Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where Jocelyn E. Remmert is active.

Publication


Featured researches published by Jocelyn E. Remmert.


PLOS ONE | 2014

Psychosocial Predictors of Non-Adherence and Treatment Failure in a Large Scale Multi-National Trial of Antiretroviral Therapy for HIV: Data from the ACTG A5175/PEARLS Trial

Steven A. Safren; Katie B. Biello; Laura Smeaton; Matthew J. Mimiaga; Ann Walawander; Javier R. Lama; Aadia Rana; Mulinda Nyirenda; Virginia Kayoyo; Wadzanai Samaneka; Anjali Joglekar; David D. Celentano; Ana Martinez; Jocelyn E. Remmert; Aspara Nair; Umesh G. Lalloo; Nagalingeswaran Kumarasamy; James Hakim; Thomas B. Campbell

Background PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS. Methods Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions  =  QOL-health, mental health  =  QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. “Life-Steps” adherence counseling was provided. Results In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p<.01) and self-report (HR = 1.13, 95% CI: 1.08, 1.13, p<.01) non-adherence were significant predictors of treatment failure over 72 weeks. In multivariable models (including pill-count or self-report nonadherence), worse QOL-health, age group (younger), and region were also significant predictors of treatment failure. Conclusion In the context of a large, multi-national, multi-continent, clinical trial there were variations in adherence over time, with more simplified regimens generally being associated with better adherence. Additionally, variables such as QOL-health, regimen, drug-use, and region play a role. Self-report and pill-count adherence, as well as additional psychosocial variables, such QOL-health, age, and region, were, in turn, associated with treatment failure.


Current Hiv\/aids Reports | 2015

Adherence to HIV Care After Pregnancy Among Women in Sub-Saharan Africa: Falling Off the Cliff of the Treatment Cascade

Christina Psaros; Jocelyn E. Remmert; David R. Bangsberg; Steven A. Safren; Jennifer A. Smit

Increased access to testing and treatment means HIV can be managed as a chronic illness, though successful management requires continued engagement with the health care system. Most of the global HIV burden is in sub-Saharan Africa where rates of new infections are consistently higher in women versus men. Pregnancy is often the point at which an HIV diagnosis is made. While preventing mother to child transmission (PMTCT) interventions significantly reduce the rate of vertical transmission of HIV, women must administer ARVs to their infants, adhere to breastfeeding recommendations, and test their infants for HIV after childbirth. Some women will be expected to remain on the ARVs initiated during pregnancy, while others are expected to engage in routine testing so treatment can be reinitiated when appropriate. The postpartum period presents many barriers to sustained treatment adherence and engagement in care. While some studies have examined adherence to postpartum PMTCT guidelines, few have focused on continued engagement in care by the mother, and very few examine adherence beyond the 6-week postpartum visit. Here, we attempt to identify gaps in the research literature and make recommendations on how to address barriers to ongoing postpartum HIV care.


Journal of Health Psychology | 2017

Relationship between depressive symptoms, alcohol use, and antiretroviral therapy adherence among HIV-infected, clinic-attending patients in South Africa

Jessica F. Magidson; Wylene Saal; Adriaan Nel; Jocelyn E. Remmert; Ashraf Kagee

Despite the prevalence of depression and alcohol use among HIV-infected individuals, few studies have examined their association together in relation to nonadherence to antiretroviral therapy in sub-Saharan Africa. This study examined depressive symptoms, alcohol use, and other psychosocial factors (stigma, demographic characteristics) in relation to nonadherence to antiretroviral therapy among clinic-attending, HIV-infected individuals in South Africa (n = 101). Nonadherence was assessed using event-level measurement (missed doses over the past weekend). Multivariable logistic regression analyses revealed that only alcohol use, over and above depressive symptoms and education level, was associated with antiretroviral therapy nonadherence(AOR = 1.15; 95%CI = 1.02–1.29; p < .05). Findings point to the independent association of alcohol use and nonadherence to antiretroviral therapy above and beyond depressive symptoms.


PLOS ONE | 2016

Implementation of Cognitive-Behavioral Substance Abuse Treatment in Sub-Saharan Africa: Treatment Engagement and Abstinence at Treatment Exit.

Hetta Gouse; Jessica F. Magidson; Warren Burnhams; Jocelyn E. Remmert; Bronwyn Myers; John A. Joska; Adam W. Carrico

Aims This study documented the treatment cascade for engagement in care and abstinence at treatment exit as well as examined correlates of these outcomes for the first certified Matrix Model® substance abuse treatment site in Sub-Saharan Africa. Design This retrospective chart review conducted at a resource-limited community clinic in Cape Town, South Africa, assessed treatment readiness and substance use severity at treatment entry as correlates of the number of sessions attended and biologically confirmed abstinence at treatment exit among 986 clients who initiated treatment from 2009–2014. Sociodemographic and clinical correlates of treatment outcomes were examined using logistic regression, modeling treatment completion and abstinence at treatment exit separately. Results Of the 2,233 clients who completed screening, approximately 44% (n = 986) initiated treatment. Among those who initiated treatment, 45% completed at least four group sessions, 30% completed early recovery skills training (i.e., at least eight group sessions), and 13% completed the full 16-week program. Approximately half (54%) of clients who provided a urine sample had negative urine toxicology results for any substance at treatment exit. Higher motivation at treatment entry was independently associated with greater odds of treatment completion and negative urine toxicology results at treatment exit. Conclusions Findings provide initial support for the successful implementation the Matrix Model in a resource-limited setting. Motivational enhancement interventions could support treatment initiation, promote sustained engagement in treatment, and achieve better treatment outcomes.


