Daily negative affect and smoking after a self-set quit attempt: The role of dyadic invisible social support in a daily diary study

Objectives Social support receipt from one's partner is assumed to be beneficial for successful smoking cessation. However, support receipt can have costs. Recent research suggests that the most effective support is unnoticed by the receiver (i.e., invisible). Therefore, this study examined the association between everyday levels of dyadic invisible emotional and instrumental support, daily negative affect, and daily smoking after a self-set quit attempt in smoker–non-smoker couples. Methods Overall, 100 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date on for 22 consecutive days, reporting daily invisible emotional and instrumental social support, daily negative affect, and daily smoking. Results Same-day multilevel analyses showed that at the between-person level, higher individual mean levels of invisible emotional and instrumental support were associated with less daily negative affect. In contrast to our assumption, more receipt of invisible emotional and instrumental support was related to more daily cigarettes smoked. Conclusions The findings are in line with previous results, indicating invisible support to have beneficial relations with affect. However, results emphasize the need for further prospective daily diary approaches for understanding the dynamics of invisible support on smoking cessation.

Synchronous and Time-Lagged Effects between Occupational Self-Efficacy and Objective and Subjective Career Success: Findings from a Four-Wave and 9-Year Longitudinal Study

We integrated research on the dimensionality of career success into social-cognitive career theory and explored the positive feedback loop between occupational self-efficacy and objective and subjective career success over time (self-efficacy → objective success → subjective success → self-efficacy). Furthermore, we theoretically accounted for synchronous and time-lagged effects, as well as indirect reciprocity between the variables. We tested the proposed model by means of longitudinal structural equation modeling in a 9-year four-wave panel design, by applying a model comparison approach and indirect effect analyses (N = 608 professionals). The findings supported the proposed positive feedback loop between occupational self-efficacy and career success. Supporting our time-based reasoning, the findings showed that unfolding effects between occupational self-efficacy and objective career success take more time (i.e., time-lagged or over time) than unfolding effects between objective and subjective career success, as well as between subjective career success and occupational self-efficacy (i.e., synchronous or concurrently). Indirect effects of past on future occupational self-efficacy via objective and subjective career success were significant, providing support for an indirect reciprocity model. Results are discussed with respect to extensions of social-cognitive career theory and occupational self-efficacy development over time.

GENERAL WELL-BEING AND USE OF SOCIAL SUPPORT

Research interest on well-being and social support has focused largely on social factors as related to attaining and maintaining well-being, self-perceptions of well-being and to a lesser extent the relationship of current level of self-perceived well-being to use of formal or informal sources of social support. This study analyzed responses to the General Well-Being Schedule of 6,913 subjects (25-74 years) interviewed during the National Health and Nutrition Examination Survey (1971-1975). The purpose of this analysis was to relate the level of GWBS scores to the use of social support, both informal (family and friends) and formal (community professionals).^ Study questions addressed were whether well-being level was related to selection of a specific social support resource and/or rate of use of resources and whether gender differences were apparent in level of well-being and social support use. Because age, sex, race, socioeconomic status (income and education) and marital status may confound the relation between level of GWB and type of social support chosen, the association between these variables with GWB and use of social support were considered. For analysis, test scores were grouped into four categories and for detailed analysis, two categories: low (0-70) and high (71-110). Cross tabulations and percentages were computed and the chi-square test of significance was used.^ Although 16 to 25 percent of the sample population reported low well-being, less than 10 percent used formal resources to discuss emotional, mental or behavior problems. Medical resources, mostly physicians, were the most used formal social supports. Informal social support was important for all well-being levels where 65-77% of each category reported using this resource.^ While well-being level does not appear to serve as a screener/selector of type of formal social support used, it is related to rates of use. Females reported slightly lower well-being than males, and except in the lowest well-being group, had higher rates of social support use. Findings support the conclusion that perceived well-being is related to use of social support such that the lower the well-being, the greater tendency to use formal and/or informal social support. ^

Back pain in migrant farmworker families and farmworker high school students from Starr County, Texas

