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Association of the built environment and neighborhood resources with obesity-related health behaviors in older veterans with hypertension

Albanese, Natalie N Y; Lin, Iris; Friedberg, Jennifer P; Lipsitz, Stuart R; Rundle, Andrew; Quinn, James W; Neckerman, Kathryn M; Nicholson, Andrew; Allegrante, John P; Wylie-Rosett, Judith; Natarajan, Sundar
OBJECTIVE:To evaluate the association of the built environment and neighborhood resources with exercise, diet, and body mass index (BMI). METHOD/METHODS:Person-level data were collected from 533 veterans with uncontrolled hypertension. Neighborhood measures were: (a) census-tract level walkability; and (b) healthy food proximity (HFP). Robust or logistic regression (adjusting for age, race, education, comorbidity, and clustered by provider) was used to evaluate associations between neighborhood and exercise duration (hours/week), exercise adherence (% adherent), saturated fat index (0-10), Healthy Eating Index (HEI; 0-100), HEI adherence (≥ 74 score), stage of change (SOC) for exercise and diet (% in action/maintenance), BMI (kg/m²), and obesity (BMI ≥ 30 kg/m²). RESULTS:= .034. CONCLUSIONS:Geographical location is associated with exercise and diet. Environment-tailored health recommendations could promote healthier lifestyles and decrease obesity-related cardiovascular disease. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMID: 35389690
ISSN: 1930-7810
CID: 5191262

Validity and reliability of a short self-efficacy instrument for hypertension treatment adherence among adults with uncontrolled hypertension

Zhao, Matthew; Rodriguez, Maria A; Wang, Binhuan; Santa Ana, Elizabeth J; Friedberg, Jennifer; Fang, Yixin; Allegrante, John P; Natarajan, Sundar
OBJECTIVE:To establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence. METHODS:This investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach's α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's ρ correlation coefficients. RESULTS:Cronbach's α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability. CONCLUSION/CONCLUSIONS:The SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension. PRACTICE IMPLICATIONS/CONCLUSIONS:This SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension.
PMID: 33516592
ISSN: 1873-5134
CID: 4775092

Sustained Benefit of Alternate Behavioral Interventions to Improve Hypertension Control: A Randomized Clinical Trial

Rodriguez, Maria Antonia; Wang, Binhuan; Hyoung, Sangmin; Friedberg, Jennifer; Wylie-Rosett, Judith; Fang, Yixin; Allegrante, John P; Lipsitz, Stuart R; Natarajan, Sundar
[Figure: see text].
PMID: 33979183
ISSN: 1524-4563
CID: 4864532

A Tailored Behavioral Intervention to Promote Adherence to the DASH Diet

Rodriguez, Maria Antonia; Friedberg, Jennifer P; DiGiovanni, Ana; Wang, Binhuan; Wylie-Rosett, Judith; Hyoung, Sangmin; Natarajan, Sundar
Objectives: In this study, we evaluated the effects of a Transtheoretical model (TTM)-based tailored behavioral intervention (TBI), a non-tailored intervention (NTI) or usual care (UC) on: (1) the Dietary Approaches to Stop Hypertension (DASH) dietary pattern in 533 individuals with uncontrolled hypertension; and (2) the change from baseline to 6 months in proportion of participants in action or maintenance stages of change (SOC). Methods: This was a randomized clinical trial. Diet was evaluated using the validated Harvard DASH score calculated from Willett Food Frequency Questionnaires (range 8-40). The randomized groups were compared using the Wilcoxon rank-sum test, with adjustment for clustering by physician and baseline DASH scores. Results: At 6 months, compared to UC, TBI had a 1.28 point increase in DASH score (p ≤ .01) while NTI was not significant. At 6-month follow-up, TBI was more effective in advancing dietary SOC when compared to UC (56% vs 43%, p < .01) and NTI was not effective (46% vs 43%, p = .64). Conclusions: A phone-delivered tailored TTM-based intervention achieved greater improvement in DASH score and dietary SOC, suggesting that TTM-based tailored interventions can increase patients' dietary adherence.
PMID: 31239010
ISSN: 1945-7359
CID: 3963642

