Social desirability, dietary intakes, and variables related to attitudes and behaviours towards eating among French-speaking adults from Quebec, Canada: The PREDISE study.

The primary objective of this study was to examine how social desirability is associated with self-reported measures of dietary intakes and variables related to attitudes and behaviours towards eating. This analysis was conducted in 1083 adults (50.0% women) from the PREDISE study. Social desirability was assessed using the Balanced Inventory of Desirable Responding (BIDR) questionnaire, which includes two subscales: (1) self-deceptive enhancement (SDE), i.e., having an overly positive self-image and (2) impression management (IM), i.e., intentional response distortion to please. BIDR total score and IM subscore were positively associated with the Canadian Healthy Eating Index (C-HEI) (ß = 0.24 and ß = 0.50; p ≤ 0.0003), calculated using data from three self-administered 24 h food recalls. All BIDR scores were positively associated with self-determined motivation for eating regulation (0.03 ≤ ß ≤ 0.06; p < 0.0001), measured by the Regulation of Eating Behavior Scale, and with the intuitive eating score (0.02 ≤ ß ≤ 0.05; p < 0.0001). Also, all BIDR scores were negatively associated with hunger and disinhibition scores measured by the Three-Factor Eating Questionnaire (-0.17 ≤ ß ≤ -0.09; p < 0.0001). All these associations were adjusted for age, sex, BMI, and the education level. Furthermore, controlling for both dimensions of social desirability did not impact the magnitude of the association between self-determined motivation (the strongest predictor of healthy eating in the PREDISE study) and C-HEI. According to our results, associations are observed with diet quality, as well as with attitudes and behaviours towards eating; therefore, a measurement of social desirability responding would be pertinent in studies using those or related variables.

Standardizing Nurse Transition to Practice: An Infrastructure to Support Nursing Excellence.

Nurse residency programs (NRPs) require effective structures and processes to ensure achievement of desired outcomes, including program accreditation, newly licensed nurse retention, and a healthy nursing workforce for the future. A healthcare system created strategic positions of director of nursing workforce transitions and nursing workforce professional development specialists to standardize an NRP across six hospitals and to achieve Practice Transition Accreditation Program accreditation. The positions provide a strong infrastructure to optimize nurse transition to practice.

Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes.

This article focuses on applying the patient empowerment, engagement, and activation (PEEA) model as an implementation strategy to achieve patient- or person-centered care. There is substantial evidence linking PEEA to improved patient care outcomes and reduced healthcare costs. Interrelationships among the 3 concepts are discussed and how the PEEA survey can be used to evaluate patients' activation for self-care postdischarge and their perceptions of nurses' empowering and engaging them during the care encounter.

The Impact of Two Telerehabilitation Supervision Schedules on Physical Activity, Mobility, and Balance Among People with Moderate to Severe Traumatic Brain Injury: A Mixed-Method Single-Subject Design.

Background: Many individuals who experience a moderate or severe traumatic brain injury (TBI) have long-term deficits in physical activity, balance, and mobility requiring specialized care. New delivery models are being investigated for interventions to address challenges caused by living in remote communities, difficulties with transportation, and/or physical distancing requirements. Determining the effectiveness of telerehabilitation is critical given the current movement toward remote health care delivery. Objective: We investigated the effectiveness of two teletherapy supervision schedules used to deliver a home-based, intensive exercise programme on 1) physical activity, mobility, balance, participation, and 2) concerns with falling, and satisfaction with life. Methods: A mixed methods approach with alternating single subject design (SSD) and interviews was used. Five individuals who experienced a moderate or severe TBI completed two intensive home-based telerehabilitation programmes. Programmes differed only by supervision schedule - daily or weekly. Impacts on objective and patient-reported outcomes were measured. Results: Four individuals demonstrated clinically significant improvements in physical activity level, balance, and mobility. One individual experienced less concerns with falling after both schedules, while two other individuals showed a trend in that direction after the weekly remote supervision. Important functional gains (i.e., improved balance and decreased fatigue) were also perceived and reported by family partners regardless of supervision schedule. Conclusion: Although the study has limitations, the findings indicate that exercise programmes delivered via telerehabilitation can improve balance and mobility as well as positively affect concerns with falling and physical activity levels for this population. No clear differences were seen between the two telerehabilitation supervision schedules.

