Martha Tamara Schuch Mednick (1929-2020).

Memorializes Martha Tamara Schuch Mednick (1929-2020). Mednick was one of the most influential women in the development of the psychology of women. In 1965, Martha joined and was very active in the Society for the Psychological Study of Social Issues (SPSSI). SPSSI, an organization of social scientists who have brought research to bear on a wide array of societal problems, and was considered the "conscience" of APA. In 1967, Martha received an offer of a faculty position at Howard University and began work there in 1968. She was promoted to full professor in 1971 and remained at Howard until her retirement in 1995. In 1972, Martha coedited, with Sandra Tangri, an issue of the Journal of Social Issues entitled "New Perspectives on Women." She later expanded the issue into a book, coedited with Tangri and Lois Wladis Hoffman, Women and Achievement: Motivation and Social Analysis (1975). Around 1972, Martha became involved in organizational work on behalf of women in psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Instagram as a tool for study engagement and community building among adolescents: A social media pilot study.

OBJECTIVE: Social media has been recognized as a promising tool for delivering health interventions and facilitating study recruitment. However, research is needed to understand how social media might be used to enhance the experiences of adolescent participants in ongoing studies. In a prospective cohort study addressing social and structural influences on health trajectories among 599 adolescents in a California agricultural community, we evaluated the effectiveness of and engagement with a human-centered, Instagram-based outreach campaign, with a focus on study retention, enhancement of participants' experiences, and increasing community awareness of the study. METHODS: We adopted a youth-centered approach to design a three-month pilot study, which included participatory design sessions, a geo-targeted Instagram campaign, and in-person events at schools. We conducted pre-/post-pilot surveys with study participants, analyzed social media metrics, and collected process measures, such as study visit show rates. RESULTS: After three months, the study Instagram account had 209 followers and 806 total engagements. Survey responses showed little change in study participants' attitudes about the study; most survey respondents agreed that the study is very important for the community (54% pre-pilot and 52% post-pilot). However, the study's Instagram account appeared to influence study participation, with 43% of post-pilot respondents who use Instagram (n=65 of 153) indicating that the Instagram account influenced their decision to continue coming to study visits. CONCLUSION: Despite little change in the participants' attitudes about the study, the findings of this pilot study suggest that Instagram is a promising tool to support engagement of adolescent participants in ongoing research, particularly if the content is designed with adolescents as partners. In addition to assessing the effectiveness of an Instagram outreach campaign to support retention, this paper also presents suggestions and insights for creating similar social media interventions targeting youth.

Attitudes and experiences regarding genetic research among persons of African descent.

Minorities are underrepresented in genetic research. This study examined the attitudes, experiences, and willingness of persons of African descent related to participation in genetic research. A total of 272 persons of African descent completed a questionnaire about attitudes and experiences associated with genetic research. Descriptive, Chi-square, and logistic regression were used to examine the impact of attitudes and experiences in predicting the odds of willingness to participate in genetic research. A majority of participants (97%) indicated that they have never participated in genetic research; however, a majority also reported that they would be willing to participate in a genetic study specifically for the detection of risk factors for cancer (87%), diabetes (89%), alcohol use disorder (73%), and Alzheimer's disease (88%). Participants who disagreed that "results from genetic research can explain why some diseases are found more often in some ethnic groups than others" were less likely to be willing to participate in studies related to cancer (OR = 0.16), diabetes (OR = .16), alcohol use disorder (OR = 0.27), and Alzheimer's disease (OR = 0.27). Participants reported limited experiences engaging in genetic research; yet, they overwhelmingly acknowledged the importance of genetic research and expressed willingness to participate in multifactorial genetic studies despite concerns about genetic discrimination, stigma, and/or a potentially poor prognosis. Further research on the underlying reasons why persons of African descent choose to participate in genetic research should be explored and addressed to make research more inclusive and ethically sound.

