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.

Interventions for Health Promotion and Obesity Prevention for Children and Adolescents with Developmental Disabilities: a Systematic Review.

This systematic review evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities (DD). Twenty-one studies including randomized control trials (n= 9) and quasi-experimental studies (n=12) published between 2010 and 2021 met inclusion criteria related to participant characteristics, intervention type, and child obesity-related outcomes. Five types of intervention programs were identified: aerobic and strength training, sport-based physical activity, aquatic exercise, active video gaming, and diet and lifestyle. Whereas analysis of intervention outcomes, efficacy, and study rigor showed mixed results and weak evidence of effective interventions, this review identified gaps in the literature, promising strategies for addressing obesity in children with DD, and implications for practice and future research. Supplementary Information: The online version contains supplementary material available at 10.1007/s40489-022-00335-5.

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).

Associations of positive and negative affect on health risk behaviors among Latinos.

OBJECTIVE: Negative affect is widely emphasized in behavior modification interventions. However, positive affect is associated with smoking cessation, physical activity, and healthy dietary habits and may be an important treatment target. Few studies have examined the relationship between positive affect and health behaviors among Latinos, who disproportionately experience modifiable health risk behaviors. This study examined the independent associations of positive affect and negative affect on modifiable health risk behaviors among Latino adults. METHOD: Data came from 432 persons who participated in one of two studies examining determinants of modifiable health risk behaviors among Latino adults. Primary outcomes were current smoking, at-risk drinking, insufficient physical activity, and insufficient fruit and vegetable consumption. Predictors were positive and negative affect as measured by the Positive and Negative Affect Schedule. Associations between positive and negative affect and health risk behaviors were examined using multiple logistic regression. RESULTS: Positive affect was associated with lower odds of insufficient physical activity and insufficient fruit and vegetable consumption and lower odds of engaging in multiple health risk behaviors. Negative affect was associated with higher odds of at-risk drinking and current smoking. CONCLUSIONS: Emphasis on increasing positive affect may be warranted for multiple health risk behavior interventions targeting Latinos. Intervention development efforts may also consider prioritizing positive affect for physical activity and dietary interventions, and negative affect for at-drinking and smoking cessation interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Improving Spanish translations of tobacco dependence measures using cognitive interviewing.

BACKGROUND: Cognitive interviewing is the practice of systematically collecting feedback about survey items from members of the priority population, with the goal of identifying and rectifying problems to increase the comprehensibility of the survey. Evidence is limited on the extent to which this method of pretesting improves survey items. OBJECTIVE: The current study examined the utility of incorporating cognitive interviewing to improve the Spanish translations of two measures of tobacco dependence. METHODS: Items from the Spanish versions of the Wisconsin Inventory of Smoking Dependence Motives (68 items) and Nicotine Dependence Syndrome Scale (19 items) were subjected to cognitive interviews with Spanish-speaking smokers. Problematic items were revised based on participant feedback and re-assessed in a second round of interviews (N = 23, 78.3% male; 21.7% female). RESULTS: Twenty-three of the 87 items demonstrated comprehension problems, and 67 items elicited at least one problem report. Number of problems were significantly fewer pre- vs. post-revision (t [90] = 6.55, p < .001). CONCLUSIONS: In combination with standard translation procedures, cognitive interviewing with the priority population appears to be a useful method for ensuring comprehensible and relevant item content.

RESUMEN Contexto: La entrevista cognitiva es la práctica de recopilar sistemáticamente información sobre los elementos de la encuesta de los miembros de la población prioritaria, con el objetivo de identificar y rectificar problemas para aumentar la comprensibilidad de la encuesta. La literatura científica existente es limitada en la medida en que este método de pruebas preliminares mejora los elementos de la encuesta. Objetivo: El estudio actual examinó la utilidad de incorporar entrevistas cognitivas para mejorar las traducciones al español de dos medidas de dependencia del tabaco. Métodos: Los elementos de las versiones en español del Inventario de Motivos de Dependencia del Fumar de Wisconsin (68 elementos) y la Escala del Síndrome de Dependencia de Nicotina (19 elementos) fueron sometidos a entrevistas cognitivas con fumadores hispanohablantes. Los ele-mentos problemáticos se revisaron basándose en la retroalimentación de los participantes y se reevaluaron en una segunda ronda de entrevistas (N = 23, 78,3% hombres; 21,7% mujeres). Resultados: Veintitrés de los 87 elementos demostraron problemas de comprensión, y 67 elementos presentaron por lo menos un reporte de problemas. El número de problemas fue significativamente menos antes y después de la revisión (t [90] = 6,55, p < 001). Conclusión: En combinación con los procedimientos de traducción estándar, las entrevistas cogni-tivas con la población prioritaria parecen ser un método útil para garantizar un contenido com-prensible y relevante para cada elemento.

"It's embarrassing. I get angry. I get frustrated.": Understanding severe hypoglycemia and glucagon usage from the perspectives of people with type 1 diabetes.

Introduction: This study characterized the emotional impact of severe hypoglycemia, views of glucagon, and barriers to glucagon use from the perspective of adults with type 1 diabetes (T1D). Methods: Participants included individuals recruited from the T1D Exchange online community. The current study conducted 7 focus groups consisting of adults with T1D (N = 38, average age 49.4, SD = 16.11 years). Average duration of diabetes was 34.4 years (SD = 17.3) and average self-reported A1c was 6.8 % (SD = 0.7). Focus group interviews were recorded, transcribed, and thematically analyzed. Results: A range of emotions was expressed about severe hypoglycemia including fear, anxiety, stress, frustration, shame, and embarrassment. Participants frequently identified prescription cost and insurance deductibles as barriers to glucagon use. Participants were also concerned about ease of administration-how difficult it is to prepare the glucagon in an emergency. Many participants expressed a preference for auto-injectables over nasal administration. Timing of glucagon action and time to recovery were high priorities. Some participants, while they had not self-administered glucagon, were interested in a mini-dose glucagon they could self-administer. They also identified desirable characteristics of glucagon treatment including reduced cost, long shelf-life, and quick activation. Conclusions: These results highlight the attitudes about severe hypoglycemia and emergency treatment with glucagon. Healthcare professionals should assess glucagon training needs and knowledge when they meet with their patients with diabetes.

