Anna H.L. Floyd

Group vs. individual exercise interventions for women with breast cancer: a meta-analysis

Abstract Background. Both during and after treatment, cancer survivors experience declines in physical and psychosocial quality of life (QoL). Prior research indicates that exercise interventions alleviate problems in physical functioning and some aspects of psychological functioning. For survivors seeking social support, exercise programmes that are conducted in group settings may foster optimal QoL improvement (by addressing additional issues related to isolation and social support) over individually based exercise programmes. Methods. We reviewed literature on group cohesion in exercise studies, and conducted a meta-analysis to test the hypothesis that group as compared to individual exercise interventions for breast cancer survivors would show greater improvement in QoL. Results. As currently implemented, group exercise interventions showed no advantage. However, they typically did not provide any evidence that they capitalised upon potentially beneficial group processes. Conclusions. Future exercise intervention studies could investigate the effect on QoL of deliberately using group dynamics processes, such as team-building experiences and group goal setting to foster group cohesion.

Self-expansion and smoking abstinence.

Helping smokers quit is important as smoking is the number one preventable cause of death in the U.S. Smoking activates the mesolimbic dopamine reward system which is also responsible for pleasure associated with other behaviors, including engaging in novel, exciting and/or challenging (i.e., self-expanding) events. We hypothesized that the reward activation achieved by experiencing self-expanding events can supplant the reinforcement normally provided by smoking and can thus facilitate quitting. We investigated this hypothesis among 74 current and 66 former smokers who reported the self-expanding events they experienced for the 2 months prior to their most successful or final, quit attempt, respectively. Former smokers, compared to current smokers, reported significantly more self-expanding events and that the events were more helpful to their quitting. For current smokers, there was a significant moderate-to-large positive correlation between number of self-expanding events and number of days subsequently abstained from smoking. The results support the proposition that experiencing self-expanding activities or events can be beneficial for smoking abstinence.

Lessons to be learned from 25 years of research investigating psychosocial interventions for cancer patients.

Conducting rigorous psychosocial intervention research with cancer patients has many challenges including encouraging them to join studies, asking them to engage in interventions or be part of control conditions, and to provide data over follow-up assessments. Here, we highlight valuable insights regarding such challenges provided by investigators studying psychosocial interventions for cancer patients. Handling these skillfully has important implications for the internal and external validity of this research and the ethical treatment of participants. Challenges noted in research reports included in a systematic review of 25 years of research (comprising 488 unique projects) investigating interventions designed to enhance cancer patients’ quality of life were compiled. Among the difficulties mentioned was the fact that patients may not feel the need for psychosocial interventions and thus may not be interested in joining an intervention study. Patients who do feel the need for such interventions may be deterred from joining trials by the prospect of being randomized to a nonpreferred group; if they do join a trial, participants may be disappointed, drop out, or seek compensatory additional assistance when they are assigned to a control group. Apart from randomization, other aspects of research may be off-putting to participants or potential participants, such as the language of consent forms or the intrusiveness of questions being asked. Potential remedies, such as research awareness interventions, monetary incentives, partnering with cancer support organizations, and using designs that take preferences into account merit consideration and further research inquiry.

Effects of participant preferences in unblinded randomized controlled trials.

Little research has deliberately investigated the effects of participant preferences for treatment condition in unblinded randomized controlled trials. We designed a study with a non-patient sample comparing a randomized arm to a preference arm of the same trial to investigate: (1) whether having a choice to select ones preference affects feelings about participation, belief in treatment effectiveness, treatment contamination, intervention adherence and engagement, and trial attrition; and (2) the interaction of preferences and treatment assignment on these variables. Contamination and attrition were rare and excluded from analyses. There was no effect of choice. Participants mismatched to preference felt less positive about their experience, but this did not affect belief in treatment, adherence, or engagement. Stronger effects may occur for patient populations.

Depressive symptoms and smokers' perceptions of lung cancer risk: Moderating effects of tobacco dependence

Smokers who acknowledge the personal health risks of smoking are more likely to attempt quitting. Unfortunately, many smokers are unrealistically optimistic about their health risks. Depressed smokers, however, may be more realistic about their risks. These studies examined the relationship between depressive symptoms and risk perceptions among two groups: college-age smokers (N = 128) and smokers from the nationally representative HINTS database (N = 1,246). In the college sample, among highly tobacco dependent smokers, more depressed smokers believed more strongly that quitting eliminates lung cancer risk (b = - .27, p = .01), and they estimated a faster reversal of risk after quitting (b = - .70, p = .03). In the HINTS sample, among highly tobacco dependent women, the more depressed they were, the higher their perceived risk of developing lung cancer (b = .23, p = .05). In sum, depressive symptoms among some smokers may lead to heightened risk perceptions. However the belief that quitting can reduce risk quickly might encourage smokers to postpone quitting. Cessation programs could benefit from tailoring their programs accordingly.

