Improvement In Self-reported Health Research Articles

Increased Salivary IgA Response as an Indicator of Immunocompetence After a Mindfulness and Self-Compassion-Based Intervention

Mindfulness-based interventions (MBIs) have been consolidated in healthcare settings as a highly useful therapeutic approach. Numerous studies have demonstrated their positive influence on physical and psychological well-being. In contrast, the scientific evidence concerning the potential beneficial effects of mindfulness on biological variables such as health indicators is still scarce. Therefore, in this study, we sought to analyse the influence of a mindfulness and self-compassion-based intervention on levels of salivary immunoglobulin A (sIgA) in order to validate its use in field studies. A secondary objective of the study was to confirm the associated decline in salivary cortisol (Csal) levels and improvements in self-reported health and mood already described in the general population. For this purpose, we conducted a longitudinal design, collecting saliva samples and self-reports before and immediately after the first and the last session of the intervention. Results show an improvement in health and self-reported mood, along with an increase in the sIgA levels of participants and a reduction in Csal levels. These results reinforce existing evidence of the beneficial effects of mindfulness and self-compassion on health, evaluated from a holistic perspective, considering both biological and self-reported variables. Moreover, as already done with other biological indicators such as Csal, sIgA could be used in clinical settings to evaluate the effectiveness of MBIs.

The Effects of Wealth on Health. Micro-Evidence from Homeowners' Housing Wealth Misestimation

The debate on the impact of economic conditions on health has been recently amplified by the drug crisis in the US attributed by some to “deaths of despair.” There is little understanding of the magnitude of the impact of economic conditions on health and the reasons why it varies across socioeconomic groups and geographical areas. We show that housing is an important unexplored driver that explains these differences. We exploit the fact that households that overvalue (undervalue) their houses experience an unexpected negative (positive) shock in their housing wealth when they sell their houses. We find that a one standard deviation positive shock in housing wealth increases the probability of an improvement in self-reported health by 1.13 percentage points and decreases the drug-related mortality rate by 0.27. We exploit the geographical variation in unexpected housing wealth shocks and find that households who live in MSAs with more inelastic housing supply experience larger changes in health outcomes.

Does retirement (really) lead to worse health among European men and women across all educational levels?

ObjectivesWhereas the view that retirement would have negative effects on health is widespread, many existing studies may be biased because they do not sufficiently take into account the issue of reverse causation. Using a large longitudinal dataset for twelve Western European countries, this study uses an instrumental variables approach to assess effects of retirement on health. MethodsLongitudinal data for the years 2009–2012 for 75,722 men and 63,911 women from twelve Western European countries are derived from the European Union Statistics on Income and Living Conditions. Health outcomes used in this study are self-rated health, activity limitations and chronic conditions. Country- and sex-specific early- and full-pension ages are used as instruments. Models were stratified by sex as well as educational levels to assess potential effect heterogeneity. ResultsResults obtained from conventional random-effects models suggest that retired men and women have higher chances of reporting bad self-rated health, activity limitations as well as chronic conditions. However, using an instrumental variables (IV) approach the results suggest that retirement can lead to health improvements in self-reported health as well as activity limitations among men and women. The health improvements associated with retirement among men and women exist across all educational levels. DiscussionContrary to several previous studies, the results suggest that retirement may have health preserving effects. The positive effects of retirement and health exist for low as well as high educated men and women.

Lifestyle Behaviors Predict Negative and Positive Changes in Self-reported Health: The Role of Immigration to the United States for Koreans.

Studies of changes in health following immigration are inconsistent, and few are based on longitudinal designs to test associations based on change. This study identified factors that predicted changes in self-reported health (SRH) among California residents of Korean descent. A sample of California residents of Korean descent were interviewed and followed-up 2 or 3 times by telephone during 2001-2009. The questionnaires dealt with SRH, lifestyle behaviors (smoking, physical activity, and fast food consumption), and socioeconomic measures. Statistical analysis included random-intercepts longitudinal regression models predicting change in SRH. A similar percentage of respondents reported improved and deteriorating SRH (30.3% and 29.1%, respectively). Smoking, consumption of fast foods, age, percentage of life spent in the United States, and being female were predictors of deteriorating SRH, whereas physical activity, education, and living with a partner were predictive of improvement in SRH. The effect of immigration on SRH is influenced by socioeconomic factors and lifestyle practices. Results support promotion of healthy lifestyle practices among immigrants.

