Changes In Self-efficacy Research Articles

33 Risk and protective factors for persistent depressive symptoms among transgender and non-binary youth: A prospective cohort study

OBJECTIVES/GOALS: While most transgender and non-binary (TNB) youth experience improved mental health post-initiating gender-affirming hormones (GAH), some continue to experience persistent, significant depressive symptoms two years post-GAH. Importantly, few studies have examined this issue given the lack of existing longitudinal studies. METHODS/STUDY POPULATION: We aimed to identify intervenable factors predicting persistent clinical depressive symptoms (PD) among TNB youth two years post-initiation of GAH utilizing the Trans Youth Care U.S. Study, an ongoing, multisite, observational study of TNB youth from four major pediatric hospitals across the U.S. We compared TNB youth (ages 12-20 at baseline) with persisting depression symptoms (PD) two-years post-GAH (i.e., PD; N=59) and those youth without (non-PD; n=215). Logistic regression estimated the association between PD and risk (e.g., negative expectations) and protective factors (e.g., parental acceptance, self-efficacy), measured at baseline and longitudinally. A mixed-effects model compared the rate of change of these factors between PD and non-PD youth. Models controlled for birth sex. RESULTS/ANTICIPATED RESULTS: Participants (Mean age=16) identified as transmasculine, then transfeminine, followed by non-binary. PD youth had higher negative expectations at baseline and internalized transphobia by 2-years, while non-PD youth reported greater parental acceptance over 2-years. The odds of PD compared to non-PD decreased with increasing self-efficacy at baseline (OR=0.7, 95% CI:0.5-0.9), whereas negative expectation for the future was associated with increased odds (OR=1.3, 95% CI:0.9,1.8). Moreover, the odds of PD increased 50% with increased rate of change in negative expectations, and odds decreased 50% with increased rate of change in self-efficacy, after adjusting for baseline negative expectations and self-efficacy, respectively. DISCUSSION/SIGNIFICANCE: We identified key intervenable factors for mental health treatment for TNB youth with PD; specifically, negative expectations increased risk for PD while self-efficacy appeared to buffer against PD risk. These findings also support assessment of youth for negative expectations for the future conferring greater risk for later PD.

149 Leadership Development for Women in Academic Medicine: Impact of Leader Self-Efficacy Change and Sustainability Over Time

OBJECTIVES/GOALS: Our objective was to evaluate the FLEX Leadership Development Program for School of Medicine Women Faculty affiliated with 4 independent hospital systems throughout Northern Ohio to determine whether women faculty develop leader self and means efficacy. We also examined whether self-efficacy is sustained over time following program completion. METHODS/STUDY POPULATION: We did a prospective multiple cohort study to determine whether FLEX Program graduates develop and sustain leader self and means efficacy as measured by the Leader Efficacy Questionnaire (LEQ) (Hannah & Avolio, 2012). The LEQ assesses both leader confidence in their capabilities (self-efficacy) and the availability of sufficient external resources (means efficacy) to achieve their goals. We surveyed participants from 5 FLEX cohorts (2017-2021) using a pre-, post-, and 1-year follow-up LEQ, which allowed each participant to act as their own control subject, pre-test, and experimental post-test. The follow-up tested whether the change from pre- to post-test was sustained over time. The comparison group was non-participant women faculty from the same institutions over a similar 2-year period. RESULTS/ANTICIPATED RESULTS: Diverse FLEX graduates from 5 different cohorts showed highly significant increases in pre- to post-program leader self-efficacy which were sustained up to one year after program completion. Overall leader efficacy as well as its three component sub-constructs (action-, means- and self-regulation- efficacy) all significantly increased equally, suggesting both that the FLEX program had robust effects on its participants, and all aspects of leader efficacy improved. We observed a mildly significant decrease at 1-year follow-up in the overall LEQ, which appeared to be driven entirely by the leader means efficacy. The large comparison group of women faculty did not show any significant changes in leader self-efficacy over a comparable 2-year period. DISCUSSION/SIGNIFICANCE: FLEX confers sustainable gains in leader self-efficacy. Post-program self-efficacy decreases are driven by the leader means efficacy which measures how work environments affect their leadership. This suggests that institutions must take responsibility for making structural changes to improve the working environment for women leaders.

