Benjamin Aronson - Academia.edu (original) (raw)
Papers by Benjamin Aronson
Eye reports, 2019
Purpose To determine the prevalence of eye diseases and utilization of dilated eye exams among a ... more Purpose To determine the prevalence of eye diseases and utilization of dilated eye exams among a sample of American Indian (AI) individuals with type 2 diabetes. Methods AI adults with type 2 diabetes utilizing health care at two reservation clinics were randomly sampled and recruited for interviewer-assisted paper surveys. The prevalence of eye diseases was compared across gender, age, income, and educational attainment. Results The prevalence of retinopathy, cataracts, macular degeneration, and glaucoma were 9.4%, 26.7%, 5.2%, and 10.6% respectively, and 59.2% reported past year dilated eye exams. Older participants were more likely to report cataracts (p < 0.001) and glaucoma (p = .003). Those with lower income were more likely to report cataracts (p = 0.001). Conclusions Rates of self-reported eye diseases in this sample were higher, and dilated eye exams lower than other samples of the general United States population with diabetes, suggesting improvement can be made to impr...
American journal of pharmaceutical education, 2021
Objective. This study aimed to provide further validity evidence for the KCES by analyzing data c... more Objective. This study aimed to provide further validity evidence for the KCES by analyzing data collected from multiple administrations of the KCES along with cognitive interviews of students in pharmacy and nursing programs to identify revisions of the Kiersma-Chen Empathy Scale: The KCES- Revised (KCES-R). Methods. De-identified data from previous KCES administrations were used for scale evaluation. Response process validity evidence was enhanced through cognitive interviews with 20 pre-pharmacy/pharmacy students at Cedarville University. After survey revisions, the cognitive interview process was repeated with 10 University of Wyoming nursing students. Results. Based on psychometric data and cognitive interviews, the KCES was revised as follows: (1) key components of cognitive and affective empathy were retained, (2) scaling was changed to reflect necessity and empathy ability, (3) negatively-worded items were removed, and (4) instrument was changed to two parallel subscales. Con...
et al. Evaluating factors impacting medication adherence among rural, urban, and suburban populat... more et al. Evaluating factors impacting medication adherence among rural, urban, and suburban populations.
American Journal of Pharmaceutical Education
Objective. To determine if a pretest assessing algebra-based problem-solving skills could aid in ... more Objective. To determine if a pretest assessing algebra-based problem-solving skills could aid in identifying those who may underperform in calculations course assessments and if this provides additional value beyond pre-admission and demographic characteristics. Methods. Student pharmacists were screened for algebraic problem-solving skills using an 18-item pretest taken the semester prior to a course containing pharmaceutical calculations content. These scores were compared to later performance on pharmaceutical calculations assessments. Linear regression models were computed to determine the relationship between pretest scores and pharmaceutical calculations performance, after controlling for pre-admission factors and demographic characteristics. Results. The median pretest score was 15 out of 18 possible points, with scores ranging from 5 to 18 correct. After controlling for age, gender, ACT scores, and high-school GPA, scores on the algebra-based, word-problem pretest were associated with performance on pharmaceutical calculation assessments. Conclusion. This research demonstrates the ability of a pretest, aimed at identifying deficiencies in algebraic problemsolving skills, to identify those at risk of failing to obtain mastery of pharmaceutical calculations, even after controlling for demographics, prior grades, and prior standardized test scores. Identifying these students is a first step towards implementing tailored interventions to improve students' algebra-based word problem skills in order to prevent deficiencies in pharmaceutical calculations mastery before class even begins.
Is It Time for a Quality Rating System for Colleges of Pharmacy?
