Robin Whittemore

Yale University | YU · Department of Nursing

Objective: The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim...

Background: Type 2 diabetes (T2D) is a chronic condition affecting more than 34.2 million United States adults, and people of African descent have a disproportionate burden. Haitian immigrants' unique cultural and biologic factors put them at elevated risk for T2D-related complications. Despite prior research highlighting the success of multimetho...

A growing body of research suggests that obesity can be understood as a complex and biobehavioral condition influenced by social relationships ─social networks. Social network analysis allows us to examine how an individual's network characteristics (e.g., popularity) are associated with obesity and obesity-related behaviors. The objectives of the...

Background: Many lifestyle interventions have demonstrated efficacy up to one-year follow-up, yet maintaining improvements at longer-term follow-up is a well-recognized worldwide challenge, especially in underserved areas. The purpose of this study is to compare the 18-month efficacy of an Intensive LifeStyle Modification Program to usual care in...

Effective antiretroviral therapy (ART) adherence strategies for HIV+ adolescents and young adults (AYA) are needed to prevent HIV-related morbidity, mortality, and onward transmission. In the Adherence Connection for Counseling, Education, and Support (ACCESS) pilot, an exploratory sequential mixed-methods design was used to develop and test a peer...

Chinese immigrants in the US are disproportionately affected by gestational diabetes mellitus (GDM) and type 2 diabetes (T2D). The aims of this study were to describe their physical activity (PA) and sedentary behaviors (SB) patterns and to identify determinates of objectively-measured PA and SB among Chinese immigrants in the US with prior GDM. We...

Background The prevalence of diabetes and its impact on mortality after acute myocardial infarction (AMI) are well-established. Sex-specific analyses of the impact of diabetes on all-cause mortality after AMI have not been updated and comprehensively investigated. Objective To conduct a systematic review and meta-analysis that examined sex-specifi...

Background Pregnant women with gestational diabetes mellitus (GDM) have a higher risk of developing elevated depressive symptoms than women without GDM. The aim of this study was to investigate the sociodemographic (eg, location), clinical (eg, health care–seeking behaviors), and psychological (eg, active coping skills) factors associated with elev...

Background: Women with prior gestational diabetes (GD) have times the risk of developing type 2 diabetes (T2D) as women without prior GD. Chinese immigrants in the US are disproportionately affected by GD and T2D. Physical activity (PA) is a modifiable lifestyle strategy to reduce the risk of T2D. The aim of this study was to identify health belief...

This study aimed to evaluate the efficacy of an intensive lifestyle modification program tailored to rural Chinese women with prior gestational diabetes mellitus compared with usual care. In a cluster randomized controlled trial, 16 towns (clusters) in two distinct rural areas in China were randomly selected (8 towns per district); and 320 women wi...

The purpose of this review is to synthesize the evidence and determine the efficacy of interventions based on family systems theory in diabetes-related family conflict, self-management, and glycemic control among adolescents with type 1 diabetes. A systematic search of five English databases was conducted. Interventions based on family systems theo...

People with diabetes frequently have elevated diabetes distress. Although mindfulness‐based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This st...

Objective To examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent Type 2 diabetes. Data Sources We conducted searches in seven databases, including Ovid MEDLINE, CINAHL, Ovid Embase, Cochrane Central, Web of Science, Ovid PsycInfo, and Pro...

Purpose The purpose of this study was to describe the experiences of older adult Haitian immigrants in managing type 2 diabetes mellitus (T2DM). Methods A descriptive qualitative approach using semistructured interviews was conducted with 20 older adult Haitian immigrants with T2DM. Interviews were transcribed verbatim and categorized using NVivo....

African American (AA) women have the highest rate of obesity in the United States. To date, there are mixed findings on AA women’s perception on obesity and their perceived changes in health behaviors over time that may have contributed to obesity. Therefore, the aims of this current qualitative descriptive study were to explore: 1) AA women’s perc...

Background Extracorporeal membrane oxygenation (ECMO) is a rescue treatment option for adult patients with severe cardiac dysfunction or respiratory failure. While short-term patient outcomes, such as in-hospital mortality and complications, have been widely described, little is known about the illness or recovery experience from the perspectives o...

