REMAP-a Resilience Resources Measure for Prediction and Management of Somatic Symptoms.

PURPOSE: Patients with symptoms but without an identified disease are a challenge to primary care providers. A 22-item measure is introduced and evaluated to offer medical care providers with an instrument to assess and discuss possible deficiencies in resilience resources that may contribute to symptoms without identifiable pathology. This instrument highlights psychosocial and lifestyle resources that serve as buffers to life's stressors rather than focusing on stress and its related symptoms. METHODS: The measure included items from five resilience domains-relational engagement, emotional sensibility, meaningful action, awareness of self and others, and physical health behaviors (REMAP). Its structure and function were evaluated using two different samples. RESULTS: Results suggest that scores from the REMAP have reasonable psychometric properties. Higher REMAP scores were predictive of fewer health symptoms in a sample representative of the US population. In a second sample, REMAP was positively associated with perceived resilience, ego strength and mindfulness attention and negatively related to perceived stress, depression, sleep disturbances, and loneliness, providing evidence of convergent and divergent validity. Furthermore, the REMAP scale was sensitive to change following a life style intervention. CONCLUSION: This suggests that REMAP can be a useful tool in practice settings for counseling patients with unexplained symptoms. With insight into the biopsychosocial aspect of their symptoms, patients may become more receptive to cognitive behavioral options to improve their resilience resources and lifestyle choices.

Preserving Self: Medication-Taking Practices and Preferences of Older Adults With Multiple Chronic Medical Conditions.

PURPOSE: To examine the experiences of older adults with multiple chronic medical conditions when a new medication was added to their existing multiple medication regimen. DESIGN: A multimethod qualitative design was used. Thirty adults 60 years of age with (a) at least three chronic medical diagnoses, (b) at least five medications at baseline, and (c) a new medication prescription were enrolled in a prospective study of 30 days duration, participating from their homes. METHODS: In-depth hermeneutic interviews (2 per 15 participants) and self-assessment diaries recorded on electronic tablets (daily per 30 participants) were completed. Transcribed interviews and self-recorded survey data were analyzed using hermeneutical analysis and ecological momentary assessment and content analysis, respectively. FINDINGS: Common reasons participants did not take medications as prescribed included tolerability, transportation, access to medications, and forgetting. The overarching pattern, "preserving self," was supported by two patterns that subsumed several themes: (a) engaging the powerful hold of my illness, and (b) engaging providers in visioning health. CONCLUSIONS: A deeper understanding of the impact of receiving a new prescription and of managing medication reveals the challenges patients experience in preserving a sense of self. Healthcare providers of all disciplines should understand the meaning of medication prescribing and medication taking to ameliorate medication-taking difficulties. CLINICAL RELEVANCE: The provider-patient relationship is often cited as an area that needs to be addressed in healthcare practice. Our study emphasized the patients' voices and their profound needs around medication management. The emphasis on preservation of self is an important finding that focalizes the concern.

Who is responsible? US Public perceptions of AI governance through the lenses of trust and ethics.

The governance of artificial intelligence (AI) is an urgent challenge that requires actions from three interdependent stakeholders: individual citizens, technology corporations, and governments. We conducted an online survey (N = 525) of US adults to examine their beliefs about the governance responsibility of these stakeholders as a function of trust and AI ethics. Different dimensions of trust and different ethical concerns were associated with beliefs in governance responsibility of the three stakeholders. Specifically, belief in the governance responsibility of the government was associated with ethical concerns about AI, whereas belief in governance responsibility of corporations was related to both ethical concerns and trust in AI. Belief in governance responsibility of individuals was related to human-centered values of trust in AI and fairness. Overall, the findings point to the need for an interdependent framework in which citizens, corporations, and governments share governance responsibilities, guided by trust and ethics as the guardrails.

Reactance to a tailored multimedia intervention encouraging teachers to promote cover-the-cough.

Teachers were presented tailored multimedia messages encouraging them to offer cover-the-cough instruction to their students. Messages were tailored by grade level (elementary, higher grade) and stage of change (preaction, action). Among teachers in the action stages, message tailoring did not make a difference. Among teachers in the preaction stages, tailored messages were rated lower than were nontailored messages. The lower ratings of the tailored messages, seemingly a reactance response, did not carry over to postintervention self-efficacy. The intervention was effective in improving self-efficacy in elementary school teachers, particularly among those in the preaction stages.

Social media multitasking (SMM) and well-being: Existing evidence and future directions.

Despite the prevalence of social media multitasking (SMM), its effects on well-being have received little attention. Of the nine studies that directly examined this topic, six found a negative relationship between SMM and well-being variables, and three found mixed or no effects. We compare the findings with those from five meta-analyses of general media multitasking (GMM) and 15 recent studies on GMM and well-being. We propose three pathways for the impact of SMM on well-being, with a potential mediating role of cognitive functions and performance. Based on the review, we suggest four directions for future research by emphasizing: (1) characteristics of SMM, (2) multiple goals of SMM, (3) different types and aspects of well-being (e.g., enjoyment, purpose), and (4) person-specific effects.

Social effects of an anthropomorphic help agent: humans versus computers.

The purpose of this study was to examine perceptions of fairness of a computer-administered quiz as a function of the anthropomorphic features of the help agent offered within the quiz environment. The addition of simple anthropomorphic cues to a computer help agent reduced the perceived friendliness of the agent, perceived intelligence of the agent, and the perceived fairness of the quiz. These differences were observed only for male anthropomorphic cues, but not for female anthropomorphic cues. The results were not explained by the social attraction of the anthropomorphic agents used in the quiz or by gender identification with the agents. Priming of visual cues provides the best account of the data. Practical implications of the study are discussed.

