Development and Validation of a Measure for Seeking Health Information in the Diabetes Online Community: Mixed Methods Study.

BACKGROUND: Individuals with chronic diseases often search for health information online. The Diabetes Online Community (DOC) is an active community with members who exchange health information; however, few studies have examined health information brokering in the DOC. OBJECTIVE: The aim of this study was to develop and validate the Attitudes Toward Seeking Health Information Online (ATSHIO) scale in a sample of adults with type 1 diabetes (T1D). METHODS: People with T1D were recruited through the DOC, specifically Facebook and Twitter. They were provided with a Qualtrics link to complete the survey. This was a mixed methods study that used thematic analysis along with existing theory and formative research to design the quantitative ATSHIO scale. RESULTS: A total of 166 people with T1D participated in this study. Confirmatory factor analyses determined a 2-factor scale (Trusting and Evaluating Online Health Information in the DOC and Engaging With Online Health Information in the DOC) with good convergent validity and discriminant validity. Correlations were found between social support, online health information-seeking, diabetes distress, and disease management. CONCLUSIONS: The ATSHIO scale can be used to investigate how people with diabetes are using the internet for obtaining health information, which is especially relevant in the age of telehealth and Health 2.0.

Discretizing continuous variables in nutrition and obesity research: a practice that needs to be cut short.

BACKGROUND/OBJECTIVES: Nutrition and obesity researchers often dichotomize or discretize continuous independent variables to conduct an analysis of variance to examine group differences. We describe consequences associated with dichotomizing and discretizing continuous variables using two cross-sectional studies related to nutrition. SUBJECTS/METHODS: Study 1 investigated the effects of health literacy and nutrition knowledge on nutrition label accuracy (n = 612). Study 2 investigated the effects of cognitive restraint and BMI on fruit and vegetable (F/V) intake (n = 586). We compare analytic approaches where continuous independent variables were either discretized/dichotomized or analyzed as continuous variables. RESULTS: In Study 1, dichotomization of health literacy and nutrition knowledge for 2 × 2 ANOVA revealed health literacy had an effect on nutrition label accuracy. Nutrition knowledge has an effect on nutrition label accuracy, but the health literacy by nutrition knowledge interaction was not significant. When analyzed using regression, the nutrition knowledge effect was significant. The simple effect of health literacy was also significant when health literacy equals zero. Finally, the quadratic effect of health literacy was negative and significant. In Study 2, dichotomization and discretization of cognitive restraint and BMI were used for three ANOVAs, which discretized BMI in three ways. For all ANOVAs, the BMI main effect for predicting fruit and vegetable intake was significant, the interaction between BMI and cognitive restraint was non-significant, and cognitive restraint was only significant when both variables were dichotomized. When analyzed using regression, the continuous mean-centered variables, and their interaction each significantly predicted F/V intake. CONCLUSIONS: Dichotomizing continuous independent variables resulted in distortions of effect sizes across studies, an inability to assess the quadratic effect of health literacy, and an inability to detect the moderating effect of BMI. We discourage researchers from dichotomizing and discretizing continuous independent variables and instead use multiple regression to examine relationships between continuous independent and dependent variables.

The influence of cognitive and affective components of the sentinel event on alcohol use following a brief intervention with trauma patients.

OBJECTIVE: Alcohol-related injury is a sentinel event, an unanticipated medical event that may prompt a re-evaluation of health behaviors, such as alcohol use. Few studies have examined the psychological components of the sentinel event that motivate behavior change. In the present study, we examined the influence of cognitive and affective components of an alcohol-related injury on changes in alcohol use following a brief intervention. METHOD: Injured patients (n = 411) who were drinking prior to their injury admission were recruited from three urban Level I trauma centers and randomized to receive brief advice or brief motivational intervention with or without a 1-month booster session. Assessments were completed at baseline and 3-, 6-, and 12-month follow-ups. Three groups were created based on endorsement (yes/no) of items assessing cognitive and affective components of the injury event: neither component, the cognitive component only, and both the cognitive and affective components. RESULTS: Mixed-effects models indicated that participants who endorsed both the cognitive and affective components had greater reductions in peak alcohol use from baseline to 3-month follow-up than those who did endorsed neither component. By contrast, participants who endorsed the cognitive component, but not the affective component, had greater increases in average drinks per week and percentage of days of heavy drinking from 3- to 12-month follow-ups than those who endorsed neither component. CONCLUSION: These results provide preliminary support for further consideration of an affective component of alcohol-related injuries that may motivate subsequent reductions in drinking following a sentinel event.