161 Peer Caregiver Navigation for Hospice Caregivers of Cancer Patients: A Feasibility Study

OBJECTIVES/GOALS: To evaluate the feasibility, acceptability, and appropriateness of a 1:1 peer-delivered psychosocial support intervention to family caregivers of hospice patients with cancer, and determine a range of potential effects of the intervention on psychological distress symptoms and perceptions of the caregiving experience. METHODS/STUDY POPULATION: Quantitative and qualitative data were collected from hospice caregivers of cancer patients who participated in a non-controlled pilot feasibility trial of a 1:1, peer-delivered psychosocial intervention called Peer Caregiver Navigation (PCN). The purpose of this study was to evaluate the feasibility, acceptability, and appropriateness of delivering PCN to hospice family caregivers of cancer patients, and to determine a range of potential effects of PCN on caregivers’ anxiety symptoms, depressive symptoms, self-efficacy, and benefit finding. Qualitative data were analyzed using deductive thematic analysis. For our study outcomes, we used both parametric and nonparametric t-tests to examine mean differences between outcomes at baseline and midpoint, and baseline and endpoint. RESULTS/ANTICIPATED RESULTS: The findings demonstrate that Peer Caregiver Navigation (PCN) is acceptable, appropriate, and feasible to deliver to hospice family caregivers of cancer patients. Appropriateness of our selected target outcomes was determined by confirming expected measurement change in depressive symptoms (lower), anxiety symptoms (lower), benefit finding (higher), and self-efficacy (higher). Exit interviews revealed that participants responded favorably to our selected measures for these outcomes and to our data collection time intervals. Moreover, recruitment and consenting processes, survey completion rates, and attrition outcomes (i.e., study exit due to active withdrawal vs. patient death) were analyzed to inform recruitment and retention feasibility for future studies. DISCUSSION/SIGNIFICANCE: Peer Caregiver Navigation (PCN) was determined to be feasible, acceptable, and appropriate to hospice family caregivers of patients with cancer. Moreover, PCN has the potential to improve caregivers' symptoms of psychological distress by providing them much needed psychoeducation, coping skills training, and emotional support.

Using Project Extension for Community Healthcare Outcomes to Enhance Substance Use Disorder Care in Primary Care: Mixed Methods Study.

Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care. The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health. We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries. The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03). These findings indicate that the ECHO program's content aligned with its stated learning objectives; met its learning objectives for the 3 themes where significant improvements were measured; and met its intent to address multiple substances in case presentations and discussions. These results demonstrate that Project ECHO is a potential tool to educate multidisciplinary providers in a comprehensive approach to SUD care.

Novel motivational interviewing-based intervention improves engagement in physical activity and readiness to change among adolescents with chronic pain.

Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI-based physical activity promotion programme, the M3 training. In our exploratory study with 35 adolescent-parent dyads, we evaluated the feasibility by enrolment, drop-out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open-ended questions. We also assessed changes in pain self-efficacy and readiness to change after the M3 training intervention. The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self-efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents. M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe. The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere).

An obesity medicine curriculum increases the obesity care self-efficacy of internal medicine residents in the primary care setting.

Primary care physicians (PCPs) report insufficient knowledge and training gaps in obesity care. Internal Medicine (IM) residency offers an opportunity to address this educational gap for future PCPs. We designed an innovative, multicomponent curriculum on obesity medicine (OM) in the primary care setting for IM residents. We then conducted a prospective, 6-month, two-arm study within two residency programs in Maryland evaluating feasibility (use, appropriateness for IM training, and satisfaction) of the curriculum as well as changes in self-efficacy within seven obesity care domains, assessed on 4-point scales (1-not at all confident to 4-very confident). One residency program received the curriculum and the other served as the control group. We recruited 35 IM residents to participate (17 intervention, 18 control). Among intervention residents, 42% used all curricular components; appropriateness and satisfaction with the curriculum were high. Compared with controls, intervention residents had statistically significant increases in five obesity care self-efficacy domains: nutrition (intervention 0.8 vs. control 0.2, p = .02), behaviour change (1.2 vs. 0.4, p < .01), weight-gain-promoting medications (0.8 vs. 0.1, p = .01), anti-obesity medications (1.2 vs. 0.5, p = .03), and bariatric surgical counselling (0.9 vs. 0.4, p = .03). There were no significant changes in physical activity or post-bariatric surgical care domains. Our OM curriculum is feasible with IM residents and increases residents' obesity care self-efficacy beyond what is achieved with usual IM training.

