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Han L, Han X. The influence of price value on purchase intention among patients with chronic diseases in medical e-commerce during the COVID-19 pandemic in China. Front Public Health 2023; 11:1081196. [PMID: 36817906 PMCID: PMC9929061 DOI: 10.3389/fpubh.2023.1081196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
Background During the COVID-19 pandemic, medical e-commerce (MEC) has provided a way for patients with chronic diseases to purchase drugs online to maintain social distancing, decrease the risk of infection and community transmission, and relieve the burden on medical resources. Therefore, research which seeks to elucidate the drivers of purchase intention (PI) among patients with chronic diseases in MEC is vital. This study extended the theory of planned behavior (TPB) by integrating the price value (PV) variable into the original TPB framework and explored the effect of PV on patients' PI in MEC during the coronavirus pandemic. Methods Empirical data was gathered from 414 Chinese participants. Structural equation modeling was applied to explore the mechanism of chronic patients' PI in MEC. In addition, this study also estimated the moderating effect of gender, income, and region and the mediating role of attitude (ATT), subjective norm (SN), and perceived behavioral control (PBC) between PV and PI. Results Patients' PI in MEC is significantly affected by ATT, SN, and PBC. PV delivers significant influence on ATT, SN, PBC, and PI, with PV having the strongest effect on ATT. Gender, income, and region can significantly moderate the relationship between PV and ATT. Conclusion These findings can contribute to design targeted interventions to increase the adoption of MEC for patients with chronic diseases, decrease infection rates, and alleviate the strain on medical resources in the COVID-19 era.
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Affiliation(s)
- Linlin Han
- Faculty of Business Information, Shanghai Business School, Shanghai, China,*Correspondence: Linlin Han ✉
| | - Xu Han
- School of Information Engineering, Minzu University of China, Beijing, China
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Li H, Cao A, Chen S, Guo L. How does risk perception of the COVID-19 pandemic affect the consumption behavior of green food? ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 26:1-23. [PMID: 36530362 PMCID: PMC9734953 DOI: 10.1007/s10668-022-02819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Attention to health is on the rise with the global pandemic of COVID-19, especially in food security. Green food is viewed as a healthy, safe, and nutritious food, which plays a significant role in enhancing immunity. This study aimed to investigate how risk perception affects the consumption behavior of green food. Risk perception and health awareness were added to the original model based on the extended theory of planned behavior. And an online survey about the influence of COVID-19 on consumers' green food consumption behavior was conducted with 612 valid respondents recruited. The results indicate that risk perception has a positive effect on both consumption intention and behavior. The mediating effect analysis shows that risk perception influences green food consumption intention by improving people's attitudes, subjective norms, and health awareness. These findings can not only help clarify the relationship between green food consumption behavior and the risk perception of COVID-19 but also provide some valuable implications for policymakers and marketers in promoting green food.
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Affiliation(s)
- Houjian Li
- College of Economics, Sichuan Agricultural University, Wenjiang District, Chengdu, Sichuan China
| | - Andi Cao
- College of Economics, Sichuan Agricultural University, Wenjiang District, Chengdu, Sichuan China
| | - Si Chen
- College of Economics, Sichuan Agricultural University, Wenjiang District, Chengdu, Sichuan China
| | - Lili Guo
- College of Economics, Sichuan Agricultural University, Wenjiang District, Chengdu, Sichuan China
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Grech P, Grech R. The role of health promotion theories in Stroke Awareness and Education. Appl Nurs Res 2021; 58:151415. [PMID: 33745555 DOI: 10.1016/j.apnr.2021.151415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
The aim of this paper is to provide an overview of health promotion theories and their application to Stroke Awareness and Education. Stroke stands as one of the leading causes of mortality and morbidity even though treatment is readily available. One of the major challenges in this area is that the effectiveness of treatment depends heavily on timely presentation to healthcare services. Unfortunately, many individuals do not seek help whilst experiencing symptoms or only do so after a significant delay. This paper explores the main health promotion theories related to this problematic health behaviour in relation to stroke.
