Learning to health yourself: a randomized, tailored self-regulation intervention among custodial employees.

This intervention sought to bring about a dietary behavior change among individuals who are vulnerable to negative health outcomes and behaviors. Using a randomized controlled trial, we examined the efficacy of a six-week Education + Self-Regulation intervention against an Education Only condition in reducing saturated fat intake among custodial workers (N = 54). Assessments were made at baseline, 4 weeks, 6 weeks and 6 months. The intervention group reported lower saturated fat intake and greater self-regulation than the Education Only control group throughout the intervention period and higher self-efficacy at week 6. Despite a fading of intervention effect at 6 months, Education + Self-Regulation participants continued to report lower saturated fat intake relative to their baseline. Supplementing health education with self-regulatory skills is an effective strategy for positive health behavior change. The authors provide recommendations for engaging non-clinical health psychologists in community-level chronic disease prevention and health promotion efforts.

Cervical cancer prevention in Malawi: a qualitative study of women's perspectives.

Researchers posit that cervical cancer knowledge is central to participation in prevention behaviors. However, of the many barriers to cervical cancer prevention in low- and middle-income countries, cervical cancer knowledge remains severely limited among communities at great risk for the disease. Malawi is one such country where the burden of cervical cancer is considerably high. Formative research targeting cervical cancer prevention is needed, particularly research that explores ways to deliver cervical cancer information efficiently and effectively to Malawian women. In this study, the authors aimed to garner Malawian women's understanding of cervical cancer and to shed light on preferences for health information delivery, including community health advocacy. Qualitative, in-depth interviews were conducted with 30 Malawian women and analyzed for recurring themes. In general, women had limited cervical cancer knowledge, which supported misperceptions about the disease, including factors pertaining to risk and prevention. Nonetheless, women reported that receiving cervical cancer information from trusted sources would help promote preventive behaviors. Women noted that they received most of their health information from hospital personnel, but distance was a barrier. Women also expressed interest in community health advocacy. Perspectives from Malawian women may be vital toward informing efforts to increase cervical cancer knowledge and prevention.

Sex differences in health care provider communication during genital herpes care and patients' health outcomes.

Research in primary care medicine demonstrates that health care providers' communication varies depending on their sex, and that these sex differences in communication can influence patients' health outcomes. The present study aimed to examine the extent to which sex differences in primary care providers' communication extend to the sensitive context of gynecological care for genital herpes and whether these potential sex differences in communication influence patients' herpes transmission prevention behaviors and herpes-related quality of life. Women (N = 123) from the United States recently diagnosed with genital herpes anonymously completed established measures in which they rated (a) their health care providers' communication, (b) their herpes transmission prevention behaviors, and (c) their herpes-related quality of life. The authors found significant sex differences in health care providers' communication; this finding supports that sex differences in primary care providers' communication extend to gynecological care for herpes. Specifically, patients with female health care providers indicated that their providers engaged in more patient-centered communication and were more satisfied with their providers' communication. However, health care providers' sex did not predict women's quality of life, a finding that suggests that health care providers' sex alone is of little importance in patients' health outcomes. Patient-centered communication was significantly associated with greater quality-of-life scores and may provide a promising avenue for intervention.

Barriers and facilitators to HPV vaccination: perspectives from Malawian women.

The aim of this research was to elucidate potential barriers and facilitators to human papillomavirus (HPV) vaccination in Malawi, a sub-Saharan country. In Malawi, approximately 31 out of every 100,000 women develop cervical cancer annually, and 80% of those affected die from this malignancy. HPV vaccination may provide a feasible strategy for cervical cancer prevention in Malawi. However, important questions and concerns regarding cervical cancer and HPV vaccination acceptance among individuals and their communities must be considered prior to vaccine delivery. Qualitative interviews were conducted with 30 Malawian mothers aged 18-49 years from Chiradzulu District. Women's knowledge and beliefs about HPV, cervical cancer, and vaccination, and their social-ecological contexts were explored in-depth. Thematic analyses revealed that despite women's limited knowledge, cervical cancer was perceived to be a serious disease. Participants believed that as women, they were responsible for their children's health. Women unanimously reported that they would vaccinate their children against HPV, especially if a health professional recommended it. Malawi's health care infrastructure could present challenges to HPV vaccine programs; however, participants did not typically report this to be a barrier to vaccination. These data shed light on factors that may influence HPV vaccination acceptance and uptake in Malawi.

Correlates of negative physical health in call center shift workers.

