Tucker, Sharon

AbstractBackgroundCompelling evidence supports multiple benefits of physical activity (PA) even in small bursts. Less than 50% of Americans achieve recommended PA levels, lower still for individuals living with chronic illness or disease.PurposeThe purpose of this study was to develop and evaluate the feasibility and preliminary effects of 3‐min follow‐along video scenarios to promote brief episodes of low–moderate levels of PA among individuals with chronic diseases.MethodsGuided by our previous studies and self‐efficacy theory, the program (WellMe in 3© for Patients) was modeled after another program developed for healthcare staff. An advisory panel and a health and fitness expert guided the creation of twelve 3‐min video scenarios that included two individuals living with chronic illness and a fitness leader who guided the PA scenarios and how to adapt them based on limitations. The 12 scenarios included 3 min of aerobic activities, stretching, or balance. Preliminary pilot effects were measured among 39 patients living with chronic conditions for one month. Standardized instruments were used to measure PA levels, PA self‐efficacy (SE), and quality of life (QoL); usability and satisfaction were assessed using researcher‐developed tools. Descriptive and inferential statistics were used to evaluate change over time.ResultsTwelve video scenarios were created tailored to persons with chronic illness. Thirty‐nine participants piloted the program, reporting an average of two chronic conditions. Baseline QoL scores were lower than normative data, self‐efficacy scores were low‐to‐moderate, and PA levels were very low. Participants averaged using one video per day. 62% of participants provided complete self‐reported pre‐ and post‐QoL and SE data and 41% provided pre‐ and post‐PA (accelerometer) data. Significant improvements were found for general health and energy scores, and trends were found for self‐efficacy scores. PA levels were highly variable with nonsignificant increases from baseline. Effect sizes were low–moderate for several measures. About 79% of participants rated program “Very good”; all recommended the program.Linking Evidence to ActionPhysical activity has multiple health benefits for all people including those living with chronic conditions. Even short bouts of physical activity have health benefits. A program of 3‐min follow‐along PA videoclips for individuals living with chronic disease holds promise for clinicians and researchers.

This study used a cross-sectional design to conduct a subgroup psychometric analysis of the Emotional Availability Scale among matched Hispanic ( n = 20), African American ( n = 20), and European American ( n = 10) English-speaking mother–child dyads in the United States. Differences by race/ethnicity were tested ( p < .05) among (a) Emotional Availability Scale dimensions with ANOVA, and (b) relationships of Emotional Availability Scale dimensions with select Dyadic Parent–Child Interaction Coding System variables with Pearson correlation and matched moderated regression. Internal consistency was .950 (Cronbach’s α; N = 50). No significant differences in the six Emotional Availability Scale dimension scores by race/ethnicity emerged. Two Dyadic Parent–Child Interaction Coding System behaviors predicted two Emotional Availability Scale dimensions each for Hispanic and African American mother–child dyads. Results suggest emotional availability similarity among race/ethnic subgroups with few predictive differences of emotional availability dimensions by specific behaviors for Hispanic and African American subgroups.

Abstract Rationale Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions. Objectives To determine the effect of comprehensive health coaching on the rate of COPD readmissions. Methods A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either (1) motivational interviewing–based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or (2) usual care. Measurements and Main Results We evaluated the rate of COPD-related hospitalizations during 1 year of follow-up. The absolute risk reductions of COPD-related rehospitalization in the health coaching group were 7.5% (P = 0.01), 11.0% (P = 0.02), 11.6% (P = 0.03), 11.4% (P = 0.05), and 5.4% (P = 0.24) at 1, 3, 6, 9, and 12 months, respectively, compared with the control group. The odds ratios for COPD hospitalization in the intervention arm compared with the control arm were 0.09 (95% confidence interval [CI], 0.01–0.77) at 1 month postdischarge, 0.37 (95% CI, 0.15–0.91) at 3 months postdischarge, 0.43 (95% CI, 0.20–0.94) at 6 months postdischarge, and 0.60 (95% CI, 0.30–1.20) at 1 year postdischarge. The missing value rate for the primary outcome was 0.4% (one patient). Disease-specific quality of life improved significantly in the health coaching group compared with the control group at 6 and 12 months, based on the Chronic Respiratory Disease Questionnaire emotional score (emotion and mastery domains) and physical score (dyspnea and fatigue domains) (P &lt; 0.05). There were no differences between groups in measured physical activity at any time point. Conclusions Health coaching may represent a feasible and possibly effective intervention designed to reduce COPD readmissions. Clinical trial registered with www.clinicaltrials.gov (NCT01058486).