Background A growing number of studies indicate that exposure to social stress, such as perceived racial discrimination, may contribute to poor health, health behaviors, and health disparities. Increased physical activity (PA) may buffer the impact of social stress resulting from racial discrimination. However, to date, data on the relationship bet...

Aims To describe the specific domains of diabetes distress and factors associated with these domains. Background Diabetes distress is a common problem but not well recognised in adolescents by healthcare providers or adolescents themselves. There is insufficient evidence on how specific domains of diabetes distress exist in adolescents, making it...

Background: People with type 1 diabetes are susceptible to disordered eating behaviors. The American Diabetes Association recommends using the Diabetes Eating Problem Survey-Revised (DEPS-R) to screen them. There is no validated diabetes-specific screening measure in China. The objectives were to adapt DEPS-R into Mandarin Chinese and to test its...

Aim The objective of this systematic review was to summarize the ecological momentary assessment (EMA) methodology and associations between EMA-measured psychosocial, contextual factors and diabetes self-management. Methods The inclusion criteria were: research of EMA and diabetes self-management behaviors such as glucose checks, administration of...

The study aim was to examine the relationship between socioeconomic status (SES) and dietary behaviors through psychological and environmental mediators among African Americans with overweight or obesity. We conducted a cross‐sectional study in 225 African American men and women. Data were analyzed using structural equation modeling with bootstrapp...

Background Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic. Objective Our objectives for this study were to (1) evaluate the effective...

BACKGROUND Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic. OBJECTIVE Our objectives for this study were to (1) evaluate the effectiv...

Family caregivers play an integral role in supporting patient self-management, yet how they perform this role is unclear. We conducted a qualitative metasynthesis of family caregivers’ processes to support patient self-management of chronic, life-limiting illness and factors affecting their support. Methods included a systematic literature search,...

Purpose The purpose of this umbrella review was to synthesize the evidence from published systematic reviews on the effectiveness of text message programs for adults with type 2 diabetes (T2DM) on glycemic management (A1C), self-management, and other clinical outcomes. The effect of directionality of the program was also explored. Methods A system...

BACKGROUND A growing number of studies indicate that exposure to social stress, such as perceived racial discrimination, may contribute to poor health, health behaviors, and health disparities. Increased physical activity (PA) may buffer the impact of social stress resulting from racial discrimination. However, to date, data on the relationship bet...

Objective To examine prevalence and characteristics of newly diagnosed diabetes (NDD) in younger adults hospitalised with acute myocardial infarction (AMI) and investigate whether NDD is associated with health status and clinical outcomes over 12-month post-AMI. Methods In individuals (18–55 years) admitted with AMI, without established diabetes,...

Perceived racial discrimination is linked to unhealthy behaviors and stress‐related morbidities. A compelling body of research indicates that perceived racial discrimination may contribute to health disparities among African Americans (AAs). The purposes of this study were to describe the study protocol including data collection procedures and stud...

Korean American immigrants (KAIs) face diverse sociocultural stressors in the acculturation process. While stress is known to cause short sleep, little is known about how acculturative stress affects sleep differently for KAI men and women. The purpose of this cross-sectional study was to examine gender differences in the association between divers...

OBJECTIVE Insulin access for people with diabetes is a growing public health concern and particularly important for people with type 1 diabetes (T1D)¹ who depend on insulin for survival. However, few studies have examined the psychosocial contexts in which people with TID confront, navigate, and attempt to resolve insulin access barriers (IABs)². W...

Purpose: The purpose of this study was to explore the perceived facilitators and barriers for obtaining sufficient sleep in young adults with T1D. Methods: A qualitative descriptive approach was used to generate data. In-depth semi-structured interviews with 30 young adults with T1D (66.7% female, mean age 22.1 years) were conducted. Interviews wer...

Abstract Background Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary prefere...

Purpose To adapt an evidence-based coping skills training program to the cultural context and healthcare system for youth with T1D in China, and to evaluate the feasibility, acceptability, and preliminary efficacy of the modified program. Design and methods A multiphase process was used based on a heuristic framework for program modification. This...

We explored perceptions and experiences of living with type 1 diabetes mellitus (T1DM) among U.S. Latino adolescents (age 12–19 years) with T1DM and parents with limited English proficiency. We used a qualitative descriptive approach with semi‐structured interviews of adolescents together with their parents. Interview data were reviewed, coded, and...

