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Supplemental material, SOD_supplemental_online_document for A New Measure of Research Participant Burden by Jennifer H. Lingler, Karen L. Schmidt, Amanda L. Gentry, Lu Hu and Lauren A. Terhorst in Journal of Empirical Research on Human... more
Supplemental material, SOD_supplemental_online_document for A New Measure of Research Participant Burden by Jennifer H. Lingler, Karen L. Schmidt, Amanda L. Gentry, Lu Hu and Lauren A. Terhorst in Journal of Empirical Research on Human Research Ethics
OBJECTIVES To determine the covariance of heart rate variability (HRV) and self-reported neurobehavioral symptoms after traumatic brain injury (TBI) collected using mobile health (mHealth) technology. SETTING Community. PARTICIPANTS... more
OBJECTIVES To determine the covariance of heart rate variability (HRV) and self-reported neurobehavioral symptoms after traumatic brain injury (TBI) collected using mobile health (mHealth) technology. SETTING Community. PARTICIPANTS Adults with lifetime history of TBI (n = 52) and adults with no history of brain injury (n = 12). DESIGN Two-week prospective ecological momentary assessment study. MAIN MEASURES Behavioral Assessment Screening Tool (BASTmHealth) subscales (Negative Affect, Fatigue, Executive Dysfunction, Substance Abuse, and Impulsivity) measured frequency of neurobehavioral symptoms via a RedCap link sent by text message. Resting HRV (root mean square of successive R-R interval differences) was measured for 5 minutes every morning upon waking using a commercially available heart rate monitor (Polar H10, paired with Elite HRV app). RESULTS Data for n = 48 (n = 38 with TBI; n = 10 without TBI) participants were included in covariance analyses, with average cross-correlation coefficients (0-day lag) varying greatly across participants. We found that the presence and direction of the relationship between HRV and neurobehavioral symptoms varied from person to person. Cross-correlation coefficients r ≤ -0.30, observed in 27.1% to 29.2% of participants for Negative Affect, Executive Dysfunction, and Fatigue, 22.9% of participants for Impulsivity, and only 10.4% of participants for Substance Abuse, supported our hypothesis that lower HRV would covary with more frequent symptoms. However, we also found 2.0% to 20.8% of participants had positive cross-correlations (r ≥ 0.30) across all subscales, indicating that higher HRV may sometimes correlate with more neurobehavioral symptoms, and 54.2% to 87.5% had no significant cross-correlations. CONCLUSIONS It is generally feasible for community-dwelling adults with and without TBI to use a commercially available wearable device to capture daily HRV measures and to complete a short, electronic self-reported neurobehavioral symptom measure for a 2-week period. The covariance of HRV and neurobehavioral symptoms over time suggests that HRV could be used as a relevant physiological biomarker of neurobehavioral symptoms, though how it would be interpreted and used in practice would vary on a person-by-person and symptom domain basis and requires further study.
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Protecting human participants requires consideration and minimization of the burdens imposed by research. Effective conceptualizations of research burden should include appraisals of indirect burdens depending on research duration,... more
Protecting human participants requires consideration and minimization of the burdens imposed by research. Effective conceptualizations of research burden should include appraisals of indirect burdens depending on research duration, intensity, and invasiveness. Introducing the concept of perceived research burden, we developed, tested, and validated a psychometric instrument for measuring burden, using vignettes of research studies presented to research volunteers and family members. We found high internal consistency of the Perceived Research Burden Assessment (PeRBA), across research scenarios (Cronbach’s alpha .87 – .96). We demonstrated convergent validity by correlating research burden with likelihood for enrolling in a research study. Because perceived research burden was largely unrelated to perceived social support, we interpreted PeRBA as demonstrating discriminant validity.
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Objective Instrumental activities of daily living (IADL) are important for managing multiple chronic conditions (MCC) and maintaining independence while aging. Using data from the National Health and Aging Trends Study (NHATS), we... more
Objective Instrumental activities of daily living (IADL) are important for managing multiple chronic conditions (MCC) and maintaining independence while aging. Using data from the National Health and Aging Trends Study (NHATS), we answered the question: are there differences in ability and performance of IADL among groups of older adults with 0–1 (no MCC), 2–4 (low MCC), and 5+ chronic conditions (multisystem morbidity: MM)? Methods Cross-sectional study using Poisson regression and incidence rate ratios. Participants were 6,019 community-dwelling older adults who regularly take medications. We derived composite variables for ability and performance of IADL; MCC groups were based on count of 11 chronic conditions. Results Older adults with MM had lower IADL count for ability (IRR = .81) and performance (IRR = .77), and MM group significantly predicted both ability and performance of IADL (p
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The purpose of our scoping review was to describe the current use of mHealth technology for long-term assessment of patient-reported outcomes in community-dwelling individuals with acquired brain injury (ABI). Following PRISMA guidelines,... more
The purpose of our scoping review was to describe the current use of mHealth technology for long-term assessment of patient-reported outcomes in community-dwelling individuals with acquired brain injury (ABI). Following PRISMA guidelines, we conducted a scoping review of literature meeting these criteria: (1) civilians or military veterans, all ages; (2) self-reported or caregiver-reported outcomes assessed via mobile device in the community (not exclusively clinic/hospital); (3) published in English; (4) published in 2015–2019. We searched Ovid MEDLINE(R) < 1946 to 16 August 2019, MEDLINE InProcess, EPub, Embase, and PsycINFO databases for articles. Thirteen manuscripts representing 12 distinct studies were organized by type of ABI [traumatic brain injury (TBI) and stroke] to extract outcomes, mHealth technology used, design, and inclusion of ecological momentary assessment (EMA). Outcomes included post-concussive, depressive, and affective symptoms, fatigue, daily activities, s...
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Introduction The purpose of this study was to examine parental use of evidence-based mealtime strategies, child mealtime behavior, and parental identification of mealtime problems over time as parents were coached to implement the... more
Introduction The purpose of this study was to examine parental use of evidence-based mealtime strategies, child mealtime behavior, and parental identification of mealtime problems over time as parents were coached to implement the Promoting Routines of Exploration and Play during Mealtime intervention as part of a pilot study. Method This repeated measures study included data collection during three phases: (a) pre-intervention; (b) intervention; (c) post-intervention. Primary outcome measures included a parental strategy use checklist (parental strategy use) and the Behavioral Pediatric Feeding Assessment (problematic child behavior and parental identification of mealtime problems). Linear mixed models were fitted to assess change over time. Results We observed significant improvements in parental strategy use ( p
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Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be identified... more
Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be identified and provided self-efficacy enhancing interventions. Scales measuring self-efficacy in the management of chronic diseases exist, but do not cover the broad spectrum of preventive services and behaviors that can improve the health of older adults, particularly older women who are vulnerable to poorer health and lesser utilization of preventive services. This study aimed to evaluate the psychometric properties of a new preventive services use self-efficacy scale, by measuring its internal consistency reliability, assessing internal construct validity by exploring factor structure, and examining differences in self-efficacy scores according to participant characteristics. The Preventive Services Use Self-Efficacy (PRESS) Scale was developed by an expert ...
Research Interests: Communication, Psychometrics, Self Care, Exercise therapy, Medicine, and 12 moreSelf Efficacy, Library and Information Studies, Humans, Chronic Disease, Female, Arthritis, Aged, Middle Aged, Public health systems and services research, Reproducibility of Results, Preventive Health Services, and Physician-Patient Relations
While it is generally accepted that the mobile cell phone has become ubiquitous within society for communicating, the actual use of the utilities on a phone have not been reported. Understanding how communication patterns are changing in... more
While it is generally accepted that the mobile cell phone has become ubiquitous within society for communicating, the actual use of the utilities on a phone have not been reported. Understanding how communication patterns are changing in society as a result of the mobile cell phone ...
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Research Interests: Psychometrics, Quality of life, Health, Menopause, Medicine, and 15 moreDiscriminant Analysis, Humans, Female, Psychometric Properties, Clinical Sciences, Middle Aged, Questionnaires, Reproducibility of Results, Personal Satisfaction, Libido, Randomized Controlled Trials as Topic, attitude to health, Paediatrics and reproductive medicine, postmenopause, and climacteric(Discriminant Analysis, Humans, Female, Psychometric Properties, Clinical Sciences, Middle Aged, Questionnaires, Reproducibility of Results, Personal Satisfaction, Libido, Randomized Controlled Trials as Topic, attitude to health, Paediatrics and reproductive medicine, postmenopause, and climacteric)
(Discriminant Analysis, Humans, Female, Psychometric Properties, Clinical Sciences, Middle Aged, Questionnaires, Reproducibility of Results, Personal Satisfaction, Libido, Randomized Controlled Trials as Topic, attitude to health, Paediatrics and reproductive medicine, postmenopause, and climacteric)
Research Interests: Psychology, Medicine, Curriculum, Drug Use, Humans, and 15 moreProgram Development, Substance Abuse, Substance Use, Nursing Education, Female, Alcohol Drinking, Male, Drug abuse, Middle Aged, Nursing Students, Education and Training, Adult, Alcohol Use, Brief Intervention, and Substance-Related Disorders
Objective: Develop and validate the Behavioral Assessment Screening Tool for Adolescents with brain injury. Setting: Concussion clinics Participants: Adolescents with mild traumatic brain injury 3 months after initial concussion clinic... more
Objective: Develop and validate the Behavioral Assessment Screening Tool for Adolescents with brain injury. Setting: Concussion clinics Participants: Adolescents with mild traumatic brain injury 3 months after initial concussion clinic visit (n = 138). Design: Assessment development and validation (cross-sectional cohort) study Main Measures: Behavioral Assessment Screening Tool – Adolescent Results: Expert panel members added or modified items specific to adolescents to the original Behavioral Assessment Screening Tool for adults. The Content Validity Index was 97.2%. Exploratory factor analysis of the Behavioral Assessment Screening Tool – Adolescent reduced the initial 70 items to 46 primary items with a 3-factor solution: Negative Affect & Fatigue, Executive & Social Function, and Risk Behaviors. Internal consistency reliabilities ranged from good to excellent for all factors (Cronbach’s α =.80-.95). We retained four secondary maladaptive coping items (from an initial six), thou...
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ABSTRACT Objective: To describe patterns of sedentary behavior over 6 weeks among ambulatory people with subacute and chronic stroke. Design: Observational longitudinal study with assessments at baseline (T0) and week 6 (T1). Methods:... more
ABSTRACT Objective: To describe patterns of sedentary behavior over 6 weeks among ambulatory people with subacute and chronic stroke. Design: Observational longitudinal study with assessments at baseline (T0) and week 6 (T1). Methods: Community-dwelling people with stroke (n = 39) pooled from two studies who were ≥18 years of age were assessed for sedentary behavior at 2 timepoints (T0, T1). Sedentary behavior was measured with the activPAL micro3 following a 7-day wear protocol to obtain mean daily: total sitting time, sitting time accumulated in bouts ≥30 minutes, number of sit-to-stand transitions, and fragmentation index (sit-to-stand transitions/total sitting hours). Paired samples t-tests were used to calculate mean group differences in sedentary behavior metrics between T0 and T1 (α =.05). Cohen’s d was calculated to describe the magnitude of within-person change between T0 and T1. Results: There were no statistically significant within-person differences between T0 and T1 on mean daily sitting time (Cohen’s d= −0.21, p=.19), sitting time accumulated in bouts ≥30 minutes (d= −0.27, p=.11), number of sit-to-stand transitions (d= −0.02, p=.53), or the fragmentation index (d= −0.11, p=.92). Conclusions: Sedentary behavior metrics were stable for over 6 weeks. The number of sit-to-stand transitions per day and the fragmentation index appeared to be the most stable indicators over 6 weeks. Future research should confirm these findings and identify correlates of sedentary behavior among people with stroke.
