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Biomedical subjects

Vicki S Conn

Publications and source records attributed to Vicki S Conn.

14 recordsLinked to original sources
PubMed2003

Research methods: managing primary study quality in meta-analyses.

Meta-analyses synthesize multiple primary studies and identify patterns of relationships. Differences in primary study methodological quality must be addressed for meta-analysis to produce meaningful results. No single standard exists for addressing these quality variations. Quality measurement scales are fraught with development and application problems. Several strategies have been proposed to address quality. Researchers can set minimum levels for inclusion or require that certain quality attributes be present. An inclusive method is to weight effect sizes by quality scores. This allows the inclusion of diverse studies but relies on questionable quality measures. By considering quality an empirical question, meta-analysts can examine associations between quality and effect sizes and thus preserve the purpose of meta-analysis to systematically examine data. Researchers increasingly are combining strategies to overcome the limitations of using a single approach. Future work to develop valid measures of primary study quality dimensions will improve the ability of meta-analysis to inform research and nursing practice.

Meta-Analysis as Topic↗
PubMed2003

Health belief model and reversal theory: a comparative analysis.

BACKGROUND: In recent years, an increasing number of nurses have demonstrated interest in health behaviour change interventions and research. Despite this heightened enthusiasm, there appears to have been less interest in exploring new and emerging health behaviour change theories. AIM: The goal of this work is to assist clinicians and researchers to make more informed choices about the use of the Health Belief Model and Reversal Theory in their practice settings and research projects. METHOD: Primary sources were analysed using qualitative data analysis methods in order to compare and contrast the two models. Four comparative categories provided the structure for analysis: origins of models, ways of knowing and behaving, role of health care providers in behaviour change, and desired outcomes. RESULTS: Based, in part, on their historical origins, the Health Belief Model and Reversal Theory offer differing tenets regarding how individuals perceive, understand, and behave. According to Reversal Theory, ways of knowing and behaving are dependent upon innate physiological factors and subjectively structured perceptions. In contrast, the Health Belief Model suggests that health-related behaviours are largely attributable to cognitive decision-making processes. As such, health care providers are directed to approach health behaviour change in different ways. CONCLUSIONS: Although the Health Belief Model has been widely implemented, Reversal Theory may offer a more comprehensive framework for health behaviour change interventions and research. Clinicians and researchers are urged to learn more about this theory and how it may apply to their areas of practice and research.

Attitude to Health↗
PubMed2003

Integrative review of physical activity intervention research with aging adults.

This paper reviews randomized, controlled trials (RCTs) that have attempted to increase physical activity behavior by aging adults. A systematic review was necessary because numerous studies target older adults, and previous reviews have addressed a limited range of primary studies. Computerized database, ancestry, and extensive search strategies by authors of research reported in English between 1960 and 2000 located diverse intervention trials. RCTs reporting endurance physical activity or exercise behavioral outcomes for at least five subjects were included. Integrative review methods were used to summarize extant research. Forty-two studies were retrieved. Seventeen RCTs with 6,391 subjects were reviewed. A wide variety of intervention strategies were reported. The most common interventions were self-monitoring, general health education, goal setting, supervised center-based exercise, problem solving, feedback, reinforcement, and relapse prevention education. Few studies individually adapted motivational interventions, used mediated intervention delivery, or integrated multiple theoretical frameworks into the intervention. Links between individual intervention components and effectiveness were not clear. Common methodological weaknesses included small samples, untested outcome measures, and time-limited longitudinal designs. Significant numbers of aging adults increased their physical activity in response to experimental interventions. The amount of increased activity rarely equaled accepted behavior standards to achieve positive health outcomes. Further work is essential to identify successful strategies to increase activity by larger numbers of elders and to accelerate the increase in activity by those who change activity behaviors. Sex and ethnic differences need further investigation. There is a vital need for rigorously designed studies to contribute to this science.

Aged↗
PubMed2003

Medication-taking beliefs of adult renal transplant recipients.

