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Brown S, Ploeger C, Guo B, Petersen JJ, Beckenstrom AC, Browning M, Dawson GR, Deckert J, Dias R, Dourish CT, Gorwood P, Kingslake J, Menke A, Sola VP, Reif A, Ruhe H, Simon J, Stäblein M, van Schaik A, Veltman DJ, Morriss R. When a test is more than just a test: Findings from patient interviews and survey in the trial of a technology to measure antidepressant medication response (the PReDicT Trial). Compr Psychiatry 2024; 132:152467. [PMID: 38608615 DOI: 10.1016/j.comppsych.2024.152467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/05/2024] [Accepted: 02/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND A RCT of a novel intervention to detect antidepressant medication response (the PReDicT Test) took place in five European countries, accompanied by a nested study of its acceptability and implementation presented here. The RCT results indicated no effect of the intervention on depression at 8 weeks (primary outcome), although effects on anxiety at 8 weeks and functioning at 24 weeks were found. METHODS The nested study used mixed methods. The aim was to explore patient experiences of the Test including acceptability and implementation, to inform its use within care. A bespoke survey was completed by trial participants in five countries (n = 778) at week 8. Semi-structured interviews were carried out in two countries soon after week 8 (UK n = 22, Germany n = 20). Quantitative data was analysed descriptively; for qualitative data, thematic analysis was carried out using a framework approach. Results of the two datasets were interrogated together. OUTCOMES Survey results showed the intervention was well received, with a majority of participants indicating they would use it again, and it gave them helpful extra information; a small minority indicated the Test made them feel worse. Qualitative data showed the Test had unexpected properties, including: instigating a process of reflection, giving participants feedback on progress and new understanding about their illness, and making participants feel supported and more engaged in treatment. INTERPRETATION The qualitative and quantitative results are generally consistent. The Test's unexpected properties may explain why the RCT showed little effect, as properties were experienced across both trial arms. Beyond the RCT, the qualitative data sheds light on measurement reactivity, i.e., how measurements of depression can impact patients.
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Affiliation(s)
- Susan Brown
- NIHR MindTech Med Tech Co-operative, University of Nottingham, Nottingham, UK.
| | - Cornelia Ploeger
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Boliang Guo
- NIHR ARC East Midlands, University of Nottingham, Nottingham, UK
| | - Juliana J Petersen
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | | | - Michael Browning
- P1vital Products Limited, Howbery Park, Wallingford, UK; P1vital Limited, Howbery Park, Wallingford, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Trust, Oxford, UK
| | - Gerard R Dawson
- P1vital Products Limited, Howbery Park, Wallingford, UK; P1vital Limited, Howbery Park, Wallingford, UK
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Rebecca Dias
- P1vital Products Limited, Howbery Park, Wallingford, UK
| | - Colin T Dourish
- P1vital Products Limited, Howbery Park, Wallingford, UK; P1vital Limited, Howbery Park, Wallingford, UK
| | - Philip Gorwood
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
| | - Jonathan Kingslake
- P1vital Products Limited, Howbery Park, Wallingford, UK; P1vital Limited, Howbery Park, Wallingford, UK
| | - Andreas Menke
- Medical Park Chiemseeblick, Department of Psychosomatic Medicine and Psychotherapy, Rasthausstr. 25, 83233 Bernau am Chiemsee, Germany; Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Victor Perez Sola
- Hospital del Mar Medical Research Institute, IMIM, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBERSAM), Madrid, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Henricus Ruhe
- Department of Psychiatry, Radboudumc, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
| | - Judit Simon
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Michael Stäblein
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany
| | - Anneke van Schaik
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Richard Morriss
- NIHR MindTech Med Tech Co-operative, University of Nottingham, Nottingham, UK; NIHR ARC East Midlands, University of Nottingham, Nottingham, UK
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2
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Vézina-Im LA, Turcotte S, Turcotte AF, Beaulieu D, Boudreau F, Morin C. Psychosocial determinants of healthy sleep habits in adults with type 1 and type 2 diabetes. Health Psychol Behav Med 2023; 12:2296464. [PMID: 38179135 PMCID: PMC10763851 DOI: 10.1080/21642850.2023.2296464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Background Many adults with type 1 (T1D) and type 2 diabetes (T2D) have inadequate sleep increasing their risk of hyperglycemia and developing complications. The objective was to identify psychosocial determinants of healthy sleep habits (HSH) among adults with T1D and T2D. Methods The two HSH were: avoiding screen use in bed and having sleep regularity. Adults (≥18 years) with T1D and T2D were invited to complete an anonymous online survey. The questionnaires were based on the Reasoned Action Approach and formative qualitative research previously conducted in 56 adults with T1D and T2D. Habit was included as an additional variable for screen use in bed. Results In total, 320 adults with diabetes (T1D: 39%; T2D: 61%) completed the questionnaires (screen use in bed: 174; sleep timing: 146). Close to 75% of participants reported screen use in bed and close to 90% reported sleep timing variability in the