Historique : de nombreuses personnes qui sont victimes d'un traumatisme crânien (TC) modéré ou grave ont des déficits à long terme en matière d'activité physique, d'équilibre et de mobilité et doivent recevoir des soins spécialisés. De nouveaux modèles de prestation sont en cours d'étude afin que les interventions relèvent les problèmes liés à la vie en région éloignée, au transport ou à la distanciation physique. Il est essentiel de déterminer l'efficacité de la téléréadaptation en raison du mouvement actuel vers la prestation des soins à distance. Objectif : examiner l'efficacité de deux horaires de supervision de la téléthérapie utilisés pour fournir un programme d'exercice intensif à domicile sur 1) l'activité physique, la mobilité, l'équilibre et la participation et 2) les craintes de chutes et la satisfaction de vivre. Méthodologie : méthodologie mixte faisant appel à une alternance entre la méthodologie individuelle et les entrevues. Cinq personnes qui avaient été victimes d'un TC modéré ou grave ont suivi deux programmes intensifs de téléréadaptation à domicile. Les programmes différaient seulement en fonction de l'horaire de supervision, qui était quotidien ou hebdomadaire. Les chercheurs ont mesuré les répercussions sur les résultats cliniques objectifs et déclarés par les patients. Résultats : quatre personnes ont démontré des améliorations cliniquement significatives au taux d'activité physique, à l'équilibre et à la mobilité. Une personne craignait moins les chutes après les deux programmes tandis que les deux autres ressentaient une tendance dans cette direction après la supervision hebdomadaire à distance. Des gains fonctionnels importants (amélioration de l'équilibre et diminution de la fatigue) étaient également perçus et déclarés par les partenaires familiaux, quel que soit l'horaire de supervision. Conclusion : même si l'étude comporte des limites, les observations indiquent que les programmes d'exercices donnés en téléréadaptation peuvent améliorer l'équilibre et la mobilité et avoir des effets positifs sur les craintes de tomber et les taux d'activité physique dans cette population. Il n'y avait pas de différences évidentes entre les deux horaires de supervision de la téléréadaptation.

Remotely Supervised Exercise Programmes to Improve Balance, Mobility, and Activity Among People with Moderate to Severe Traumatic Brain Injury: Description and Feasibility.

Purpose: Further investigation into the feasibility of using videoconferencing and activity tracking devices to provide high-intensity home-based exercise programmes for people with a moderate or severe traumatic brain injury (TBI) is needed to inform clinical implementation and patient adoption. This study aimed to (1) determine if home-based telerehabilitation exercise programmes were feasible for people with a moderate or severe TBI and (2) better understand the lived experience of people with a TBI and their family partners with this programme. Methods: A mixed-methods approach consisting of measures of feasibility and semi-structured interviews was used. Five participants with moderate to severe TBI and their family partners completed two high-intensity home-based exercise programmes delivered remotely by a physiotherapist (i.e., daily and weekly). Results: Telerehabilitation services in home-based settings were feasible for this population. Adherence and engagement were high. Dyads were satisfied with the use of technology to deliver physiotherapy sessions. Conclusion: Telerehabilitation provides a delivery option that allows people with TBI to spend energy on therapy rather than on travelling. A pre-programme training on key components, such as the use of technology, safety precautions, and communication methods, likely improved the overall feasibility. Further research is needed to better understand the effectiveness of such a programme on balance, mobility, and physical activity levels.

Objectif : des recherches plus approfondies s'imposent sur la faisabilité d'utiliser les visioconférences et les dispositifs de suivi des activités pour fournir des programmes d'exercices à domicile à haute intensité aux personnes atteintes d'un traumatisme crânien (TC) modéré à grave qui éclaireront la mise en œuvre clinique et l'adoption par le patient. Cette étude visait à 1) déterminer s'il était faisable d'offrir des programmes d'exercices en téléréadaptation à domicile pour les personnes atteintes d'un TC modéré à grave et 2) mieux comprendre l'expérience vécue des personnes atteintes d'un TC et de leurs partenaires familiaux au sein de ce programme. Méthodologie : les chercheurs ont utilisé une approche mixte composée de mesures de faisabilité et d'entrevues semi-structurées. Cinq participants atteints d'un TC modéré à grave et leurs partenaires familiaux ont effectué deux programmes d'exercices à domicile à haute intensité donnés à distance par un physiothérapeute (quotidiennement et hebdomadairement). Résultats : les services de téléréadaptation à domicile étaient faisables pour cette population. L'adhésion et la participation étaient élevées. Les dyades étaient satisfaites par l'utilisation de la technologie pour la prestation des séances de physiothérapie. Conclusion : la téléréadaptation fournit un mode de prestation qui permet aux personnes atteintes d'un TC à consacrer leur énergie au traitement plutôt qu'aux déplacements. Une formation avant le programme portant sur les principaux éléments, tels que le recours à la technologie, les mesures de précaution et les modes de communication, améliorait probablement la faisabilité globale. D'autres recherches seront réalisées pour mieux comprendre l'efficacité de ce programme sur l'équilibre, la mobilité et les taux d'activité physique.