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Affiliation(s)
- Paulann Grech
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Malta.
| | - Reuben Grech
- Medical Imaging Department, Mater Dei Hospital, Malta
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Bao Y, Chen S, Jiang R, Li Y, Chen L, Li F, Tai J. The physical activity of colorectal cancer survivors during chemotherapy : Based on the theory of planned behavior. Support Care Cancer 2019; 28:819-826. [PMID: 31154534 DOI: 10.1007/s00520-019-04873-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate the physical activity (PA) of colorectal cancer (CRC) survivors during chemotherapy and to explain it based on the theory of planned behavior (TPB). In addition, the effects of planning, past physical activity (P-PA), and self-efficacy on the PA of CRC survivors were analyzed. METHODS CRC survivors were recruited in a third-grade hospital of Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, PA, constructs from the TPB, P-PA, planning, and self-efficacy. RESULTS A total of 174 CRC survivors were included in this study. Only 7.5% (13) of these CRC survivors had sufficient PA, and 32.2% (56) of CRC survivors were completely sedentary. Gender, education level, working status, residential location, method of payment for medical expenses, and cancer stage were all associated with PA in these patients (P < 0.05). The path model was able to explain 54% (R2 = 0.54) of the PA variance in these CRC survivors. P-PA had the greatest impact on PA during chemotherapy, and P-PA affected PA both directly and indirectly through planning. CONCLUSIONS Insufficient PA in CRC survivors was associated with a variety of factors, with P-PA having the greatest impact on this outcome. The results of this study suggest that attention must be paid to survivors who had exhibited insufficient PA prior to initial diagnosis.
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Affiliation(s)
- Yinan Bao
- School of Nursing, Jilin University, Changchun, Jilin province, China.,School of Nursing, Inner Mongolia Medical College, Hohhot, Inner Mongolia, China
| | - Si Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Ruxin Jiang
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Lei Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin province, China.
| | - Jiandong Tai
- The First Hospital of Jilin University, Changchun, Jilin province, China.
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Abidi S, Vallis M, Piccinini-Vallis H, Imran SA, Abidi SSR. Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform. JMIR Med Inform 2018; 6:e25. [PMID: 29669705 PMCID: PMC5932333 DOI: 10.2196/medinform.9629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. OBJECTIVE The aim of this study was to develop and evaluate a computerized decision support platform called "Diabetes Web-Centric Information and Support Environment" (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. METHODS A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners' readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association's (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients' progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient's self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. RESULTS For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool's screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. CONCLUSIONS This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients' feedback is now being used to make necessary modification to DWISE.
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Affiliation(s)
- Samina Abidi
- Medical Informatics Program, Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Michael Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Helena Piccinini-Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Syed Ali Imran
- Division of Endocrinology and Metabolism, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Syed Sibte Raza Abidi
- Knowledge Intensive Computing for Healthcare Enterprises Research Group, Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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Gabbiadini A, Greitemeyer T. Fitness mobile apps positively affect attitudes, perceived behavioral control and physical activities. J Sports Med Phys Fitness 2018; 59:407-414. [PMID: 29619794 DOI: 10.23736/s0022-4707.18.08260-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recent studies suggest that about 6 out of 10 users have installed a fitness tracking application on their smartphone. Nevertheless, more than 59% of adults do not engage in sufficient daily physical activity and much remains unknown with regard to the effectiveness of mobile applications. By adopting the Theory of Planned Behavior, we tested whether the use of fitness apps for daily steps tracking could positively influence people's health behavior. METHODS Participants (N.=78) were randomly assigned to one of two experimental conditions; in one condition, they were asked to adopt a fitness app for two weeks. No information regarding mobile apps was given for participants in the control condition. In order to test the effects of using a fitness app, a series of two-way mixed ANOVAs were conducted. RESULTS Participants in the experimental condition reported more favorable attitudes in the post-test compared to the pre-test, t(43)=4.09, P<0.001, d=0.65. By contrast, in the control condition, the difference on attitudes between pre-test and post-test was not significant (P=1.00). They also reported higher perceived behavioral control (PBC) scores, t(43) =4.97, P<0.001, d=0.75, whereas the difference on PBC for the control condition was not significant (P=0.27). Participants who used a fitness app reported to have walked more in the post-test compared to the pre-test, t(43) =2.41, P=0.02, d=0.36, whereas self-reported behavior did not change for participants in the control condition (P=0.46). CONCLUSIONS The present study provides encouraging evidence for the positive effects of using a fitness-tracking app in promoting health behavior.
