Conclusions: Weight loss interventions using social media should aim to include messages that are informational and provide social support to assist in weight loss muscle relaxant japan cheap 10mg baclofen with mastercard. Future studies should investigate the positive (social support spasms back pain and sitting order baclofen 10 mg online, informational posts) and negative impacts (social comparisons spasms near anus buy 10mg baclofen fast delivery, body image) of social media on weight loss behaviors spasms 2 order 25 mg baclofen mastercard. Furthermore spasms after surgery order 25 mg baclofen amex, understanding the effectiveness of social media on weight loss and maintenance behaviors as a stand-alone delivery method is important for future interventions spasms trailer cheap baclofen 25mg otc. Focus group participants completed a demographic survey and engaged in a semi-structured discussion to identify challenges to purchasing healthy foods spasms meaning buy discount baclofen 25mg line. Inclusion criteria included: 21 years old muscle relaxant pregnancy safe discount 10mg baclofen fast delivery, doing 50% of household grocery shopping, desire to improve dietary quality, and agreement to audio-recording. Exclusion criteria included: bariatric surgery, meals delivered to the home, or meal replacements for 2 meals/day. Increasing prices, not knowing how to prepare some healthy foods (mainly produce), and becoming accustomed to tedious diets were barriers. They reported frustration when stores rearrange inventory and motivation to purchase items on sale or with coupons. Clear barriers to healthy food selection while grocery shopping were therefore identified. Given that full-time workers spend approximately a third of their day at work, it is important to understand the influence of the workplace environment on healthy eating and obesity. Eating behavior at work was influenced by social, emotional, and practical factors. Specifically, 28% of participants reported that coworkers influenced them to eat more "junk" food; 48% reported that work stress influenced them to eat more "junk" food; and 32% reported that time constraints interfered with healthy eating at work. Weight-related self-efficacy was the most consistent correlate of workplace eating behaviors with low self-efficacy being related to more reported workplace barriers to healthy eating, including eating food that others brought to work (r=-. Additionally, work/social impairment was related to eating more food in response to stress, (r =. These results suggest that employees view coworkers, stress, and time constraints as significant barriers to healthy workplace eating, that unplanned food is readily available in the workplace, and that addressing weight-related self-efficacy may help individuals reduce eating in response to these workplace influences. Data were collected on sociodemographic, anthropometric, and behavioral variables for children and parents at baseline. The sample is ethnically/racially diverse (36% Hispanic or Latino; 37% African-American; 16% White; 10% multiracial/other). Forty-one percent of the children and 69% of parents enrolled are overweight or obese. Few children consumed 5 or more servings of vegetables (9%) or fruits (12%) per day. One-third of parents reported that their children consumed at least 1 sugar-sweetened beverage per day. These data highlight the need for dissemination of evidence-based weight gain prevention programs for low-income children and their parents. Currently, gaps in the research about body image in adult men, middleaged and older populations, and overweight and obese populations remain. The present analysis seeks to elucidate the relationship between body size and body image and potential similarities or differences between women and men who are overweight or obese, prior to engaging in the weight loss process. These scores were not statistically significantly different, suggesting that men and women who are overweight or obese have similar, relatively positive feelings about their bodies. This work is unique in considering body image in both overweight and obese men and women as well as an older sample of participants. Body mass index, however, is not the only important aspect between weight and well-being. In fact, perceptions of overweight and attractiveness might be more influential on quality of life than actual weight status. The aim of the current study was to investigate the influence of two distinct components of body image. The differential impact of these body image variables on men and women was also examined. Similarly, for men, perceived attractiveness may buffer the impact of weight status on self-esteem. The analysis included 169,695 men and women (African American, Native Hawaiian, Japanese American, Latino, or White) who were 45-78 years old at baseline. Identification of individuals lacking literacy skills prior to participation in behavioral weight-loss interventions designed to promote energy balance may benefit from attention to this deficit. The aim of this secondary analysis was to explore changes in health literacy following a 12week mHealth behavioral weight loss intervention. Health literacy was measured at baseline and 12 weeks using the Newest Vital Sign, a quiz that involved reading a food label. We classified subjects as having adequate (score 4) or limited (score < 4) health literacy. Wilcoxon signed-rank test was used to analyze the change in health literacy for all subjects and within literacy groups that completed the 12-week trial. Subjects having limited health literacy at baseline improved their scores over time (median= 3. Those with adequate health literacy at baseline showed a significant change over time (p=. The limited literacy group improved their health literacy level and, overall, those with adequate baseline health literacy maintained adequate literacy over time. The improvement in health literacy for those with limited literacy may be related to use of a smartphone app in this pilot intervention study where individuals could track their food intake. Future studies should examine how tailored mobile apps for self-monitoring may benefit those with limited health literacy and promote healthful eating habits. However, evidence is lacking as to whether consistency in daily calorie intake is important for successful weight loss. The current study sought to explore the relation between day-to-day calorie consistency and weight loss in the context of behavioral weight loss treatment, as well as to examine the relation between variability in intake and several factors known to be associated with weight control success. Method: Participants (N = 283) enrolled in a 12-month groupbased, behavioral weight loss program completed assessments that included self-report measures of psychological variables related to weight management and 24-hour recalls of dietary intake. Results: Low calorie variability and greater weight loss were associated at end-oftreatment, but variability was not predictive of weight loss independent of mean calories in continuous analyses. Interestingly, participants who met the program goal of 10% weight loss had less calorie variability at end-of-treatment compared to those who did not meet this target, although groups did not differ significantly on mean calorie intake. Results suggest that daily calorie consistency may facilitate successful weight loss for some. Additionally, autonomous motivation for weight management and cognitive dietary restraint were inversely related to end-of-treatment calorie variability. Discussion: these findings suggest that lower calorie variability across days is associated with greater treatment success. Additional research is needed to examine whether recommendations to limit calorie variability during behavioral weight loss treatment improve long-term weight control. Ninety percent of adults living in the United States own a cell phone and 58% own a smartphone. Smartphones allow for a convenient way to record events as they occur in real-time, which is ideal in behavioral research. Understanding smartphone use by participants involved in research can provide valuable information that may increase participant recruitment and retention. Questions pertaining to cell phone use examined the number of phones carried by participants, type of phone, phone carrier and plan, and frequency of use. Other questions assessed smartphone use and examined the type of user the participants considered themselves to be, type of operating system, and access to wireless internet at home. However, findings show limited experience using smartphones, which has several implications for study participation including the need to train individuals prior to study participation and provide financial support for data plans. Future studies would benefit from a better understanding of participant preferences, knowledge of and experience with smartphones, especially for studies that require frequent use of a smartphone for self-monitoring and responding to queries about behaviors, context and mood. We evaluated the association between baseline cognitive function, adherence to program components and weight loss in 36 middle age (M=41. Results indicated that attention (Flanker task) was positively correlated with session attendance (p=0. Executive control (Stroop task) was positively correlated with session attendance (p=0. These results suggest that stronger baseline cognitive function is associated with better adherence and weight loss in response to a 3mo. Additional trials to assess the role of baseline