Manfred Stommel - Academia.edu (original) (raw)

Papers by Manfred Stommel

Journal of extension, Oct 1, 2018

Healthful dietary intakes are crucial for stemming the current childhood obesity epidemic. We exa... more Healthful dietary intakes are crucial for stemming the current childhood obesity epidemic. We examined the dietary intakes of 392 Michigan children aged 1-12 years. About 70% and 58% of children ate fruits and vegetables, respectively, each day; 26% drank sugar-sweetened beverages; and 31% ate with a television on. Children's vegetable intakes were significantly and moderately correlated with their parents' vegetable intakes (r = .34-.38), but their fruit intakes were more related to their grandparents' fruit intakes (r = .31). Due to the relative representativeness of our sample and similarities in eating patterns across the region, Extension professionals may consider our study findings when designing tailored nutrition education programs for families in the midwestern United States.

Oncology Nursing Forum, Nov 1, 2005

The use of complementary and alternative medicine (CAM) therapies continues to increase in genera... more The use of complementary and alternative medicine (CAM) therapies continues to increase in general populations and among those with cancer. It is important to understand the factors that predict use of these nonconventional methods of care and symptom management. ➤ In our study of patients with lung, breast, colon, or prostate cancer, nearly 30% used CAM therapies. The two most frequently used CAM therapies were herbal and vitamin supplements and spiritual healing. ➤ Factors that predict CAM use include gender, marital status, cancer stage, cancer treatment, and number of severe symptoms. ➤ To promote comprehensive quality care, nurses should assess for CAM use and increase their understanding of which CAM therapies patients are using and why.

International Journal of Obesity, Jan 24, 2012

<b>Copyright information:</b>Taken from "Changes in practice patterns affecting ... more <b>Copyright information:</b>Taken from "Changes in practice patterns affecting in-hospital and post-discharge survival among ACS patients"BMC Health Services Research 2006;6():140-140.Published online 24 Oct 2006PMCID:PMC1630429.

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Public Health Nursing, 2010

Objectives: To examine whether and how toddlers' vegetable and fruit consumption is associated wi... more Objectives: To examine whether and how toddlers' vegetable and fruit consumption is associated with maternal vegetable and fruit consumption, mothers' perceptions of toddlers as ''picky eaters,'' maternal efficacy, and sociodemographic characteristics of the family. Design and Sample: A cross-sectional survey. One hundred and ninety-nine African American and 200 Non-Hispanic White low-income, mother-toddler dyads enrolled in 8 Early Head Start programs in a Midwestern state. Measures: Mothers completed the Feeding Self-Efficacy Scale, Toddler-Parent Mealtime Behavior Questionnaire, and Mothers' and Toddlers' Food Frequency Questionnaires. Data were analyzed using linear and logistic regression models. Results: Toddlers were less likely to consume vegetables 4 or more times a week if their mothers: viewed them as ''picky eaters'' (OR: 2.5), did not consume vegetables 4 or more times a week themselves (OR: 10.1), and were African American (OR: 2.2). Toddlers were less likely to consume fruits 4 or more times a week if their mothers: viewed them as ''picky eaters'' (OR: 1.6) and did not consume fruit 4 or more times a week (OR: 9.9) themselves. Conclusions: Health professionals need to consider mothers' own consumption of fruits and vegetables when developing strategies to increase toddler consumption of fruits and vegetables.

Journal of Hospital Medicine, 2009

BACKGROUND: A hospital admission for a serious cardiac event offers a unique opportunity for smok... more BACKGROUND: A hospital admission for a serious cardiac event offers a unique opportunity for smoking cessation. Understanding the factors that predict and enhance cessation among smoking cardiac inpatients is important for hospital physicians and clinical staff. STUDY OBJECTIVE: To determine factors that predict smoking cessation, relapse, or continued smoking among posthospitalized cardiac patients who were smoking at the time of admission. SAMPLE: Patients hospitalized with acute coronary syndrome (ACS) were recruited from 5 hospitals in Michigan to participate in a study assessing hospital quality improvement plus at-home health behavior change counseling. MEASUREMENTS: Patient interview data were collected shortly after discharge and 3 and 8 months later to describe patient demographics, clinical characteristics, tobacco use, and other behaviors. Multinomial logit regression was used to predict smoking cessation, relapse, and continued smoking. RESULTS: Of patients smoking at hospitalization who completed both follow-up interviews, 56.8% (n 5 111) were not smoking at 8 months. A significant predictor of successful cessation was higher household income (odds ratio [OR] 5 4.72; P 5 0.003), while having other smokers in the household decreased the odds of cessation (OR 5 0.20; P 5 0.001). History of depression increased the odds of relapse (OR 5 6.38; P 5 0.002) and being a lighter smoker decreased the odds (OR 5 0.16; P 5 0.026). CONCLUSIONS: Although approximately one-half of the smokers in this study reported successful cessation, interventions are still needed to assist all smokers to successfully quit smoking after an ACS hospitalization. Our data suggest targeting follow-up programs to include other family members and using specialized methods for heavy smokers.