A brief report examining the stereotype content model with blind Americans.

PURPOSE/OBJECTIVE: The stereotype content model is a unifying theory of the makeup of stereotypes and their consequences on emotions and behaviors. There is a need to study this theory from the perspectives of those most affected by them-targets of stereotypes. RESEARCH METHOD/DESIGN: Blind adults (n = 264) living in the United States completed the stereotype content measure asking participants to rate the extent to which they believed members of wider society held certain beliefs about Blind persons. RESULTS: Confirmatory factor analyses showed good fit for the four-factor model of stereotype content: warmth, competence, status, and competition. CONCLUSIONS: This study confirms the stereotype content model and begins to extend the stereotype content model to be inclusive of the perspectives of those who are the targets of stereotypes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans.

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

Measurement Invariance of the Readiness to Change Questionnaire Among Injured Patients Who Received a Brief Intervention for Alcohol Use.

We tested measurement invariance of the Readiness to Change Questionnaire (RCQ) to evaluate its utility in assessing the stages of change in the context of brief intervention for alcohol use in opportunistic settings. Participants (N = 596) were patients admitted from three Level I trauma centers who were randomly assigned to one of three brief alcohol interventions. The RCQ was administered at baseline and 3-month follow-up. The RCQ was scalar invariant across biological sex and partially scalar invariant across race/ethnicity and alcohol use severity. Hispanic participants were higher on contemplation and action and Black participants were higher on action than White participants. Hazardous drinkers were lower in precontemplation and higher in contemplation and action than nonhazardous drinkers. The RCQ was scalar invariant across intervention conditions and time. Brief motivational intervention with a booster increased action from baseline to 3 month. These findings provide further support for the use of the RCQ.

A brief report of the prevalence of chronic and acute health conditions among blind American adults.

BACKGROUND: Prior research demonstrates disparities in the prevalence of certain chronic and acute health conditions among persons who are blind (PWB) compared to non-blind persons, such as diabetes and infectious diseases. However, a comprehensive understanding of the prevalence of chronic and acute health conditions among PWB is currently lacking. OBJECTIVE: The present study addressed this gap by examining the prevalence of chronic and acute conditions among blind persons, and examining differences by gender. METHODS: The present study surveyed 410 PWB residing in the U.S. about their health conditions and activities. Lifetime prevalence for eight chronic and six acute health conditions were estimated separately for men and women. Engagement in physical activity, regular use of medication, and satisfaction with health were also estimated. RESULTS: We found that men more often reported their health conditions interfered with daily activities compared to women, as well as higher prevalence of stroke and arthritis compared to women. CONCLUSION: The current study contributes information that is vital to understanding the burden of specific health conditions on this population and necessary to understand the extent to which this burden disproportionately affects PWB.

Seeking Health Information and Social Support in the Diabetes Online Community.

Purpose: People with type 1 diabetes (T1D) search for health information online in the Diabetes Online Community (DOC), where individuals with diabetes, researchers and caregivers post and respond to health questions. The aims of this study were 1) to understand how people with T1D are seeking health information and engaging in health behaviors in the DOC, and 2) develop a measure of online health information seeking in adults with T1D. Research Method: Ninety-five adults with T1D completed qualitative prompts online. Results: Themes that emerged in this study included sense of community, and multiple types of social support that are necessary in disease management. Conclusions: This study used qualitative methods to develop a valid scale tailored for adults with T1D. Future research should seek to collect additional data to bolster validity and reliability.

The psychometric properties of a version of the Treatment Self-Regulation Questionnaire for assessing motivations for responsible drinking.

OBJECTIVE: The aim of the present studies was to provide a psychometric evaluation of a version of the Treatment Self-Regulation Questionnaire (TSRQ) for assessing motivations derived from self-determination theory for responsible drinking among college students. Methods: A convenience sample of 308 college student drinkers (71.7% female) were recruited for Study 1 and a random sample of 192 college student drinkers (58.9% female) were recruited for Study 2. Participants completed the TSRQ and other self-report measures in both studies. Results: In Study 1, confirmatory factor analyses supported a revised four-factor structure of the TSRQ. In Study 2, correlation analyses generally provided support for the concurrent validity of the TSRQ subscales. Conclusion: The present studies provide some initial support for the TSRQ for assessing motivations for responsible drinking. Directions for future research and implications of a measure for assessing motivations for responsible drinking among college students are discussed.

