Sarah E. Hampson

Personal-model beliefs and social-environmental barriers related to diabetes self-management

OBJECTIVE The specific aims of the present study were to report on the level of personal beliefs and social and environmental barriers across different regimen areas and patient subgroups and on the relationship of personal models and perceived barriers to the level of self-management. RESEARCH DESIGN AND METHODS This study focused on several issues related to personal models (representations of illness) and perceived barriers to diabetes self-management among a large heterogeneous survey sample of 2,056 adults throughout the U.S. RESULTS Respondents felt that diabetes was a serious disease and that their self-management activities will control their diabetes and reduce the likelihood of long-term complications. Most frequently reported barriers were related to dietary adherence, followed by exercise and glucose testing barriers. Both personal models and barriers significantly predicted level of self-management in all three regimen areas studied (diet, exercise, and glucose testing) after controlling for the influence of demographic and medical history factors. Regimen-specific models and barriers proved to be stronger predictors than more global measures. Differences on personal models and barriers were observed among different patient groups (e.g., age, health insurance, and insulin-taking status). Possible reasons for these differences and implications for intervention and future research are discussed. CONCLUSIONS Both the personal-model and barriers scales had good internal consistency and predicted variance in each of the self-management variables after controlling for demographic and medical history factors. These brief self-report personal-model scales demonstrated good internal reliability and were as predictive of self-management as the lengthier interview-based measures in previous studies. The assessment of the treatment effectiveness component of personal models may be sufficient for most clinical purposes.

Measuring the Big Five with single items using a bipolar response scale

The convergence on the Big Five in personality theory has produced a demand for efficient yet psychometrically sound measures. Therefore, five single‐item measures, using bipolar response scales, were constructed to measure the Big Five and evaluated in terms of their convergent and off‐diagonal divergent properties, their pattern of criterion correlations and their reliability when compared with four longer Big Five measures. In a combined sample (N = 791) the Single‐Item Measures of Personality (SIMP) demonstrated a mean convergence of r = 0.61 with the longer scales. The SIMP also demonstrated acceptable reliability, self–other accuracy, and divergent correlations, and a closely similar pattern of criterion correlations when compared with the longer scales. It is concluded that the SIMP offer a reasonable alternative to longer scales, balancing the demands of brevity versus reliability and validity. Copyright

Long term effects and costs of brief behavioural dietary intervention for patients with diabetes delivered from the medical office

This study evaluated the 12-month follow-up results and costs of a personalized, medical office-based intervention focused on behavioral issues related to dietary self-management. Two hundred and six adults having diabetes attending an internal medicine outpatient clinic visit were randomized to either Usual Care or to Brief Intervention. The single session intervention involved touchscreen computer-assisted assessment that provided immediate feedback on key barriers to dietary self-management, goal setting and problem-solving counselling. Follow-up components included phone calls and videotape intervention relevant to each participant. Brief Intervention produced significantly greater improvement than Usual Care on multiple measures of change in dietary behaviour (e.g., covariate adjusted difference of 2.2% of calories from fat; p = 0.023) and on serum cholesterol levels (covariate adjusted difference of 15 mg/dl; p = 0.002) at 12-month follow-up. There were also significant differences favouring intervention on patient satisfaction (p < 0.02) but not on HbA1c levels. The costs of intervention (

Improving self-care among older patients with type II diabetes: the "Sixty Something..." Study.

137 per patient) were modest relative to many commonly used practices.

A First Large-Cohort Study of Personality-Trait Stability Over the 40 Years Between Elementary School and Midlife

A 10-session, self-management training program was designed specifically for persons over 60 years of age having Type II diabetes. It targeted social learning variables, especially problem-solving skills and self-efficacy, found to be related to diabetes self-care in earlier correlational research. One hundred two adults were randomized to immediate or delayed intervention conditions. At posttest, subjects in the immediate intervention condition showed significantly greater reductions in caloric intake and percent of calories from fat than control subjects. The intervention also produced greater weight reductions and increases in the frequency of glucose testing than did the control condition. Improvements among immediate intervention subjects were generally maintained at a 6-month follow-up. Intervention results from subjects receiving delayed intervention closely replicated those for immediate intervention subjects. We conclude that a relatively short-term program can improve self-management skills of older diabetic adults, and that there is an important need for such interventions.

