Robert F DeVellis

University of North Carolina at Chapel Hill | UNC · Health Behavior

Hope is a future expectancy characterized by an individual’s perception that a desirable future outcome can be achieved. Though scales exist to measure hope, they may have limited relevance in low resource, high HIV prevalence settings. We developed and validated a hope scale among young women living in rural South Africa. We conducted formative in...

The information–motivation–behavioral skills (IMB) model has been used to explain and promote medication adherence among patients with diabetes and HIV. The objective of this study was to examine whether the IMB model predicted medication adherence among vasculitis patients. Adult vasculitis patients (n=228) completed online questionnaires at basel...

Background: Concurrent sexual partnerships (partnerships that overlap in time) may contribute to higher rates of HIV transmission in African Americans. Attitudes toward a behavior constitute an important component of most models of health-related behavior and behavioral change. We have developed a scale, employing realistic vignettes that appear t...

Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumat...

Objective The aim of this study was to investigate the relationship between the attentional coping styles (monitoring and blunting) of rheumatoid arthritis (RA) and osteoarthritis (OA) patients and: (a) receipt of medication information; (b) receipt of conflicting medication information; (c) ambiguity aversion; (d) medication-related discussions wi...

Our goals were to describe the balance of social support to negative social interactions (i.e. social constraints) for autoimmune disease patients and determine whether support and constraints from spouses and non-spousal family and friends interact to influence patients' psychological adjustment. Using cross-sectional survey data from 109 married...

Objectives: To describe the information about medication risks/benefits that rheumatologists provide during patient office visits, the gist that patients with rheumatoid arthritis (RA) extract from the information provided, and the relationship between communication and medication satisfaction. Methods: Data from 169 RA patients were analyzed. E...

Background: Health literacy has been found to be a crucial component of successful communication and navigation in health care. Various tools have been developed to measure health literacy skills, but few have been developed specifically for adolescents, and most require in-person administration. This study sought to develop a self-report health l...

We investigated whether comorbidities differentially impacted health-related quality of life (HRQOL) for rheumatoid arthritis (RA) and osteoarthritis (OA) patients. Adult patients with self-reported doctor-diagnosed RA (n=159) or OA (n=149) were recruited from multiple sources and completed an online cross-sectional survey. Patients self-reported s...

Osteoarthritis (OA) places a significant burden on worldwide public health because of the large and growing number of people affected by OA and its associated pain and disability. Pain coping skills training (PCST) is an evidence-based intervention targeting OA pain and disability. To reduce barriers that currently limit access to PCST, we develope...

HIV testing in prison settings has been identified as an important mechanism to detect cases among high-risk, underserved populations. Several public health organizations recommend that testing across health-care settings, including prisons, be delivered in an opt-out manner. However, implementation of opt-out testing within prisons may pose challe...

Despite their widespread use and extensive technical features, little is known about how to use online social networking sites to increase physical activity. This study aims to examine Facebook engagement among participants in the online social networking arm of a randomized controlled physical activity promotion trial (n = 67). Facebook communicat...

Objective We used a multidimensional framework to describe the types of information about medication risks that rheumatologists provide to rheumatoid arthritis (RA) patients during routine office visits.Methods We analyzed 1,094 audiotaped rheumatology office visits involving 450 RA patients. Each patient had up to 3 visits audiotaped. In conjuncti...

Objective Fuzzy trace theory was used to develop a coding scheme that captures the gist that patients extract from information about medication risks and benefits and to explore the extent to which different patients extract different gist representations from the same information. Methods Data were collected from 2003-2007 in a study that included...

Objective Foot and ankle problems are common in adults, and large observational studies are needed to advance our understanding of the etiology and impact of these conditions. Valid and reliable measures of foot and ankle symptoms and physical function are necessary for this research. This study examined psychometric properties of the Foot and Ankl...

Objective: To develop psychometrically sound, culturally relevant, and linguistically equivalent English and Spanish self-report measures of social health guided by a comprehensive conceptual model and applicable across chronic illnesses. Methods: The Patient-Reported Outcomes Measurement Information System (PROMIS) Social Health Workgroup imple...

The primary objective of the current study was to examine the relationship between social support and physical activity within the theory of planned behavior (TPB) theoretical framework. This study used data from the Internet Support for Healthy Associations Promoting Exercise randomized controlled trial. A total of 134 female undergraduate student...

Conflicting medication information has been defined as contradictory information about a medication topic from two or more sources. The objective of this study was to determine whether arthritis patients are exposed to conflicting medication information, to document sources of conflicting information, and to explore whether conflicting information...

Purpose: To determine associations between multiple joint symptoms and radiographic osteoarthritis (rOA) and functional outcomes. Method: Complete cross-sectional data for multi-joint symptoms and radiographs, Health Assessment Questionnaire (HAQ) scores, and gait speed were available for 1307 Johnston County Osteoarthritis Project participants...