Perspectives of Interactions with Healthcare Providers Among Patients Who Are Blind.

Healthcare providers' (HCPs) stereotypes about the incompetence of blind and low-vision patients may lead them to patronize blind patients, over-focus on impairments, and neglect the presenting problem. The content of perceived HCP stereotypes about blind patients in the clinical setting was examined from the patient perspective with seven focus groups, including a total of 42 individual participants. Most participants reported an interaction when their HCPs treated them as if they were incompetent, and discussed how perceived evaluations of their warmth and competence impacted whether their HCPs trusted and respected them. Participants also discussed their evaluations of their HCPs' warmth and competence, and how these evaluations impacted their trust and respect for the HCP. These results provide insight into blind patients' experiences interacting with their HCPs and can inform interventions to 1) help HCPs avoid stereotypic attitudes and 2) improve HCPs' comfort and abilities when working with patient with disabilities.

Factor, Concurrent and Predictive Validity of the Readiness to Change Questionnaire [Treatment Version] Among Non-Treatment-Seeking Individuals.

AIMS: This study assessed the factor, concurrent and predictive validity of the revised Readiness to Change Questionnaire [Treatment Version] (RCQ[TV]) among non-treatment-seeking individuals. METHODS: Non-treatment-seeking patients (Mage = 34.8, SD = 12.4) who screened positive for alcohol misuse were recruited from three urban Level I Trauma Centers and completed the RCQ[TV] (Heather et al. [(1999) Development of a treatment version of the Readiness to Change Questionnaire. Addict Res7, 63-83]). RESULTS: A confirmatory factor analysis supported the three-factor structure of the RCQ[TV]. Observed scores for precontemplation, contemplation and action demonstrated concurrent validity, as they were correlated with drinking and alcohol-related problems prior to baseline assessment. Finally, RCQ[TV] scores at baseline added to the predictability of an alcohol consumption composite score at a 3-month follow-up after controlling for baseline alcohol consumption and randomization to treatment arm. CONCLUSIONS: The results of the present study suggest that the RCQ[TV] has desirable psychometric properties and supports the use of the RCQ[TV] among non-treatment-seeking patients with alcohol misuse.

Developing a measure of blind patients' interactions with their healthcare providers.

BACKGROUND: People who are blind (PWB) are often perceived as being incompetent with common tasks and functions. When patients detect that their healthcare providers (HCPs) have negative perceptions of them, they often report less satisfaction with their healthcare and disengage in their own healthcare. OBJECTIVE: A scale assessing the experiences of PWB interacting with HCPs was developed and validated across two studies. METHODS: In Study 1, 144 participants completed the scale and provided feedback. In Study 2, 214 participants completed the scale and 4 additional scales to assess construct validity. RESULTS: An exploratory factor analysis in Study 1 revealed a two-factor model consisting of General Quality of Health Care (30.5% variance explained) and Stereotype Content-related items (9.4% variance explained). Study 2 confirmed and validated this two-factor structure (RMSEA (90% CI) = 0.068 (0.057, 0.079), CFI = 0.898, SRMR = 0.066, AIC = 14568.902). CONCLUSIONS: This scale is one of the first tools developed from the perspectives of PWB. Results from these studies highlight and elaborate on how PWB perceive that they are viewed by their HCPs in terms of competence and how they perceive to be treated by these HCPs. This scale can be used in training HCPs to better serve their patients with disabilities.

Protective behavioral strategies predict alcohol-related problems among injured patients following a brief intervention.

