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Zhang CQ, Zhang R, Chung PK, Duan Y, Lau JTF, Chan DKC, Hagger MS. Promoting influenza prevention for older adults using the Health Action Process Approach: A randomized controlled trial. Appl Psychol Health Well Being 2023; 15:1427-1445. [PMID: 36951134 DOI: 10.1111/aphw.12445] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/06/2023] [Indexed: 03/24/2023]
Abstract
Older adults are at greater risk of complications from seasonal influenza, and promoting uptake and adherence to preventive behaviors is key to attenuating this risk. The current study examined the efficacy of a theory-based telephone-delivered intervention to promote uptake and maintenance of influenza preventive behaviors in a sample of Hong Kong residents 65 years and older. The intervention adopted a three-group randomized controlled design (n = 312) with two intervention conditions, motivational and motivational + volitional, and a measurement-only control condition. The primary outcome variable was self-reported compliance with influenza preventive behaviors, including washing hands, avoiding touching eyes, nose, or mouth, and wearing face masks. Secondary outcomes were theory-based psychological variables. Influenza preventive behaviors in participants in the motivational + volitional intervention group were significantly improved 3 months post-intervention relative to those in the control condition. However, participants in the intervention group demonstrated no difference in behavior at 6 and 12 months post-intervention relative to the participants in the control group. Intervention effects were observed on the theory-based social support, action planning, and coping planning variables. Although short-term benefits of the intervention were observed, effects appeared to be short-lived and future research should investigate more intensive interventions that lead to greater behavioral maintenance.
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Affiliation(s)
- Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Ru Zhang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Pak-Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Joseph Tak Fai Lau
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Derwin King Chung Chan
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, China
| | - Martin S Hagger
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- School of Applied Psychology, Griffith University, Nathan Campus, Nathan, Queensland, Australia
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2
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Sheeran P, Suls J, Bryan A, Cameron L, Ferrer RA, Klein WMP, Rothman AJ. Activation Versus Change as a Principle Underlying Intervention Strategies to Promote Health Behaviors. Ann Behav Med 2023; 57:205-215. [PMID: 36082928 PMCID: PMC10305802 DOI: 10.1093/abm/kaac045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Interventions are effective in promoting health behavior change to the extent that (a) intervention strategies modify targets (i.e., mechanisms of action), and (b) modifying targets leads to changes in behavior. To complement taxonomies that characterize the variety of strategies used in behavioral interventions, we outline a new principle that specifies how strategies modify targets and thereby promote behavior change. We distinguish two dimensions of targets-value (positive vs. negative) and accessibility (activation level)-and show that intervention strategies operate either by altering the value of what people think, feel, or want (target change) or by heightening the accessibility of behavior-related thoughts, feelings, and goals (target activation). METHODS AND RESULTS We review strategies designed to promote target activation and find that nudges, cue-reminders, goal priming, the question-behavior effect, and if-then planning are each effective in generating health behavior change, and that their effectiveness accrues from heightened accessibility of relevant targets. We also identify several other strategies that may operate, at least in part, via target activation (e.g., self-monitoring, message framing, anticipated regret inductions, and habits). CONCLUSIONS The Activation Vs. Change Principle (AVCP) offers a theoretically grounded and parsimonious means of distinguishing among intervention strategies. By focusing on how strategies modify targets, the AVCP can aid interventionists in deciding which intervention strategies to deploy and how to combine different strategies in behavioral trials. We outline a research agenda that could serve to further enhance the design and delivery of interventions to promote target activation.
