Point of decision signs and stair use in a university worksite setting: General versus specific messages

Point-of-decision signs to promote stair use have been found to be effective in various environments. However, these signs have been more consistently successful in public access settings that use escalators, such as shopping centers and transportation stations, compared to worksite settings, which are more likely to contain elevators that are not directly adjacent to the stairs. Therefore, this study tested the effectiveness of two point-of-decision sign prompts to increase stair use in a university worksite setting. Also, this study investigated the importance of the message content of the signs. One sign displayed a general health promotion message, while the other sign presented more specific information. Overall, this project examined whether the presence of the point-of-decision signs increases stair use. In addition, this research determined whether the general or specific sign promotes greater stair use. ^ Inconspicuous observers measured stair use both before the signs were present and while they were posted. The study setting was the University of Texas School of Nursing, and the target population was anyone who entered the building, including employees, students, and visitors. The study was conducted over six weeks and included two weeks of baseline measurement, two weeks with the general sign posted, and two weeks with the specific sign posted. Each sign was displayed on a stand in the decision point area near the stairs and the elevator. Logistic regression was used to analyze the data. ^ After adjustment for covariates, the odds of stair use were significantly greater during the intervention period than the baseline period. Furthermore, the specific sign period showed significantly greater odds of stair use than the general sign period. These results indicate that a point-of-decision sign intervention can be effective at promoting stair use in a university worksite setting and that a sign with a specific health information message may be more effective at promoting stair use than a sign with a general health promotion message. These findings can be considered when planning future worksite and university based stair promotion interventions.^

DOES THE MESSAGE MATTER? ENHANCING PATIENT ADHERENCE THROUGH PERSUASIVE MESSAGES

To improve health and reduce costs, we need to encourage patients to make better healthcare decisions. Many informatics interventions are aimed at improving health outcomes by influencing patient behavior. However, we know little about how the content of a message in these interventions can influence a health-related decision. In this research we formulate a conceptual model to help explain and guide the design of “persuasive messages”, those which can change and influence patient behavior. We apply the conceptual model to design persuasive appointment reminder messages using humancentered design principles. Finally, we empirically test our hypotheses in a randomized controlled trial in order to determine the effectiveness of persuasive appointment reminders to reduce the number of missed appointments in a sample of 1016 subjects in a community health center. The results of the study confirm that reminder messages are effective in reducing missed appointment compared with no reminders (p=0.028). Further, reminder messages that incorporate heuristic cues such as authority, commitment, liking, and scarcity are more effective than reminder messages without such cues (p=0.006). However, the addition of systematic arguments or reasons for attending appointments have no effect on appointment adherence (p=0.646). The results of this research suggest that the content of reminder messages may be an important factor in helping to reduce missed appointments.

The characterization of mouse carboxypeptidase N small subunit gene structure and presence in developing embryos

Carboxypeptidase N (CPN) is a plasma zinc metalloprotease, which consists of two enzymatically active small subunits and two large subunits that protect the protein from degradation. CPN cleaves carboxy-terminal arginines and lysines from peptides found in the bloodstream such as complement anaphylatoxins, kinins, and creatine kinase MM. In this study, the mouse CPN small subunit (CPN1) coding region, gene structure, and chromosomal location were characterized and the expression of CPN1 was investigated in mouse embryos at different stages of development. The CPN1 gene, which was approximately 29 kb in length, contained nine exons and localized to mouse chromosome 19D2. The fifth and sixth exons of CPN1 encoded the amino acids necessary for substrate binding and catalytic activity. CPN1 RNA was expressed predominately in adult liver and contained a 1371 bp open reading frame encoding 457 amino acids. In the mouse embryo, CPN1 RNA was observed at 8.5 days post coitus (dpc), while its protein was detected at 10.5 dpc. In situ hybridization of the fetal liver detected CPN1 RNA in erythroid progenitor cells at 10.5, 13.5, and 16.5 dpc and in hepatocytes at 16.5 dpc. This was compared to the expression of the complement component C3, the parent molecule of complement anaphylatoxin C3a. Consistently throughout the experiments, CPN1 message and protein preceded the expression of C3. To obtain a better understanding of the biological significance of CPN1 in vivo, studies were initiated to produce a genetically engineered mouse in which the CPN1 gene was ablated. To facilitate this project a targeting vector was constructed by removing the functionally important fifth and sixth exons of the CPN1 gene. Collectively, these studies have: (1) provided important detailed information regarding the structure and organization of the murine CPN1 gene, (2) yielded insights into the developmental expression of mouse CPN1 in relationship to C3 expression, and (3) set the stage for the generation of a CPN1 “knock-out” mouse, which can be used to determine the biological significance of CPN1 in both normal and diseased conditions. ^