Understanding Physicians' Perceptions of Patient-Identified Barriers to Osteoporosis Medication Initiation: A Cognitive Mapping Approach.

Objective: Interventions to initiate medication and increase adherence for postmenopausal women who have had a fragility fracture were not always successful. The purpose of this study was to derive an empirical framework for patient-identified barriers to osteoporosis medication initiation and adherence from physician experts.

Methods: A cognitive mapping approach involving nominal group technique (NGT) meetings and a card sorting and rating task were used to obtain formative data.

Identifying Patient Profiles for Developing Tailored Diabetes Self-Management Interventions: A Latent Class Cluster Analysis.

Purpose: Interventions that are tailored to the specific psychosocial needs of people with diabetes may be more effective than a "one size fits all" approach. The purpose of this study is to identify patient profiles with distinct characteristics to inform the development of tailored interventions.

Methods: A latent class cluster analysis was conducted with data from the ENCOURAGE trial based on participant responses to 6 baseline psychosocial measures, including trust in physicians, perceived discrimination, perceived efficacy in patient-physician interactions, social support, patient activation, and diabetes distress.

Promoting Physical Activity in Rural Settings: Effectiveness and Potential Strategies.

Purpose: Implementing efficacious physical activity interventions in real-world rural settings is needed because rural cancer survivors are more physically inactive and experience poorer health. To address this gap, this study evaluated effectiveness of an evidenced-based physical activity program (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) for rural women cancer survivors when implemented by community-based, non-research staff.

Methods: 16 rural women cancer survivors received BEAT Cancer implemented by a rural, community organization and non-research staff; physical activity, patient-reported outcomes, and social cognitive constructs were measured at baseline and post-program.

Cognitive mapping as an approach to facilitate organ donation among African Americans.

Making up 13.4% of the United States population, African Americans (AAs) account for 28.7% of candidates who are currently waiting for an organ donation.

Determining patient needs to enhance exercise program implementation and uptake in rural settings for women after a cancer diagnosis.

Purpose: To qualitatively explore exercise barriers and facilitators experienced by rural female cancer survivors from the program interventionist and recipient perspective for the purpose of enhancing exercise program implementation and uptake in rural settings.

Methods: A descriptive qualitative study design was utilized. Focus groups were conducted prior to implementation of an evidence-based exercise program by a rural non-research cancer clinical site.

Hospice inpatient services provision, utilization, and financial performance.

Background: Hospice performance is an overlooked area in the health care field due to the difficulty of measuring quality of care and the infrequent quality inspection. Based on the daily reimbursement mechanism for different levels of hospice care, inpatient services provision could influence both hospice-level length of stay (LOS) and financial performance.

Purpose: The objective of this study was to explore the relationship between hospice inpatient services provision and hospice utilization and financial performance.

Factors associated with the provision of inpatient care in hospices.

Background: Hospices provide end-of-life care to patients who have complex health care needs and whose symptoms are difficult to control. Understanding why some hospices offer inpatient hospice care to patients could bring more evidence for policy makers and researchers to focus on the role of inpatient care in hospice.

Purpose: The purpose of this study was to examine market and organizational factors that are associated with the provision of hospice inpatient care.

Systematic review of the hospice performance literature.

Background: Hospice is the key provider of end-of-life care to patients. As the number of U.S.

Mapping Perceptions of Lupus Medication Decision-Making Facilitators: The Importance of Patient Context.

Objective: Numerous factors can impede or facilitate patients' medication decision-making and adherence to physicians' recommendations. Little is known about how patients and physicians jointly view issues that affect the decision-making process. Our objective was to derive an empirical framework of patient-identified facilitators to lupus medication decision-making from key stakeholders (including 15 physicians, 5 patients/patient advocates, and 8 medical professionals) using a patient-centered cognitive mapping approach.

Barriers to Medication Decision Making in Women with Lupus Nephritis: A Formative Study using Nominal Group Technique.

Objective: To assess the perspectives of women with lupus nephritis on barriers to medication decision making.

Methods: We used the nominal group technique (NGT), a structured process to elicit ideas from participants, for a formative assessment. Eight NGT meetings were conducted in English and moderated by an expert NGT researcher at 2 medical centers.

Patient assessment of primary care physician communication: segmentation approach.

Purpose: The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient perception of PCP professional competence, patient assessment of the relationship with the doctor and patient demographic characteristics using a segmentation approach.

Design/methodology/approach: The authors surveyed 514 adult patients waiting for appointments with their PCPs in two US primary care clinics. A latent class analysis was used to identify mutually exclusive unobserved homogeneous classes of patients.

Resilience in the initial year of caregiving for a family member with a traumatic spinal cord injury.

Objective: Individuals who assume caregiving duties for a family member disabled in a traumatic injury often exhibit considerable distress, yet few studies have examined characteristics of those who may be resilient in the initial year of caregiving. Reasoning from the influential Pearlin model of caregiving (Pearlin & Aneshensel, 1994) and the resilience process model (Bonanno, 2005), we expected a significant minority of caregivers would be chronically distressed and another group would be resilient throughout the inaugural year of caregiving for a person with a traumatic spinal cord injury (SCI), and these groups would differ significantly in primary and secondary stress and in personal resources and mediators.