BMC Health Services Research, 2012

Background: The search for a reliable, valid and cost-effective comorbidity risk adjustment metho... more Background: The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI) is limited due to frequent missing data in medical records and administrative data. Patient self-report data has the potential to be more complete but has not been widely used. The purpose of this study was to evaluate the performance of the Self-Administered Comorbidity Questionnaire (SCQ) to predict functional capacity, quality of life (QOL) health outcomes compared to CCI medical records data. Method: An SCQ-score was generated from patient interview, and the CCI score was generated by medical record review for 525 patients hospitalized for Acute Coronary Syndrome (ACS) at baseline, three months and eight months post-discharge. Linear regression models assessed the extent to which there were differences in the ability of comorbidity measures to predict functional capacity (Activity Status Index [ASI] scores) and quality of life (EuroQOL 5D [EQ5D] scores). Results: The CCI (R 2 = 0.245; p = 0.132) did not predict quality of life scores while the SCQ self-report method (R 2 = 0.265; p < 0.0005) predicted the EQ5D scores. However, the CCI was almost as good as the SCQ for predicting the ASI scores at three and six months and performed slightly better in predicting ASI at eight-month follow up (R 2 = 0.370; p < 0.0005 vs. R 2 = 0.358; p < 0.0005) respectively. Only age, gender, family income and Center for Epidemiologic Studies-Depression (CESD) scores showed significant association with both measures in predicting QOL and functional capacity. Conclusions: Although our model R-squares were fairly low, these results show that the self-report SCQ index is a good alternative method to predict QOL health outcomes when compared to a CCI medical record score. Both measures predicted physical functioning similarly. This suggests that patient self-reported comorbidity data can be used for predicting physical functional capacity and QOL and can serve as a reliable risk adjustment measure. Self-report comorbidity data may provide a cost-effective alternative method for risk adjustment in clinical research, health policy and organizational improvement analyses.

BMC Health Services Research, 2008

Background: Comorbidity is an important adjustment measure in research focusing on outcomes such ... more Background: Comorbidity is an important adjustment measure in research focusing on outcomes such as health status and mortality. One recurrent methodological issue concerns the concordance of comorbidity data obtained from different reporting sources. The purpose of these prospectively planned analyses was to examine the concordance of comorbidity data obtained from patient selfreport survey interviews and hospital medical record documentation. Methods: Comorbidity data were obtained using survey interviews and medical record entries from 525 hospitalized Acute Coronary Syndrome patients. Frequencies and descriptive statistics of individual and composite comorbidity data from both sources were completed. Individual item agreement was evaluated with simple and weighted kappas, Spearman Rho coefficients for composite scores. Results: On average, patients reported more comorbidities during their patient survey interviews (mean = 1.78, SD = 1.99) than providers had documented in medical records (mean = 1.27, SD = 1.43). Higher proportions of positive responses were obtained from self-reports compared to medical records for all conditions except congestive heart failure and renal disease. Older age and higher depressive symptom levels were significantly associated with poorer levels of data concordance. Conclusion: These results demonstrate that survey comorbidity data from ACS patients may not be entirely concordat with medical record documentation. In the absence of a gold standard, it is possible that hospital records did not include all pre-admission comorbidities and these patient survey interview methods may need to be refined. Self-report methods to facilitate some patients' complete recall of comorbid conditions may need to be refined by health services researchers.