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Clough BA, Nazareth SM, Casey LM. The Therapy Attitudes and Process Questionnaire: A Brief Measure of Factors Related to Psychotherapy Appointment Attendance. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 10:237-250. [PMID: 27718132 DOI: 10.1007/s40271-016-0199-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient non-attendance and dropout remains problematic in mental health settings. The theory of planned behavior (TPB) has proven useful in understanding such challenges in a variety of healthcare settings, but the absence of an adequate measure in mental health has hampered research in this area. OBJECTIVE The aim of the current study was to develop and conduct an initial psychometric investigation of a brief measure, the Therapy Attitudes and Process Questionnaire (TAP), utilizing the TPB to understand factors associated with attendance in mental health settings. METHODS We used a quantitative survey-based design and administered the TAP to 178 adult participants who were engaged in individual or group psychotherapy. A subsample also provided data to assess validity and reliability. RESULTS A four-factor solution was revealed through exploratory factor analysis and accounted for approximately 75 % of the variance in scores. Factors corresponded to those predicted by the TPB. Analyses supported the reliability, validity, and internal consistency of the measure. CONCLUSIONS Results suggest that the TAP may be a useful tool for examining patients' attitudes and beliefs about attending psychotherapy appointments. The TAP can be used to better understand patients' intentions, attitudes, perceptions of behavioral control, and subjective norms relating to psychotherapy attendance. This understanding may facilitate improved outcomes for patients and clinicians.
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Affiliation(s)
- Bonnie A Clough
- School of Psychology and Counselling, Institute for Resilient Regions, University of Southern Queensland, 37 Sinnathamby Boulevard, Springfield Central, QLD, 4300, Australia.
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia.
| | - Sonia M Nazareth
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia
| | - Leanne M Casey
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia
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Mitzner TL, McBride SE, Barg-Walkow LH, Rogers WA. Self-Management of Wellness and Illness in an Aging Population. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/1557234x13492979] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this chapter, we review the last 10 years of literature on self-management of illnesses (acute/episodic and chronic) and wellness (e.g., health promotion). We focus on health self-management in the context of an aging population, wherein middle-aged adults are more likely to be managing wellness activities and older adults are often managing both maintenance of health and chronic illnesses. The critical issues related to self-management of health are discussed, including those imposed by health care demands and those stemming from individual differences in general abilities (e.g., motor, perception, cognition) and socioemotional characteristics. The dynamic relationship between theory and practice is highlighted. Health care demands reflect the nature of the illness or wellness activity and include managing comorbidities, symptoms, and medications; engaging in health promotion activities (e.g., exercise, diet); the required use of health technologies; the need for health-related information; and coordination of the care network. Individual differences in motor, perceptual, and cognitive abilities, as well as in the severity and complexity of the illness and the consequent demands, also impact how a person self-manages health. Cognitive abilities, such as decision making, knowledge, literacy (i.e., general, health, and e-health literacy), and numeracy are particularly implicated in the process of managing one’s own health and are especially important in the context of an aging population; therefore we give these cognitive abilities special attention in this chapter. Socioemotional characteristics, and attitudes and beliefs about one’s health, impact an individual’s self-management of health as well, impacting his or her motivation and goal-setting behaviors. Moreover, we discuss literature on interventions that have been used to improve self-management of health, and we examine the potential for technology. We conclude with guidelines for technology design and instruction, and discuss emerging themes.
