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The article discusses the increasing prevalence of older adults living with obesity and the challenges they face, such as multimorbidity, mobility disability, and frequent healthcare visits. It emphasizes the need for a comprehensive and personalized approach to obesity care, highlighting the importance of patient priority goals, mental health recognition, and deprescribing weight-promoting medications. The study underscores the significance of a patient-centered 4M framework that aligns care with individual preferences and risk aversion, focusing on holistic approaches to weight management in older adults. [Extracted from the article]

This article provides an overview of various research training courses and programs in the social and behavioral research field. It discusses the evaluation and updating of a course on community and stakeholder engagement, which was well-received by participants. The article also highlights the importance of incorporating best practices for community engagement into research training. Additionally, it includes a list of references to articles and reports related to clinical and translational research, covering topics such as diversity, inclusion, and the impact of the COVID-19 pandemic on research training. Lastly, the article examines a breakout session focused on advancing diversity, equity, and inclusion in clinical and translational science training programs, offering valuable insights for promoting inclusivity in the field. [Extracted from the article]

Introduction: Family and friends often help chronically ill adults manage their conditions. Information about specific ways supporters help with disease management, and their experiences with and concerns about helping are lacking. This study describes key roles and concerns of family members who support the health management of adults with chronic illness, and compares experiences of health supporters living in and outside of support recipients' homes. Methods: Data were obtained from a national internet survey of 1,722 adults selected to represent the U.S. population. Detailed survey questions were completed by 703 respondents who reported providing regular disease-management help to at least one functionally-independent family member or friend with at least one of five chronic conditions (diabetes, heart failure, chronic lung disease, arthritis, depression). Results: Current supporters assisted 834 chronically ill adults: 257 receiving in-home support and 577 receiving out-of-home support. Current supporters spent 2.1 hours/week on average helping their support recipient with health care, and 21.2% attended their recipient's health care appointments. Many recipients discussed crucial concerns about medication side effects (47.0%) and trouble paying for medications (32.0%) with supporters. However, 41.0% of supporters reported insufficient information about recipients' health conditions and regimen to be helpful. In-home supporters reported arguing more often with support recipients, but also received more information from recipients' health care providers than out-of-home supporters. Discussion: Family and friends have significant potential to influence patients' chronic illness self-management. Programs to engage chronically ill patients' families to support self-management could provide information and skills targeting needs identified by supporters. Keywords: social support, chronic disease, self-management, family, informal caregivers Supplemental materials: http://dx.doi.org/10.1037/fsh0000293.supp, Optimal management of chronic health conditions, such as diabetes, heart disease, and chronic lung disease, involves multifaceted daily self-management routines and often complex interactions with health care professionals (Bayliss et [...]

Diet and exercise are important for the wellbeing of people with cancer and their family caregivers. Unfortunately, little is known about their behaviors over time or factors that may influence their engagement in these behaviors. This exploratory study examined the influence of chronic conditions, symptom distress, and perceived social support on exercise and diet behaviors of patients with advanced cancer and their caregivers using the actor-partner interdependence mediation model (APIMeM) and interdependence theory as guiding frameworks. This secondary analysis uses self-report data from a large RCT (N = 484 patient-caregiver dyads) at three time points: baseline data was collected within three months of the diagnosis, at 3 months post-baseline, and 6 months post-baseline. A number of actor effects were observed: patient and caregiver prior exercise and diet were significant predictors of their own future exercise and diet behaviors; more patient-reported social support was associated with less patient exercise; more patient symptom distress was associated with poorer patient diet; and, more caregiver-reported social support was associated with more caregiver exercise and better caregiver diet. Partner effects were also observed: more patient exercise was positively associated with more caregiver exercise; more patient comorbidities were associated with better caregiver diet; more caregiver-reported social support was associated with better patient diet; and, more patient-reported social support was associated with better caregiver diet. Despite the challenges of advanced cancer and caregiving, past exercise and diet behavior remained a significant predictor of future behavior. Other health problems and perceptions of social support within the dyad may exert a positive or negative influence on patient/caregiver diet and exercise., Author(s): Katrina R. Ellis [sup.1] , Mary R. Janevic [sup.2] , Trace Kershaw [sup.3] , Cleopatra H. Caldwell [sup.2] , Nancy K. Janz [sup.2] , Laurel Northouse [sup.4] Author Affiliations: [...]

Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U.S. population of potential and current 'disease management supporters' [...]

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise. KEYWORDS physical activity, heart disease, self-management, self-regulation, women DOI: 10.1080/08952841.2010.518874

This study examined the effects of: 1) four dimensions of social support, 2) the number of close social ties, and 3) marital status on the physical and psychological health and functioning of 471 women aged 60 years and over with heart disease. Linear mixed models were used to assess the impact of each baseline social relations predictor on health outcomes at four-, 12-, and 18-month follow-up intervals. A second set of models examined the association between change in support variables over time with concomitant change in health outcomes. Results indicated that baseline emotional/ informational support, positive social interaction, affectionate support, tangible support, number of close friends and relatives, and marital status all significantly predicted (p < .05) one or more health outcomes over time. Increases in positive social interaction and emotional support over time were significantly associated with concurrent improvement in all self-reported physical and psychological health outcomes. Interventions that enhance the availability of emotional/informational support and promote social interaction are needed for this population.