SUSTAINABILITY OF A TAILORED BEHAVIORAL INTERVENTION TO IMPROVE HYPERTENSION CONTROL: OUTCOMES OF A RANDOMIZED CONTROLLED TRIAL [Meeting Abstract]

Rodriguez, Maria Antonia; Friedberg, Jennifer P; Wang, Binhuan; Fang, Yixin; Natarajan, Sundar
ISI:000358386901097
ISSN: 1525-1497
CID: 2711372

ASSOCIATION OF THE BUILT ENVIRONMENT AND NEIGHBORHOOD RESOURCES WITH OBESITY-RELATED HEALTH BEHAVIOR [Meeting Abstract]

Albanese, Natalie N; Friedberg, Jennifer P; Rundle, Andrew; Quinn, James; Neckerman, Kathryn; Lipsitz, Stuart R; Natarajan, Sundar
ISI:000358386900142
ISSN: 1525-1497
CID: 1730002

Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial

Friedberg, Jennifer P; Rodriguez, Maria A; Watsula, Michelle E; Lin, Iris; Wylie-Rosett, Judith; Allegrante, John P; Lipsitz, Stuart R; Natarajan, Sundar
Blood pressure (BP) control rates are suboptimal. We evaluated the effectiveness of 2 behavioral interventions to improve BP control via a 3-arm, randomized controlled trial of 533 adults with repeated uncontrolled BP, despite antihypertensive drug treatment for >/=6 months. The interventions were a tailored stage-matched intervention (SMI) or a nontailored health education intervention (HEI) of 6 monthly calls targeting diet, exercise, and medication. Control was usual care (UC). There were no baseline group differences. Baseline BP control was 42.6%, 40.6%, and 44.6% in SMI, HEI, and UC (P=0.74), respectively; systolic BP (with SEs) was 136 (0.89), 137 (1.33), and 137 (0.96) mm Hg. Six-month control was 64.6% (SMI), 54.3% (HEI), and 45.8% (UC) (P values for pairwise comparisons versus UC, 0.001 [SMI] and 0.108 [HEI]). At 6 months, systolic BP (SE) was 131.2 (1.05), 131.8 (0.99), and 134.7 (1.02) for SMI, HEI, and UC, respectively (P values for pairwise comparisons versus UC, 0.009 for SMI and 0.047 for HEI). SMI led to lower systolic BP and better BP control than UC. SMI constitutes a new, potent approach to assist patients with uncontrolled hypertension to reach BP goals. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00286754.
PMID: 25403606
ISSN: 0194-911x
CID: 1459662

Forgiveness and health in patient populations

Chapter by: Friedberg, Jennifer P; Tuvia, Hillary Lewin; Cha, Rose
in: Forgiveness and health : scientific evidence and theories relating forgiveness to better health by Toussaint, Loren L; Worthington, Everett L Jr [Eds]
New York : Springer, 2015
pp. -
ISBN: 978-94-017-9992-8
CID: 1910182

EFFECT OF BEHAVIORAL INTERVENTIONS ON NOVEL CARDIOVASCULAR RISK FACTORS IN DIABETES [Meeting Abstract]

Friedberg, Jennifer P; Rodriguez, Maria Antonia; Jung, Sangmin; Wang, Binhuan; Begum, Rohima; Gelinas, Michael; Steinberg, Rachel; Natarajan, Sundar
ISI:000367825001222
ISSN: 1532-4796
CID: 2049012

IMPACT OF A QUALITY IMPROVEMENT PROGRAM ON QUALITY OF LIFE IN HEART FAILURE: THE VALOR IN HEART FAILURE STUDY [Meeting Abstract]

Friedberg, Jennifer P; Jung, Sangmin; Begum, Rohima; Rodriguez, Maria Antonia; Wang, Binhuan; Fang, Yixin; Natarajan, Sundar
ISI:000334408301150
ISSN: 1532-4796
CID: 2537562