cognitive function on longer-term weight loss (12 mos. An independent samples ttest revealed that those in the low restrained eating group more frequently reported "boredom" (p = 0. Participants with high external disinhibition reported negative thoughts as frequent triggers (p = 0. The low restraint group being triggered by boredom, low motivation and feeling like they deserved it, is consistent with the behavior of low restrained eaters. However, the high external disinhibition group (expected to be triggered by external disinhibitors) frequently reported negative thoughts (a seemingly internal disinhibitor). Few studies have examined potential mechanisms explaining this link, despite the potential for mediation analyses to identify targets for intervention. We use a cumulative risk framework to examine how the accumulation of multiple psychosocial and sociodemographic stressors affects child weight. This study examined the relationship between race and eating behaviors and whether eating behaviors mediated the relationship between race and weight loss. This study showed that racial differences in weight loss were partially explained by adoption of more, and different, strategies to change eating behaviors. However, these weight loss practices are often associated with disordered eating as well. Participants were those who had completed a 12-month weight loss intervention that included daily self-weighing using a Wi-Fi scale. Five main themes emerged: 1) reasons for daily weighing, 2) reasons for not daily weighing, 3) factors that encouraged weighing, 4) recommendations for others about daily weighing, and 5) suggestions for future weight loss programs. The reasons for daily weighing included: feeling motivated, receiving feedback for eating and exercise behaviors, and feeling under control. The reasons for not daily weighing were: feeling frustrated when weight increased and experiencing barriers to daily weighing due to interruption of routine. Conclusions: Our results identified several positive aspects to daily self-weighing, which can be used to promote adherence to this important weight loss strategy. The purpose of this study was to ascertain facilitators and barriers to following clinical guidelines. Methods: Forty-three clinical, scientific, policy, and insurance experts were invited to participate in a two-day conference in July 2015 on improving access to childhood obesity treatment. The survey was guided by the multilevel framework for understanding causal factors (structural, organizational, provider, patient, and innovation factors) on implementation effectiveness (adoption, fidelity, implementation cost, penetration, and sustainability). Results: Thirty-three experts completed the survey (59% women, 85% Caucasian, and 88% non-Hispanic). Most had been in their field for at least 16 years (58%) and represented national interests (49% national, 21% urban, 30% other). Organizational and provider factors were rated as most important to implementation effectiveness. Effect sizes were subsequently calculated to determine the magnitude of each effect. Individuals were eligible to participate regardless of their frequency of self-weighing. Five main themes emerged: 1) reasons for daily weighing, 2) reasons for not weighing daily, 3) factors that encouraged weighing, 4) recommendations for others about daily weighing, and 5) suggestions for future weight loss programs. The reasons for not weighing daily were: feeling frustrated when weight increased and experiencing barriers to daily weighing due to interruption of routine. Participants reported the following factors encouraged daily weighing: it is efficient; scale is reliable; weight is automatically recorded, synchronized, and graphically displayed with smartphone app. However, the etiology of this well-established comorbid presentation and its associated consequences remain largely unknown. In line with emerging evidence, a multidimensional view of impulsivity was adopted. In addition, every one unit increase in lack of perseverance was associated with 2. Alternatively, every one unit increase in sensation seeking was associated with 1. Symone McKinnon, Bachelors of Arts in Psychology1, Breanna Holloway, Bachelors of Arts in Psychology2, April May, Bachelors of Arts in Psychology3, Maya Santoro, Masters of Arts in Psychology4, Terry A. The healthcare system is difficult to navigate and designed to treat acute illnesses, often neglecting to address the multifaceted healthcare needs of older adults who require long-term care. The purpose of the present study was to examine whether age (70, 80, 90), having a cognitive or mental health disorder. Participants (N = 1134) recruited from a large urban cultural park were randomly selected to complete a questionnaire. In the last decade, several entities emphasized these goals in their preventive health efforts. Attribute-specific disparities for each behavior were calculated for sex, age, education, income, and race. Overall disparity scores (mean of attribute-specific disparity scores) were calculated for each behavior. Binge drinking was the only behavior where disparities declined consistently over the years (2003=. Secondary prevention interventions targeting specific education and age groups are necessary. Results from this study lead to the conclusion that neurofeedback enhances neural activations relating to attention and promotes a faster motor response. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. This study aims at exploring whether family support is associated with pain and depression in older adults with arthritis. Using logistic regression and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other immediate family) on pain and depressive symptoms. Results: Positive and negative family support were significantly associated with depressive symptoms but not with pain. Discussion: Overall our results suggest that with higher positive family support, depressive symptoms and pain were more likely to decrease among individuals with arthritis. In addition, our results indicated that both pain and depressive symptoms were more likely to increase when higher levels of negative family support were present. Management of symptoms using self-management strategies such as smoking cessation, attendance at pulmonary rehab, and adherence to medication regimens is the focus of treatment. A secondary aim is to understand how marital status, living arrangement, and employment impact health-related quality of life as well as perceived social support. Participants (N=41) completed a multi-item survey which included self-report measures of social support and health-related quality of life. Results of multiple regression analysis showed that higher levels of perceived social support were associated with increased health-related quality of life (= -. This finding may be due to increased social functioning and less disease-related psychological disturbance (= -. Participants reporting current employment or non-health related retirement endorsed higher levels of social support (t(31) = 2. Marital status and living alone were not associated with perceived social support or healthrelated quality of life. There are now many disease-specific groups on public social networking sites such as Facebook; unfortunately, there is often concern regarding the clinical accuracy of information and safety of advice provided through these public sites. A moderated Facebook site presents an opportunity to ensure quality information and support is provided to patients through a site they already use and frequently visit. In this study, we were interested in how moderation strategies of online health groups influence the content of discussions and interaction. We identified two popular Facebook groups, with different moderation policies, dedicated to providing support for patients with Sickle-cell disease. In contrast, Sickle Cell Unite is a closed group with very little moderation on messages posted to the group. We retrieved from each Facebook page posted messages, number of comments and likes to each post, from February 2014 to February 2015 (over 15000 posts). Two independent coders manually coded, using 14 thematic categories, a subset of 128 randomly selected messages (68 Unite, 60 Warriors). The top categories accounting for 78% of codes were: self-expression (20%), advertisement (12%), God/prayer (11%), seeking information (11%), encouragement (8%), seeking shared experience (8%), and sharing information (8%). Comparison of messages between the two Facebook groups showed there are 75% more advertisements on Unite while there are 136% more "self-expression" messages on Warriors. This study provides insight on the impact of moderation strategies on user dynamics of health-related online groups. The level of activity and types of interactions differed significantly on a public social networking site with the presence of a medically trained moderator. Preparedness was measured at all 3 time points (T1-T3) using a one item Likert scale (1 not at all prepared to 5 very prepared) that asked, "Overall, how prepared did you feel for your most recent visit with your health care provider Methods A prospective cohort study was performed at two hospitals in New York City and Chicago.
