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CONTEXT Most older adults with dementia will be cared for by primary care physicians, but the primary care practice environment presents important challenges to providing quality care. OBJECTIVE To test the effectiveness of a collaborative care model to improve the quality of care for patients with Alzheimer disease. DESIGN, SETTING, AND PATIENTS(More)
OBJECTIVE To assess the relationship between depression and anxiety comorbidity on pain intensity, pain-related disability, and health-related quality of life (HRQL). METHODS Analysis of baseline data from the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study. All patients (n = 500) had chronic pain (>or=3-month duration) of the(More)
BACKGROUND AND PURPOSE Balance impairment is common after stroke; modified yoga may be able to improve balance and other important poststroke variables. Scientific-evidence is needed to support such treatment interventions. The purpose of this study was to assess the impact of a yoga-based rehabilitation intervention on balance, balance self-efficacy, fear(More)
Secondary stroke prevention is championed as guideline care; yet there are no systematic programs offered. We developed a stroke self-management program to address this gap and pilot test the program. We conducted a randomized controlled trial at two Veterans Administration (VA) hospital sites where we recruited patients with an acute stroke to receive(More)
BACKGROUND The Promoting Action on Research Implementation in Health Services framework, or PARIHS, is a conceptual framework that posits key, interacting elements that influence successful implementation of evidence-based practices. It has been widely cited and used as the basis for empirical work; however, there has not yet been a literature review to(More)
BACKGROUND Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for primary care. A brief and straightforward(More)
This research investigated the effects of health and environmental factors on the dropout and intermittent nonattendance of an exercise program designed specifically for older, female, primary-care patients living in the inner city. Class-attendance records (n = 21,538) from a cohort 110 women were analyzed. Women who dropped out early had poorer perceived(More)
BACKGROUND Although previous research suggests women report more severe pain than men, evidence for sex-related differences in pain-related disability is conflicting. Also, the impact of psychological factors on sex differences in disability is uncertain. OBJECTIVE The purpose of this study is to assess sex differences in pain-related disability and(More)
Physical activity after stroke may prevent disability and stroke recurrence; yet, physical impairments may inhibit poststroke exercise and subsequently limit recovery. The goal of this study was to elicit barriers to and facilitators of exercise after stroke. We conducted three focus groups and achieved content saturation from 13 stroke survivors--eight men(More)
OBJECTIVE Fear of falling (FoF) after stroke is not well understood. We assessed change in FoF over the first 6 mo after a stroke and compared 6-mo anxiety, depression, balance, and quality of life (QoL) scores between people with and without baseline FoF (at the time of hospital discharge). METHOD Data for this longitudinal study were collected at(More)