The influence of student language and student-teacher relationships on student-specific teacher self-efficacy in early childhood

ABSTRACT Teacher self-efficacy (TSE) changes according to context. Limited research has been conducted to understand how TSE can vary in relation to student characteristics or the student-teacher relationship (STR) in preschool. The aims of the current study were to 1) examine student-specific TSE variability among monolingual English-speaking and Spanish-speaking dual language learners (DLLs) and 2) examine the extent to which STR quality moderates the relationship between student language and student-specific TSE. Results demonstrated that when controlling for closeness in the STR, teachers felt higher levels of student-specific TSE in the domains of instructional support and student engagement for English-speaking students versus DLLs. However, teachers reported equal levels of student-specific TSE in the domains of behavior management and emotional support irrespective of student language. Secondly, STR quality did not significantly moderate relationships between language and student-specific TSE. Limitations and future research directions are discussed.

Working on Counseling Skills to Improve Nursing Undergraduates' Knowledge and Breastfeeding Professional Self-Efficacy.

Being well prepared and feeling confident when working with women who are breastfeeding is a challenge for many health professionals who need to be prepared to manage breastfeeding or any associated problems. The purpose of this study was to explore the changes in students' breastfeeding professional self-efficacy and knowledge after a workshop on breastfeeding counseling. The counseling workshop increased their knowledge (p ≤ .001) and breastfeeding professional self-efficacy (p ≤ .001) in the provision of labor support. Counseling skills help students to integrate the knowledge and feel more confident to provide breastfeeding care.

Efficacy of health literacy interventions aimed to improve health gains of higher education students—a systematic review

BackgroundHealth literacy (HL) among higher education students is low, making them vulnerable about their health. To reverse this trend, higher education institutions promote HL interventions with various topics and methods. A comprehensive understanding of HL interventions is essential to determine whether these interventions meet the health information needs to improve health outcomes (health gains). The aim of this review was to identify and synthesise evidence on the efficacy of HL interventions implemented in academic settings to improve health outcomes.MethodsA systematic review was performed followed the PRISMA guidelines, protocol was registered in PROSPERO (CRD42022369869). A search strategy was performed in the EBSCO Host Web platform, the time limit placed was: 01/01/2017 to 30/09/2022. Eligible studies were those published in peer-reviewed journals and involved higher education students over the age of 18 as the subject of the intervention. Eligible interventions included any interventions evaluated in a study with comparison group that included a pre-post measure of health outcomes, were conducted in an academic setting. To methodology quality of included studies, it was used the Joanna Briggs Institute critical appraisal tool. To synthesise results narrative and thematic synthesis was conducted.ResultsA total of 9 articles were included in this review, identified health literacy interventions with an impact on health outcomes. The total studies involved 2902 higher education students. All 9 studies were randomised controlled trials. The synthesised evidence supports the efficacy of interventions that contributed to positive changes in mental health, attitudes, norms, and self-efficacy of condom use, emotional, social, and psychological well being, subjective sleep quality, sleep latency, and habitual sleep efficiency, physical activity, and self-reported servings fried foods. HL interventions were educational or motivational and related to health promotion, disease prevention or healthcare.ConclusionsHL interventions in higher education students can significantly improve health outcomes protecting them from the negative effects of threats for their health. The interventions designed with different strategies are more effective. HL interventions are associated with health benefits on health promotion, disease prevention and healthcare. For the attendance of higher education to be a successful experience, continuity of HL interventions developed in academic settings is necessary.

