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Biomedical subjects

Barbara C Tilley

Publications and source records attributed to Barbara C Tilley.

27 records · Page 2Linked to original sources
PubMed2004

A pilot study of health education via a nurse-run telephone self-management programme for elderly people with osteoarthritis.

We conducted a pilot study of a nurse-run telephone self-management programme for elderly people with osteoarthritis (OA). Thirty-two subjects, aged 60 years or more, with a diagnosis of OA were recruited from two hospital rheumatology clinics and were randomized to a control or intervention group. The intervention group received six weekly mailings of OA health education modules, a relaxation audio-tape and six weekly 45 min follow-up telephone self-management sessions. There was a 100% compliance rate in the intervention group, and all subjects completed baseline and three-month interviews; one subject in each group was lost to six-month follow-up. There were no significant differences in self-management between the control and intervention groups. However, at three months there were improvements in the intervention group (relative to baseline) on some outcome measures. The results suggest that the telephone may be a useful tool for reinforcing health-promoting activities for patients.

Aged↗
PubMed2003

Recruiting older African American men to a cancer screening trial (the AAMEN Project).

PURPOSE: This article describes the demographic characteristics of participants in a randomized trial (the AAMEN Project) designed to recruit older (aged 55+ years) African American men to a cancer screening trial. DESIGN AND METHODS: The AAMEN Project is a recruitment trial developed for African American men aged 55+ years living in southeastern Michigan. RESULTS: Of the 34,376 African American men in the study, 37.6% had low incomes and 62.4% had moderate-to-high incomes. The average age of the men was 63.3 years (SD = 5.9 years). Among men who were eligible and interested in participating, the proportion of men with low incomes was significantly greater than the proportion of men with moderate-to-high incomes (p <.001). IMPLICATIONS: The AAMEN Project demonstrated success in recruiting a substantial proportion of men with low incomes as well as men with moderate-to-high incomes. These findings may facilitate the development of future recruitment efforts involving older African American men.

Black or African American↗
PubMed2003

Intention to be screened over time for colorectal cancer in male automotive workers.

Intention is an important construct in health promotion research, yet very little is known about whether cross-sectional correlates of intention to be screened for colorectal cancer (CRC) also predict intention over time or intention change. We used survey data from The Next Step Trial, a worksite health promotion trial, to address the following questions: (1) What is the consistency over time of intention to be screened for CRC? (2) Are the patterns and magnitude of associations between intention to be screened and the Preventive Health Model variables consistent over time? (3) What are the predictors of improving weaker intention to be screened, i.e., changing to strong intention? (4) What are the predictors of no change in strong intention to be screened, i.e., maintaining strong intention? and (5) What is the predictive ability of the models to predict intention to be screened for CRC? The study population consisted of white male automotive employees who responded to baseline (1993) and follow-up (1994 and 1995) surveys and did not have CRC at baseline or develop it during the study period. Of 5042 eligible workers, 2903 (58%) returned a baseline survey, and 2556 (88% of survey responders) met eligibility criteria; 75% (1929 of 2556) returned the year 1 survey, and 74% (1892 of 2556) returned the year 2 survey. We fit logistic regression models separately for the Preventive Health Model variables measured at baseline and each outcome (intention at year 1, intention at year 2, improving weaker intention, and no change in strong intention). The prevalence of strong intention to be screened for CRC was approximately 60% on all three surveys. Overall, 66% maintained their baseline intention over time. The most consistent predictors of strong intention, improving weaker intention, and no change in strong intention were family support, belief in the salience and coherence of screening, prior screening, and lack of concern about screening-related discomfort. Intention measured at baseline predicted intention measured 1 and 2 years later. Perceived susceptibility and lack of fear and worry about a CRC diagnosis predicted improving weaker intention. Having a family history of CRC or polyps predicted maintaining strong intention. Plant factors, self-efficacy, and beliefs about polyp removal were not predictors beyond the baseline year. Basing intervention development on cross-sectional associations may miss important factors or may incorrectly assume that cross-sectional associations are stable over time. A more focused, tailored intervention may be developed using factors that consistently predict intention.

Attitude to Health↗
PubMed2002

Perceptions of diabetes among patients in an urban health care system.

OBJECTIVES: A major problem facing health care providers today is adherence to treatment regimens by patients. Adherence is of even greater significance for patients with diabetes, who shoulder a great deal of responsibility in their disease management. Perceptions of diabetes have been found to play a major role in adherence. The effects of race and socioeconomic status on the disease perceptions remain unclear. This exploratory study encompassed two themes: (1) assessing perceptions of diabetes among African American and white American adults with diabetes who were patients in 1994 in a large, Midwestern, urban health care system and (2) examining the psychometric properties of the measurement instruments used to study perceptions. DESIGN: A stratified random sampling scheme (by race and socioeconomic status (SES)) was used. Diabetes perceptions were measured using three scales from the Meaning of Illness Questionnaire assessing the impact, loss, and stress associated with diabetes. Perceptions of physician efficacy were also measured. The study population consisted of 50 (68% response rate) African American and white American patients aged 18-65 years. RESULTS: No differences in SES were found between the African American and white American participants (p = 0.44). However, the African Americans in the study indicated a greater sense of loss associated with diabetes than the white Americans in the study (p < 0.05). In the combined racial group, the reliability coefficients, as measured by Cronbach's alpha, were 0.76, 0.78, 0.68, and 0.68 for the Impact, Loss, Stress, and Perceptions of Physician Efficacy scales, respectively. However, the results of within-racial-group analyses tell a different story. The Impact scale fitted the African American and white American subgroups, although there was some item variation by racial group. The Loss scale did not fit the white American subgroup, and the Stress and Perceptions of Physician Efficacy scales did not fit the African American subgroup. CONCLUSION: Perceptions of diabetes may vary by race, even when controlling for SES. Health professionals are in a unique position to develop diabetes management programs to help patients understand more about their diabetes, and thus to reduce some of the negative outcomes of diabetes by promoting adherence to recommended treatment regimens. In addition, overall measures of reliability may mask the instability of scales within specific study groups.