Automaticity mediates the association between action planning and physical activity, especially when autonomous motivation is high.

OBJECTIVES: Action planning promotes physical activity (PA). However, mechanisms underlying this association are poorly understood, as are the variables that moderate this link remain unexplored. To fill these gaps, we investigated whether automaticity mediated the association between action planning and PA, and whether autonomous motivation moderated this mediation. METHODS AND MEASURES: PA was measured by accelerometry over seven days among a sample of 124 adults. Action planning, automaticity, and autonomous motivation were assessed by questionnaires. RESULTS: Structural equation models revealed that automaticity mediated the association between action planning and PA (total effect, ß = .29, p < .001) - action planning was associated with automaticity (a path, ß = .47, p < .001), which in turn related to PA (b path, ß = .33, p = .003). Autonomous motivation moderated the a path (ß = .16, p = .035) - action planning was more strongly associated with automaticity when autonomous motivation was high (+1 standard-deviation [SD]) (unstandardized b = 0.77, p < .001) versus low (-1 SD) (b = 0.35, p = .023). CONCLUSION: These findings not only support that action planning favors an automatic behavioral regulation, but also highlight that a high autonomous motivation toward PA may reinforce this mechanism.

Characterizing variability in total mercury hair:blood ratio in the general Canadian population.

BACKGROUND/OBJECTIVES: The body burden of mercury in humans can be measured through hair or blood biomarkers. To compare results from different studies, it is often required to convert mercury in hair to an equivalent level in blood, using a default hair:blood ratio of 250:1 by the World Health Organization (WHO). However, the actual ratio may vary within and between populations. The objectives of this study were to analyze the hair:blood mercury ratio in the general Canadian population, explore factors associated with higher/lower ratios, and determine if the standard ratio of 250:1 is supported. METHODS: The Canadian Health Measures Survey (CHMS) Cycle 5 (2016-2017) measured total mercury (THg) in both hair and blood of 1168 participants 20-59 years of age. We calculated geometric mean (GM) concentrations of THg for this entire sample and subgroups. The subgroups included biological sex, women of childbearing age, race, hair treatments, categories of blood and hair selenium, urinary arsenobetaine/arsenocholine, categories of blood and hair mercury, and food consumption. We calculated a hair:blood ratio for each participant and determined population-level ratios from the GMs of the distributions. Differences by subgroups, and agreement with the WHO ratio of 250:1, were tested. The combined effect of factors on the THg hair:blood ratio was explored using staged regression analysis. RESULTS: For participants with paired hair and blood mercury measurements, the GM of the hair:blood THg ratio was 293 (95%CI:273-316), and significantly >250. In women of childbearing age, the ratio did not differ from 250. The GMs of the ratio were higher (i.e.>300) for second tertile blood selenium (365, 95%CI:307-433), third and fourth quartiles hair mercury (347, 95%CI:308-390 and 376, 95%CI:336-422), and consumers of shellfish (338, 95%CI:308-371). Shellfish consumption was the only statistically significant factor associated with the hair:blood ratio as identified in the regression model. CONCLUSIONS: The mean hair:blood THg ratio among Canadians generally exceeded the default ratio of 250:1. Higher ratios were observed in certain subgroups, such as seafood consumers, and shellfish consumption was the most important variable associated with the ratio. Our results suggest that population-specific hair:blood THg ratios be considered, if possible, when converting mercury levels from hair to blood to better characterize the variation around the conversion.

A physiotherapist's perception of their own behavior compared to the perception of their behavior by persons with TBI within the context of telerehabilitation: A self-determination theory perspective.

