Background: There has been a growth surge in the use of social media among individuals today. The... more Background: There has been a growth surge in the use of social media among individuals today. The widespread adoption of these platforms, coupled with their engaging features, presents a unique opportunity for the dissemination of health advocacy information. Social media is known as a powerful tool used to share health policy and advocacy efforts and disseminate health information to digital community members and networks. Yet, there is still a gap in the full exploitation of this powerful instrument, among health care professionals, for health advocacy campaigns. Objective: This paper aims to describe the process of mobilizing social media platforms such as Twitter (rebranded to X Corp in 2023) for health advocacy of the digital community. Additionally, it aims to share the lessons and insights gained during this digital health advocacy engagement process. Methods: We performed a comprehensive review of Twitter analytical data to examine the impact of our social media posts. We then consolidated these analytic reports with our meeting logs to describe our systematic, iterative, and collaborative design process to implement social media efforts and generate key lessons learned. Results: Our review of monthly Twitter analytical reports and regular team meeting logs revealed several themes for successful and less successful practices in relation to our social media-based health advocacy efforts. The successful practices noted by the team included using personable, picture-based tweets; using a series of posts on a particular topic rather than an isolated post; leveraging team members' and partners' collaborations in shared posts; incorporating hashtags in tweets; using a balanced mix of texts and graphics in posts; using inclusive (nondestigmatizing) languages in tweeted posts; and use of polls to share tweets. Among the many lessons learned, we also experienced limitations including a lack of comprehensive statistics on Twitter usage for health care-related purposes such as health advocacy and limits in collating the estimates of the actual impact made on the intended digital community members by our posts. Conclusions: Twitter has been successfully used in promoting health advocacy content, and the social media team aims to explore other social media platforms that have a wider reach than Twitter. We will continue making necessary adjustments in strategies, techniques, and styles to engage the audience as we expand onto new platforms like Instagram and TikTok for health advocacy promotions.
IntroductionReported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. ... more IntroductionReported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. Nevertheless, limited research addresses the health impact of perceived anti-Asian racism on Asian Americans, especially among older adults, during COVID-19. To address the gap, we examined how the novel coronavirus pandemic affected Korean American older adults, one of the largest Asian subgroups. Specifically, this study addressed the magnitude of racism or discrimination related to the pandemic and impact of anti-Asian racism on negative mental health symptoms among Korean American older adults and their caregivers.MethodsWe used survey data collected from 175 Korean American older adults with probable dementia and their primary caregivers (female = 62%, mean age = 71 years) who went through eligibility screening for an ongoing randomized controlled trial involving dyads in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347).Result...
With increasing numbers of researchers targeting ethnic minorities to address health disparities,... more With increasing numbers of researchers targeting ethnic minorities to address health disparities, it is important to address the unique needs of Korean American (KA) older adults—a “hard to reach” yet one of the most rapidly increasing ethnic and age groups in the nation. The purpose of this paper is to describe the main barriers to research participation and to identify facilitators for recruitment of older KAs. We have analyzed recruitment data pertaining to more than 10 community-based KA research studies we have conducted for the last ten years. There were a number of unique recruitment challenges in regard to the culture, language, and sociodemographic characteristics of the participants. Examples of effective recruitment strategies included: aligning the research agenda with the priorities of the community; establishing collaboration with ethnic churches and ethnic media; recruiting and training bilingual volunteers and community health workers; and placing liaison research st...
The: Experiences and Challenges of Caregivers of Frail or Chronically III Elderly: An Integrative... more The: Experiences and Challenges of Caregivers of Frail or Chronically III Elderly: An Integrative Review Hae-Ra Hall, PhD, RN 1) BACKGROill\rD: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chroniically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few ...
Title: Health literacy enhanced intervention for inner-city African Americans with uncontrolled d... more Title: Health literacy enhanced intervention for inner-city African Americans with uncontrolled diabetes: A pilot study Authors: Hae-Ra Han ([email protected]; [email protected]) Manka Nkimbeng ([email protected]) Olayinka Ajomagberin ([email protected]) Kelli Grunstra ([email protected]) Phyllis Sharps ([email protected]) Susan Renda ([email protected]) Nisa Maruthur ([email protected]) Version: 1 Date: 22 Jul 2019 Author’s response to reviews: Response to Reviewers’ Comments We appreciate the thorough comments from the reviewers. Suggested changes have been made and highlighted in bold letters in the text. Our response to each comment is presented below.