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis pat...

Objective: The authors explored whether demographic and psychosocial variables predicted differences in physical activity for participants with arthritis in a trial of Active Living Every Day (ALED). Method: Participants (N = 280) from 17 community sites were randomized into ALED or usual care. The authors assessed participant demographic charac...

Online social networks, such as Facebook™, have extensive reach, and they use technology that could enhance social support, an established determinant of physical activity. This combination of reach and functionality makes online social networks a promising intervention platform for increasing physical activity. To test the efficacy of a physical a...

Objectives: To determine whether patients with a rare illness (1) use pharmacists for medication information more or less frequently than physicians and the Internet, (2) perceive pharmacists as a more or less credible medical information resource than physicians and the Internet, and (3) obtain different types of medication information from pharm...

With the aim of developing a novel strategy for identifying vulnerability for early sexual activity and adjustment problems, African American girls (n = 39) completed partially structured scenarios in which female characters of similar age faced circumstances characterized by varying levels of risk. Most girls indicated that they believed the chara...

When patients consult more than one source of information about their medications, they may encounter conflicting information. Although conflicting information has been associated with negative outcomes, including worse medication adherence, little is known about how patients make health decisions when they receive conflicting information. The obje...

Few studies have explored mediators between medication-related support and medication adherence for individuals with rare, systemic autoimmune conditions. Using the Information-Motivation-Behavioral Skills model, we tested whether depressive symptomatology and medication adherence self-efficacy mediated the relationship between adherence support an...

Despite being used in multiple studies, the Menopause-Specific Quality of Life Questionnaire (MENQOL) has not been assessed with factor analysis, a common method of item reduction in quality of life tools. The Menopause Epidemiology Study is a cross-sectional population-based study of women 40 to 65 years old in the United States chosen from a sour...

Our objective is to explore how vasculitis affects patients' friendships and social participation. Vasculitis patients (n=221) completed an online questionnaire that asked if, and how, relationships with friends have changed since receiving a vasculitis diagnosis. Participants' written responses were imported into Atlas.ti, and two independent rese...

Background. The psychometric properties of the Modified Work APGAR (MWA) scale are not established, yet researchers use this scale as an overall measure of job satisfaction. Objective. Perform psychometric analyses on the MWA scale using data from two populations. Methods. A landmark occupational cohort and a clinical cohort are populations with...

Although osteoarthritis (OA) commonly involves multiple joints, no widely accepted method for quantifying whole-body OA burden exists. Therefore, our aim was to apply factor analytic methods to radiographic OA (rOA) grades across multiple joint sites, representing both presence and severity, to quantify the burden of rOA. We used cross-sectional da...

Patients with rare illnesses may use medication information sources that are appreciably different from those used by patients with more common illnesses. This article's purpose is to describe vasculitis patients' most frequently used medication information sources, determine which sources patients perceive as credible, and explore gender differenc...

Few studies have investigated whether the utility of social support for patients with a relapsing, remitting illness varies by activity level of the disease. Our goal was to determine whether disease status (relapse vs remission) moderates the effect of medication-related support from physicians and partners on the health-related quality of life (H...

This book presents complex concepts in a way that helps students to understand the logic underlying the creation, use, and evaluation of measurement instruments and to develop a more intuitive feel for how scales work. Robert DeVellis demystifies measurement by relating it to familiar experiences and by emphasizing a conceptual rather than a strict...

Although mood clarity has been found to negatively correlate with depressive symptoms (Salovey, Mayer, Goldman, Turvey, & Palfai, 1995), little is known about why this relationship exists Using two waves of longitudinal data collected from an older community sample we tested whether mood clarity decreases depressive symptoms by mitigating the negat...

This article explores the effect of conflicting information, defined as contradictory information about medication topics from different sources, on medication adherence in a sample of chronically ill patients. We specifically investigate whether conflicting information and physician support directly affect medication adherence or whether the effec...

Patient-reported outcomes (PROs) are essential when evaluating many new treatments in health care; yet, current measures have been limited by a lack of precision, standardization, and comparability of scores across studies and diseases. The Patient-Reported Outcomes Measurement Information System (PROMIS) provides item banks that offer the potentia...

Vasomotor and psychosocial symptoms persist as common manifestations of menopause; their explicit association is unclear. We investigated this association among postmenopausal women over a 2-year period. The Menopause Epidemiology Study is a cross-sectional population-based study of women 40 to 65 years old in the United States. We followed partici...

To describe the lessons learned in the initial development of Patient-Reported Outcomes Measurement Information System social function item banks. Development and testing of 2 item pools within a general population to create item banks that measure ability to participate and satisfaction with participation in social activities. Administration via t...