Peer navigation: a pilot study to improve recovery capital for alcohol and other drug telephone helpline callers

Background People with alcohol and other drug (AOD) use problems face multiple barriers to care. Peer navigation may overcome known barriers to care. This pilot study explored the impact of peer navigation integrated into an AOD telephone helpline. Methods Helpline callers (n = 34; 21 male, 12 female, 1 non-binary; mean age 41.3 years) were connected to a peer worker for 6 weekly phone sessions. Linear mixed models were performed to assess change in recovery capital, self-efficacy, and substance use post-intervention and 3-months follow-up. A descriptive approach was used to analyse qualitative data. Results Participants attended a mean of 4.2 sessions (range 0 to 8). Analyses showed significant improvements in recovery capital (B = 2.56, p <.001) and self-efficacy (B = 0.18, p =.015) at exit and follow-up respectively. Participants showed significant reductions in substance use at follow-up. Qualitative analysis indicated participants described unique benefits related to working with a peer, including help to access resources and support. Conclusion Peer navigation via an AOD helpline has potential to support callers to improve recovery-related outcomes. More research is needed to assess the efficacy of peer programs in helping overcome barriers to accessing care.

Parental perceptions of participation in young adult-focused eating disorder treatment.

Eating disorders (ED) are serious mental illnesses affecting young adults (YA). Parent-supported treatment for this age cohort is an important consideration given the unique developmental needs and norms of familial social support, but more research is needed to understand parental perceptions of treatment involvement. 33 parent-supports of YA with ED completed self-report assessments at admission and discharge of participation in brief, intensive, young-adult focused eating disorder treatment. Assessments measured programme satisfaction, parental self-efficacy, and parent and YA report of eating disorder-related psychopathology. Repeated measures ANOVAs were used toexamine pre-post outcome differences and between group differences among parent-supports and their YA (i.e., the patients) on eating disorder psychopathology, clinical impairment, and family functioning using the EDEQ/P-EDEQ Global, P-CIA/CIA, and Family Assessment Device Family Functioning scales. Group differences across time points were examined with paired sample t-tests adjusted for multiple comparisons. Changes in parental self-efficacy were examined separately using two-tailed paired sample t-tests. Parents reported high acceptability and learning, improvements in self-efficacy, and significant reductions of YA psychopathology at post-treatment. Parents reported comparable reductions in ED psychopathology post-treatment, but significantly greater reductions in clinical impairment compared to YA. Measures of family functioning did not improve for either parent or YA at post-treatment. Results from this study suggest that parental involvement in a YA programme is feasible and acceptable from a parental perspective and improves parental self-efficacy.

Differences in Psychological Health and Weight Loss after Bariatric Metabolic Surgery between Patients with and without Pain Syndromes

PurposeChronic pain and obesity often co-occur, negatively affecting one another and psychological wellbeing. Pain and psychological wellbeing improve after bariatric metabolic surgery (BMS), however, it is unknown whether psychological wellbeing improves differently after weight loss between patients with and without chronic pain. We investigated whether weight loss is associated with greater psychological wellbeing and functioning change after BMS, comparing patients with and without preoperative pain syndromes.MethodsDepression, health-related quality of life, self-esteem, self-efficacy to exercise and controlling eating behaviours, physical activity, and food cravings were measured before and 24 months after BMS among 276 patients with obesity. The presence of preoperative chronic pain syndromes was examined as a moderator for the relationship between 24-month weight loss and changes in psychological outcomes.ResultsChronic pain syndromes were present among 46% of patients. Weight loss was associated with greater improvement in health-related quality of life, self-efficacy to exercise and controlling eating behaviours, self-esteem and greater amelioration in food cravings. Pain syndromes only moderated negatively the relationship between the postoperative weight loss and change in self-efficacy to control eating behaviours (b = -0.49, CI [-0.88,-0.12]).ConclusionPatients with and without chronic pain showed similar improvements in weight and psychological wellbeing and behaviours after BMS. The relationship between weight loss and the improvement of self-efficacy to control eating behaviours was weaker among patients with chronic pain syndrome. Further work, measuring pain severity over time, is needed to shed light on the mechanism underlying pain and postoperative change in psychological wellbeing and weight loss.Graphical