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Date Presented 03/28/20 This presentation will characterize our experiences integrating stakeholder engagement into a multisite pragmatic clinical trial focused on optimizing care for nursing-home residents with dementia. We will discuss... more
Date Presented 03/28/20 This presentation will characterize our experiences integrating stakeholder engagement into a multisite pragmatic clinical trial focused on optimizing care for nursing-home residents with dementia. We will discuss our methods for building OT capacity to conduct research that includes the voices of stakeholders. Primary Author and Speaker: Jenny Martinez Contributing Authors: Catherine Piersol, Lauren Terhorst, Sherrie Holloway, Carin Wong, Felicia Chew, Natalie Leland
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OBJECTIVES Sleep health in rare disease is often overlooked due to the complex nature of the disease. For males with Duchenne muscular dystrophy, sleep assessment is typically focused on pulmonary function and identification of sleep... more
OBJECTIVES Sleep health in rare disease is often overlooked due to the complex nature of the disease. For males with Duchenne muscular dystrophy, sleep assessment is typically focused on pulmonary function and identification of sleep disordered breathing. Unfortunately for young boys with Duchenne muscular dystrophy, sleep assessment is often neglected, resulting in a dearth of knowledge on sleep health in this population. This study describes sleep quantity and quality in both younger (4-9 years) and older (10-17 years) males with Duchenne muscular dystrophy (n = 19) and compares these characteristics with sleep characteristics of unaffected peers (n = 17). METHODS This study was a longitudinal, observational study. Sleep measures were collected using the parent-proxy Children's Sleep Habits Questionnaire-Abbreviated version and objective sleep measures from actigraphy (sleep efficiency, awakenings, and awakening duration) over 30 days for all participants. Means and standard deviations were examined, and effect sizes were computed to quantify the magnitude of difference between the Duchenne muscular dystrophy and unaffected groups. RESULTS Overall, boys with Duchenne muscular dystrophy were found to experience worse sleep than their unaffected peers as measured by parent report and actigraphy. Effect sizes of both measures demonstrated moderate to large magnitudes of difference in many of the sleep variables. Parents of boys with Duchenne muscular dystrophy reported higher scores (indicating worse sleep) in all subsections and total score of the Children's Sleep Habits Questionnaire - Abbreviated version. Actigraphy data indicated that the Duchenne muscular dystrophy group had lower percent sleep efficiency, more night awakenings and longer duration of night awakenings than their unaffected peers. CONCLUSION Our findings offer a novel look into sleep in young boys with Duchenne muscular dystrophy. Both parent-report and actigraphy data indicate poor sleep health in this population compared with age-matched unaffected peers. Actigraphy was found to align with parent-report of sleep in this population, supporting the use of these two different ways to measure sleep in Duchenne muscular dystrophy. Results from this study should encourage clinicians and researchers alike to further explore sleep and its impact on disease in young boys with Duchenne muscular dystrophy.
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Date Presented 04/05/19 Identifying factors early in the rehabilitation process that predict the inability to return home independently after stroke may better inform treatment decisions. Therefore, we performed a secondary analysis to... more
Date Presented 04/05/19 Identifying factors early in the rehabilitation process that predict the inability to return home independently after stroke may better inform treatment decisions. Therefore, we performed a secondary analysis to examine demographic, medical, and cognitive factors that might predict nonresponse during inpatient rehabilitation. Using a backward stepwise logistic regression, we found that the variables most strongly correlated with dependence were cognitive impairment and motor impairment. Primary Author and Speaker: Sarah Walker Contributing Authors: Elizabeth Skidmore, Lauren Terhorst
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Background and PurposeThe informal care demands of primary malignant brain tumor (PMBT) patients include unique issues associated with neurological and cognitive symptoms. Existing caregiver needs questionnaires do not include these... more
Background and PurposeThe informal care demands of primary malignant brain tumor (PMBT) patients include unique issues associated with neurological and cognitive symptoms. Existing caregiver needs questionnaires do not include these disease-specific symptoms, which are particularly distressing. Therefore, we have developed the neuro-oncology Caregiver Needs Screen (CNS) and evaluated its psychometric properties.MethodsThe 32-item instrument was developed based on PMBT caregiver interviews (N= 109) and expert review. The CNS was tested along measures of depression, anxiety, burden, and mastery in 122 PMBT caregivers. Principal components analysis was used to examine item properties and internal structure. Internal consistency reliability and construct validity were assessed.ResultsSix subscales were identified with internal consistency ranging between alpha = .653 and .857. Convergent validity was verified by moderate/high correlations between measures of caregiver well-being and CNS...
