Project description:Health literacy is a dynamic construct that changes with specific health conditions; thus, new disease-specific health literacy tools are needed. Since cancer is the leading cause of death among Latinos, the largest and fastest-growing minority population in the nation, there is a need to develop tools to assess cancer health literacy (CHL) among the Spanish-speaking population. The Cancer Health Literacy Test, Spanish version (CHLT-30-DKspa) was applied to identify Spanish-speaking individuals with low CHL and ascertain which items in the tool best discriminate between CHL level groups. Cross-sectional field test of the CHLT-30-DKspa among Spanish-speaking Latinos. Latent class analysis (LCA) identified participants with varying CHL levels. Probability of correct answers, odds ratios, and standardized errors were used to identify the items that allow the classification of individuals among the latent classes. LCA resulted in a three-latent-class model predicting 39.4% of participants to be in the HIGH class, 43.3% in the MEDIUM class, and 17.3% in the LOW class. Eleven items (the CHLT-11-DKspa) meet the criteria to clearly separate participants with HIGH and LOW classes of CHL. Although the best model fit was a three-class solution, results showed a clear separation of individuals from HIGH versus LOW levels of CHL, but separation of those in the MEDIUM level was not as clear. The CHLT-11-DKspa is a shorter measure that may be relatively easy to use in a clinical encounter to identify Spanish-speaking patients with the poorest levels of CHL who may require additional support to understand medical instructions and care plans.
Project description:ContextThere is need for a short validated self-report instrument for assessing the feeling of being loved. The Feeling Loved instrument asks: "Do you feel loved?" and "How loved do you feel?" as well as "Do you love yourself?" and "How much do you love yourself?" with 100 mm visual analogue scales assessing the continuous response options.ObjectiveTo assess convergent and discriminant validity and to explore psychometric structure for this novel self-report measure.DesignConvergent validity comparators include: general mental health, perceived social support, perceived stress, depressive symptoms, and positive/negative emotion. Discriminant validity comparators include: gender, age, ethnicity, socioeconomic status, and body mass index. Latent class analysis techniques explore psychometric structure.SettingBaseline evaluation for a randomized controlled trial.ParticipantsCommunity-recruited adults in Madison, Wisconsin.InterventionThis validation study is based on pre-intervention data.Main outcome measuresStrength of correlation with comparators is used to assess convergence and discrimination. Goodness-of-fit indicators assess latent class models.ResultsOf n = 412 respondents, 92% answered positively to both Yes/No questions, and 59% self-rated ≥75/100 on both 0-to-100 VAS scales. Supporting convergent validity, highly significant (p < 0.001) Spearman's rho=ρ correlations of a summed Feeling Loved score were: mental health (ρ = 0.49); social support (ρ = 0.46); perceived stress (ρ = -0.46), depressive symptoms (ρ = -0.31), and both positive (ρ = 0.50) and negative (ρ = -0.43) emotion. Significant associations were also found for personality indicators. Supporting discriminant validity, Feeling Loved scores did not correlate significantly with physical health (ρ = -0.08), body mass index (ρ = 0.01), age (ρ = 0.06), or income (ρ = 0.07) (p values all ≥ 0.12). Latent class analysis models suggested a 3-class structure, with strong goodness-of-fit indicators.
Project description:ObjectiveThis study considered various factors as predictors of antidepressant adherence over time as assessed by self-report and medication possession ratios (MPRs) derived from administrative pharmacy data.MethodsAdherence was assessed at six and 12 months among 443 veterans in ongoing treatment for depression in a trial of peer support. Logistic regression models were utilized to consider predictors of adequate adherence.ResultsAt six and 12 months, respectively, 36% and 35% of patients had poor adherence on the basis of MPRs and 24% and 18% had poor adherence on the basis of self-report. MPRs indicating poor adherence were more likely among men, members of racial groups other than white, and patients with Hispanic ethnicity. Poor self-reported adherence was associated with increased depressive symptoms and unemployment.ConclusionsThese adherence measures may be complementary. Strategies to improve adherence might target specific demographic groups, unemployed persons, and persons with higher levels of depressive symptoms.
