Browsing by Subject "Professional-Patient Relations"

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    Infant and Toddler Child-Care Quality and Stability in Relation to Proximal and Distal Academic and Social Outcomes.
    (Child development, 2020-11) Bratsch-Hines, Mary E; Carr, Robert; Zgourou, Eleni; Vernon-Feagans, Lynne; Willoughby, Michael
    This study considered the quality and stability of infant and toddler nonparental child care from 6 to 36 months in relation to language, social, and academic skills measured proximally at 36 months and distally at kindergarten. Quality was measured separately as caregiver-child verbal interactions and caregiver sensitivity, and stability was measured as having fewer sequential child-care caregivers. This longitudinal examination involved a subsample (N = 1,055) from the Family Life Project, a representative sample of families living in rural counties in the United States. Structural equation modeling revealed that children who experienced more positive caregiver-child verbal interactions had higher 36-month language skills, which indirectly led to higher kindergarten academic and social skills. Children who experienced more caregiver stability had higher kindergarten social skills.
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    Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial.
    (Trials, 2014-04-27) Vedanthan, Rajesh; Kamano, Jemima H; Naanyu, Violet; Delong, Allison K; Were, Martin C; Finkelstein, Eric A; Menya, Diana; Akwanalo, Constantine O; Bloomfield, Gerald S; Binanay, Cynthia A; Velazquez, Eric J; Hogan, Joseph W; Horowitz, Carol R; Inui, Thomas S; Kimaiyo, Sylvester; Fuster, Valentin
    BACKGROUND: Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and delays in seeking care are associated with increased mortality. Thus, a critical component of hypertension management is to optimize linkage and retention to care. METHODS/DESIGN: This study investigates whether community health workers, equipped with a tailored behavioral communication strategy and smartphone technology, can increase linkage and retention of hypertensive individuals to a hypertension care program and significantly reduce blood pressure among them. The study will be conducted in the Kosirai and Turbo Divisions of western Kenya. An initial phase of qualitative inquiry will assess facilitators and barriers of linkage and retention to care using a modified Health Belief Model as a conceptual framework. Subsequently, we will conduct a cluster randomized controlled trial with three arms: 1) usual care (community health workers with the standard level of hypertension care training); 2) community health workers with an additional tailored behavioral communication strategy; and 3) community health workers with a tailored behavioral communication strategy who are also equipped with smartphone technology. The co-primary outcome measures are: 1) linkage to hypertension care, and 2) one-year change in systolic blood pressure among hypertensive individuals. Cost-effectiveness analysis will be conducted in terms of costs per unit decrease in blood pressure and costs per disability-adjusted life year gained. DISCUSSION: This study will provide evidence regarding the effectiveness and cost-effectiveness of strategies to optimize linkage and retention to hypertension care that can be applicable to non-communicable disease management in low- and middle-income countries. TRIAL REGISTRATION: This trial is registered with (NCT01844596) on 30 April 2013.
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    The role of therapeutic alliance in mindfulness interventions: therapeutic alliance in mindfulness training for smokers.
    (J Clin Psychol, 2013-09) Goldberg, Simon B; Davis, James M; Hoyt, William T
    OBJECTIVE: Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors. METHODS: In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment. RESULTS: Results suggest that client-reported therapeutic alliance measured midtreatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in posttreatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β = -.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = -.33, p = .040), as well as treatment compliance (β = .39, p = .011). CONCLUSION: Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored.