Cathy Roche

A Review of the Health Beliefs and Lifestyle Behaviors of Women with Previous Gestational Diabetes

OBJECTIVE To critically review and synthesize original research designed to examine the health beliefs, including risk perceptions and health behaviors related to diet and physical activity of women with previous gestational diabetes mellitus. DATA SOURCES PubMed and CINAHL databases were searched for studies published in the last decade (1998-2008) that examined variables related to the health beliefs and behaviors of women with previous gestational diabetes mellitus. Keyword searches included health beliefs, health behaviors, perceived risk, gestational diabetes, type 2 diabetes, diet, physical activity, and postpartum. STUDY SELECTION Eight articles, representing 6 studies, were selected that met the inclusion criteria of original research, dependent variable of health beliefs and behaviors of women with previous gestational diabetes mellitus, and measurement after pregnancy. DATA EXTRACTION Articles were reviewed and discussed according to the concepts of risk perception and health beliefs, health behaviors related to diet and physical activity, and psychosocial factors related to womens health beliefs and behaviors. DATA SYNTHESIS Data revealed common health beliefs and behaviors of women with previous gestational diabetes mellitus, including low risk perceptions for future type 2 diabetes mellitus and suboptimal levels of physical activity and fruit and vegetable intake. The majority of studies revealed a distinct knowledge-behavior gap among women with previous gestational diabetes mellitus, whereas others revealed a lack of knowledge regarding necessary lifestyle modifications. CONCLUSIONS Findings from this review may assist womens health researchers and clinicians in developing appropriate interventions for increasing risk awareness, promoting self-efficacy for weight loss and physical activity behaviors, and decreasing rates of diabetes and cardiovascular disease among women with previous gestational diabetes mellitus. Further research is necessary to identify factors that influence the health beliefs and behaviors of women with previous gestational diabetes mellitus. Future research should focus on populations of greater racial, ethnic, and socioeconomic diversity, as the majority of studies have been conducted with non-Hispanic White, socioeconomically advantaged women.

Baseline Predictors of Missed Visits in the Look AHEAD Study

To identify baseline attributes associated with consecutively missed data collection visits during the first 48 months of Look AHEAD—a randomized, controlled trial in 5,145 overweight/obese adults with type 2 diabetes designed to determine the long‐term health benefits of weight loss achieved by lifestyle change.

Recruiting bereaved parents for research after infant death in the neonatal intensive care unit

Understanding parental experiences following infant death in the neonatal intensive care unit (NICU) is a high research priority and a necessary first step to improving health services. However, recruiting bereaved parents to discuss their experiences on such an extremely sensitive topic can be challenging and research procedures must be planned carefully in order to get an adequate sample. There is little published in the literature detailing specific strategies for recruiting bereaved parents for grief research, especially strategies for contacting parents and identifying factors that might affect participation. The purpose of this paper is to describe the process of recruiting bereaved parents into a qualitative research study exploring parental NICU experiences and grief responses following infant death. We describe a successful recruitment plan that led to the enrollment of difficult to recruit participants such as fathers, and individuals representing minorities and those from lower socioeconomic (SES) groups. Bereaved parents of infants after an NICU hospitalization should continue to be recruited for research studies for their unique perspectives and valuable insights about the devastating experience of infant death. Participants in this study reported more benefits than harm and the results addressed a critical gap in the literature.

Where are they now? Retention strategies over 25 years in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Purpose In 1991, we described the recruitment and goals for a cohort of young adults. At the time, little was known about long-term retention of young, healthy and mobile adults or minorities. We present retention strategies and rates over 25 years, and predictors of participation at the year 25 follow-up examination of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a longitudinal investigation of coronary artery disease risk factors in a biracial population initially ages 18–30 years recruited from four U.S. centers in 1985. Methods CARDIA has employed a range of strategies to enhance retention, including two contacts per year, multiple tracking methods to locate participants lost-to-follow-up, use of birthday and holiday cards, participant newsletters, examination scheduling accommodations and monetary reimbursements, and a standing committee whose primary purpose has been to continually review retention rates and strategies and identify problems and successes. Results For 25 years, CARDIA has maintained >90% contact with participants between examinations, over 80% at any 2-year interval, and a 72% 25-year examination attendance rate. Baseline predictors of year 25 examination attendance include white race, female sex, older age, higher education, nonsmoking and moderate alcohol consumption. Conclusion Consistent use of multiple retention strategies, including attention to contact rates and sharing of best strategies across study centers, has resulted in high retention of a diverse, initially young, biracial cohort.