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OBJECTIVE. Poor self-awareness co-occurs with cognitive impairments after stroke and may influence independence in daily activities. Strategy training promotes independence after stroke, but poor awareness may attenuate treatment... more
OBJECTIVE. Poor self-awareness co-occurs with cognitive impairments after stroke and may influence independence in daily activities. Strategy training promotes independence after stroke, but poor awareness may attenuate treatment response. We examined the degree to which awareness status affected changes in independence attributed to strategy training. METHOD. We conducted a secondary analysis of 30 participants with cognitive impairments after acute stroke randomized to strategy training or attention control in addition to typical inpatient rehabilitation. We measured awareness with the Self-Awareness of Deficits Interview and independence with the FIM™. Data were analyzed using general linear models. RESULTS. Poor awareness attenuated improvements in independence over time, F(3, 55) = 3.04, p = .038. Strategy training promoted greater improvements in independence over time relative to attention control, F(3, 55) = 5.93, p = .002. However, the interaction between awareness and inte...
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The aims of this study were to examine the potential association between sleep problems, symptom burden, and survival in patients with advanced cancer. A prospective study of 294 patients with gastrointestinal cancer administered... more
The aims of this study were to examine the potential association between sleep problems, symptom burden, and survival in patients with advanced cancer. A prospective study of 294 patients with gastrointestinal cancer administered questionnaires assessing sleep, depression, anxiety, stress, pain, fatigue, and health-related quality of life. Serum levels of cytokines including interleukin (IL)-1α, IL-1β, tumor necrosis factor α, IL-10, IL-2, and interferon-γ were measured to assess biological mediation between sleep and survival. Survival was measured as time from diagnosis to death. Fifty-nine percent of patients reported poor sleep quality, 53% reported poor sleep efficiency, 39% reported sleep latency greater than 30 minutes, and 45% reported sleeping less than 6 hours or greater than 10 hours. We found a significant association between sleep duration and symptom burden. Shorter sleep duration was significantly associated with higher levels of fatigue (r = -0.169, p = .01), pain (r...
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Date Presented 3/30/2017 The Mealtime PREP intervention shows promise to improve dietary variety and mealtime behaviors and lower risk of nutritional deficiency in toddlers with sensory food aversions. Moderate to large effect sizes were... more
Date Presented 3/30/2017 The Mealtime PREP intervention shows promise to improve dietary variety and mealtime behaviors and lower risk of nutritional deficiency in toddlers with sensory food aversions. Moderate to large effect sizes were observed in a small sample of 11 families trained to deliver this intervention in the home. Primary Author and Speaker: Angela Caldwell Contributing Authors: Roxanna Bendixen, Cynthia Danford, Lauren Terhorst, Elizabeth Skidmore
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Background: Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be... more
Background: Preventive services offered to older Americans are currently under-utilized despite considerable evidence regarding their health and economic benefits. Individuals with low self-efficacy in accessing these services need to be identified and provided self-efficacy enhancing interventions. Scales measuring self-efficacy in the management of chronic diseases exist, but do not cover the broad spectrum of preventive services and behaviors that can improve the health of older adults, particularly older women who are vulnerable to poorer health and lesser utilization of preventive services. This study aimed to evaluate the psychometric properties of a new preventive services use self-efficacy scale, by measuring its internal consistency reliability, assessing internal construct validity by exploring factor structure, and examining differences in self-efficacy scores according to participant characteristics. Methods: The Preventive Services Use Self-Efficacy (PRESS) Scale was de...
Research Interests: Communication, Psychometrics, Self Care, Exercise therapy, Medicine, and 12 moreSelf Efficacy, Library and Information Studies, Humans, Chronic Disease, Female, Arthritis, Aged, Middle Aged, Public health systems and services research, Reproducibility of Results, Preventive Health Services, and Physician-Patient Relations
Date Presented 4/8/2016 Food refusal in young children is common. Parent-led intervention is needed to support improvement during daily meals. This pilot study supports the use of parent-led intervention and data collection for... more
Date Presented 4/8/2016 Food refusal in young children is common. Parent-led intervention is needed to support improvement during daily meals. This pilot study supports the use of parent-led intervention and data collection for family-centered intervention optimization. Primary Author and Speaker: Angela R Caldwell Contributing Authors: Lauren Terhorst, Ketki Raina, Joan Rogers
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Evaluating engagement in a research partnership can capture the success and impact of the research team–stakeholder partnerships. This article describes the Stakeholder-Centric Instrumentation Process (SCIP), an iterative method to... more
Evaluating engagement in a research partnership can capture the success and impact of the research team–stakeholder partnerships. This article describes the Stakeholder-Centric Instrumentation Process (SCIP), an iterative method to develop an evaluation that reflects research team–stakeholder collective values, language, and priorities. We describe our implementation of the SCIP and provide the Stakeholder-Centric Engagement Evaluation, an evaluation developed in collaboration with our advisory committee. Mean scores across three administrations of the tool remained constant. We monitored responses received from our advisory committee during each administration for changes in scores that guided refinements to our stakeholder engagement strategy. Face validity and acceptability questions showed high satisfaction for the tool’s time required to complete, ( M = 4.50, SD = 0.86), clarity ( M = 4.56, SD = 0.78), and relevance ( M = 4.67, SD = 0.49) (maximum score = 5). The SCIP methodolo...
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Aims Given the importance of addressing provider attitudes toward individuals with unhealthy alcohol use and the current emphasis on person-centered language to help decrease stigma and mitigate negative attitudes, the aim of this study... more
Aims Given the importance of addressing provider attitudes toward individuals with unhealthy alcohol use and the current emphasis on person-centered language to help decrease stigma and mitigate negative attitudes, the aim of this study was to evaluate the psychometric properties of a contemporary version of the Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) that uses person-centered language and addresses the spectrum of alcohol use. Methods The authors created a person-centered version of the AAPPQ (PC-AAPPQ) and conducted a cross-sectional study of its psychometric properties in academic settings in the Northeastern United States. The PC-AAPPQ was administered to 651 nursing students. Reliability analysis of the new instrument was performed using the total sample. Only surveys with complete data (n = 637) were randomly split into two datasets, one used for the exploratory factor analysis (EFA) (n = 310) and the other for confirmatory factor analysis (CFA) (n = 327)...
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Few instruments that measure physical activity (pa) can accurately quantify pa performed at light and moderate intensities, which is particularly relevant to older adults. Evidence for responsiveness of these instruments after an... more
Few instruments that measure physical activity (pa) can accurately quantify pa performed at light and moderate intensities, which is particularly relevant to older adults. Evidence for responsiveness of these instruments after an intervention is limited. o estimate and compare the responsiveness of two activity monitors and one questionnaire in assessing PA after an intervention following total knee Arthroplasty. This one-group pretest-posttest, repeated-measures study analyzed changes in duration of daily PA and the standardized response mean (SRM) to assess internal responsiveness that were compared across instruments. Correlations between changes in PA measured by the proposed instruments and the global rating of change were used to test external responsiveness. Agreement between PA instruments on identifying individuals who changed their PA based on measurement error was assessed using weighted-Kappa (K). Thirty subjects, mean age 67(6) and 73% female, were analyzed. Changes in ...
This study aimed to develop a novel tool for measuring behavioural dysregulation in adults with traumatic brain injury (TBI) using objective data sources and real-world application and provide preliminary evidence for its psychometric... more
This study aimed to develop a novel tool for measuring behavioural dysregulation in adults with traumatic brain injury (TBI) using objective data sources and real-world application and provide preliminary evidence for its psychometric properties. Fourteen adults with TBI receiving services at a local brain injury rehabilitation programme completed multiple assessments of behaviour and followed by a series of challenging problem-solving tasks while being video recorded. Trained clinicians completed post-hoc behavioural assessments using the behavioural dysregulation ratings scale, and behavioural event data were then extracted for comparison with self-report measures. Subject matter experts in neurorehabilitation were in 100% agreement that preliminarily, the new tool measured the construct of behavioural dysregulation. Construct validity was established through strong convergence with 'like' measures and weak correlation with 'unlike' measures. Substantial inter-rate...
Research Interests: Psychometrics, Attention, Humans, Female, Male, and 11 moreMental Disorders, Awareness, Brain injury, Reproducibility of Results, Professional Competence, Pilot Projects, Cross Sectional Studies, Neuropsychological Tests, Psychology and Cognitive Sciences, Outcome assessment (Health care), and Medical and Health Sciences
The purpose of this exploratory study was to identify clinical predictors that could distinguish clients' level of engagement in inpatient rehabilitation following stroke. This is a secondary analysis of pooled data from three... more
The purpose of this exploratory study was to identify clinical predictors that could distinguish clients' level of engagement in inpatient rehabilitation following stroke. This is a secondary analysis of pooled data from three randomized controlled trials that examined the effects of a behavioral intervention. The sample (n=208) consisted of clients with stroke who had cognitive deficits (Quick-EXIT≥3) and were admitted to inpatient rehabilitation facilities associated with a university medical center. Individuals with pre-morbid dementia, aphasia and mood disorders were excluded. The Pittsburgh Rehabilitation Participation Scale was used to measure engagement. Clinical predictors were measured using the Functional Independence Measure, National Institutes of Health Stroke Scale, Repeatable Battery for the Assessment of Neuropsychological Status, selected subtests of the Delis-Kaplan Executive Function System, Patient Health Questionnaire-9, and Chedoke McMaster Stroke Assessmen...
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Treatment of carpal tunnel syndrome (CTS) in commercially insured patients across the spectrum of provider types rarely has been described. To describe patterns of types of treatment for patients with CTS using a large commercial... more
Treatment of carpal tunnel syndrome (CTS) in commercially insured patients across the spectrum of provider types rarely has been described. To describe patterns of types of treatment for patients with CTS using a large commercial insurance database. Retrospective cohort descriptive study. Administrative health data from the Clinformatics Data Mart (OptumInsight, Eden Prairie, MN). Adults with a primary diagnosis of CTS seen from between January 2010 to December 2012 who had a total of 48 months of continuous data (12 months before diagnosis and 36 months after diagnosis) (n = 24,931). Frequency of types of treatment (heat, manual therapy, positioning, steroids, stretching, surgery) by number of treatments, number of visits, provider type, and characteristics. Fifty-three percent of patients received no reported treatment, and 50.4% had no additional visits. Surgery (42.5%) and positioning (39.8%) were the most frequent single treatments. Patients who were seen by orthopedist for the...
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Purpose The purpose of this study is to determine feasibility, satisfaction, and preliminary effects of Mindful Stress Reduction in Diabetes Education (Mind-STRIDE), a mindfulness-based intervention for veterans. Methods The study used a... more
Purpose The purpose of this study is to determine feasibility, satisfaction, and preliminary effects of Mindful Stress Reduction in Diabetes Education (Mind-STRIDE), a mindfulness-based intervention for veterans. Methods The study used a single-group pretest-posttest repeated-measures design. The 90-minute Mind-STRIDE training, adapted from Mindfulness Based Stress Reduction (MBSR), was provided as the final component of a half-day diabetes self-management education class at a Veterans Affairs (VA) outpatient diabetes clinic. Following initial training, participants were asked to practice mindfulness at home for 10 minutes each day during the 3-month study. Study recruitment and retention were calculated as rates. Veteran and diabetes educator satisfaction were assessed by rating scales and open-ended comments. Psychosocial-behavioral and metabolic outcomes were assessed at baseline and 3 months after initial training. Bivariate correlations were performed to describe relationships ...