Jiying Ling

The role of self-transcendence: a missing variable in the pursuit of successful aging?

While successful aging is often defined as the absence of disease and disability or as life satisfaction, self-transcendence may also play an important role. The objective of this research was to test a nursing theory of successful aging proposing that transcendence and adaptation predict successful aging. In this cross-sectional exploratory study, a convenience sample of older adults (N = 152) were surveyed about self-transcendence, proactive coping, and successful aging. Using hierarchical multiple regression, self-transcendence, proactive coping, and all control variables (i.e., sex, race, perceived health, place of residence) together explained 50% of the variance in successful aging (p < 0.001). However, proactive coping alone was not a significant predictor of successful aging. Thus, this study did not support the theory that both self-transcendence and proactive coping predict successful aging. Self-transcendence was the only significant contributor to this multidimensional view of successful aging. Self-transcendence is an important variable in the pursuit of successful aging, which merits further investigation.

Preliminary Assessment of a School-Based Healthy Lifestyle Intervention Among Rural Elementary School Children

BACKGROUND Childhood obesity has become a national public health crisis in America. Physical inactivity and unhealthy eating behaviors may contribute to the childhood obesity epidemic. School-based healthy lifestyle interventions play a promising role in preventing and controlling childhood obesity. A comprehensive school-based healthy lifestyle intervention was implemented in 4 rural elementary schools in Kentucky. METHODS The intervention included 4 goals: improving physical education, health education, family/community involvement, and school wellness policies. Childrens physical activity was assessed by pedometer, and nutrition was assessed by a previous day recall survey in January (baseline), February (t1), March (t2), April (t3), and May (t4) of 2011. RESULTS The intervention had significant effects on increasing the percentages of children meeting physical activity (1% vs 5%, p < .01) and nutrition (15% vs 26%, p < .01) recommendations. The effects of the intervention on physical activity and nutrition depended on school, grade, and age of the children. There was an increasing linear trend of physical activity and an increasing quadratic trend of nutrition over time among children. CONCLUSIONS The intervention had beneficial effects in improving healthy behaviors among children. Further studies are needed to assess its long-term effects and cost-effectiveness.

Multiple valued logic approach for matching patient records in multiple databases

Many problems arise when linking medical records from multiple databases. Matching these data to other data is problematic since even small errors, such as data entry errors, different text format, and missing data, can prevent the exact-match algorithms. Evidence from previous studies suggested that approximate field matching represent a solution to resolve the problem by identifying equivalent string values in different representations. The purpose of this article is to explore the effectiveness of a medical record matching method using a fuzzy logic framework. This article considers quantitative measures of the typical elements in medical records, and fuzzy logic is applied to link to the linguistic concepts. Moreover, this article discusses the medical record matching from the developed framework, which is tested on a public data set. The results from the test on a public data set indicate that the medical record matching method using fuzzy logic framework provides an effective solution for dealing with linkage problems, and illustrate that the multiple valued logic method outlined can potentially be applied to address similar problems in other databases.

Using Motivational Interviewing for Smoking Cessation in Primary Care

Objectives To compare the effects of resident physician motivational interviewing (MI), resident physician MI plus registered nurse (RN), and the standard of care counseling approach— ask, advise, assess, assist, and arrange follow-up (5 As)—on current smokers’ behaviors (readiness to quit, cigarettes smoked per day, current smoking rates), self-efficacy to quit smoking, and nicotine dependence. Methods The study design was quasi-experimental pretest/posttest with a comparison group. Pencil/paper measures were completed in the clinic setting at baseline and via telephone approximately 1 and 2 months after the clinic visit. Results There were no differences among the three groups in the proportion of participants who quit smoking, and the stages of change did not differ among the groups or over time. There was a significant time effect and a decrease in the number of cigarettes smoked per day (F2,160 = 41.04, P < 0.001). Significant group × time interactions were present for self-efficacy (F4,140 = 8.20, P < 0.001), nicotine dependence (F4,140 = 6.22, P < 0.001) and satisfaction with clinician (F4,160 = 3.81, P = 0.006). Post hoc analyses showed that participants in the MI groups smoked fewer cigarettes, had higher self-efficacy, and had lower nicotine dependence scores. Only participants in the MD-plus-RN follow-up group had significant positive changes in satisfaction scores. Conclusions Resident physicians who use MI techniques have a tremendous effect on patients’ smoking behaviors. When the resident physician and the RN worked together, participants achieved better outcomes.

Social support and peer norms scales for physical activity in adolescents.

OBJECTIVES To evaluate psychometric properties of a Social Support and Peer Norms Scale in 5th-7th grade urban girls. METHODS Baseline data from 509 girls and test-retest data from another 94 girls in the Midwestern US were used. RESULTS Cronbachs alpha was .83 for the Social Support Scale and .72 for the Peer Norms Scale, whereas test-re-test reliability was .78 for both scales. Exploratory factor analysis suggested a single factor structure for the Social Support Scale, and a 3-factor structure for the Peer Norms Scale. Social support was correlated with accelerometer-measured physical activity (r = .13, p = .006), and peer norms (r = .50, p < .0001). CONCLUSIONS Both scales have adequate psychometric properties.