Efficacy of brief personcentered cognitive behavioral therapy to facilitate self-management for patients with Rheumatoid Arthritis: A mixed methods case series feasibility study / Eficacia de la terapia cognitivo conductual breve centrada en la persona para facilitar la autogestión de pacientes con artritis reumatoide: un estudio de la viabilidad de métodos mixtos para una serie de casos

The psychological consequences of living with rheumatoid arthritis (RA) are common. The objectives of this study were: (I) to investigate views of patients with RA about the provision of psychological support; (II) to study the efficacy of a person-centred cognitive behavioural therapy (CBT) self-management approach, including a health economic investigation. A mixed methods was applied: a formative qualitative interview study and a quantitative CBT intervention formed the case series feasibility study design, and a health economic investigation. The qualitative study highlighted that patients welcome emotional support. The CBT intervention from a small sample suggested that participants may have benefitted from the intervention until to the point of the follow-up. The results of the economic component need to be interpreted with caution in relation to service gaps. A broad approach in the delivery of a psychological intervention may benefit patients with long-term conditions. The practice implications are that RA patients may benefit from psychological interventions to cope better with their condition through personal intervention, and flexible appointment system. Intervention studies need to test this question in detail in the future

Las consecuencias psicológicas de vivir con artritis reumatoide (AR) son frecuentes. Los objetivos de este estudio fueron: (I) investigar las opiniones de los pacientes con AR acerca de la provisión de apoyo psicológico, (II) estudiar la eficacia de un enfoque de autogestión basado en la terapia cognitivo conductual (TCC) centrada en la persona, incluyendo una investigación económica de la salud. Se utilizaron métodos mixtos. Un estudio formativo de entrevista cualitativa y una intervención cuantitativa de TCC formaron el diseño del estudio de viabilidad de la serie de casos y una investigación económica de la salud. El estudio cualitativo destacó que los pacientes agradecen el apoyo emocional. La intervención de TCC con una pequeña muestra sugirió que los participantes podrían haberse beneficiado de la intervención hasta el seguimiento. Los resultados del componente económico deben interpretarse con precaución respecto a las carencias de los servicios. Un enfoque amplio en la prestación de una intervención psicológica puede beneficiar a los pacientes con dolencias a largo plazo. Las implicaciones prácticas son que los pacientes con AR pueden beneficiarse de intervenciones psicológicas para afrontar de mejor manera su enfermedad a través de una intervención personal y un sistema flexible de citas. Los estudios de intervención necesitan comprobar con detalle esta cuestión en el futuro

Improving low health literacy and patient engagement: A social ecological approach.

OBJECTIVE: This article posits four principal objectives related to the overarching goal of broadening the conceptualization of health literacy. We propose a social ecological approach to health literacy and patient engagement by illustrating how this multilevel approach offers an array of strategic options for interventions. DISCUSSION: A social ecological approach supports a broader understanding of health literacy that aligns with increased patient engagement. The ecological model highlights the importance of context, demonstrates how health literacy and patient engagement are inextricably connected, and gives rise to strategies to enhance them both. We illustrate the five multilevel intervention strategies for addressing low health literacy and promoting patient engagement: accumulation, amplification, facilitation, cascade, and convergence strategies. In addition, we provide a theoretical foundation to facilitate the development of interventions to enhance health literacy and ultimately increase patient engagement. CONCLUSIONS: The practice implications of adopting a broader social ecological perspective to address low health literacy shifts the field from thinking about individual educational interventions to how individual interventions may be augmented or supported by interventions at additional levels of influence. The potential benefit of adopting a multilevel intervention approach is that combining interventions could produce synergies that are greater than interventions that only utilize one level of influence.

Prime Time Sister Circles(®)II: Evaluating a Culturally Relevant Intervention to Decrease Psychological and Physical Risk Factors for Chronic Disease in Mid-Life African American Women.