Still quad spasms after acl surgery generic baclofen 25mg on-line, the association between older age and more teen biomedical talk is consistent with a transition to adulthood muscle spasms zinc buy generic baclofen 25 mg on line. Future research should examine how communication patterns and age relate to teen adherence and health outcomes spasms to the right of belly button buy discount baclofen 10mg on line. Over three days muscle relaxant euphoria order baclofen 10 mg with amex, nine local middle schoolers (aged 10-14) received the lessons muscle relaxant pregnancy safe baclofen 25mg without prescription, then provided feedback on the age/cultural appropriateness of the content through surveys and facilitated discussion muscle relaxant 563 pliva generic 10mg baclofen visa. Specifically muscle relaxant use order baclofen 25 mg with mastercard, participants showed an increase in civic orientation muscle relaxant use in elderly buy discount baclofen 10 mg line, a key public health literacy concept. These process and the resulting changes will improve the planned effectiveness testing among a larger group of Appalachian youth. Methods: We randomly assignedonline panelists with depression (N=1,071) to view a fictitious prescription drug website that had: (1) no link to a disease information website (control), (2) a link with no disclosure, (3) a link with a short pop-up disclosure, or (4) a link with a long pop-up disclosure. If participants in the link conditions did not click the link before leaving the drug website, they were returned to the website and prompted to click it. After viewing one or both websites, all participants completed an online questionnaire assessing recall, perceptions, and intentions. Results: Few participants (12%) clicked the disease link without prompting; 67% did so when prompted. Compared with control participants,participants in link conditions were more likely to confuse disease information with drug benefits, pp=. Disclosures did not diminish these effects, and exposure to disease information did not affect other drug perceptions or intentions. Discussion: Consumers seem to confuse information on disease websites with information on branded prescription drug websites. Disclosures may not adequately help consumers to distinguish between the two types of information, which may influence treatment decisions. Past research on nutrition transition suggests that an obesogenic food environment (including food marketing) contributes to this problem. These responses help to illuminate consumer attitudes in a developing-world food market, one that is beginning to experience marketing practices already established in wealthier food markets. Results suggest that consumer attitudes and associated food decisionmaking factors vary across markets. Having frequent contact with a range of different people could buffer the negative effects of low health literacy on mortality risk. We investigated the relationships between social isolation, health literacy, and all-cause mortality, and the potential modifying effect of social isolation on the latter relationship. Social isolation was assessed by assigning one point for less than monthly contact with each of children, family members, and friends, and not participating in organisations. Health literacy was assessed as reading comprehension of a fictitious medicine label from the International Adult Literacy and Skills Survey. Low health literacy and high social isolation are independent risk factors for mortality. Frequent contact with a diverse group of people may buffer the negative effect of low health literacy on mortality risk. Nigeria in particular remains a focus for increasing contraceptive use, as it is one of the most populous countries in SubSaharan Africa. The objective of the current study was to investigate determinants of contraceptive use in Nigeria couples, with particular attention toward male attitudes toward contraception and power dynamics within couples. Data from the 2013 Nigeria Demographic and Health Survey were analyzed for this study. The primary outcome variable was whether a woman was using contraceptives or not, delineated as not using contraceptives, using traditional/folkloric method, or using modern method. Male partner perception that decisions regarding health should be made jointly or primarily by women was positively associated with use. Women were less likely to use contraceptives in couples in which male partners had greater earning power. Number of children born was a significant, positive indicator of contraceptive use. Finally, men who viewed contraceptives as an enabler for promiscuity had female partners less likely to use contraceptives. Initiatives to increase contraceptive use in Nigeria and other African countries should move beyond individual reproductive health education and work towards fostering positive attitudes towards contraception in men. Understanding the correlates of illness information avoidance can inform ways health campaigns can mitigate information avoidance. The goal of this research was to identify modifiable factors associated with diabetes risk information avoidance. We identified predictors of diabetes information avoidance with a single multivariable linear regression model that controlled for family history of diabetes and demographic characteristics. One-quarter of participants had risk information avoidance scores >3 out of 5 (M=2. Individuals who avoid disease risk information are less likely to engage in disease prevention. Understanding and addressing diverse aspects of risk information avoidance will improve health information campaigns. For example, individuals with low need for cognition rely more heavily on peripheral cues to evaluate messages, so messenger attractiveness or credibility may mitigate information avoidance. Health messaging campaigns that address maladaptive beliefs about illness such as the unpredictability of illness and cognitive causation might also help mitigate information avoidance. Studies on professionals at assisted reproduction clinics revealed that infertilite patients as unassertive, compliant and largely reliant on physicians in different aspects of treatment decisions, especially whether deciding to continue or terminate treatment altogether. However, without recruiting patients as informers, little is known about their actual experience and preference. The study attempted to understand the treatment decision making preferences in Chinese women undergoing fertility treatments. Information was collected on infertility diagnosis, treatment history, their preferred decision making role, and demographic characteristics. Similarly, most women prefer minimal role and rely heavily on physicians to decide whether to continue or terminate further treatments (84. Chinese infertile women appeared to be more compliant in making treatment decisions as compared to their Western counterparts. Results revealed majority of Chinese infertile women prefer to rely on healthcare physicians and adopt minimal role in treatment decisionmaking, which aligned with subjective impression held by healthcare professionals, highlighting a need to empower and facilitate Chinese women in fertility treatment decisions in order to improved clinical outcomes. Chan, assisstant professor /Phd, the university of HongKong, Hong Kong, nil; chancelia@hku. Physicians reported that patient anxiety influences their own treatment recommendations ("One of the biggest impacts is patient anxiety. Methods: Inner city women (N=210) scheduled for a diagnostic colposcopy completed a questionnaire assessing demographics and cognitive-affective variables including perceived risk for cervical cancer, self-efficacy in managing those risks, fatalism, affective distress, and attentional style. They were then randomized to one of three conditions (standard care, tailored print intervention, and tailored telephone intervention). Lower fatalism and higher self-efficacy predicted timely adherence compared to delayed and non-adherence respectively, after controlling for intervention condition. Conclusions: Higher selfefficacy and lower fatalistic beliefs were associated with greater adherence to initial colposcopy, while low monitoring attentional style was associated with greater adherence to 6month follow-up. Patient preferences for information may be affected by their demographic characteristics, communication preferences, and emotional state. A 5-point Likert scale was used for rating level of detail desired from low (1) "the big picture and the basics that the medical team thinks I must know" to high (5) "I want to know absolutely everything the medical team knows including all the specific medical details". Participants generally preferred a moderate to high level of medical detail (M = 3. To understand more about demographic and communication styles that might affect individual preferences for the desired detail in medical communication, we developed a regression model to predict preferred degree of detail, incorporating age, sex, degree of preference for communication using medical terms, and current treatment for anxiety or depression (Adjusted R2 =. To effectively support patients in gathering information it will be important to understand what drives gender and age differences and how to effectively tailor information to patient needs and preferences. We recruited a national cohort of recent and expectant parents who completed a self-administered online survey (N = 1,001). Using a mixed-level fractional factorial experiment, we studied parental preferences for timing of consent. In Block 1, attitude, perceived normative influence, and perceived behavioral control explained 80% of the variance in intention, F(3, 997) = 1320. In Block 2, we found no evidence that manipulated program features altered mean levels of intention, F(6, 991) = 0. In Block 3, we introduced interaction terms and found