Stress and psychological distress were assessed in 457 older women who were subsequently randomized to a six-week heart disease management program ('Women take PRIDE') or to a 'usual care' control group. Baseline distress was significantly associated with age, symptoms, physical functioning, social support, optimism, and self-esteem (p < .05). Only 20% of women reported their physician had recommended reducing stress. At four months follow-up, intervention women compared to controls were significantly more likely to report reductions in stress levels (p = 0.02) and also showed improvement in emotional behavior (p = 0.09). KEYWORDS. Stress, psychological distress, disease-management, heart disease, women

Support provided by family and friends may influence the extent to which older women who are primary caregivers for a spouse with dementia adhere to an exercise routine. The current study reports on qualitative interviews with 30 older female caregivers taking part in an exercise intervention regarding the support they received for their exercise goals. Results indicate that nearly all women received some level of verbal encouragement from family and friends, though far fewer had exercise partners or someone to stay with their husbands while they exercised. To reflect the wide variation observed in the amount of exercise support received and needed by caregivers, a typology of support situations was constructed as follows: Self-reliant, Well-supported, Under-supported, and Superfluous support. Implications for future exercise interventions targeting this population are discussed. KEYWORDS. Exercise, older adults, women, caregivers, Alzheimer's disease, social support

Although the randomized, controlled trial (RCT) is considered the gold standard in research for determining the efficacy of health education interventions, such trials may be vulnerable to 'preference effects'; that is, differential outcomes depending on whether an individual is randomized to his or her preferred treatment. In this study, we review theoretical and empirical literature regarding designs that account for such effects in medical research, and consider the appropriateness of these designs to health education research. To illustrate the application of a preference design to health education research, we present analyses using process data from a mixed RCT/preference trial comparing two formats (Group or Self-Directed) of the 'Women take PRIDE' heart disease management program. Results indicate that being able to choose one's program format did not significantly affect the decision to participate in the study. However, women who chose the Group format were over 4 times as likely to attend at least one class and were twice as likely to attend a greater number of classes than those who were randomized to the Group format. Several predictors of format preference were also identified, with important implications for targeting disease-management education to this population. Keywords: USA; Research design; Heart disease; Women's health; Randomized controlled trials; Preference trials

Accumulated evidence demonstrates a strong relationship between socioeconomic status (SES) and health. Our examination of this relationship focuses on education, an established indicator of SES, and tests whether social relations, particularly with children, mediate and/or moderate the education-health link for middle-aged and older parents. The data are drawn from a regionally representative sample of adults (aged 40-93) in the Detroit area, USA. All analyses are stratified by gender (N = males: 330; females: 468). A series of multiple regression analyses were performed to test whether social relations mediate the association between education and health. Although analyses revealed no mediation effect, both men and women with less education were found to have smaller social networks. Women with more education confided less in their children than women with less education did. A series of hierarchical regression analyses were performed to test whether social relations variables moderate the relationship between education and health. Separate analyses by gender indicated that men, but not women, with less education who had larger networks and who perceived emotional, financial and sick care support to be available from a child had lower scores on a health problems index. Findings indicate that the health of lower-educated men in the presence of key social supports parallels the advantaged health status of men with higher levels of education. These findings suggest that social relationships may be a protective factor for the health of men in the lower socioeconomic strata. Keywords: USA: Physical health; Social support; Parent-child relationship; Socioeconomic status; Gender; Aging

Abstract Background Among adults in the United States, asthma prevalence is disproportionately high among African American women; this group also experiences the highest levels of asthma-linked mortality and asthma-related health care utilization. Factors linked to biological sex (e.g., hormonal fluctuations), gender roles (e.g., exposure to certain triggers) and race (e.g., inadequate access to care) all contribute to the excess asthma burden in this group, and also shape the context within which African American women manage their condition. No prior interventions for improving asthma self-management have specifically targeted this vulnerable group of asthma patients. The current study aims to evaluate the efficacy of a culturally- and gender-relevant asthma-management intervention among African American women. Methods/Design A randomized controlled trial will be used to compare a five-session asthma-management intervention with usual care. This intervention is delivered over the telephone by a trained health educator. Intervention content is informed by the principles of self-regulation for disease management, and all program activities and materials are designed to be responsive to the specific needs of African American women. We will recruit 420 female participants who self-identify as African American, and who have seen a clinician for persistent asthma in the last year. Half of these will receive the intervention. The primary outcomes, upon which the target sample size is based, are number of asthma-related emergency department visits and overnight hospitalizations in the last 12 months. We will also assess the effect of the intervention on asthma symptoms and asthma-related quality of life. Data will be collected via telephone survey and medical record review at baseline, and 12 and 24 months from baseline. Discussion We seek to decrease asthma-related health care utilization and improve asthma-related quality of life in African American women with asthma, by offering them a culturally- and gender-relevant program to enhance asthma management. The results of this study will provide important information about the feasibility and value of this program in helping to address persistent racial and gender disparities in asthma outcomes. Trial Registration ClinicalTrials.gov: NCT01117805