Jessica Brooks

Motivational and Volitional Variables Associated With Stages of Change for Exercise in Multiple Sclerosis A Multiple Discriminant Analysis

The main objective of this study was to determine whether motivational and volitional variables identified in the health action process approach (HAPA) model can be used to successfully differentiate people with multiple sclerosis (MS) in different stages of change for exercise and physical activity. Ex-post-facto design using multiple discriminant analysis was used. Participants were 215 individuals with MS. The outcome variable was measured by the Physical Activity Stages of Change Instrument, along with motivational and volitional measures (severity, action self-efficacy, outcome expectancy, risk perception, perceived barriers, intention, maintenance self-efficacy, action and coping planning, and recovery self-efficacy). Participants in the precontemplation, contemplation, and action groups can be maximally separated by two significant canonical discriminant functions, volition and motivation. The action group can be differentiated from other groups based on high group mean (centroid) score on the volition function, and the precontemplation group can be differentiated based on low group means on both the motivation and volition functions. The contemplation group can be differentiated based on high centroid score on the motivation function. Research findings of this study support the concept of stage-matching exercise and physical activity intervention. The HAPA framework can be used to design health promotion behavioral interventions for people with MS in vocational rehabilitation.

Psychometric Validation of the Moorong Self-Efficacy Scale in People With Spinal Cord Injury A Brief Report

The main study objective was to further evaluate the factorial validity of the Moorong Self-Efficacy Scale (MSES) with 266 Canadians with spinal cord injuries (SCI). Exploratory factor analysis yielded three reliable factors (Interpersonal, Instrumental, and Participation Self-Efficacy) building on earlier studies that extracted two factors. The MSES appears to be a promising rehabilitation assessment tool for individuals with SCI.

Assessing Vocational Rehabilitation Engagement of People With Disabilities: A Factor-Analytic Approach

The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) in a sample of state vocational rehabilitation (VR) service consumers. A total of 277 individuals with disabilities were recruited from Alaska, Kentucky, Florida, Michigan, New Mexico, Texas, Utah, and Wisconsin. The measurement structure of the VRES was evaluated using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis results support a one-factor measurement structure of the VRES. Confirmatory factor analysis results also indicated a good model fit for the one-factor measurement model. Internal consistency reliability (Cronbach’s α) for the scores on the VRES was computed to be .94. VR engagement was found to be associated with working alliance, vocational self-efficacy, internal motivation, and VR outcome expectancy in the expected direction. The VRES is a brief, reliable, and valid instrument for assessing VR engagement and contributes to the use of self-determination as a paradigm for improving motivation and engagement of people with disabilities receiving services from state VR agencies.

Relationships between self-determination theory and theory of planned behavior applied to physical activity and exercise behavior in chronic pain

Abstract This study examined the relationships between self-determination theory (SDT) and theory of planned behavior (TpB) applied to physical activity and exercise behavior (PA&E) in people with chronic pain. Two hundred and eleven adults with chronic musculoskeletal pain (28 males and 183 females, age range 18 to 82 years, mean age 43 years) were recruited from online support groups and clinic networks in the United States. Participants completed SDT measures relevant to PA&E on perceived autonomy support, autonomy, competence, and relatedness, as well as TpB measures relevant to PA&E on intention, attitudes, subjective norms, and perceived behavioral control. Correlational techniques and canonical correlation analysis were performed to examine the relationships and variance within and between theoretical dimensions. Overall, the SDT set accounted for 37% of the TpB variance and the TpB set accounted for 32% of the SDT set variance. The results indicate there are statistical similarities and differences between concepts in SDT and TpB models for PA&E. Using both empirical guidance and clinical expertise, researchers and practitioners should attempt to select and integrate non-redundant and complementary components from SDT, TpB, and other related health behavior theories.

Correlates of Depressive Symptoms among Homebound and Semi-Homebound Older Adults

ABSTRACT This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.

Relationships between World Health Organization "International Classification of Functioning, Disability and Health" Constructs and Participation in Adults with Severe Mental Illness.