Type 2 diabetes (T2D) is a complex, lifelong condition that is disproportionately prevalent among minority populations. Haitian immigrants (HIs) living in the US with T2D have unique factors that influence diagnosis, treatment, and self-management. The purpose of this integrative review was to provide a synthesis of the research on T2D in the HI po...

Introduction The purpose of this integrative review was to synthesize the literature on women's perceived barriers and facilitators to achieving a vaginal birth after cesarean. Methods A search of Scopus and PubMed databases and relevant citations from 2000 to 2018 was conducted to identify resources meeting inclusion criteria. Conclusion drawing...

Background: Type 2 diabetes (T2D) is a public health pandemic disproportionately affecting low- and middle-income countries. The purpose of this formative research was to adapt evidence-based diabetes self-management education programs to the context of Seguro Popular clinics in Mexico. A theory-based mHealth (pictorial text messaging) component w...

Background: Maintaining adherence to antiretroviral therapy is a significant challenge for HIV-infected racial and ethnic minority adolescents and young adults (youth). Given the consequences of suboptimal antiretroviral therapy adherence, there is a pressing need for an expanded understanding of adherence behavior in this cohort. Objectives: As...

To review the evidence and determine the factors influencing the effect of mindfulness-based interventions (MBI) on diabetes distress. A systematic search of nine databases (PubMed, Cochrane Library, Web of Science, PsycINFO, Embase, China Knowledge Resource Integrated, VIP Data, SinoMed Data, and Wan Fang Data) was conducted. Randomized controlled...

Purpose The purpose of this study was to evaluate the short-term effects of the Type 1 Teamwork program for parents of adolescents with type 1 diabetes mellitus (T1DM) on the primary outcome of psychosocial stress. Methods The study was a randomized wait-list control trial evaluating an eHealth program to reduce parenting stress around T1DM manage...

Aims: The aims of this study were to: a) determine if self-efficacy mediates the relationship between perceived stress and diabetes self-management in adolescents with type 1 diabetes; and b) explore whether perceived stress moderated the self-efficacy and diabetes self-management relationship. Design: Non-experimental, descriptive correlational...

Background: Managing type 1 diabetes can be challenging, especially for youth, so there is a need for effective interventions to help youth live with diabetes. Objective: To determine the efficacy of a coping skills training program for Chinese youth with type 1 diabetes and to explore whether the efficacy of the program was different for school...

Background: Extracorporeal membrane oxygenation (ECMO), a rescue treatment for patients with severe pulmonary and/or cardiac dysfunction, is increasingly being used worldwide. A better understanding of long-term health-related quality of life (HRQOL) is needed. Objective: To synthesize research on long-term (at least 6 months post-ECMO) HRQOL of...

Objectives Despite high rates of cardiometabolic diseases in Korean immigrants (KIs), little is known about cultural and environmental factors contributing to lifestyle behaviors. The purpose of this cross-sectional study was to examine the relationships among acculturation, environment, and lifestyle behaviors (dietary behavior, physical activity,...

Background Diabetes mellitus increases the risk of mortality after acute myocardial infarction ( AMI ). However, little is known about the association of diabetes mellitus with post‐ AMI health status outcomes (symptoms, functioning, and quality of life) in younger adults. Methods and Results We investigated the association between diabetes mellit...

Background: The prevalence of adults with type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease (CVD) is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. Objectives: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms...

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from...

Purpose of Review To identify factors associated with obesity in veterans of the recent, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) war conflicts. Recent Findings Over 44% OEF/OIF/OND veterans are obese (BMI > 30 kg/m²), which exceeds the national obesity prevalence rate of 39% in people younger t...

Aims a) to explore the effect of perceived stress on satisfaction with quality of life among Chinese adolescents with type 1 diabetes; and b) to determine if coping styles and self‐efficacy are mediators of the association between perceived stress and satisfaction with quality of life. Background Adolescents with type 1 diabetes experience ongoing...