American Journal of Pharmaceutical Education
A longitudinal study of the stress of poor glucose control and diabetes distress
Journal of Health Psychology
Poor glucose control can be viewed as a stressor, possibly promulgating diabetes distress. We exa... more Poor glucose control can be viewed as a stressor, possibly promulgating diabetes distress. We examined the relationship between perceived blood glucose control and diabetes distress over time using a partially controlled cross-lagged path analysis model. After controlling for demographics, control at 6 months was directly related to change in distress at 12 months. Subsequently, distress at 12 months was directly related to change in control at 18 months. Both 6-month control and distress had significant indirect effects on 18-month control and distress. This demonstrates the nuanced bi-directional relationship between the stress of poor perceived control and diabetes distress.
The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences
Health Education & Behavior
Background. Medication adherence is negatively related to both diabetes distress (DD) and depress... more Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence a...
Assessment of Feasibility and Outcomes of a Salivary Cortisol Collection Protocol in Five American Indian Communities
Stress
Perceptions and Prevalence of Alcohol and Cigarette Use Among American Indian Adults With Type 2 Diabetes
Clinical Diabetes
INNOVATIONS in pharmacy
The development of student pharmacists must include inspiring within them a sense of engagement i... more The development of student pharmacists must include inspiring within them a sense of engagement in their profession. This paper provides the rationale for and the potential implications of this concept, as well as an overview of experiences with professional engagement in student pharmacists at one college of pharmacy. Curricular-based experiences and research will be discussed, including the insights gained and suggestions for developing and encouraging professional engagement. Lastly, this article provides future direction for furthering professional engagement on both the conceptual and curricular level. Type: Idea Paper
INNOVATIONS in pharmacy
Purpose This pilot sought to determine feasibility of studying the impact on hypertension in over... more Purpose This pilot sought to determine feasibility of studying the impact on hypertension in over-the-road truck drivers who met with pharmacists for Medication Therapy Management (MTM) compared to those who did not. Design/methodology/approach Drivers were randomly assigned to control or treatment (MTM) group for 52 weeks. Drivers assigned to the MTM arm could receive services in person or via secure videoconferencing technology located in a private space at the trucking company. All subjects were provided education and received a blood pressure monitor and log for recording daily blood pressures. Findings Eleven drivers enrolled and seven drivers completed the study. The primary barriers to participation included unpredictable driver schedules and lack of access to MTM provider while on the road. Research limitations/implications This pilot study was limited by small sample size. Pharmacists were not available to meet with truckers "on demand." Therefore, researchers are...
Destination Better Quality: Examining Quality on a Mobile Health Clinic
Research in Social and Administrative Pharmacy
American Indian and Alaska Native Mental Health Research
Despite alarming health disparities among American Indians (AIs) and acknowledgement that stresso... more Despite alarming health disparities among American Indians (AIs) and acknowledgement that stressors negatively influence health, conceptualization of the full spectrum of stressors that impact Indigenous communities is underdeveloped. To address this gap, we analyze focus group transcripts of AI adults with type 2 diabetes from five tribal communities and classify stressors using an inductive/deductive analytical approach. A Continuum of American Indian Stressor Model was constructed from categorization of nineteen stressor categories within four domains. We further identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for AIs and conclude that stressors are generally experienced as chronic, regardless of the duration of the stressor. This work on AI-specific stressors informs future health research on the stress burden in AI communities and identifies target points for intervention and health promotion.
Using a mock board of pharmacy disciplinary hearing to teach concepts related to administrative law, addiction, empathy, and professionalism
Currents in Pharmacy Teaching and Learning
Language as a Facilitator of Cultural Connection
ab-Original : journal of indigenous studies and first nations' and first peoples' culture, 2017
Understanding culture as a means of preventing or treating health concerns is growing in populari... more Understanding culture as a means of preventing or treating health concerns is growing in popularity among social behavioral health scientists. Language is one component of culture and therefore may be a means to improve health among Indigenous populations. This study explores language as a unique aspect of culture through its relationship to other demographic and cultural variables. Participants ( = 218) were adults who self-identified as American Indian, had a type 2 diabetes diagnosis, and were drawn from two Ojibwe communities using health clinic records. We used chi-squared tests to compare language proficiency by demographic groups and ANOVA tests to examine relationships between language and culture. A higher proportion of those living on reservation lands could use the Ojibwe language, and fluent speakers were most notably sixty-five years of age and older. Regarding culture, those with greater participation and value belief in cultural activities reported greater language pr...