PURPOSE: To describe the medication-taking beliefs of younger and older adult renal transplant recipients. METHOD: A descriptive design was used to study 16 adult renal transplant recipients, 8 older and 8 younger, recruited from a renal transplant program in the midwest. A semistructured interview was conducted based on the theory of planned behavior. Data were examined using manifest content analyses. RESULTS: Both groups had similar behavioral, normative, control, and problem-solving medication-taking beliefs. Planning ahead, organizing, using cues, involving a support person, and remembering the donor and life on dialysis were key control beliefs. Differences were found in beliefs regarding difficulties with taking immunosuppressive medications. The majority in both groups mentioned forgetting to take their immunosuppressive medications on at least one occasion. CONCLUSIONS/APPLICATION: As empiric evidence in this area grows, the clinical nurse specialist is paramount in assisting both younger and older renal transplant recipients with immunosuppressive medication taking and, consequently, in fostering better outcomes.

Adult↗
PubMed2003

Beyond MEDLINE for literature searches.

PURPOSE: To describe strategies for a comprehensive literature search. ORGANIZING CONSTRUCT: MEDLINE searches result in limited numbers of studies that are often biased toward statistically significant findings. Diversified search strategies are needed. METHODS: Empirical evidence about the recall and precision of diverse search strategies is presented. Challenges and strengths of each search strategy are identified. FINDINGS: Search strategies vary in recall and precision. Often sensitivity and specificity are inversely related. Valuable search strategies include examination of multiple diverse computerized databases, ancestry searches, citation index searches, examination of research registries, journal hand searching, contact with the "invisible college," examination of abstracts, Internet searches, and contact with sources of synthesized information. CONCLUSIONS: Extending searches beyond MEDLINE enables researchers to conduct more systematic comprehensive searches.

Computer User Training↗
PubMed2002

Interventions to increase physical activity among aging adults: a meta-analysis.

OBJECTIVES: This review applied meta-analytic procedures to integrate primary research findings that test interventions to increase activity among aging adults. METHODS: We performed extensive literature searching strategies and located published and unpublished intervention studies that measured the activity behavior of at least five participants with a mean age of 60 years or greater. Primary study results were coded, and meta-analytic procedures were conducted. RESULTS: The overall effect size, weighted by sample size, was d(w) = .26 +/- .05. Effect sizes were larger when interventions targeted only activity behavior, excluded general health education, incorporated self-monitoring, used center-based exercise, recommended moderate intensity activity, were delivered in groups, used intense contact between interventionists and participants, and targeted patient populations. Effect sizes were larger for studies that measured exercise duration and studies with a time interval of less than 90 days between intervention and behavior measurement. CONCLUSIONS: These findings suggest that group-delivered interventions should encourage moderate activity, incorporate self-monitoring, target only activity, and encourage center-based activity. Findings also suggest that patient populations may be especially receptive to activity interventions. Primary research testing interventions in randomized trials to confirm causal relationships would be constructive.

Adult↗
PubMedDate not supplied

Are there different predictors of distinct exercise components?

Rehabilitation nurses often recommend to aging adults that they exercise. Despite the recommendations and the widespread evidence of its benefits, few older adults exercise. This study examined the predictors of distinct components of exercise behavior: exercise intensity, frequency per week, duration of sessions, and months per year. Social cognitive theory predictors of exercise were measured with previously developed instruments. Interviews were conducted with community-dwelling elders (N = 147). The study constructs accounted for modest to moderate amounts of variance (41% of months per year, 35% of frequency, 35% of exercise intensity, and 20% of episode duration). Self-efficacy was the most important predictor of each construct, with Beta weights ranging from .23 to .53. Barriers significantly predicted months' per year, frequency per week, and exercise intensity, but not the duration of individual exercise sessions. Outcome expectancy predicted only exercise intensity. These findings support the importance of self-efficacy and perceived barriers for most components of exercise behavior.

Aged↗
PubMedDate not supplied

Older women and exercise: explanatory concepts.