Adolescent↗
PubMed2002

Recruitment of African Americans with type 2 diabetes to a randomized controlled trial using three sources.

OBJECTIVES: To assess the usefulness of three sources (faith-based organizations (FBOs), health system, and community) for recruitment of African Americans with type 2 diabetes to a randomized controlled trial (RCT). DESIGN: African Americans with type 2 diabetes were recruited to a diabetes self-management program at four FBO sites. An observational study of a multifaceted recruitment strategy to enroll subjects in the RCT that evaluated the effectiveness of a diabetes self-management program and the effect of recruitment source on retention after enrollment. Self-administered demographic surveys and weekly class attendance records were collected. RESULTS: Of 184 interested individuals, 109 (59.2%) were enrolled. Of those enrolled, 60.6% recruited through the health system, 13.8% FBOs, and 19.2% the community. The highest yield was achieved through the health system. However, for both the intervention (I) and control (C) groups, respectively, participants recruited from FBOs (85.7% I; 62.5% C) were more likely to attend four or more sessions than those from the health system (75.0% I; 43.3% C) and community (55.6% I; 25.0% C). Despite similar class size, participants in the intervention group (74.5%; n = 41) were more likely to attend four or more of the seven classes than those in the delayed intervention (control group) (40.7%; n = 22). CONCLUSIONS: The findings suggest that African American adults with diabetes can be successfully recruited and retained in a racially targeted RCT conducted in FBOs. Key elements to consider are the use of a multifaceted approach for participant recruitment, particularly the benefit of health system physician involvement in recruitment since the highest yield was achieved through health system providers, and importance of site location for retention.

Adult↗
PubMedDate not supplied

Acculturation and diabetes among Hispanics: evidence from the 1999-2002 National Health and Nutrition Examination Survey.

OBJECTIVE: Hispanic individuals in the United States have a greater prevalence of diabetes mellitus than non-Hispanic white individuals; however, it is unclear whether Hispanics' risk of diabetes differs based on their level of acculturation. The purpose of our research was to examine acculturation among Hispanic Americans with respect to prevalence and control of diabetes. METHODS: We conducted an analysis of the National Health and Nutrition Examination Survey (NHANES), 1999-2002, a nationally representative sample of the noninstitutionalized U.S. population. We evaluated data on Hispanic adults (> or = 18 years of age, unweighted n=2,696), analyzing diagnosed diabetes, glycemic blood pressure and lipid control, and diabetes complications according to acculturation as measured by language and birth outside the United States. RESULTS: Hispanics with low acculturation were more likely to be without a routine place for health care, have no health insurance, and have low levels of education. In adjusted analyses, individuals with low acculturation, measured by language, were more likely to have diabetes (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.02, 3.54). Among individuals with diagnosed diabetes, no significant association was yielded between acculturation and diabetes control. However, individuals with low language acculturation were more likely to have the diabetes complication of peripheral neuropathy (OR 4.01, 95% CI 1.40, 11.48). CONCLUSIONS: Acculturation as measured through language is associated with diabetes and complications among Hispanics even after controlling for a variety of demographic characteristics including health insurance and education. The findings suggest that even within a "single" minority ethnic group, there are differences in disease prevalence and complications and access to health care.

Acculturation↗
PubMedDate not supplied

Development of a measure to assess patient trust in medical researchers.

PURPOSE: Many researchers find it difficult to recruit individuals, particularly minorities, for participation in studies. Mistrust of research and researchers may act as a barrier to participation. The purpose of this study was to develop a scale for assessing trust in medical researchers. METHODS: We developed a multi-item scale by means of multiple cognitive pretests with 25 African American adults and a random-digit-dialing telephone survey of 512 adults in South Carolina. Psychometric characteristics of the Trust in Medical Researchers Scale was assessed by factor analysis using both orthogonal and oblique rotations and Cronbach's alpha. We assessed construct validity as well as a behavioral intention for future participation in a medical research project. RESULTS: The results of the orthogonal and oblique rotations in the exploratory factor analysis were similar and suggested 2 distinct factors in the final 12 items included in the scale. Cronbach's alpha for the entire scale was 0.84, whereas it was 0.78 for the first factor of Participant Deception and 0.75 for the second factor of Researcher Honesty. White respondents (28.7 +/- 5.6) had greater trust than African American respondents (24.1 +/- 6.9) (P <.001). Individuals with high trust in medical researchers were more likely to express interest in future participation in medical research. CONCLUSIONS: The Trust in Medical Researchers Scale has good psychometric qualities and differentiates African American from white respondents, as well as individuals who indicate that they are likely to participate in medical research from those who are not. More focused investigations in hard-to-recruit populations will help to establish the utility of the Trust in Medical Researchers Scale.

Adult↗