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, Jan 10, 2018
To evaluate differences in prescription medication adherence rates, as well as influencing factor... more To evaluate differences in prescription medication adherence rates, as well as influencing factors, in rural and urban adults. This is a retrospective analysis of the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Role. A total of 26,173 participants completed the survey and provided usable data. Participants using between 1 and 30 prescription medications and living more than 0 miles and up to 200 miles from their nearest pharmacy were selected for the study, resulting in a total of 15,933 participants. Data from the 2010 US Census and Rural Health Research Center were used to determine the population density of each participant's ZIP code. Participant adherence to reported chronic medications was measured based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Overall adherence rates did not differ significantly between rural and urban adults with average adherence based on MMAS-8 scores of 5.58 and 5.64, respectively (P = .253). Age, ...
International Journal of Environmental Research and Public Health
American Indian (AI) communities experience disproportionate exposure to stressors and health ine... more American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose-response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.
Reproductive Health
Background: Preconception care, including family planning, is a vital component of healthcare for... more Background: Preconception care, including family planning, is a vital component of healthcare for women of reproductive age. An average female spends the majority of her reproductive life trying to prevent a pregnancy. In order to prevent unintended pregnancy, women often rely on the use of hormonal contraceptives. In the United States, the majority of hormonal contraceptive users are prescribed oral contraceptive pills (OCPs). Reduced adherence to OCPs decreases their ability to prevent pregnancy. The study aimed to measure OCP adherence among female college students, and explore the relationship between OCP adherence, knowledge, and self-efficacy. Methods: This cross-sectional study recruited a random sample of female college students to participate in an online survey. OCP adherence was based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Secondary reporting of medication adherence included participant reports of the number of missed OCP doses in the previous month and typical month of use. Results: Of the 5000 invited, 1559 (31.3%) completed the survey. Of those responding, 670 (41.3%) reported use of OCPs. A total of 293 (44.3%) OCP users met criteria for low adherence, 241 (36.4%) met criteria for medium adherence, and 128 (19.3%) met criteria for high adherence. Those with high adherence had higher self-efficacy (P < 0.001) and perceived knowledge (p < 0.001). After controlling for other factors, self-efficacy (b = .37) and perceived knowledge (b = .09) remained associated with OCP adherence. Conclusion: Less than 20% of respondents met the criteria for high adherence to OCPs. Self-efficacy and knowledge were associated with higher OCP adherence. Targeted interventions from healthcare providers, health educators, and other adherence related media to increase the knowledge and self-efficacy of patients using OCPs may improve adherence rates. Additional research is needed to evaluate the impact of innovative interventions focused on social and behavioral patient factors, like knowledge and self-efficacy, on adherence to OCPs.
Apathy and Type 2 Diabetes among American Indians: Exploring the Protective Effects of Traditional Cultural Involvement
Journal of health care for the poor and underserved, 2017
In this study we examine relationships between traditional cultural factors, apathy, and health-r... more In this study we examine relationships between traditional cultural factors, apathy, and health-related outcomes among a sample of American Indian adults with type 2 diabetes. Participants completed cross-sectional interviewer-assisted paper and pencil surveys. We tested a proposed model using latent variable path analysis in order to understand the relationships between cultural participation, apathy, frequency of high blood sugar symptoms, and health-related quality of life. The model revealed significant direct effects from cultural participation to apathy, and apathy to both health-related outcomes. No direct effect of cultural participation on either health-related outcome was found; however, cultural participation had a negative indirect effect through apathy on high blood sugar and positive indirect effects on health-related quality of life. This study highlights a potential pathway of cultural involvement to positive diabetes outcomes.