last month. Perceived behavioral control (PBC) to avoid screen use in bed (β = -0.4486, p < 0.0001), habit of using screens in bed (β = 0.4002; p < 0.0001), and age (β = -0.0202; p = 0.0086) were determinants of screen use in bed, and this model explained 71% of the variance. PBC for sleep regularity (β = -0.2909; p = 0.0004) and being female (β = 0.5057; p = 0.0069) were determinants of sleep timing variability, and this model explained 28% of the variance. The most important beliefs associated with each HSH were identified to obtain information to design targeted interventions. Conclusions Few adults with diabetes have HSH. Screen use in bed was strongly influenced by habit and the results suggest that both HSH are not easy to adopt among adults with diabetes. Younger adults with diabetes should be prioritized for screen use in bed, while females with diabetes should be prioritized for sleep timing variability. Adults with diabetes should have access to behavior change interventions to encourage them to adopt HSH.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, Québec, Canada
- Centre de Recherche du CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Stéphane Turcotte
- Centre de Recherche du CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
| | | | - Dominique Beaulieu
- Département des sciences de la santé, Université du Québec à Rimouski (UQAR), Lévis, Québec, Canada
- Centre de Recherche du CISSS de Chaudière-Appalaches, Lévis, Québec, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec, Québec, Canada
| | - François Boudreau
- Département des Sciences infirmières, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, Québec, Canada
| | - Christine Morin
- Clinique de Diabète, Hôtel-Dieu de Lévis, Lévis, Québec, Canada
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3
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Chen C, Okubo R, Okawa S, Nakagawa S, Tabuchi T. The diagnostic accuracy of the Edinburgh Postnatal Depression Scale without the self-harm item. J Psychiatr Res 2023; 165:70-76. [PMID: 37478685 DOI: 10.1016/j.jpsychires.2023.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/07/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used screening tool for perinatal depression. However, the 10th item of the EPDS intended to evaluate suicide ideation does not accurately capture suicide ideation and may cause psychological distress. Whereas endorsement of the strongest agreement "yes, quite often" on this item may be associated with suicide ideation, the response on this frequency is perfectly predicted by the EPDS full score. The discard of this item, therefore, is preferred. In the current study, using data from a nation-wide internet survey conducted in Japanese postpartum (n = 5688) and pregnant women (n = 1639), we show that the EPDS-9 without the 10th item correlates perfectly with the full EPDS or EPDS-10. Furthermore, the EPDS-9 and EPDS-10 have equivalent performance in differentiating participants' self-reported depression diagnosis as well as Kessler Psychological Distress Scale (K6)-based screening of depression. Lastly, at the cutoff of 9, the EPDS-9 performs well in predicting participants' response on the 10th item of EPDS; specifically, the sensitivity of differentiating frequent thoughts of self-harm is 0.968 and 1 in postpartum and pregnant women, respectively. Therefore, the EPDS-9 performs equivalently to EPDS-10 and can be considered to replace EPDS-10 in future use.
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Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University and Graduate School of Medicine, Ube, Japan.
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization and Obihiro Hospital, Obihiro, Japan
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University and Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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4
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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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5
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Willems I, Verbestel V, Calders P, Lapauw B, De Craemer M. Test-Retest Reliability and Internal Consistency of a Newly Developed Questionnaire to Assess Explanatory Variables of 24-h Movement Behaviors in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4407. [PMID: 36901416 PMCID: PMC10001532 DOI: 10.3390/ijerph20054407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
A questionnaire on explanatory variables for each behavior of the 24-h movement behaviors (i.e., physical activity, sedentary behavior, sleep) was developed based on three levels of the socio-ecological model, i.e., the intrapersonal level, interpersonal level and the physical environmental level. Within these levels, different constructs were questioned, i.e., autonomous motivation, attitude, facilitators, internal behavioral control, self-efficacy, barriers, subjective norm, social modeling, social support, home environment, neighborhood, and work environment. The questionnaire was tested for test-retest reliability (i.e., intraclass correlation (ICC)) for each item and internal consistency for each construct (i.e., Cronbach's Alpha Coefficient) among a group of 35 healthy adults with a mean age of 42.9 (±16.1) years. The total questionnaire contained 266 items, consisting of 14 items on general information, 70 items on physical activity, 102 items on sedentary behavior, 45 items on sleep and 35 items on the physical environment. Seventy-one percent of the explanatory items showed moderate to excellent reliability (ICC between 0.50 and 0.90) and a majority of constructs had a good homogeneity among items (Cronbach's Alpha Coefficient ≥ 0.70). This newly developed and comprehensive questionnaire might be used as a tool to understand adults' 24-h movement behaviors.