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Affiliation(s)
- Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jerry Suls
- Center for Personalized Health, Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
| | - Angela Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Linda Cameron
- Psychological Sciences, School of Social Sciences, University of California, Merced, Merced CA, USA
| | - Rebecca A Ferrer
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
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Kruse SP, Nguyen L, Karki S, Thorpe R, Davison TE. "Please help us with important research": A retrospective analysis examining the impact of research invitation and participation on subsequent blood donor behavior. Transfusion 2022; 62:2086-2094. [PMID: 36082532 DOI: 10.1111/trf.17078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND As over-communication can negatively impact consumer behavior, it is important to understand the impact of research communication on donors' future donation behavior. The aim of this study was to determine the effect of (i) being invited to participate in research, and (ii) participating in that research, on future donation behavior. STUDY DESIGN AND METHODS A retrospective cohort analysis was conducted with 36,418 donors who were invited to participate in one of 17 research projects, and a matched control group of 36,252 non-invited donors. Poisson regression models were used to examine the associations between invitation or participation in the studies and the likelihood of creating an appointment to donate and attending an appointment at 1, 3, and 6 months. RESULTS Donors were significantly more likely to create an appointment within 14 days of receiving an invitation compared to controls (RR: 1.91, 95% CI 1.81-2.02), and to return to donate at 1 (RR:1.18, 95% CI 1.13-1.24), 3 (RR:1.10, 95% CI 1.07-1.13) and 6 (RR:1.11, 95% CI 1.09-1.13) months compared to non-invited controls. Donors who participated in the research were more likely to return than control donors at all time points, while donors who were invited but did not participate were also likely to return more at 1 month (RR:1.06, 95% CI 1.00-1.11) and 6 months (RR:1.03, 95% CI 1.00-1.5) than non-invited controls. DISCUSSION Our findings suggest that research participation is positively associated with future donor behavior and provides reassurance that contacting donors for research does not negatively impact blood collections.
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Affiliation(s)
- Sarah P Kruse
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Lilly Nguyen
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Surendra Karki
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia.,School of Population Health, University of New South Wales, Kennington, New South Wales, Australia
| | - Rachel Thorpe
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia.,Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tanya E Davison
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia.,Monash Art, Design and Architecture, Monash University, Clayton, Victoria, Australia
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Teixeira da Silva AC, Chagas Gerônimo de Lima CC, de Oliveira Prado Sousa B, Dos Santos MA, Pillon SC, Souza ALTD. Tobacco and alcohol consumption and health behaviors among nursing students. AVANCES EN ENFERMERÍA 2022. [DOI: 10.15446/av.enferm.v40n2.92408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Objetive: To evaluate the association between attitudes, health behaviors, and the use of tobacco and alcohol among nursing students.
Materials and method: Exploratory, descriptive and cross-sectional study conducted with 182 undergraduate nursing students in the countryside of São Paulo, Brazil. Sociodemographic Information Form, Alcohol Use Disorders Identification Test – C(AUDIT-C), Fagerström Test for Nicotine Dependence (FTND), Attitudes and Health Behaviors Questionnaire (AHBQ), and Patient Health Questionnaire – 2 (PHQ-2) were applied.
Results: More than half of the students showed appropriate health behaviors and positive attitudes. Approximately 50% of the participants had consumed alcoholic beverages in the last month. Experimental use of illicit drugs and smoking were also observed. In addition, students who reported excessive alcohol use presented a deficit in self-care.
Conclusion: The precariousness in health attitudes and behaviors identified in this study was associated with various patterns of psychoactive substance use. Thus, the results indicate the need for interventions aimed at promoting well-being and a healthy lifestyle in the university environment.