Project description:BackgroundPhysical activity (PA) has documented health benefits, but older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance holds a promise as a culturally appropriate form of PA that challenges individuals physically and cognitively. This paper describes a randomized controlled trial that will test the efficacy of BAILAMOS, a 4-month Latin dance program followed by a 4-month maintenance program, for improving lifestyle PA and health outcomes.MethodsOlder adults (n=332), aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels, and at risk for disability will be randomized to one of two programs, a dance program or health education control group. BAILAMOS is a 4-month program that meets two times per week for one 1h per session. Dance sessions focus on instruction, including four styles of dance, and couples dancing. Bi-monthly Fiestas de Baile (dance parties) are also included, in which participants dance and practice what they have learned. Monthly 1-hour discussion sessions utilize a Social Cognitive framework and focus on knowledge, social support, and self-efficacy to increase lifestyle PA. The health education control group will meet one time per week for two 2h per session.OutcomesPrimary outcomes including PA changes and secondary outcomes including self-efficacy, physical function, cognitive function, and disability will be assessed at baseline, 4, and 8 months. It is hypothesized that PA, self-efficacy, physical function, cognitive function, and functional limitations and disability scores will be significantly better in the BAILAMOS group at 4 and 8 months compared to the control group.
Project description:AimsA disproportionate number of people with mental ill-health experience social exclusion. Appropriate measurement tools are required to progress opportunities to improve social inclusion. We have developed a novel measure, the Filia Social Inclusion Measure (F-SIM). Here we aimed to present a more concise, easy-to-use form, while retaining its measurement integrity by (i) refining the F-SIM using traditional and contemporary item-reduction techniques; and (ii) testing the psychometric properties of the reduced measure.MethodsFive hundred and six participants completed the F-SIM, younger and older groups of people with serious mental illness (including psychosis, mood, anxiety disorders) and same-aged community counterparts. The F-SIM was completed at baseline and 2-week follow-up, alongside other measures (including social inclusion, loneliness). The F-SIM was refined using multidimensional scaling network analysis, confirmatory factor analysis and item response theory. The psychometric evaluation included assessment of dimensionality, internal consistency, test-retest reliability, discriminant ability and construct validity.ResultsThe F-SIM was reduced from 135-items to 16; with 4-items in each domain of housing and neighbourhood, finances, employment and education and social participation and relationships. Psychometric properties were sound, including strong internal consistency within domains (all α > 0.85) and excellent overall (α = 0.92). Test-retest reliability was also high (γ = 0.90). Differences between groups were observed; clinical subgroups consistently reported lower levels of social inclusion compared to community counterparts.ConclusionsThe F-SIM16 is a sound, reliable, brief self-report measure of social inclusion suitable for use in clinical and research settings. It has the potential to evaluate the effectiveness of interventions, and aid in fostering targeted and personalised needs-based care.
Project description:Chronic non-communicable diseases (NCDs) are a public health problem that affect the quality of life and well-being of people, especially the youth, who have been identified as a high-risk population. Physical inactivity is a key risk factor for NCDs, and an unhealthy diet is a significant driver of NCDs. On the other hand, physical exercise and healthy habits are effective methods of prevention. Although there are scales that measure different behaviors related to NCDs, most of them have been developed in another language (e.g., English) or only focus on one aspect of NCDs. The present study aimed to develop a scale to assess healthy behaviors (i.e., healthy eating and physical exercise) in Spanish-speaking university students, using an instrumental design, with a sample of 369 Chilean university students between 18 and 25 years of age. The results presented show evidence of validity through an exploratory structural equation model (ESEM), reliability estimation through McDonald's omega and Cronbach's alpha, evidence of invariance by sex, and evidence of validity in relation to other variables with an SEM model. It is concluded that the Healthy Behavior Scale, consisting of nine items to measure healthy eating and physical exercise, is a brief instrument with evidence of reliability and validity (CFI = 0.998; TLI = 0.995; and RMSEA = 0.063) for application in a Spanish-speaking university population, offering potential applications in research instruments, screening studies, and the development of new studies for other contexts.