BACKGROUND: According to Self-Determination Theory, the fulfillment of basic psychological needs of autonomy, competence, and relatedness plays an important role in one's motivation, engagement, and well-being. How a therapist is perceived to support or thwart these needs can impact adherence to treatment, thus influencing the effectiveness of therapeutic interventions. OBJECTIVES: This alternating single-subject design explores how the physiotherapist self-reports interpersonal behaviors, how the person living with a disability (PwD) perceives the physiotherapist's supportive/thwarting interpersonal behaviors, and how the two align in the context of telerehabilitation. METHODS: Five PwD and their physiotherapist completed two telerehabilitation exercise programs. The PwD completed the Interpersonal Behavior Questionnaire (IBQ) to examine how they perceived the physiotherapist interpersonal behaviors. The physiotherapist completed the Interpersonal Behavior Questionnaire-Self (IBQ-Self) to document how they self-reported these same behaviors. Descriptive statistics were used to document self-reports and perceptions of behaviors. RESULTS: Each PwD perceived the physiotherapist as being more supportive than thwarting. The supportive/thwarting behaviors varied across relationships. Greater alignment of the perceptions of therapist and the PwD was observed at the end of the programme when compared to baseline. CONCLUSION: Assessing how therapist support/thwart psychological needs and how these behaviors are perceived by PwD is recommended as it may influence the therapist's behavior and the PwD's adherence to future telerehabilitation exercise programs.

An Examination of Mentors' Interpersonal Behaviors and Mentees' Motivation, Turnover Intentions, Engagement, and Well-Being.

Using self-determination theory among a sample of student employees, the present cross-sectional study (N = 358) examines how mentors' interpersonal behaviors relate to both motivation at work and motivation for a mentoring relationship and how these two contexts of motivation can differentially relate to mentees' work outcomes. Results revealed that mentors' need-supportive interpersonal behaviors were associated with greater autonomous motivation at work and in the mentoring relationship and, in turn, to greater well-being and work engagement, and to lower turnover intentions. In contrast, need-thwarting interpersonal behaviors were associated with greater controlled motivation at work and in the mentoring relationship and, in turn, to lower well-being and work engagement, and to greater turnover intentions. Overall, this study illustrates the impact of the mentor-mentee relationship on motivation for work and for the mentoring relationship and provided support for the contribution of both motivational contexts in the work-related outcomes of employees in the workplace.

Family members and peers' negative and positive body talk: How they relate to adolescent girls' body talk and eating disorder attitudes.

Research examining the interpersonal correlates of body talk has primarily focused on the negative consequences of perceiving fat talk on women's own body talk and eating behaviours; however, little is known about the correlates and effects of positive body talk. This study examined the associations between perceived family and peer negative and positive body talk and adolescent girls' body talk and eating disorder attitudes, and the mediating role of adolescents' fear of negative evaluation and self-compassion in these relationships. Influences of family members and peers were compared to examine the uniformity of these interpersonal processes. Adolescent girls (N = 331, M age = 15.7, SD = 1.0) completed a survey. Path analysis models suggested that in the peer and family models, perceived negative body talk was associated with more self-related negative talk through fear of negative evaluation and lower self-compassion, whereas perceived positive body talk was associated with more self-related positive talk through self-compassion. Additionally, adolescents' fear of negative evaluation and self-related negative talk were mediators between perceived negative body talk and eating disorder attitudes. Results suggest that negative and positive body talk are cultivated interpersonally by increasing evaluative concerns and decreasing self-compassion.

A 1-Year Accredited Nurse Residency Program's Effect on Intent to Leave.

OBJECTIVE: This article describes the evaluation of a system-wide program to enhance new graduate nurse resident (NGNR) experience, enculturation, and commitment to the organization. BACKGROUND: Structured nurse residency programs support NGNR transition to the work environment and increase retention and organizational commitment. METHODS: The study used a descriptive, comparative design measuring NGNR perceptions of affective commitment, job satisfaction, job stress, and other variables over 3 times from baseline to 24 months. RESULTS: Findings demonstrated a reduction in affective commitment and an increase in nursing stress from baseline to 12 and 24 months of employment. The highest mean in intent to leave occurred at 12 months, highlighting the vulnerability of the NGNR at that time. CONCLUSIONS: Nurse leaders must consider resources supporting NGNRs beyond the traditional 12 months to ensure retention and organizational commitment, thereby decreasing intent to leave.

Individuals with self-determined motivation for eating have better overall diet quality: Results from the PREDISE study.