The call center industry, a burgeoning sector is characterized by unique job demands, which render it susceptible to high attrition rates and negative health concerns. This study examined the relationship between job stress from interpersonal factors, job stress from work factors, coping, inadequate sleep, and negative physical health reports among call center shift workers (n = 239), a relatively under-researched population. Inadequate sleep and job stress from interpersonal factors were associated with negative physical health outcome for the participants in this study. Further, spending longer in the call center industry was associated with negative health outcome for the shift worker participants.

Psychological adjustment among women living with genital herpes.

This study investigated the psychosocial factors that influence psychological adjustment among women with genital herpes, while taking into account the physical factors. Women with herpes (N = 105, age 18-30) completed an on-line survey about factors related to their diagnosis and herpes-related quality of life. Perceived stigma, acceptance coping, denial coping, support from the Internet, and support from religious/spiritual figures accounted for 65.9 percent of the variance in quality of life scores. The findings reveal the importance of specific coping strategies and sources of support on psychological adjustment to herpes. Furthermore, a significant interaction between stigma and acceptance coping suggests a complex relationship between these two psychosocial factors that warrants future research.

Predictors of parents' willingness to vaccinate for human papillomavirus and physicians' intentions to recommend the vaccine.

BACKGROUND: The present study examined potential predictors of parents' willingness to vaccinate their children for human papillomavirus (HPV) and physicians' intentions to encourage parents to vaccinate their children, now that the U.S. Food and Drug Administration (FDA) has approved a highly effective vaccine. METHODS: Parents (n=100) and physicians (n=100) were surveyed on-line in fall 2006, 4 months after the HPV vaccine, Gardasil, was approved by the FDA as a prophylactic vaccine for females ages 9-26 years. RESULTS: Religiosity, perceiving their children as susceptible to HPV, and perceived negative consequences of HPV infection were significant predictors of parents' intent to vaccinate. Physician specialty and whether or not physicians would vaccinate their own children were significant predictors of physicians' intent to encourage parents to vaccinate their children. CONCLUSION: Campaigns aimed at increasing HPV vaccination should focus on educating parents about children's susceptibility to and the potential negative consequences of HPV infection. Furthermore, because there is now a significant body of evidence indicating that pediatricians and gynecologists have high intentions to encourage parents to vaccinate their children, the focus should be placed on strengthening the intentions of physicians in other specialties who serve children and their parents.

Influence of communicator's race on efficacy of an HIV/STD prevention intervention among African American and Caucasian college students.

OBJECTIVES: The present research examined the influence of communicator's race on the efficacy of intervention videos in the reduction of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) among African American and Caucasian college females. DESIGN: Experimental HIV/STD prevention digital versatile disks (DVDs) featured a White female as a primary or a secondary communicator relative to a Black female, while a control DVD featured 2 Black females. Respondents watched 1 DVD and completed questionnaires before and after viewing the DVD as well as 2 and 4 weeks later. SAMPLE: 79 African American females and 88 Caucasian females participated. MEASUREMENTS: Perceptions of the DVDs, HIV/STD risk, intentions to use condoms, and number of condoms purchased after viewing the videos were assessed. RESULTS: The intervention was effective in increasing intentions to use condoms with a current partner across the follow-up periods. There was no effect of race of communicator on any variable for African American or Caucasians. CONCLUSIONS: While communicator's race did not affect this intervention, more research is necessary. Future studies should use multiple Black and White communicators to isolate the role of race and should be conducted where larger samples of African American college students can be recruited.

Postoperative cognitive dysfunction in older patients with a history of alcohol abuse.

BACKGROUND: Postoperative cognitive dysfunction (POCD) affects a significant number of patients and may have serious consequences for quality of life. Although POCD is most frequent after cardiac surgery, the prevalence of POCD after noncardiac surgery in older patients is also significant. The risk factors for POCD after noncardiac surgery include advanced age and preexisting cognitive impairment. Self-reported alcohol abuse is a risk factor for postoperative delirium, but its significance for long-term POCD has not been investigated. The goal of this study was to determine whether neurocognitive function is impaired after noncardiac surgery during general anesthesia in older patients with a history of alcohol abuse. METHODS: Subjects aged 55 yr and older with self-reported alcohol abuse (n = 28) and age-, sex-, education-matched nonalcoholic controls (n = 28) were tested using a neurocognitive battery before and 2 weeks after elective surgery (n = 28) or a corresponding time interval without surgery (n = 28). Verbal memory, visuospatial memory, and executive functions were assessed. A neurologic examination was performed to exclude subjects with potential cerebrovascular damage. RESULTS: Significant three-way interactions (analysis of variance) for Visual Immediate Recall, Visual Delayed Recall, Semantic Fluency, Phonemic Fluency, and the Color-Word Stroop Test implied that cognitive performance in the alcoholic group decreased after surgery more than it did in the other three groups. CONCLUSIONS: The results suggest that a history of alcohol abuse in older patients presents a risk for postoperative cognitive impairment in the domains of visuospatial abilities and executive functions that may have important implications for quality of life and health risks.