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Al-Lozi E, Papazafeiropoulou A. Intention-Based Models: The Theory of Planned Behavior Within the Context of IS. INFORMATION SYSTEMS THEORY 2012. [DOI: 10.1007/978-1-4419-9707-4_12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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10
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Clough BA, Casey LM. Technological adjuncts to increase adherence to therapy: A review. Clin Psychol Rev 2011; 31:697-710. [DOI: 10.1016/j.cpr.2011.03.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/14/2011] [Accepted: 03/17/2011] [Indexed: 11/24/2022]
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Mosler HJ, Kraemer S. Which psychological factors change when habitual water treatment practices alter? J Public Health (Oxf) 2011. [DOI: 10.1007/s10389-011-0435-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Park BH, Lee MS, Hong JY, Bae SH, Kim EY, Kim KK, Kim DK. The Stages of Physical Activity and Exercise Behavior: An Integrated Approach to the Theory of Planned Behavior. Asia Pac J Public Health 2008; 21:71-83. [DOI: 10.1177/1010539508327089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This research aims to verify whether it is possible to explain the health-promoting behaviors based on sociodemographic characteristics by integrating the theory of planned behavior (TPB) proposed by Ajzen in 1988 and the transtheoretical model (TTM) proposed by Prochaska and DiClemente in 1983. In particular, the aim was to verify whether the variables of the TPB can properly distinguish the stages of change in exercise in the proposed integrated model and to figure out how attitude, subjective norm, perceived behavior control, influence, and intention-can explain the stages of change in exercise. Investigators who have taken previous training for the survey visited and interviewed 3658 people older than 30 years in the chosen town by multistage sampling method from July 27 to July 31, 2003. After the exclusion of inappropriate data out of 760 participants, only data from 584 participants were used for this research. χ2 test, t test, and 1-way analysis of variance were used to identify the difference between the distribution of the stages of change in exercise and the variables of the means. A discriminant analysis to verify the accuracy of the stages of change in exercise by means of the variables of the TPB and a path analysis to verify the fit of the integrated model were also used. The variables of the TPB were useful to satisfactorily distinguish and predict the stages of change in exercise. But to clarify the validity of this model, more diversified research should be conducted in the future, and the results must be accumulated.
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Affiliation(s)
- Byung-Ha Park
- Department of Public Health, Gradualte School, Inje
University, Gimhae
| | - Moo-Sik Lee
- Department of Preventive Medicine, College of Medicine,
Konyang University, Daejeon,
| | - Jee-Young Hong
- Department of Preventive Medicine, College of Medicine,
Konyang University, Daejeon
| | - Seok-Hwan Bae
- Department of Preventive Medicine, College of Medicine,
Konyang University, Daejeon
| | - Eun-Young Kim
- Department of Preventive Medicine, College of Medicine,
Konyang University, Daejeon
| | - Kwang-Kee Kim
- Department of Public Health, Gradualte School, Inje
University, Gimhae
| | - Dae-Kyoung Kim
- Department of Physical Education, Mokwon University
Republic of Korea
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Gatt S, Sammut R. An exploratory study of predictors of self-care behaviour in persons with type 2 diabetes. Int J Nurs Stud 2008; 45:1525-33. [DOI: 10.1016/j.ijnurstu.2008.02.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 02/13/2008] [Accepted: 02/20/2008] [Indexed: 11/26/2022]
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14
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Lorentzen C, Ommundsen Y, Holme I. Psychosocial correlates of stages of change in physical activity in an adult community sample. Eur J Sport Sci 2007. [DOI: 10.1080/17461390701456122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kloek GC, van Lenthe FJ, van Nierop PWM, Schrijvers CTM, Mackenbach JP. Stages of change for moderate-intensity physical activity in deprived neighborhoods. Prev Med 2006; 43:325-31. [PMID: 16808969 DOI: 10.1016/j.ypmed.2006.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2004] [Revised: 05/15/2006] [Accepted: 05/16/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND This article describes the association of external and psychosocial factors with the stages of change for moderate-intensity physical activity among individuals with generally low socioeconomic positions. METHODS A self-administered questionnaire among individuals aged 18-65 years (response rate 60%, n = 2781) in deprived neighborhoods in Eindhoven, The Netherlands, was conducted in September 2000. To identify factors associated with stages of change an ordinal logistic regression model, the "Threshold of Change model (TCM)", was used to analyze the data. RESULTS Thirty-six percent of the respondents were in the pre-action stages, 15% was in action and 49% in maintenance. Individuals who were, older, lower educated, had low health locus of control, had less knowledge of physical activity issues, and presented other risky health behaviors, were more likely to be in a lower stage of change category. A positive attitude, high self-efficacy expectations, perceiving the physical activity level of others as high, and much social support were associated with the higher stages of change categories. CONCLUSION The distribution across the stages of change supports the need to improve physical activity behavior in these deprived neighborhoods. Interventions need to be tailored to the psychosocial, and the external factors that are likely to play a role in the behavioral change process.
