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Article: Recent experiences of weight-based stigmatization in a weight loss surgery population: psychological and behavioral correlates.

Friedman, Kelli E / Ashmore, Jamile A / Applegate, Katherine L

2008 Volume 16 Suppl 2, Page(s) S69–74

Abstract: Objective: This study evaluated the association between experiences of weight-based stigmatization (e.g., job discrimination, inappropriate comments from physicians) within the past month, psychological functioning, and binge eating among a sample of ... ...

Abstract	Objective: This study evaluated the association between experiences of weight-based stigmatization (e.g., job discrimination, inappropriate comments from physicians) within the past month, psychological functioning, and binge eating among a sample of individuals seeking weight loss surgery. Methods and procedure: Ninety-four obese adults (25 males and 69 females) seeking weight loss surgery underwent a diagnostic clinical interview and completed a battery of self-report questionnaires measuring experiences of weight-related stigmatization, psychological adjustment, and binge eating behavior. Results: Weight-based stigmatization was a common experience within the past month among participants. Frequency of stigmatizing experiences was negatively associated with self-esteem and positively associated with depression, anxiety, body image disturbance, and emotional eating. Recent experiences of stigmatization were associated with a diagnosis of binge eating disorder. Discussion: Weight-based stigmatization is a common experience among obese individuals seeking weight loss surgery, and these experiences are associated with deleterious consequences. It appears that environmental barriers (e.g., chairs too small, not being able to find medical equipment in an appropriate size) and interpersonal attacks are the most common stigmatizing experiences. These data justify future studies to better understand causal relationships and efforts to design and test interventions aimed at reducing weight-based stigmatization and the associated negative consequences.
MeSH term(s)	Adult ; Anxiety/etiology ; Attitude of Health Personnel ; Bariatric Surgery/psychology ; Body Image ; Bulimia/etiology ; Bulimia Nervosa/etiology ; Depression/etiology ; Feeding Behavior ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Obesity/physiopathology ; Obesity/psychology ; Obesity/surgery ; Prejudice ; Referral and Consultation ; Self Concept ; Stereotyping ; Surveys and Questionnaires ; Time Factors
Language	English
Publishing date	2008-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2230457-5
ISSN	1930-739X ; 1930-7381 ; 1071-7323
ISSN (online)	1930-739X
ISSN	1930-7381 ; 1071-7323
DOI	10.1038/oby.2008.457
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Article ; Online: Home-based Physical Activity Coaching, Physical Activity, and Health Care Utilization in Chronic Obstructive Pulmonary Disease. Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial Secondary Outcomes.

Coultas, David B / Jackson, Bradford E / Russo, Rennie / Peoples, Jennifer / Singh, Karan P / Sloan, John / Uhm, Minyong / Ashmore, Jamile A / Blair, Steven N / Bae, Sejong

Annals of the American Thoracic Society

2018 Volume 15, Issue 4, Page(s) 470–478

Abstract: Rationale: Physical inactivity among patients with chronic obstructive pulmonary disease is associated with exacerbations requiring high-cost health care utilization including urgent, emergent, and hospital care.: Objectives: To examine the ... ...

Abstract	Rationale: Physical inactivity among patients with chronic obstructive pulmonary disease is associated with exacerbations requiring high-cost health care utilization including urgent, emergent, and hospital care. Objectives: To examine the effectiveness of a behavioral lifestyle physical activity intervention combined with chronic obstructive pulmonary disease self-management education to prevent high-cost health care utilization. Methods: This was an analysis of secondary outcomes of the Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial, a two-arm randomized trial of stable adult outpatients with chronic obstructive pulmonary disease recruited from primary care and pulmonary clinics. Following a 6-week self-management education run-in period, participants were randomized to usual care or to a telephone-delivered home-based health coaching intervention over 20 weeks. Secondary outcomes of physical activity and health care utilization were determined by self-report 6, 12, and 18 months after randomization. Associations between treatment allocation arm and these secondary outcomes were examined using log-binomial and Poisson regression models. Results: A total of 325 outpatients with stable chronic obstructive pulmonary disease were enrolled in the trial. Their average age was 70.3 years (standard deviation, 9.5), and 50.5% were female; 156 were randomized to usual care and 149 to the intervention. A greater proportion of participants reported being persistently active over the 18-month follow-up period in the intervention group (73.6%) compared with the usual care group (57.8%) (mean difference, 15.8%; 95% confidence interval, 4.0-27.7%). This association varied by severity of forced expiratory volume in 1 second impairment (P for interaction = 0.09). Those in the intervention group with moderate impairment (forced expiratory volume in 1 second, 50-70% predicted), more frequently reported being persistently active compared with the usual care (86.0 vs. 65.1%; mean difference, 20.9%; 95% confidence interval, 5.7-36.1%). Patients with severe and very severe forced expiratory volume in 1 second impairment (forced expiratory volume in 1 second < 50% predicted) in the intervention group also reported being persistently active more frequently compared with usual care (63.3 vs. 50.8%; mean difference, 12.6%; 95% confidence interval, -4.7 to 29.8). The intervention was associated with a lower rate of lung-related utilization (adjusted rate ratio, 0.38; 95% confidence interval, 0.23-0.63) only among participants with severe spirometric impairment. Conclusions: Our results demonstrate that a feasible and generalizable home-based coaching intervention may decrease sedentary behavior and increase physical activity levels. In those with severe chronic obstructive pulmonary disease, this intervention may reduce lung disease-related health care utilization. Clinical trial registered with www.clinicaltrials.gov (NCT01108991).
MeSH term(s)	Aged ; Disease Progression ; Exercise ; Female ; Forced Expiratory Volume ; Humans ; Lung/physiopathology ; Male ; Mentoring/methods ; Middle Aged ; Outcome Assessment, Health Care ; Patient Acceptance of Health Care/statistics & numerical data ; Pulmonary Disease, Chronic Obstructive/rehabilitation ; Quality of Life ; Self Report ; Self-Management/methods ; Spirometry ; Time Factors
Language	English
Publishing date	2018-01-02
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.201704-308OC
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Article: Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults.

