Helping persons with multiple chronic conditions overcome barriers to self-management.

The prevalence of multiple chronic conditions is growing dramatically, which complicates day-to-day self-management for patients. This article describes the features of multiple chronic conditions, an updated chronic care model, barriers to self-management, and strategies NPs can use to reduce or eliminate barriers to self-management in adults with multiple chronic conditions.

U.S. Preventive Services Task Force Methods to Communicate and Disseminate Clinical Preventive Services Recommendations.

The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations.

Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement.

Description: Update of the US Preventive Services Task Force (USPSTF) recommendation on screening for impaired visual acuity in older adults.

Methods: The USPSTF reviewed the evidence on screening for visual acuity impairment associated with uncorrected refractive error, cataracts, and age-related macular degeneration among adults 65 years or older in the primary care setting; the benefits and harms of screening; the accuracy of screening; and the benefits and harms of treatment of early vision impairment due to uncorrected refractive error, cataracts, and age-related macular degeneration.

Population: This recommendation applies to asymptomatic adults 65 years or older who do not present to their primary care clinician with vision problems.

Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement.

Description: New US Preventive Services Task Force (USPSTF) recommendation on screening for autism spectrum disorder (ASD) in young children.

Methods: The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of brief, formal screening instruments for ASD administered during routine primary care visits and the benefits and potential harms of early behavioral treatment for young children identified with ASD through screening.

Population: This recommendation applies to children aged 18 to 30 months who have not been diagnosed with ASD or developmental delay and for whom no concerns of ASD have been raised by parents, other caregivers, or health care professionals.

Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement.

Description: Update of the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for depression in adults.

Methods: The USPSTF reviewed the evidence on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations.

Population: This recommendation applies to adults 18 years and older.

A demonstration of peer support for Ugandan adults with type 2 diabetes.

Background: By 2030, 80% of people with diabetes will be living in developing countries.

Purpose: The purpose of this pre-post quasi-experimental study was to test the feasibility of a peer intervention to improve the following: (1) diabetes self-care behaviors, (2) glycemic control, (3) social support and emotional well-being, (4) linkages to health care providers, and (5) to assess the sustainability of the intervention 18 months later.

Method: Participants were adults with type 2 diabetes who resided in rural Uganda.

Evaluation of a Web-based malaria risk reduction game for study abroad students.

Objective: Compare feedback strategies in 3 versions of an educational game.

Participants: Study abroad students (N = 482) participated by playing the game and completing pregame/postgame surveys January-March 2010.

Methods: This study employed an experimental design.

Helping patients with chronic conditions overcome barriers to self-care.

This article provides an overview of barriers to self-care, patients' perceptions and understanding of their chronic illness, interviewing techniques, and approaches nurse practitioners can use to reduce or eliminate barriers to self-care in adults with chronic conditions.

Peer support for self-management of diabetes improved outcomes in international settings.

Self-management of diabetes is essential to reducing the risks of associated disabilities. But effective self-management is often short-lived. Peers can provide the kind of ongoing support that is needed for sustained self-management of diabetes.

Development of a malaria knowledge test for student travelers.

This paper describes a malaria knowledge test (MKT) developed to evaluate a web-based game for students who increasingly travel to malaria-risk regions of the world. The 18-item MKT was structured according to the dimensions of the self-regulation model (SRM) to measure the accuracy of students' beliefs about malaria. An experimental design was used to compare three game versions.

Insights on conducting research in low-resource settings: examples from Vietnam and Uganda.

This commentary describes key observations and strategies, based on the author's experiences in Vietnam and Uganda, for tailoring evidence-based behavioral medicine research in low-resource settings.

Perspectives on healthy behaviors among low-income Latino and non-Latino adults in two rural counties.

Objectives: Rural populations and individuals with low incomes are less likely than the general population to achieve recommended levels of physical activity and fruit and vegetable consumption. The purpose of this study was to describe the perspectives of low-income adults in 2 rural Wisconsin counties on the factors that influence physical activity and healthy eating.

Design And Sample: A qualitative descriptive study was conducted using 4 focus groups: 2 in English and 2 in Spanish.

Self-care beliefs and behaviors in Ugandan adults with type 2 diabetes.

Purpose: The purpose of this study was to describe illness beliefs and diabetes self-care behaviors of Ugandan adults with type 2 diabetes.

Methods: A convenience sample of 340 adults with type 2 diabetes was recruited from 2 outpatient settings in Kampala, Uganda. Participants were interviewed by a nurse about diabetes self-care behaviors; had their weight, height, and waist and hip circumference measured; and shared with the interviewer the blood glucose and blood pressure values obtained during their clinic visit.

