1
|
Collins CC, Benedict J. Evaluation of a Community-based Health Promotion Program for the Elderly: Lessons from Seniors CAN. Am J Health Promot 2018; 21:45-8. [PMID: 16977912 DOI: 10.1177/089011710602100108] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate the effects of a community-based educational program designed to promote health by enhancing older adults’ mastery while decreasing loneliness and stress. Methods Between 1999 and 2004, 339 older adults who participated in Seniors CAN completed standardized assessments of mastery, loneliness, and stress, prior to and upon completion of the 4–month intervention. Participants’ scores were compared using paired t-tests to measure changes from preintervention to postintervention. Change scores were then subjected to three-way ANOVA to assess the relative effectiveness based upon participants’ sociodemographic characteristics. Results Participants demonstrated significant improvements from preintervention to postintervention for mastery, loneliness, and stress. Additional analysis revealed that improvement in loneliness was significantly greater among low-income ethnic minorities and minorities with a high level of formal education, p < .05. Conclusion The 16-week intervention resulted in significant improvements in constructs associated with better health and a higher quality of life for independent-living older adults. These findings suggest that a community-based educational intervention can be an effective strategy to reduce risk and promote the health and independence of older adults.
Collapse
Affiliation(s)
- Claudia C Collins
- University of Nevada Cooperative Extension, 8050 S. Maryland Pkwy #100, Las Vegas, NV 89123, USA
| | | |
Collapse
|
2
|
Abstract
Empathy is a multifaceted skill and asset for health care providers. This paper uses current neuroscience literature of empathy to generate nuanced theory of how empathy can be blocked by personal stress and aversion among health care professionals. Current training approaches for educating sustainable empathy are reviewed in depth. The final part of the paper provides suggestions on how to spread empathy education farther and wider across medical education.
Collapse
Affiliation(s)
- Eve Ekman
- a Osher Center of Integrative Medicine, University of California San Francisco , San Francisco , CA , USA
| | - Michael Krasner
- b School of Medicine, University of Rochester , Rochester , NY , USA
| |
Collapse
|
3
|
Walker TJ, Tullar JM, Taylor WC, Román R, Amick BC. How Do Stages of Change for Physical Activity Relate to Employee Sign-Up for and Completion of a Worksite Physical Activity Competition? Health Promot Pract 2016; 18:93-101. [DOI: 10.1177/1524839916659846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction. This study evaluated whether stages of change for physical activity (PA) predict sign-up, participation, and completion in a PA competition. Method. Deidentified data were provided to evaluate a PA competition between 16 different institutions from a public university system. Employees who completed a health assessment (HA) prior to the start of the PA competition ( n = 6,333) were included in the study. Participants completed a self-report HA and logged their PA throughout the competition. Multivariable logistic regression models tested whether stages of change predicted PA competition sign-up and completion. An ordinal logistic regression model tested whether stages of change predicted number of weeks of PA competition participation. Results. Stages of change predicted PA competition sign-up and completion, but not weeks of participation. The odds for PA competition sign-up were 1.64 and 1.98 times higher for employees in preparation and action/maintenance (respectively) compared with employees in precontemplation/contemplation. The odds for PA competition completion were 4.17 times higher for employees in action/maintenance compared with employees in precontemplation/contemplation/preparation. Conclusion. The PA competition was more likely to reach employees in preparation, action, or maintenance stages than precontemplation/contemplation. Most of the completers were likely participating in regular PA prior to the competition.
