A Spanish-Language Risk Perception Survey for Developing Diabetes: Translation Process and Assessment of Psychometric Properties.

Background And Purpose: Create a Spanish-language version of the Risk Perception Survey for Developing Diabetes (RPS-DD) and assess psychometric properties.

Research Design And Methods: The Spanish-language version was created through translation, harmonization, and presentation to the tool's original author. It was field tested in a foreignborn Latino sample and properties evaluated in principal components analysis.

Leukocyte Telomere Length in Postmenopausal Women.

Objective: To compare leukocyte telomere length (LTL) by race and describe demographic, health, and psychosocial factors associated with LTL in postmenopausal women.

Design: Descriptive study with comparative analyses and correlations.

Setting: Data were collected at the University of California-San Francisco, San Francisco Clinical and Translational Science Institute.

Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer.

Context: Patients with breast cancer receiving chemotherapy (CTX) experience multiple concurrent symptoms, but little is known about how symptoms change during and after treatment. Knowledge of the identity and trajectory of symptom clusters (SCs) would enhance measurement and management.

Objectives: We aimed to identify SCs and their change over time from baseline to completion of breast cancer CTX.

A Qualitative Understanding of Midlife Sources of Stress and Support in African-American Women.

African-American women suffer from disproportionate adverse health outcomes compared to women of other ethnicities living in the United States. It is suggested in the literature that chron- ic stress can be an antecedent to health disparity. The purpose of this study was to evaluate changes in perceived stress from late pre-menopause to post-menopause and to identify significant life stressors perceived by a cohort of African-American women.

Perception of Risk for Developing Diabetes Among Foreign-Born Spanish-Speaking US Latinos.

Purpose: The purpose of the study was to describe perception of risk for developing diabetes among foreign-born Spanish-speaking US Latinos.

Methods: Participants (N = 146), recruited at food-pantry distribution events and free clinics, were surveyed using the Risk Perception Survey for Developing Diabetes in Spanish. Type 2 diabetes risk factors measured included body mass index, physical activity, and A1C.

Omalizumab adherence in an observational study of patients with moderate to severe allergic asthma.

Background: Adherence to omalizumab is not well characterized and its association with asthma control has not been well established.

Objective: To evaluate adherence in patients initiating omalizumab in the Epidemiologic Study of Xolair (omalizumab): Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate to Severe Asthma (EXCELS) observational study.

Methods: Adherence was assessed over 5 years using the proportion of patients who missed any dose, rates of doses missed, and proportions of patients with good (<10% doses missed) or poor (≥30% doses missed) adherence.

A pilot study to evaluate the magnitude of association of the use of electronic personal health records with patient activation and empowerment in HIV-infected veterans.

The HITECH Act signed into law in 2009 requires hospitals to provide patients with electronic access to their health information through an electronic personal health record (ePHR) in order to receive Medicare/Medicaid incentive payments. Little is known about who uses these systems or the impact these systems will have on patient outcomes in HIV care. The health care empowerment model provides rationale for the hypothesis that knowledge from an electronic personal health record can lead to greater patient empowerment resulting in improved outcomes.

Veteran Affairs Centers of Excellence in Primary Care Education: transforming nurse practitioner education.

To integrate health care professional learners into patient-centered primary care delivery models, the Department of Veterans Affairs has funded five Centers of Excellence in Primary Care Education (CoEPCEs). The main goal of the CoEPCEs is to develop and test innovative structural and curricular models that foster transformation of health care training from profession-specific "silos" to interprofessional, team-based educational and care delivery models in patient-centered primary care settings. CoEPCE implementation emphasizes four core curricular domains: shared decision making, sustained relationships, interprofessional collaboration, and performance improvement.

Effect of culturally tailored diabetes education in ethnic minorities with type 2 diabetes: a meta-analysis.

Background: Diabetes is a major cause of cardiovascular morbidity and mortality. Ethnic minorities experience a disproportionate burden of diabetes; however, few studies have critically analyzed the effectiveness of a culturally tailored diabetes intervention for these minorities.

Objective: The aim of this study was to evaluate the effectiveness of a culturally tailored diabetes educational intervention (CTDEI) on glycemic control in ethnic minorities with type 2 diabetes.

Determinants of frequency, duration, and continuity of home walking in patients with COPD.

The purpose of this study was to identify determinants of frequency (days per week), duration (minutes per session), and continuity (persistence over 1 year) of home walking in 103 patients with chronic obstructive pulmonary disease (COPD) who participated in a dyspnea self-management program. Dimensions of home walking exercise were measured by logs and reports of biweekly telephone calls with the intervention nurse. The selection of personal, cognitive, and environmental determinants of home walking was guided by social cognitive theory.

Barriers to diabetes management: patient and provider factors.

Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians.

Objective airway monitoring improves asthma control in the cold and flu season: a cluster randomized trial.

Background: The goals of asthma care are reductions in risk and impairment, but achieving these goals requires collaborative work between patients and their clinicians. The purpose of this study was to improve inhaled corticosteroid (ICS) adherence and asthma control by cueing therapeutic communication between patients with asthma and their primary care clinicians.