Back symptoms are a major global public health problem with the lifetime prevalence ranging between 50-80%. Research suggests that work-related factors contribute to the occurrence of back pain in various industries. Despite the hazardous nature, strenuous tasks, and awkward postures associated with farm work, little is known about back injury and symptoms in farmworker adults and children. Research in the United States is particularly limited. This is a concern given the large proportion of migrant farmworkers in the United States without adequate access to healthcare as well as a substantial number of youth working in agriculture. The present study describes back symptoms and identifies work-related factors associated with back pain in migrant farmworker families and farmworker high school students from Starr County, TX. Two separate datasets were used from two cohort studies "Injury and Illness Surveillance in Migrant Farmworkers (MANOS)" (study A: n=267 families) and "South Texas Adolescent Rural Research Study (STARRS)" (study B: n=345). Descriptive and inferential statistics including multivariable logistic regression were used to identify work-related factors associated with back pain in each study. In migrant farmworker families, the prevalence of chronic back pain during the last migration season ranged from 9.5% among youngest children to 33.3% among mothers. Chronic back pain was significantly associated with increasing age; fairly bad/very bad quality of sleep while migrating; fewer than eight hours of sleep at home in Starr County, TX; depressive symptoms while migrating; self-provided water for washing hands/drinking; weeding at work; and exposure to pesticide drift/direct spray. Among farmworker adolescents, the prevalence of severe back symptoms was 15.7%. Severe back symptoms were significantly associated with being female; history of a prior accident/back injury; feeling tense, stressed, or anxious sometimes/often; lifting/carrying heavy objects not at work; current tobacco use; increasing lifetime number of migrant farmworker years; working with/around knives; and working on corn crops. Overall, results support that associations between work-related exposures and chronic back pain and severe back symptoms remain after controlling for the effect of non-work exposures in farmworker populations. ^

The role of self-efficacy in a low fat high fiber intervention to reduce breast cancer risk among African American women

Purpose. To determine if self-efficacy (SE) changes predicted total fat (TF) and total fiber (TFB) intake and the relationship between SE changes and the two dietary outcomes. ^ Design. This is a secondary analysis, utilizing baseline and first follow up (FFU) data from the NULIFE, a randomized trial. ^ Setting. Nutrition classes were taught in the Texas Medical Center in Houston, Texas. ^ Participants. 79 pre-menopausal, 25--45 year old African American women with an 85% response rate at FFU. ^ Method. Dietary intake was assessed with the Arizona Food Frequency Questionnaire and SE with the Self Efficacy for Dietary Change Questionnaire. Analysis was done using Stata version 9. Linear and logistic regression was used with adjustment for confounders. ^ Results. Linear regression analyses showed that SE changes for eating fruits and vegetables predicted total fiber intake in the control group for both the univariate (P = 0.001) and multivariate (P = 0.01) models while SE for eating fruits and vegetables at first follow-up predicted total fiber intake in the intervention for both models (P = 0.000). Logistic regression analyses of low fat SE changes and 30% or less for total fat intake, showed an adjusted OR of 0.22 (95% CI = 0.03, 1.48; P = 0.12) in the intervention group. The logistic regression analyses of SE changes in fruits and vegetables and 10g or more for total fiber intake, showed an adjusted OR of 6.25 (95% CI = 0.53, 72.78; P = 0.14) in the control group. ^ Conclusion. SE for eating fruits and vegetables at first follow-up predicted intervention groups' TFB intake and intervention women that increased their SE for eating a low fat diet were more likely to achieve the study goal of 30% or less calories from TF. SE changes for eating fruits and vegetables predicted the control's TFB intake and control women that increased their SE for eating fruits and vegetables were more likely to achieve the study goal of 10 g or more from TFB. Limitations are use of self-report measures, small sample size, and possible control group contamination.^

Assessing residents' readiness to screen for domestic violence: Utilizing the transtheoretical model - stages of change, decisional balance and self-efficacy

Domestic violence is a major public health problem, yet most physicians do not effectively identify patients at risk. Medical students and residents are not routinely educated on this topic and little is known about the factors that influence their decisions to include screening for domestic violence in their subsequent practice. In order to assess the readiness of primary care residents to screen all patients for domestic violence, this study utilized a survey incorporating constructs from the Transtheoretical Model, including Stages of Change, Decisional Balance (Pros and Cons) and Self-Efficacy. The survey was distributed to residents at the University of Texas Health Science Center Medical School in Houston in: Internal Medicine, Medicine/Pediatrics, Pediatrics, Family Medicine, and Obstetrics and Gynecology. Data from the survey was analyzed to test the hypothesis that residents in the earlier Stages of Change report more costs and fewer benefits with regards to screening for domestic violence, and that those in the later stages exhibit higher Self-Efficacy scores. The findings from this study were consistent with the model in that benefits to screening (Pros) and Self-Efficacy were correlated with later Stages of Change, however reporting fewer costs (Cons) was not. Very few residents were ready to screen all of their patients.^