Collapse
Affiliation(s)
| | | | | | | | - Benjamin C. Amick
- Florida International University, Miami, FL, USA
- Institute for Work & Health, Toronto, Ontario, Canada
| |
Collapse
|
4
|
MacNeill V, Foley M, Quirk A, McCambridge J. Shedding light on research participation effects in behaviour change trials: a qualitative study examining research participant experiences. BMC Public Health 2016; 16:91. [PMID: 26825583 PMCID: PMC4733277 DOI: 10.1186/s12889-016-2741-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 01/15/2016] [Indexed: 11/15/2022] Open
Abstract
Background The sequence of events in a behaviour change trial involves interactions between research participants and the trial process. Taking part in such a study has the potential to influence the behaviour of the participant, and if it does, this can engender bias in trial outcomes. Since participants’ experience has received scant attention, the aim of this study is thus to generate hypotheses about which aspects of the conduct of behaviour change trials might matter most to participants, and thus have potential to alter subsequent behaviours and bias trial outcomes Methods Twenty participants were opportunistically screened for a health compromising behaviour (unhealthy diet, lack of exercise, smoking or alcohol consumption) and recruited if eligible. Semi structured face to face interviews were conducted, after going through the usual processes involved in trial recruitment, baseline assessment and randomisation. Participants were given information on the contents of an intervention or control condition in a behaviour change trial, which was not actually implemented. Three months later they returned to reflect on these experiences and whether they had any effect on their behaviour during the intervening period. Data from the latter interview were analysed thematically using a modified grounded theory approach. Results The early processes of trial participation raised awareness of unhealthy behaviours, although most reported having had only fleeting intentions to change their behaviour as a result of taking part in this study, in the absence of interventions. However, careful examination of the accounts revealed evidence of subtle research participation effects, which varied according to the health behaviour, and its perceived social acceptability. Participants’ relationships with the research study were viewed as somewhat important in stimulating thinking about whether and how to make lifestyle changes. Conclusion These participants described no dramatic impacts attributable to taking part in this study. This study demonstrates the likely value of well conducted qualitative studies of subtle research participation effects, which may be particularly important to explore for alcohol. Separating unintended influences in trial participation from the effects of behaviour change interventions being evaluated therein is necessary for valid estimates of intervention effects.
Collapse
Affiliation(s)
- Virginia MacNeill
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Marian Foley
- Faculty Health, Psychology and Social Care Manchester Metropolitan University, 799 Wilmslow Road, Manchester, M20 2RR, UK
| | - Alan Quirk
- Royal College of Psychiatrists' Centre for Quality Improvement, 21 Prescot Street, London, E1 8BB, UK
| | - Jim McCambridge
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. .,Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| |
Collapse
|
5
|
Welch J. Building a foundation for brief motivational interviewing: communication to promote health literacy and behavior change. J Contin Educ Nurs 2015; 45:566-72. [PMID: 25401341 DOI: 10.3928/00220124-20141120-03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/12/2014] [Indexed: 11/20/2022]
Abstract
The use of collaborative communication styles such as motivational interviewing promotes patient engagement, health literacy, self-management, and improved outcomes for individuals with chronic illness. Brief motivational interviewing is an adaptation developed for use with medical populations in time-limited encounters. Inpatient nurses caring for individuals with chronic diagnoses may lack knowledge regarding brief motivational interviewing. This evidence-based quality improvement project used an online approach to introduce continuing education regarding brief motivational interviewing within the constraints of the inpatient setting. Nurses on four units in a community hospital completed a web-based learning module in preparation for context-based skills training. A significant increase in knowledge scores, combined with strong positive attitudes prior to and following the module, indicated a reliable foundation for skills training within the practice setting. Nurses' enhanced ability to recognize the practice of motivational interviewing in scenarios following online education supported the potential value of a hybrid approach to education.