Obesity science & practice | 2016

Small weight gains during obesity treatment: normative or cause for concern?

Leah M. Schumacher; Monika Gaspar; Jocelyn E. Remmert; Fengqing Zhang; Evan M. Forman; Meghan L. Butryn

The objectives of the study are to characterize the frequency and size of small weight gains during behavioural weight loss treatment and to evaluate the relationship between small weight gains and weight loss outcomes.


Medical Clinics of North America | 2018

Treatment of Obesity in Primary Care

Adam Gilden Tsai; Jocelyn E. Remmert; Meghan L. Butryn; Thomas A. Wadden

This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered.


Journal of School Nursing | 2018

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents:

Jocelyn E. Remmert; Amanda Woodworth; Larissa Chau; Leah M. Schumacher; Meghan L. Butryn; Margaret Schneider

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.


Eating Behaviors | 2018

Do participants with children age 18 and under have suboptimal weight loss

Diane L. Rosenbaum; Jocelyn E. Remmert; Evan M. Forman; Meghan L. Butryn

OBJECTIVES Parenthood is a time marked by behaviors that may promote risk for weight gain, including decreased physical activity and increased unhealthy eating. Little is known about parents in the context of behavioral weight loss, such as whether they differ in weight losses, and related barriers, or behaviors. METHOD We compared parents of children aged 18 and younger (n = 105) to other participants who did not have children, or whose children were in adulthood (n = 215) in a behavioral weight loss program to evaluate six-month weight losses, and weight loss barriers and behaviors. RESULTS Parents of minor children lost less weight than other participants, and parental status interacted with gender such that men without minor children lost the most weight. Although parents of minor children identified greater stress, depression, time-related barriers to physical activity, and had less adherence to calorie goals, they did not differ from other participants in session attendance, emotional overeating, disinhibited eating, or physical activity. DISCUSSION Parents of minor children appear to have greater weight loss barriers, greater difficulty adhering to calorie goals, and less weight loss. Additional research is needed to identify ways to better serve parents in behavioral weight loss programs.


Psychotherapy Research | 2017

Learning to address multiple syndemics for people living with HIV through client perspectives on CBT

Nicholas S. Perry; Jocelyn E. Remmert; Christina Psaros; Megan Pinkston; Steven A. Safren

Abstract Objective: The mental health burden among people living with HIV/AIDS (PLWHA) is high and often involves multiple comorbid psychological and substance use-related psychosocial problems. These co-occurring problems, or syndemics, additively impair engagement in HIV disease management. Existing psychotherapies for mental health and HIV health have generally focused on a single psychosocial problem and little research exists to guide future psychotherapies that address multiple mental health issues. Method: To address this gap in understanding, we conducted qualitative interviews with multiply comorbid PLWHA (N = 30) who completed cognitive-behavioural therapy (CBT) for depression and medication adherence. Results: Themes emerged regarding participants’ perspectives on how overlapping substance use and mood disorders interacted to reduce the benefit of CBT. Substance use was a dominant theme compared to other syndemics, highlighting the need for integrated mental health and substance use interventions. Interviews also suggested modifications of which psychosocial concerns participants felt should be prioritized in treatment delivery. Finally, participants described content they would want in a psychotherapy intervention, including intimacy and sexual health. Conclusions: Future psychotherapeutic interventions for syndemic problems and HIV self-care will need to comprehensively address complex concerns, including issues salient to the overall well-being of PLWHA. This may improve client engagement and, ultimately, mental, and physical health outcomes. Clinical or methodological significance of this article: Although mental health comorbidity is common and often complex among clients living with HIV, little research exists to guide psychotherapy for such intricate mental health concerns. The current study used content analysis of in-depth qualitative interviews with clients living with HIV and multiple mental health comorbidities who had recently completed cognitive-behavioural therapy. Recommendations based on these findings suggest strategies for clinicians working with similar clients to consider and offers suggestions for future treatment development research.


Archive | 2017

Women’s Health: Behavioral Medicine Interventions for Women During Childbearing and Menopause

Christina Psaros; Jocelyn E. Remmert; Nicole Amoyal; Rebecca Hicks

After decades of health-related research that focused predominantly on males, the field of women’s health is now well established. Reproductive events are important transitions for women. While these transitions are uncomplicated for most women, some will experience recurrent or new onset mood and/or anxiety symptoms. Awareness of these issues represents an opportunity for early behavioral medicine interventions alone or as adjuncts to medical care, either to prevent or improve symptoms and facilitate quality of life. While women’s health encompasses a broad array of topics, the present chapter will focus on behavioral medicine approaches to working with women during childbearing and menopause. Specifically, this chapter will describe the course of depression and anxiety (the most common psychiatric presentations) during childbearing-related events and the menopausal transition, discuss the evidence base for cognitive behavioral therapy (CBT)-based interventions as well as specific population concerns, and conclude with a case study of how CBT might be used in women with a history of depression who hope to conceive.

Collaboration


Dive into the Jocelyn E. Remmert's collaboration.

Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Hetta Gouse

University of Cape Town

View shared research outputs
Researchain Logo
Decentralizing Knowledge