Methods: We conducted a prospective, cluster-randomized, controlled effectiveness trial to assess the effect of providing visually standardized, interpreted peak flow graphs (CUE intervention) to patients and their clinicians on ICS adherence and asthma control.

Factors associated with psychological insulin resistance in individuals with type 2 diabetes.

Objective: To describe the predictive relationships of selected sociodemographic, biomedical, and psychosocial variables to reluctance to use insulin among patients with type 2 diabetes.

Research Design And Methods: A total of 178 patients with type 2 diabetes participated in this cross-sectional, observational study. Data were obtained by patient interview using validated measures of diabetes attitude, knowledge, self-efficacy, care communication, and perceived barriers to treatment, as well as sociodemographic and biomedical data.

Barriers to patient-clinician collaboration in asthma management: the patient experience.

Objective: To describe what adult patients with asthma report about their experiences with their own self-management behavior and working with their clinicians to control asthma.

Methods: The study sample consisted of 104 patients with persistent asthma participating in a clinical trial on asthma monitoring. All subjects were seen by primary care clinicians of a large, academic medical center.

Improving chronic care of type 2 diabetes using teams of interprofessional learners.

Purpose: To improve the care and outcomes of adult patients with type 2 diabetes by teaching interprofessional teams of learners the principles and practices of the Improving Chronic Illness Care Model.

Method: The study population consisted of 384 adult patients with type 2 diabetes. The study design was a nonrandomized, parallel-group, clinical trial conducted during 18 months in the University of California, San Francisco internal medicine clinics.

Individualized asthma self-management improves medication adherence and markers of asthma control.

Background: Adherence to inhaled anti-inflammatory therapy and self-management skills are essential parts of the asthma treatment plan to improve asthma control and prevent exacerbations. Whether self-management education improves long-term medication adherence is less clear.

Objective: A 24-week prospective, randomized controlled trial was performed to study the effect of self-management education on long-term adherence to inhaled corticosteroid (ICS) therapy and markers of asthma control.

Predictors of asthma medication nonadherence.

Background: The purpose of this study was to describe asthma medication adherence behavior and to identify predictors of inhaled corticosteroid (ICS) underuse and inhaled beta-agonist (IBA) overuse.

Methods: Self-reported medication adherence, spirometry, various measures of status, and blood for immunoglobulin E measurement were collected on 158 subjects from a larger cohort of adults with asthma and rhinitis who were prescribed an ICS, an IBA, or both.

Results: There was a positive association between ICS underuse and higher forced expiratory volume in one second percent (FEV1%) predicted (P = .

Meeting a primary care challenge in the United States: chronic illness care.

Leading health care experts in the United States have stated that the greatest primary care challenge today is meeting the complex needs of patients with chronic illness/long-term conditions or impairment.To address this challenge, there is a need for health care system redesign that requires a multidisciplinary team approach, including active participation from professional nurses. In particular, it is essential for advanced practice nurses to provide leadership in health systems design for which they are specifically trained and experienced.

Effects of treatment on two types of self-efficacy in people with chronic obstructive pulmonary disease.

Self-management is crucial in people with chronic diseases, and self-efficacy has been shown to impact patients' self-management. The purposes of this study were to 1) determine the effect of intervention on self-efficacy and 2) determine the relationship between domain-specific self-efficacy, walking performance, and symptom severity in patients with chronic obstructive pulmonary disease (COPD). Subjects (n=102, forced expiratory volume in 1 second % predicted 44.

Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis.

The diurnal rhythm of cortisol secretion in chronic disease can reflect the interactions between exogenous and endogenous factors. Exogenous glucocorticoid use may impact salivary cortisol measurements, but this has not been well-studied in ambulatory settings. In this report salivary cortisol levels were used to evaluate aspects of the diurnal rhythm of cortisol secretion within an ambulatory population of patients with asthma and allergic rhinitis.

Asthma management across the life span: applications for the adult and older adult.

Asthma is one of the most common and chronic diseases of adults and creates substantial health problems. The disease must be diagnosed appropriately, its severity assessed, and treatment prescribed that matches the level of severity. Patient education in self-management techniques and attention to the problems of adherence are essential for long-term management.

Effects of individual self-management education on clinical, biological, and adherence outcomes in asthma.

Background: Asthma guidelines urge teaching patients the knowledge and skills required for self-management, based on the assumption that education will lead to improved skills and better asthma control.

Methods: In a prospective, randomized controlled trial of 65 adults with mild-to-moderate asthma, we examined whether an educational self-management intervention would improve adherence to inhaled corticosteroid therapy, decrease markers of airway inflammation, and improve clinical control. Peak flow, symptoms, and adherence were monitored for 7 weeks.

The burden of asthma in the United States: level and distribution are dependent on interpretation of the national asthma education and prevention program guidelines.

Asthma imposes a growing burden on society in terms of morbidity, quality of life, and healthcare costs. Although federally sponsored national surveys provide estimates of asthma prevalence, these surveys are not designed to characterize the burden of asthma by self-reported disease activity. We sought to characterize asthma burden in the United States.