Browsing by Author "Shanahan, Mackenzie L."

Now showing 1 - 4 of 4
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    Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): Rationale, study design, methods, and sample characteristics
    (Elsevier, 2022-07) Matthias, Marianne S.; Adams, Jasma; Burgess, Diana J.; Daggy, Joanne; Eliacin, Johanne; Flores, Perla; Hirsh, Adam T.; Myers, Laura J.; Perkins, Anthony J.; Menen, Tetla; Procento, Philip; Rand, Kevin L.; Salyers, Michelle P.; Shanahan, Mackenzie L.; Bair, Matthew J.; Medicine, School of Medicine
    Background Chronic pain is associated with profound negative effects, and racial disparities are well-documented in chronic pain treatment. In addition, Black patients report poorer communication with providers and exhibit lower levels of patient activation (self-management self-efficacy) than White patients. Although the causes of healthcare disparities are complex and require intervention at multiple levels, empowering patients is one critical path to achieving health equity. The current study is a coaching intervention focused on increasing patient activation and building communication skills for Black patients with chronic pain. Methods In this randomized controlled trial, 250 Black patients with chronic pain were randomized to either the coaching intervention or an attention control arm. Intervention patients attended 6 telephone-delivered individual coaching sessions over 12 weeks. Coaching focused on clarifying and prioritizing goals and on communication skills, such as agenda setting. The primary outcome is patient activation. Secondary outcomes include communication self-efficacy, pain intensity and interference, and psychological functioning. Discussion Having the knowledge and confidence to participate in one's pain care, coupled with the skills needed to effectively communicate with providers, is essential to optimize chronic pain care. This is particularly important for Black patients who often experience lower quality pain care. Interventions such as COOPERATE hold promise for helping patients to acquire the requisite tools to take greater control of their chronic pain care.
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    Effects of Mindfulness-Based Interventions on Fatigue in Cancer Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    (Elsevier, 2021-04) Johns, Shelley A.; Tarver, Will L.; Secinti, Ekin; Mosher, Catherine E.; Stutz, Patrick V.; Carnahan, Jennifer L.; Talib, Tasneem L.; Shanahan, Mackenzie L.; Faidley, Micah T.; Kidwell, Kelley M.; Rand, Kevin L.; Psychology, School of Science
    This systematic review and meta-analysis was designed to determine the efficacy of mindfulness-based interventions (MBIs) in improving fatigue-related outcomes in adult cancer survivors. Randomized controlled trials (RCTs) were identified from PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, and EMBASE databases and reference lists of included studies. Separate random-effects meta-analyses were conducted for fatigue and vitality/vigor. Twenty-three studies reporting on 21 RCTs (N=2,239) met inclusion criteria. MBIs significantly reduced fatigue compared to controls at post-intervention (g=0.60, 95% CI [0.36, 0.83]) and first follow-up (g=0.42, 95% CI [0.20, 0.64]). Likewise, MBIs significantly improved vitality/vigor at post-intervention (g=0.39, 95% CI [0.25, 0.52]) and first follow-up (g=0.35, 95% CI [0.03, 0.67]). The evidence grade was low due to risk of bias, substantial heterogeneity, and publication bias among studies. MBIs show promise in improving fatigue and vitality/vigor in cancer survivors. More rigorous trials are needed to address current gaps in the evidence base.
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    Hope and Optimism as Predictors of Academic Performance and Subjective Well-Being in College Students
    (Elsevier, 2020-07) Rand, Kevin L.; Shanahan, Mackenzie L.; Fischer, Ian C.; Fortney, Sarah K.; Psychology, School of Science
    Objective Snyder's (1994) hope and Scheier and Carver's (1985) optimism have been shown to independently predict academic performance and changes in subjective well-being. This study seeks to clarify their unique associations. Method An undergraduate class (N = 334, 59.6% female, 75.7% Caucasian, M = 19.89 years) was studied at two time points in a semester. Students predicted their expected grade in the course and completed measures of hope, optimism, and subjective well-being (i.e., positive affect, negative affect, and life satisfaction) the first week of classes. The final week of classes, students completed subjective well-being measures and final grades were obtained from the instructor. Results Path analysis showed that hope, but not optimism, predicted grade expectancy. Grade expectancy, in turn, predicted final grades, even after controlling for previous academic achievement. Hope did not directly predict final course grade, but had a significant indirect effect through grade expectancy. Path analysis showed that hope significantly predicted increases in positive affect and life satisfaction over the semester; whereas, optimism predicted decreases in negative affect. Conclusion These findings extend previous research demonstrating that hope and optimism, while conceptually similar, have differential longitudinal associations with academic performance and subjective well-being among college students. Implications for screening for at-risk college students and employing targeted interventions are discussed.
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    Hope, Optimism, and Affect as Predictors and Consequences of Expectancies: The Potential Moderating Roles of Perceived Control and Success
    (Elsevier, 2020) Shanahan, Mackenzie L.; Fischer, Ian C.; Rand, Kevin L.; Psychology, School of Science
    Hope and optimism may be differentially influential depending on the situational context. This study sought to (1) experimentally test whether hope and optimism differentially predict specific expectancies in controllable versus uncontrollable situations and (2) examine the relative impact of specific expectancies on affect when desired outcomes are (or are not) achieved. A 2 × 2 independent samples design was used to experimentally manipulate perceived control and situational outcome (i.e., success or failure). Online participants (N = 571) completed self-report measures of hope and optimism before being randomly assigned to one of four experimental conditions. Results showed that hope, but not optimism, predicted specific expectancies in the perceived control condition. Conversely, optimism, but not hope, predicted specific expectancies in the no perceived control condition. More optimistic specific expectancies of success predicted greater positive affect regardless of success or failure outcome.