Feasibility of a wearable self-management application for patients with COPD at home: a pilot study

BackgroundAmong people with COPD, smartphone and wearable technology may provide an effective method to improve care at home by supporting, encouraging, and sustaining self-management. The current study was conducted to determine if patients with COPD will use a dedicated smartphone and smartwatch app to help manage their COPD and to determine the effects on their self-management.MethodsWe developed a COPD self-management application for smartphones and smartwatches. Participants were provided with the app on a smartphone and a smartwatch, as well as a cellular data plan and followed for 6 months. We measured usage of the different smartphone app functions. For the primary outcome, we examined the change in self-management from baseline to the end of follow up. Secondary outcomes include changes in self-efficacy, quality of life, and COPD disease control.ResultsThirty-four patients were enrolled and followed. Mean age was 69.8 years, and half of the participants were women. The most used functions were recording steps through the smartwatch, entering a daily symptom questionnaire, checking oxygen saturation, and performing breathing exercises. There was no significant difference in the primary outcome of change in self-management after use of the app or in overall total scores of health-related quality of life, disease control or self-efficacy.ConclusionWe found older patients with COPD would engage with a COPD smartphone and smartwatch application, but this did not result in improved self-management. More research is needed to determine if a smartphone and smartwatch application can improve self-management in people with COPD.Trial registrationClinicalTrials.Gov NCT03857061, First Posted February 27, 2019.

“Maze Out”: a study protocol for a randomised controlled trial using a mix methods approach exploring the potential and examining the effectiveness of a serious game in the treatment of eating disorders

BackgroundEating Disorders (ED) are severe and costly mental health disorders. The effects of existing treatment approaches are limited and there is a need to develop novel interventions, including digital strategies that can increase engagement and effectiveness. Maze Out is a new serious game coproduced by patients and ED therapists, which allows patients to “play” with the reality of an ED and reflect on associated challenges.ObjectivesThe present study has two main objectives: (1) to evaluate the effectiveness of adding Maze Out to treatment as usual (TAU) in a randomised controlled trial (RCT); and (2) to examine in depth the potential of Maze Out by examining how it is perceived and used in the context of an RCT.MethodsParticipants will be recruited from mental health care services, endocrinology departments or Community Centres offering treatment for ED. Patients suffering from ED (N = 94) will be randomised to either TAU or TAU plus Maze Out. Primary outcome will be measured in terms of changes in self-efficacy, measured by a 5-item self-efficacy questionnaire (5-item SE_ED). Secondary outcome measures will include feelings of ineffectiveness and self-image, as measured by Eating Disorder Inventory, version 3 (EDI-3), Brief INSPIRE-O and Structural Analysis of Social Behaviour Intrex Questionnaire (SAS-B). Data will be collected at baseline (enrolment in the study), and subsequently 8 and 15 weeks after inclusion. Experiences of playing Maze Out will be examined in a sub-sample of participants, utilising both quantitative user analytics and qualitative interview data of patients, interview data of significant others, and healthcare professionals to explore the possible impact of Maze Out on disorder insight, communication patterns between patients and therapists and understanding of their disorder.DiscussionTo our knowledge Maze Out is the first serious game coproduced by patients and therapists. It is a novel and theoretically grounded intervention that may significantly contribute to the healing process of ED. If found effective, the potential for wide-spread impact and scalability is considerable.Trial registration ClinicalTrials.gov NCT05621018.

