Biomedical subjects

Michele M Carter

Publications and source records attributed to Michele M Carter.

8 recordsLinked to original sources

PubMed2006

Cultural competency training for third-year clerkship students: effects of an interactive workshop on student attitudes.

UNLABELLED: With an increasing awareness of health disparities, medical schools are challenged to develop training in cultural competency for their students. We developed and evaluated the effectiveness of an interactive workshop designed to improve third-year students' attitudes, beliefs and cross-cultural communication skills. METHODS: At the start of a six-week required family medicine clerkship, 196 medical students participated in small group (20-24 students) workshops. Didactics included facts about health disparities and a model of cultural competency. During a skill-building component, students were exposed to live vignettes portraying ineffective and effective cross-cultural doctor-patient interactions. Impact on students' attitudes, perceived bias and knowledge of techniques was assessed by comparing pre- and postworkshop scores. RESULTS: Participants increased their cultural awareness on most items of a cultural awareness scale. Fifty-five-, 71- and 66% of the sample agreed or strongly agreed the program was valuable, appropriate and effective, respectively. Conversely, only 17-, 6- and 9% of the sample disagreed or strongly disagreed, respectively. CONCLUSIONS: A workshop for third-year students led to an increase in cultural awareness and was considered appropriate and valuable. Further study, including longitudinal training and evaluation, is needed regarding effective methods to increase cultural competence in clinical practice.

Adult↗

PubMed2005

Ataques de nervios in relation to anxiety sensitivity among island Puerto Ricans.

This study investigated the symptom profile of ataques de nervios (ADN) among Puerto Rican volunteers from the community who self-identified as having experienced at least one ataque. As expected, the most commonly reported ataques-specific symptoms were crying, anger, nervousness, and becoming hysterical. Comparing the responses of those with ADN to those with no history of ADN but who reported elevated anxiety sensitivity (AS) indicated that both groups were comparable on measures of depression, state and trait anxiety, and associated panic symptoms. As expected, both groups scored significantly higher on all measures than did participants with no history of ADN and low AS with the exception of the measure of state anxiety. It is unclear, however, whether the overlap in symptom severity between those with ADN and those with elevated anxiety sensitivity indicates that ADN and AS are the same or distinct conditions.

Adult↗

PubMed2005

Factor structure and construct validity of the Anxiety Sensitivity Index among island Puerto Ricans.

The factor structure and convergent and discriminant validity of the Anxiety Sensitivity Index (ASI) were examined among a sample of 275 island Puerto Ricans. Results from a confirmatory factor analysis (CFA) comparing our data to factor solutions commonly reported as representative of European American and Spanish populations indicated a poor fit. A subsequent exploratory factor analysis (EFA) indicated that a two-factor solution (Factor 1, Anxiety Sensitivity; Factor 2, Emotional Concerns) provided the best fit. Correlations between the ASI and anxiety measures were moderately high providing evidence of convergent validity, while correlations between the ASI and BDI were significantly lower providing evidence of discriminant validity. Scores on all measures were positively correlated with acculturation, suggesting that those who ascribe to more traditional Hispanic culture report elevated anxiety.

Adolescent↗

PubMed2005

Obstetrician-gynecologists' decision making about the diagnosis of major depressive disorder and premenstrual dysphoric disorder.

Major depressive disorder (MDD) is underdiagnosed and undertreated in ambulatory care settings including gynecologic practices. Far less is known about the diagnosis of Premenstrual Dysphoric Disorder (PMDD). Three hundred and thirty-five gynecologists responded to mailed questionnaires that used descriptive scenarios as analogues to clinical cases. Questionnaire recipients were randomly selected to receive either a MDD or PMDD version of the questionnaire. Respondents were less accurate when diagnosing MDD cases (48% accuracy; p = 0.526), than PMDD cases (80% accuracy; p < 0.001), but were significantly more confident about their probability ratings of MDD cases, t = 2.57, p < 0.02. Qualitative analysis suggested that less accurate MDD respondents did not prioritize case data according to DSM-IV criteria, whereas almost all PMDD respondents made use of valid reasoning strategies. Respondents did not take base rates into account when deciding about the probability of either affective disorder. Results imply that gynecologists employ cognitive strategies that result in accurate diagnostic judgments about PMDD, but overconfidence, lack of attention to DSM-IV criteria and base rate neglect could hinder clinical decisions about MDD, and may contribute to underdiagnosis of depression.