Eye reports, 2019
Purpose To determine the prevalence of eye diseases and utilization of dilated eye exams among a ... more Purpose To determine the prevalence of eye diseases and utilization of dilated eye exams among a sample of American Indian (AI) individuals with type 2 diabetes. Methods AI adults with type 2 diabetes utilizing health care at two reservation clinics were randomly sampled and recruited for interviewer-assisted paper surveys. The prevalence of eye diseases was compared across gender, age, income, and educational attainment. Results The prevalence of retinopathy, cataracts, macular degeneration, and glaucoma were 9.4%, 26.7%, 5.2%, and 10.6% respectively, and 59.2% reported past year dilated eye exams. Older participants were more likely to report cataracts (p < 0.001) and glaucoma (p = .003). Those with lower income were more likely to report cataracts (p = 0.001). Conclusions Rates of self-reported eye diseases in this sample were higher, and dilated eye exams lower than other samples of the general United States population with diabetes, suggesting improvement can be made to impr...
American journal of pharmaceutical education, 2021
Objective. This study aimed to provide further validity evidence for the KCES by analyzing data c... more Objective. This study aimed to provide further validity evidence for the KCES by analyzing data collected from multiple administrations of the KCES along with cognitive interviews of students in pharmacy and nursing programs to identify revisions of the Kiersma-Chen Empathy Scale: The KCES- Revised (KCES-R). Methods. De-identified data from previous KCES administrations were used for scale evaluation. Response process validity evidence was enhanced through cognitive interviews with 20 pre-pharmacy/pharmacy students at Cedarville University. After survey revisions, the cognitive interview process was repeated with 10 University of Wyoming nursing students. Results. Based on psychometric data and cognitive interviews, the KCES was revised as follows: (1) key components of cognitive and affective empathy were retained, (2) scaling was changed to reflect necessity and empathy ability, (3) negatively-worded items were removed, and (4) instrument was changed to two parallel subscales. Con...
et al. Evaluating factors impacting medication adherence among rural, urban, and suburban populat... more et al. Evaluating factors impacting medication adherence among rural, urban, and suburban populations.
American Journal of Pharmaceutical Education
Objective. To determine if a pretest assessing algebra-based problem-solving skills could aid in ... more Objective. To determine if a pretest assessing algebra-based problem-solving skills could aid in identifying those who may underperform in calculations course assessments and if this provides additional value beyond pre-admission and demographic characteristics. Methods. Student pharmacists were screened for algebraic problem-solving skills using an 18-item pretest taken the semester prior to a course containing pharmaceutical calculations content. These scores were compared to later performance on pharmaceutical calculations assessments. Linear regression models were computed to determine the relationship between pretest scores and pharmaceutical calculations performance, after controlling for pre-admission factors and demographic characteristics. Results. The median pretest score was 15 out of 18 possible points, with scores ranging from 5 to 18 correct. After controlling for age, gender, ACT scores, and high-school GPA, scores on the algebra-based, word-problem pretest were associated with performance on pharmaceutical calculation assessments. Conclusion. This research demonstrates the ability of a pretest, aimed at identifying deficiencies in algebraic problemsolving skills, to identify those at risk of failing to obtain mastery of pharmaceutical calculations, even after controlling for demographics, prior grades, and prior standardized test scores. Identifying these students is a first step towards implementing tailored interventions to improve students' algebra-based word problem skills in order to prevent deficiencies in pharmaceutical calculations mastery before class even begins.
Is It Time for a Quality Rating System for Colleges of Pharmacy?
American Journal of Pharmaceutical Education
A longitudinal study of the stress of poor glucose control and diabetes distress
Journal of Health Psychology
Poor glucose control can be viewed as a stressor, possibly promulgating diabetes distress. We exa... more Poor glucose control can be viewed as a stressor, possibly promulgating diabetes distress. We examined the relationship between perceived blood glucose control and diabetes distress over time using a partially controlled cross-lagged path analysis model. After controlling for demographics, control at 6 months was directly related to change in distress at 12 months. Subsequently, distress at 12 months was directly related to change in control at 18 months. Both 6-month control and distress had significant indirect effects on 18-month control and distress. This demonstrates the nuanced bi-directional relationship between the stress of poor perceived control and diabetes distress.