Sexual abuse and sexual functioning in a chronic pelvic pain sample.

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index of the extent of sexual abuse experiences in childhood and adolescence/adulthood, higher scores were related to lower rates of sexual activity, less satisfaction with orgasm and feelings of closeness with sexual partners, and greater severity of and interference from pain. Findings point to the importance of controlling for relationship status in analyses of long-term effects of sexual abuse and of assessing chronic pelvic pain patients for histories of sexual abuse using measures that address the extent or severity of abuse.

Sexual functioning in women with chronic pelvic pain: the impact of depression, support, and abuse.

Many studies have documented associations between sexual functioning, depression, experiences of childhood sexual abuse, relationship support, and chronic pelvic pain, but none have addressed the interrelationships among all of these variables in a unified model. The aim of this preliminary study was to construct an integrative model predicting sexual functioning for women with chronic pelvic pain. Sixty-three women with chronic pelvic pain completed measures of sexual functioning for use as the criterion variable, and measures of the impact of chronic pain, depression, experiences of sexual abuse, and relationship support as predictors. The primary finding was that depression mediated the effects of child sexual abuse and partially mediated the effects of relationship support on sexual behavior and satisfaction with the sexual relationship. In addition to its indirect relationship through depression, relationship support also independently predicted sexual function. Thus, in this nonclinical sample, the effects of child sexual abuse on sexual function depended on the extent of depressive symptoms, while the influence of relationship support depended in part on depression.

Effect of relaxation on working memory and the Bispectral Index of the EEG.

Beneficial effects of relaxation on cardiovascular and immune functions and on memory has been implied but an empirical relationship between task performance and anxiety reduction has not been reported. In this study, we investigated whether guided imagery of relatively short duration would decrease S-Anxiety and electroencephalogram Bispectral Index and improve working memory. 42 participants (age: M=39, SD=11, 14 men, 28 women, university students and VA Medical Center employees, recruited by their professor or by fellow employees) underwent relaxation by 16-min. guided imagery or no treatment (control). Spielberger's State-Trait Anxiety Inventory and the WAIS-III Letter-Number Sequencing Test were administered before and after relaxation. S-Anxiety and BIS Index decreased and the Letter-Number test score increased by 30% after relaxation but not in the control group. This score was higher for participants with low anxiety and BIS Index. There was no significant difference between the groups before treatment. The results suggest that guided imagery of short duration produces relaxation as measured by psychological and neurophysiological indices and improves working memory performance.

Effect of mandatory parental notification on adolescent girls' use of sexual health care services.

CONTEXT: Mandatory parental notification for adolescents to obtain prescribed contraceptives is a controversial issue. Recently, legislation that would prohibit prescribed contraceptives for adolescents without parental involvement was introduced in 10 states and the US Congress. OBJECTIVE: To determine the effect of mandatory parental notification for prescribed contraceptives on use of sexual health care services by adolescent girls. DESIGN, SETTING, AND PARTICIPANTS: Girls younger than 18 years and seeking services at all 33 Planned Parenthood family planning clinics in Wisconsin (n = 1118) were surveyed during the spring of 1999. A response rate of 85% was achieved, yielding a sample of 950 girls. MAIN OUTCOME MEASURES: Percentages of girls who reported that they would stop using all sexual health care services, delay testing or treatment for human immunodeficiency virus (HIV) or other sexually transmitted diseases (STDs), or discontinue using specific (but not all) services because of parental notification. RESULTS: Fifty-nine percent (n = 556) indicated they would stop using all sexual health care services, delay testing or treatment for HIV or other STDs, or discontinue use of specific (but not all) sexual health care services if their parents were informed that they were seeking prescribed contraceptives. Eleven percent indicated they would discontinue or delay STD tests or treatment, even though the survey made it clear that mandatory parental notification would occur only for prescribed contraceptives. Analyses comparing girls of different ages and races and from urban vs rural clinics showed that, although the 17-year-olds and African American girls were significantly less likely to stop using sexual health care services with mandatory parental notification, roughly half of the 17-year-olds (56%) and African American girls (49%) indicated that they would stop using all sexual health care services, delay testing or treatment for HIV or other STDs, or discontinue use of specific (but not all) services with mandatory parental notification. CONCLUSION: Mandatory parental notification for prescribed contraceptives would impede girls' use of sexual health care services, potentially increasing teen pregnancies and the spread of STDs.