The role of social support in HIV prevention among young Latino men who have sex with men

The purpose of this formative study was to determine and prioritize the HIV-prevention needs of Latino young men who have sex with men (YMSM) in Chihuahua (Mexico), Texas, and California, based on YMSM and service provider perceptions of the factors affecting the assimilation and implementation of HIV-preventive behaviors. These factors included: perceived social support, identification of the modes of HIV transmission, perceived risk of HIV, perceived norms and attitudes of peers.^ The study, drawn from a secondary data set, was a convenience sample of providers (n=8) and clients (n=15). Participants completed face-to face interviews and a survey instrument. Interviews were analyzed to identify common themes and congruence among client groups, and among clients and providers. Providers’ understanding of theoretical constructs of interventions was also assessed. Survey data were analyzed to determine variable frequencies and their congruence to the qualitative analysis. ^ The results revealed several differences and many commonalities in the assimilation of protective messages. Client and provider perceptions were congruent across all domains. Providers demonstrated intuitive command of theoretical concepts but inconsistently verbalized their application. Both clients and providers recognized Latinos possessed high HIV-knowledge levels, despite inconsistent protective behaviors. Clients and providers consistently identified important reasons leading to inconsistent protective behaviors, such as: lack of access to targeted information and condoms, self-esteem, sexual identification, situational factors, decreased perceived HIV-risk, and concerns about homophobia, stigma, and rejection. Other factors included: poverty, failure to reach disenfranchised populations, and lack of role models/positive parental figures. The principal conclusion of the study was that there is a need for further study to understand the interrelationship between larger socioeconomic issues and consistent protective behaviors.^

An examination of spirituality, self efficacy, and smoking cessation among adults in Houston, Texas

Over the past decade there has been a growing interest in the association between spirituality and health outcomes. Little is known about the role of spirituality among adult smokers who are motivated to stop smoking. The purpose of this dissertation is to examine the relations among immutable individual differences, spirituality, and self efficacy among adults motivated to stop smoking. The first paper of this dissertation systematically reviewed literature to measure the concordance between spirituality and smoking status among adults in the United States. The second paper of this dissertation explored the association between spirituality and smoking cessation. We hypothesized that higher levels of spirituality were positively associated with smoking cessation. The third paper of this dissertation examined the association between perceived self efficacy and spirituality. We hypothesized that both high levels of self efficacy and spirituality were positively associated with smoking cessation.^ A total of 152 citations were identified based on the preliminary search of databases and reference lists. After a preliminary title- and abstract-based review, 17 full text articles were retrieved for further assessment. Of these, eight met the criteria for inclusion. Results of the systematic review suggest that there is inconsistent evidence to support or refute an association between spirituality and smoking status among adults.^ Smokers (N = 200) at least 18 years of age enrolled in a minimal contact smoking cessation intervention in Houston, Texas completed questionnaires. To examine our hypotheses we conducted cross-sectional analyses of responses to questions included in selected baseline questions and the final in-person visit three weeks post-quit day. Results of the logistic regression analyses indicated that individuals with higher levels of spirituality and self efficacy were significantly more likely to abstain from smoking. The positive association is also evident when controlling for employment, income, race, education, and nicotine dependence. The interaction between self efficacy and spirituality was not statistically significant in predicting smoking abstinence.^ Recommendations for future research and implications for smoking cessation interventions are discussed. Further research in this area would benefit from using standard measures of abstinence, recruiting larger and more diverse populations, and using longitudinal study designs.^

Using service-learning to encourage community health advocacy among high school students