timing of consent, cost, and consent format moderated the relative importance of reasoned action constructs on intention, R2 =. Program design features may impact the psychological mechanisms underlying parental decision making for expanded voluntary screening, with important implications for strategic development of parent education, outreach, and informed consent procedures. Design and methods: We completed a crosssectional study of inpatient rounds on pediatrics and internal medicine services over a 12-week period. Results: A total of 32 teams (16 pediatrics, 16 medicine), 95 ward rounds (48 pediatrics, 47 medicine), and 268 unique patient encounters (141 pediatrics, 127 medicine) were observed. Interprofessional clinical care and interprofessional teaching both hold great promise. However, little is known about appropriate strategies to assist in achieving healthy pre-conception weight status. Willingness to recommend and potential positive effects were strongly, positively correlated (r>. Individuals seeking to enroll in health insurance may struggle to assess plan options and decide on the health insurance plan that best suits their needs. We also elicited feedback about information essential to include in health insurance decision support tools. Interviews were transcribed and coded and themes were identified using an inductive thematic analysis method. Stakeholders recommended using plain language tables defining complex terms, chunking information into small pieces, and using engaging graphics to communicate information about health insurance. Stakeholders thought that narratives of how others made decisions about insurance might be helpful to consumers, but recommended that they be tailored to the needs of specific consumers. Strategies that clarify health insurance terms, tailor information, acknowledge the fear associated with making the wrong choice and enable cost comparison could benefit consumers. Narratives developed should be simple and inclusive enough for diverse populations. Of particular interest are symptoms of anhedonia, given previous research demonstrating anhedonia is related to poor treatment compliance among patients with chronic health problems. The present study examined the relationship between anhedonia and diabetes self-care among 115 participants (Mage = 54. Notably, anhedonia did not predict enrollment in or completion of a 5-week diabetes management program. Anhedonia symptoms appear to impede adherence to diabetes self-management behaviors such as diet and exercise. However, it does not seem to impede enrollment in adjunctive treatment or serve as an additional barrier to completing treatment. A short screening measure can provide immediate information for treatment planning and identifying barriers for diabetes self-management. The required shared decision-making process between care providers and patients is largely unexplored. Intervention fidelity, feasibility, patient values, screening intent, acceptability and satisfaction were measured. Four primary care physicians and twenty patients were recruited from an urban primary care center affiliated with a School of Medicine and a large, community medical center in the southeast U. The majority of patients were female (n=14; 70%), African American (n=10; 50%) and had a high school education (n=15; 75%). After the decision-making discussion, the majority of patients (n=16; 80%) wanted to be screened. The findings are limited by the one-group design, small sample size and staged setting. Methods: Forty stakeholders (consumers, certified application counselors, policy experts, and health care providers) in the St. Louis area were recruited to participate in semi-structured qualitative interviews. Interviews were audio recorded, transcribed, coded by two members of the research team, and analyzed using an inductive thematic analysis approach. Many felt the narratives were realistic and served as helpful models of the decision-making process. However, some were concerned that narratives might take too much time and overwhelm consumers. Some also felt that written narratives could be less accessible for consumers with limited literacy. Tailoring narratives more closely to individuals or adding audio to the narratives could reduce the time and cognitive burden associated with reading each narrative story. Phase 2 of the study then focused on implementing the resulting four-session curriculum, An Active Approach to Diabetes Self-Management, in local community centers and examining its early acceptability, feasibility, and effectiveness in producing clinical and psychosocial outcomes of interest. In addition, results indicate that both participants and community liaisons were highly satisfied with the intervention. Little is known about the daily challenges facing emerging adults with type 1 diabetes. We examined the types of daily stressors experienced by high school seniors as they transitioned into emerging adulthood. Adolescents with type 1 diabetes completed a 2-week daily diary in their senior year of high school (late adolescents) and one year later (emerging adults) (N=219; 60% female; 77% nonHispanic White, 12% Hispanic). Shifts in daily stress have implications for diabetes outcomes, as evidenced by work stress associations with poor glycemic control in emerging adults. Findings illuminate the stressful context of daily diabetes management during emerging adulthood, and may guide programs to facilitate better adjustment across this important transition. Dysthymia, Adjustment Disorder with Depressed Mood and Depressive Disorder Not Otherwise Specified). Stress associated with the burden of diabetes (diabetes distress) has been associated with worse diabetes control. We examined the relationship between diabetes distress, social support, and glycemic control in a sample of low-income African Americans with T2D living in Alabama. Methods: A sample of 120 low-income African American adults with uncontrolled T2D (HbA1c 7. Linear regression analyses tested for bivariate associations and also tested whether perceived support mediated the relationship between diabetes distress and glycemic control. In the final mediation model, perceived support did not significantly mediate the relationship between diabetes distress and change in glycemic control. Conclusions: Although analyses found no mediation of social support on the relationship between diabetes distress and glycemic control in this small study, it was observed that social support from family/friends was associated with less diabetes distress. These relationships should be examined in a larger sample and in intervention trials designed to improve social support. Youth with T1D (n = 80, aged 12-16 yrs) participated in an 18-month, randomized trial of a family-based behavioral nutrition intervention. All questions were assigned to predefined categories (etiology, treatment/procedure/self-management, diagnosis, prognosis/ risk, diet/exercise, symptom/side effect, self-motivation, and other) and agreement between what patients asked and what physicians expected was analyzed. Patients asked questions of etiology and symptoms/side effect while physicians expected patients to ask prognosis/ risk, treatment/procedure/self-management and diet/exercise. We speculate that psychological factors (patients may not want to discuss uncomfortable prognosis or outcome) and time constraint during the visit (physicians may not have time explaining etiology) play important roles although the causes of mismatch will be investigated in the future. Methods: Mixed method design was used for an in-depth understanding of the benefits and barriers of program effectiveness. Trained health coaches led educational sessions and provided weekly quick and easy tips to attain the desired health-related behavior. A community-based participatory research was used to culturally tailor the curriculum. Program participants included adults with dysglycemia (pre-diabetes or had diabetes). The benefits and barriers survey gathered information related to health literacy, and benefits and barriers of program participation followed by a focus group. The majority of target audience did not perceive transportation and community location as barriers to participation. Additionally, program participation allowed the majority of participants to change their lifestyles (88. Physical activity (and sleep) was measured using a wrist-worn accelerometer over 6-days. The average activity count/minute during waking hours was used to create 2 groups (n=20 each) of the most and least active subjects. Data do not support the view that individuals are able to manage diabetes on their own. An increasing number of studies have therefore looked to the context in which individuals live and neighborhoods have been shown to be particularly important. The purpose of this study was to explore and categorize how neighborhood determinants affect behavioral, clinical, mental health, and quality of life outcomes among U. Using three databases, we identified 5,320 published articles between 1990 and 2015 focusing on neighborhood/ community-level factors and diabetes. Following duplicate removal, title and abstract screening, and full text review of 188 articles, we identified 37 articles for inclusion. Regarding measurement, self-report from study participants was the most common method of measuring neighborhood determinants, followed by census-derived measures. Almost all of the studies assessing the social environment and the majority of studies assessing the physical environment relied on self-report whereas census-derived measures were most commonly applied to assessment of the economic environment.