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Rosenberg D, Mano R, Mesch GS. Ethnicity and Perceived Influence of Social Media-Based Health Information on Health Decisions and Behaviors: A Test of the Social Diversification Hypothesis. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2021.1997055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dennis Rosenberg
- Department of Social Sciences and Philosophy, University of Jyvaskyla, Jyvaskyla, Finland
- School of Public Health, University of Haifa, Haifa, Israel
| | - Rita Mano
- Faculty of Social Welfare and Health Sciences, Department of Human Services, University of Haifa, Haifa, Israel
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6
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Lecours A, Beaulieu AA, Poulin V, Nastasia I, St-Hilaire F. Development of a Questionnaire Measuring Preventive Behaviors at Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:570-580. [PMID: 33398507 DOI: 10.1007/s10926-020-09955-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Purpose This study aimed to develop a questionnaire measuring preventive behaviors at work. Methods A three-step design, including qualitative and quantitative methods, was followed: (1) item generation, (2) experts' validation of content, and (3) pretesting. Results For step 1, 49 relevant existing scales were reviewed, and a pool of 172 items was generated. Redundant items were deleted (n = 48), and unclear items were reworded (n = 27). For step 2, 14 experts (five occupational therapists, four researchers, and five workers) assessed the representativeness, relevance, and clarity of each item through content validity indices (CVIs). An average overall CVI of 0.97 was obtained, and 87.5% of the experts stated that the questionnaire was comprehensive. During this step, 63 items were deleted, and 35 were modified. For step 3, the tool was pretested in the clinical settings of four dyads (occupational therapist-worker). The thematic analysis of interview content allowed several changes to be made to the questionnaire, including the addition of information and format changes. Conclusions Overall, this three-step study led to the construction of a 61-item French questionnaire entitled the Échelle de fréquence des comportements préventifs au travail [Frequency Scale of Preventive Behaviors at Work]. In rehabilitation settings, this tool could be useful to support professionals in enabling workers to adopt preventive behaviors, thereby fostering a healthy, sustainable return to work after a disability period. However, further metrological property assessment is required. A validating study using a large pool of workers is ongoing.
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Affiliation(s)
- Alexandra Lecours
- Département de réadaptation, Université Laval, Pavillon Ferdinand-Vandry 1050, Avenue de la Médecine, Québec, QC, G1V 0A6, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada.
- Équipe sur les organisations en santé, École de gestion, Université de Sherbrooke, Sherbrooke, Canada.
| | - Alex-Anne Beaulieu
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada
| | - Valérie Poulin
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et Sécurité du Travail, Montréal, Canada
| | - France St-Hilaire
- Équipe sur les organisations en santé, École de gestion, Université de Sherbrooke, Sherbrooke, Canada
- Département de management et gestion des ressources humaines, École de gestion, Université de Sherbrooke, Sherbrooke, Canada
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Chandu VC, Lingamaneni KP, Pachava S, Baddam VRR, Marella Y. The Influence of Dissonance Induction and Assessment Reactivity in Improving Adherence to COVID-19 Precautionary Measures: A Cluster Randomised Controlled Trial. Int Dent J 2021; 72:141-148. [PMID: 33875277 PMCID: PMC7980182 DOI: 10.1016/j.identj.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) pandemic, adherence to suggested precautionary measures has been emphasized as important in preventing and curtailing its spread. However, strict adherence to precautionary measures can be demanding. Methods This cluster randomised controlled trial done among 1517 undergraduate dental students tested the effectiveness of ‘dissonance induction’ (DI) and ‘assessment reactivity’ (AR) in improving adherence to World Health Organization (WHO) measures as compared to a control group. At baseline, participants in the DI group were tested for their knowledge of precautionary measures, immediately followed by assessment of their adherence to them. This methodology was adapted to systematically reveal the poor adherence of the participants in their self-held cognitions, should there be any. The magnitude of dissonance was measured as the proportion of such dissonant cognitions held by an individual. In the AR group, at baseline, participants were asked about their attitudes alone toward measures. The control group was neither assessed for knowledge and adherence nor for attitudes toward the measures at baseline. Two weeks after the administration of these interventions in the DI and AR groups, the 3 study groups were assessed for adherence. Results The follow-up adherence scores in the DI group were found to be significantly higher (15.11 ± 4.1) compared to the AR (13.13 ± 2.01) and control (12.87 ± 2.97) groups as analysed by Kruskal-Wallis analysis of variance (H = 243.5; P < .001). Wilcoxon signed-rank test showed that the adherence scores significantly improved in the DI group from baseline to follow-up (z = -8.84; P < .001). Magnitude of dissonance at baseline was found to be a significant predictor of follow-up adherence scores (R2 = 0.255). Conclusion This study found that DI is an easy intervention to bring an immediate and significant change in adherence to precautionary measures.