PURPOSE: This article presents the results of two evaluation studies of the Prime Time Sister Circles(®) (PTSC). The PTSC is a gender, cultural, and age specific, curriculum-based, low-cost, short-term, replicable support group approach aimed at reducing key modifiable health risk factors for chronic illnesses in midlife African American women. METHODS: Study 1 includes an evaluation of 31 PTSCs (N=656 women) documenting changes in psychological and attitudinal outcomes (health satisfaction, health locus of control), behavioral outcomes (healthy eating patterns, physical activity, stress management), and clinical outcomes (weight, BMI, blood pressure, non-fasting blood sugar). Study 2 includes evaluation of a subset of the PTSC sites (N=211 women) with comparison (N=55 women) data from those same locations. RESULTS: Study 1 showed significant changes (p<.0001) in the PTSC women's reports of (lower) stress, (higher) health locus of control, (increased) health satisfaction, (increased) physical activity, and (healthier) eating patterns. The PTSC women demonstrated a significant weight reduction at posttest (p <.0001) and had slightly better clinical outcomes in BMI, hypertension, and non-fasting blood sugar. Results document the sustainability of selected changes over a six-month period. Findings from the Study 2 strengthen the effectiveness claims of the PTSC intervention with significant changes for the PTSC women on selected outcomes and little changes for the comparison women. CONCLUSIONS: Results reaffirm findings regarding the effectiveness of the PTSC, as originally reported in Gaston, Porter, and Thomas (2007) and extends the credibility of findings by examining participants' clinical outcomes in addition to self-reports.

Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

OBJECTIVES: Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009-2010) and using the revised criteria for "ease of use," we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. METHODS: We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the "ease of use" criteria with socio-demographic, complexity of need, and access variables. RESULTS: Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. CONCLUSIONS: for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources.

Evaluation guidelines for the Clinical and Translational Science Awards (CTSAs).

The National Center for Advancing Translational Sciences (NCATS), a part of the National Institutes of Health, currently funds the Clinical and Translational Science Awards (CTSAs), a national consortium of 61 medical research institutions in 30 states and the District of Columbia. The program seeks to transform the way biomedical research is conducted, speed the translation of laboratory discoveries into treatments for patients, engage communities in clinical research efforts, and train a new generation of clinical and translational researchers. An endeavor as ambitious and complex as the CTSA program requires high-quality evaluations in order to show that the program is well implemented, efficiently managed, and demonstrably effective. In this paper, the Evaluation Key Function Committee of the CTSA Consortium presents an overall framework for evaluating the CTSA program and offers policies to guide the evaluation work. The guidelines set forth are designed to serve as a tool for education within the CTSA community by illuminating key issues and practices that should be considered during evaluation planning, implementation, and utilization. Additionally, these guidelines can provide a basis for ongoing discussions about how the principles articulated in this paper can most effectively be translated into operational reality.

The psychosocial experience of patients with end-stage renal disease and its impact on quality of life: findings from a needs assessment to shape a service.

Background. A needs assessment was conducted on renal patients registered to a leading hospital trust in London in order to explore their psychological, social, and spiritual needs. The aim of the needs assessment was to create an evidence base for the development of a comprehensive health psychology service to run concurrently with a renal counselling support service within the department. Methodology. This study utilised a series of semistructured face-to-face interviews and focus groups with renal patients and their carers, to explore how ESRD impacted quality of life. Results. A thematic analysis was undertaken. Seven emergent themes were identified that influenced the quality of life of people with EDRD: physiological impact, impact of treatment, impact on daily life, psychological impact, impact on relationships, social impact and coping responses. Conclusion. The needs assessment clearly identified that ESRD carries with it emotional, physical, psychological, social, and existential burdens. The data from this needs assessment study has created an evidence base upon which future health psychology services can be built within this leading UK hospital.

The lives of adults over 30 living with sickle cell disorder.

OBJECTIVES: The study investigated the lived experiences of adults over 30 years old living with sickle cell disorder (SCD) and sought to develop a model understanding participants' ability to function. DESIGN: Over a period of 10 months, in-depth individual interviews were held with nine participants and three focus groups were held with six further participants. METHODS: Grounded theory, a qualitative methodology, was chosen to explore functioning across domains of experience in order to build an explanatory model. RESULTS: Physical, psychological, and social functioning were adversely effected by SCD. Access to and quality of resources including friends, family, and finances formed the context in which participants attempted to manage the disorder. Management of SCD improved over time as participants moved to acceptance of the condition. This allowed participants to strengthen their resilience by creating meaning, developing their identity, and actively coping with the effects of SCD, thus improving their ability to function and to appreciate life. CONCLUSIONS: The study demonstrates the considerable resilience of people over 30 with SCD, providing a positive and hopeful model which can be utilized clinically to support the functioning of people with SCD.

