A patient choice-driven lifestyle intervention lowers HbA1c in type 2 diabetes: A feasibility study.

Type 2 diabetes (T2D) is a common metabolic disorder in which only 25% of patients meet management targets. While the primary care setting is positioned to provide lifestyle management education, studies are lacking which integrate behavior interventions in this setting utilizing clinic staff. Thus, we evaluated a 90-day lifestyle intervention for management of glycemia at a family practice clinic administered by clinic medical assistants.

Cannabis use in Parkinson's disease: Patient access to medical cannabis and physician perspective on product safety.

The rate of medical cannabis use has increased in parallel with the number of states legalizing its use. Parkinson's disease (PD) patients are of particular concern due to their higher cannabis use rate than in the general US population (25-40 % PD patient cannabis users vs. ∼18 % in the general population), as well as their susceptibility to environmental contaminants in cannabis, including pesticides, toxic elements, solvents, microbes, and mycotoxins.

The Impact of Monetary Incentives on Delay Discounting Within a Year-Long Physical Activity Intervention.

Background: Delay discounting is the depreciation in a reward's perceived value as a function of the time until receipt. Monetary incentive programs that provide rewards contingent on meeting daily physical activity (PA) goals may change participants' delay discounting preferences.

Purpose: Determine if monetary incentives provided in close temporal proximity to meeting PA goals changed delay discounting, and if such changes mediated intervention effects.

The moderating impact of neighborhood walkability on mHealth interventions to increase moderate to vigorous physical activity for insufficiently active adults in a randomized trial.

Background: Ecological models suggest that interventions targeting specific behaviors are most effective when supported by the environment. This study prospectively examined the interactions between neighborhood walkability and an mHealth intervention in a large-scale, adequately powered trial to increase moderate-to-vigorous physical activity (MVPA).

Methods: Healthy, insufficiently active adults (N = 512) were recruited purposefully from census block groups ranked on walkability (high/low) and socioeconomic status (SES, high/low).

Practice integration profile revised: Improving item readability and completion.

Introduction: The Practice Integration Profile (PIP) is a reliable, valid, and broadly used measure of the integration of behavioral health (BH) into primary care. The PIP assesses operational and procedural elements that are grounded in the AHRQ Lexicon for Behavioral Health and Primary Care Integration. Prior analyses of PIP data and feedback from users suggested the measure was in need of revisions.

Improving multimorbidity measurement using individualized disease-specific quality of life impact assessments: predictive validity of a new comorbidity index.

Background: Interpretation of health-related quality of life (QOL) outcomes requires improved methods to control for the effects of multiple chronic conditions (MCC). This study systematically compared legacy and improved method effects of aggregating MCC on the accuracy of predictions of QOL outcomes.

Methods: Online surveys administered generic physical (PCS) and mental (MCS) QOL outcome measures, the Charlson Comorbidity Index (CCI), an expanded chronic condition checklist (CCC), and individualized QOL Disease-specific Impact Scale (QDIS) ratings in a developmental sample (N = 5490) of US adults.

Patient screening for integrated behavioral health in adult primary care: A rapid review of effective procedures.

Purpose: Although many primary care clinics screen for behavioral health (BH) conditions using validated tools, it is not clear whether adult BH screening leads to better patient outcomes. Our objective was to determine the evidence base by reviewing effectiveness research for multiple strategies of BH screening in adult primary care identified in the Practice Integration Profile.

Method: We conducted five rapid reviews of effectiveness research supporting BH screening strategies cited in the Practice Integration Profile.

Measuring visual electrophysiological responses in individuals with low-functioning autism: a feasibility and pilot study.

Background: Although visual abnormalities are considered common in individuals with autism spectrum disorders, the associated electrophysiological markers have remained elusive. One impediment has been that methodological challenges often preclude testing individuals with low-functioning autism (LFA).

Methods: In this feasibility and pilot study, we tested a hybrid visual evoked potential paradigm tailored to individuals with LFA that combines passively presented visual stimuli to elicit scalp-recorded evoked responses with a behavioral paradigm to maintain visual attention.

Adaptive Goals and Reinforcement Timing to Increase Physical Activity in Adults: A Factorial Randomized Trial.

Introduction: Potent lifestyle interventions to increase moderate-to-vigorous physical activity are urgently needed for population-level chronic disease prevention. This trial tested the independent and joint effects of a mobile health system automating adaptive goal setting and immediate financial reinforcement for increasing daily walking among insufficiently active adults.

