To clarify the relationships between physical, and psychosocial components of chronic pain, a path analytic model was tested conceptualizing self efficacy as a mediator of disability. In turn, disability was hypothesized to mediate depression. This model could help explain the circumstances under which disability develops and why so many chronic pain patients become depressed. Questionnaires from 126 chronic pain patients (without prior depression) were reviewed from three pain clinics. Hypothesized and alternate models were tested using separate regression equations to identified models which best fit these data. Regression analysis supported that self efficacy partially mediates the relationship between pain intensity and disability. This model accounted for 47% of the explained variance in disability (P < 0.001). Six additional variables that were significantly related to disability in preliminary analysis, added to the explained variance in disability (R2 = 0.56), with gender and pain location paths remaining significant. In separate regression analyses, disability was found to partially mediate the relationship between pain intensity and depression (b = 0.47-0.33). This model accounted for 26% of the explained variance in depression. The addition of self efficacy to this model supported it as a stronger mediator (R2 = 0.32), and suggested that support for disability as a mediator of depression was a spurious finding. Both pain intensity and self efficacy contribute to the development of disability and depression in patients with chronic pain. Therefore, the lack of belief in ones own ability to manage pain, cope and function despite persistent pain, is a significant predictor of the extent to which individuals with chronic pain become disabled and/or depressed. Nevertheless, these mediators did not eliminate the strong impact that high pain intensity has on disability and depression. Therefore, therapy should target multiple goals, including: pain reduction, functional improvement and the enhancement of self efficacy beliefs.

This article presents data in support of the reliability and validity of afour-item measure of acculturationfor Hispanics. The study has three strengths. First, this brief measure is evaluated with a probability sample of Hispanic adolescents and young adults (ages 15-24 years) living in urban, low-income households. Second, the sample contains both second-and third-generation Puerto Rican and Mexican American adolescents and young adults. Third, the acculturation measure was administeredas part ofaface-to-face interview. The four-item acculturation scale correlated highly with generation, length of time in the United States, subjective evaluation of acculturation, country of birth, and language chosen for the interview. The psychometric properties of this brief scale are comparable to those obtained for other published scales. Results support the use of this four-item measure of acculturation as a simple, inexpensive measure that involves minimal respondent burden.

The Demands of Immigration Scale (DI) measures demands associated with immigration, including loss, novelty, occupational adjustment, language accommodation, discrimination, and not feeling at home in the resettlement country. The DI scale was evaluated in a sample of 1,647 immigrants from the former Soviet Union who had resided in the United States from a few months to 20 years. Confirmatory factor analysis supported the proposed factor model. The DI subscales were internally consistent and had good test-retest reliability. Support for concurrent validity was demonstrated by correlations in the expected direction between the DI total and subscale scores and measures of depression and somatization. Support for discriminant validity was demonstrated by mean group differences in some or all of the DI dimensions according to age and years in the United States.

This article reports the relationships between resilience, demographic characteristics, immigration demands, and depression in a sample of 450 adult Russian immigrants to Israel. Contrary to theories of how resilience is related to psychological outcomes, no support was found for resilience modifying or mediating the relationship between the demands of immigration and depression. Resilience did, however, increase the risk of not being depressed by about two-fold (p < .0001).

Nurses can use this evidence to discuss potential benefits of health promotion mobile apps with parents, children, and adolescents to combat childhood obesity.

No abstract

No abstract

BACKGROUND Research suggests that adolescents can use peer resistance skills to avoid being pressured into risky behavior, such as early sexual behavior. Avatar-based Virtual Reality (AVR) technology offers a novel way to build these skills. OBJECTIVES Study aims were to: evaluate the feasibility of an AVR peer resistance skill building game (DRAMA-RAMA™); explore the impact of game play on peer resistance self-efficacy; and assess how positively the game was perceived. METHOD 45 low income early adolescent Hispanic girls were randomly assigned to either the intervention (DRAMA-RAMA™) or comparison game (Wii Dancing with the Stars™ [Wii DWTS™]) condition. All participants were offered a 5 session curriculum that included peer resistance skill content before playing their respective game for 15 minutes, once a week, for two weeks. Participants completed electronic surveys assessing demographics, peer resistance self-efficacy, and sexual behavior at baseline, after game play, and at 2 months. They also completed a paper-pencil game experience questionnaire immediately after playing their game. Data were analyzed using descriptive statistics, chi-square, and analyses of covariance. RESULTS The separate analyses of covariance showed a significant game effect at post-test for the peer resistance self-efficacy measure (F = 4.21, p < 0.05), but not at follow-up (F = 0.01, p = 0.92). DRAMA-RAMA™ was rated as positively as the Wii DWTS™ (p ≥ .26). DISCUSSION This randomized control trial provides initial support for the hypothesis that playing an AVR technology game can strengthen peer resistance skills, and early adolescent Hispanic girls will have a positive response to this game.