How are previous physical activity and self-efficacy related to future physical activity and self-efficacy?

Self-efficacy (SE) has been found to be a robust predictor of success in achieving physical activity (PA) goals. While much of the current research has focused on SE as a trait, SE as a state has received less attention. Using day-to-day measurements obtained over 84 days, we examined the relationship between state SE and PA. Postmenopausal women (n = 71) participated in a 12-week PA intervention administered via cell phone and monitored their daily PA using a pedometer. At the end of each day, they reported their state SE and number of steps. Using a longitudinal model, state SE was found to be a robust predictor of PA even after accounting for trait SE and other covariates. The findings offer insights about the temporal relationship between SE and PA over the course of an intervention, which can be of interest to researchers and intervention designers.

Improving symptom communication through personal digital assistants: the CHAT (Communicating Health Assisted by Technology) project.

BACKGROUND: Communication problems impede effective symptom management during chemotherapy. The primary aim of this pilot randomized controlled trial was to test the effects of a personal digital assistant-delivered communication intervention on pain, depression, and fatigue symptoms among breast cancer patients undergoing chemotherapy. Secondary aims included assessment of 1) study feasibility, 2) patient and clinician responses to study participation, and 3) intervention effects on health-related quality of life (HRQoL) and communication self-efficacy. METHODS: Intervention group participants (n = 27) completed symptom inventories at baseline, once per week during treatment, and at posttreatment. Depending on symptom severity, they viewed race-concordant videos on how to communicate about pain, depression and/or fatigue, using the personal digital assistant. Symptom records were tracked and shared with clinicians. Control group participants (n = 23) received usual care. Longitudinal random effects modeling assessed the changes in average symptom scores over time. Descriptive statistics assessed study feasibility and intervention effects on HRQoL and communication self-efficacy. Postintervention focus groups, interviews, and surveys assessed responses to study participation. RESULTS: Mean age of the participants was 51.0 years; 42 participants (84%) were white. In comparison with control, intervention group participants reported lower average pain severity over time (P = .015). Mean pain interference scores over time were marginally different between groups (P = .07); mean depression and fatigue scores over time were statistically nonsignificant. Feasibility outcomes and perspectives about study participation were positive. Mean pre-post decreases in HRQoL were generally higher among intervention group participants; pre-post changes in communication self-efficacy were equivalent. CONCLUSION: Mixed findings of the study indicate the need for future research.

A walking intervention for postmenopausal women using mobile phones and Interactive Voice Response.

We conducted a feasibility study of a 12-week walking intervention administered through an Interactive Voice Response (IVR) system and mobile phones. We also examined the added benefit of a human coach. Post-menopausal women (n = 71) were given a daily-steps goal, which they monitored using a pedometer. Each day, they answered an automated call from the IVR system to their mobile phone and provided assessments of walking goals and mood. Every evening, they called the IVR system to report their steps, answered a brief questionnaire and received a message with a helpful hint. Participants took less time to complete a one-mile walk after the intervention, compared to baseline (0.77 min, SE = 0.22, P < 0.001). In addition, a significant loss in body weight (0.93 kg, SE = 0.31) and body-mass index (0.28 kg/m(2), SE = 0.11) were observed. The key psychometric measures of exercise goal setting (0.67 units, SE = 0.12) and exercise planning (0.48 units, SE = 0.09) also improved from baseline (both P < 0.001). However, results in the coach and no-coach conditions were not significantly different. The study suggests that mobile phones can be used to deliver an effective, low-cost walking intervention, irrespective of the addition of a human coach.

Development Of An Educational Video To Improve Patient Knowledge And Communication With Their Healthcare Providers About Colorectal Cancer Screening.

BACKGROUND: Low rates of colorectal cancer (CRC) screening persist due to individual, provider and system level barriers. PURPOSE: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. METHODS: Focus groups of patients were conducted prior to the development of an educational video and focus groups of patients provided initial feedback about the developed CRC screening educational video. Medical personnel reviewed the video and made recommendations prior to final editing of the video. RESULTS: Patients identified CRC screening barriers and made suggestions about the information to include in the educational video. Their suggestions included using a healthcare provider to state the importance of completing CRC screening, demonstrate how to complete the fecal occult blood test, and that men and women from diverse ethnic groups and races could be included in the same video. Participants reviewed the developed video and mentioned that their suggestions were portrayed correctly, the video was culturally appropriate, and the information presented in the video was easy to understand. Medical personnel made suggestions on ways to improve the content and the delivery of the medical information prior to final editing of the video. DISCUSSION: Participants provided valuable information in the development of an educational video to improve patient knowledge and patient-provider communication about CRC screening. The educational video developed was based on the Protection Motivation Theory and addressed the colon cancer screening barriers identified in this mostly minority and low-income patient population. Future research will determine if CRC screening increases among patients who watch the educational video. TRANSLATION TO HEALTH EDUCATION PRACTICE: Educational videos can provide important information about CRC and CRC screening to average-risk adults.

Information seeking and satisfaction with physician-patient communication among prostate cancer survivors.

Relatively little is known about prostate cancer patients' information seeking after diagnosis, how they use such information in making a treatment decision, or what role information plays in adjusting to quality-of-life issues posttreatment. This research sought to explore some of these issues by examining prostate cancer patients' information seeking and its relationship to assessments of feeling informed and satisfied with physician-patient communication about prostate cancer. Respondents felt reasonably informed about prostate cancer, although over one third of them reported being less then informed. Similarly, many respondents were generally satisfied with their communication with physicians, but nearly 40% of them reported being less than satisfied. However, there was no relationship between respondents' information seeking about prostate cancer and their assessments of being informed or satisfied with physician-patient communication. These and other results are discussed with respect to future research on prostate cancer patients' information needs and uses of such information.