Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT) Burke, V., Beilin, L. J., Cutt, H. E., Mansour, J., Mori, T. A. Tue, 08 Jul 2008 00:00:00 -0000
We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits. Outcomes examined were saturated fat intake (% energy) and physical activity (hours per week). In total, 90/118 individuals randomized to usual care and 102/123 to the program-completed follow-up. Sex was a moderator of response post-intervention for diet and physical activity, with a greater response among women with usual care and among men with the program. Change in self-efficacy was a mediator of dietary change post-intervention [effect size (ES) –0.055, 95% confidence interval (CI) –0.125, –0.005] and at follow-up (ES 0.054, 95% CI –0.127, –0.005), and in physical activity post-intervention (ES 0.059, 95% CI 0.003, 0.147). These findings highlight different responses of men and women to the program, and the importance of self-efficacy as a mediator. Mediators for physical activity in the longer term should be investigated in other models, with appropriate cognitive measurements, in future trials.
Storage of household firearms: an examination of the attitudes and beliefs of married women with children Johnson, R. M., Runyan, C. W., Coyne-Beasley, T., Lewis, M. A., Bowling, J. M. Tue, 08 Jul 2008 00:00:00 -0000
Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n = 185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon–Mann–Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.
Will patients agree to have their literacy skills assessed in clinical practice? Ryan, J. G., Leguen, F., Weiss, B. D., Albury, S., Jennings, T., Velez, F., Salibi, N. Tue, 08 Jul 2008 00:00:00 -0000
If health providers are aware of their patients' literacy skills, they can more appropriately tailor their communication with patients. Few providers, however, assess patient's literacy skills for fear of offending patients, but no research has ever determined if patients object to such assessments. Our objectives were to determine the percentage of patients seen for routine health care that would agree to undergo literacy assessment and if satisfaction of patients differs in practices that perform literacy assessments versus practices that do not. We randomized 20 private and public medical practices to an intervention group that implemented literacy assessments with the Newest Vital Sign and a control group that did not. For intervention practices, we noted the percentage of patients agreeing to undergo the assessment. For both intervention and control practices, we assessed patient satisfaction. Of 289 patients asked to undergo literacy assessment in the intervention practices, 284 (98.3%) agreed to do so, including 125 (46.1%) with low or possibly low literacy skills. There was no difference in satisfaction between the intervention group and the control group. We conclude that patients are willing to undergo literacy assessments during routine office visits and performing such assessments does not decrease patient satisfaction.
Public Health News Headlines from Johns Hopkins
Malaria Researchers Identify New Mosquito Virus tmparson@jhsph.edu (Office of Communications) Fri, 22 Aug 2008 12:00:00 -0400 Researchers at the Johns Hopkins Bloomberg School of Public Health?s Malaria Research Institute have identified a previously unknown virus that is infectious to Anopheles gambiae?the mosquito primarily responsible for transmitting malaria. According to the researchers, the discovered virus could one day be used to pass on new genetic information to An. gambiae mosquitoes as part of a strategy to control malaria, which kills over one million people worldwide each year. De Beers African Health Scholars Named nwoodwri@jhsph.edu (Office of Communications) Thu, 24 Jul 2008 15:00:00 -0400 De Beers African Health Scholars Named
Older Patients More Satisfied with Care When Accompanied to Medical Visits paffairs@jhsph.edu (Office of Communications) Mon, 14 Jul 2008 16:30:00 -0400 A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that 38 percent of Medicare beneficiaries are accompanied to routine medical visits. These accompanied beneficiaries tended to be older, sicker and less educated but more satisfied with their health care provider compared to unaccompanied patients. The study is published in the July 14 edition of Archives of Internal Medicine.
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