BACKGROUND: Alcohol protective behavioral strategies (PBS) have been proposed as mechanisms of change underlying interventions for reducing alcohol use and alcohol-related problems. Few studies have examined PBS use among non-college student populations and no study has examined PBS use among adult injured patients. The current study tested types of PBS as mediators of the effects of a brief motivational intervention (BMI) delivered in the trauma care setting on alcohol-related problems. METHOD: Secondary data analyses were conducted using data from a multisite randomized controlled trial of brief intervention in the trauma care setting. The current study used data from a subset of participants who reported having consumed alcohol at least once at 3-month follow-up (N = 324). Following a baseline assessment, participants were assigned to either brief advice (BA; n = 107), BMI (n = 119), or BMI with a telephone booster (BMI + B; n = 98). Participants completed measures of PBS at 3-month follow-up and of alcohol-related problems at baseline and 6-month follow-up. A multiple mediation model was conducted to simultaneously test the mediation effects of types of PBS. RESULTS: BMI and BMI + B relative to BA did not increase PBS use. However, more frequent use of certain types of PBS at 3-month follow-up were predictors of greater reductions in alcohol-related problems from baseline to 6-month follow-up. There were no statistically significant mediation effects. CONCLUSIONS: The present study suggests that PBS use reduces alcohol-related problems among trauma patients and implications for future studies are discussed.

Brief Intervention Among Mexican-Origin Young Adults in the Emergency Department at the USA-Mexico Border: Examining the Role of Patient's Preferred Language of Intervention in Predicting Drinking Outcomes.

AIMS: Determine if the language in which brief intervention (BI) is delivered influences drinking outcomes among Mexican-origin young adults in the emergency department when controlling for ethnic matching. SHORT SUMMARY: Aim of study was to determine if a patient's preferred language of intervention influences drinking outcomes among Mexican-origin young adults in the emergency department. Results indicate no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. METHODS: This is a secondary data analysis on data from 310 patients randomized to receive a BI completed in Spanish (BI-S) or English (BI-E), with 3- and 12-month follow-up. Outcome measures of interest were drinking days per week, drinks per drinking day, maximum drinks in a day and negative consequences of drinking. RESULTS: There were no significant differences in drinking outcomes among those who received BI in Spanish and BI in English. CONCLUSIONS: Reduced drinking outcomes following BI among Mexican-origin young adults in the emergency department may not have been due to the language used to deliver intervention. Thus, our results provide evidence that language of intervention is not a crucial factor to achieve cultural congruence. In addition, our findings suggest that receiving the intervention is beneficial regardless of language, thus, facilitating real-world implementation.

A psychometric evaluation of the Protective Behavioral Strategies Scale-20 among internet samples of adult drinkers.

Protective behavioral strategies (PBS) are most commonly defined as behaviors that are used while drinking to reduce alcohol use and/or limit alcohol-related problems. Few studies have examined and quantified PBS use among non-college student populations. The purpose of the present two studies was to evaluate the psychometric properties of the Protective Behavioral Strategies Scale-20 (PBSS-20; Treloar, Martens, & McCarthy, 2015) among internet samples of adult drinkers. In the first study, we conducted an exploratory factor analysis of the PBSS-20 with a sample (n = 360) of adult drinkers who were recruited from Mechanical Turk. We then conducted a second study that recruited adult drinkers from Mechanical Turk and randomly split the data in half. With the first split-half sample (n = 339), we conducted a confirmatory factor analysis of the PBSS-20 and assessed the internal consistency and concurrent validity of the subscales. With the second split-half sample (n = 338), we tested measurement invariance across gender. The results support a three-factor structure of the PBSS-20 that is similar to what has been found among college students. However, six items were dropped and two Serious Harm Reduction items loaded best onto the Manner of Drinking factor. Furthermore, two subscales demonstrated adequate internal consistency and all three subscale were negatively associated with alcohol-related outcomes. Similar to college students, there was lack of measurement invariance across gender. We discuss the implications of the present findings in extending research on PBS to the more general population of U.S. adult drinkers.

Healthcare Use and Mammography Among Latinas With and Without Health Insurance Near the US-Mexico Border.

INTRODUCTION: Among Latinas, lacking health insurance and having lower levels of acculturation are associated with disparities in mammography screening. OBJECTIVE: We seek to investigate whether differences in lifetime mammography exist between Latina border residents by health insurance status and health care site (i.e., U.S. only or a combination of U.S. and Mexican health care). METHODS: Using data from the 2009 to 2010 Ecological Household Study on Latino Border Residents, mammography screening was examined among (n = 304) Latinas >40 years old. RESULTS: While more acculturated women were significantly (p < .05) more likely to report ever having a mammogram than less acculturated women, ever having a mammogram was not predicted by health care site or insurance status. CONCLUSION: Latinas who utilize multiple systems of care have lower levels of acculturation and health insurance, thus representing an especially vulnerable population for experiencing disparities in mammography screening.