Collapse
|
6
|
Seifert CM, Chapman LS, Hart JK, Perez P. Enhancing Intrinsic Motivation in Health Promotion and Wellness. Am J Health Promot 2012; 26:TAHP1-12. [DOI: 10.4278/ajhp.26.3.tahp] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Colleen M. Seifert
- Colleen M. Seifert, PhD, is Arthur F. Thurnau Professor and Professor of Psychology, Department of Psychology, University of Michigan, Ann Arbor, Michigan. Larry S. Chapman, MPH, is President and CEO, Chapman Institute, Lake Forest Park, Washington. Joseph K. Hart, JD, is with Asset Health Inc., Troy, Michigan. Paul Perez, CWPC, PCC, is in Edmonds, Washington
| | - Larry S. Chapman
- Colleen M. Seifert, PhD, is Arthur F. Thurnau Professor and Professor of Psychology, Department of Psychology, University of Michigan, Ann Arbor, Michigan. Larry S. Chapman, MPH, is President and CEO, Chapman Institute, Lake Forest Park, Washington. Joseph K. Hart, JD, is with Asset Health Inc., Troy, Michigan. Paul Perez, CWPC, PCC, is in Edmonds, Washington
| | - Joseph K. Hart
- Colleen M. Seifert, PhD, is Arthur F. Thurnau Professor and Professor of Psychology, Department of Psychology, University of Michigan, Ann Arbor, Michigan. Larry S. Chapman, MPH, is President and CEO, Chapman Institute, Lake Forest Park, Washington. Joseph K. Hart, JD, is with Asset Health Inc., Troy, Michigan. Paul Perez, CWPC, PCC, is in Edmonds, Washington
| | - Paul Perez
- Colleen M. Seifert, PhD, is Arthur F. Thurnau Professor and Professor of Psychology, Department of Psychology, University of Michigan, Ann Arbor, Michigan. Larry S. Chapman, MPH, is President and CEO, Chapman Institute, Lake Forest Park, Washington. Joseph K. Hart, JD, is with Asset Health Inc., Troy, Michigan. Paul Perez, CWPC, PCC, is in Edmonds, Washington
| |
Collapse
|
7
|
|
8
|
Seaverson ELD, Grossmeier J, Miller TM, Anderson DR. The Role of Incentive Design, Incentive Value, Communications Strategy, and Worksite Culture on Health Risk Assessment Participation. Am J Health Promot 2009; 23:343-52. [DOI: 10.4278/ajhp.08041134] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine the impact of financial incentives, communications strategy, and worksite culture on health risk assessment (HRA) participation rates. Design. A cross-sectional study design was used to examine factors that influence employee participation, including incentive value, incentive design, communications strategy, and worksite culture. Setting. Large private-sector and public-sector employers. Participants. Thirty-six employers (n = 559,988 employees) that provided financial incentives to promote employee HRA participation. Intervention. Organizations implemented the HRA as part of a more comprehensive worksite health promotion strategy that included follow-up interventions and a variety of other components. The primary outcome of interest was employee HRA participation. Measures. Information on program design and structure, as well as on HRA eligibility and participation, was collected for each organization via standard client report and semi-structured interviews with account managers. General linear regression models were used to examine the extent to which factors influence HRA participation independently and when controlled for other factors. Results. Incentive value (r2 = .433; p < .000), benefits-integrated incentive design (r2 = .184; p = .009), culture (r2 = .113; p = .045), and communications strategy (r2 = .300; p = .001) had positive bivariate associations with HRA participation rates. When all factors were included in the model, incentive value (p = .001) and communications strategy (p = .023) were significantly associated with HRA participation. Variance accounted for by all factors combined was R2 = .584. Conclusion. This study suggests that incentive value, incentive type, supportive worksite culture, and comprehensive communications strategy may all play a role in increasing HRA participation.