The project outlined throughout this program management plan aims to develop a health-focused student advocacy group in the San Antonio Independent School District (SAISD). At its core, this project will be an opportunity for SAISD students to engage in service-learning, through which they will learn and develop by designing, organizing and participating in meaningful public health service experiences. ^ This program management plan addresses the genuine need for public health community education by using the service-learning model as a framework to engage students to effect change. The plan delineates the process by which the student advocacy group is to be assembled, selection of service-learning project, project objectives, technical objectives, and communication requirements. Ideally, the plan should help to facilitate project coordination, communication, and planning, and to support the direction of resources. The appendices that follow also provide useful tools with which to follow through with project implementation. ^ The plan is about more than providing a tool to educate students about the health issues in their community. It is about providing a way to teach health advocacy and self-interest and encourage civic engagement via public health. Students have the potential to positively effect lasting change among their peers, in their schools and in the community.^

Sexual initiation of U.S. Latino and Colombian high school students: Toward a new theory of adolescent sexuality and implications for sexual health prevention and promotion

The general research question for this dissertation was: do the data on adolescent sexual experiences and sexual initiation support the explicit or implicit adolescent sexuality theories informing the sexual health interventions currently designed for youth? To respond to this inquiry, three different studies were conducted. The first study included a conceptual and historical analysis of the notion of adolescence introduced by Stanley Hall, the development of an alternative model based on a positive view of adolescent sexuality, and the rationale for introducing to adolescent sexual health prevention programs the new definitions of sexual health and the social determinants of health approach. The second one was a quantitative study aimed at surveying not only adolescents' risky sexual behaviors but also sexual experiences associated with desire/pleasure which have been systematically neglected when investigating the sexual and reproductive health of the youth. This study was conducted with a representative sample of the adolescents attending public high schools in the State of Caldas in the Republic of Colombia. The third study was a qualitative analysis of 22 interviews conducted with male and female U.S. Latino adolescents on the reasons for having had or having not had vaginal sex. The more relevant results were: most current adolescent sexual health prevention programs are still framed in a negative approach to adolescent sexuality developed a century ago by Stanley Hall and Sigmund Freud which do not accept the adolescent sexual experience and propose its sublimation. In contrast, the Colombian study indicates that, although there are gender differences, adolescence is for males and females a normal period of sexual initiation not limited to coital activity, in which sexual desire/pleasure is strongly associated with sexual behavior. By the same token, the study about the reasons for having had or not had initiated heterosexual intercourse indicated that curiosity, sexual desire/pleasure, and love are basic motivations for deciding to have vaginal sexual intercourse for the first time and that during adolescence, young women and men reach the cognitive development necessary for taking conscious decisions about their sexual acts. The findings underline the importance of asking pertinent questions about desire/pleasure when studying adolescent sexuality and adopting an evidence-based approach to sexual health interventions.^

THE EFFECT OF PERSON-ENVIRONMENT FIT ON THE PSYCHOLOGICAL WELL-BEING OF PSYCHIATRIC AIDES WORKING IN A STATE HOSPITAL (COPING RESOURCES, SOCIAL SUPPORT, OCCUPATIONAL STRESS, LOCUS-OF-CONTROL)

This study addressed two purposes: (1) to determine the effect of person-environment fit on the psychological well-being of psychiatric aides and (2) to determine what role the coping resources of social support and control have on the above relationship. Two hundred and ten psychiatric aides working in a state hospital in Texas responded to a questionnaire pertaining to these issues.^ Person-environment fit, as a measure of occupational stress, was assessed through a modified version of the Work Environment Scale (WES). The WES subscales used in this study were: involvement, autonomy, job pressure, job clarity, and physical comfort. Psychological well-being was measured with the General Well-Being Schedule which was developed by the National Center for Health Statistics. Co-worker and supervisor support were measured through the WES and finally, control was assessed through Rotter's Locus of Control Scale.^ The results of this study were as follows: (1) all person-environment (p-e) dimensions appeared to have linear relationships with psychological well-being; (2) the p-e fit - well-being relationship did not appear to be confounded by demographic factors; (3) all p-e fit dimensions were significantly related to well-being except for autonomy; (4) p-e fit was more strongly related to well-being than the environmental measure alone; (5) supervisor support and non-work related support were found to have additive effects on the relationship between p-e fit and well-being, however no interaction or buffering effects were observed; (6) locus of control was found to have additive effects in the prediction of well-being and showed interactive effects with work pressure, involvement and physical comfort; and (7) the testing of the overall study model which included many of the components mentioned above yielded an R('2) = .27.^ Implications of these findings are discussed, future research suggested and applications proposed. ^

