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Gao R, Guo H, Liu Y, Pang Y, Zhang X, Lian X, Yu T, Zhu L, Li F. The effects of message framing on self-management behavior among people with type 2 diabetes: A randomized controlled trial. Int J Nurs Stud 2023; 142:104491. [PMID: 37059032 DOI: 10.1016/j.ijnurstu.2023.104491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Message framing describes how information is communicated and demonstrated to influence its effect on future attitudes and behaviors. Message content can be structured as 'gain-framed', emphasizing the benefits of engagement as recommended, whereas 'loss-framed' describes the negative consequences of not engaging as recommended. However, the impact of message framing on behavior change in people with chronic diseases like diabetes is not well understood. OBJECTIVE Analyze the impact of message framing in diabetes education on self-management in people with type 2 diabetes, and identify potential moderating effects of patient activation on message framing. DESIGN A three-arm randomized controlled trial was performed. SETTING(S) Participants were recruited from inpatients in the endocrine and metabolic unit of a university-affiliated hospital in Changchun. PARTICIPANTS A total of 84 adults with type 2 diabetes were equally randomized into gain-, loss-, or no-message framing groups and received a 12-week intervention. METHODS Both the message framing groups received 30 video messages. One group of participants received the gain-framed messages emphasizing desirable outcomes from effective diabetes self-care. The other group of participants received the loss-framed messages emphasizing the undesirable consequences of ineffective diabetes self-care. The control group received 30 videos about diabetes self-care without message framing. Self-management behavior, self-efficacy, patient activation, diabetes knowledge, attitudes, and quality of life were measured at baseline and 12 weeks. RESULTS Compared with the control group, participants who watched either gain or loss-framed messages had significant increases in self-management behavior and quality of life after the intervention. The scores of self-efficacy, patient activation, knowledge, and attitudes of the loss-framing group were considerably higher than the control group. Further analysis revealed an interaction between patient activation and message framing (P = 0.002), with gain and loss message framing interventions more effective in increasing self-management behaviors in people with type 2 diabetes who had a higher and lower activation level, respectively. CONCLUSIONS Using message framing in diabetes education is a promising strategy to build and foster self-management behavior. It also suggests that appropriate message framing be chosen to enhance self-management behavior based on the level of patient activation. REGISTRATION NUMBER ChiCTR2100045772.
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Affiliation(s)
- Ruitong Gao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, N.T. Shatin, Hong Kong.
| | - Hui Guo
- Department of Endocrinology and Metabolism, the Eastern Division of the First Bethune Hospital of Jilin University, 3302 Jilin Road, Changchun, Jilin 130031, China.
| | - Yandi Liu
- Department of Endocrinology and Metabolism, the First Bethune Hospital of Jilin University, 1 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yue Pang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xin Zhang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Xiaoqian Lian
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Tianyue Yu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
| | - Lanyu Zhu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China; Changchun University of Chinese Medicine, Changchun, Jilin 130117, China.
