Orientation and mobility outcome measures

Despite orientation and mobility (O&M) being a significant factor determining quality of life of people with low vision or blindness, there are no gold standard measures or agreement on how to measure O&M performance. In the first part of this systematic review, an inventory of O&M outcome measures used by recent studies to assess the performance of orientation and/or mobility of adults with vision impairment (low vision and blindness) is presented. A wide variety of O&M outcome measures have been implemented in different fields of study, such as epidemiologic research and interventional studies evaluating training, assistive technology, vision rehabilitation and vision restoration. The most frequent aspect of outcome measures is efficiency such as time, distance, speed and percentage of preferred walking speed, followed by obstacle contacts and avoidance, and dis/orientation and veering. Other less commonly used aspects are target identification, safety and social interaction and self-reported outcome measures. Some studies employ sophisticated equipment to capture and analyse O&M performance in a laboratory setting, while others carry out their assessment in real-world indoor or outdoor environments. In the second part of this review, the appropriateness of implementing the identified outcome measures to assess O&M performance in clinical and functional O&M practice is evaluated. Nearly a half of these outcome measures meet all four criteria of face validity (either clinical or functional), responsiveness, reliability and feasibility and have the potential to be implemented in clinical or functional O&M practice. The findings of this review confirm the complicated and dynamic nature of O&M. Multiple measures are required in any evaluation of O&M performance to facilitate holistic assessment of O&M abilities and limitations of each individual.     

Effects on Smokers of Exposure to Graphic Warning Images

Background and Objectives : Several countries have introduced graphic warning images aimed at discouraging smoking. The objective of this study was to evaluate the impact on smokers of graphic warnings showing cosmetically important harm caused by smoking. Methods : Fifty‐six adult smokers were randomly assigned to view either written smoking warnings or the same written warnings with related graphic images. The smokers viewed the warnings at a rate of one per week for 4 weeks. The smokers were assessed before and after the warnings with regard to stage of change toward smoking cessation and level of smoking. Results : The randomized control trial showed that the warnings with graphic images led to significantly more progress in stage of change toward smoking cessation than written warnings alone. However, the images did not lead to decreases in smoking rates. Conclusions and Scientific Significance : The results indicate that written smoking warnings accompanied by images of cosmetically important harm caused by smoking have more potential than warnings alone in prompting changes in the direction of quitting. (Am J Addict 2012;21:555–557)     

Online scan of FASD prevention and health promotion resources for Aboriginal and Torres Strait Islander communities

Issue addressed

Foetal Alcohol Spectrum Disorder (FASD) includes a range of life‐long impairments caused by alcohol exposure in utero. Health professionals are vital to preventing FASD but many are hesitant to discuss FASD with clients due to their need for additional resources to aid the conversation. This scan sought to identify the scope and gaps in publicly available FASD prevention and health promotion resources, and assess their cultural appropriateness for use among five key groups of Indigenous Australian people including: (i) pregnant women, (ii) women of childbearing age, (iii) grandmothers and aunties, (iv) men, and (v) health professionals.

Methods

Relevant resources published 1995‐2017 were identified through the Australian Indigenous HealthInfoNet, FASD organisation websites, grey literature, Google searches, and field experts. Results were screened by inclusion and cultural appropriateness criteria developed and piloted by the research team, and further screened by health professionals attending FASD training workshops.

Results

115 of the 2146 identified resources were eligible. Relevant resources were found for all five key groups; however, no resources were specifically designed for men, grandmothers or aunties.

Conclusions

A range of high‐quality, culturally appropriate resources were identified, however, health professionals attending the training workshops were not aware of their availability. Further resource development is suggested for men, grandmothers and aunties.

So what?

Prioritisation of active dissemination and implementation strategies is suggested to increase awareness and use of future resource developments. The inclusion of a resource trial among health professionals is a recommended strategy to increase awareness and use of newly developed resources.

     

The Role of Behavioral,Normative and Control Beliefs in Breast Self-Examination

ABSTRACT

Context: A limited number of studies have been conducted examining the role of beliefs in the prediction of breast self-examination (BSE) behavior in Australian women, particularly women under 50 years of age for which it is the primary method of early detection of breast cancer.

Objective: The present research investigated the differences in behavioral, normative and control beliefs between BSE performers and non-performers, within a theory of planned behavior framework, to assist in the development of specific education programs aimed at increasing BSE amongst this demographic group.

Method: Two hundred and fifty-three women enrolled in an undergraduate psychology course completed a questionnaire assessing beliefs regarding BSE. One month later, these women reported their BSE behavior during the previous month. Multivariate analyses were performed to identify belief-based differences between BSE performers and non-performers.

Results: Underlying behavioral and control, but not normative, beliefs about BSE distinguished between BSE performers and non-performers. Performers were more likely than non-performers to believe that engaging in BSE would be associated with identifying a lump or breast change sooner and detecting a breast cancer earlier in its course. Non-performers were more likely to perceive factors such as forgetting to perform the behavior, lack of time, lack of knowledge about how to perform the behavior, laziness, and a lack of confidence in their ability to identify lumps and breast changes as factors preventing their control over the performance of BSE.

Conclusions: The belief-based differences between BSE performers and non-performers found in this study can be used to inform health promotion strategies aimed at increasing BSE behavior in women less than 50 years of age.     

Medical tests: women's reported and preferred decision-making roles and preferences for information on benefits, side-effects and false results

Objective To determine women's preferences for and reported experience with medical test decision‐making. Design Computer‐assisted telephone survey. Setting and participants Six hundred and fifty‐two women resident in households randomly selected from the New South Wales electronic white pages. Main outcome measures Reported and preferred test and treatment (for comparison) decision‐making, satisfaction with and anxiety about information on false results and side‐effects; and effect of anxiety on desire for such information. Results Overall most women preferred to share test (94.6%) and treatment (91.2%) decision‐making equally with their doctor, or to take a more active role, with only 5.4–8.9% reporting they wanted the doctor to make these decisions on their behalf. This pattern was consistent across all age groups. In general, women reported experiencing a decision‐making role that was consistent with their preference. Women who had a usual doctor were more likely to report experiencing an active role in decision‐making. More women reported receiving as much information as they wanted about the benefits of tests and treatment than about the side‐effects of tests and treatment. Most women wanted information about the possibility of false test results (91.5%) and test side‐effects (95.6%), but many reported the doctor never provided this information (false results = 40.0% and side‐effects = 31.3%). A substantial proportion said this information would make them anxious (false results = 56.6% and side‐effects = 43.1%), but reported they wanted the information anyway (false results = 77.6% and side‐effects = 88.1%). Conclusions Women prefer an active role in test and treatment decision‐making. Many women reported receiving inadequate information. If so, this may jeopardize informed decision‐making.