Purpose: To examine the World Health Organization International Classification of Functioning, Disability and Health (ICF) constructs as correlates of community participation of people with severe mental illnesses (SMI). Methods: Quantitative descriptive research design using multiple regression and correlational techniques was used to analyze 193 persons with SMI. Results: This study examined the unique relationships between each of the ICF constructs and participation in a series of simultaneous regression analyses. Age, schizophrenia/schizoaffective diagnosis, insight, self-care activity, social competency, and social support from friends were significant predictors of participation when compared to variables in the same ICF constructs. In addition, these significant ICF predictors of participation were entered in a hierarchical regression, and only insight, social competency, and social support from friends were found to be significant predictors of participation after controlling for the effect of other ICF variables. Conclusion: In this ICF model, insight, social competency, and social support from friends were found to be associated with participation and mediated the individual contributions of types of psychiatric disabilities and self-care activity to participation. Rehabilitation practitioners should focus on interventions that increase these factors for people with SMI. Rehabilitation researchers should continue to use the ICF as a model from which to predict participation in specific life activities (e.g., employment) for people with SMI. Continued application and validation of the ICF model could positively impact recovery-oriented outcomes for individuals with SMI.

Self-efficacy as a mediator for the relationship between secure attachment style and employment status in individuals with spinal cord injuries

PURPOSE: To evaluate the mediation effect of self-efficacy on the relationship between secure attachment and employment status of people with spinal cord injuries (SCI). DESIGN: Quantitative descriptive research design using logistic regression, multiple regression, and correlational techniques. METHODS: One hundred and ninety individuals with SCI were recruited from the Canadian Paraplegic Association. Only individuals ages between 25–54 years (prime working age) were selected for this study. RESULTS: Secure attachment and self-efficacy were significantly related to employment status. Self-efficacy was found to be a significant mediator of the relationship between secure attachment and employment status. CONCLUSION: Results provide support for the importance of building a strong working alliance and helping individuals with SCI in the professional practice of rehabilitation counseling.

Attachment and Employment Outcomes for People With Spinal Cord Injury The Intermediary Role of Hope

The purpose of this article is to evaluate the mediation effect of hope on the relationship between attachment and full-time employment for people with spinal cord injury (SCI). Quantitative descriptive research design using logistic regression, multiple regression, and correlational techniques were used. Eighty-four persons with SCI were recruited from several SCI advocacy organizations in Canada, the United Kingdom, and the United States. The results show that secure attachment, anxious attachment, and hope were significantly related to employment. Hope was found to be a significant mediator of the relationship between attachment and full-time employment. Results provide support for the use of hope-based interventions by vocational rehabilitation counselors working with individuals with SCI.

Psychometric Properties of the Vocational Rehabilitation Engagement Scale When Used with People with Mental Illness in Clubhouse Settings.

Purpose: The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) for use in the Clubhouse Model of Psychosocial Rehabilitation. Method: There were 124 individuals with serious mental illness recruited from 8 Clubhouse programs in Hawaii. Measurement structure of the VRES was evaluated using exploratory factor analysis. Results: Exploratory factor analysis of the Clubhouse version of the VRES yielded 2 reliable factors (cognitive-affective engagement and behavioral engagement). Both the cognitive-affective engagement and behavioral engagement factors were found to correlate with other self-determination theory constructs including autonomy support, relatedness, and outcome expectancy. Conclusions: The Clubhouse version of the VRES is a brief, reliable, and valid instrument for assessing vocational rehabilitation (VR) engagement and contributes to the use of self-determination as a paradigm for improving recovery outcomes in psychiatric rehabilitation.

Social-Cognitive Predictors of Readiness to Use Evidence-Based Practice: A Survey of Community-Based Rehabilitation Practitioners

Community-based rehabilitation organizations (CBRO) play an important role in providing rehabilitation and support services to individuals with disabilities. Increased utilization of CBROs by state vocational rehabilitation (VR) agencies requires a better understanding of how evidence-based practices (EBPs) are used in CBROs. The aim of the study was to examine the readiness of CBRO practitioners to implement EBP, based on social-cognitive predictors of confidence in knowledge and use of EBP, expected benefits of EBP, and perceived barriers and supports to use EBP. A total of 187 CBRO practitioners were surveyed using the Evidence-Based Practice CBRO (EBP-CBRO) survey. Participants were in moderate agreement that they were ready to implement EBP. They were moderately confident in their knowledge about EBP, in high agreement about the expected improvements by using EBP, and perceived low barriers and moderate supports to implementing EBP. The social-cognitive predictors accounted for 55% of the variance in readiness to implement EBP, with knowledge about EBP as the most significant predictor of readiness to use EBP. Social-cognitive theory is a useful framework for exploring CBRO practitioners’ attitudes toward and knowledge of EBP. CBRO practitioners are in moderate agreement about readiness to use EBP. Improving practitioner confidence to use EBP might be the best means of increasing utilization.