Ashmore, Jamile A / Friedman, Kelli E / Reichmann, Simona K / Musante, Gerard J

Eating behaviors

2008 Volume 9, Issue 2, Page(s) 203–209

Abstract: Objective: To evaluate the associations between weight-based stigmatization, psychological distress, and binge eating behavior in a treatment-seeking obese sample.: Methods: Ninety-three obese adults completed three questionnaires: 1) Stigmatizing ... ...

Abstract	Objective: To evaluate the associations between weight-based stigmatization, psychological distress, and binge eating behavior in a treatment-seeking obese sample. Methods: Ninety-three obese adults completed three questionnaires: 1) Stigmatizing Situations Inventory, 2) Brief Symptoms Inventory, and 3) Binge Eating Questionnaire. Correlational analyses were used to evaluate the association between stigmatizing experiences, psychological distress and binge eating behavior. Results: Stigmatizing experiences predicted both binge eating behavior (R(2)=.20, p<.001) and overall psychological distress (R(2)=.18, p<.001). A substantial amount of the variance in binge eating predicted by weight-based stigmatization was due to the effect of psychological distress. Specifically, of the 20% of the variance in binge eating accounted for by stigmatizing experiences, between 7% and 34% (p<.01) was due to the effects of various indicators of psychological distress. Conclusions: These data suggest that weight-based stigmatization predicts binge eating behavior and that psychological distress associated with stigmatizing experiences may be an important mediating factor.
MeSH term(s)	Adult ; Body Weight ; Bulimia Nervosa/psychology ; Bulimia Nervosa/therapy ; Female ; Humans ; Male ; Middle Aged ; Obesity/psychology ; Obesity/therapy ; Personality Inventory ; Prejudice ; Stress, Psychological/complications
Language	English
Publishing date	2008-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2073366-5
ISSN	1471-0153
ISSN	1471-0153
DOI	10.1016/j.eatbeh.2007.09.006
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Article: Recent Experiences of Weight-based Stigmatization in a Weight Loss Surgery Population: Psychological and Behavioral Correlates

Friedman, Kelli E / Ashmore, Jamile A / Applegate, Katherine L

Obesity. 2008 Nov., v. 16, suppl. 2

2008

Keywords	obesity ; bariatric surgery ; physicians ; psychology ; psychological stress ; binge eating disorder ; men ; women ; adults ; questionnaires ; surveys ; interviews ; eating habits ; self-esteem ; depression ; anxiety ; stereotyped behavior ; perceptions (cognitive) ; United States
Language	English
Dates of publication	2008-11
Size	p. S69-S74.
Document type	Article
Note	In the special issue: Weight bias: New science on a significant social problem / edited by Rebecca Puhl and Janet Latner.
ISSN	1930-7381
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: White Paper AGA: An Episode-of-Care Framework for the Management of Obesity-Moving Toward High Value, High Quality Care: A Report From the American Gastroenterological Association Institute Obesity Episode of Care and Bundle Initiative Work Group.

Brill, Joel V / Ashmore, Jamile A / Brengman, Matthew L / Buffington, Daniel E / Feldshon, S David / Friedman, Kelli E / Margolis, Peter S / Markus, Danielle / Narramore, Leslie / Rastogi, Amita / Starpoli, Anthony A / Strople, Kenneth / White, Jane V / Streett, Sarah E

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2017 Volume 15, Issue 5, Page(s) 650–664.e2

Abstract: The American Gastroenterological Association acknowledges the need for gastroenterologists to participate in and provide value-based care for both cognitive and procedural conditions. Episodes of care are designed to engage specialists in the movement ... ...

