysis: (1) risk perception and knowledge regarding future diabetes, (2) suboptimal diet and physical activity after delivery and (3) factors influencing the postpartum lifestyle. CONCLUSIONS The study findings provided useful information on the postpartum lifestyle beliefs and behaviors among women with a history of GDM. Most participants had low risk perception of future diabetes and their diet and physical activity after delivery were suboptimal due to various influences. These insights can be used to design tailored materials and programs to support women who have had GDM reduce their risk of developing future T2DM.
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92
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Waite LJ, Iveniuk J, Kotwal A. Takes Two to Tango: Cognitive Impairment and Sexual Activity in Older Individuals and Dyads. J Gerontol B Psychol Sci Soc Sci 2021; 77:992-1003. [PMID: 34460903 DOI: 10.1093/geronb/gbab158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This paper examines the association between cognitive impairment, including mild cognitive impairment (MCI) and early dementia (ED), and sexual activity in a large, longitudinal sample of community-dwelling older adults. We focus here on sexual activity, which includes both sexual activity with a partner and masturbation. METHODS We analyzed 3777 older individuals and members of 955 intimate dyads using the National Social Life, Health and Aging Project (2010 and 2015). We used ordered-probit regression, cross-lagged panels models, and probit regression. RESULTS We find that older adults with cognitive limitations, either MCI or early dementia, are about as likely to be sexually active with a partner as those with normal cognitive function. This is the case both in the cross section and longitudinally. Both men and women with early dementia are less likely to have masturbated, however. Among married and cohabiting couples, we find no association between cognitive impairment in either the husband, the wife, or in both partners and their joint sexual activity. Women whose measured cognitive function is lower than their husband's are less likely to report any masturbation. DISCUSSION Sex with a partner, a fundamentally social activity, seems to be conserved in the face of cognitive limitation but masturbation, a solitary activity, does not. We argue that the intimate dyad plays an important role in conserving partnered sexual activity. Results can inform strategies to maintain sexual well-being of older adults with cognitive impairment and their partners as part of overall strategies to improve quality of life.
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Affiliation(s)
- Linda J Waite
- University of Chicago & NORC at the University of Chicago
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93
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Griesemer I, Phillips A, Khan C, Bahorski S, Altpeter M, Callahan LF, Porter LS, Rini C. Developing a couple typology: A qualitative study of couple dynamics around physical activity. Transl Behav Med 2021; 10:751-759. [PMID: 31220320 DOI: 10.1093/tbm/ibz052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Partner-based social support can motivate engagement in physical activity (PA); however, couples approach exchanging support in different ways. This study aimed to elucidate the role of relationship dynamics in couple-based support for PA, with the goal of informing intervention strategies that will effectively leverage couple characteristics to increase support for PA. We conducted a qualitative study of couples who completed a longitudinal study of social support for PA. Participants were people with osteoarthritis who were not meeting PA recommendations and their cohabitating partners (n = 19 couples). We conducted in-depth, semistructured interviews and analyzed transcripts using narrative analysis. Participants were 76% non-Hispanic White and, on average, 62 years old. Themes in the data included (a) attitudes about working together to be more active (ranging from positive to negative) and (b) couples' narrative concordance (high to low shared reality). We developed a couple typology with four categories: "Working together works" (positive attitudes/high shared reality; n = 4 couples), "Doing our own thing" (range of attitudes with practical/preferential barriers to working together/high shared reality; n = 5 couples), "Conscious conflict" (discrepant attitudes/high shared reality; n = 5 couples), and "Different realities" (discrepant attitudes/low shared reality; n = 5 couples). We describe examples of each type. In a sample of 19 couples, there were observable differences in participants' attitudes about working together to be more active and in couples' shared reality around those attitudes. Future research should investigate implications for the efficacy of interventions and, if warranted, develop methods to identify couple types and offer appropriate intervention strategies.
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Affiliation(s)
- Ida Griesemer
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Ashley Phillips
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Stephanie Bahorski
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Mary Altpeter
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.,Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Christine Rini
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA.,Georgetown University School of Medicine, Washington, DC, USA
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94
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Sud D, Maidment I, Bradley E, Tritter J. The experiences of the caring dyad: (Un)articulated realities of living with cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness. Health Expect 2021; 24:1821-1832. [PMID: 34339575 PMCID: PMC8483201 DOI: 10.1111/hex.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Informal carers play an important role in the care of patients with mental illness. Little is known of the relationship experience of the patient and their informal carer (caring dyad) as the context for the intersection between physical and mental health. AIM This study aimed to explore the impact of comorbid cardiometabolic risk (CMR), metabolic syndrome (MetS) and related diseases and severe mental illness (SMI) on the caring dyad. DESIGN Between October 2018 and March 2020, we conducted 11 in-depth semi-structured interviews across 6 adult caring dyads, interviewing each individual separately. SETTING Dyads were recruited within the United Kingdom; informal carers were nominated by the patient as a person who provided a significant amount of support. VARIABLE BEING STUDIED Participants were asked about the impacts of illness and caring on daily life. DATA ANALYSIS Data were analysed at the dyad level using thematic analysis, comparing and contrasting responses from each individual. RESULTS Themes were identified: enhanced closeness, dissonance and balance within the caring dyad. DISCUSSION AND CONCLUSIONS This study uses a particular population of patients with comorbid CMR factors, MetS and related diseases and SMI and their informal carers to explore the relevance and utility of caring dyads as an analytical framework to inform practice and policy. Future interventions should consider factors impacting on dyadic relationships to formulate effective and sustainable dyadic care and treatment to improve health outcomes for both patients with SMI and their informal carers. PATIENT/PUBLIC INVOLVEMENT In this study, patients and informal carers were participants. Topic guides were piloted with a patient and informal carer.
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Affiliation(s)
- Dolly Sud
- Aston Pharmacy School, College of Life and Health Sciences, Aston University, Birmingham, UK.,Pharmacy Department, Leicestershire Partnership NHS Trust, Bradgate Mental Health Site, Glenfield Hospital Site, Leicester, UK
| | - Ian Maidment
- Aston Pharmacy School, College of Life and Health Sciences, Aston University, Birmingham, UK
| | - Eleanor Bradley
- College of Life, Health and Environmental Sciences, University of Worcester, Grove, UK
| | - Jonathan Tritter
- School of Humanities and Social Sciences, Aston University, Birmingham, UK
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95
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Stephenson R, Garofalo R, Sullivan PS, Hidalgo MA, Bazzi AR, Hoehnle S, Bratcher A, Finneran CA, Mimiaga MJ. Stronger Together: Results from a Randomized Controlled Efficacy Trial of a Dyadic Intervention to Improve Engagement in HIV Care Among Serodiscordant Male Couples in Three US Cities. AIDS Behav 2021; 25:2369-2381. [PMID: 33630199 PMCID: PMC8247634 DOI: 10.1007/s10461-021-03199-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/23/2022]
Abstract
Engagement in HIV care and a high level of antiretroviral therapy (ART) adherence for people living with HIV is crucial to treatment success and can minimize the population burden of the disease. Despite this, there is a critical gap in HIV prevention science around the development of interventions for serodiscordant male couples. This paper reports on the results of a randomized controlled trial to assess the efficacy of Stronger Together, a dyadic counseling intervention aimed at increasing engagement in and optimizing HIV care among serodiscordant male couples in Atlanta, GA, Boston, MA, and Chicago, IL. Between 2014 and 2017, 159 male serodiscordant couples (total N = 318) in Atlanta, GA, Boston, MA, and Chicago, IL were enrolled and equally randomized to either the Stronger Together intervention arm (a three-session dyadic intervention involving HIV testing and adherence counseling) or a standard of care (SOC) control arm. Couples completed individual study assessments via an audio computer assisted self-interviewing (ACASI) system at baseline, 6, 12 and 18 months. Primary outcomes included being prescribed and currently taking ART, and fewer missed doses of ART in the past 30 days; because the trial was not powered to examine viral suppression, we examined this as an exploratory outcome. Longitudinal data analysis was by an intention-to-treat approach. Participants ages ranged from 18 to 69 (mean = 35.9), and are predominantly white (77.5%), and college educated (68.4% earned a college degree or higher). Participants randomized to the Stronger Together arm had a significantly greater odds of being prescribed and currently taking ART over time than those in the SOC arm (at 12 months OR 2.75, 95%CI 1.35-4.67, p-value 0.020, and at 18 months OR 2.91, 95%CI 1.61-4.88, p-value 0.013). Similarly, those in the Stronger Together arm had a significantly lower odds of missing a dose of ART in the past 30 days over time compared to those in the SOC arm (at 12 months OR 0.28, 95%CI 0.09-0.81, p-value 0.019, and at 18 months OR 0.25, 95%CI 0.07-0.82, p-value 0.023). Among male couples in serodiscordant relationships, the Stronger Together intervention resulted in significantly improved HIV treatment outcomes at both 12 and 18 months of follow-up. This trial is the first to date to demonstrate evidence of efficacy for a dyadic counseling intervention and has the potential to fill a critical gap in secondary HIV prevention interventions for serodiscordant male couples.