| | - Feng Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
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Gao R, Guo H, Liu Y, Pang Y, Zhang X, Lian X, Yu T, Zhu L, Li F. Effects of message framing on self-management behaviour among patients with type 2 diabetes: a randomised controlled trial protocol. BMJ Open 2022; 12:e056450. [PMID: 35768085 PMCID: PMC9240941 DOI: 10.1136/bmjopen-2021-056450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Accumulating evidence has indicated successful diabetes health education can potentially help to improve blood sugar levels in people with diabetes. However, with a rapid rise in the number of people with diabetes cases and the increasing burden on healthcare, it is often difficult for healthcare providers to find suitable time to provide health education to meet their needs. Thus, more novel and effective ways are needed to conduct education. The message frame provides a new perspective for implementation of a more effective health education in the form of changing information presentation, and the same objective content is described in either positive or negative language or outcomes. Gain framing emphasises the positive consequences of adhering to useful recommendations, while loss framing highlights the negative consequences of the non-adherence. The purpose of our research is to potentially explore the effectiveness of diabetes education based on message framing on the self-management behaviour. METHODS AND ANALYSIS A single-blind, three-arm randomised controlled trial involving 84 participants will be conducted. The participants will be assigned into three groups randomly in a 1:1:1 ratio and will receive 12-week intervention. Patients in group 1 will be provided gain framing education videos about the self-management skills for type 2 diabetes, patients in group 2 will be given education videos based on loss framing and patients in group 3 will receive education with no specific message framing. The primary outcome is self-management behaviour. The secondary outcomes will be self-efficacy, patient activation, diabetes-related knowledge and attitude, quality of life and blood glucose level. All outcomes will be measured at baseline and 12 weeks. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of School of Nursing, Jilin University (No. 2020101501). The research results will be published in peer-reviewed publications and presented in international conferences. TRIAL REGISTRATION NUMBER ChiCTR 2100045772; Pre-results.
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Affiliation(s)
- Ruitong Gao
- School of Nursing, Jilin University, Changchun, Jilin, China
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Hui Guo
- Department of Endocrinology and Metabolism, Eastern Division of the First Bethune Hospital of Jilin University, Changchun, China
| | - Yandi Liu
- Department of Endocrinology and Metabolism, First Bethune Hospital of Jilin University, Changchun, China
| | - Yue Pang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xin Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xiaoqian Lian
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Tianyue Yu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Lanyu Zhu
- School of Nursing, Jilin University, Changchun, Jilin, China
- School of Nursing, Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin, China
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Aubert M, Clavel C, Martin JC. Relationship Between Psychological Needs and Regulatory Focus Among Adults with Type 2 Diabetes. Health Psychol Res 2022; 10:35608. [DOI: 10.52965/001c.35608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/05/2022] [Indexed: 11/06/2022] Open
Abstract
Background Diabetes is a chronic disease. A sustained change in lifestyle is generally necessary for terms of diet and physical activity. According to Self-Determination Theory, the nature of the motivation to regulate one’s behavior is linked to the satisfaction of three psychological needs: autonomy, competence, and relatedness. According to Regulatory Focus Theory, there is a promotion focus and a prevention focus. The prevention focus has been shown to have a different relationship with the satisfaction of the needs of the Self-Determination Theory between a general population and a population with health problems. Objective This study investigates the relationship between psychological needs and regulatory focus for people with type 2 diabetes (T2D). Methods 295 adults with T2D completed an online questionnaire measuring autonomy and perceived competence and regulatory focus. Results The promotion focus predicts the satisfaction of needs for autonomy and competence (β = 1.50, p < .01). The prevention focuses positively predicts the satisfaction of autonomy and competence needs (β = 2.06, p < .001). Conclusion These factors display different relationships between them among people with type 2 diabetes compared to the general population. Prevention focus seems to be more beneficial in the specific context of T2D than in the general population.
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Affiliation(s)
| | - Céline Clavel
- Laboratoire Interdisciplinaire des Sciences du Numérique
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Ledford CJW, Fisher CL, Cafferty LA, Jackson JT, Crawford PF, Seehusen DA. How patients make sense of a diabetes diagnosis: An application of Weick's model of organizing. Diabetes Res Clin Pract 2020; 162:108117. [PMID: 32179127 DOI: 10.1016/j.diabres.2020.108117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
AIMS To identify communication cycles patients use to make sense of a diabetes diagnosis and barriers patients encounter in their sensemaking process. METHODS Researchers conducted interviews with 33 participants with type 2 diabetes mellitus or prediabetes at medical centers in Georgia and Nevada. A thematic analysis using the constant comparative method identified communication cycles. RESULTS Patients reported engaging three communication cycles to make sense of the diagnosis: (1) interacting with healthcare clinicians; (2) seeking information online; and (3) taking a nutrition/diabetes management class. Patients reported system-level barriers that impact sensemaking: (1) lack of consistent or routine care; and (2) lack of access to resources. CONCLUSION Results here reinforce the theoretical proposition that receiving a diagnosis is an equivocal process that requires patients to make sense of new information through communication cycles. Patients in this sample repeatedly described communication cycles to interpret this new information rather than relying on assembly rules. Clinicians can promote patient understanding of diabetes and self-management by taking time to explain the diagnosis, maintaining consistent care, providing guidance to online sources, and ensuring patients have access to diabetes education.