Paradoxes in obesity with mid-life African American women.

PURPOSE: To examine the relationship among socioeconomic status, psychological factors (ie, health locus of control, health satisfaction), and health behaviors (ie, physical exercise, eating patterns) in a volunteer sample of mid-life African American women residing within Washington, DC. METHODS: The study's sample included 351 African American women who participated in the 12-week Prime Time Sister Circles (PTSC) intervention and completed the initial self-report survey. Of the women completing the baseline survey, clinical assessments were taken on 277 participants. RESULTS: The majority (64.4%) of the women were either obese or extremely obese based upon their body mass index (BMI). Fewer than one-third of the women were satisfied with their weight. Despite these outcomes, most (61.8%) of the sample rated their health, in comparison to other African American women, as either good or very good. Further, more than one-half of the women were somewhat to very satisfied with their health knowledge, attitudes, behaviors, and their physical, emotional, and spiritual health. There was no significant relationship between obesity level and socioeconomic status, as measured by education, personal income, and total household income. Additionally, there were no significant differences in weight or eating behaviors by education, personal income, and total household income. The findings revealed a significant difference in the number of days the women reported engaging in physical exercise by personal income (p < .01) and total household income (p = .05), surprisingly, with the women in the lower-income categories reporting engaging in more days of physical exercise than women in the higher-income categories. CONCLUSIONS: This study documents the paradox of obesity in mid-life African American women related to socioeconomic status inasmuch as there were no differences observed in the prevalence of obesity by socioeconomic status indicators. The obese women of lower socioeconomic status reported exercising more than obese women of high socioeconomic status. Paradoxically, most of the obese women were dissatisfied with their body weight, shape, and physical health, but more than 50% were satisfied with their health attitudes and behaviors and 61.8% rated their health favorably. The paradoxes of obesity and African American women across various income levels are important to understand for interventions to success.

Pain management and quality of life in sickle cell disease.

Sickle cell disease (SCD) is the most common inherited disease worldwide and is responsible for a massive health burden. Its main clinical feature is severe pain that is unpredictable and recurrent, and this, in addition to the other acute and chronic features of SCD, may have a huge impact on the quality of life of both the patient and their families and carers. We consider medical and psychological methods of pain management in SCD, drawing on recently published UK Standards of Care, and also consider the effect of SCD on quality of life.

Prime Time Sister Circles: evaluating a gender-specific, culturally relevant health intervention to decrease major risk factors in mid-life African-American women.

PURPOSE: To evaluate the effectiveness of Prime Time Sister Circles (PTSC), a curriculum-based, culture- and gender-specific health intervention, in assisting mid-life African-American women to decrease the major risk factors of physical inactivity, poor nutrition and stress. METHODS: One-hundred-thirty-four African-American women were involved in 11 sites across the country in PTSC and comparison groups. PTSC uses a cognitive behavioral modality based on three theoretical approaches to reduce risk factors and promote positive health changes. Pretest and posttest (10 weeks, and six and 12 months) data were collected on various indicators. RESULTS: t test analyses demonstrated a statistically significant increase in the women's involvement in physical activity at 10 weeks, and six and 12 months. A significant 10-week difference was found in the women's diet, with them reporting eating more nutritious foods, t(77) = 3.32, p < 0.001. The women also indicated from pretest to 10 weeks, and six and 12 months that they changed what they ate to prevent disease (40.4%, 62.8%, 97.5% and 100%, respectively). A majority of the women at 10 weeks (62.7%) and 12 months (65.9%) reported utilizing stress management strategies. There was also a 60% increase in yearly mammograms and a 54% increase in blood pressures checks. Finally, 83.7% of the women at 12 months felt that the positive changes could be maintained over their lifetime. CONCLUSIONS: This study demonstrates the effectiveness of PTSC in modifying health-related knowledge, attitudes and certain high-risk behaviors in mid-life African-American women.