Project description:BackgroundLatinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA.PurposeTo describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group.MethodsAdults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood.ResultsA series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects.ConclusionsThe study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives.Clinical trial informationNCT01988233.
Project description:BackgroundThe impact of the National Diabetes Prevention Program (N-DPP) for Latinos post-program participation is uncertain.PurposeWe examine the experiences of Latinos who participated in the N-DPP in continuing the dietary and physical activity changes learned in the program.MethodsThis is a qualitative descriptive interview study. We recruited 19 Latino adults who participated in a culturally and linguistically adapted N-DPP. Thematic analysis was used to analyze the data and report emerging themes.ResultsParticipants discussed how the program improved their knowledge about healthier lifestyles, and shared specific tools and strategies that they used to maintain learned program behaviors. Factors related to discontinuation of behaviors included missing the group social support, losing commitment over time, and avoiding family conflict. Maintenance of behaviors was mainly facilitated by family support.DiscussionOur study suggests that Latinos who participated in the N-DPP gained useful knowledge on healthier behaviors and learning strategies for implementation into their lifestyle, but barriers remain.Translation to health education practiceAdaptations of the program for Latinos should consider the important roles of family and social support to improve N-DPP outcomes for this group and better support Latinos in preventing diabetes.
Project description:We assessed the efficacy of a Spanish-language HIV/AIDS and HIV testing video as a substitute for comparable orally-delivered information in healthcare and non-health care settings for Spanish-speakers regardless of health literacy level. In a non-inferiority clinical trial, Spanish-speaking Latinos from an emergency department, a clinic, and community-based organizations were randomly assigned to receive HIV/AIDS and HIV testing information orally or from a video. Comprehension of the information was measured using a questionnaire. Of the 150 participants, 39 % met criteria for lower health literacy and 75 % previously had been tested for HIV. Mean scores on the questionnaire for the video (20.4; 95 % CI 19.5 ~ 21.3) and the orally-delivered information arms (20.6; 95 % CI 19.7 ~ 21.5) were similar (Δ = -0.15; 95 % CI -1.4 ~ 1.1). Mean scores among lower health literacy participants also were similar (18.3 (video) vs. 19.6 (in-person); p < 0.30). This Spanish-language video is a viable substitute for orally-delivered HIV/AIDS and HIV testing information.
Project description:Background: Cancer-related self-efficacy, a multidimensional construct, is the confidence that one can overcome challenges associated with cancer and its treatment; higher levels have been associated with better psychosocial outcomes of breast cancer survivors. Little is known about factors that influence it among Latina breast cancer survivors. Purpose: Assess associations of several aspects of health care processes and of spirituality with self-efficacy for coping with breast cancer treatment among primarily Spanish-speaking Latina breast cancer survivors. Methods: We analyzed baseline data from a randomized controlled trial of a cognitive-behavioral stress management intervention that enrolled 151 Spanish-speaking Latinas within 1 year of breast cancer diagnosis. Multivariate linear regression models examined associations of health care processes (quality of breast cancer care and information, participating in medical care, difficulty engaging with doctors) and spirituality (meaning/peace, faith, acceptance) with self-efficacy for coping with breast cancer treatment. Results: Mean age was 51 (standard deviation [SD]=11), 66% completed high school or less, and most reported financial hardship in the past year (78%). Average time since diagnosis was 3.8 months (SD=2.7). In bivariate analyses, all six determinants were significantly associated with self-efficacy for coping with breast cancer treatment; participating in medical care (B=0.56, p<0.001) and having a sense of meaning/peace (B=0.76; p<0.001) were independently associated, controlling for sociodemographic and treatment characteristics. Discussion: Interventions that promote participation in treatment decisions and sense of meaning and peace could improve confidence in coping with breast cancer treatment, and potentially quality of life, among Latinas living with breast cancer (Trial Registration Number: NCT01383174 [ClinicalTrials.gov]).