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Using Multivariate Statistics

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovas...

Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

Emotion and Adaptation

Principles and Practice of Structural Equation Modeling (2nd ed.)

Background: The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. Objectives: The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. Methods: We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. Results: We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d+ = 0.16, 95% CI 0.09-0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d+ = 0.36, 95% CI 0.15-0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. Conclusions: The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery. [J Med Internet Res 2010;12(1):e4]

Using the Internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy

The impact of self-monitoring food intake on motivation, physical activity and weight loss in rural adults.

Background: Maintaining muscle strength is problematic for patients with heart failure (HF) and may be related to increasing HF symptoms and exercise intolerance, leading to further decline in physical functioning. No recommendation for muscle strength assessment with HF patients is established in routine clinical practice. The purpose of this study was to compare differences in HF symptoms (dyspnea and fatigue) and exercise intolerance between patients with high versus low knee extensor strength. Method: Using a cross‐sectional design, 102 patients with HF, New York Heart Association (NYHA) class II‐IV were recruited at a HF clinic. Measures included: knee extensor muscle strength (hand‐held dynamometer); dyspnea with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and physical functioning (0‐10 cm visual analogue scale); fatigue (Piper Fatigue Scale); and exercise tolerance (6‐Minute Walk Test). Results: Patients were, on average, 59.6 years of age (SD 12.46). They had been diagnosed with HF for 3.34 years, and primarily had non‐ischemic HF (60%) and NYHA Class II (80%). Patients were divided into groups of high vs. low knee extensor strength based on a median split (Mdn = 6.70 kg). Subjects with high knee extensor strength had significantly less dyspnea with ADLs, IADLs, and physical function (p < 0.05) and greater distances in the 6‐minute walk test (t = ‐2.43, p<0.05). There was no significant difference in fatigue between groups. Conclusion: Findings indicate that symptoms of dyspnea and exercise intolerance were less in HF patients with greater knee extensor strength. Largerscale studies are needed to substantiate these results, and to determine if early interventions would improve strength and exercise tolerance in patients with HF.

Comparisons of Dyspnea, Fatigue, and Exercise Intolerance Between Individuals with Heart Failure with High Versus Low Knee Extensor Muscle Strength

Background Fatigue is the most reported and most distressing symptom among patients with cancer. However, no questionnaire that measures fatigue and fatigue interference with life has been translated into Arabic. Aims This study aimed to translate and validate the Arabic version of the Brief Fatigue Inventory (BFI-A). Methods The BFI was translated into Arabic using the forward-backward translation technique. This cross-sectional study collected data from cancer patients through a self-administered questionnaire that included the BFI-A, Insomnia Severity Index (ISI), Zung Depression Scale (ZDS), MD Anderson Symptom Inventory total score (MDASI), and Medical Outcome Study Short Form 36 (SF-36) Vitality Subscale. Descriptive and inferential statistics were used including mean, standard deviation, internal consistency, and correlation coefficient using Pearson's correlation. Results A total of 79 patients were recruited in Amman, Jordan, in 2015. Mean of the total BFI-A was 4.01 (2.4), showing that 83.5% had nonsevere fatigue. Cronbach's α coefficient of the BFI-A was 0.93. The correlations between total BFI-A scores and BFI-A items were significant (P < 0.05) and ranged from 0.75 to 0.86. BFI-A showed a significant correlation (P< 0.05) with the following tools: ISI = 0.70, ZDS = 0.69, MDASI = 0.75, and SF-36 Vitality Subscale = -0.57. Conclusions This study suggests that the BFI-A is a reliable and valid tool to assess fatigue among Arab cancer patients.

/pdf/validation-study-of-the-arabic-version-of-the-brief-fatigue-240gcspr7i.pdf

Validation study of the Arabic version of the Brief Fatigue Inventory (BFI-A).

This article examined the intervention fidelity strategies used and lessons learned in a translational study. In this study, the behavioral intervention was delivered within an existing clinical practice environment, outpatient cardiac rehabilitation (CR). The primary lessons learned were that the fidelity components of design, training, and delivery of the intervention were the most different from fidelity strategies used in typical intervention studies. The design component needed to take into account the unique characteristics of the clinical environments where the study was conducted and build these unique differences into the study design. Training and delivery of the intervention was different because existing CR staff delivered the intervention in this study; which is unlike typical intervention studies where research staff are trained to deliver the intervention. Monitoring receipt and enactment fidelity components were similar to monitoring in usual intervention studies probably because these components focus on monitoring the behaviors of the research participant. Translational research presents unique challenges and requires the development of a flexible and novel intervention fidelity plan tailored to a particular study.

Bernice C. Yates

Papers

The impact of self-monitoring food intake on motivation, physical activity and weight loss in rural adults.

Comparisons of Dyspnea, Fatigue, and Exercise Intolerance Between Individuals with Heart Failure with High Versus Low Knee Extensor Muscle Strength

Validation study of the Arabic version of the Brief Fatigue Inventory (BFI-A).

Intervention fidelity in a translational study: lessons learned.

Council on Cardiovascular Nursing.