Adult↗

PubMed2005

Church-based obesity treatment for African-American women improves adherence.

This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment program that promotes weight loss and exercise, among 22 Caucasian-American and 10 African-American overweight women in a university setting to 10 African-American overweight women in a church setting. Behavioral Choice Treatment (BCT) promotes moderate behavior change that can be comfortably and therefore permanently maintained. Participants obtained feedback from computerized eating diaries and kept exercise logs. Results indicated that both university groups exhibited comparable eating pathology at pre- and post-treatment and comparable weight loss, despite the African-American sample attending fewer sessions. The African-American church group exhibited less disordered eating attitudes, less interpersonal distrust (eg, reluctance to form close relationships or sense of alienation) at pre-treatment, and experienced significantly greater weight loss than either university group. All groups lost weight and maintained these losses at 12-month follow-up. Preliminary results suggest treatment setting may play an important role in treatment adherence and sample characteristics.

Adolescent↗

PubMed2004

Factor structure, reliability, and validity of the Penn State Worry Questionnaire: differences between African-American and White-American college students.

This study examined differences in the factor structure of the Penn State Worry Questionnaire (PSWQ) between African-American (n=181) and White-American (n=180) college students. Results from a confirmatory factor analysis indicated that the traditional single-factor solution did not provide the best fit for the data from either ethnic group. A multiple-group factor analysis indicated that underlying structure of Factor 1 was roughly equivalent between ethnic groups. Structure of Factor 2, however, differed between groups. Specifically, item 10 loaded on different factors for each group. In support of these analyses, an exploratory factor analyses (EFA) among White-American participants indicated the presence of a two-factor model while an EFA among African-Americans indicated the presence of three factors. Despite some overlap in the overall factor structure between ethnic groups, African-Americans scored significantly lower on the PSWQ than the White-American group. Furthermore, among African-Americans level of ethnic identity was negatively related to state and trait measures of anxiety, but unrelated to measures of depression and worry.

Adult↗

PubMed2004

Ethnic differences in preferences for female weight and waist-to-hip ratio: a comparison of African-American and White American college and community samples.

This study examined both ethnic differences and differences between college and community samples in male preferences for ideal body size and shape in women. As expected, it was found that African-American men were more likely to choose heavier figures as ideal than White American men did. Contrary to expectations, there were no differences in chosen ideal weight between college and community subsamples. As expected, both ethnic groups chose figures with a low waist-to-hip ratio (WHR), but African-American men were more likely to choose a very low WHR as ideal. The findings replicate and extend research showing weight to be a more important cue than WHR in the mate-selection process and support the theory that African-American men's preferences may serve as a protective factor against eating and body image pathology in African-American women.

Adult↗

PubMed2004

Anger cognitions and cardiovascular recovery following provocation.

The current study describes the creation and validation of the Anger Cognitions Inventory (ACI) to assess the cognitive appraisals associated with resentful and reflective anger. The ACI was created based on a content analysis of self-reports of participants' thoughts and feelings following anger provocation in the laboratory. Exploratory and confirmatory factor analyses on two separate college student samples (N = 267 and N = 276, respectively) revealed five subscales which could validly be grouped into resentful and reflective anger. Convergent and divergent validity data showed that resentful anger correlated positively with anger-out/trait anger and reflective anger correlated positively with anger-in/brooding. A second study showed positive correlations between rumination and delayed cardiovascular recovery following anger provocation. Limitations of both studies include restricted samples which limit generalizability of results and cardiovascular recovery data collected in Study II which does not include assessment of autonomic balance between vagal and sympathetic responsivity.

Adolescent↗