Background As the world is becoming increasingly connected by the World Wide Web, the internet is... more Background As the world is becoming increasingly connected by the World Wide Web, the internet is becoming the main source of health information. With the novel COVID-19 pandemic, ubiquitous use of the internet has changed the daily lives of individuals, from working from home to seeking and meeting with health care providers through web-based sites. Such heavy reliance on internet-based technologies raises concerns regarding the accessibility of the internet for minority populations who are likely to already face barriers when seeking health information. Objective This study aims to examine the level of technology access and common modes of technology used by Korean American women and to investigate how key psychosocial determinants of health such as age, education, English proficiency, and health literacy are correlated with sources of health information used by Korean American women and by their use of the internet. Methods We used data from a subsample of Korean American women (...
BACKGROUND In the United States, nearly 80% of family caregivers of people with dementia have at ... more BACKGROUND In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. OBJECTIVE The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. METHODS We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community eve...
Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in ... more Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95% CI:-3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI:-8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI:-8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.
The purposes of this study were (1) to describe stressful life events experienced by urban young ... more The purposes of this study were (1) to describe stressful life events experienced by urban young black men (YBM) with HBP over time and (2) to examine the effect of cumulative stressful life events on a variety of outcome variables. Using a prospective study design, data were collected on 230 YBM with HBP over a 24-month period. The most prevalent events that were reported at two or more 6-month points during the 24-month period were death of family member or close friend (34.8%), change in residence (17.4%), difficulty finding a job (15.2%), having been fired or laid off from work (10.9%), and a new, close personal relationship (10.9%). One or more of the following involvements with the crime or legal matters (i.e., major/minor violation of the law, being a violence victim, or being arrested or held in jail) were also reported more than twice during the period by 6.5% of men. A cumulative stressful life events score, as calculated by summing the number of life events experienced at 6, 12, 18, and 24-month follow-ups, was significantly (p Ͻ 0.05) correlated with illicit drug use (rϭ0.19), alcohol intake (rϭ0.13), depression (rϭ0.25), and several domains of quality of life such as psychological general well-being (rϭ-0.27), cognitive function (rϭ0.15), and symptom bother (rϭ0.15) at 24 months. The results indicate that stressful life events pose a high risk for substance use, depression, and poor quality of life in YBM with HBP, and necessitate additional study to elucidate the mechanisms that underlie these relationships. Interventions for YBM with HBP should focus on assisting individuals in managing distress related to stressful events and providing them with specific skills (e.g., education on financial management skills) and community resources.
Background-Mobile phone Short Message Service (SMS) is a tool now used by the health research com... more Background-Mobile phone Short Message Service (SMS) is a tool now used by the health research community, providing the capability for instant communication between patients and health professionals. Greater understanding of how to best utilize SMS as a means to improve healthcare delivery and outcomes will foster innovation in research and provide an opportunity to progress as a public health community. Purpose-The purposes of this systematic review were twofold: (1) to provide insight on the most utilized mobile phone SMS practices and characteristics in hypertension (HTN) outcomefocused publications, and (2) to critically evaluate empirical evidence associated with SMS utilization and blood pressure (BP) outcomes. Methods-Two independent systematic literature searches were completed. The final selected studies each then underwent data extraction and quality-rating assessment, followed by an evaluation for a meta-analysis to measure mean difference of the change in BP. Results-A total of 6 studies meeting the inclusion criteria were included in the review. Feasibility assessment for a meta-analysis was found unfavorable due to the variation among studies. SMS interventions focused on BP management were most effective in studies featuring two-way communication and individual patient-tailored content, and guided by evidence-based HTN management practices. Implications-SMS interventions for HTN management were supported through evidence provided by the studies reviewed. SMS holds strong potential to bring greater innovation to HTN management and care, especially in racial/ethnic minority populations that face psychosocial and structural barriers in health care access and utilization.
The Journal of cardiovascular nursing, Jan 7, 2015
Persons with heart failure (HF) are required to make decisions on a daily basis related to their ... more Persons with heart failure (HF) are required to make decisions on a daily basis related to their declining health and make urgent decisions during acute illness exacerbations. However, little is known about the types of decisions patients make. The aims of this study were to critically evaluate the current quantitative literature related to decision making among persons with HF and identify research gaps in HF decision-making research. A systematic search of literature about decisions persons with HF make was conducted using PubMed, CINAHL, and PsychINFO databases. The following inclusion criteria were used: sample composed of at least 50% HF participants, concrete decisions were made, and a quantitative study design was used. Two authors performed title, abstract, and full-text reviews independently to identify eligible articles. Twelve quantitative articles were included. Study samples were predominately older, white, male, and married. Two-thirds of the articles focused on decisi...