The Mediating Role of Diabetes Distress and Depressive Symptoms in Type 2 Diabetes Medication Adherence Gender Differences
Health Education & Behavior
Background. Medication adherence is negatively related to both diabetes distress (DD) and depress... more Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence a...
Assessment of Feasibility and Outcomes of a Salivary Cortisol Collection Protocol in Five American Indian Communities
Stress
Perceptions and Prevalence of Alcohol and Cigarette Use Among American Indian Adults With Type 2 Diabetes
Clinical Diabetes
INNOVATIONS in pharmacy
The development of student pharmacists must include inspiring within them a sense of engagement i... more The development of student pharmacists must include inspiring within them a sense of engagement in their profession. This paper provides the rationale for and the potential implications of this concept, as well as an overview of experiences with professional engagement in student pharmacists at one college of pharmacy. Curricular-based experiences and research will be discussed, including the insights gained and suggestions for developing and encouraging professional engagement. Lastly, this article provides future direction for furthering professional engagement on both the conceptual and curricular level. Type: Idea Paper
INNOVATIONS in pharmacy
Purpose This pilot sought to determine feasibility of studying the impact on hypertension in over... more Purpose This pilot sought to determine feasibility of studying the impact on hypertension in over-the-road truck drivers who met with pharmacists for Medication Therapy Management (MTM) compared to those who did not. Design/methodology/approach Drivers were randomly assigned to control or treatment (MTM) group for 52 weeks. Drivers assigned to the MTM arm could receive services in person or via secure videoconferencing technology located in a private space at the trucking company. All subjects were provided education and received a blood pressure monitor and log for recording daily blood pressures. Findings Eleven drivers enrolled and seven drivers completed the study. The primary barriers to participation included unpredictable driver schedules and lack of access to MTM provider while on the road. Research limitations/implications This pilot study was limited by small sample size. Pharmacists were not available to meet with truckers "on demand." Therefore, researchers are...
Destination Better Quality: Examining Quality on a Mobile Health Clinic
Research in Social and Administrative Pharmacy
American Indian and Alaska Native Mental Health Research
Despite alarming health disparities among American Indians (AIs) and acknowledgement that stresso... more Despite alarming health disparities among American Indians (AIs) and acknowledgement that stressors negatively influence health, conceptualization of the full spectrum of stressors that impact Indigenous communities is underdeveloped. To address this gap, we analyze focus group transcripts of AI adults with type 2 diabetes from five tribal communities and classify stressors using an inductive/deductive analytical approach. A Continuum of American Indian Stressor Model was constructed from categorization of nineteen stressor categories within four domains. We further identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for AIs and conclude that stressors are generally experienced as chronic, regardless of the duration of the stressor. This work on AI-specific stressors informs future health research on the stress burden in AI communities and identifies target points for intervention and health promotion.
Using a mock board of pharmacy disciplinary hearing to teach concepts related to administrative law, addiction, empathy, and professionalism
Currents in Pharmacy Teaching and Learning
Language as a Facilitator of Cultural Connection
ab-Original : journal of indigenous studies and first nations' and first peoples' culture, 2017
Understanding culture as a means of preventing or treating health concerns is growing in populari... more Understanding culture as a means of preventing or treating health concerns is growing in popularity among social behavioral health scientists. Language is one component of culture and therefore may be a means to improve health among Indigenous populations. This study explores language as a unique aspect of culture through its relationship to other demographic and cultural variables. Participants ( = 218) were adults who self-identified as American Indian, had a type 2 diabetes diagnosis, and were drawn from two Ojibwe communities using health clinic records. We used chi-squared tests to compare language proficiency by demographic groups and ANOVA tests to examine relationships between language and culture. A higher proportion of those living on reservation lands could use the Ojibwe language, and fluent speakers were most notably sixty-five years of age and older. Regarding culture, those with greater participation and value belief in cultural activities reported greater language pr...
