Longitudinal research is needed to improve understanding of the directionality of effects. Efforts need to concentrate on how best to make inroads in terms of primary and secondary prevention.

ObjectivesWe examined nurse practitioners’ use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes.MethodsA 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010. Use of communication techniques and opinions about their effectiveness were analyzed using descriptive statistics. General linear models explored provider and practice characteristics to predict differences in the total number and the mean number of communication techniques routinely used in a week.ResultsMore than 80% of NPs (N = 194) routinely used 3 of the 7 basic communication techniques: simple language, limiting teaching to 2–3 concepts, and speaking slowly. More than 75% of respondents believed that 6 of the 7 basic communication techniques are effective. Sociodemographic provider characteristics and practice characteristics were not significant predictors of the mean number or the total number of communication techniques routinely used by NPs in a week. Potential predictors for using more of the 7 basic communication techniques, demonstrating significance in one general linear model each, were: assessing the office for user-friendliness and ever taking a communication course in addition to nursing school.ConclusionsNPs in Maryland self-reported routinely using some recommended health-literate communication techniques, with belief in their effectiveness. Our findings suggest that NPs who had assessed the office for patient-friendliness or who had taken a communication course beyond their initial education may be predictors for using more of the 7 basic communication techniques. These self-reported findings should be validated with observational studies. Graduate and continuing education for NPs should increase emphasis on health-literate and patient-centered communication techniques to increase patient understanding of dental caries prevention. Non-dental healthcare providers, such as NPs, are uniquely positioned to contribute to preventing early childhood dental caries through health-literate and patient-centered communication.

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While past research has examined the deleterious effects of racism on Asian Americans, fewer studies have investigated lesbian, gay, bisexual, and transgender (LGBT) Asian Americans' unique experiences of oppression and unbelonging within the broader LGBT community. Guided by intersectionality and minority stress theoretical frameworks, the present study examined the effect of discomfort due to one's race/ethnicity within the LGBT community on psychological well-being in a national sample of 480 LGBT Asian Americans from the Social Justice Sexuality Project. The moderating role of how important one considered their race/ethnicity to their identity was also examined. Regression analyses revealed that greater discomfort due to one's race/ethnicity within the LGBT community was associated with reduced psychological well-being for LGBT Asian Americans who viewed their racial/ethnic identity as moderately or highly important, whereas this association was not significant for LGBT Asian Americans who considered their racial/ethnic identity as less important. These findings highlight the necessity of examining the role of racial/ethnic discomfort in relation to LGBT Asian Americans' psychological wellbeing, as well as the extent to which LGBT Asian Americans consider their race/ethnicity as important. What is the public significance of this article?This study uses a national sample of LGBT Asian Americans to show that experiencing discomfort due to one's race/ethnicity within the LGBT community is associated with reduced psychological wellbeing. The effect of racial/ethnic discomfort for LGBT Asian Americans may also depend on how important they consider their race/ethnicity.

The purpose of this study was to extend the initial evaluation of the Yale Physical Activity Survey to assess physical activity in older adults. The survey yields three indicators of physical activity reflecting activities performed during a typical week of the previous month (Total Time, Total Energy Expenditure) and the past month (Total Activity Summary Index). Questionnaire validity was studied in 56 men and women, ages 56 to 86 years, by comparing the average of 3- or 7 day 24-hr. physical activity records (n=56), predicted maximal oxygen consumption (VO2 max) (n = 23) and the sum of three skinfold measurements. Two-week repeatability was estimated by calculating an intraclass coefficient using an analysis of variance with repeated measures. Spearman rhos were used to study questionnaire validity. Analysis showed the survey was easily administered and scored and exhibited moderate-to-good repeatability. For the first administration the Total Energy Expenditure Index was significantly associated with the physical activity diary (r = .27). On the second administration, correlations were significant for the physical activity diary with the Total Energy Expenditure Index (r = .30), the Total Activity Summary Index (r = .36), and the Total Time Index (r = .27), and for VO2 max and the Total Time Index (r = .49) and Total Activity Summary Index (r = .64). Relative to the criterion measures used in this study, some validity was evident for the second administration in this relatively active and healthy sample of older adults.