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Affiliation(s)
- Viswa Chaitanya Chandu
- Assistant Professor, Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, AP, India.
| | - Krishna Prasad Lingamaneni
- Professor and Head, Department of Oral & Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Guntur, AP, India
| | - Srinivas Pachava
- Professor and Head, Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, AP, India
| | - Venkat Ramana Reddy Baddam
- Professor and Head, Department of Oral Pathology & Microbiology, SIBAR Institute of Dental Sciences, Guntur, AP, India
| | - Yamuna Marella
- Assistant Professor, Department of Periodontics, SIBAR Institute of Dental Sciences, Guntur, AP, India
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Boggs JM, Beck A, Ritzwoller DP, Battaglia C, Anderson HD, Lindrooth RC. A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths. J Gen Intern Med 2020; 35:1709-1714. [PMID: 32040838 PMCID: PMC7280370 DOI: 10.1007/s11606-020-05641-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/03/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Counseling on access to lethal means is highly recommended for patients with suicide risk, but there are no formal evaluations of its impact in real-world settings. OBJECTIVE Evaluate whether lethal means assessment reduces the likelihood of suicide attempt and death outcomes. DESIGN Quasi-experimental design using an instrumental variable to overcome confounding due to unmeasured patient characteristics that could influence provider decisions to deliver lethal means assessment. SETTING Kaiser Permanente Colorado, an integrated health system serving over 600,000 members, with comprehensive capture of all electronic health records, medical claims, and death information. PARTICIPANTS Adult patients who endorsed suicide ideation on the Patient Health Questionnaire-9 (PHQ-9) depression screener administered in behavioral health and primary care settings from 2010 to 2016. INTERVENTIONS Provider documentation of lethal means assessment in the text of clinical notes, collected using a validated Natural Language Processing program. MEASUREMENTS Main outcome was ICD-9 or ICD-10 codes for self-inflicted injury or suicide death within 180 days of index PHQ-9 event. RESULTS We found 33% of patients with suicide ideation reported on the PHQ-9 received lethal means assessment in the 30 days following identification. Lethal means assessment reduced the risk of a suicide attempt or death within 180 days from 3.3 to 0.83% (p = .034, 95% CI = .069-.9). LIMITATIONS Unmeasured suicide prevention practices that co-occur with lethal means assessment may contribute to the effects observed. CONCLUSIONS Clinicians should expand the use of counseling on access to lethal means, along with co-occurring suicide prevention practices, to all patients who report suicide ideation.
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Affiliation(s)
- Jennifer M Boggs
- Kaiser Permanente Colorado Institute for Health Research, 2550 S. Parker Rd., Suite 200, Aurora, CO, 80014, USA.
- University of Colorado Anschutz Medical Campus, Aurora, USA.
| | - Arne Beck
- Kaiser Permanente Colorado Institute for Health Research, 2550 S. Parker Rd., Suite 200, Aurora, CO, 80014, USA
- University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Debra P Ritzwoller
- Kaiser Permanente Colorado Institute for Health Research, 2550 S. Parker Rd., Suite 200, Aurora, CO, 80014, USA
- University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Catherine Battaglia
- University of Colorado Anschutz Medical Campus, Aurora, USA
- Department of Veterans Affairs (VA) Eastern Colorado Health Care System, Aurora, CO, USA
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Self-Efficacy for Physical Activity-A Question of Item Framing and Age? J Aging Phys Act 2020; 28:173-179. [PMID: 31715580 DOI: 10.1123/japa.2019-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/03/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022]
Abstract
Older adults process and remember positive information relatively better than negative information, compared with younger adults; this is known as the positivity effect. This study examined whether older adults compared with younger adults also respond differently to positively and negatively framed questionnaire items. Participants (N = 275; age = 18-81 years) were randomly assigned to a positively or negatively framed version of a self-efficacy for physical activity questionnaire. Self-efficacy, physical activity intentions, and planned physical activity in the following week were regressed on experimental group and age, controlling for baseline physical activity and covariates. A significant Age × Frame interaction showed that item framing made a difference in planned physical activity for the oldest age group (+350 min compared with the youngest group). This study provides initial support for the positivity effect in item framing on physical activity plans, but not on intentions or self-efficacy. Item framing should be taken into consideration for accurate measurement, but could also be a simple intervention approach.