Feeling more confident to encounter negative emotions: The mediating role of distress tolerance on the relationship between self-efficacy and outcomes of exposure and response prevention for OCD

BackgroundWhile exposure and response prevention (ERP) is the first-line treatment for obsessive-compulsive disorder (OCD), up to half of patients do not effectively respond. In an effort to better understand the mechanisms behind ERP, the inhibitory learning model emphasizes the roles of increasing perceived self-efficacy and distress tolerance. While self-efficacy and distress tolerance have separately been shown to predict OCD symptoms and treatment outcomes, no studies have assessed their joint effects in ERP. The current study examined distress tolerance as a mediator of the relationship between self-efficacy and ERP outcomes. MethodsPatients in an intensive ERP-based treatment program (N = 116) completed weekly self-report measures. ResultsOver the course of treatment, as OCD symptoms reduced, self-efficacy and distress tolerance both significantly increased. Importantly, increases in self-efficacy and distress tolerance mediated each other in explaining symptom reduction, suggesting a possible bi-directional effect. LimitationsThe temporal relationship between changes in self-efficacy and distress tolerance is worthy of further investigation. In addition, the current sample had limited racial diversity and might not be representative of patients receiving lower levels of care. Findings merit replication to be ascertained of their reliability. ConclusionsFindings suggest that during ERP, patients gain confidence in their abilities both to cope with general challenges and to withstand distress, potentially helping them engage with exposures and overcome initial fears. These findings provide support for the inhibitory learning model and highlight the mechanistic roles of self-efficacy and distress tolerance in ERP. Clinical implications to target both in treatment are discussed.

Inspirational Book Reading: The Changes in Self-Efficacy and Locus of Control in Minority Students: A Mixed Method Study

Abstract The literature on college attrition rates has revealed that self-efficacy and locus of control play a critical role in academic performance and retention. However, despite the importance of students’ attitudes in academic performance, there have been few studies focused on how to develop students’ self-efficacy and internal locus of control. We examined the impact of motivational book reading on the promotion of self-efficacy and locus of control by leveraging a mixed method study, analyzing quantitative and qualitative data. One hundred diverse, business students participated in the research, where they read one motivational book and wrote essays to reflect their learning and took surveys that measured the quantitative variables before and after reading the book. The analysis revealed that motivational book reading significantly increased self-efficacy and locus of control of the participants. The qualitative analysis revealed that students expressed improvement in self-efficacy and internal locus of control after reading the book. The limitations, practical implications, and future research implications are discussed in this paper.

Home Visits for Postpartum Depression Intervention among Low-Income Latinas: Results from the PST4PPD Project

ABSTRACT Research shows that U.S. Latinas are at risk for high rates of postpartum depression (PPD) but have low rates of treatment compared to non-Hispanic White mothers. This study examined the feasibility of a multi-site home-visiting intervention (PST4PPD) conducted by bilingual community health workers (CHW) among low-income Latina mothers. A one-group, pre/posttest design and paired sample’s t-test were used to measure changes in depressive symptoms and self-efficacy for participants (n = 76) across five sites. The Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) were used to assess depression; the New General Self-Efficacy Scale and the Maternal Efficacy Questionnaire measured general self-efficacy and parenting self-efficacy. Depression scores decreased significantly from pretest to posttest. Participants’ general self-efficacy, maternal self-efficacy, and PPD knowledge increased. With a 76% completion rate, demonstrable improvements were seen in participants’ depression and self-efficacy. Implications for addressing modifiable factors such as self-efficacy and stress management are discussed.

Effect of health education based on information-motivation-behavioral skills model on patients with unilateral vestibular dysfunction.

Vestibular dysfunction (VH) is a common concomitant symptom of late peripheral vestibular lesions, which can be trauma, poisoning, infection, heredity, and neurodegeneration, but about 50% of the causes are unknown. The study uses the information-motivation-behavioral skills (IMB) model for health education, effectively improve the quality of life, increase their self-confidence, reduce anxiety and depression, and effectively improve the psychological state of patients. To explore the effect of health education based on the IMB model on the degree of vertigo, disability, anxiety and depression in patients with unilateral vestibular hypofunction. The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects, and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods. Among them, the control group was given routine nursing health education and guidance, and the observation group was given health education and guidance based on the IMB model. The changes in self-efficacy, anxiety and depression, and quality of life of patients with unilateral VH were compared between the two groups. There was no significant difference in General Self-Efficacy Scale (GSES) scale scores between the two groups of patients before nursing (P > 0.05), which was comparable; after nursing, the GSES scale scores of the two groups were higher than those before nursing. The nursing group was higher than the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in the scores of Hospital Anxiety and Depression Scale (HADS) and anxiety and depression subscales between the two groups before nursing (P > 0.05). After nursing, the HADS score, anxiety, and depression subscale scores of the two groups of patients were lower than those before nursing, and the nursing group was lower than the control group, and the difference was statistically significant (P < 0.05). After nursing, the Dizziness Handicap Inventory (DHI) scale and DHI-P, DHI-E and DHI-F scores in the two groups were decreased, and the scores in the nursing group were lower than those in the control group, and the difference was statistically significant (P < 0.05). Health education based on the IMB model can effectively improve patients' quality of life, increase self-efficacy of patients with unilateral vestibular hypofunction, enhance patients' confidence, enable patients to resume normal work and life as soon as possible, reduce patients' anxiety and depression, and effectively improve patients' psychological status.