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Affiliation(s)
- Christy J W Ledford
- Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Department of Family Medicine, 4301 Jones Bridge Road, Bethesda, MD, USA
| | - Carla L Fisher
- University of Florida, College of Journalism and Communications, P.O. Box 118400, Gainesville, FL, USA
| | - Lauren A Cafferty
- Henry M. Jackson Foundation, 6720A Rockledge Dr. Bethesda, MD, USA; Henry M. Jackson Foundation, 6720A Rockledge Dr. Bethesda, MD, USA
| | - Jeremy T Jackson
- Henry M. Jackson Foundation, 6720A Rockledge Dr. Bethesda, MD, USA; Henry M. Jackson Foundation, 6720A Rockledge Dr. Bethesda, MD, USA.
| | - Paul F Crawford
- Henry M. Jackson Foundation, 6720A Rockledge Dr. Bethesda, MD, USA; Nellis Family Medicine Residency, 4700 Las Vegas Boulevard North, Las Vegas, NV, USA
| | - Dean A Seehusen
- Augusta University, Department of Family Medicine, 1120 15th Street, Augusta, GA, USA
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Karatekin C, Ahluwalia R, Desir M. Tailoring health-related messages for young adults with adverse childhood experiences (ACEs). CHILD ABUSE & NEGLECT 2018; 80:194-202. [PMID: 29625325 DOI: 10.1016/j.chiabu.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/05/2018] [Accepted: 03/10/2018] [Indexed: 06/08/2023]
Abstract
The goal was to identify factors that might affect likelihood of seeking health-related interventions for young adults with adverse childhood experiences (ACEs). We tested whether ACEs were associated with (1) regulatory focus (tendency toward promoting good outcomes versus preventing bad outcomes), and (2) patient activation (the intention to take active charge of one's health). We further tested whether promotion and prevention and patient activation were associated with each other and with health. Students at a public university (N = 321) completed online questionnaires assessing ACEs, regulatory focus, patient activation, and health. Greater childhood adversity showed small but significant associations with being a less activated patient and being less focused on promoting good outcomes. In contrast, greater childhood adversity had a much stronger association with focusing on preventing negative outcomes. Students with a more significant mental health history were more likely to have been exposed to childhood adversity, to be less activated patients, and to focus more on prevention. Results suggest that using a prevention focus may be effective in health messages aimed to reach individuals with high levels of ACEs. Furthermore, individuals with high levels of ACEs may benefit from interventions aimed at increasing patient activation.
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Affiliation(s)
- Canan Karatekin
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA.
| | - Rohini Ahluwalia
- Department of Marketing, Carlson School of Management, University of Minnesota, 321 19th Avenue South, Minneapolis, MN 55455, USA.
| | - Michelle Desir
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN, 55455, USA.
