Publications by authors named "Edwin Fisher"

Background: Black and Hispanic adults with diabetes are more likely to experience diabetes complications and die from diabetes compared to non-Hispanic whites. This disparity may be due to medication adherence being negatively affected by social determinants of health (SDOH) and negative beliefs about diabetes and diabetes medicines. Pharmacist delivered medication therapy management (MTM) improves clinical outcomes.

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What sense does it make to say that a new program implemented in a community with roots as old as evolution caused an observed health benefit? Evaluation of community approaches has often sought to isolate the causal roles of interventions. Central to this is the assumption that there are causes to be proven and isolated. Benedict Spinoza (1632-1677) dismissed the concept of cause, arguing that all things, "substances," are not caused but simply are.

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Article Synopsis
  • Innovative peer support approaches are crucial for addressing the complex needs of individuals with serious mental illnesses, but their effectiveness is mixed due to diverse study components that previous reviews didn't adequately analyze.
  • * This review highlights significant variation in both the intervention components and outcomes across 26 studies, identifying key areas such as "being there," self-management assistance, and peer support values.
  • * The findings suggest that peer support services should be researched more specifically rather than treated as a single, unified intervention, to better understand what aspects are most effective.
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Aims: To evaluate sustainability of peer support (PS) benefits in diabetes management.

Methods: Supporting a Peer Leader program through Community Health Centers (CHCs) included trainings and consultations from baseline to 12 months. Evaluation at baseline, 12-month, and 18-month follow-up included primary outcome, HbA, and other outcomes of SBP, DBP, LDLc, PHQ-8, diabetes distress, and EQ-5D.

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Background: Loneliness is a frequent experience among family members engaging in caregiving responsibilities and may vary across racial and ethnic groups. This study aimed to examine (a) the difference in loneliness between non-Hispanic Black and non-Hispanic White caregivers, (b) the associations between loneliness and perceptions of choice and purpose in caregiving, and (c) whether those associations with loneliness differ by caregivers' race.

Method: Descriptive statistics and ordinal logistic regression were conducted in a population-based sample of 1000 caregivers (Black caregivers, n = 199; White caregivers, n = 801) from the 2020 Caregiving in the U.

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Background: Mobile health (mHealth) is a promising intervention mode for HIV prevention, but little is known about its feasibility and effects in promoting pre-exposure prophylaxis (PrEP) uptake among Chinese gay, bisexual and other men who have sex with men (GBMSM).

Methods: We evaluated an instant messaging application using a WeChat-based mini-app to promote PrEP uptake among GBMSM via a mixed-methods design that includes a 12-week, two-arm randomized controlled pilot trial and in-depth progress interviews in Guangzhou, China. Primary outcomes include the number of PrEP initiations, individual-level psychosocial variables related to PrEP initiation, and usability of the PrEP mini-app.

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Diabetes is one of the fastest-growing non-communicable diseases, becoming an important public health concern worldwide as well as in China. Currently, China has the largest population living with diabetes. Artificial intelligence (AI) is a fast-growing field and its applications to diabetes could enable the delivery of better management services for people with diabetes.

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Objective: The purpose of this article is to characterize the current evidence base related to peer support interventions for adolescents and young adults (AYAs) with inflammatory bowel disease (IBD) and to describe a peer support program to enhance self-management for AYAs with IBD through a case study. There is strong theory and compelling evidence suggesting that AYAs with IBD could benefit from and are interested in receiving peer support to enhance self-management; however, literature on peer support interventions for AYAs with IBD is lacking.

Methods: This study (a) presents a topical review describing qualitative factors AYAs with IBD would seek in a peer support program as well as existing peer support programs for this population, (b) presents an innovative one-to-one peer support program targeting self-management through a case study, and (c) discusses clinical implications and directions for future research.

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Background: The increasing prevalence of diabetes is placing important demands on the Chinese health care system. Providing self-management programs to the fast-growing number of people with diabetes presents an urgent need in rural primary care settings in China. Peer support has demonstrated effectiveness in improving self-management for individuals with diabetes in urban communities in China.

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To assess the association between insulin regimens and health-related quality of life (HRQoL) after the introduction of basal insulin (BI) among people with type 2 diabetes in real-world clinical settings. 16,339 registered people with diabetes who had inadequate glycaemic control by oral agents initiated BI (either single BI or Basal-bolus) and completed a 6-month follow-up from 209 hospitals were included in the analyses. At the end of the follow-up, the switches of insulin regimens, change of HRQoL (EQ-5D-3L) and their associations were assessed.

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Although there is broad evidence for the value of peer support (PS) in preventing and managing diabetes and other chronic diseases, identifying approaches to stage, scale, and adapt PS interventions is a challenge. Community organization may provide a process for such adaptation of standardized PS and diabetes management to individual communities. This community organization approach was used to develop PS in 12 communities in Shanghai, China.

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Background: Peer support programs are promising approaches to diabetes prevention. However, there is still limited evidence on the health benefits of peer support programs for lay peer leaders.

Purpose: To examine whether a peer support program designed for diabetes prevention resulted in greater improvements in health behaviors and outcomes for peer leaders as compared to other participants.

