Katherine J. Roberts

On the positive relation between received social support and negative affect: a test of the triage and self-esteem threat models in women with breast cancer

Objective: There is a seemingly paradoxical positive relation between received social support and psychological distress in cancer patients. This study evaluates two models that explain this positive relation: (a) the triage model, which argues that more distressed people receive more support and (b) the self‐esteem threat model, which argues that receiving support increases distress by undermining self‐esteem.

Quality of life after thyroid cancer: An assessment of patient needs and preferences for information and support

Background. In this article, we desscribe the quality of life and central information and support needs of people with thyroid cancer. We also describes patients’ preferences for services to address their needs. This report may help patients to anticipate how thyroid cancer will affect them and inform physicians on useful ways to help address their patients’ needs. Methods. We collected data through a survey (n=62) of people who had been treated for thyroid cancer. Results. Most respondents indicated that quality of life was quite good, and most of their information needs were adequately addressed during routine care. However, respondents also indicated a desire for ongoing access to information, including information about lifestyle factors that might affect risk of recurrence, signs and symptoms of recurrence, and recent developments in thyroid cancer diagnostics and treatments. They also reported some unmet social and emotional support needs. Respondents reported a strong preference for gaining access to information through convenient resources such as the Internet. Conclusions. Patient care following thyroid cancer treatment could be improved by providing ongoing education about lifestyle factors related to cancer risk, disease surveillance, and resources for treating and coping with cancer. Health care providers should become familiar with local and Internet-based sources of information and support related to thyroid cancer to improve patient access to this information.

ACTIVE SURVEILLANCE FOR PAPILLARY THYROID MICROCARCINOMA: NEW CHALLENGES AND OPPORTUNITIES FOR THE HEALTH CARE SYSTEM.

OBJECTIVE The dramatic increase in papillary thyroid carcinoma (PTC) is primarily a result of early diagnosis of small cancers. Active surveillance is a promising management strategy for papillary thyroid microcarcinomas (PTMCs). However, as this management strategy gains traction in the U.S., it is imperative that patients and clinicians be properly educated, patients be followed for life, and appropriate tools be identified to implement the strategy. METHODS We review previous active surveillance studies and the parameters used to identify patients who are good candidates for active surveillance. We also review some of the challenges to implementing active surveillance protocols in the U.S. and discuss how these might be addressed. RESULTS Trials of active surveillance support nonsurgical management as a viable and safe management strategy. However, numerous challenges exist, including the need for adherence to protocols, education of patients and physicians, and awareness of the impact of this strategy on patient psychology and quality of life. The Thyroid Cancer Care Collaborative (TCCC) is a portable record keeping system that can manage a mobile patient population undergoing active surveillance. CONCLUSION With proper patient selection, organization, and patient support, active surveillance has the potential to be a long-term management strategy for select patients with PTMC. In order to address the challenges and opportunities for this approach to be successfully implemented in the U.S., it will be necessary to consider psychological and quality of life, cultural differences, and the patients clinical status.

Randomised controlled trial of expressive writing and quality of life in men and women treated for colon or rectal cancer

Objective: This randomised trial tested (i) whether a home-based expressive writing (EW) intervention improves quality of life in patients with colorectal cancer (CRC) and (ii) whether the intervention is more beneficial for men or for people who feel constrained in disclosing cancer-related concerns and feelings. Design: Patients treated for CRC were randomised to an EW (n = 101) or control writing (CW; n = 92) group. Assessments were completed at 1 month pre- and post-intervention. Sex and perceived social constraints on disclosure were evaluated as moderators. Main outcome measures: Primary outcomes were depressive symptoms, sleep problems and quality of life indicators. Results: Eighty-one per cent of participants completed all writing assignments. Consistent with hypotheses, relative to the CW group, participants in the EW group expressed more negative emotion in writing and rated their writings as more meaningful, personal and emotionally revealing. There were no significant main effects of EW or moderating effects of sex or social constraints on outcomes. Conclusions: Although EW is feasible to use with persons who have CRC, it was not effective as a stand-alone psychotherapeutic intervention. Neither was it more effective for men nor for people who felt they could not freely disclose cancer-related concerns and feelings.