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, Jan 10, 2018
To evaluate differences in prescription medication adherence rates, as well as influencing factor... more To evaluate differences in prescription medication adherence rates, as well as influencing factors, in rural and urban adults. This is a retrospective analysis of the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Role. A total of 26,173 participants completed the survey and provided usable data. Participants using between 1 and 30 prescription medications and living more than 0 miles and up to 200 miles from their nearest pharmacy were selected for the study, resulting in a total of 15,933 participants. Data from the 2010 US Census and Rural Health Research Center were used to determine the population density of each participant's ZIP code. Participant adherence to reported chronic medications was measured based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Overall adherence rates did not differ significantly between rural and urban adults with average adherence based on MMAS-8 scores of 5.58 and 5.64, respectively (P = .253). Age, ...
International Journal of Environmental Research and Public Health
American Indian (AI) communities experience disproportionate exposure to stressors and health ine... more American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose-response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.
Reproductive Health
Background: Preconception care, including family planning, is a vital component of healthcare for... more Background: Preconception care, including family planning, is a vital component of healthcare for women of reproductive age. An average female spends the majority of her reproductive life trying to prevent a pregnancy. In order to prevent unintended pregnancy, women often rely on the use of hormonal contraceptives. In the United States, the majority of hormonal contraceptive users are prescribed oral contraceptive pills (OCPs). Reduced adherence to OCPs decreases their ability to prevent pregnancy. The study aimed to measure OCP adherence among female college students, and explore the relationship between OCP adherence, knowledge, and self-efficacy. Methods: This cross-sectional study recruited a random sample of female college students to participate in an online survey. OCP adherence was based on the 8-item Morisky Medication Adherence Scale (MMAS-8). Secondary reporting of medication adherence included participant reports of the number of missed OCP doses in the previous month and typical month of use. Results: Of the 5000 invited, 1559 (31.3%) completed the survey. Of those responding, 670 (41.3%) reported use of OCPs. A total of 293 (44.3%) OCP users met criteria for low adherence, 241 (36.4%) met criteria for medium adherence, and 128 (19.3%) met criteria for high adherence. Those with high adherence had higher self-efficacy (P < 0.001) and perceived knowledge (p < 0.001). After controlling for other factors, self-efficacy (b = .37) and perceived knowledge (b = .09) remained associated with OCP adherence. Conclusion: Less than 20% of respondents met the criteria for high adherence to OCPs. Self-efficacy and knowledge were associated with higher OCP adherence. Targeted interventions from healthcare providers, health educators, and other adherence related media to increase the knowledge and self-efficacy of patients using OCPs may improve adherence rates. Additional research is needed to evaluate the impact of innovative interventions focused on social and behavioral patient factors, like knowledge and self-efficacy, on adherence to OCPs.
Apathy and Type 2 Diabetes among American Indians: Exploring the Protective Effects of Traditional Cultural Involvement
Journal of health care for the poor and underserved, 2017
In this study we examine relationships between traditional cultural factors, apathy, and health-r... more In this study we examine relationships between traditional cultural factors, apathy, and health-related outcomes among a sample of American Indian adults with type 2 diabetes. Participants completed cross-sectional interviewer-assisted paper and pencil surveys. We tested a proposed model using latent variable path analysis in order to understand the relationships between cultural participation, apathy, frequency of high blood sugar symptoms, and health-related quality of life. The model revealed significant direct effects from cultural participation to apathy, and apathy to both health-related outcomes. No direct effect of cultural participation on either health-related outcome was found; however, cultural participation had a negative indirect effect through apathy on high blood sugar and positive indirect effects on health-related quality of life. This study highlights a potential pathway of cultural involvement to positive diabetes outcomes.