The purpose of this study was to evaluate the preliminary efficacy of a self-management group + mHealth program (Yo Puedo!) on clinical (A1C, BP, BMI), self-management (diet, exercise, blood glucose monitoring), depressive symptom, and self-efficacy outcomes in adults with type 2 diabetes (T2D) at Seguro Popular clinics in Mexico City. Participants...

Ecological momentary assessment (EMA) is a mHealth method of real-time data collection in which people report on behavior and the context of the behavior at multiple time points in their natural environment. It is an innovative counterpart to traditional research methods that have relied on retrospective measures. The aim of this systematic review...

Aims and objectives: To explore clinical reasoning about alarm customisation among nurses in intensive care units. Background: Critical care nurses are responsible for detecting and rapidly acting upon changes in patients' clinical condition. Nurses use medical devices including bedside physiologic monitors to assist them in their practice. Cust...

Objective: To evaluate the effects of a positive psychology intervention for adolescents with type 1 diabetes (T1D) on adherence, glycemic control, and quality of life. Methods: Adolescents with T1D (n = 120) and their caregivers were randomized to either an Education (EDU) (n = 60) or Positive Affect (PA) intervention (n = 60). Adolescents in t...

The prevalence of obesity among African Americans is higher than among other racial/ethnic groups. African American churches hold a central role in promoting health in the community; yet, church-based interventions have had limited impact on obesity. While recent studies have described the influence of social networks on health behaviors, obesity i...

Introduction Decision aids are central to shared decision making and are recommended for value‐sensitive pregnancy decisions, such as birth after cesarean. However, effective strategies for widespread decision aid implementation, with interactive web‐based platforms, are lacking. This study tested the feasibility and acceptability of implementing a...

BACKGROUND The highest rates of new human immunodeficiency virus (HIV)-infections are observed in African Americans/Blacks and Hispanics (AABH) adolescents and young adults (AYA). Initiation and maintenance of optimal antiretroviral treatment (ART) adherence is the single most important criterion to prevent HIV related morbidity, mortality, and sec...

Background The highest rates of new HIV infections are observed in African Americans and Hispanics/Latinos (ethnic minority) adolescents and young adults (youth). HIV-infected ethnic minority youth are less likely to initiate and maintain adherence to antiretroviral treatment (ART) and medical care, as compared with their adult counterparts. Objec...

Purpose: The purpose of this study was to evaluate relationships between behavioral and psychosocial constructs, A1C, and diabetes-dependent quality of life (DQoL) among low-socioeconomic status, ethnically diverse young adults with diabetes. Methods: Using baseline data of 81 participants in the Resilient, Empowered, Active Living (REAL) random...

Problems with adherence are common among adolescents with Type 1 diabetes (T1D), who must follow a complex treatment regimen. Positive psychology interventions increase adherence and improve health outcomes in adults with chronic conditions; however, they have not been translated to pediatric populations. We evaluated the acceptability and feasibil...

Introduction Decision aids have been recommended for value‐sensitive health care decisions such as mode of birth after previous cesarean. However, effective strategies for widespread clinical implementation of decision aids, to reduce disparities and improve shared decision‐making experiences, are currently lacking. The purpose of this study was to...

Background: Customizing monitor alarm settings to individual patients can reduce alarm fatigue in intensive care units (ICUs), but has not been widely studied. Objectives: To understand ICU nurses' approaches to customization of electrocardiographic (ECG) monitor alarms. Methods: A convergent mixed methods study was conducted in 3 ICUs in 1 ho...

Purpose of review: Despite increased survivorship and the subsequent need for chronic management of cancer, the association of self-management and palliative care is still emerging within cancer care. Routine and timely use of self-management strategies in the palliative setting can help reduce self-management burden and maximize quality of life....

Background: In China, about 53.4 million women (11%) have type 2 diabetes (T2DM). Women with prior 2 (GDM) are at a high risk for T2DM. Postpartum lifestyle interventions have been effective in reducing T2DM for this population, but the evidence is limited to interventions provided in urban areas, despite the fact that a higher prevalence of undia...

There is limited understanding about the obesity-related behaviors of diet, physical activity, and sedentary behavior in Korean American women. The purpose of this study was to cluster obesity-related behavior patterns of Korean American women and to examine group differences in acculturation, socioeconomic status (SES), and body mass index (BMI)....