To develop a social health measurement framework, to test items in diverse populations and to develop item response theory (IRT) item banks. A literature review guided framework development of Social Function and Social Relationships sub-domains. Items were revised based on patient feedback, and Social Function items were field-tested. Analyses inc...

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Previous studies suggest that people with arthritis have high rates of using complementary and alternative medicine (CAM) approaches for managing their arthritis, in addition to conventional treatments such as prescription medications. However, little is known about the use of CAM by diagnosis, or which forms of CAM are most frequently used by peop...

This study compared pain and function among African Americans and Caucasian with radiographic hip and/or knee osteoarthritis (OA), controlling for radiographic severity and other patient characteristics. Participants were 1368 individuals (32% African American) from the Johnston County Osteoarthritis Project with only knee OA, only hip OA, and both...

Introduction: Previous studies suggest that people with arthritis have high rates of using complementary and alternative medicine (CAM) approaches for managing their arthritis, in addition to conventional treatments such as prescription medications. However, little is known about the use of CAM by diagnosis, or which forms of CAM are most frequent...

A husband's beliefs about his wife's rheumatoid arthritis (RA) may be important to his provision of support and well-being. We adapted seven subscales of the Illness Perception Questionnaire-Revised to assess husbands' beliefs about their wives' RA. We recruited 190 couples (average years married = 22; average years with RA = 14) from community set...

Chronic disease affects both patients and spouses, yet the effect of vasculitis on the spouses of patients has not been systematically examined. We addressed this research gap by describing 8 dimensions of health-related quality of life (HRQOL) for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) patients and their spouses and compar...

We examined health-related quality of life (HRQOL) in white and African American patients based on their own and their community's socioeconomic status. Participants were 4,565 adults recruited from 17 family physician practices in urban and rural areas of North Carolina. Education was used as a proxy for individual socioeconomic status, and the ce...

Shared decision making may increase satisfaction with health care and improve outcomes, but little is known about adolescents' decision-making preferences. The primary purpose of this study is to describe the decision-making preferences of adolescents with chronic illnesses and their parents, and the extent to which they agree. Survey. Participants...

Introduction: We examined health-related quality of life (HRQOL) in white and African American patients based on their own and their community's socioeconomic status. Methods: Participants were 4,565 adults recruited from 17 family physician practices in urban and rural areas of North Carolina. Education was used as a proxy for individual socioe...

To examine the psychometric properties of the Arthritis Body Experience Scale (ABES) in a US sample of people with osteoarthritis, rheumatoid arthritis, fibromyalgia and other rheumatic conditions. The ABES, with the scoring direction modified, was phone-administered to 937 individuals who self-identified as having one or more arthritis conditions...

Our aim was to assess the content validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) social health item banks by comparing a prespecified conceptual model with concepts that focus-group participants identified as important social-health-related outcomes. These data will inform the process of improving health-related q...

To characterize similarities and differences in illness perceptions between women with rheumatoid arthritis (RA) and their husbands, and examine whether illness perception congruence predicted wives' subsequent psychological adjustment. Women with RA and their husbands (N=190 couples) recruited from community and clinical settings completed mailed...

This study tests the association between residents' cognitive impairment and nursing homes' pain management practices. We used chart abstraction to collect data on 551 adults in six North Carolina nursing homes. From the standard data collected in the Minimum Data Set, 24% of residents experienced pain in the preceding week. Reports of pain decreas...

To examine if patients with arthritis who reported using complementary and alternative medicine (CAM) were more likely to tell their physicians about their CAM use if they rated their rheumatologist as using a more participatory decision-making style and what reasons patients gave for telling or not telling their rheumatologist about their CAM use....

The purpose of this systematic review is to assess the literature pertinent to healthy coping in diabetes management and to identify effective or promising interventions and areas needing further investigation. A PubMed search identified 186 articles in English published between January 1, 1990, and July 31, 2006, addressing diabetes and emotion, q...

To develop a measure of illness self-management for adults living with antineutrophil cytoplasmic antibody (ANCA)-associated small-vessel vasculitis (ANCA-SVV) and to gather evidence of its reliability and validity. Development of the Vasculitis Self-Management Scale (VSMS) was guided by previous research on self-management in other chronically ill...

Although many studies suggest lower rates of depressive symptoms in those who report greater spirituality, few have investigated the mechanisms by which spirituality might relate to depressive symptoms. The current study aimed to elucidate potential psychosocial mechanisms that link these 2 variables. Data were drawn from a community-dwelling strat...

The AUStralian CANadian Osteoarthritis Hand Index (AUSCAN) is a self-report assessment of hand pain, stiffness, and function. Prior studies have examined its validity in small clinical samples and family-based samples. This study examined measurement properties of the AUSCAN in a large, community-based sample, extending knowledge about the scale's...