Background-The popularity of mobile phones and similar mobile devices makes it an ideal medium fo... more Background-The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. Purpose-This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to: (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. Methods-PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Conclusions-Ten articles, representing nine studies, were included in this review. Majority of the studies utilized mobile health technology as part of a HF monitoring system, which typically included a blood pressure measuring device, weighing scale, and an ECG recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, NYHA functional class, LVEF, quality of life, and self-care were inconsistent at best. Implications-Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (e.g. inadequate sample size, quasi-experimental design, use of older mobile phone models, etc.) should be taken into account when designing future studies.
Objectives. We examined variations in having a usual source of care (USC) among non-Hispanic Whit... more Objectives. We examined variations in having a usual source of care (USC) among non-Hispanic White and Asian American adults in California. Methods. Data were from the 2005 and 2009 California Health Interview Survey. Using a modified Anderson model, we used multiple logistic regression to compare odds of having a USC between non-Hispanic White (n = 38 554) and Asian American adults (n = 7566) and to examine associations with acculturation factors (English proficiency, length of residence, residence in a racially concordant neighborhood) and key enabling (employment, income, insurance) and predisposing (education) factors. Results. Race-related disparities between Asian Americans and non-Hispanic Whites in having a USC were no longer significant after accounting for acculturation factors. Limited English proficiency and short time in the United States (< 5 years) were significantly associated with not having a USC for both races. Increasing levels of education and insurance were ...
Objectives: The purpose of this study was to examine relational aggression and its relationship w... more Objectives: The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Design and Sample: Quantitative, cross-sectional survey design.The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. Measures: The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. Results: 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Conclusions: Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several
Objectives: While socioeconomic status (SES) is considered a key socialeenvironment factor affect... more Objectives: While socioeconomic status (SES) is considered a key socialeenvironment factor affecting health outcomes, sex differences in the association between SES and the risk of type 2 diabetes remain unclear. The aims of this study were: (1) to identify risk factors associated with type 2 diabetes in a representative sample of Korean adults with a focus on socioeconomic determinants; and (2) to examine how the association between SES and type 2 diabetes is affected by sex. Study design: Cross-sectional study. Methods: This study used data obtained from 3870 Korean adults (age 35 years) who participated in the 2005 Korean National Health and Nutritional Examination Survey (KNHANES III). The risk of type 2 diabetes in relation to SES was calculated, after controlling for other risk factors such as medical characteristics (hypertension, family history, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol), lifestyle factors (body mass index, smoking, alcohol intake, exercise) and perceived stress. Odds ratios (ORs) were calculated separately for Korean men and women using multivariate logistic regression. Results: Compared with individuals with 13 years of education, those with 6 years of education or 7e12 years of education had higher ORs for the risk of type 2 diabetes e 2.10 (95% confidence interval (CI) 1.27e3.48) and 1.62 (95% CI 1.04e2.52), respectively e after adjusting for age, sex, medical characteristics, lifestyle factors and stress level. The OR for women with 6 years of education was particularly high (OR 10.16, 95% CI 2.08e49.53), even after adjusting for the study covariates. However, this increasing trend in the OR was not observed for men. Conclusions: SES significantly influences the risk of type 2 diabetes in Korean adults, and there are interactions with sex. Korean women with a low level of education represent a particularly high-risk group for type 2 diabetes. Future interventions should incorporate more targeted diabetes prevention efforts for women with a low level of education.
Doctoral students and new faculty members often seek advice from more senior faculty on how to ad... more Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development (K) award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this paper, we describe literature on the impact of selected aspects of pre and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. Keywords nursing; doctoral; students; research; faculty When It comes to advising doctoral students and new faculty members on advancing their program of research, the published evidence on which to ground this advice is admittedly weak. In a systematic review of literature on the promotion of faculty research productivity, Segrott,
Background-Childhood cancer survivors are a growing population at risk for poor cardiac outcomes.... more Background-Childhood cancer survivors are a growing population at risk for poor cardiac outcomes. Acute lymphoid leukemia (ALL) survivors are among those at increased risk of cardiovascular complications. Early identification of impaired vascular health may allow for interventions to improve these outcomes. The purpose of this study is to evaluate vascular health using peripheral artery tonometry in ALL survivors and compare results to healthy siblings. Procedure-Sixteen ALL survivor, healthy sibling pairs, ages 8-20, were evaluated for vascular health and cardiovascular risk factors (body mass index, central adiposity, blood pressure and fitness). One tailed paired T-test was used to compare the groups. Results-Survivors were similar to siblings in cardiovascular risk measures but had poorer vascular health as measured by reactive hyperemia index (survivor RHI 1.54 vs sibling 1.77, p=0.0474). Conclusion-This study reveals that even among survivors who are comparable to their healthy siblings in other traditional cardiovascular risks there is evidence of poorer vascular health.
Purpose The aim of the study was to assess the prevalence, knowledge and behavior about reproduct... more Purpose The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. Methods The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. Results About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. Conclusions The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population. [
This paper provides a comprehensive methodological review of the literature concerning anxiety me... more This paper provides a comprehensive methodological review of the literature concerning anxiety measurement in children. Initially, a conceptual basis for anxiety measures is introduced, followed by specific approaches to measuring childhood anxiety based on 14 original articles. In particular, a variety of strategies that have been used in previous research are discussed in detail with theoretical underpinnings. Common approaches to measure anxiety such as self-reported instruments, observational ratings, and behavioral checklists are reviewed one by one with a critical look at the strengths and weaknesses of each of these approaches. While multiple measures of anxiety are available to assess the level of anxiety in children, selection of measurement approach should be an iterative process based on rigorous evaluation of evidence of reliability and cross-validation of the tool across different age groups of children.
Background: There has been a growth surge in the use of social media among individuals today. The... more Background: There has been a growth surge in the use of social media among individuals today. The widespread adoption of these platforms, coupled with their engaging features, presents a unique opportunity for the dissemination of health advocacy information. Social media is known as a powerful tool used to share health policy and advocacy efforts and disseminate health information to digital community members and networks. Yet, there is still a gap in the full exploitation of this powerful instrument, among health care professionals, for health advocacy campaigns. Objective: This paper aims to describe the process of mobilizing social media platforms such as Twitter (rebranded to X Corp in 2023) for health advocacy of the digital community. Additionally, it aims to share the lessons and insights gained during this digital health advocacy engagement process. Methods: We performed a comprehensive review of Twitter analytical data to examine the impact of our social media posts. We then consolidated these analytic reports with our meeting logs to describe our systematic, iterative, and collaborative design process to implement social media efforts and generate key lessons learned. Results: Our review of monthly Twitter analytical reports and regular team meeting logs revealed several themes for successful and less successful practices in relation to our social media-based health advocacy efforts. The successful practices noted by the team included using personable, picture-based tweets; using a series of posts on a particular topic rather than an isolated post; leveraging team members' and partners' collaborations in shared posts; incorporating hashtags in tweets; using a balanced mix of texts and graphics in posts; using inclusive (nondestigmatizing) languages in tweeted posts; and use of polls to share tweets. Among the many lessons learned, we also experienced limitations including a lack of comprehensive statistics on Twitter usage for health care-related purposes such as health advocacy and limits in collating the estimates of the actual impact made on the intended digital community members by our posts. Conclusions: Twitter has been successfully used in promoting health advocacy content, and the social media team aims to explore other social media platforms that have a wider reach than Twitter. We will continue making necessary adjustments in strategies, techniques, and styles to engage the audience as we expand onto new platforms like Instagram and TikTok for health advocacy promotions.
IntroductionReported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. ... more IntroductionReported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. Nevertheless, limited research addresses the health impact of perceived anti-Asian racism on Asian Americans, especially among older adults, during COVID-19. To address the gap, we examined how the novel coronavirus pandemic affected Korean American older adults, one of the largest Asian subgroups. Specifically, this study addressed the magnitude of racism or discrimination related to the pandemic and impact of anti-Asian racism on negative mental health symptoms among Korean American older adults and their caregivers.MethodsWe used survey data collected from 175 Korean American older adults with probable dementia and their primary caregivers (female = 62%, mean age = 71 years) who went through eligibility screening for an ongoing randomized controlled trial involving dyads in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347).Result...