Cost-effectiveness of a Home-Exercise Program Among Older People After Hospitalization

BackgroundOlder people who have been recently discharged from hospital are at increased risk of falls and deterioration in physical functioning. ObjectiveTo investigate the cost-effectiveness of a 12-month home-exercise program for older adults after hospitalization. MethodAn economic evaluation was conducted alongside a randomized controlled trial. The analysis was conducted from the health and community service provider perspective. A total of 340 people aged 60 years and older, with a recent hospital admission, were randomized into exercise and usual care control groups. Incremental costs per extra person showing improvement in mobility performance (using the Short Physical Performance Battery), per person indicating improvement in health (self-reported using a 3-point Likert scale) and per quality-adjusted life year (QALY) gained (utility measured using the EQ-5D) were estimated. Uncertainty was represented using cost-effectiveness acceptability curves. Subgroup analyses for participants with better cognition (above the median MMSE score of 28) also were undertaken. ResultsThe average cost of the intervention was $A751 per participant. The incremental cost-effectiveness of the program relative to usual care was $A22,958 per extra person showing an improvement in mobility, $A19,020 per extra person indicating an improvement in health, and $A77,403 per QALY. The acceptability curve demonstrates that the intervention had an 80% probability of being cost-effective relative to the control at a threshold of $A48,000 per extra person achieving mobility improvement and $A36,000 indicating an improvement in self-reported health. There was no threshold value at which the program can be considered as having an 80% probability of cost-effectiveness for the QALY outcome. Subgroup analyses for participants with better cognitive status indicated improved cost-effectiveness for all outcomes. ConclusionThe exercise intervention appeared to offer reasonable value for money for mobility outcomes and self-reported health status. Value for money for all measures was greater in the higher cognitive status subgroup.

Giving Mom a Break: The Impact of Higher EITC Payments on Maternal Health

The 1993 expansions of the Earned Income Tax Credit created the first meaningful separation in benefits between families containing two or more children and those with only one child. If income is protective of health, we should see improvements over time in the health for mothers eligible for these higher EITC benefits. Using data from the Behavioral Risk Factors Surveillance Survey, we find improvements in self-reported health for affected mothers. Using data from the National Health and Nutrition Examination Survey, we find reductions in the probability of having risky levels of biomarkers for these same women. (JEL H24, I12, I14, J16)

Patient engagement as a risk factor in personalized health care: a systematic review of the literature on chronic disease

BackgroundThe role of patient engagement as an important risk factor for healthcare outcomes has not been well established. The objective of this article was to systematically review the relationship between patient engagement and health outcomes in chronic disease to determine whether patient engagement should be quantified as an important risk factor in health risk appraisals to enhance the practice of personalized medicine.MethodsA systematic review of prospective clinical trials conducted between January 1993 and December 2012 was performed. Articles were identified through a medical librarian-conducted multi-term search of Medline, Embase, and Cochrane databases. Additional studies were obtained from the references of meta-analyses and systematic reviews on hypertension, diabetes, and chronic care. Search terms included variations of the following: self-care, self-management, self-monitoring, (shared) decision-making, patient education, patient motivation, patient engagement, chronic disease, chronically ill, and randomized controlled trial. Studies were included only if they: (1) compared patient engagement interventions to an appropriate control among adults with chronic disease aged 18 years and older; (2) had minimum 3 months between pre- and post-intervention measurements; and (3) defined patient engagement as: (a) understanding the importance of taking an active role in one’s health and health care; (b) having the knowledge, skills, and confidence to manage health; and (c) using knowledge, skills and confidence to perform health-promoting behaviors. Three authors and two research assistants independently extracted data using predefined fields including quality metrics.ResultsWe reviewed 543 abstracts to identify 10 trials that met full inclusion criteria, four of which had ‘high’ methodological quality (Jadad score ≥ 3). Diverse measurement of patient engagement prevented robust statistical analyses, so data were qualitatively described. Nine studies documented improvements in patient engagement. Five studies reported reduction in clinical markers of disease (for example HbA1C). All studies reported improvements in self-reported health status.ConclusionsThis review suggests patient engagement should be quantified as part of a comprehensive health risk appraisal given its apparent value in helping individuals to effectively self-manage chronic disease. Patient engagement measures should include assessment of the knowledge, confidence and skills to prevent and manage chronic disease, plus the behaviors to do so.

The relationship between workers’ self-reported changes in health and their attitudes towards a workplace intervention: lessons from smoke-free legislation across the UK hospitality industry

BackgroundThe evaluation of smoke-free legislation (SFL) in the UK examined the impacts on exposure to second-hand smoke, workers’ attitudes and changes in respiratory health. Studies that investigate changes in the health of groups of people often use self-reported symptoms. Due to the subjective nature it is of interest to determine whether workers’ attitudes towards the change in their working conditions may be linked to the change in health they report.MethodsBar workers were recruited before the introduction of the SFL in Scotland and England with the aim of investigating their changes to health, attitudes and exposure as a result of the SFL. They were asked about their attitudes towards SFL and the presence of respiratory and sensory symptoms both before SFL and one year later. Here we examine the possibility of a relationship between initial attitudes and changes in reported symptoms, through the use of regression analyses.ResultsThere was no difference in the initial attitudes towards SFL between those working in Scotland and England. Bar workers who were educated to a higher level tended to be more positive towards SFL. Attitude towards SFL was not found to be related to change in reported symptoms for bar workers in England (Respiratory, p = 0.755; Sensory, p = 0.910). In Scotland there was suggestion of a relationship with reporting of respiratory symptoms (p = 0.042), where those who were initially more negative to SFL experienced a greater improvement in self-reported health.ConclusionsThere was no evidence that workers who were more positive towards SFL reported greater improvements in respiratory and sensory symptoms. This may not be the case in all interventions and we recommend examining subjects’ attitudes towards the proposed intervention when evaluating possible health benefits using self-reported methods.