Topical microbicides will only be effective if they are acceptable to potential users. The purpose of this study is to develop a scale to evaluate characteristics and aspects of topical microbicides that are important to adolescent girls. Girls (n = 207) completed a questionnaire on perceptions of microbicide-like products. A principal components f...

Studies of low energy reporting in the elderly are limited, yet changes in energy balance and the incidence of chronic disease make this a critical time to assess energy intake in this population. The objective of this study was to assess low energy reporting on 24-h recalls (24HR), a FFQ, a picture sort FFQ (PSFFQ), and a meal pattern questionnair...

To compare the validity of a modified Block food-frequency questionnaire (FFQ), a picture-sort administration of the FFQ (PSFFQ) and a meal pattern-based questionnaire (MPQ) in a multi-ethnic population of low socio-economic status (SES). Participants completed six 24-hour dietary recalls (24HR) over six months; the FFQ, PSFFQ and MPQ were complete...

Doctors must understand patients' priorities to create an effective treatment partnership. Little is known about whether subspecialist pediatricians understand chronically ill adolescents' preferences. A survey was conducted of 155 adolescents with chronic illnesses and 52 subspecialty physicians recruited from the same clinics of a children's hosp...

Interpersonal relationships and self-efficacy have each been independently studied in the context of coping with chronic illness. To examine a new type of interpersonal efficacy in couples coping with rheumatoid arthritis (RA), we developed and tested new measures of perceptions of arthritis dyadic efficacy. We assessed both partners' perceptions o...

To evaluate diet quality of rural older adults using national dietary guidelines and the Healthy Eating Index (HEI). Five to six 24-hour recalls were conducted at monthly intervals over a 6-month period, using the Nutrition Coordinating Center food grouping system to calculate intake. Included in this cross-sectional study were 63 females and 59 ma...

The role of spirituality in depression is understudied. We examined the relationship between one dimension of spirituality, spiritual experiences, and depressive symptoms, and evaluated whether differences in gender, race, age, and stress moderated the relationship. The study was conducted with a community-based sample of 630 racially diverse middl...

Classical test theory (CTT) comprises a set of concepts and methods that provide a basis for many of the measurement tools currently used in health research. The assumptions and concepts underlying CTT are discussed. These include item and scale characteristics that derive from CTT as well as types of reliability and validity. Procedures commonly u...

Recent clinical trials have demonstrated that increasing physical activity among patients at risk for diabetes can prevent or delay the onset of type 2 diabetes. In this study, we surveyed primary care patients at risk for diabetes to 1) describe physical activity habits, supports, and barriers; 2) identify characteristics associated with increased...

This study examined the types of social comparisons made by individuals with rheumatoid arthritis (RA) and the role these comparisons play in illness adjustment. Seventy-five women with RA were interviewed. The interview included measures of social comparison preferences assessed within two different contexts: the establishment of standards for des...

To estimate the smallest decrease in Headache Impact Test (HIT) scores that reflects meaningful clinical change among patients with chronic daily headache (CDH). We applied four methods of estimating the minimum important difference (MID) to data from 71 patients with CDH who participated in a clinical trial. The HIT was administered at baseline an...

This study examines the levels of and factors associated with consumption of sugar and fat-reduced foods in sample of rural, ethnically diverse older adults. Data were collected from 122 older adults, including demographic and health characteristics and six 24-hour recalls over 16-month period. About one-quarter of sweetened foods were modified, wh...

Measuring health-related quality of life (HRQOL) is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC) HRQOL measures HRQOL for people with arthritis. This study's purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item He...

This study examines the levels of and factors associated with consumption of sugar-and fat-reduced foods in sample of rural, ethnically diverse older adults. Data were collected from 122 older adults, including demographic and health characteristics and six 24-hour recalls over 16-month period. About one-quarter of sweetened foods were modified, wh...

Many medications present special risks when used by older adults (ie, those aged > or = 65 years) and are considered potentially inappropriate for this population. The Beers criteria are often used to identify such medications. Past research has documented that use of Beers drugs is common among older adults. The aim of this work was to examine fac...

The success of long-term therapy in schizophrenia is contingent upon real-world effectiveness or improvements in several domains, including efficacy, safety and tolerability. This report describes the Investigator's Assessment Questionnaire (IAQ), a new 10-item instrument designed to assess relative effectiveness (efficacy, safety and tolerability)...

The purpose of this study was to examine: (1) which patient demographics were related to whether patients rated their family physicians as using a participatory decision-making style, and (2) whether arthritis patients who reported using complementary and alternative medicine (CAM) were more likely to report discussing CAM use with their providers...

To evaluate the performance and score interpretability of the Headache Impact Test (HIT-6) questionnaire in a headache patient population. The HIT-6 is a standardized questionnaire designed to assess headache-related disability. Norms have been established using randomly sampled respondents from the general population. This study evaluated the psyc...