Carry-Over of Exercise-Related Self-Regulation to Eating-Related Self-Regulation in Women Participating in Behavioral Obesity Treatments

ABSTRACT Purpose: Because obesity has not responded well to instructing affected adults in healthier eating behaviors and increased physical activity/exercise, enhanced research on psychosocial determinants of those behavioral changes is needed. Intervention foci on self-regulation have been suggested, but targeted research is required. Method: Women with obesity participated in community-based treatments that were either self-regulation-focused (self-regulation emphasis group; n = 52) or typical instruction-based (education [treatment-as-usual] group; n = 54). Results: There were overall significant increases in exercise-related self-regulation, physical activity/exercise, exercise-related self-efficacy, and eating-related self-regulation that were each significantly more pronounced in the self-regulation emphasis group. Increase in exercise-related self-regulation over 3 months predicted eating-related self-regulation over 6 months; however, sequential entry of changes in physical activity and exercise-related self-efficacy significantly mediated that relationship. However, only the path from changes in exercise-related self-regulation to exercise self-efficacy to eating-related self-regulation was significant. In a revised model where change in exercise self-efficacy was the sole mediator, treatment group did not significantly moderate the exercise self-regulation to eating self-regulation change relationship, but full mediation of that relationship occurred. Conclusion: Findings indicated salience for perceived ability/self-efficacy for physical activity, over actual physical activity progress, and its role in the transfer of self-regulatory skills from an exercise to eating context. Increased eating self-regulation significantly predicted weight loss over 6, 12, and 24 months. In the self-regulation emphasis group that translated to meaningful weight loss/weight-loss maintenance of greater than 5% of initial weight. Findings contributed to an increased understanding of psychosocial-change processes within obesity treatment research.

Influence of patients' preoperative expectations on postoperative outcomes after total knee or hip arthroplasty: a systematic review.

The association between preoperative expectations and treatment outcomes in total hip arthroplasty (THA) or total knee arthroplasty (TKA) is still unclear. Therefore the aim is to examine the association between preoperative outcome expectations, process expectations, and self-efficacy, and the postoperative outcomes overall outcome, pain, function, stiffness, satisfaction, and quality of life following THA/TKA. A systematic review with narrative synthesis was conducted. PubMed, EMBASE, PsycINFO, CINAHL and Cochrane Library were searched from inception to October 17, 2022. Included were prospective longitudinal cohort studies published in English, German, or Dutch, with an adult population undergoing THA/TKA, and including at least one measure of preoperative expectations and the postoperative outcomes mentioned earlier. Two independent reviewers screened the retrieved articles for eligibility, a third solved disagreements. Risk of bias (RoB) was assessed using the QUIPS tool. Of the 50 included studies, 38 had high RoB and 12 moderate RoB. Unadjusted results suggest a positive association between preoperative outcome expectations and overall outcome in the medium and long term, and between self-efficacy and change in 'overall outcome' in the long term. Adjusted results suggest positive associations between outcome expectations and function and between self-efficacy and overall outcome in the medium term, and for outcome expectations with pain and change in pain, respectively, and self-efficacy and stiffness in the long term. Preoperative expectations show a possible positive association with specific outcome measures, such as pain or function. For future research, it is advised to link matching specific expectations with specific outcomes.