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.

The contribution of positive affect and loneliness on readiness and self-efficacy to quit smoking among Spanish-speaking Mexican American smokers.

BACKGROUND: The existing research on affective and interpersonal determinants of smoking cessation largely under-represents minority smokers, such as Latinos. OBJECTIVE: The current study examined associations between affective and interpersonal factors with intermediary smoking cessation variables among Mexican-American smokers (N = 290; 60% male). METHODS: Measures of positive and negative affect, social support, and loneliness were each examined for associations with measures of motivational readiness to quit smoking, and smoking abstinence self-efficacy. Significant predictors were entered into models simultaneously to examine their unique associations. Covariates included gender, age, and educational attainment. RESULTS: Negative affect (b = .68, SE b = .14, p < .001) and loneliness (b = .20, SE b = .09, p < .05) were independently associated with motivation. Negative affect (b = .20, SE b = .06, p < .01) and positive affect (b = .34 SE b = .07, p < .001) were independently associated with self-efficacy. In the final models, only negative affect was associated with motivation (b = .68, SE b = .17, p < .001); whereas negative (b = .17, SE b = .06, p < .01) and positive (b = . 32, SE b = .07, p < .001) affect were associated with self-efficacy. CONCLUSION: Results highlight the importance of resilience factors (e.g., positive affect) among Mexican-American smokers. Cessation interventions regularly target negative affect among smokers; additional focus on positive affect in cessation interventions with this population may be warranted.

Visual Impairment and Self-Efficacy in Diabetes Management.

PURPOSE: The purpose of this study is to examine the relationship between visual impairment and diabetes management self-efficacy. METHODS: The present study utilized pooled cross-sectional data (2008-2018) from the Medical Expenditure Panel Survey Household Component and Diabetes Care Survey. Binary and generalized ordinal logit regression models were used to compare diabetes management self-efficacy between patients with and without visual impairments. RESULTS: Compared to their non-visually impaired counterparts, visually impaired persons had a lower odds of reporting high diabetes management self-efficacy. Similarly, visually impaired adults with diabetes have a significantly lower odds of being very confident in their ability to manage their conditions compared with adults who reported being not confident, somewhat confident, or confident. Several control factors, including self-behaviors and receipt of diabetes self-management education (DSME), were also associated with diabetes management self-efficacy. CONCLUSIONS: Visually impaired persons experience significant disparities in diabetes management self-efficacy. Given the relationship between self-efficacy and diabetes-related outcomes, it is crucial that DSME be tailored to effectively meet the individual needs of this population. Future research should explore the relationship between DSME and self-care behaviors, self-efficacy, and diabetes-related outcomes in visually impaired persons.

Impact of COVID-19 on the Mental Health and Well-Being of Latinx Caregivers of Children with Intellectual and Developmental Disabilities.

The COVID-19 pandemic has impacted the entire world in unprecedented ways. However, populations that have had a history of marginalization have experienced a more profound impact. One such group is Latinx families of children with intellectual and developmental disabilities (IDD) in the Unites States. In this study, we used a mixed methods approach to explore the impact of the pandemic on the mental health and well-being of Latinx caregivers of children with IDD. Specifically, we (1) identified which social determinants of health are correlated with maternal caregivers perceived general health, mental health, and well-being; (2) explored the impact of the pandemic on families' overall eating and physical activity routines; and (3) identified emergent themes from caregivers' experiences during the pandemic. Thirty-seven Latinx caregivers participated in three interviews in which several validated instruments were administered. The results indicated that perceived social support, annual family income, food security, and receipt of financial benefits were correlated with fewer depressive symptoms. Annual family income was also significantly correlated with perceived general health. Most caregivers reported that the pandemic had placed a strain on their economic situation; increased their isolation; and disrupted their child's therapeutic supports, online education, eating routines, and engagement in physical activity. Meanwhile, some caregivers reported positive changes as a result of the pandemic. Implications for future research and practice are discussed.

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.

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.

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.

Recall and response time norms for English-Swahili word pairs and facts about Kenya.

In the vast literature exploring learning, many studies have used paired-associate stimuli, despite the fact that real-world learning involves many different types of information. One of the most popular materials used in studies of learning has been a set of Swahili-English word pairs for which Nelson and Dunlosky (Memory 2; 325-335, 1994) published recall norms two decades ago. These norms involved use of the Swahili words as cues to facilitate recall of the English translation. It is unclear whether cueing in the opposite direction (from English to Swahili) would lead to symmetric recall performance. Bilingual research has suggested that translation in these two different directions involves asymmetric links that may differentially impact recall performance, depending on which language is used as the cue (Kroll & Stewart, Journal of Memory and Language 33; 149-174,1994). Moreover, the norms for these and many other learning stimuli have typically been gathered from college students. In the present study, we report recall accuracy and response time norms for Swahili words when they are cued by their English translations. We also report norms for a companion set of fact stimuli that may be used along with the Swahili-English word pairs to assess learning on a broader scale across different stimulus materials. Data were collected using Amazon's Mechanical Turk to establish a sample that was diverse in both age and ethnicity. These different, but related, stimulus sets will be applicable to studies of learning, metacognition, and memory in diverse samples.