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Affiliation(s)
- Gitte C Kloek
- Erasmus MC, Department of Public Health, 3000 CA Rotterdam, The Netherlands.
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Spencer L, Adams TB, Malone S, Roy L, Yost E. Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature. Health Promot Pract 2006; 7:428-43. [PMID: 16840769 DOI: 10.1177/1524839905278900] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Three questions guided a literature review of the transtheoretical model (TTM) as applied to exercise to address the evidence for stage-matched interventions, the description of priority populations, and the identification of valid TTM measurement tools. One-hundredand-fifty studies were reviewed. Results indicate preliminary support for the use of stage-matched exercise interventions. Most studies have focused on White, middle-class, female populations, limiting the generalizability of their findings. Valid and reliable measures exist for stage of change, decisional balance, processes of change, self-efficacy, and temptations to not exercise; however, more research is needed to refine these measures. Evidence for the construct validity of the TTM as applied to exercise is mixed. When designing and implementing TTM-based exercise interventions, practitioners and policy makers are encouraged to clearly define the term exercise, choose a valid and reliable staging tool, and employ all TTM constructs and not just stage membership.
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Lippke S, Ziegelmann JP. Understanding and modeling health behavior: the multi-stage model of health behavior change. J Health Psychol 2006; 11:37-50. [PMID: 16314379 DOI: 10.1177/1359105306058845] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate the Multi-Stage Model (MSM). The MSM proposes eight different stages that are distinguished by cognitions and behavior and concepts of habituation as well. The MSM stages were assessed in 835 rehabilitation patients with a questionnaire. People in the different stages were compared and trends across the means of individuals in the different stages were evaluated to test for discontinuity patterns. Discontinuity patterns across the stages were found in social-cognitive variables such as intention, self-efficacy, outcome expectancies and social support. Most predictions according to stage differences were empirically found. This supported the validity of the MSM. Implications for further investigations and stage-specific interventions are discussed.
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Affiliation(s)
- Sonia Lippke
- Health Psychology, Freie Universität Berlin, Germany.
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Abstract
BACKGROUND Critical thinking has been proposed as crucial for processing conflicting information when people make decisions about participation in health behaviors. The critical thinking of individuals about participation in health behaviors may depend on their perceived health status. OBJECTIVES To examine the relations between critical thinking and participation in three categories of health behaviors, and to determine whether these relations are moderated by perceived health status. METHODS A cross-sectional, correlational design was used to study a sample of 112 community-dwelling adults who resided in a large, urban Midwest community. The participants were women and men 18 to 90 years of age (mean, 55 +/- 20.47 years) who completed self-report, written questionnaires including the Test of Everyday Reasoning and the Health Practices Instrument. RESULTS According to hierarchical multiple regression analyses, the relation between critical thinking and health promotion behaviors and the relation between critical thinking and secondary prevention behaviors were moderated by perceived health status, whereas the relation between critical thinking and health protection behaviors was not. CONCLUSIONS The relation between critical thinking and participation in health behaviors depends on perceived health status and category of health behaviors. Researchers can explore the role of other variables (e.g., functional status and perceived susceptibility to disease) to explain why perceived health status moderates the relations between critical thinking and participation in various types of health behaviors differently.
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Affiliation(s)
- Lori Settersten
- College of Nursing, University of Wisconsin-Milwaukee 53201, USA.