Most participants agreed that sunless tanning products were safe for use and inadequate substitutes for sunscreen spasms in lower left abdomen effective 10mg baclofen. Among females who had used sunless tanning (n=182) spasms under left rib purchase 10 mg baclofen with visa, attitudes regarding convenience and appearance of sunless tans were generally favorable spasms left side discount 25mg baclofen otc. Despite the survival benefit of medication adherence spasms from colonoscopy cheap baclofen 10mg online, non-adherence rates remain high among women with breast cancer taking endocrine therapies spasms under right rib cage order 25mg baclofen visa. In this study muscle relaxant glaucoma trusted baclofen 10mg, we examined barriers to and facilitators of endocrine therapy adherence among women with breast cancer (N = 1371) spasms translation purchase baclofen 25mg without prescription. Participants who were currently taking either tamoxifen or aromatase inhibitors were recruited from the Dr muscle relaxant gel india purchase baclofen 10mg. Two weeks after completion of the first survey, women were sent an invitation to complete a second online survey to assess current endocrine therapy adherence. Thirty-six percent of participants reported that there are factors that make taking endocrine therapy difficult and 31% of participants reported using strategies to increase motivation to continue taking endocrine medication. In response to close-ended questions regarding strategies used to increase motivation to adhere, 46. Reporting any barriers to medication adherence was significantly associated with non-adherence (r = 0. However, reporting the use of any strategies to increase motivation was not significantly associated with non-adherence. Self-reported endocrine therapy adherence (adapted Morisky Adherence Scale) was regressed on hypothesized predictors. Taken collectively, these results suggest that many women face factors that make taking endocrine therapy difficult and that those factors are associated with non-adherence. Participants were instructed to read the message and answer 6 yes/no questions (used in prior studies) about it. The messages were: "According to a report from the National Cancer Institute, the death rate from colon cancer for Blacks has dropped over the past 20 years, and continues to decrease. Transcribed interviews were evaluated using a thematic content analysis approach consisting of coding and interpretation of the data by team consensus. Three participants (19%) intended to share these results with family members for their reproductive benefit. Future studies should examine the implications of learning this information for patients and its effects on their families. This pattern suggests that successful online health communities need members to Identify with the group as whole, and Bonding is important to promote social uses of online communities, especially giving support to other members. Thus distress screening and referral is now a recommended component of patient care. As implementation increases, it is essential to monitor if concerns and resource needs vary among diverse racial-ethnic groups to ensure programs are adequately resourced to fit these specific needs. English speaking cancer survivors (n=905) from a nationwide cancer support organization participated in a distress screening, referral and follow up program. Participants rated the level of concern (0 to 4) about 15 items, including a 4 item depression subscale, and identified the type of help they want. Adjusting for age and income, we examined via regression analysis differences among racial-ethnic groups in level of distress; type of concerns (rated 2); and items selected to talk with the health care team. We limited the analysis to the largest racial-ethnic groups in the sample: nonHispanic white (n=629); black or African American (n=79); and Latino or Hispanic (n=85). The sample was 79% female, 40% employed, 57% partnered or married, and median age 57 y. Latinos had significantly higher levels of distress than whites and higher but not significantly different levels than blacks. Sleep problems were a greater concern among Latinos (59%) and blacks (55%) than among whites (39%). Yet, blacks were significantly less likely than Latinos and whites to request help for sleep problems (19%, 46%, 28%; respectively). A similar pattern was observed for financial worries and pain, with greater concern among Latinos and blacks but lower likelihood of requesting help among black patients. Latinos were significantly more concerned than whites and blacks about financial worries, feeling sad or depressed, feeling nervous or afraid, making a treatment decision, finding meaning, and feeling lonely or isolated. Future research should explore implementation among diverse groups of patients and investigate factors that impact distress. These findings contribute toward recognizing that certain populations might be more receptive to certain forms of help. The aim of the present study was to build upon previous work while broadening the sample to all cancer types, locally advanced, and metastatic cancer. The original sample consisted of 13 participants, who were randomized to the intervention or control group, which received no intervention. Of those enrolled, 2 females from each group (50% white; mean age=46) were retained and completed assessments. A final assessment using measures noted above were completed by subjects post- radiotherapy. Due to recruitment and implementation difficulties, future researchers should dedicate full-time staff to conduct this study, identify participants and locate them on treatment days, and use briefer assessments to decrease subject attrition. Finally, a team approach, including physicians and nurses, in the recruitment process may help increase interest in the study due to the close and meaningful relationship patients have with their physicians. The challenges experienced with this study, further support the importance of a multidisciplinary team approach to interventions in health care settings. Any chemotherapy delay beyond 7 days, early therapy cessation, or dose reduction in the prescribed time was obtained from chart review. Having any chemotherapy delays or reductions was not associated with beliefs in chemotherapy, interpersonal processes of care, distrust of health care, or number of baseline symptoms. Early tailored interventions should be considered in these subgroups to improve treatment outcome. Methods Black and White breast cancer survivors (N= 328; 56% Black) were recruited via hospitals and outreach. Bivariate relationships between spirituality and other factors were assessed; variables with p. Chaplains) is not often integrated within the outpatient setting which may be a missed opportunity to support survivors. Race was a robust predictor of spirituality; this suggests opportunities to provide support to Black women. Contrary to qualitative findings, spirituality was not associated with negative treatment attitudes. However, most of these studies focus on homogenous groups and few studies have included ethnic minorities such as Chinese, the fastest growing immigrant group in the U. In many European countries, cancer screening is organised centrally via national programmes, which send invitations directly to those who are eligible. We explored decisional preferences for cancer screening (alone vs with help from others), and associations with sociodemographic characteristics and anxiety about cancer. We assessed decisional preference for cancer screening (alone/with help from a doctor/ with help from someone close to me), age, gender, ethnicity, socioeconomic, marital, and smoking status, and anxiety about cancer. Results: 45% preferred to make decisions about cancer screening alone, 43% preferred help from a doctor, and 12% from someone close to them. There were no associations with age, ethnicity, socioeconomic or smoking status, or feeling very anxious about cancer. Conclusions: Men, those from lower socioeconomic backgrounds, and those who are slightly anxious about cancer are more likely to want help when making decisions about participation in cancer screening. A lack of readily available support and resources for these individuals may affect uptake of screening. The present study was performed to determine if a training regimen of neurofeedback can remediate the cognitive deficits as well as other documented psychological impairment following chemotherapy. Nine breast cancer subjects, with significant cognitive impairment as demonstrated by neurocognitive testing, and at least one year post chemotherapy, were given a neurofeedback training intervention. The intervention consisted of 18, 30 minute sessions of neurofeedback at two training sites, C3 and C4 simultaneously and occurring three times per week. Three key elements were assessed in this study regarding the cognitive functioning of the study subjects. These assessments were performed pre and immediately-post the neurofeedback intervention. The Brief Symptom Inventory was administered to all the study participants pre and immediately post the neurofeedback intervention. Results showed that 6 of the 9 subjects showed robust psychological improvement of symptomatology after the intervention. Methods: Participant recruitment was conducted via mailings sent to Howard University Cancer Center registry members and flyers posted throughout the Howard University community. Implementation of distress screening programs