Parents of teens with type 1 diabetes (T1D) are responsible for a labor-intensive and complicated daily regimen that has been described as overwhelming and requiring constant vigilance. Parents report high levels of stress, particularly during the adolescent transition. The primary aim of this study was to identify demographic (parent/child age, ge...

Parents of teens with type 1 diabetes (T1D) report challenges in maintaining involvement with diabetes care while supporting teen autonomy. We developed a web-based tool to support parents in this transition—Type 1 Teamwork—that provides interactive content and video vignettes of real families on challenges and strategies to transition T1D care fro...

Objectives African Americans (AAs) have a higher prevalence of sleep disorders than other racial/ethnic groups. However, little is known about the relationships among individual and neighborhood factors related to sleep quality in AAs. The purposes of this study were to (1) describe beliefs about sleep, sleep hygiene behaviors, and sleep quality am...

Purpose of review: The purpose of this review was to synthesize the research on the experience of partners living with adults with type 1 diabetes (T1D). Recent findings: Eleven studies were included in the review. Three themes on the experience of living with a person with T1D were identified: the undercurrent of hypoglycemia, partners' involve...

Heart failure (HF) is a chronic disease associated with poor prognosis, poor quality of life (QOL), and high medical costs among older adults. Monitoring symptoms, interpreting symptoms, and decision making are self-care skills required for effective HF management. Telemonitoring (TM) is increasingly used to reduce incidence of symptom exacerbation...

Objective: To assess the efficacy of a manualized occupational therapy (OT) intervention (Resilient, Empowered, Active Living with Diabetes [REAL Diabetes]) to improve glycemic control and psychosocial well-being among ethnically diverse young adults with low socioeconomic status (SES) who have type 1 or type 2 diabetes. Research design and metho...

Background: Alarm fatigue threatens patient safety by delaying or reducing clinician response to alarms, which can lead to missed critical events. Interventions to reduce alarms without jeopardizing patient safety target either inaccurate or clinically irrelevant alarms, so assessment of alarm accuracy and clinical relevance may enhance the rigor...

Purpose The purpose of this study was to understand the experience of parenting an adolescent with type 1 diabetes (T1DM), to develop a prototype of an eHealth program for parents of adolescents with T1DM, and to evaluate the prototype content and acceptability from the perspective of parents and health care providers. Methods A multiphase method...

The objective of this integrative review was to describe current US trends for health technology-enabled adherence interventions among behaviorally HIV-infected youth (ages 13–29 years), and present the feasibility and efficacy of identified interventions. A comprehensive search was executed across five electronic databases (January 2005–March 2016...

The aim of this study was to identify aggressive event incidence rates in the inpatient psychiatric setting, describe characteristics of events and differences based on aggression target and type (verbal vs. physical). A longitudinal study was carried out of aggressive events identified by workers in four inpatient psychiatric units using the Staff...

Aim and objectives: The purpose of the paper was to describe obesity-risk behaviors (diet, physical activity, and sedentary behavior) and examine the relationships of the obesity-risk behaviors with body mass index (BMI) in school-aged Korean American children. Background: Korean American children have a risk of becoming overweight or obese and...

Background Type 1 diabetes (T1D) is one of the most common chronic health conditions in adolescents in the United States. Adherence to the recommended treatment regimen has been reported as a source of stress for adolescents. Aim The purpose of this study was to examine the associations among general and diabetes-specific stress and glycemic contr...

Although the Korean church has been frequently used to recruit Korean immigrants in research, little is known about the specific strategies and process. The purpose of this integrative review was to describe recruitment strategies in studies of Korean immigrants and to identify the process of Korean church-based recruitment. Thirty-three studies me...

The objective was to describe Diabetes Prevention Program (DPP)-based lifestyle interventions delivered via electronic, mobile, and certain types of telehealth (eHealth) and estimate the magnitude of the effect on weight loss. A systematic review was conducted. PubMed and EMBASE were searched for studies published between January 2003 and February...

Aims: To describe the prevalence of overweight and obesity in adolescents with type 1 diabetes (T1D) and to examine the associations among socio-demographic, clinical, and self-management factors by weight status. Methods: We analyzed baseline data obtained from 5529 adolescents with T1D (mean age=15.4±1.4years, 51.8% male, 77.9% white, mean HbA...