The study aimed at documenting motivational orientations for the regulation of eating as defined by self-determination theory and their association with sociodemographic characteristics and overall diet quality. As part of the PREDISE study, French-speaking women (n = 550) and men (n = 547), aged 18-65 years, living in the Province of Québec, Canada, completed online validated questionnaires. The Regulation of Eating Behavior Scale, based on the self-determination theory, assessed self-determined and non-self-determined motivation to regulate one's eating behavior. Three web-based 24-h food recalls were completed and used to compute the Canadian Healthy Eating Index 2007 (C-HEI), an indicator of the overall adherence to Canadian guidelines for healthy eating. Multiple linear regressions were performed to assess how regulation styles are associated with the C-HEI. Model 1 included no covariate, model 2 included sociodemographic covariates, and fully adjusted model 3 included as covariates sociodemographic variables as well as variables that were previously associated with diet quality, namely nutrition knowledge and social support for healthy eating. Women (p < 0.0001), older individuals (p = 0.0002), those with a higher education level (p < 0.0001), and non-smokers (p < 0.0001) reported higher self-determined motivation score than their counterparts. Self-determined motivation was positively (model 1: B = 4.67, p < 0.0001; model 2: B = 3.82, p < 0.0001; model 3: B = 3.61, p < 0.0001) and non-self-determined motivation was negatively (model 1: B = -1.62, p = 0.0009; model 2: B = -1.63, p = 0.0006; model 2: B = -1.49, p = 0.0022) associated with C-HEI. The present study suggests that some subgroups of the general adult population show more self-determined motivation for eating, which is associated with a better diet quality independently of individual characteristics and other individual and social determinants of healthy eating. Strategies to help individuals internalize the regulation of eating should be further investigated.

Associations Between Nutrition Knowledge and Overall Diet Quality: The Moderating Role of Sociodemographic Characteristics-Results From the PREDISE Study.

PURPOSE: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. DESIGN: Cross-sectional web-based study. PARTICIPANTS: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. SUBJECTS: A probability sample of 1092 participants (50% female). MEASURES: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. ANALYSIS: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. RESULTS: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI (P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: -0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association (P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). CONCLUSION: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.

Trainer-exerciser relationship: The congruency effect on exerciser psychological needs using response surface analysis.

Perceptions of fitness trainers' need-supportive and need-thwarting behaviors have been shown to impact exercisers' psychological need satisfaction and frustration. Currently, it is unknown whether an agreement or disagreement between exercisers' and fitness trainers' reported perceptions of these behaviors leads to the satisfaction and/or frustration of psychological needs. Based on self-determination theory, the present study examined the effect of congruency between fitness trainers' and exercisers' perceptions of need-supportive and need-thwarting interpersonal behaviors on basic psychological need satisfaction and frustration. A sample of 130 fitness trainers (43 females; Mage  = 31.58 ± 7.65) and a total of 640 gym exercisers (350 females; Mage  = 34.23 ± 11.59) participated in this study. Findings suggested that the majority of fitness trainers tended to over-report their use of need-supportive behavior and under-report their need-thwarting behaviors. Results showed that when there was congruency between fitness trainers' reported use and exercisers' perception of interpersonal behaviors, basic need satisfaction tended to increase. This effect was greater for exercisers that rated their respective fitness trainer high on relatedness support. Fitness trainers should be self-aware of their interpersonal behaviors when engaging with exercisers and interventions based on self-determination theory could serve as a promising avenue to improve the quality of exercisers' experience.

Planning and self-monitoring the quality and quantity of eating: How different styles of self-regulation strategies relate to healthy and unhealthy eating behaviors, bulimic symptoms, and BMI.

This research examined if planning and self-monitoring could be distinguished in terms of quality and quantity, and if differences in the uses of these strategies were associated with distinct eating outcomes. In Study 1 (n = 355), the structure of a new scale designed to measure planning and self-monitoring in terms of quality (i.e., nutrient intake) and quantity (i.e., calories and portion sizes) was examined through Confirmatory Factor Analysis. Structural equation models were also tested in which the relationships between the proposed strategies, healthy and unhealthy eating behaviors and bulimic symptoms, as well as BMI, were examined. The purpose of Study 2 (n = 318) was to replicate the results found in Study 1, using a different sample. Overall, a 6-factor structure was found for the scale and results revealed that strategies related to the quality of eating were more strongly and positively associated with healthy eating and more strongly and negatively associated with unhealthy eating behaviors, whereas strategies related to the quantity of eating were more strongly and positively associated with bulimic symptoms and BMI. Results are discussed in terms of implications for health professionals who wish to improve individuals' eating behaviors and/or weight.

Examining fat talk and self-compassion as distinct motivational processes in women's eating regulation: A self-determination theory perspective.