that meet accreditation requirements can be challenging, especially for clinics with limited resources. This presentation will describe the processes and outcomes associated with a distress screening program implemented at a Veterans Affairs Medical Center oncology clinic. Guided by elements of the Quality Implementation Framework, a multi-phase clinical demonstration project was undertaken. An implementation team was assembled to first conduct an assessment of clinic needs and system resources. This needs assessment guided the development of several specific aims for program implementation: 1) select a brief, psychometrically sound screening instrument with high utility. Results from outcomes assessment at 6- and 18-months were stable, with 84% of patients screened, typically during their first consultation with oncology. Multiple sources of distress were commonly reported on the Distress Thermometer, with the top three concerns identified as pain (67%), worry (66%), and fatigue (62%). Evaluation findings will be discussed in relation to program strengths and areas for improvement, including expanding program reach to reduce missed opportunities, increasing the frequency of screening beyond the initial consultation, and improving patient engagement in behavioral health referrals. Based on a formative evaluation and perceptual mapping (multidimensional scaling) and vector modeling to compare barriers and facilitators to participation in African American cancer patients who had and had not participated in two Philadelphia hospital and the application of best practices in intervention development, we created an mHealth tool to assist patients in an informed decision making process. Methods: Using the results from the formative interviews and surveys with African American patients who had and had not participated in a clinical trial, we designed an interactive mHealth tool to help patients more fully understand clinical trials, address common concerns, and support preparation for discussions with health care providers. The tool is designed to be used either with tablets, smartphones or computers and engage patients through animations, real world patient perspectives, and tools to develop tailored questions for the provider/patient encounter. The mHealth tool if tailored to African American patients, but addresses issues that are shared with other populations. User feedback has been obtained with patients who participated in the development of the mHealth tool, African American patients considering a clinical trial and health care providers and clinical trial educators at two cancer centers. Conclusions: Perceptual mapping and vector modeling methods provided insights into specific message strategies to encourage clinical trial participation including spending time discussing the clinical trial process, addressing negative perceptions of clinical trials and promoting their benefits have been integrated into an engaging, interactive mHealth tool and early user and stakeholder testing provides additional insights to refine the tool. Next steps include a controlled study to measure the impact of the tool on patient decision making. Respondents undergoing radiation therapy and newly diagnosed patients at a medical oncology practice were asked to complete a survey in English or Spanish. The sample was 80% white (non-Hispanic), 8% black (nonHispanic), 8% Hispanic/Latino. Patients who were Hispanic were more likely to request social work services and chaplain services compared to Non-Hispanics (p>. Hispanics were less likely to rate that it was "easy" to obtain or find the services that they needed through the cancer center compared to nonHispanics (p. Patients who were blackwere more likely to request nutrtional counseling, social work services and nurse navigation compared to those who were white (p <. Patients who were black and Hispanic were moer likely to report having transportation difficulties in getting to treatment compared to white patients (<. Cumulatively these data suggest the need to study the experiences of black and Hispanic/Latino cancer patients. These preliminary data suggest that the need and desire for instrumental support, spiritual support and psychological support is higher in these subgroups. Early assessment and referral for supportive care services could help to reduce the burden of cancer among racial and ethnic minorities. However, with respect to obesity-related parenting behavior, there is more theoretical support rather than empirical evidence. A national sample of n = 1657 parent-adolescent dyads reported their home address. From this information, home addresses were geocoded and a series of neighborhood buffers were constructed based on a 10-15 minute walk around the home. Percent of population living in an urban area was positively associated with adolescent-reported parental overt control over junk food/sugary drink intake (r = 0. Living in a neighborhood with a higher percentage of female-headed households was positively associated with adolescent-reported autonomy-supporting parenting practices for fruit/vegetable intake (r = 0. These neighborhood characteristics and other factors such as the percentage of owner-occupied housing units were also positively associated with adolescent beliefs about the legitimacy of parental authority over fruit/vegetable intake, but not junk food/sugary drink intake. A need exists for a shorter, valid, and reliable scale in order to reduce burden on adolescent research participants. Methods: Participants were 224 adolescents attending public high school in the Midwestern United States. Principal component analysis made use of oblique rotation and revealed a seven-factor solution with 30-items. Results: With this scale revision, each of the original seven subscales were maintained, but thirteen items were deleted. In addition, two items that were originally included in the social support subscale, but also loaded strongly on the stress management subscale, were moved to the stress management subscale. The revised subscales were 1) identity awareness (four items), 2) nutrition (seven items), 3) safety (six items), 4) physical participation (four items), 5) stress management (three items), 6) social support (three items), and 7) health awareness (three items). Results: Neither physical nor social functioning mediated nor moderated the relationship between missed schooldays pre- and post-intervention. Instead, higher parent-rated physical functioning directly predicted decreased number of missed schooldays, while lower parent-rated social and child-rated physical functioning predicted increased missed schooldays. We sought to categorize mothers in terms of their rear-facing car safety seats utilization and its relationship to other health behaviors. Methods: We conducted a cross-sectional, online survey of mothers of children under 3 years of age (n=141). Outcomes were knowledge of car safety seats, breastfeeding duration, and adherence to vaccination schedules. We utilized cluster analysis with Euclidean distance and Ward linkage to define four distinct groups based on perceived risk, worry, and duration of rear-facing car seat use. Two primary groups of interest had (Group 1) long duration of rear-facing use with low perceived risk and worry and (Group 2) short use with high perceived risk and worry. Conclusion: Propensity for risk aversion by the mother may be the crucial element in both an appropriate duration of rear-facing car safety seat use and refusal of recommended vaccination schedule. Methods: Providerdelivered skills were reproduced on the Android-based mobile app, specifically, valence (feelings) report [0 ("Bad") to 100 ("Good")], problem type. Qualitative interviews indicated overall high level of acceptability of the app but varying satisfaction with the form and function of the biosensorband. Summary: There was a high level of interaction with the app and qualitative data provided specific barriers and facilitators of acceptability. Study aims were to: (1) identify the proportion of provider, teen, and caregiver talk during clinic visits and (2) distinguish whether quantity and type of talk differs between older and younger teens. Age was dichotomized as younger (<15 years, N=40) and older (15+ years, N=53) teens. Providers made more biomedical statements, biomedical questions, and psychosocial questions than caregivers and teens, but did not differ on psychosocial statements. Turning to relationships with diabetes outcomes, the majority of studies found associations after controlling for a variety of individual-level characteristics, (usually a combination of race, age, sex, other health complications, income / education, and duration of diabetes). Clinical and behavioral outcomes, including diabetes self-care behaviors were the most common outcomes evaluated. More associations, however, were found between the neighborhood-level determinants and the behavioral, mental health, and quality of life outcomes compared to the clinical outcomes. Thus, neighborhoods appear to affect the health of individuals with diabetes especially in the area of mental health and behavioral outcomes, but neighborhood research in diabetes includes a notable lack of objective measures of the physical and social environments. However, there is a paucity of evidence on how to effectively integrate peer support programs with health care efforts. Methods: We developed a mobile health (mHealth) application to connect peer supporters to the health care team, creating synergy through the bidirectional exchange of information. Peer supporters