Jessica Risser, Terry A Jacobson, Sunil Kripalani
Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease
Journal of nursing measurement
extent environmental exposures community characteristics built environment collectively predict rapid lung function decline adolescence early adulthood cystic fibrosis cf examined identify built environment characteristics predictive rapid cf lung function decline performed retrospective singlecenter longitudinal cohort study n 173 individuals cf aged 620 years 20122017 used stochastic model predict lung function measured forced expiratory volume 1 fev1 predicted traditional demographicclinical characteristics evaluated predictors built environmental predictors included exposure elemental carbon attributable traffic sources ecat neighborhood material deprivation poverty education housing healthcare access greenspace near home residential drivetime cf center final model included ecat material deprivation index greenspace alongside traditional demographicclinical predictors significantly improved fit prediction compared demographicclinical predictors likelihood ratio test statistic 2678 p 00001 difference akaike information criterion 15 increase 01 gm3 ecat associated 0104 predictedyr 95 confidence interval 0024 0183 rapid decline although statistically significant material deprivation similarly associated 01unit increase corresponded additional decline 0103 predictedyear 0113 0319 highrisk regional areas rapid decline agerelated heterogeneity identified prediction mapping trafficrelated air pollution exposure important predictor rapid pulmonary decline coupled communitylevel material deprivation routinely collected demographicclinical characteristics enhance cf prognostication enable personalized environmental health interventions