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Background: Oral pre-exposure prophylaxis (PrEP) as a safe and effective antiretroviral medicine-based prevention against HIV has not been widely adopted by gay, bisexual, and other men who have sex with men (MSM) in China. A deeper understanding of barriers and facilitators to PrEP uptake is needed to inform the development of effective interventions.

Method: During July-August 2020, we conducted one-on-one semi-structured interviews with 31 Chinese MSM with varied PrEP use experiences (PrEP-naïve, former, and current PrEP users).

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Introduction: India currently has more than 74.2 million people with Type 2 Diabetes Mellitus (T2DM). This is predicted to increase to 124.

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Aims: Diabetes distress is positively associated with HbA and may mediate the relationship between depressive symptoms and HbA . This study examined these relationships in a geographically, socioeconomically, and ethnically diverse sample of adults with type 2 diabetes.

Methods: Using data from five US sites evaluating peer support for diabetes management (n = 917), Structural Equation Modeling (SEM) examined whether diabetes distress (four items from Diabetes Distress Scale) mediated the relationship between depressive symptoms (PHQ-8) and HbA .

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This study examined how African American church members communicated and cooperated as dyads to attain health goals. Participants completed nine weeks of group classes then worked as dyads for nine weeks. Communication logs and interviews were used to assess: (1) dyad communication and (2) dyad cooperation.

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Background: College students are at heightened risk for negative psychological outcomes due to COVID-19. We examined the prevalence of psychological distress and its association with social isolation among public university students in the southern United States.

Methods: A cross-sectional survey was emailed to all University of North Carolina-Chapel Hill students in June 2020 and was open for two weeks.

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Through his broad perspectives and curiosity, Howard Rachlin took behaviorism, added critical perspectives and behavioral economics, and contributed substantially to developing behaviorism as an approach to addressing complex human actions and engagements. This essay describes the influence of Rachlin's work in three areas that reflect this broader growth of the field: 1) teleological behaviorism as a response to essentialist thinking about behavior, typified by Ryle's category mistake and including concepts in psychopathology; 2) self-control as choices among rewards differing by amount and delay and the application of this model to clinical and preventive interventions; and 3) behavioral economic modeling of social support as a commodity substitutable for other commodities of interest such as nicotine. These and the body of Rachlin's work suggest a view not only of interdependencies among behaviors, patterns of behavior, and their consequences, but more broadly, of interdependencies among different settings and their effects on behavior, leading to a behaviorism of systems and contexts.

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Background: Peer support provides varied health benefits, but how it achieves these benefits is not well understood.

Purpose: Examine a) predictors of participation in peer support interventions for diabetes management, and b) relationship between participation and glycemic control.

Methods: Seven peer support interventions funded through Peers for Progress provided pre/post data on 1,746 participants' glycemic control (hemoglobin A1c), contacts with peer supporters as an indicator of participation, health literacy, availability/satisfaction with support for diabetes management from family and clinical team, quality of life (EQ-Index), diabetes distress, depression (PHQ-8), BMI, gender, age, education, and years with diabetes.

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Introduction: The large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up, suggesting an urgent need for innovative and accessible interventions. This study aims to develop and pilot test a theory-informed, tailored mobile phone intervention that was codeveloped by young gay men, HIV clinicians and public health researchers to increase engagement in PrEP education and initiation among Chinese gay, bisexual and other men who have sex with men (GBMSM), who bear a disproportionate burden of HIV infections and remain underserved in the healthcare system.

Methods And Analysis: This two-phase study includes a formative assessment using in-depth interviews (N=30) and a 12-week experimental pilot study using a two-arm randomised controlled trial design (N=70).

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Background: Mobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD).

Objective: The aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants.

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Objective: Optimizing resources within environments where people live, work, and pray can aid nurses in improving public health. Religion and social capital significantly influence the health of individuals and communities, particularly among racial and ethnic minorities in the United States. A concept analysis of religious social capital was conducted to clarify how this resource is used in the context of health.

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Globally, diabetes has brought an enormous burden to public health resources, and the situation of disease burden caused by diabetes in China is especially severe. China is currently facing the dual threat of aging and diabetes, and wearable activity trackers could promote elderly diabetic patients' physical activity levels and help them to manage blood glucose control. Therefore, examining the influencing factors of elderly patients' adoption intention is critical as wearing adoption determines actual wearing behaviors.

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There have been very limited prospective studies examining social-cognitive models within stages of behavior change in the exercise domain. We examined the utility of the theory of planned behavior (TPB), incorporating self-identity and descriptive norm constructs, to predict exercise behavior across the stages of change, in individuals with type 2 diabetes. Data were obtained from a longitudinal study.

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Article Synopsis
  • - The study aimed to blend peer support with a diabetes management app (DMA) to enhance self-management for adults with type 2 diabetes (T2DM), testing the model's scalability.
  • - 43 participants received phone support from trained lay health coaches and free access to the DMA, which helped them track blood glucose, carbohydrate intake, and medications over six months.
  • - Results showed high engagement, with 88.4% enrolling in the DMA, leading to notable health improvements; participants' average hemoglobin A1c levels dropped significantly from 9.93% to 8.86%, despite varied usage patterns of the app and coaching assistance.
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