Study Design: Participants were randomized into a 2 (adaptive versus static goal setting) X 2 (immediate versus delayed financial incentive timing) condition factorial trial to increase walking.

Effects of Goal Type and Reinforcement Type on Self-Reported Domain-Specific Walking Among Inactive Adults: 2×2 Factorial Randomized Controlled Trial.

Background: WalkIT Arizona was a 2×2 factorial trial examining the effects of goal type (adaptive versus static) and reinforcement type (immediate versus delayed) to increase moderate to vigorous physical activity (MVPA) among insufficiently active adults. The 12-month intervention combined mobile health (mHealth) technology with behavioral strategies to test scalable population-health approaches to increasing MVPA. Self-reported physical activity provided domain-specific information to help contextualize the intervention effects.

Integrated Behavioral Treatment for Veterans With Co-Morbid Chronic Pain and Hazardous Opioid Use: A Randomized Controlled Pilot Trial.

Opioid prescription in the treatment of chronic pain is frequent and carries a risk of increased morbidity and mortality in a clinically significant number of patients, particularly those who are using opioids in a hazardous manner. Few treatment options are available that target both pain-related interference and hazardous opioid use among patients with chronic pain. In military Veterans, this issue is of particular importance as numerous reports indicate continued high rates of opioid prescription for chronic pain, as well as significant opioid-related problems.

A Comparative Meta-Analysis of Unidisciplinary Psychology and Interdisciplinary Treatment Outcomes Following Acceptance and Commitment Therapy for Adults with Chronic Pain.

While much of the literature provides positive support for psychological interventions for chronic pain, 2 recent meta-analyses indicate small to moderate benefits only. This inconsistency in findings suggests that there are other treatment-related variables to consider. One possible consideration pertains to treatment format, as psychological models form the basis for both unidisciplinary psychology and integrated interdisciplinary treatments for chronic pain.

Alcohol and Opioid Use in Chronic Pain: A Cross-Sectional Examination of Differences in Functioning Based on Misuse Status.

Unlabelled: Opioid misuse is regularly associated with disrupted functioning in those with chronic pain. Less work has examined whether alcohol misuse may also interfere with functioning. This study examined frequency of opioid and alcohol misuse in 131 individuals (61.

Using Analgesics for Emotional Modulation is Associated With Increased Distress, Depression, and Risk of Opioid and Alcohol Misuse: Initial Evaluation and Component Analysis of the Reasons for Analgesic Use Measure (RAUM).

Objectives: It is important to identify aspects of analgesic use that are associated with harm in chronic pain. Historically, the focus has been patterns of use (eg, overuse). This study evaluated another aspect of use-rather than evaluating how analgesics were being used, the primary interest was in why they were being used.

Preliminary Evaluation of the Values Tracker: A Two-Item Measure of Engagement in Valued Activities in Those With Chronic Pain.

Engagement in valued activities is an important outcome, particularly in treatments that aim to enhance quality of life in those with chronic conditions. The present study describes the initial evaluation of the Values Tracker (VT), a two-item measure of values engagement, in 302 treatment-seeking adults with chronic pain. Hierarchical regression analyses were conducted to examine the utility of the VT in the statistical prediction of pain-related functioning, after controlling for demographic variables, pain intensity, and pain-related distress.

Development of a chronic pain-specific version of the Sickness Impact Profile.

Objective: Given the prevalence and complexity of chronic pain, there is a need for measures of disability that (a) provide comprehensive, useful clinical information with regard to patient functioning, and (b) do so as briefly as possible to minimize respondent burden. The primary objective of this study was to reduce the length of a well-known, highly detailed measure of disability, the 136-item Sickness Impact Profile (SIP), and develop a psychometrically sound short form for use in chronic pain (SIP for Chronic Pain, SIP-CP).

Method: A 2-parameter logistic item response theory model was used to develop the SIP-CP in a sample of adults presenting for treatment at an interdisciplinary rehabilitation program (N = 723).

Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.

Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain.

Adequate health literacy is associated with higher heart failure knowledge and self-care confidence in hospitalized patients.

Heart failure (HF) patients with inadequate health literacy are at increased risk for poor self-care and negative health outcomes such as hospital readmission. The purpose of the present study was to examine the prevalence of inadequate health literacy, the reliability of the Dutch HF Knowledge Scale (DHFKS) and the Self-care of Heart Failure Index (SCHFI), and the differences in HF knowledge, HF self-care, and 30-day readmission rate by health literacy level among patients hospitalized with HF. The convenience sample included adults (n = 95) admitted to a large, urban, teaching hospital whose primary diagnosis was HF.