Transtheoretical Model Constructs' Longitudinal Prediction of Sun Protection Over 24 Months

Determinants of the utilization of allergy management measures among hay fever sufferers: a theory-based cross-sectional study

Background

The quality of life of chronically ill individuals, such as hay fever sufferers, is significantly dependent on their health behavior. This survey aimed to explain the health-related behavior of allergic individuals using the protection motivation theory (PMT) and the transtheoretical model (TTM).

Methods

The influencing variables stated by PMT were operationalized based on data from semistructured pilot interviews and a pretest with 12 individuals from the target population. The final questionnaire inquired perceived seriousness and severity of hay fever, response efficacy, response costs, self-efficacy, and the use of various hay fever management measures in relation to the TTM stages. Multivariate logistic regression was performed to investigate the relationships between the PMT constructs and the examined health behavior.

Results

A total of 569 allergic individuals completed the online questionnaire. Only 33.26% of allergic individuals were in the maintenance stage for treatment under medical supervision, and almost 60% preferred hay fever self-management. A total of 67.56% had a well-established habit of taking anti-allergic medication, but only 25.31% had undergone specific immunotherapy. The likelihood of seeking medical supervision was positively influenced by perceived severity (OR = 1.35, 95% CI: 1.02–1.81), perceived seriousness (OR = 2.12, 95% CI: 1.56–2.89), and self-efficacy (OR = 4.52, 95% CI: 3.11–6.65). The perceived severity of symptoms predicted the practice of hay fever self-management (OR = 1.60, 95% CI: 1.21–2.11), as well as anti-allergic medication intake (OR = 1.65, 95% CI: 1.16–2.35). The latter measure was also positively influenced by self-efficacy (OR = 1.52, 95% CI: 1.01–2.28) and hay fever self-management (OR = 4.76, 95% CI: 2.67–7.49). Undergoing specific immunotherapy was significantly predicted only by medical supervision (OR = 9.80, 95% CI: 8.16–13.80). Allergen avoidance was a strategy used by allergic individuals who preferred hay fever self-management (OR = 2.56, 95% CI: 1.87–3.52) and experienced notable symptom severity (OR = 2.12, 95% CI: 1.60–2.81).

Conclusion

Educational interventions that increase the awareness of health risks associated with inadequate hay fever management and measures to increase self-efficacy might be beneficial for the promotion of appropriate hay fever management among allergic individuals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09959-w.

A Comparison of Profiles of Transtheoretical Model Constructs of Change among Depressed and Nondepressed Women at Risk for an Alcohol-Exposed Pregnancy

INTRODUCTION

The efficacy of a series of interventions to reduce risk of alcohol-exposed pregnancies is well-established, yet some subsets of women remain at risk. For instance, in CHOICES, a randomized clinical trial of an intervention to prevent alcohol-exposed pregnancy, nondepressed women reduced risk drinking at roughly twice the rate of women with depression (49% vs. 24%). This secondary analysis of CHOICES data examines constructs that can explicate differences between nondepressed and depressed women in the process of changing alcohol behavior.

METHODS

Profile analysis was used to compare the current status on transtheoretical model constructs of change between groups of depressed (n = 41) and nondepressed (n = 171) women in CHOICES at baseline and at the 9-month follow-up (end of the study). Participants were women aged 18 to 44 years who were at risk for an alcohol-exposed pregnancy at baseline. Measures included the Timeline Followback, Brief Symptom Inventory, and the transtheoretical model measures of decisional balance, self-efficacy, and experiential and behavioral processes of change.

RESULTS

Differences in profiles of the transtheoretical model constructs between groups were found at baseline and 9 months (p < .001). Women with depression had a profile that has historically predicted failure to change. Profiles among depressed women were distinguished by high scores on cons for changing alcohol use and temptation to drink.

CONCLUSIONS

Prevention interventions should assess for depression and target interventions to improve success. Results of this study can help practitioners to better tailor interventions to the needs of individuals with depression by strategically targeting decisional balance and self-efficacy.

Extending Theory-Based Quantitative Predictions to New Health Behaviors

BACKGROUND

Traditional null hypothesis significance testing suffers many limitations and is poorly adapted to theory testing.

PURPOSE

A proposed alternative approach, called Testing Theory-based Quantitative Predictions, uses effect size estimates and confidence intervals to directly test predictions based on theory.

METHOD

This paper replicates findings from previous smoking studies and extends the approach to diet and sun protection behaviors using baseline data from a Transtheoretical Model behavioral intervention (N = 5407). Effect size predictions were developed using two methods: (1) applying refined effect size estimates from previous smoking research or (2) using predictions developed by an expert panel.

RESULTS

Thirteen of 15 predictions were confirmed for smoking. For diet, 7 of 14 predictions were confirmed using smoking predictions and 6 of 16 using expert panel predictions. For sun protection, 3 of 11 predictions were confirmed using smoking predictions and 5 of 19 using expert panel predictions.

CONCLUSION

Expert panel predictions and smoking-based predictions poorly predicted effect sizes for diet and sun protection constructs. Future studies should aim to use previous empirical data to generate predictions whenever possible. The best results occur when there have been several iterations of predictions for a behavior, such as with smoking, demonstrating that expected values begin to converge on the population effect size. Overall, the study supports necessity in strengthening and revising theory with empirical data.