BUILDing SCHOLARS: enhancing diversity among U.S. biomedical researchers in the Southwest.

BACKGROUND AND PURPOSE: With funding from the National Institutes of Health, BUILDing SCHOLARS was established at The University of Texas at El Paso with the goal of implementing, evaluating and sustaining a suite of institutional, faculty and student development interventions in order to train the next generation of biomedical researchers from the U.S. Southwest region, where the need is dire among underserved communities. The focus is on supporting the infrastructure necessary to train and mentor students so they persist on pathways across a range of biomedical research fields. The purpose of this article is to highlight the design and implementation of BUILDing SCHOLARS' key interventions, which offer a systemic student training model for the U.S. Southwest. In-depth reporting of evaluation results is reserved for other technical publications. PROGRAM AND KEY HIGHLIGHTS: BUILDing SCHOLARS uses a comprehensive regional approach to undergraduate training through a multi-institution consortium that includes 12 research partners and various pipeline partners across Texas, New Mexico, and Arizona. Through faculty collaborations and undergraduate research training, the program integrates social and behavioral sciences and biomedical engineering while emphasizing seven transdisciplinary nodes of biomedical research excellence that are common across partner institutions: addiction, cancer, degenerative and chronic diseases, environmental health, health disparities, infectious diseases, and translational biomedicine. Key interventions aim to: (1) improve institutional capacities by expanding undergraduate research training infrastructures; (2) develop an intra- and cross-institutional mentoring-driven "community of practice" to support undergraduate student researchers; (3) broaden the pool of student participants, improve retention, and increase matriculation into competitive graduate programs; and (4) support faculty and postdoctoral personnel by training them in research pedagogy and mentoring techniques and providing them with resources for increasing their research productivity. Student training activities focus on early interventions to maximize retention and on enabling students to overcome common barriers by addressing their educational endowments, science socialization, network development, family expectations, and material resources. Over the long term, BUILDing SCHOLARS will help increase the diversity of the biomedical research workforce in the U.S. by meeting the needs of students from the Southwest region and by serving as a model for other institutions.

Undergraduate Research Participation Is Associated With Improved Student Outcomes at a Hispanic-Serving Institution.

Few scholars have comprehensively examined benefits of undergraduate research (UGR) participation for students at an institution campus-wide. In this study we examined benefits of UGR participation at a Hispanic-majority institution using National Survey of Student Engagement data. Generalized estimating equations were used to examine the influence of UGR participation on 5 student outcomes: gains in knowledge and skills, institutional support, overall satisfaction, grade point average, and student-faculty interaction. Results indicate that UGR participation is a robust positive predictor of all 5 outcomes. We provide insights into strategies for enhancing the beneficial impacts of UGR participation, especially for students from underrepresented groups.

Factors Influencing Student Gains from Undergraduate Research Experiences at a Hispanic-Serving Institution.

Undergraduate research experiences (UREs) confer many benefits to students, including improved self-confidence, better communication skills, and an increased likelihood of pursuing science careers. Additionally, UREs may be particularly important for racial/ethnic minority students who are underrepresented in the science workforce. We examined factors hypothetically relevant to underrepresented minority student gains from UREs at a Hispanic-serving institution, such as mentoring quality, family income, being Latino/a, and caring for dependents. Data came from a 2013 survey of University of Texas at El Paso students engaged in 10 URE programs (n = 227). Using generalized linear models (GzLMs) and adjusting for known covariates, we found that students who reported receiving higher-quality mentorship, spending more hours caring for dependents, and receiving more programmatic resources experienced significantly greater gains from their URE in all three areas we examined (i.e., thinking and working like a scientist, personal gains, and gains in skills). In two of three areas, duration of the URE was positive and significant. Being Latino/a was positive and significant only in the model predicting personal gains. Across the three models, quality of mentorship was the most important correlate of gains. This suggests that providing training to faculty mentors involved in UREs may improve student outcomes and increase program efficacy.

Coefficient α as a Measure of Test Score Reliability: Review of 3 Popular Misconceptions.

We discuss 3 popular misconceptions about Cronbach α or coefficient α, traditionally used in public health and the behavioral sciences as an index of test score reliability. We also review several other indices of test score reliability. We encourage researchers to thoughtfully consider the nature of their data and the options when choosing an index of reliability, and to clearly communicate this choice and its implications to their audiences.