Abstract	The American Gastroenterological Association acknowledges the need for gastroenterologists to participate in and provide value-based care for both cognitive and procedural conditions. Episodes of care are designed to engage specialists in the movement toward fee for value, while facilitating improved outcomes and patient experience and a reduction in unnecessary services and overall costs. The episode of care model puts the patient at the center of all activity related to their particular diagnosis, procedure, or health care event, rather than on a physician's specific services. It encourages and incents communication, collaboration, and coordination across the full continuum of care and creates accountability for the patient's entire experience and outcome. This paper outlines a collaborative approach involving multiple stakeholders for gastrointestinal practices to assess their ability to participate in and implement an episode of care for obesity and understand the essentials of coding and billing for these services.
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2017.02.002
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Article ; Online: Evaluating the effectiveness and implementation of evidence-based treatment: A multisite hybrid design.

The American psychologist

2018 Volume 74, Issue 4, Page(s) 459–473

Abstract: The gap between treatment development and efficacy testing to scaled up implementations of evidence-based treatment (EBT) is an estimated 20 years, and hybrid research designs aim to reduce the gap. One was used for a multisite study in cancer control, ... ...

Abstract	The gap between treatment development and efficacy testing to scaled up implementations of evidence-based treatment (EBT) is an estimated 20 years, and hybrid research designs aim to reduce the gap. One was used for a multisite study in cancer control, testing coprimary aims: (a) determine the feasibility and utility of a flexible EBT implementation strategy and (b) determine the clinical effectiveness of an EBT as implemented by newly trained providers. Therapists from 15 diverse sites implemented the biobehavioral intervention (BBI) for cancer patients (
MeSH term(s)	Adult ; Evidence-Based Practice ; Female ; Humans ; Male ; Middle Aged ; Models, Psychological ; Neoplasms/psychology ; Psychotherapy/methods ; Social Support ; Stress, Psychological/psychology ; Stress, Psychological/therapy ; Treatment Outcome
Language	English
Publishing date	2018-07-19
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	209464-2
ISSN	1935-990X ; 0003-066X
ISSN (online)	1935-990X
ISSN	0003-066X
DOI	10.1037/amp0000309
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Article: Marital adjustment among patients with chronic obstructive pulmonary disease who are participating in pulmonary rehabilitation.

Ashmore, Jamile A / Emery, Charles F / Hauck, Emily R / MacIntyre, Neil R

Heart & lung : the journal of critical care

2005 Volume 34, Issue 4, Page(s) 270–278

Abstract: Background: Marital adjustment has been associated with morbidity and mortality across various chronic diseases but has been largely ignored among patients with chronic obstructive pulmonary disease (COPD).: Purpose: This study was designed to ... ...

Abstract	Background: Marital adjustment has been associated with morbidity and mortality across various chronic diseases but has been largely ignored among patients with chronic obstructive pulmonary disease (COPD). Purpose: This study was designed to evaluate the relationship among marital adjustment, quality of life, psychologic functioning, and functional capacity among married patients with COPD who are participating in a 5-week exercise rehabilitation program and their spouses. Sample: A convenience sample of 31 patients with COPD and their partners was included. Design: A prospective 1-group pretest-posttest study was conducted. Results: Marital adjustment scores indicated that patients and partners were, on average, satisfied with their marriages. Patient marital adjustment was associated with patient psychologic well-being, whereas partner marital adjustment was associated with patient physical functioning. In addition, patient and partner perceptions of marital adjustment predicted change in patient functioning after exercise rehabilitation. Patients who entered the program with poor marital adjustment experienced a greater magnitude of improvement in mental health after rehabilitation than did well-adjusted patients. Conclusions: These findings suggest that marital adjustment is associated with both psychologic well-being and physical functioning among patients with COPD, and that it may predict change among patients with COPD participating in exercise rehabilitation.
MeSH term(s)	Adult ; Exercise Therapy ; Family Relations ; Female ; Humans ; Male ; Marital Status ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/psychology ; Pulmonary Disease, Chronic Obstructive/rehabilitation ; Quality of Life ; Respiratory Function Tests
Language	English
Publishing date	2005-07-15
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	193129-5
ISSN	1527-3288 ; 0147-9563
ISSN (online)	1527-3288
ISSN	0147-9563
DOI	10.1016/j.hrtlng.2004.12.005
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Article: Weight Stigmatization and Ideological Beliefs: Relation to Psychological Functioning in Obese Adults

Friedman, Kelli E / Reichmann, Simona K / Costanzo, Philip R / Zelli, Arnaldo / Ashmore, Jamile A / Musante, Gerard J

Obesity research. 2005 May., v. 13, no. 5

2005

Abstract: OBJECTIVE: This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample. Research Methods and Procedure: Ninety-three obese, treatment-seeking ... ...

