Brief, cost-effective interventions to promote diabetes self-management are needed. This study evaluated the effects of a brief, regular, proactive, telephone "coaching" intervention delivered by paraprofessionals on diabetes adherence, glycemic control, diabetes-related medical symptoms, and depressive symptoms. Therapeutic mechanisms underlying the intervention's effect on the primary outcomes were also examined. Adults diagnosed with type 2 diabetes (N = 62) were randomly assigned to receive the "coaching" intervention and treatment as usual, or only treatment as usual. The intervention increased frequency of exercise and feet inspection, improved diet, reduced diabetes medical symptoms, and lowered depressive symptoms. Self-efficacy, reinforcement, and awareness of self-care goals mediated the treatment effect on depression, exercise, and feet inspection, respectively. A brief telephone intervention delivered by paraprofessionals had positive effects on type 2 diabetes patients.

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Inconsistency in operationally defining sleep efficiency (SE) creates confusion with regard to the conceptualization and use of the construct by researchers and clinicians. The source of the inconsistency is the denominator of the widely published operational definition of SE: ratio of total sleep time (TST) to time in bed (TIB) (multiplied by 100 to yield a percentage). When taken literally, TIB includes non-sleep-related activity (e.g., reading, texting, conversing with a partner, watching television) both prior to initiating sleep and after the final awakening. However, the construct of SE refers to TST compared to the amount of time spent attempting to initially fall asleep and sleep discontinuity. Non-sleep related activities in bed do not reflect that construct. Also, time out of bed during nighttime awakenings, a manifestation of sleep discontinuity, should be included in the SE denominator. Using TIB as the denominator can also create a methodological problem when SE is an outcome measure in sleep intervention research. It is proposed that research and practice would benefit by clarifying and adopting a consistent operational definition that more accurately captures the construct of SE. An alternate denominator, duration of the sleep episode (DSE), is suggested, where DSE = sleep onset latency (SOL) + TST + time awake after initial sleep onset but before the final awakening (WASO) + time attempting to sleep after final awakening (TASAFA). The proposed formula for SE would be: SE = TST / DSE (× 100). DSE can be easily calculated using standard sleep diary entries along with one item from the Expanded Consensus Sleep Diary. Implications for insomnia research and practice are discussed.

Two studies investigated the domain of attitudes about condom use as an AIDS-relevant behavior and their relation to serf-reported condom use, past and intended. In so doing, the Condom Attitude Scale (CAS) was developed. Subjects for both studies (n = 248, n = 528) were undergraduates, primarily heterosexual. Factor analysis of the initial item pool indicated 8 attitude factors (subscales). The total CAS, its subscales, and measures of condom use had high internal consistency. The total CAS and the majority of subscales explained a substantial amount of variance in condom use and in carrying and keeping condoms at home. Gender was unrelated to past and intended condom use. However, despite having generally more positive attitudes about condoms, women were more inhibited about buying and keeping condoms and were less likely to do so. Test-retest and cross-validation analyses revealed, for the most part, consistent findings.

Considerable evidence links depression with the development and worsening of diabetes, but the factors contributing to this link have not been established. The authors examined the role of adherence, body mass index (BMI), and self-efficacy. Adult patients with Type 2 diabetes (N = 56) completed self-report measures of diet and exercise adherence, diet and exercise self-efficacy, and depression. BMI was obtained from medical records. Path and mediation analyses indicated that both adherence and BMI independently contributed to self-efficacy. Self-efficacy mediated both the association between adherence and depression and the association between BMI and depression. These findings are consistent with the proposal that lower self-efficacy in reaction to adherence failure and higher BMI contributes to depression in adults with diabetes.