were employed by a local church-based non-profit organization and were trained to provide support for diabetes self-management. We assessed glycemic control, diabetes distress, and health care utilization at baseline and 6 months. We examined group, time, and group by time differences simultaneously using mixed models repeated measures analyses. The overall pre-post change in clinical characteristics was examined using the paired t-test. Mean age was 55 years, mean HbA1c 10%; 71% were female, and 81% had a high school degree or more. The peer support group experienced a greater reduction in diabetes distress compared to the education only group (-0. Peer supporters tracked 72 participants using the mHealth web application: 125 diabetes self-management goals were set, mostly focused on physical activity (44%) and diet (37%). Over the course of the study, 314 unique messages regarding 53 participants were sent between peer supporters and the health care team. Conclusions: this study provides additional evidence for the positive impact of peer support in the setting of diabetes selfmanagement efforts. Findings also demonstrate the feasibility of integrating communitybased peer support with the efforts of the health care team, achieved through the use of an mHealth web-application. The present study examined the relationship of coping and social desirability to psychological distress by evaluating a structural model in which individualistic coping both directly and indirectly predicts distress (indicated by dysphoria, anxiety, negative affect, and perceived stress).
Interventions to reduce risky sexual practices and improve conversations about sex may want to include hopeful scenarios and examples to college-age students spasms right buttock order baclofen 25mg. However spasms upper left abdomen buy baclofen 10mg on line, few studies examine how the bed partner affects sleep infantile spasms 2 month old order baclofen 25 mg line, and most have focused on couples in which one partner has obstructive sleep apnea spasms in 6 month old baby baclofen 10mg amex. Our study used a dyadic (couples) approach to examine three specific questions: 1 muscle relaxant hiccups discount baclofen 25mg without prescription. Secondary analysis was conducted on a sample of 543 healthy middle-aged heterosexual couples in which both partners had data on sleep duration muscle relaxant stronger than flexeril 25 mg baclofen sale, anxiety muscle relaxant safe in pregnancy baclofen 25mg with amex, and depressive symptoms obtained during annual physical exams in two sequential years spasms diaphragm generic baclofen 10mg. The findings suggest that sleep and mental health might better be treated as a couple-level phenomenon than an individual one. Evidence is also emerging that healthful sleep may be a protective factor for health risks, like obesity. So, behavioral medicine approaches to promoting healthful sleep in populations with higher incidence of disrupted or poor sleep is critical. This study used qualitative focus groups to understand sleep behavior patterns and beliefs about sleep among Blacks. Methods: Three focus groups were conducted with 17 Black participants (12 female and 5 male). The interview protocol was designed to facilitate discussion on the topics of sleep, consequences what happens when you do not get enough sleep, and good sleep strategies. Focus groups were conducted by the first author, and analyzed by the second author. Response were first read through, then analyzed using the constant comparative method. In this method, the analyst assigned codes in iterative fashion, first freely, then in several analytical approaches where each additional round of codes was assigned, then synthesized and collated into themes upon completion. Among the consequences participants listed that result from poor sleep, the most commonly observed were cognitive impairments. When asked for feedback on good sleep strategies this population employs in their life, the most common techniques were relaxation and alternative therapies like yoga or meditation. In addition, a large number of participants reported relying on religious activities, including reading the bible and listening to gospel music to help them fall asleep. Conclusion: these findings suggest myriad factors contribute to sleep disturbance among blacks. Results also suggested salient beliefs and strategies this population holds and practices when it comes to sleep. Researchers could use this information to develop culturally tailored behavioral interventions that promote sleep health among minority populations. The present study aimed to unravel this relationship and to identify predictors for insomnia and depression symptom reduction. Data collected at baseline (T0) and three-month follow-up (T2) was used (n of 1=56; n of 2=70). Symptoms improvement and affliction decrease was calculated by reduction rate at T2 (T0-T2/ T0). Linear regression was firstly conducted to identify predictors for insomnia and depression reduction rate respectively. Then, mediation analysis was used to further explore relations between insomnia and depression improvement. Conclusion this study indicated a bi-directional pathway existing between improvement of insomnia symptom, especially daytime functioning and depression remission. In addition to behavior therapy, spiritual components should also be included in a comprehensive treatment. We hypothesized that poor sleep is associated with disinhibited eating behaviors that may contribute to excess adiposity. We therefore evaluated whether sleep behaviors were associated with disinhibited eating in a sample of overweight girls. In conclusion, greater sleep problems were associated with more self-reported disinhibited eating behaviors among overweight girls but not with observed intake. Prospective data are needed to determine whether these behaviors uniquely contribute to excess gains in adiposity. Graduate students gave the screening results to primary care providers, prior to their seeing the patient. Results: Participants (n=95), who were predominantly women (77%) and either Black, Non-Hispanic (46. Nearly 40% of participants wanted to get help with their sleep now; 12% were currently getting help for sleep problems. Self-reported comorbidities included high blood pressure (45%), cardiovascular disease (12%) and diabetes (24%). Providers (n=37) reported that the screening tools were at least somewhat useful (73%) and brought sleep to their attention (51%). Fewer reported that they informed patient counseling (16%), testing (5%), and referrals (5%). Conclusions: There appears to be a high unmet need for screening and treatment of sleep problems in primary care. The current study examined the potential role emotional distress may play to explain racial/ethnic difference in inadequate sleep duration. Chi-Square analyses revealed that more blacks reported short and long sleep, compared to more whites reporting average sleep (7-8 hrs. Conclusion: In general, being black and emotionally distressed are significant predictors of short sleep and long sleep durations. Specifically, more blacks reported emotional distress compared to whites; and blacks compared to whites are more likely to report short sleep and long sleep durations at lower emotional distress levels. Emotional distress may play an important role in sleep disparities between blacks and whites. Previous research suggests that emotion dysregulation is likely to be associated with poor sleep and that negative affectivity and perceived stress may confound this relationship (Mauss et al. This study explored the contribution of different aspects of emotion dysregulation to poor sleep. Results: Poor sleep quality was reported by 21% of the sample; moderate levels of emotion dysregulation (M = 2. Emotion dysregulation, negative affectivity, and perceived stress were significantly and positively associated with poorer sleep quality. Controlling for negative affectivity and perceived stress, hierarchical multiple regression analyses indicated that emotion dysregulation had a positive direct effect on poor sleep quality (b =. Secondary analyses suggest the specific emotion regulation strategies of nonacceptance of emotional response (b =. Conclusions: Emotion dysregulation contributes to poorer sleep quality beyond the influence of negative affectivity and perceived stress. Difficulties with specific emotion regulation strategies, are associated with poor sleep quality. Efforts to promote healthy emotion management, motivation, and impulse-related decisions. Weight loss is associated with improvements in sleep disturbance, and is a frequently recommended treatment particularly for those who are obese. Yet, little research exists on the amount of weight loss needed or the preferred weight loss approach to induce sleep improvements. The Heads Up Demonstration Project is a non-randomized prospective cohort study funded by a state insurance company examining the effectiveness of both surgical and nonsurgical approaches for weight loss among adults with severe obesity. Sleep quality was significantly improved at 6 months for all women and White males (all ps <. Overall, these results suggest that race, gender, and weight loss approach may influence the impact of weight loss on sleep outcomes. Additional analyses examining the influence of demographic factors and one year outcomes will also be presented. Evidence indicates that self-efficacy may offer insights as to why blacks, compared to whites, are less likely to seek treatment. However, studies attempting to increase self-efficacy