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6
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Gimbel R, Shi L, Williams JE, Dye CJ, Chen L, Crawford P, Shry EA, Griffin SF, Jones KO, Sherrill WW, Truong K, Little JR, Edwards KW, Hing M, Moss JB. Enhancing mHealth Technology in the Patient-Centered Medical Home Environment to Activate Patients With Type 2 Diabetes: A Multisite Feasibility Study Protocol. JMIR Res Protoc 2017; 6:e38. [PMID: 28264792 PMCID: PMC5359418 DOI: 10.2196/resprot.6993] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/16/2017] [Accepted: 02/12/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys. Each of these tools, used alone or in combination, have demonstrated varying degrees of effectiveness. Some of the more promising results have been demonstrated using regular collection of biometric devices, SMS text messaging, secure email communication with clinical teams, and regular reporting of quality-of-life variables. In this study, we seek to incorporate several of the most promising mHealth capabilities in a patient-centered medical home (PCMH) workflow. OBJECTIVE We aim to address underlying technology needs and gaps related to the use of mHealth technology and the activation of patients living with type 2 diabetes. Stated differently, we enable supporting technologies while seeking to influence patient activation and self-care activities. METHODS This is a multisite phased study, conducted within the US Military Health System, that includes a user-centered design phase and a PCMH-based feasibility trial. In phase 1, we will assess both patient and provider preferences regarding the enhancement of the enabling technology capabilities for type 2 diabetes chronic care management. Phase 2 research will be a single-blinded 12-month feasibility study that incorporates randomization principles. Phase 2 research will seek to improve patient activation and self-care activities through the use of the Mobile Health Care Environment with tailored behavioral messaging. The primary outcome measure is the Patient Activation Measure scores. Secondary outcome measures are Summary of Diabetes Self-care Activities Measure scores, clinical measures, comorbid conditions, health services resource consumption, and technology system usage statistics. RESULTS We have completed phase 1 data collection. Formal analysis of phase 1 data has not been completed. We have obtained institutional review board approval and began phase 1 research in late fall 2016. CONCLUSIONS The study hypotheses suggest that patients can, and will, improve their activation in chronic care management. Improved activation should translate into improved diabetes self-care. Expected benefits of this research to the scientific community and health care services include improved understanding of how to leverage mHealth technology to activate patients living with type 2 diabetes in self-management behaviors. The research will shed light on implementation strategies in integrating mHealth into the clinical workflow of the PCMH setting. TRIAL REGISTRATION ClinicalTrials.gov NCT02949037. https://clinicaltrials.gov/ct2/show/NCT02949037. (Archived by WebCite at http://www.webcitation.org/6oRyDzqei).
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Affiliation(s)
- Ronald Gimbel
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Joel E Williams
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Cheryl J Dye
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Liwei Chen
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Paul Crawford
- Nellis Family Medicine Residency Program, Mike O'Callaghan Federal Hospital, Las Vegas, NV, United States
| | - Eric A Shry
- Madigan Army Medical Center, Tacoma, WA, United States
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Karyn O Jones
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Windsor W Sherrill
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Khoa Truong
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Jeanette R Little
- MHIC Laboratory Lead, Telemedicine & Advanced Technology Research Center, U.S. Army Medical Research & Materials Command, Fort Gordon, GA, United States
| | - Karen W Edwards
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Marie Hing
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Jennie B Moss
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
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Notthoff N, Carstensen LL. Promoting walking in older adults: Perceived neighborhood walkability influences the effectiveness of motivational messages. J Health Psychol 2015; 22:834-843. [PMID: 26604128 DOI: 10.1177/1359105315616470] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Positively framed messages seem to promote walking in older adults better than negatively framed messages. This study targeted elderly people in communities unfavorable to walking. Walking was measured with pedometers during baseline (1 week) and intervention (4 weeks). Participants ( n = 74) were informed about either the benefits of walking or the negative consequences of not walking. Perceived neighborhood walkability was assessed with a modified version of the Neighborhood Walkability Scale. When perceived walkability was high, positively framed messages were more effective than negatively framed messages in promoting walking; when perceived walkability was low, negatively framed messages were comparably effective to positively framed messages.