Perceived influences on physical activity and diet in low-income adults from two rural counties.

Background: Despite the increased use of ecological models in health behavior research, multilevel influences on health behaviors in rural, low-income people, an aggregate at high risk for sedentary behavior and inadequate diets, have been examined in few studies.

Objective: The purpose of this study was to describe influences on physical activity and diet in low-income, rural adults.

Method: A cross-sectional survey was conducted using face-to-face interviews in a convenience sample of 137 low-income Anglo and Latino adults recruited from two rural Wisconsin counties.

Travel health risk perceptions and prevention behaviors of US study abroad students.

Background: The number of American study abroad students increased more than 150% in the past decade, along with growth in destinations with increased health risks. This study investigated travel health risk perceptions and prevention behaviors to guide interventions that address the emerging health needs of US study abroad students.

Method: A cross-sectional design was used to collect data from 318 American study abroad students using a Web-based survey.

Applying the common sense model to measure representations of arsenic contaminated well water.

Theory-based research is needed to understand how people respond to environmental health risk information. Both the common sense model (CSM) of self-regulation and the mental models approach propose that information shapes individuals' personal understandings that, in turn, influence their decisions and actions. We compare these frameworks and explain how the CSM was applied to describe and measure mental representations of arsenic contaminated well water.

A sense of community among immigrant Latinas.

Immigration can mean an escape from economic deprivation and hope for a better future, yet it can also lead to the loss of social networks, family, and community ties. The purpose of this study was to use a focused ethnography to explore a sense of community from the perspective of immigrant Latinas. Ten individual interviews were conducted and analyzed to document Latinas' experiences of immigrating to the United States and how this affected their sense of community.

Applying a health behavior theory to explore the influence of information and experience on arsenic risk representations, policy beliefs, and protective behavior.

The common sense model (CSM) shows how people process information to construct representations, or mental models, that guide responses to health threats. We applied the CSM to understand how people responded to information about arsenic-contaminated well water. Constructs included external information (arsenic level and information use), experience (perceived water quality and arsenic-related health effects), representations, safety judgments, opinions about policies to mitigate environmental arsenic, and protective behavior.

A training program for diabetes care in Vietnam.

Purpose: This article will describe a project designed to enhance the knowledge and skills of Vietnamese nurses and physicians to improve diabetes care.

Methods: Strategies used to achieve these goals included training in behavioral and educational approaches and physical assessment skills.

Results: Six-month follow-up reports on the outcomes of diabetes education projects and institutional strategies for diabetes education will be presented.

Predictors of fat intake behavior differ between normal-weight and obese WIC mothers.

Purpose: To determine whether predictors of fat intake behavior were the same for normal-weight and obese WIC mothers when applying the PRECEDE-PROCEED model and to identify predictors for each group.

Design: Proportional stratified convenience sampling.

Subjects: Five hundred eighty-one nonpregnant, black and white normal-weight (n = 180) or obese (n = 401) women.

Duration of signs and survival in premenopausal women with breast cancer.

Unlabelled: CONDENSED: Among 550 women reporting a lump as the first sign of breast cancer, those with this sign for 6-29 months compared to those with 1-6 months, had bigger tumors and more frequent axillary node involvement. Overall survival, however, was not significantly different in these two groups.

Background: The relationship of delay in diagnosis of breast cancer to survival is uncertain.

Cancer prevention services and physician consensus in primary care group practices.

Background: We conducted a randomized clinical trial of interventions to achieve physician consensus, practice changes, and patient activation designed to help primary care group practices enhance the delivery of cancer prevention and screening services.

Methods: In each of 42 primary care practices in 1991 to 1994, we studied approximately 60 patients per physician who were between the ages 53 and 64. Data sources included patient and physician questionnaires, medical record audits of consenting patients for evidence of 11 cancer prevention services during the previous 3 years, and telephone interviews with key practice personnel.

Development of an instrument to assess predisposing, enabling, and reinforcing constructs associated with fat intake behaviors of low-income mothers.

Objective: To establish reliability and construct and discriminant validity of selected factors adapted from the Health and Taste Attitudes Questionnaire developed in Finland and the Food Choice Questionnaire developed in England for use with low-income mothers in the United States.

Design: Cross-sectional.

Setting: Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children sites in south-central Wisconsin.

Development and validation of a self-efficacy measure for fat intake behaviors of low-income women.

Objective: To develop a valid self-efficacy measure for eating low-fat diets in low-income women.

Design: Cognitive interviews followed by self-administered questionnaires.

Participants/settings: 206 (6 + 200) nonpregnant black and white women participating in Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Wisconsin.