Abstract	OBJECTIVE: This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample. Research Methods and Procedure: Ninety-three obese, treatment-seeking adults (24 men and 69 women) completed a battery of self-report questionnaires measuring psychological adjustment, attitudes about weight, belief in the controllability of weight, and the frequency of weight-based stigmatization. RESULTS: Weight-based stigmatization was a common experience for participants. Frequency of stigmatizing experiences was positively associated with depression, general psychiatric symptoms, and body image disturbance, and negatively associated with self-esteem. Further, participants' own negative attitudes about weight problems were associated with their psychological distress and moderated the relation between the experience of stigmatization and body image. DISCUSSION: Weight-based stigmatization is a common experience for obese individuals seeking weight loss treatment and appears to contribute to poor mental health adjustment. The negative effects of these experiences are particularly damaging for those who hold strong antifat beliefs.
Keywords	appetite ; hunger ; satiety ; dieting ; food deprivation ; palatability ; undereating ; overeating ; psychosocial factors ; food intake ; motivation
Language	English
Dates of publication	2005-05
Size	p. 907-916.
Document type	Article
ZDB-ID	1201744-9
ISSN	1550-8528 ; 1071-7323
ISSN (online)	1550-8528
ISSN	1071-7323
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Article: Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults.

Friedman, Kelli E / Reichmann, Simona K / Costanzo, Philip R / Zelli, Arnaldo / Ashmore, Jamile A / Musante, Gerard J

Obesity research

2005 Volume 13, Issue 5, Page(s) 907–916

Abstract: Objective: This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample.: Research methods and procedure: Ninety-three obese, treatment- ... ...

Abstract	Objective: This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample. Research methods and procedure: Ninety-three obese, treatment-seeking adults (24 men and 69 women) completed a battery of self-report questionnaires measuring psychological adjustment, attitudes about weight, belief in the controllability of weight, and the frequency of weight-based stigmatization. Results: Weight-based stigmatization was a common experience for participants. Frequency of stigmatizing experiences was positively associated with depression, general psychiatric symptoms, and body image disturbance, and negatively associated with self-esteem. Further, participants' own negative attitudes about weight problems were associated with their psychological distress and moderated the relation between the experience of stigmatization and body image. Discussion: Weight-based stigmatization is a common experience for obese individuals seeking weight loss treatment and appears to contribute to poor mental health adjustment. The negative effects of these experiences are particularly damaging for those who hold strong antifat beliefs.
MeSH term(s)	Attitude ; Body Image ; Body Mass Index ; Depression/epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Mental Disorders/epidemiology ; Obesity/psychology ; Self Concept ; Stereotyping ; Surveys and Questionnaires
Language	English
Publishing date	2005-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1201744-9
ISSN	1550-8528 ; 1071-7323
ISSN (online)	1550-8528
ISSN	1071-7323
DOI	10.1038/oby.2005.105
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Article: Predictors of adherence to physical activity in the Lifestyle Interventions and Independence for Elders pilot study (LIFE-P).

Rejeski, W Jack / Miller, Michael E / King, Abby C / Studenski, Stephanie A / Katula, Jeffrey A / Fielding, Roger A / Glynn, Nancy W / Walkup, Michael P / Ashmore, Jamile A

Clinical interventions in aging

2007 Volume 2, Issue 3, Page(s) 485–494

Abstract: Objectives: A prospective design was used to examine predictors of adherence to a physical activity intervention in older adults with compromised function.: Methods: The sample included 213 men (31.1%) and women (68.9%) with an average age of 76.53 ... ...

Abstract	Objectives: A prospective design was used to examine predictors of adherence to a physical activity intervention in older adults with compromised function. Methods: The sample included 213 men (31.1%) and women (68.9%) with an average age of 76.53 years. Results: The predictor variables accounted for 10% of the variance in percent attendance during adoption and transition, respectively. Adding percent attendance during adoption to the prediction of percent attendance during transition increased the explained variance in this phase to 21%. During maintenance, the predictors accounted for 13% of the variance in frequency of physical activity; this estimate increased to 46% when adding in percent attendance from the transition phase. Discussion: These results are encouraging in that the physical activity intervention appears to have been well tolerated by diverse subgroups of older adults. The role of prior behavior in predicting downstream adherence underscores the importance of developing proactive interventions for treating nonadherence in older adult populations.
MeSH term(s)	Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging ; Disability Evaluation ; Female ; Health Behavior ; Humans ; Life Style ; Male ; Motor Activity ; Patient Compliance ; Pilot Projects ; Prospective Studies ; United States
Language	English
Publishing date	2007-11-28
Publishing country	New Zealand
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	2364924-0
ISSN	1176-9092
ISSN	1176-9092
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