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Abstract
Despite well-documented benefits of exercise, aging women remain largely sedentary. Further understanding of beliefs associated with exercise could result in more-effective public health interventions to increase exercise in this vulnerable population. This study examined the relationships between theory of planned behavior constructs and exercise behavior and exercise intention in older women. Constructs from the theory of planned behavior (behavioral beliefs, perceived control beliefs, and normative beliefs) were examined in a sample of 225 women aged 65 and older. Exercise was measured with the Baecke Physical Activity Scale. All women were interviewed, to prevent literacy and vision problems from hampering participation. Significant predictors of exercise behavior were perceived control beliefs and behavioral beliefs. Significant predictors of exercise intentions were perceived control beliefs, behavioral beliefs, and normative beliefs. Specific belief items predicting exercise behavior were that exercise is good for health and that exercise is difficult because of tiredness, as well as the lack of commitment and time. These findings provide partial support for the application of the theory of planned behavior to exercise in older women. The findings suggest that interventions should focus on increasing women's confidence that they can overcome barriers to exercise.
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Affiliation(s)
- Vicki S Conn
- Sinclair School of Nursing, University of Missouri, Columbia 65211, USA.
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Marshall SJ, Biddle SJ. The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Ann Behav Med 2002; 23:229-46. [PMID: 11761340 DOI: 10.1207/s15324796abm2304_2] [Citation(s) in RCA: 304] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The purpose of this study was to summarize findings from empirical applications of the transtheoretical model (TTM) (Prochaska & DiClemente, 1983) in the physical activity domain by using the quantitative method of meta-analysis. Ninety-one independent samples from 71 published reports were located that present empirical data on at least one core construct of the TTM applied to exercise and physical activity. In general, results support the application because core constructs differ across stages and most changes are in the direction predicted by the theory. Three general conclusions are offered. First, existing data are unable to confirm whether physical activity behavior change occurs in a series ofstages that are qualitatively different or along adjacent segments of an underlying continuum. Second, the growing number of studies that incorporate TTM concepts means that there is an increasing need to standardize and improve the reliability of measurement. Finally, the role ofprocesses of change needs reexamining because the higher order constructs are not apparent in the physical activity domain and stage-by-process interactions are not evident. There now are sufficient data to confirm that stage membership is associated with different levels of physical activity, self-efficacy, pros and cons, and processes of change. Further studies that simply stage participants or examine cross-sectional differences between core constructs of the TTM are of limited use. Future research should examine the moderators and mediators of stage transition.
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Affiliation(s)
- S J Marshall
- British Heart Foundation National Centre for Physical Activity and Health, Loughborough University, Leicestershire, United Kingdom.
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Abstract
PURPOSE To test the ability of the theory of planned behavior (TPB) in predicting the stage of change for physical activity promotion by mental health professionals. DESIGN Six-month prospective questionnaire study. SETTING One mental health trust in the East Midlands, United Kingdom. SUBJECTS Three hundred ninety-four mental health professionals (men, n = 131; women, n = 263) of an initial sample of 477 participated in the study (83% response rate). MEASURES Attitudes, subjective norms, intentions, perceived behavioral control, and stage of change were measured at the first wave of data collection. Stage of change was also assessed 6 months later. Data were analyzed using structural equation modeling. RESULTS Intention and stage of change were successfully predicted from TPB variables. Overall, 27% of the variance in self-reported stage of promoting physical activity was explained by the model. Sixty-one percent of the variance in intention to promote physical activity was explained. When included, past behavior was the strongest predictor of both intention and stage of change and attenuated all other path coefficients. Past behavior improved the predicted variance in intention by 11% and stage by 6%. CONCLUSIONS The TPB variables of attitude, subjective norms, perceived behavioral control, and intention predict stage of change of physical activity promotion in a health care setting. However, promoting physical activity in the past had a sizable effect on predicting subsequent promotion. Due to unequal distribution across stages, the stage model's application to understanding the behavior of health professionals may be limited.
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Affiliation(s)
- G Faulkner
- School of Postgraduate Medicine and Health Science, Department of Exercise and Sport Sciences, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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