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Affiliation(s)
- Rob Stephenson
- Department of Systems, Population and Leadership & The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI, 48109, USA.
| | - Robert Garofalo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Marco A Hidalgo
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Angela R Bazzi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Samuel Hoehnle
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anna Bratcher
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Matthew J Mimiaga
- Center for LGBTQ Advocacy, Research, and Health, UCLA, Los Angeles, CA, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
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96
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Hampanda K, Matenga TFL, Nkwemu S, Shankalala P, Chi BH, Darbes LA, Turan JM, Mutale W, Bull S, Abuogi L. Designing a couple-based relationship strengthening and health enhancing intervention for pregnant women living with HIV and their male partners in Zambia: Interview findings from the target community. Soc Sci Med 2021; 283:114029. [PMID: 34242890 PMCID: PMC10790566 DOI: 10.1016/j.socscimed.2021.114029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/08/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Interpersonal support can promote positive outcomes among people living with HIV. In order to develop an acceptable psychoeducational couples-based intervention aimed at strengthening the relationship context and improving HIV outcomes before and after pregnancy, we conducted qualitative interviews with pregnant women living with HIV and their male partners. METHODS We interviewed a convenience clinic-based sample of pregnant women living with HIV (n = 30) and male partners (n = 18) in Lusaka, Zambia. Interviews included pile sorting relationship topics in order of perceived priority. Interviews also focused on family health concerns. Interviews were audio-recorded, translated, transcribed, and thematically analyzed. Pile sorting data was analyzed using descriptive statistics. RESULTS All female participants were living with HIV; 61% of the male partners interviewed were additionally living with HIV. The most prioritized relationship topic among both genders was communication between couples. Honesty and respect were important relationship topics but prioritized differently based on gender. Female participants considered emotional and instrumental support from male partners critical for their physical and mental health; men did not prioritize support. Intimate partner violence was discussed often by both genders. Family health priorities included good nutrition during pregnancy, preventing infant HIV infection, safe infant feeding, sexual health, and men's alcohol use. CONCLUSIONS A major contribution of this study is a better understanding of the dyad-level factors pregnant women living with HIV and their male partners perceive to be the most important for a healthy, well-functioning relationship. This study additionally identified gaps in antenatal health education and the specific family health issues most prioritized by pregnant women living with HIV and their male partners. The findings of this study will inform the development of an acceptable couples-based intervention with greater likelihood of efficacy in strengthening the relationship context and promoting family health during and after pregnancies that are affected by HIV.
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Affiliation(s)
- K Hampanda
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
| | - T F L Matenga
- Department of Health Policy, The University of Zambia, Zambia
| | - S Nkwemu
- Department of Health Policy, The University of Zambia, Zambia
| | - P Shankalala
- Department of Health Policy, The University of Zambia, Zambia
| | - B H Chi
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA
| | - L A Darbes
- Department of Health Behavior and Biological Sciences, University of Michigan, USA
| | - J M Turan
- Department of Health Care Organization and Policy, University of Alabama at Birmingham, USA
| | - W Mutale
- Department of Health Policy, The University of Zambia, Zambia
| | - S Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| | - L Abuogi
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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97
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de la Haye K, Whitted C, Koehly LM. Formative Evaluation of the Families SHARE Disease Risk Tool among Low-Income African Americans. Public Health Genomics 2021; 24:280-290. [PMID: 34233327 DOI: 10.1159/000517309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Family Health Histories (FHH) have been endorsed by the surgeon general as a powerful yet underutilized tool for identifying individuals at risk for complex chronic diseases such as diabetes, heart disease, and cancer. FHH tools provide a mechanism for increasing communication about disease history and motivating behavior change to reduce disease risk. A critical gap in translation efforts includes a lack of research that adapts and evaluates tools for low-income, minority populations who experience disparities in chronic disease. METHODS This study is a formative mixed-methods evaluation of an evidence-based FHH intervention called "Families SHARE" among African Americans residing in low-income neighborhoods. Participants (N = 51) completed assessments before and 6 weeks after receiving the intervention, including surveys and focus groups. We evaluated (a) their use, understanding, and perceived value of the tool; (b) if the intervention led to increased intentions to adopt disease risk-reducing behaviors among those with heightened disease risk, given their FHH; and (c) acceptability of and recommendations for the tool. RESULTS The quantitative and qualitative data indicated that this population valued and used the tool, and it prompted communication about FHH with family, friends, and others. Receipt of the intervention resulted in mixed accuracy of their perceived disease risk, and it did not shift intentions to change health behaviors. Qualitative data provide insights for future iterations of the Families SHARE tool. CONCLUSION Families SHARE is an engaging FHH tool that can be further tailored to optimize its value and benefits for low-income African Americans.