BMC Public Health, 2009

Background: The Body Mass Index (BMI) based on self-reported height and weight ("selfreported BMI... more Background: The Body Mass Index (BMI) based on self-reported height and weight ("selfreported BMI") in epidemiologic studies is subject to measurement error. However, because of the ease and efficiency in gathering height and weight information through interviews, it remains important to assess the extent of error present in self-reported BMI measures and to explore possible adjustment factors as well as valid uses of such self-reported measures. Methods: Using the combined 2001-2006 data from the continuous National Health and Nutrition Examination Survey, discrepancies between BMI measures based on self-reported and physical height and weight measures are estimated and socio-demographic predictors of such discrepancies are identified. Employing adjustments derived from the socio-demographic predictors, the selfreported measures of height and weight in the 2001-2006 National Health Interview Survey are used for population estimates of overweight & obesity as well as the prediction of health risks associated with large BMI values. The analysis relies on two-way frequency tables as well as linear and logistic regression models. All point and variance estimates take into account the complex survey design of the studies involved. Results: Self-reported BMI values tend to overestimate measured BMI values at the low end of the BMI scale (< 22) and underestimate BMI values at the high end, particularly at values > 28. The discrepancies also vary systematically with age (younger and older respondents underestimate their BMI more than respondents aged 42-55), gender and the ethnic/racial background of the respondents. BMI scores, adjusted for socio-demographic characteristics of the respondents, tend to narrow, but do not eliminate misclassification of obese people as merely overweight, but health risk estimates associated with variations in BMI values are virtually the same, whether based on selfreport or measured BMI values. Conclusion: BMI values based on self-reported height and weight, if corrected for biases associated with socio-demographic characteristics of the survey respondents, can be used to estimate health risks associated with variations in BMI, particularly when using parametric prediction models.

Journal of Cardiopulmonary Rehabilitation and Prevention, 2009

Hopelessness has been associated with a higher risk of fatal and nonfatal coronary heart disease,... more Hopelessness has been associated with a higher risk of fatal and nonfatal coronary heart disease, yet very few studies have examined hopelessness after a cardiac event. This investigation examined hopelessness as an independent predictor of participation in a hospital-based cardiac rehabilitation exercise program. A total of 207 patients with acute coronary syndrome were interviewed at 3 and 8 months after hospital discharge. Measures included 1 factor of the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, the Activity Status Index, the Charlson Comorbidity Index, a sociodemographic variables tool, and a cardiac rehabilitation exercise participation questionnaire. Random-effects logistic regression analysis revealed that hopelessness persisted over time and was an independent predictor of lower exercise participation. In contrast, depression showed no significant influence on exercise participation. Study findings suggest the importance of assessing hopelessness in patients with acute coronary syndrome and identifying approaches to exercise recommendations that directly address hopelessness. Interventions focused on the prevention and treatment of hopelessness symptoms may contribute to improved recovery of patient with acute coronary syndrome.

Behavioral Medicine

Four common health risk behaviors have the greatest impact on all-cause mortality risk, but studi... more Four common health risk behaviors have the greatest impact on all-cause mortality risk, but studies are needed with larger samples and the appropriate age range for cigarette smokers. We examined the impact of smoking in the context of multiple health behaviors on all-cause mortality using a nationally representative sample of adults aged 30 and older in the United States. National Health Interview Survey data from 1997 to 2005 were linked to the National Death Index with a follow-up to December 2015. The primary dependent variable was all-cause mortality, and the primary predictors were smoking, heavy drinking, physical inactivity, and unhealthy weight (underweight or obesity). The sample contained 189,087 individuals (≥ age 30; population estimate = 140.7 million). Our primary statistical analysis tool involved fitting Cox proportional hazards models. Our findings demonstrated that smoking led to the highest mortality risk among the four risk behaviors examined, but more than half of smokers engaged in at least one additional health risk behavior. Smokers who engaged in multiple health behaviors experienced higher increased mortality risks: smoking combined with one other health risk behavior increased mortality risk by 32% and by 82% when combined with two behaviors. Engaging in all four risk behaviors more than doubled the mortality risk of smokers. Smoking cessation interventions that address multiple risk behaviors-physical inactivity, heavy drinking, and unhealthy weight-will likely prevent premature death better than interventions that address only smoking.

Health Care for Women International

We examined husbands' knowledge and attendance at their wives' postpartum visit i... more We examined husbands' knowledge and attendance at their wives' postpartum visit in a sample of rural husband-and-wife farmer dyads in central Malawi. A cross-sectional matched-pairs survey of 70 husband-and-wife farmer dyads, who lived in rural communities in Ntcheu district, and had a live birth in the past year was conducted. Data were collected using an interviewer-administered, structured postpartum questionnaire adapted from WHO Safe Motherhood Needs Assessment Questionnaires. Many husbands did not know about postpartum assessments and education their wives received from health facilities. Percent agreement between dyads' responses was lower on questions referring to assessments than to education. The odds of reporting that the woman received postpartum assessments were greater among husbands than among wives. Fifty-nine percent of husbands did not go with their wives for 1-week postpartum visits. Top three reasons for not attending visits were: at work, out of town, and did not see the need.