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Miles LM, Rodrigues AM, Sniehotta FF, French DP. Asking questions changes health-related behavior: an updated systematic review and meta-analysis. J Clin Epidemiol 2020; 123:59-68. [PMID: 32229251 PMCID: PMC7308800 DOI: 10.1016/j.jclinepi.2020.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 11/22/2022]
Abstract
Objectives The question-behavior effect (QBE) refers to whether asking people questions can result in changes in behavior. Such changes in behavior can lead to bias in trials. This study aims to update a systematic review of randomized controlled trials investigating the QBE, in light of several large preregistered studies being published. Study Design and Setting A systematic search for newly published trials covered 2012 to July 2018. Eligible trials randomly allocated participants to measurement vs. non-measurement control conditions or to different forms of measurement. Studies that reported health-related behavior as outcomes were included. Results Forty-three studies (33 studies from the original systematic review and 10 new studies) compared measurement vs. no measurement. An overall small effect was found using a random effect model: standardized mean difference = 0.06 (95% CI: 0.02–0.09), n = 104,388. Statistical heterogeneity was substantial (I2 = 54%). In an analysis restricted to studies with a low risk of bias, the QBE remained small but significant. There was positive evidence of publication bias. Conclusion This update shows a small but significant QBE in trials with health-related outcomes but with considerable unexplained heterogeneity. Future trials with lower risk of bias are needed, with preregistered protocols and greater attention to blinding.
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Affiliation(s)
- Lisa M Miles
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Angela M Rodrigues
- Department of Psychology, Northumbria University, Northumberland Building, Newcastle upon Tyne, NE1 8ST, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Baddiley Clark Building, Newcastle upon Tyne, NE2 4BN, UK
| | - David P French
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Conner M, Norman P. Health behaviour: cancer screening, blood and organ donation, and opioid (mis)use. Psychol Health 2019; 34:1029-1035. [DOI: 10.1080/08870446.2019.1649408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schüz B, Brick C, Wilding S, Conner M. Socioeconomic Status Moderates the Effects of Health Cognitions on Health Behaviors within Participants: Two Multibehavior Studies. Ann Behav Med 2019; 54:36-48. [DOI: 10.1093/abm/kaz023] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.
Purpose
Current research on SES as moderator of the health cognitions–health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models.
Methods
Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES.
Results
Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES.
Conclusions
Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.
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Affiliation(s)
- Benjamin Schüz
- Institute for Public Health and Nursing, University of Bremen, Bremen, Germany
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Cameron Brick
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Mark Conner
- School of Psychology, University of Leeds, UK
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Sheeran P, Conner M. Degree of reasoned action predicts increased intentional control and reduced habitual control over health behaviors. Soc Sci Med 2019; 228:68-74. [PMID: 30884424 DOI: 10.1016/j.socscimed.2019.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/18/2019] [Accepted: 03/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Research is needed to understand factors that attenuate the association between habits and health behavior performance. PURPOSE We tested whether degree of reasoned action (DRA) moderates both intention-behavior and habit-behavior relations. DRA was defined by how well cognitions predict behavioral intentions, and was measured by the respective within-participants multiple correlation (R). METHODS Four studies were undertaken. Two pilot studies established the validity of our measure of DRA. Studies 1 (N = 663) and 2 (N = 1014) were prospective surveys of eight and six health behaviors, respectively. Intentions were measured via standard scales and habits were indexed by measures of frequency of performance × context stability. RESULTS In both studies, habits attenuated the predictive validity of intention. However, well-reasoned intentions better predicted health behaviors than poorly reasoned intentions, and habits offered weaker prediction of behavior when intentions were well reasoned. Three-way DRA × intention × habit interactions were also observed. Habits best predicted health behaviors when intentions were weak and poorly reasoned (Study 1), or offered poorest prediction of health behaviors when intentions were both strong and well-reasoned (Study 2). CONCLUSIONS Degree of reasoned action predicts increased intentional control and reduced habitual control over multiple health behaviors.
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Affiliation(s)
- Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill and Center for Advanced Hindsight, Duke University, USA.
| | - Mark Conner
- School of Psychology, University of Leeds, UK
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