With increasing numbers of researchers targeting ethnic minorities to address health disparities,... more With increasing numbers of researchers targeting ethnic minorities to address health disparities, it is important to address the unique needs of Korean American (KA) older adults—a “hard to reach” yet one of the most rapidly increasing ethnic and age groups in the nation. The purpose of this paper is to describe the main barriers to research participation and to identify facilitators for recruitment of older KAs. We have analyzed recruitment data pertaining to more than 10 community-based KA research studies we have conducted for the last ten years. There were a number of unique recruitment challenges in regard to the culture, language, and sociodemographic characteristics of the participants. Examples of effective recruitment strategies included: aligning the research agenda with the priorities of the community; establishing collaboration with ethnic churches and ethnic media; recruiting and training bilingual volunteers and community health workers; and placing liaison research st...
The: Experiences and Challenges of Caregivers of Frail or Chronically III Elderly: An Integrative... more The: Experiences and Challenges of Caregivers of Frail or Chronically III Elderly: An Integrative Review Hae-Ra Hall, PhD, RN 1) BACKGROill\rD: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chroniically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few ...
Title: Health literacy enhanced intervention for inner-city African Americans with uncontrolled d... more Title: Health literacy enhanced intervention for inner-city African Americans with uncontrolled diabetes: A pilot study Authors: Hae-Ra Han ([email protected]; [email protected]) Manka Nkimbeng ([email protected]) Olayinka Ajomagberin ([email protected]) Kelli Grunstra ([email protected]) Phyllis Sharps ([email protected]) Susan Renda ([email protected]) Nisa Maruthur ([email protected]) Version: 1 Date: 22 Jul 2019 Author’s response to reviews: Response to Reviewers’ Comments We appreciate the thorough comments from the reviewers. Suggested changes have been made and highlighted in bold letters in the text. Our response to each comment is presented below.
Background As the world is becoming increasingly connected by the World Wide Web, the internet is... more Background As the world is becoming increasingly connected by the World Wide Web, the internet is becoming the main source of health information. With the novel COVID-19 pandemic, ubiquitous use of the internet has changed the daily lives of individuals, from working from home to seeking and meeting with health care providers through web-based sites. Such heavy reliance on internet-based technologies raises concerns regarding the accessibility of the internet for minority populations who are likely to already face barriers when seeking health information. Objective This study aims to examine the level of technology access and common modes of technology used by Korean American women and to investigate how key psychosocial determinants of health such as age, education, English proficiency, and health literacy are correlated with sources of health information used by Korean American women and by their use of the internet. Methods We used data from a subsample of Korean American women (...
BACKGROUND In the United States, nearly 80% of family caregivers of people with dementia have at ... more BACKGROUND In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. OBJECTIVE The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. METHODS We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community eve...
Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in ... more Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status). Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes. Results: Women reported poorer functional status (β − 2.23, 95% CI:-3.52, − 0.94) and AF-related quality of life (β − 4.12, 95% CI:-8.10, − 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β − 4.41, 95% CI:-8.25, − 0.57) and functional status. Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.
The purposes of this study were (1) to describe stressful life events experienced by urban young ... more The purposes of this study were (1) to describe stressful life events experienced by urban young black men (YBM) with HBP over time and (2) to examine the effect of cumulative stressful life events on a variety of outcome variables. Using a prospective study design, data were collected on 230 YBM with HBP over a 24-month period. The most prevalent events that were reported at two or more 6-month points during the 24-month period were death of family member or close friend (34.8%), change in residence (17.4%), difficulty finding a job (15.2%), having been fired or laid off from work (10.9%), and a new, close personal relationship (10.9%). One or more of the following involvements with the crime or legal matters (i.e., major/minor violation of the law, being a violence victim, or being arrested or held in jail) were also reported more than twice during the period by 6.5% of men. A cumulative stressful life events score, as calculated by summing the number of life events experienced at 6, 12, 18, and 24-month follow-ups, was significantly (p Ͻ 0.05) correlated with illicit drug use (rϭ0.19), alcohol intake (rϭ0.13), depression (rϭ0.25), and several domains of quality of life such as psychological general well-being (rϭ-0.27), cognitive function (rϭ0.15), and symptom bother (rϭ0.15) at 24 months. The results indicate that stressful life events pose a high risk for substance use, depression, and poor quality of life in YBM with HBP, and necessitate additional study to elucidate the mechanisms that underlie these relationships. Interventions for YBM with HBP should focus on assisting individuals in managing distress related to stressful events and providing them with specific skills (e.g., education on financial management skills) and community resources.