BACKGROUND: Older women remain predominantly sedentary despite potential health benefits and reduced risks of cardiovascular disease associated with regular exercise. Primary care interventions to increase exercise need to focus on constructs amenable to intervention that predict exercise behavior. PURPOSE: The study tested an explanatory model of older women's exercise behavior using concepts from social cognitive theory, the transtheoretical model, and the theory of planned behavior (self-efficacy, outcome expectancy, perceived exercise barriers, processes of change, perceived health, and age). METHODS: Data were collected by interviews with 203 older community-dwelling women physically capable of some exercise. Ordinary least squares regression results were used to determine the direct and indirect effects in a path model. FINDINGS: All concepts and 13 hypothesized paths were retained in the trimmed model. The constructs accounted for 46% of the variance in exercise behavior. Outcome expectancy had the largest total effect. Processes of change had the largest direct effect on exercise behavior. Exercise self-efficacy and perceived exercise barriers accounted for similar amounts of variance in exercise behavior, whereas age and health had only modest effects. CONCLUSION: Important constructs for future exercise model testing and intervention research should include outcome expectancy, processes of change, exercise self-efficacy, and perceived barriers to exercise. Primary care interventions designed to increase older women's exercise should focus on these same constructs.

Aged↗
PubMedDate not supplied

Older women and exercise: theory of planned behavior beliefs.

Despite well-documented benefits of exercise, aging women remain largely sedentary. Further understanding of beliefs associated with exercise could result in more-effective public health interventions to increase exercise in this vulnerable population. This study examined the relationships between theory of planned behavior constructs and exercise behavior and exercise intention in older women. Constructs from the theory of planned behavior (behavioral beliefs, perceived control beliefs, and normative beliefs) were examined in a sample of 225 women aged 65 and older. Exercise was measured with the Baecke Physical Activity Scale. All women were interviewed, to prevent literacy and vision problems from hampering participation. Significant predictors of exercise behavior were perceived control beliefs and behavioral beliefs. Significant predictors of exercise intentions were perceived control beliefs, behavioral beliefs, and normative beliefs. Specific belief items predicting exercise behavior were that exercise is good for health and that exercise is difficult because of tiredness, as well as the lack of commitment and time. These findings provide partial support for the application of the theory of planned behavior to exercise in older women. The findings suggest that interventions should focus on increasing women's confidence that they can overcome barriers to exercise.

Aged↗
PubMedDate not supplied

Grey literature in meta-analyses.

BACKGROUND: In meta-analysis, researchers combine the results of individual studies to arrive at cumulative conclusions. Meta-analysts sometimes include "grey literature" in their evidential base, which includes unpublished studies and studies published outside widely available journals. Because grey literature is a source of data that might not employ peer review, critics have questioned the validity of its data and the results of meta-analyses that include it. OBJECTIVE: To examine evidence regarding whether grey literature should be included in meta-analyses and strategies to manage grey literature in quantitative synthesis. METHODS: This article reviews evidence on whether the results of studies published in peer-reviewed journals are representative of results from broader samplings of research on a topic as a rationale for inclusion of grey literature. Strategies to enhance access to grey literature are addressed. RESULTS: The most consistent and robust difference between published and grey literature is that published research is more likely to contain results that are statistically significant. Effect size estimates of published research are about one-third larger than those of unpublished studies. Unfunded and small sample studies are less likely to be published. Yet, importantly, methodological rigor does not differ between published and grey literature. CONCLUSIONS: Meta-analyses that exclude grey literature likely (a) over-represent studies with statistically significant findings, (b) inflate effect size estimates, and (c) provide less precise effect size estimates than meta-analyses including grey literature. Meta-analyses should include grey literature to fully reflect the existing evidential base and should assess the impact of methodological variations through moderator analysis.

Information Dissemination↗
PubMedDate not supplied

Randomized trial of 2 interventions to increase older women's exercise.

OBJECTIVE: To test 2 interventions to increase older women's physical activity. METHODS: A randomized 2-way factorial experimental design compared the effects of 2 limited-contact interventions, motivational sessions and periodic prompts, among 190 women. Experimental participants received a 3-encounter motivational intervention. Those randomized to prompts received weekly telephone or mail-delivered cues. RESULTS: The prompting intervention consistently increased exercise and physical activity scores. The motivational intervention did not affect outcome scores. CONCLUSIONS: Prompting is a low-cost strategy for increasing exercise and physical activity among older women. Future research should examine alternative modes for prompt delivery.

Aged↗