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Affiliation(s)
- Nanna Notthoff
- 1 Stanford University, USA.,2 Humboldt University of Berlin, Germany
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8
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Ledford CJW, Cafferty LA, Russell TC. The Influence of Health Literacy and Patient Activation on Patient Information Seeking and Sharing. JOURNAL OF HEALTH COMMUNICATION 2015; 20 Suppl 2:77-82. [PMID: 26513034 DOI: 10.1080/10810730.2015.1066466] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study provided an assessment of how patients looked for information to prepare for a clinical appointment and whether they shared those findings with their provider. A cross-sectional survey allowed insight into patient attitudes, motivations, and behavior in clinical real time. At two hospital-based clinics, 243 patients completed surveys before and after clinical appointments. Younger patients with higher communicative and critical health literacy prepared for clinical appointments with information searches. The predicted association of health literacy and patient activation with information sharing was not supported. This study shows that patients with higher patient activation perceived that their providers responded more positively to patient-obtained medical information. The role of critical health literacy may show that individuals choosing to seek information are considering not just their ability to conduct the search but also their ability to synthesize and critically analyze the results of the information search. An implication for providers is to become skilled in directly asking or passively surveying what outside information sources the patient has engaged with, no matter if the patient does or does not introduce the information.
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Affiliation(s)
- Christy J W Ledford
- a Department of Family Medicine , Uniformed Services University of the Health Sciences , Bethesda , Maryland , USA
| | - Lauren A Cafferty
- a Department of Family Medicine , Uniformed Services University of the Health Sciences , Bethesda , Maryland , USA
| | - Travis C Russell
- b Department of Family Medicine , Mike O'Callaghan Federal Medical Center , Nellis Air Force Base , USA
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Ledford CJW, Childress MA, Ledford CC, Mundy HD. Refining the Practice of Prescribing: Teaching Physician Learners How to Talk to Patients About a New Prescription. J Grad Med Educ 2014; 6:726-32. [PMID: 26140126 PMCID: PMC4477570 DOI: 10.4300/jgme-d-14-00126.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/18/2014] [Accepted: 08/05/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Clinician counseling about medication can improve patient understanding and adherence. This study developed a teaching session for physician learners about medication prescribing and communication, with evaluation at the physician and patient levels. OBJECTIVE We analyzed whether patients would perceive and report more comprehensive clinician presentation of medication information when receiving prescriptions from their physician in the intervention clinic. METHODS We conducted a single site, prospective intervention study that included lectures, role play, an objective standardized clinical examination (OSCE), and reminders displayed in patient care areas. For physician-level assessment, pretests and posttests included a written case presentation and a OSCE. For patient-level assessment, we used a cross-sectional observational design that included study of patient recall information, and assessment of patient satisfaction before and after intervention. RESULTS Twenty-seven family medicine residents and sports medicine fellows participated in the teaching session, focused on presenting patients the reasons, risks, and regimen of prescribed medication. In written testing, learners presented significantly more comprehensive information in posttests. In the OSCE (n = 14), all learners presented risks and regimen information. However, patient-level assessment showed no significant difference between before and after intervention. Notably, the covariates patient activation and satisfaction with communication both had a significant association with patient recall information. CONCLUSIONS Our intervention improved learner presentation of medication information. However, patient recall of the information conveyed did not change. Although physician training did not have a positive effect on patient recall, patient activation emerged as a critical influence of patients' perceptions of medication discussions.
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Sims T, Tsai JL. Patients respond more positively to physicians who focus on their ideal affect. ACTA ACUST UNITED AC 2014; 15:303-18. [PMID: 25313670 DOI: 10.1037/emo0000026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous findings suggest that patients choose physicians whose affective focus matches how they ideally want to feel (Sims et al., 2014). For instance, the more people wanted to feel excitement, the more likely they were to hypothetically choose a new physician who promoted excitement. What remains unknown is whether this match shapes how patients actually respond to physicians after being assigned to them (i.e., whether they adhere to physicians' recommendations more and evaluate physicians more positively). To this end, community adults reported their global ideal affect and actual affect (how they ideally want to feel and actually feel during a typical week, respectively), and were randomly assigned to receive health recommendations from either a physician who expressed and promoted high arousal positive states (HAP) (e.g., excitement), or one who expressed and promoted low arousal positive states (LAP) (e.g., calm). For the next 5 days, participants reported their daily adherence to the recommendations and their daily ideal and actual affect. At the end of the week, participants evaluated their physician. As predicted, the more participants wanted to feel HAP, the more they adhered to the "HAP-focused" physician's recommendations, and the more participants wanted to feel LAP, the more they adhered to the "LAP-focused" physician's recommendations. Participants also evaluated their physician more positively when his affective focus matched their ideal affect. Neither global nor daily actual affect systematically predicted how patients responded to their physicians. These findings suggest that patients respond better to physicians whose affective focus matches their ideal affect.