Collapse
Affiliation(s)
- Erin L. D. Seaverson
- Erin L. D. Seaverson, MPH; Jessica Grossmeier, MPH; Toni M. Miller; and David R. Anderson, PhD, are with StayWell Health Management, Saint Paul, Minnesota 55121
| | - Jessica Grossmeier
- Erin L. D. Seaverson, MPH; Jessica Grossmeier, MPH; Toni M. Miller; and David R. Anderson, PhD, are with StayWell Health Management, Saint Paul, Minnesota 55121
| | - Toni M. Miller
- Erin L. D. Seaverson, MPH; Jessica Grossmeier, MPH; Toni M. Miller; and David R. Anderson, PhD, are with StayWell Health Management, Saint Paul, Minnesota 55121
| | - David R. Anderson
- Erin L. D. Seaverson, MPH; Jessica Grossmeier, MPH; Toni M. Miller; and David R. Anderson, PhD, are with StayWell Health Management, Saint Paul, Minnesota 55121
| |
Collapse
|
9
|
Rose SB, Lawton BA, Elley CR, Dowell AC, Fenton AJ. The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design. BMC Public Health 2007; 7:166. [PMID: 17645805 PMCID: PMC1971069 DOI: 10.1186/1471-2458-7-166] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Accepted: 07/23/2007] [Indexed: 11/13/2022] Open
Abstract
Background Physical inactivity is an independent risk factor for diabetes and heart disease. There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases, but less evidence about effective ways to increase adherence to physical activity. Interventions are therefore needed that produce sustained increases in adherence to physical activity, are cost-effective and improve clinical endpoints. Methods The Women's Lifestyle Study is a two year randomized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care. Baseline measures were assessed in a face-to-face interview with a primary care nurse. The intervention involved delivery of a 'Lifestyle script' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months. Outcome measurements are assessed at 12 and 24 months. The primary outcome is physical activity measured using a validated physical activity questionnaire. Secondary outcomes include blood pressure, weight, waist circumference, physical fitness (step test), serum HbA1c, fasting glucose, lipids, insulin, and quality of life (SF36). Costs were measured prospectively to allow a subsequent cost-effectiveness evaluation if the trial is positive. Discussion Due to report in 2008, the Women's Lifestyle Study tests the effectiveness of an enhanced low-cost, evidence-based intervention in increasing physical activity, and improving cardiovascular and diabetes risk indicators over two years. If successful in demonstrating improvements in health outcomes, this randomized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit, in addition to improvements in physical activity, from a sustainable physical activity intervention based in primary care. Trial Registration Australian Clinical Trials Registry (ACTR), ACTRN012605000490673.
Collapse
Affiliation(s)
- Sally B Rose
- Women's Health Research Centre, Department of Primary Health Care and General Practice, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington, New Zealand
| | - Beverley A Lawton
- Women's Health Research Centre, Department of Primary Health Care and General Practice, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington, New Zealand
| | - C Raina Elley
- Department of General Practice & Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Anthony C Dowell
- Department of Primary Health Care and General Practice, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington, New Zealand
| | - Anna J Fenton
- Christchurch Women's Hospital and the Oxford Clinic, 38 Oxford Terrace, Christchurch, New Zealand
| |
Collapse
|
10
|
Serxner S, Noeldner SP, Gold D. Best practices for an integrated population health management (PHM) program. Am J Health Promot 2006; 20:suppl 1-10, iii. [PMID: 16706008 DOI: 10.4278/0890-1171-20.5.tahp-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Large employers are beginning to create much more robust and potentially effective systems of integrated health management interventions. This organization-wide activity is referred to as a "Population Health Management" (PHM) approach. Best practices are also beginning to emerge in this area, and a number of technical developments are helping shape the patterns of response from innovative employers. This initiative is rapidly emerging as a critical part of overall business and health care strategy.
Collapse
|
11
|
Talking Oneself Into Change: Motivational Interviewing, Stages of Change, and Therapeutic Process. J Cogn Psychother 2004. [DOI: 10.1891/jcop.18.4.299.64003] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Motivational interviewing (MI) is a directive, person-centered clinical method for helping clients resolve ambivalence and move ahead with change. It can be applied as a preparation for treatment, a freestanding brief intervention, an enduring clinical style, or a fallback approach when motivational obstacles are encountered. A psycholinguistic theory is emerging to account for the efficacy of MI that has been demonstrated in numerous clinical trials. For cognitive therapists, MI provides an evidence-based alternative to direct disputation of client cognitions.
Collapse
|