Communication skills and cultural awareness courses for healthcare professionals who care for patients with sickle cell disease.

AIMS: This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease. BACKGROUND: Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice. METHODS: Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3- and 6-month postintervention. FINDINGS: A repeated measures anova revealed a statistically significant increase in confidence from pre- to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse. CONCLUSION: The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.

"Reduced to nods and smiles": experiences of professionals caring for people with cancer from black and ethnic minority groups.

Despite growing research in the UK suggesting that patients from black and ethnic minority groups feel that they do not always receive the best treatment and care, little is known about how care professionals themselves respond to working with this group. The study, involving focus groups with health and social care staff, was undertaken to learn about their views and experiences. The principal finding was the extent to which staff experience difficulties in caring for patients from black and ethnic minority groups. Entailing serious challenges to their own professional practice, these were found to arise at all stages of patients' experience of cancer, including at diagnosis, during treatment and at the palliative phase. Staff were concerned that their inability to communicate with some patients meant that they were not able to provide them a good service, as they could not develop an easy relationship and talk around issues. Yet it could be difficult to work with interpreters, as well as family members, both of who could be reluctant to translate important information. They were also conscious of not being fully sensitive to patients' differing cultures, while noting the importance of not making assumptions about particular beliefs or behaviour. Staff would welcome training to help them to explore their attitudes and assumptions in working with black and ethnic minority patients, but did not seek induction into the detailed practices of different cultures. Some staff felt they would benefit from training in working with interpreters.

Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective.

This study sought to explore the impact of the psychological variables anxiety and depression, on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4-6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and one-third of the sample experienced levels of anxiety in psychiatric proportions whilst under one-third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care.

Barriers to effective uptake of cancer screening among Black and minority ethnic groups.

AIM: To describe some of the factors that act as barriers to effective uptake of breast and cervical cancer screening services among black minority ethnic (BME) groups living in Brent and Harrow in the UK. DESIGN: A series of focus groups among African Caribbean, African, Gujarati, Pakistani, Greek and Arabic groups were held to discover their perceptions of cancer screening, the barriers to effective uptake and some strategies for intervention. SAMPLE: This consisted of 135 participants: 85 women and 50 men. RESULTS: Analysis of focus group data has revealed poor knowledge, underlying health and cultural beliefs, attitudes, language and unhelpful attitudes of health professionals to be important barriers. In terms of strategies for effective intervention, the most popular strategy for improving uptake of screening services was community-based cancer awareness education that is sensitive to religious and cultural needs. CONCLUSION: There is a need to provide community-based education to increase the uptake of screening services among BME groups. It is essential to plan concurrently to educate GPs and other health professionals in cultural beliefs and customs, language needs, racial awareness and communication skills.

The comprehensiveness care of sickle cell disease.

Millions of people across the world have sickle cell disease (SCD). Although the true prevalence of SCD in Europe is not certain, London (UK) alone had an estimated 9000 people with the disorder in 1997. People affected by SCD are best managed by a multidisciplinary team of professionals who deliver comprehensive care: a model of healthcare based on interaction of medical and non-medical services with the affected persons. The components of comprehensive care include patient/parent information, genetic counselling, social services, prevention of infections, dietary advice and supplementation, psychotherapy, renal and other specialist medical care, maternal and child health, orthopaedic and general surgery, pain control, physiotherapy, dental and eye care, drug dependency services and specialist sickle cell nursing. The traditional role of haematologists remains to co-ordinate overall management and liase with other specialities as necessary. Co-operation from the affected persons is indispensable to the delivery of comprehensive care. Working in partnership with the hospital or community health service administration and voluntary agencies enhances the success of the multidisciplinary team. Holistic care improves the quality of life of people affected by SCD, and reduces the number as well as length of hospital admissions. Disease-related morbidity is reduced by early detection and treatment of chronic complications. Comprehensive care promotes awareness of SCD among affected persons who are encouraged to take greater control of their own lives, and achieves better patient management than the solo efforts of any single group of professionals. This cost-effective model of care is an option for taking haemoglobinopathy services forward in the new millennium.