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Affiliation(s)
- Tamara Sims
- Department of Psychology, Stanford University
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11
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Park CL, Riley KE, Bedesin E, Stewart VM. Why practice yoga? Practitioners’ motivations for adopting and maintaining yoga practice. J Health Psychol 2014; 21:887-96. [DOI: 10.1177/1359105314541314] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We examined motives for adopting and maintaining yoga practice in a national survey of yoga practitioners (360 yoga students, 156 yoga teachers). Both students and teachers adopted yoga practice primarily for exercise and stress relief, but reported many other reasons, including flexibility, getting into shape, and depression/anxiety relief. Over 62 percent of students and 85 percent of teachers reported having changed their primary reason for practicing or discovering other reasons; for both, the top changed primary reason was spirituality. Findings suggest that most initiate yoga practice for exercise and stress relief, but for many, spirituality becomes their primary reason for maintaining practice.
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Affiliation(s)
| | | | - Elena Bedesin
- Abt Associates Inc., 55 Wheeler Street, Cambridge, MA, USA
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12
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Van 't Riet J, Cox AD, Cox D, Zimet GD, De Bruijn GJ, Van den Putte B, De Vries H, Werrij MQ, Ruiter RAC. Does perceived risk influence the effects of message framing? A new investigation of a widely held notion. Psychol Health 2014; 29:933-49. [PMID: 24579986 DOI: 10.1080/08870446.2014.896916] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Health-promoting messages can be framed in terms of the beneficial consequences of healthy behaviour (gain-framed messages) or the detrimental consequences of unhealthy behaviour (loss-framed messages). An influential notion holds that the perceived risk associated with the recommended behaviour determines the relative persuasiveness of gain- and loss-framed messages. This 'risk-framing hypothesis', as we call it, was derived from prospect theory, has been central to health message framing research for the last two decades, and does not cease to appeal to researchers. The present paper examines the validity of the risk-framing hypothesis. We performed six empirical studies on the interaction between perceived risk and message framing. These studies were conducted in two different countries and employed framed messages targeting skin cancer prevention and detection, physical activity, breast self-examination and vaccination behaviour. Behavioural intention served as the outcome measure. None of these studies found evidence in support of the risk-framing hypothesis. We conclude that the empirical evidence in favour of the hypothesis is weak and discuss the ramifications of this for future message framing research.
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Affiliation(s)
- Jonathan Van 't Riet
- a Department of Communication Science, Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
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13
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Goodworth MCR, Stepleman L, Hibbard J, Johns L, Wright D, Hughes MD, Williams MJ. Variables associated with patient activation in persons with multiple sclerosis. J Health Psychol 2014; 21:82-92. [PMID: 24591120 DOI: 10.1177/1359105314522085] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Identifying variables associated with patient activation in the multiple sclerosis population could serve to facilitate better multiple sclerosis self-management behaviors. Using a cross-sectional survey design, 199 participants were recruited from a multiple sclerosis center in the Southeastern United States. Depression, multiple sclerosis quality of life, and multiple Sclerosis self-efficacy were all significantly correlated with patient activation. Results of a hierarchical regression indicated that patient activation was significantly related to educational attainment, depression, and self-efficacy but not to quality of life. The results suggest several possible targets for intervention to increase patient activation, including health literacy, depression symptoms, and self-efficacy for multiple sclerosis disease management.