Method: Twenty men and 108 women who identified as caregivers for a family member who incurred a traumatic SCI consented to complete measures during the inpatient rehabilitation and at 1 month, 6 months, and 12 months postdischarge.

Teaching behaviors that define highest rated attending physicians: a study of the resident perspective.

Background: Better understanding teaching behaviors of highly rated clinical teachers could improve training for teaching. We examined teaching behaviors demonstrated by higher rated attending physicians.

Methods: Qualitative and quantitative group consensus using the nominal group technique (NGT) among internal medicine residents and students on hospital services (2004-2005); participants voted on the three most important teaching behaviors (weight of 3 = top rated, 1 = lowest rated).

Frictions as barriers to perioperative alignment: results from a latent class analysis.

The quality of the relationship between the sterile processing department (SPD) and the operating room (OR) is an important determinant of OR safety and performance. In this article, the concept of "friction" refers to the SPD behaviors and attributes that can negatively affect OR performance. Panels of SPD professionals initially were asked to identify and operationally define different ways in which behaviors of a hospital's SPD could compromise OR performance.

Health care providers' recommendations for physical activity and adherence to physical activity guidelines among adults with arthritis.

Introduction: Physical activity is beneficial for reducing pain and improving health-related quality of life among people with arthritis. However, physical inactivity is prevalent among people with arthritis. Health care providers' recommendations act as a catalyst for changes in health behavior.

What Hispanic parents do to encourage and discourage 3-5 year old children to be active: a qualitative study using nominal group technique.

Purpose: Hispanic preschoolers are less active than their non-Hispanic peers. As part of a feasibility study to assess environmental and parenting influences on preschooler physical activity (PA) (Niños Activos), the aim of this study was to identify what parents do to encourage or discourage PA among Hispanic 3-5 year old children to inform the development of a new PA parenting practice instrument and future interventions to increase PA among Hispanic youth.

Methods: Nominal Group Technique (NGT), a structured multi-step group procedure, was used to elicit and prioritize responses from 10 groups of Hispanic parents regarding what parents do to encourage (5 groups) or discourage (5 groups) preschool aged children to be active.

Feeding style differences in food parenting practices associated with fruit and vegetable intake in children from low-income families.

Objective: To examine the moderating effects of feeding styles on the relationship between food parenting practices and fruit and vegetable (F & V) intake in low-income families with preschool-aged children.

Design: Focus group meetings with Head Start parents were conducted by using the nominal group technique. Parents completed information on food parenting practices and feeding styles.

Age bias in physicians' recommendations for physical activity: a behavioral model of healthcare utilization for adults with arthritis.

Objective: To examine whether age bias exists in physicians' recommendations for physical activity among individuals with arthritis.

Methods: A cross-sectional sample with 33,071 U.S.

Using cognitive mapping to define key domains for successful attending rounds.

Background: Ward attending rounds are an integral part of internal medicine education. Being a good teacher is necessary, but not sufficient for successful rounds. Understanding perceptions of successful attending rounds (AR) may help define key areas of focus for enhancing learning, teaching and patient care.

Child temperament, parent emotions, and perceptions of the child's feeding experience.

Background: Associations between parent and child characteristics and how they influence the approach parents take toward children in the feeding environment have not been examined extensively, especially in low-income minority families who are at a higher risk for obesity. The primary aim of the study was to examine positive and negative parent emotions as potential mediators of the relationship between child temperament and parents' perceptions of strategy effectiveness and problems encountered in feeding children fruit and vegetables.

Methods: Participants were low-income families (n = 639, 73% minority, children aged 3-5 years) participating in Head Start programs in two states.

Primary care patient satisfaction segmentation.

Purpose: The aim of this study is to examine patient satisfaction with non-physician staff as related to patient demographics, satisfaction with physician, and intentions to recommend their physicians to others.

Design/methodology/approach: A survey was conducted at two internal medicine primary care clinics affiliated with a major university health system. A latent class analysis was used to detect patient subpopulations based on profiles of response for five satisfaction-with-staff indicators.

Association between adherence to physical activity guidelines and health-related quality of life among individuals with physician-diagnosed arthritis.

Purpose: To examine the association between adherence to physical activity guidelines and health-related quality of life (HRQOL) among individuals with arthritis.

Methods: A cross-sectional sample with 33,071 US adults, 45 years or older with physician-diagnosed arthritis was obtained from 2007 Behavioral Risk Factor Surveillance System survey. We conducted negative binomial regression analysis to examine HRQOL as a function of adherence to physical activity guidelines controlling for physicians' recommendations for physical activity, age, sex, race, education, marital status, employment, annual income, health insurance, personal physician, emotional support, body mass index, activity limitations, health status, and co-morbidities based on Behavioral Model of Health Services Utilization.

Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families.

Background: A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures) and behavioral feeding practices among those reporting different feeding styles on the Caregiver's Feeding Styles Questionnaire.

The art and science of patient storytelling-harnessing narrative communication for behavioral interventions: the ACCE project.

Narrative communication is an emerging form of persuasive communication used in health education to solicit actual patient stories. Eliciting a narrative is an open-ended process and may or may not map to desired intervention objectives or underlying behavioral constructs. In addition, incorporating actual, unscripted narratives into multimedia interventions is challenging.