have not been successful and raise the question as to whether other psychological factors might be impacting self-efficacy. The current study investigated associations between anxiety and self-efficacy, particularly risk perception selfefficacy. Method: Data came from a sample of 362 black participants from the Metabolic Syndrome Outcome Study (MetSo). Controlling for hypertension, diabetes, heart progress, arthritis, cancer, respiratory problems, and dyslipidemia, patients with moderate or higher anxiety were 2. Responses to treatment efficacy and outcome expectancy were not significantly different between high and low anxiety. Interestingly, the current study revealed participants with higher anxiety perceived themselves to be at greater risk for sleep apnea. Goodness-of-fit statistics and bootstrapped standard errors were determined using maximum likelihood estimation. Further, the model predicting sleep based on sleep setting factors fit the data well, 2(132)=293. Participants with more noise in their sleep setting reported reduced sleep quality (=0. Similarly, unpleasant room temperature and poor sleep hygiene related to greater sleep disturbance (=0. As measures and methodologies develop and society secularizes, it is important to confirm these relationships in new samples and with current measures. A sample of 917 college students (age 18 to 60) participated in an online survey during spring 2013 or fall 2014. These findings confirm that religiosity predicts a lower incidence of hypertension, over and above the contributions of gender, age, and stress. Medical interventions predominate treatment of depression but multiple impairments urge to treat depression holistically. Being a core component of holistic health, spirituality remains under researched and cared for in depressed individuals. Spirituality emerges in clay-work of art therapy as its constant construction and reconstruction processes resemble rich life experiences. Clay-work transcends spirituality in the dimensions of making meaning, reconstructing life view, and enhancing resilience to adversity in life. This study aims to evaluate the effects of clay-work on spirituality for depressed patients which has rarely been reported in the literature. Despite these trends, little is understood about the development of humility and critical factors that enhance this virtue. The present study sought to examine the relationships among humility, commitment to spiritual formation, and approach to worship leading in a study of exemplar worship leaders (N=26) from diverse backgrounds. Humility that was observed as a process theme in coded transcripts (observed humility) was most closely associated with a God-centered approach and commitment to spiritual formation, while participant discussed humility (expressed humility) was associated with incongruence. Differences in observed and expressed humility shed light on how humility may be authentically cultivated through continual practice that focuses on God and others, rather than intentional conscious effort to cultivate it oneself. Assessment of humility may be strengthened by methodologies that use process themes for observed humility. Future study of observed humility may increase understanding of how authentic humility enhances spiritual growth and health-related outcomes. Whether or not they are affiliated with any particular religious tradition, people tend to endorse sanctification in various aspects of their life. Seventy-three samples from eight peer-reviewed studies evaluated the relationship between sanctification of the body and various correlates of health and well-being. Of the eight studies included in this analysis, two examined a national sample of church members, two studied parents of children with cystic fibrosis, two used an elderly community sample, and the remaining two drew from college student populations. Using a random effects model, we found an overall relationship between sanctification and all correlates of zr =. This indicates that sanctifying the body is modestly linked to health-protective behaviors. Given that the majority of health outcomes were concrete behaviors, even this small effect size is noteworthy. Global meaning refers to global beliefs and goals guiding people in living their lives. Interviews were analyzed using qualitative research methods: structural and provisional coding. Elements of the rehabilitation process included motivation, regulation of emotion, making decisions, and handling stress. Elements of the outcome of rehabilitation included physical functioning, emotional functioning, social functioning, and subjective sense of meaning. The influence of global meaning on the process and outcome of rehabilitation was positive as well as negative, but mainly positive. Global meaning was found to affect elements of the process and outcome of rehabilitation. The influence of global meaning on the rehabilitation process and outcome is mostly positive. The extant research on style of dress in relation to body satisfaction focuses on women whose style of dress is self-determined. However, associations may be different in women who dress in accordance with religious mandates. A study of Muslim women did find that women who adhered to the strictest level of veiling had the highest body satisfaction. To our knowledge, no published study has examined body satisfaction and dress in Orthodox Jewish women, who are required to dress modestly by wearing loose-fitting clothes that cover the arms, legs and chest. Six items assess modesty level in relation to the covering of body parts (chest, arms, thighs, lower legs) and clothing style (slits, tightness of skirts/pants). Religiosity was assessed in three ways: subjective religiosity, religious behaviors and religious faith. Most women (85%) reported that Jewish law was very influential in deciding how to dress, and between group comparisons revealed no differences in satisfaction between those reporting high versus low influence. Bivariate correlations revealed no associations between body satisfaction and clothing modesty. However, body dissatisfaction was negatively associated with subjective religiosity (r=. Our results indicate that modest dress itself may not influence body satisfaction, but that religiosity/religious behaviors may play a role in body satisfaction. These associations should be considered in interventions targeting body satisfaction and eating behaviors in Orthodox Jewish women. It is critical to identify protective factors that may buffer against the effects of stress on excess alcohol use. Mindfulness (defined as non-judgmental attention to the present moment) is one promising protective factor. We hypothesized that dispositional mindfulness would moderate the relationship between stress and alcohol use in collegiate athletes, such that higher stress would be related to more frequent drinking among athletes with low, but not high levels of mindfulness. Participants completed measures including the Five Facet Mindfulness Questionnaire (Baer et al. Correlations were conducted to examine relationships among mindfulness, number of drinks per week, and stress. Regression analyses were then performed to predict number of drinks per week from mindfulness, stress, and their interaction. There was a significant interaction between mindfulness and stress in predicting number of drinks per week, b = -. For participants with low levels of mindfulness, there was a strong, positive relationship between higher stress and greater number of drinks per week, b = 2. For those with high levels of mindfulness, there was no relationship between stress and drinking, p =. These results suggest that mindfulness may serve as a protective factor against problematic drinking when faced with stress. This survey study investigated the prevalence of permissive parental attitudes towards alcohol and the impact these attitudes had on adolescent risky behaviors. Those respondents with parents who would not mind if they consumed alcohol were more likely to have been suspended (p=0. Further, those whose parents had more permissive attitudes towards drinking were more likely to say it is "very easy" to drink at home (p < 0. Programming for alcohol consumption and its risks should include a parental component to address such attitudes. Dissemination and implementation (D&I) research, however, has rarely been conducted in this area. This presentation reports adoption (# of churches and characteristics) and reach (# of members). Results: Of the 173 identified churches, 133 are operating; 68% are predominantly African American; 30% predominantly Caucasian. The most common denominations are Baptist (40%) and non-denominational/independent (21%). Adoption was unrelated to membership size, but was positively related to participation in a previous health-related initiative (80% vs. Churches with predominantly African American, compared to Caucasian, congregations were more likely to sign up for the study (70% vs. Conclusions: 50% of churches and 18% of residents in a medically underserved, rural county are expected to be directly exposed to the intervention. Interest was greater in predominantly African American churches, suggesting greater integration of health into the broader church mission. Studies examining retention rates following implementation of P4P strategies have yielded mixed results (Brucker & Stewart, 2011; Vandrey et al. While retention remains an essential outcomes, little research has examined the relationship between P4P and distal outcomes.
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