FAMILY MEDICINE RESIDENT SURVEY ON HEALTH PROMOTION (PERSONAL EXPECTATIONS, BEHAVIORS, PERCEIVED SELF-EFFICACY, COGNITIVE ASSESSMENT, OUTCOME EXPECTANCY)

This study was designed to test the theoretical predictors of personal efficacy expectations among family medicine resident physicians for helping their patients change thirteen high risk health behaviors. A survey questionnaire was sent to 781 family medicine residents in the six state south central region. The response rate was 60 percent. The hypothesized relationship between lower levels of difficulty and higher personal efficacy expectations was supported by the data. Effort was a significant predictor of perceived self efficacy for health behaviors considered less difficult to change. Situational support did not prove to be a significant predictor for many of the health behaviors. Rate and pattern of success were consistent and significant predictors of perceived self efficacy for helping patients change all thirteen of the health behaviors. Modeling of effective methods by faculty was a significant predictor of efficacy expectations for several but not all of the behaviors. Personal modeling was a significant predictor of perceived efficacy for helping patients change behaviors related to alcohol misuse and exercise. The respondents personally modeled positive health behaviors more consistently than their older colleagues or the general population.^ The results of this study lend substantially to the usefulness of the cognitive-behavioral theory of perceived self efficacy and provide a mechanism for assessing the predictors of personal efficacy expectations of family medicine resident physicians. The findings are expected to have direct implications for faculty to institute systematic programs of interventions designed to increase residents' perceptions of efficacy in facilitating more positive health behaviors among their patients. ^

Posttraumatic stress disorder among veterans of the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) wars: Psychological comorbidities, postdeployment social support and unit support

Much attention has been given to treating Operation Iraqi Freedom/Operation Enduring (OIF/OEF) Veterans with posttraumatic stress disorder (PTSD). However, little attention is given to those Veterans who do not meet diagnostic criteria for PTSD but who may still benefit from intervention. Research is needed to investigate the impact of how different racial/ethnic backgrounds, different levels of social support and comorbid mental health disorders impact OIF/OEF Veterans with varying levels of PTSD. The purpose of this dissertation is to examine the association of comorbid Axis I disorders, race/ethnicity, different levels of postdeployment social support and unit support on OIF/OEF Veterans with varying levels of PTSD. Data for this dissertation were from postdeployment screenings of OIF/OEF Veterans from a large Veterans Affairs hospital in southeast Texas. To examine the study hypotheses, we conducted multinomial logistic regressions of the clinician reported data. ^ The first article examined the prevalence of subthreshold and full levels of PTSD and compared Axis I and alcohol use comorbidity rates among 1,362 OIF/OEF Veterans with varying levels of PTSD. Results suggest that OIF/OEF Veterans with subthreshold PTSD experience similar levels of psychological distress as those with full PTSD and highlight the need to provide timely and appropriate mental health services to individuals who may not meet the diagnostic criteria for full PTSD. ^ These results suggest that OIF/OEF Veterans of all race/ethnicities can benefit from strong social support systems. Postdeployment social support was found to be a protective factor against the development of PTSD among White, Black and Hispanic veterans while deployment unit support was a protective factor only among Black Veterans. The second article investigated the association between postdeployment social support and unit support with varying levels of PTSD by race/ethnicity among 1,115 OIF/OEF Veterans. ^ The results of this study can help to formulate treatment and interventions for OIF/OEF Veterans with varying levels of PTSD and social support systems.^

Vocational guidance in people with special educational needs as the result of visual impairment during the transition stage from high school to advanced education

This work proposes to seek for the factors related to the choices that people with special educational needs make as the result of the visual impairment, during the transition stage from high school to advanced education. Therefore, we have taken into consideration that Vocational Guidance and the transition towards adulthood get specific characteristics in case of visually impaired young people, particularly in what's related to continue with advanced education. The focus of this work is to be able to clarify the existence of factors that make this transition stage easier or harder, through the observation of visually impaired and blind people who complete high school. This matter has aroused interest and concern about the strategies to follow to ensure the successful entrance and remaining in the selected advanced education. However, if we don?t know the factors involved in the described fact, it's difficult to design an appropriate intervention strategy. Then, in order to take acknowledge about the specific issues of visually impaired young people who complete high school, we chose a special school for this disability and some students who will join this project