Background-Mobile phone Short Message Service (SMS) is a tool now used by the health research com... more Background-Mobile phone Short Message Service (SMS) is a tool now used by the health research community, providing the capability for instant communication between patients and health professionals. Greater understanding of how to best utilize SMS as a means to improve healthcare delivery and outcomes will foster innovation in research and provide an opportunity to progress as a public health community. Purpose-The purposes of this systematic review were twofold: (1) to provide insight on the most utilized mobile phone SMS practices and characteristics in hypertension (HTN) outcomefocused publications, and (2) to critically evaluate empirical evidence associated with SMS utilization and blood pressure (BP) outcomes. Methods-Two independent systematic literature searches were completed. The final selected studies each then underwent data extraction and quality-rating assessment, followed by an evaluation for a meta-analysis to measure mean difference of the change in BP. Results-A total of 6 studies meeting the inclusion criteria were included in the review. Feasibility assessment for a meta-analysis was found unfavorable due to the variation among studies. SMS interventions focused on BP management were most effective in studies featuring two-way communication and individual patient-tailored content, and guided by evidence-based HTN management practices. Implications-SMS interventions for HTN management were supported through evidence provided by the studies reviewed. SMS holds strong potential to bring greater innovation to HTN management and care, especially in racial/ethnic minority populations that face psychosocial and structural barriers in health care access and utilization.
The Journal of cardiovascular nursing, Jan 7, 2015
Persons with heart failure (HF) are required to make decisions on a daily basis related to their ... more Persons with heart failure (HF) are required to make decisions on a daily basis related to their declining health and make urgent decisions during acute illness exacerbations. However, little is known about the types of decisions patients make. The aims of this study were to critically evaluate the current quantitative literature related to decision making among persons with HF and identify research gaps in HF decision-making research. A systematic search of literature about decisions persons with HF make was conducted using PubMed, CINAHL, and PsychINFO databases. The following inclusion criteria were used: sample composed of at least 50% HF participants, concrete decisions were made, and a quantitative study design was used. Two authors performed title, abstract, and full-text reviews independently to identify eligible articles. Twelve quantitative articles were included. Study samples were predominately older, white, male, and married. Two-thirds of the articles focused on decisi...
Background-The popularity of mobile phones and similar mobile devices makes it an ideal medium fo... more Background-The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. Purpose-This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to: (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. Methods-PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Conclusions-Ten articles, representing nine studies, were included in this review. Majority of the studies utilized mobile health technology as part of a HF monitoring system, which typically included a blood pressure measuring device, weighing scale, and an ECG recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, NYHA functional class, LVEF, quality of life, and self-care were inconsistent at best. Implications-Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (e.g. inadequate sample size, quasi-experimental design, use of older mobile phone models, etc.) should be taken into account when designing future studies.
Objectives. We examined variations in having a usual source of care (USC) among non-Hispanic Whit... more Objectives. We examined variations in having a usual source of care (USC) among non-Hispanic White and Asian American adults in California. Methods. Data were from the 2005 and 2009 California Health Interview Survey. Using a modified Anderson model, we used multiple logistic regression to compare odds of having a USC between non-Hispanic White (n = 38 554) and Asian American adults (n = 7566) and to examine associations with acculturation factors (English proficiency, length of residence, residence in a racially concordant neighborhood) and key enabling (employment, income, insurance) and predisposing (education) factors. Results. Race-related disparities between Asian Americans and non-Hispanic Whites in having a USC were no longer significant after accounting for acculturation factors. Limited English proficiency and short time in the United States (< 5 years) were significantly associated with not having a USC for both races. Increasing levels of education and insurance were ...