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Affiliation(s)
- Kayla de la Haye
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Calandra Whitted
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, Maryland, USA.,Behavioral Sciences and Health Education, Florida A&M University, Tallahassee, Florida, USA
| | - Laura M Koehly
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
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98
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Soto SH, Hales DP, Callahan LF, Rini C. Partner and Relationship Predictors of Longitudinal Physical Activity Trajectories Among Individuals with Osteoarthritis Using Latent Class Growth Analysis. Ann Behav Med 2021; 56:685-697. [PMID: 34223870 PMCID: PMC9274998 DOI: 10.1093/abm/kaab054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Physical activity reduces osteoarthritis symptoms, yet many individuals with the disease are insufficiently active. PURPOSE We identified physical activity trajectories over 12 months of individuals with osteoarthritis and examined how their cohabiting spouses'/partners' baseline physical activity and relationship factors affected trajectory membership. METHODS In this longitudinal observational study, we collected data from 168 adults with knee/hip osteoarthritis. We used latent class growth curve analysis to identify physical activity trajectories and logistic regression to predict trajectory membership using partners' physical activity, relationship satisfaction, and communal coping (belief that both partners are responsible for osteoarthritis management). Measures, including objectively assessed physical activity, were collected at baseline from the couple, who then received an educational class on physical activity and social support. Objectively assessed physical activity was also collected from individuals with osteoarthritis at 1 week, 3 months, 6 months, and 12 months post-baseline. RESULTS Three trajectories were identified: stable active, increaser, and stable sedentary (24%, 40%, 37% of participants, respectively). Individuals with osteoarthritis with partners who were more active and who believed they alone were responsible for their osteoarthritis were more likely to follow the stable active (versus stable sedentary) trajectory. Those with partners who were less active and had higher relationship satisfaction were more likely to follow the increaser (vs. stable active) trajectory. CONCLUSIONS Findings demonstrate the importance of considering partner and relationship factors in physical activity interventions for couples.
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Affiliation(s)
- Sandra H Soto
- School of Nursing, University of North Carolina, Carrington Hall, Chapel Hill, NC, USA.,Thurston Arthritis Research Center, CB# 7280, Chapel Hill, NC, USA
| | - Derek P Hales
- Department of Nutrition, UNC Gillings School of Public Health, Chapel Hill, NC, USA
| | - Leigh F Callahan
- Thurston Arthritis Research Center, CB# 7280, Chapel Hill, NC, USA.,Department of Medicine, UNC, Chapel Hill, NC, USA
| | - Christine Rini
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
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Zhao X, Li D, Zhang Q, Liu H. Spousal concordance in frailty predicting mental and functional health decline: A four-year follow-up study of older couples in urban and rural China. J Clin Nurs 2021; 31:679-688. [PMID: 34216057 DOI: 10.1111/jocn.15927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/22/2022]
Abstract
AIMS AND OBJECTIVES To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. BACKGROUND Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. DESIGN Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self-robust spouse (RR), robust self-frail spouse (RF), frail self-robust spouse (FR) and frail self-frail spouse (FF). METHODS Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. RESULTS The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow-up than the RR group; urban individuals in the RF group reported higher follow-up depression than the RR group; and rural individuals from the FR or RF groups reported more follow-up ADL/IADL difficulties than the RR group. CONCLUSION Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. RELEVANCE TO CLINICAL PRACTICE Couples-based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty.
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Affiliation(s)
- Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Danyu Li
- Department of Sociology, Central South University, Changsha, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China.,Social Survey and Opinion Research Centre, Central South University, Changsha, China
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