• Healthcare Provider Communication with Young Adults: Patient-Centered Communication, Patient Satisfaction, Patient Trust, Social Support, Self-Care Skills, and Emotional Well-Being

      Nichols, Helen M.; Sacco, Paul; 0000-0002-6782-0869 (2018)
      Patient-centered communication is critical to the delivery of quality healthcare services. Although numerous health outcomes have been connected to patient-provider communication, there is limited research that has explored the processes and pathways between communication and health. Research among young adults (ages 26-39 years) is even more scarce, despite findings that health communication does vary with age. This study used data from the 2014 Health Interview National Trends Survey to (1) test a scale of seven items measuring patient-centered communication among young adults age 26 to 39 and (2) explore the relationship between patient-centered communication, patient trust, patient satisfaction, social support, self-care skills, and emotional well-being among young adults age 26 to 39. Exploratory and confirmatory factor analyses were conducted and results showed that a one-factor model of patient-centered communication among young adults fit the data well. In the final regression model, income, history of depression diagnosis, patient-centered communication, patient trust, social support, and patient self-efficacy (self-care skills) were all significantly related to emotional well-being. Post-hoc analyses showed that self-efficacy and patient trust modify the association between general health and emotional well-being. Among respondents who reported poor overall health, increases in self-efficacy and trust in their provider are associated with corresponding improvement in their predicted emotional well-being. This is in contrast to respondents who reported excellent overall health, for whom an improvements in self-efficacy and trust did not have the same effect on predicted emotional well-being. There was a significant interaction between depression and self-efficacy, as respondents who reported being diagnosed with depression showed a stronger relationship between self-efficacy and greater predicted well-being. Post-hoc analyses also showed significant interactions between patient-centered communication, satisfaction, and social support. Respondents who reported lower levels of PCC, showed decreased predicted emotional well-being as their satisfaction and perceived social support increased. These findings suggest the need to explore the means through which communication can impact emotional well-being, specifically among young adults who are in poor health or have a history of depression. Future research should also include longitudinal studies, in order to determine causality and directionality among constructs.
    • The Relationship Between Alcohol Use and Gambling in Emerging Adulthood

      Jun, Hyun-Jin; Harrington, Donna; Sacco, Paul (2017)
      Emerging adults (ages 18-29 years) display higher prevalence and co-occurrence of alcohol use and gambling than do adults over age 29, which may lead to negative psychological symptoms, behavioral problems, and socioeconomic and medical costs. However, nationally representative research focused on the developmental relationships across these behaviors is limited. This study used multiple waves of National Longitudinal Study of Adolescent to Adult Health (Add Health) data to examine the relationships between earlier depressive symptoms (Wave III), antisocial behaviors (Wave III), alcohol use (Wave III), and gambling behaviors (Wave III) as predictors of later gambling behaviors (Wave IV) in emerging adults ages 18-29 while adjusting for relevant sociodemographic characteristics ((Waves I, II, and IV). It also examined gender differences in those prospective links. Findings from the path analysis suggested that alcohol-use behaviors were associated with antisocial behaviors but not with depressive symptoms, and earlier gambling behaviors were the best predictors of later gambling behaviors. Earlier depressive symptoms and binge drinking were associated with decreased risk of later gambling participation. Interestingly, endorsement of earlier antisocial behaviors was indirectly associated with a decreased risk of later gambling participation through its effect on binge drinking. The findings from multigroup analyses identified significant gender differences in the relationships between past-year alcohol use and heavy drinking (Wave III), binge drinking (Wave III) and gambling problems (Wave IV), and alcohol-related problems and gambling participation (Wave III). However, the only parameter statistically significant in models for both gender groups was past-year alcohol use and heavy drinking, indicating that a stronger association for men than women. The results suggest the need to focus on multiple risk behaviors and support for screening and early intervention for these risk behaviors (i.e., alcohol use and gambling) as a means of secondary prevention in emerging adults. Future research should further investigate the roles of antisocial behaviors, binge drinking, and gambling during emerging adulthood in vulnerability for future alcohol and gambling problems and consider other confounding factors and gender-specific risk factors.