This study examined whether pursuing intrinsic versus extrinsic goals was associated with distinct motivational processes in eating regulation and with healthy versus unhealthy eating. Path analysis demonstrated that appearance goals were associated with fat talk, whereas health goals were associated with self-compassion. Fat talk was positively associated with non-self-determined motivation and unhealthy eating, whereas self-compassion was positively associated with self-determined motivation and healthy eating, and negatively associated with unhealthy eating. Findings emphasize the negative effects of pursuing appearance goals and engaging in fat talk and the benefits of pursuing health goals and being self-compassionate.

The validation of the Healthy and Unhealthy Eating Behavior Scale (HUEBS): Examining the interplay between stages of change and motivation and their association with healthy and unhealthy eating behaviors and physical health.

The purpose of the present research was to examine how self-determined and non-self-determined motivation for eating was related to healthy and unhealthy eating behaviors at different stages of change. In Study 1 (n = 360), the structure of a new scale designed to measure healthy and unhealthy eating behaviors based on recent recommendations of the Canadian Food Guide was examined through Principal Component Analysis. Study 2 (n = 711) retested the structure of the scale and also examined whether women reported different patterns of motivation and eating behaviors depending on their stage of change for eating regulation. In Study 3 (n = 264), moderated mediation models were used to examine if eating behaviors served to mediate the relationship between motivation and waist circumference, and whether stages of change moderated the link from motivation to eating behaviors. Overall, the studies provided evidence for the 2-factor structure of the scale, where the first factor represents healthy eating and the second factor represents unhealthy eating behaviors. It was also demonstrated that as women moved along the stages of change for eating regulation, they reported higher levels of self-determined motivation and lower levels of non-self-determined motivation, as well as a higher consumption of healthy foods and a lower consumption of unhealthy foods. Finally, findings indicated that healthy eating fully mediated the relationship between self-determined motivation and waist circumference, and that the relationship between self-determined motivation and healthy eating was moderated by stages of change. Together, these studies highlight the interactive roles of motivation and stages of change in their association with healthy and unhealthy eating behaviors, as well as the importance of healthy eating for a lower waist circumference.

Psychometric Testing of a Patient Empowerment, Engagement, and Activation Survey.

BACKGROUND: Patient or person-centered care has become a widely used philosophical framework and yet has varying definitions and characteristics. Person-centered care has recently been conceptualized as patient empowerment, engagement, and activation with studies citing positive outcomes. PURPOSE: This study reports the psychometric properties of the Patient Empowerment, Engagement, and Activation Survey. METHODS: An instrument development and testing approach was used. RESULTS: A 21-item survey was developed demonstrating respectable Cronbach α coefficients for the total scale (α = 0.88) and for each subscale: Empowerment (α = 0.71), Engagement (α = 0.81), and Activation (α = 0.76). A regression analysis with 1 item, "I am ready to be discharged" as the dependent variable and all other items as independent variables explained 65% of the variance in readiness for discharge (P < .001). DISCUSSION: The Patient Empowerment, Engagement, and Activation Survey can be used to evaluate patients' perspectives of care quality (empowerment and engagement) and readiness for discharge (activation).

Social Support, but Not Perceived Food Environment, Is Associated with Diet Quality in French-Speaking Canadians from the PREDISE Study.

The objectives were to assess whether social support for healthy eating and perceived food environment are associated with diet quality, and to investigate if sociodemographic characteristics moderate these associations. A probability sample of French-speaking adults from the Province of Québec, Canada, was recruited in the context of the PREDISE study. Participants reported their perceptions of supportive and non-supportive actions related to healthy eating from close others at home and outside of home (n = 952), and of the accessibility to healthy foods (n = 1035). The Canadian Healthy Eating Index (C-HEI) was calculated based on three Web-based 24 h food recalls. Multiple linear regression models showed that supportive (B = 1.50 (95% CI 0.46, 2.54)) and non-supportive (B = -3.06 (95% CI -4.94, -1.18)) actions related to healthy eating from close others at home were positively and negatively associated with C-HEI, respectively, whereas actions from close others outside of home were not. The negative association between non-supportive actions occurring at home and C-HEI was stronger among participants with lower (vs. higher) levels of education (p interaction = 0.03). Perceived accessibility to healthy foods was not associated with C-HEI (p > 0.05). These results suggest that the social environment may have a stronger influence on healthy eating than the perceived physical environment. This adds support for healthy eating promotion programs involving entire families, especially for more socioeconomically disadvantaged individuals, whose efforts to eat healthily may be more easily thwarted by non-supportive households.