Multitasking and the illusion of safety

Evidence suggests that conducting two or more tasks simultaneously (i.e., “multitasking”) leads to decreased attention overall and plays a contributing role to accidents and injuries. This paper examines the potential impact multitasking can have in a work environment influenced by electrical hazards. The paper will: (a) provide an example of an incident scenario in which multitasking could play a role; (b) describe the psychology of multitasking; (c) explain why we overestimate our multitasking ability and how this leads us to take risks; and (d) suggest how to apply this knowledge in certain electrical hazard scenarios.

Bringing attention to residual risk: Psychology of Warnings, Administrative Controls and PPE

In the context of the Hierarchy of Risk Controls, Warnings, Administrative Controls and Personal Protective Equipment are sometimes referred to as Lower Order Controls. In practice, the effectiveness of Lower Order Controls can be overestimated due to a misunderstanding of the human factors that affect error likelihood in implementation of Lower Order Controls. This paper will explore one human factor limitation of Lower Order Controls in assessing residual risks in preventing injuries from electrical energy. We will specifically focus on the limitation of attention, which has implications for: • identifying hazards, • assessing risks, • taking appropriate actions based on warnings, • executing safe work practices, and • proper selection and use of personal protective equipment Raising awareness and improved understanding of these topics can enable more effective risk assessment, quantification of residual risks, and more effective selection and combination of risk controls to achieve risk as low as reasonably practicable (ALARP).

Methods to influence change in home safety

This paper focuses on methods to influence change in the safety market of today; taking it from one that has historically focused on meeting construction safety codes, to one that has the desire to exceed construction safety codes. A change in our markets, on a corporate and individual level, is needed to a degree that structure owners are motivated to increase the level of safety within the structure or in the design of a new structure that exceeds existing safety codes. This paper presents two paths through which corporations and individuals could be influenced to shift their prioritization toward exceeding existing safety standards. The first path is through realizing incentives for going above and beyond when it comes to safety. The second path includes marketing campaigns directed toward individuals based on the psychological variables surrounding behavior change. This paper will describe the factors needed to consider when following those two paths. It will also review the success that the green sustainability market has experienced through understanding of the background behind Leadership in Energy and Environmental Design (LEED) and the United States Green Building Council (USGBC). To some degree, these two programs can be used as a blueprint for a similar movement around safety. Many structures have been positively impacted by sustainable designs that also benefit the environment, the economy and well being of many. It has taken an international presence and safety must do the same. The goal and end result of such a program/movement in the safety market would help to reduce the number of lives lost and the financial impact of fires, natural disasters, electrocutions and other events that occur each year.

Residual Risk and the Psychology of Lower Order Controls

In the context of the hierarchy of risk controls, warnings, administrative controls, and personal protective equipment are sometimes referred to as lower order controls. In practice, the effectiveness of these controls can be overestimated due to a misunderstanding of the human factors that affect error likelihood in their implementation. This paper explores one human factor: the limitation of attention on residual risk inherent in lower order controls. The limitation of attention has implications for identifying hazards, assessing risk, taking appropriate actions based on warnings, executing safe work practices, and proper selection and use of personal protective equipment. Raising awareness and improved understanding of these topics can enable more effective risk assessment, quantification of residual risk, and more effective selection and combination of risk controls to achieve risk as low as reasonably practicable.

“Choosing” Health Under Conditions of Limited Control and Competing DemandsGender and Health: The Effects of Constrained Choices and Social Policies. BirdChloe E.RiekerPatricia P.. New York: Cambridge University Press, 2008. 256 pp.,

Some border on the prosaic: “The Industrial Revolution continues to be an engine of social change” (p. 375). “Women in leadership positions may not be motivated to or able to create positive social change for women” (p. 381). Others seem too abstract to guide theory development, research, or policy formation. For example, “Social change affecting females is rooted in power relations” (p. 389). We question how useful a universal report card on female well-being can be. Is there a set of indicators of female well-being that are equally salient to (for example) subsistence farmers in Cambodia and stock traders on Wall Street? Are there universal meanings of well-being? In some cultures, for example, family well-being is more important than personal well-being. In rural Sri Lanka, for example, aspirations (for both sons and daughters) may focus less on individual advancement than on the survival, welfare, and honor of the extended family and future generations. We also wonder whether there can be principles of social change that are applicable to all locales, cultures, and historical moments. The effort to eliminate subjectivity from the assessment of well-being may inadvertently obliterate culture and sociopolitical context. Our reservations notwithstanding, this book offers a valuable perspective for feminist psychologists. The realm of psychology rarely includes large-scale social forces, history, or locales outside the urban United States. Female Well-Being takes readers on a tour of 11 countries that are diverse in size, wealth, political and economic organization, and colonial history. It also affords a bird’s-eye view of a century that was, as the editors put it, an “incubator” for changes in women’s lives (p. 374). Reading it taught us much about the challenges women have taken on, the fruits of their activist efforts, and the distance yet remaining to travel.