Effects of vacation from work on health and well-being: Lots of fun, quickly gone

Although vacation from work provides a valuable opportunity for recovery, few studies have met the requirements for assessing its effects. These include taking measurements well ahead of the vacation, during the vacation and at several points in time afterwards. Our study on vacation (after-) effects focused on two related questions: (1) Do health and well-being of working individuals improve during a vacation? and (2) How long does a vacation effect last after resumption of work? In a longitudinal study covering seven weeks, 96 Dutch workers reported their health and well-being levels two weeks before a winter sports vacation, during vacation and one week, two weeks and four weeks after vacation on seven indicators. Participants' health and well-being improved during vacation on five indicators: health status, mood, tension, energy level and satisfaction. However, during the first week of work resumption, health and well-being had generally returned to pre-vacation levels. In conclusion, a winter sports vacation is associated with improvements in self-reported health and well-being among working individuals. However, these effects fade out rapidly after work resumption. We propose a framework for future vacation research and suggest investigating the role of vacation type, duration and means to prolong vacation relief.

The health benefits of a physical activity program for older adults living in congregate housing.

In Saskatoon in 2002, as one of the key strategies for the in motion health promotion strategy, the Forever...in motion program was developed with the general goal of increasing opportunities for physical activity among older adults living in congregate housing. The three components of the program were a low-intensity exercise program, informal socialization and educational sessions. The objective of the present study was to examine whether participation in this program positively influenced participants' physical, emotional, psychological and social well-being. A quasi-experimental, pretest/post-test design was employed to examine the impact of the program on various aspects of participant well-being. Thirty-six program participants and a comparison group of 22 non-participants from two congregate housing facilities took part in the study. The pretest was administered to the study and comparison groups before or shortly after the 12-week session commenced, and the post-test was administered after the 12-week session had concluded. Pretest and post-test assessment consisted of self-report measures of (1) vitality, (2) self-rated health, 3) mental health, (4) social functioning, (5) role limitations due to emotional problems, 6) physical activity-related knowledge, and (7) self-efficacy for exercise. A multivariate analysis of covariance (MANCOVA) was conducted using the seven post-test scores as dependent variables and the pretest scores as covariates. After adjusting for differences in baseline characteristics, the findings revealed statistically significant improvements in self-reported health and self-efficacy for exercise in the program participant group as compared with non-participants. The results of this study suggest that a relatively low-cost, low-intensity exercise program such as the Forever...in motion program may positively influence the well-being of older adults living in congregate housing. However, additional research with a larger number of participants and a more rigorous study design is needed to further elucidate the health benefits of the Forever...in motion program.

PHYSICAL FUNCTION TESTING OF ELDERLY SUBJECTS: ASSOCIATION WITH SELF-REPORTED ACTIVITY AND HEALTH PERCEPTION 603

Physical function is thought to be important to maintain health and independence in later life. Balance, gait, strength, endurance and flexibility were evaluated in a community setting for 461 elderly subjects (mean age 75, range 66-95) who also completed a PA questionnaire and a Short Form 36 (SF-36) general health questionnaire. Of these subjects, 303 were offered regular supervised physical activities within their own community or home. Repeat SF-36s were completed at 1 year into the PA intervention. Poorer health perception was associated with lower PA scores and poorer scores on physical performance tests (Spearman). Greater scores on self reported physical activity were associated with better physical function (Kendall's Tau-c). Reported physical activity declined steadily with age for females but remained about the same for males. Performance on the functional tests of chair rise, grip strength, endurance walk, shoulder flexibility and 8-foot walk declined steadily with age for both males and females. Those who participated in at least 1 exercise session/week reported significant improvement in the dimensions of general health, vitality and physical role. This study provides evidence that simple field-based physical function measures can be used to categorize older persons and that physical function is related to self-reported health. Furthermore, the provision of community based physical activities for older people leads to significant improvement in self-reported health for regular attenders.

Claims that retirement improves health.

The notion that retiring can benefit health has gone largely unexplored, though large proportions of retirees retrospectively claim improved health upon retirement. Although some of these claims may have a medical basis, it is more likely that retirees perceive that their health has improved due to the reduced role demands that may accompany retirement. This study used prospective data to compare men who claimed that retirement had a good effect on their health (n = 114) with men who claimed no effect of retirement on health (n = 149). Results showed that retrospective claims of good effects were not corroborated by a corresponding longitudinal, pre- to post-retirement improvement in self-reported health. Claims of good effects, however, were indeed more likely among men whose retirement entailed the reduction of prior job strain and role demands, thereby supporting the interpretation that such claims represent the enhancement of functional health status.