An Evaluation of the Effectiveness of School-Based Breastfeeding Education

School-based interventions aimed at modifying the knowledge, attitudes, social norms, and intended future practice regarding breastfeeding may be an effective way of improving breastfeeding rates. A systematic review of relevant literature was conducted to identify scientifically rigorous studies on school-based interventions and promotion activities that focus on breastfeeding. Of the 1990 citations reviewed, only 6 empirical articles on school-based interventions to promote breastfeeding were found and these interventions vary greatly in terms of format, duration, outcome measures, and significance of the results. Overall, these studies demonstrated positive effects on perceptions and attitudes toward breastfeeding and increased behavioral intention of breastfeeding later in life. School-based breastfeeding promotion programs hold promise for increasing knowledge of breastfeeding and support for breastfeeding, promoting positive attitudes, creating a culture where breastfeeding is the norm, and increasing future intentions to breastfeed.

An Examination of Marketing Techniques used to Promote Children’s Vitamins in Parenting Magazines

More than a third of children and adolescents in the United States take vitamins even though professional medical organizations do not endorse their use in healthy children. Regardless of their efficacy, children’s vitamin products are aggressively promoted. Therefore, the goal of this study was to describe and analyze advertisements related to vitamins in the following three popular parenting magazines, Parents, Parenting Early Years, and Parenting School Years. A total of 135 magazines across four years were reviewed. There were 207 advertisements for children’s vitamins, all in the form of chewy or gummy. None of these advertisements included a dosage or a warning. Almost all (92.3%) included a cartoon in the advertisement. Almost a quarter (23.2%) of the advertisements promoted their product with the theme of prevention and more than half (51.2%) included the theme of peace of mind. Parenting magazines are a popular medium for providing exposure to products geared towards children. Companies that market children’s vitamins in these magazines can increase awareness among parents of the risks by providing warning and dosage information in their advertisements. Magazines can also play a role by encouraging responsible marketing and providing editorial content on children’s vitamins and potential consequences of pediatric overdose.

Promoting weight loss methods in parenting magazines: Implications for women

ABSTRACT Weight gain before and after pregnancy is important for women’s health. The purpose of this study was to assess articles and advertisements related to weight loss in three widely read parenting magazines, “Parenting School Years,” “Parenting Early Years,” and “Parenting,” which have an estimated combined readership of approximately 24 million (mainly women readers). Almost a quarter (23.7%, n = 32) of the 135 magazine issues over a four year period included at least one feature article on weight loss. A variety of topics were covered in the featured articles, with the most frequent topics being on losing weight to please yourself (25.2%), healthy ways to lose weight (21.1%), and how to keep the weight off (14.7%). Less than half (45.9%) of the articles displayed author credentials, such as their degree, qualifications, or expertise. A fifth (20.0%, n = 27) of the magazines included at least one prominent advertisement for weight loss products. Almost half (46.9%) of the weight loss advertisements were for weight loss programs followed by weight loss food products (25.0%), weight loss aids (21.9%), and only 6.2% of the advertisements for weight loss were on fitness. Parenting magazines should advocate for healthy weight loss, including lifestyle changes for sustained health.

Testing with feedback improves recall of information in informed consent: A proof of concept study.

OBJECTIVE This study investigates whether applying educational testing approaches to an informed consent video for a medical procedure can lead to greater recall of the information presented. METHODS Undergraduate students (n=120) were randomly assigned to watch a 20-min video on informed consent under one of three conditions: 1) tested using multiple-choice knowledge questions and provided with feedback on their answers after each 5-min segment; 2) tested with multiple choice knowledge questions but not provided feedback after each segment; or 3) watched the video without knowledge testing. RESULTS Participants who were tested and provided feedback had significantly greater information recall compared to those who were tested but not provided feedback and to those not tested. The effect of condition was stronger for moderately difficult questions versus easy questions. CONCLUSIONS Inserting knowledge tests and providing feedback about the responses at timed intervals in videos can be effective in improving recall of information. PRACTICAL IMPLICATION Providing informed consent information through a video not only standardizes the material, but using testing with feedback inserted within the video has the potential to increase recall and retention of this material.