Objectives: The purpose of this study was to examine relational aggression and its relationship w... more Objectives: The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Design and Sample: Quantitative, cross-sectional survey design.The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. Measures: The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. Results: 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Conclusions: Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several
Objectives: While socioeconomic status (SES) is considered a key socialeenvironment factor affect... more Objectives: While socioeconomic status (SES) is considered a key socialeenvironment factor affecting health outcomes, sex differences in the association between SES and the risk of type 2 diabetes remain unclear. The aims of this study were: (1) to identify risk factors associated with type 2 diabetes in a representative sample of Korean adults with a focus on socioeconomic determinants; and (2) to examine how the association between SES and type 2 diabetes is affected by sex. Study design: Cross-sectional study. Methods: This study used data obtained from 3870 Korean adults (age 35 years) who participated in the 2005 Korean National Health and Nutritional Examination Survey (KNHANES III). The risk of type 2 diabetes in relation to SES was calculated, after controlling for other risk factors such as medical characteristics (hypertension, family history, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol), lifestyle factors (body mass index, smoking, alcohol intake, exercise) and perceived stress. Odds ratios (ORs) were calculated separately for Korean men and women using multivariate logistic regression. Results: Compared with individuals with 13 years of education, those with 6 years of education or 7e12 years of education had higher ORs for the risk of type 2 diabetes e 2.10 (95% confidence interval (CI) 1.27e3.48) and 1.62 (95% CI 1.04e2.52), respectively e after adjusting for age, sex, medical characteristics, lifestyle factors and stress level. The OR for women with 6 years of education was particularly high (OR 10.16, 95% CI 2.08e49.53), even after adjusting for the study covariates. However, this increasing trend in the OR was not observed for men. Conclusions: SES significantly influences the risk of type 2 diabetes in Korean adults, and there are interactions with sex. Korean women with a low level of education represent a particularly high-risk group for type 2 diabetes. Future interventions should incorporate more targeted diabetes prevention efforts for women with a low level of education.
Doctoral students and new faculty members often seek advice from more senior faculty on how to ad... more Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development (K) award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this paper, we describe literature on the impact of selected aspects of pre and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. Keywords nursing; doctoral; students; research; faculty When It comes to advising doctoral students and new faculty members on advancing their program of research, the published evidence on which to ground this advice is admittedly weak. In a systematic review of literature on the promotion of faculty research productivity, Segrott,
Background-Childhood cancer survivors are a growing population at risk for poor cardiac outcomes.... more Background-Childhood cancer survivors are a growing population at risk for poor cardiac outcomes. Acute lymphoid leukemia (ALL) survivors are among those at increased risk of cardiovascular complications. Early identification of impaired vascular health may allow for interventions to improve these outcomes. The purpose of this study is to evaluate vascular health using peripheral artery tonometry in ALL survivors and compare results to healthy siblings. Procedure-Sixteen ALL survivor, healthy sibling pairs, ages 8-20, were evaluated for vascular health and cardiovascular risk factors (body mass index, central adiposity, blood pressure and fitness). One tailed paired T-test was used to compare the groups. Results-Survivors were similar to siblings in cardiovascular risk measures but had poorer vascular health as measured by reactive hyperemia index (survivor RHI 1.54 vs sibling 1.77, p=0.0474). Conclusion-This study reveals that even among survivors who are comparable to their healthy siblings in other traditional cardiovascular risks there is evidence of poorer vascular health.
Purpose The aim of the study was to assess the prevalence, knowledge and behavior about reproduct... more Purpose The aim of the study was to assess the prevalence, knowledge and behavior about reproductive tract infections (RTIs) among rural Chinese women in Hunchun, China. Methods The study employed a cross-sectional research design with a convenience sample of 190 participants who had received microfinancing. Data were collected by trained research staff, utilizing face to face interviews and physical examinations. Results About 1 in 5 participants (20.3%) had had more than 5 pregnancies and 26.7% had had 3 or more abortions. More than half (57.3%) of study participants had an RTI at the time of examination, and 92.3% reported having had at least one RTI symptom. Nearly half (49.6%) of the women who exhibited RTI symptoms reported no utilization of any healthcare services. Age, number of pregnancies, RTI knowledge, and behavior were found to be significant correlates in the sample. Conclusions The prevalence of RTI among low-income rural Chinese women were extremely high, indicating the urgent need for effective and culturally sensitive health education, particularly targeted to the poor rural population. [
This paper provides a comprehensive methodological review of the literature concerning anxiety me... more This paper provides a comprehensive methodological review of the literature concerning anxiety measurement in children. Initially, a conceptual basis for anxiety measures is introduced, followed by specific approaches to measuring childhood anxiety based on 14 original articles. In particular, a variety of strategies that have been used in previous research are discussed in detail with theoretical underpinnings. Common approaches to measure anxiety such as self-reported instruments, observational ratings, and behavioral checklists are reviewed one by one with a critical look at the strengths and weaknesses of each of these approaches. While multiple measures of anxiety are available to assess the level of anxiety in children, selection of measurement approach should be an iterative process based on rigorous evaluation of evidence of reliability and cross-validation of the tool across different age groups of children.
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Papers by Hae-ra Han