Effects of a Brief Office-Based Intervention to Facilitate Diabetes Dietary Self-Management

This report provides some initial findings from an investigation of the relations between childhood Big Five personality traits assessed by elementary school teachers and similar traits assessed 40 years later by self-reports at midlife (N = 799). Short-term (1-3 years) test-retest reliabilities were lower (.22-.53) in childhood when personality was developing than they were in adulthood (.70-.79) when personality stability should be at its peak. Stability coefficients across the 40-year interval between the childhood assessment and the 2 measures of adulthood personality were higher for Extraversion (e.g., .29) and Conscientiousness (e.g., .25) than for Openness (e.g., .16), Agreeableness (e.g., .08), and Neuroticism (e.g., .00). Construct continuity between childhood and adulthood was evaluated by canonical analysis and by structural equation modeling and indicated continuity at both a broad, two-dimensional level and at the level of the Big Five. The findings are discussed in relation to A. Caspi, B. W. Roberts, and R. L. Shiners (2005) principles of rank-order personality stability.

The Perception of Emotion from Body Movement in Point-Light Displays of Interpersonal Dialogue

OBJECTIVE There is a pressing need for brief practical interventions that address diabetes management. Using a randomized design, we evaluated a medical office-based intervention focused on behavioral issues relevant to dietary self-management. RESEARCH DESIGN AND METHODS There were 206 adult diabetes patients randomized to usual care or brief intervention, which consisted of touchscreen computer-assisted assessment to provide immediate feedback on key barriers to dietary self-management, and goal setting and problem-solving counseling for patients. Follow-up components to the single session intervention included phone calls and interactive video or videotape instruction as needed. RESULTS Multivariate analyses of covariance revealed that the brief intervention produced greater improvements than usual care on a number of measures of dietary behavior (e.g., fewer calories from saturated fat, fewer high-fat eating habits and behaviors) at the 3-month follow-up. There were also significant differences favoring intervention on changes in serum cholesterol levels and patient satisfaction but not on glycosylated hemoglobin. The intervention effects were relatively robust across a variety of patient characteristics, the two participating physicians, and intervention staff members. CONCLUSIONS If the long-term results are equally positive and generalize to other setting, this intervention could provide a prototype for a feasible cost-effective way to integrate patient views and behavioral management into office-based care for diabetes.

Mechanisms by which childhood personality traits influence adult health status: educational attainment and healthy behaviors.

We examined whether it is possible to identify the emotional content of behaviour from point-light displays where pairs of actors are engaged in interpersonal communication. These actors displayed a series of emotions, which included sadness, anger, joy, disgust, fear, and romantic love. In experiment 1, subjects viewed brief clips of these point-light displays presented the right way up and upside down. In experiment 2, the importance of the interaction between the two figures in the recognition of emotion was examined. Subjects were shown upright versions of (i) the original pairs (dyads), (ii) a single actor (monad), and (iii) a dyad comprising a single actor and his/her mirror image (reflected dyad). In each experiment, the subjects rated the emotional content of the displays by moving a slider along a horizontal scale. All of the emotions received a rating for every clip. In experiment 1, when the displays were upright, the correct emotions were identified in each case except disgust; but, when the displays were inverted, performance was significantly diminished for some emotions. In experiment 2, the recognition of love and joy was impaired by the absence of the acting partner, and the recognition of sadness, joy, and fear was impaired in the non-veridical (mirror image) displays. These findings both support and extend previous research by showing that biological motion is sufficient for the perception of emotion, although inversion affects performance. Moreover, emotion perception from biological motion can be affected by the veridical or non-veridical social context within the displays.

The basic level in personality-trait hierarchies : studies of trait use and accessibility in different contexts

OBJECTIVE The purpose of this study was to test a life span health behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. DESIGN The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. OUTCOME Childhood Agreeableness, Conscientiousness, and Intellect-Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. CONCLUSION The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health behavior mechanisms may not provide a complete account of relations between personality and health.

Forty years on: teachers' assessments of children's personality traits predict self-reported health behaviors and outcomes at midlife.

A persons behavior and experiences can be described at different levels of abstraction. For example, a person might be described as charitable, as generous, as kind, or as good. Is there a level in such a trait hierarchy that is particularly useful in personality descriptions? The present 4 studies show that there is indeed a general preference for a particular level; the size of this preference depends on the familiarity and likability of the target people, which included various others and the self. These findings suggest that in trait hierarchies, people prefer the highest level of abstraction that is still descriptive of behavior (e.g., kind) over more descriptive subordinate levels (e.g., charitable and generous) and over an even broader level devoid of descriptive meaning (e.g., good). This level is basic in that it represents the optimal resolution of the trade-off between bandwidth and fidelity that characterizes all hierarchies.