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Affiliation(s)
| | | | | | - Lisa Johns
- The Ohio State University College of Medicine, USA
| | - Dustin Wright
- Charlie Norwood Veterans Affairs Medical Center, USA
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Ledford CJW, Childress MA, Ledford CC, Mundy HD. The practice of prescribing: discovering differences in what we tell patients about prescription medications. PATIENT EDUCATION AND COUNSELING 2014; 94:255-260. [PMID: 24183710 DOI: 10.1016/j.pec.2013.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 08/26/2013] [Accepted: 10/05/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study explored patient recall of clinician presentation of information about prescription medication, looking specifically for communication patterns and differences by patient individual characteristics and by medication availability type. METHODS A cross sectional survey collected information about 216 patients' perceptions of clinician presentations of medication information. RESULTS Demographically, males recalled receiving more information about reasons, risks, and regimen in medication discussions. By medication type, patients reported receiving more medication information when the clinician presented a prescription-only medication as opposed to a medication that was also available over the counter. CONCLUSION Given the broad and unmonitored use of over-the-counter products, coupled with the increasing awareness of risks associated with many of these medications, it is concerning that patients report receiving less information about these products. PRACTICE IMPLICATIONS The emphasis on appropriate medication counseling should not be limited to medications available only by prescription. Prescribers should be mindful of these potential tendencies when discussing medications.
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Affiliation(s)
- Christy J W Ledford
- Department of Biomedical Informatics, Uniformed Services University of the Health Sciences, Bethesda, USA.
| | - Marc A Childress
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, USA
| | | | - Heather D Mundy
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, USA
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Jones L, Crabb S, Turnbull D, Oxlad M. Barriers and facilitators to effective type 2 diabetes management in a rural context: a qualitative study with diabetic patients and health professionals. J Health Psychol 2013; 19:441-53. [PMID: 23493867 DOI: 10.1177/1359105312473786] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although effective type 2 diabetes management is essential for the prevention of complications, it is rarely carried out. Type 2 diabetes deaths in rural areas are higher than in metropolitan areas. A focus group (n = 8) and telephone interviews with patients (n = 10), and telephone interviews with health professionals (n = 18) in rural areas were conducted to examine this issue in a rural context. Inductive thematic analysis was used to generate 13 themes of barriers and facilitators to type 2 diabetes management at intrapersonal (denial of the illness, motivation, knowledge and skills and lack of time), interpersonal (stress and relationships), organisational (access to recommended foods, transport, health professionals, and exercise options) and societal (engagement and societal attitudes) levels of influence. Across all themes, participants highlighted the difficulty of maintaining management behaviours.
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Ledford CJW, Ledford CC, Childress MA. Exploring patient activation in the clinic: measurement from three perspectives. HEALTH EDUCATION & BEHAVIOR 2012; 40:339-45. [PMID: 22984210 DOI: 10.1177/1090198112455173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To further conceptualize and operationalize patient activation (PA), using measures from patient, physician, and researcher perspectives. DATA SOURCE/STUDY SETTING Multimethod observation in 2010 within a family medicine clinic. STUDY DESIGN Part of an intervention with 130 patients with type 2 diabetes, this observational study further looked at PA in 19 physician-patient dyads. Data Collection. Observations occurred in a teaching hospital, which served as recruiting and study site. PRINCIPAL FINDINGS PA correlated with knowledge, self-efficacy, promotion orientation, and exercise intent. Patient-reported PA did not correlate with researcher-observed or physician-reported PA behavior. Researcher-observed PA correlated with physician-observation items. CONCLUSIONS Results provide evidence for measuring different perspectives in studies of PA. When patients report they are activated in self-management, behavior does not indicate they are active in clinical communication, a critical component of collaborative decision making.
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Affiliation(s)
- Christy J W Ledford
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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