Lifestyle Interventions in Preschool Children: A Meta-analysis of Effectiveness

CONTEXT With healthy behaviors becoming established in the preschool years, intervening with preschool children to assist them in establishing a healthy lifestyle and maintaining a long-term healthy weight is critical. To optimize future intervention designs, this meta-analysis aimed to estimate the effects of lifestyle interventions on BMI among preschool children and explore potential intervention moderators. EVIDENCE ACQUISITION In October 2015, a search of PubMed, CINAHL, EMBASE, PsycINFO, ERIC, and Cochrane library databases yielded 52 eligible articles with 42 randomized intervention-control comparisons (31 prevention and 11 treatment). In 2016, weighted standardized mean differences for BMI were calculated using random-effects models to estimate effect sizes. EVIDENCE SYNTHESIS The effect sizes were -0.19 (95% CI=-0.28, -0.09) and -0.28 (95% CI=-0.48, -0.09) kg/m2 for prevention and treatment interventions, with sustained effect sizes of -0.21 (95% CI=-0.35, -0.08) and -0.23 (95% CI=-0.43, -0.04) kg/m2, respectively. Child mean age, percentage Hispanic, and parental intervention sessions were common significant moderators. School-based or prevention interventions with active parental involvement did not yield better outcomes. Interventions targeting parents with parenting skill training and behavioral change strategies, and children with general health and nutrition education, resulted in greater effects. CONCLUSIONS Although publication bias limits the validity of the study findings, the meta-analysis results highlight the promising intervention approaches of parenting skill training and behavioral change strategies to target parents. However, for children, general health and nutrition education should be employed.

Psychosocial determinants of physical activity in children attending afterschool programs : a path analysis.

BackgroundPhysical activity (PA) is important for controlling childhood obesity, but a comprehensive PA model for school-aged children is lacking. ObjectivesGuided by the youth PA promotion (YPAP) model, this study estimated the direct and indirect effects of self-efficacy, enjoyment, parental influence, and environment on self-reported PA and pedometer steps. A secondary purpose was to explore the association between self-reported PA and pedometer steps. MethodsAn observational and prospective study was conducted among 133 children, aged 8–11 years old, from 10 elementary schools with afterschool programs in a Midwestern U.S. school district from August through October 2013. PA was assessed by a 7-day recall scale and pedometers. Other variables were assessed by validated questionnaires. ResultsApproximately 65 (49%) children were overweight or obese—only 17 (13%) met national PA recommendations—and body mass index z-score was negatively correlated with pedometer steps (r = −.18 p = .04). A path analysis showed that self-efficacy had a direct effect on self-reported PA and pedometer steps, enjoyment had only a direct effect on self-reported PA, and parental influence had a direct effect on pedometer steps and an indirect effect on self-reported PA through self-efficacy and enjoyment. The association between self-reported PA and pedometer steps was not significant. DiscussionBecause this study only partially supports the YPAP model, studies with a larger sample size and longitudinal design are essential to further examine this model. The nonsignificant relationship of self-reported PA with pedometer steps may be due to the systematic error resulting from a common method artifact of self-report. Given the importance of parental influence, enjoyment, and self-efficacy, targeting these three determinants in future interventions to increase PA among children is recommended.

Successful aging in the United States and China : a theoretical basis to guide nursing research, practice, and policy.

Successful aging is gaining increasing attention given the growth in the older adult population. Criteria and definitions within multiple disciplines vary greatly in Western literature, with no consensus on its meaning. Sociocultural, economic, and political differences between the Western view of successful aging and its view in China add to the confusion. Similarities and differences in the meaning of successful aging in the United States and China are examined, and potential for a common definition useful to nursing in both countries is explored. Using concept analysis, shared criteria for successful aging were the following: decreased incidence of disease and disability, life satisfaction, meaning and purpose in life, and ability to cope effectively to achieve goals based on personal values and priorities. A comprehensive, multidimensional definition of successful aging for nursing and a midrange nursing theory of successful aging were identified that may be useful to guide nursing research, practice, and policy.

Measuring Physical Activity of Elementary School Children With Unsealed Pedometers: Compliance, Reliability, and Reactivity.

Background and Purpose: Evidence of compliance, reliability, and reactivity of using pedometers in children remains inconsistent. This study aimed to examine these aspects of unsealed pedometers. Methods: There were 133 children who wore pedometers for 7 days. A subsample of 50 children completed surveys measuring self-efficacy, enjoyment, parental influence, and environment on Day 1 and 8. Investigator presence and incentives were used to increase compliance. Results: About 87% of children returned pedometers, with 62% wearing pedometers for 4 days or longer. The intraclass correlation coefficients ranged from .70 to .87, with ICC for 4-day pedometer steps exceeding .80. Wearing pedometers did not change pedometer steps nor alter children’s perceptions of self-efficacy, enjoyment, parental influence, and environment significantly. Conclusions: Children were compliant wearing pedometers, and there was no reactivity from wearing them.

Results of a 3-year, nutrition and physical activity intervention for children in rural, low-socioeconomic status elementary schools

Improving childrens nutrition and physical activity have become priorities in the United States. This quasi-experimental study evaluated the longitudinal effects of a 3-year, school-based, health promotion intervention (i.e. nutrition and physical education, classroom physical activity, professional development and health promotion for teachers and families, and strengthening wellness policies and family/community partnerships) on childrens health behaviors in four, rural, low-socioeconomic status elementary schools. A total of 999 kindergarten to third-grade children participated in data collection consisting of 4-day pedometer tracking and previous-day fruits and vegetables consumption recall from baseline in January, 2011 through 12 follow-up assessments ending May, 2013. The mixed-effects regression models showed that childrens nutrition and physical activity behaviors significantly improved over the 3-year intervention. The percentages of children who met the nutrition recommendation increased from 11 to 23% for girls and 12 to 23% for boys, while the percent who met the physical activity recommendation increased from 1 to 16% for girls and 3 to 7% for boys. Further, childrens age and their school impacted certain intervention effects. This school-based intervention could be disseminated to promote healthy behaviors among rural disadvantaged children. Engaging parents and community partnerships is recommended to expand the traditional, children-focused education interventions.