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Affiliation(s)
- Iris Willems
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
- Research Foundation Flanders, 1000 Brussels, Belgium
| | - Vera Verbestel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
| | - Bruno Lapauw
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
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6
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Dauber S, Beacham A, West A, Devkota J, Barrie K, Thrul J. Ecological Momentary Assessment of Heavy Episodic Drinking in the Early Postpartum Period: A Feasibility Study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100146. [PMID: 37012980 PMCID: PMC10066518 DOI: 10.1016/j.dadr.2023.100146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
Background Postpartum mothers are at heightened risk for heavy episodic drinking (HED). Research with this population is critical to developing acceptable and effective tailored interventions, but new mothers who use alcohol are often reluctant to engage in research due to stigma and fear of child removal. This study examined feasibility of recruitment and ecological momentary assessment (EMA) in early postpartum mothers with histories of HED. Methods Participants were recruited via Facebook and Reddit and completed 14 days of EMA surveys. Baseline characteristics, recruitment feasibility, and EMA feasibility and acceptability were examined. Participants attended focus groups to further inform quantitative data. Results Reddit yielded a larger proportion of eligible individuals than Facebook, and 86% of the final enroled sample was recruited via Reddit. The average compliance rate of 75% is in line with other studies of similar populations. Half the sample reported alcohol use, and 78% reported the urge to drink at least once, supporting feasibility of EMA for collecting alcohol use data. Participants reported low burden and high acceptability of the study on both quantitative and qualitative measures. Baseline low maternal self-efficacy was associated with greater EMA compliance, and first-time mothers reported lower EMA burden compared to veteran mothers. College graduates, and participants with lower drinking refusal self-efficacy and greater alcohol severity were more likely to report alcohol use on EMA. Conclusions Future studies should consider Reddit as a recruitment strategy. Findings generally support feasibility and acceptability of EMA to assess HED in postpartum mothers.
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Affiliation(s)
- Sarah Dauber
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, USA
- Corresponding author.
| | - Alexa Beacham
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, USA
| | - Allison West
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janardan Devkota
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kadjatu Barrie
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, USA
| | - Johannes Thrul
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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7
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Perski O, Keller J, Kale D, Asare BYA, Schneider V, Powell D, Naughton F, ten Hoor G, Verboon P, Kwasnicka D. Understanding health behaviours in context: A systematic review and meta-analysis of ecological momentary assessment studies of five key health behaviours. Health Psychol Rev 2022; 16:576-601. [PMID: 35975950 PMCID: PMC9704370 DOI: 10.1080/17437199.2022.2112258] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University College London, London, United Kingdom, Olga Perski
| | - Jan Keller
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Dimitra Kale
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Perth, Australia,Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Verena Schneider
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Daniel Powell
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom,Rowett Institute, University of Aberdeen, Aberdeen, United Kingdom
| | - Felix Naughton
- Behavioural and Implementation Science Research Group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Gill ten Hoor
- Department of Work and Social Psychology, Faculty of Psychology and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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8
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König LM, Allmeta A, Christlein N, Van Emmenis M, Sutton S. A systematic review and meta-analysis of studies of reactivity to digital in-the-moment measurement of health behaviour. Health Psychol Rev 2022; 16:551-575. [PMID: 35264084 DOI: 10.1080/17437199.2022.2047096] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Self-report measures of health behaviour have several limitations including measurement reactivity, i.e., changes in people's behaviour, cognitions or emotions due to taking part in research. This systematic review investigates whether digital in-the-moment measures induce reactivity to a similar extent and why it occurs. Four databases were searched in December 2020. All observational or experimental studies investigating reactivity to digital in-the-moment measurement of a range of health behaviours were included if they were published in English in 2008 or later. Of the 11,723 records initially screened, 30 publications reporting on 31 studies were included in the qualitative synthesis/ 7 studies in the quantitative synthesis. Eighty-one percent of studies focused on reactivity to the measurement of physical activity indicators; small but meaningful pooled effects were found (Cohen's ds: 0.27-0.30). Only a small number of studies included other behaviours, yielding mixed results. Digital in-the-moment measurement of behaviour thus may be as prone to reactivity as self-reports in questionnaires. Measurement reactivity may be amplified by (1) ease of changing the behaviour (2) awareness of being measured and social desirability, and (3) resolving discrepancies between actual and desired behaviour through self-regulation.
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Affiliation(s)
- Laura M König
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.,Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anila Allmeta
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany
| | - Nora Christlein
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany
| | - Miranda Van Emmenis
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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9
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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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10
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Nudging societally relevant behavior by promoting cognitive inferences. Sci Rep 2022; 12:9201. [PMID: 35654869 PMCID: PMC9161190 DOI: 10.1038/s41598-022-12964-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/19/2022] [Indexed: 12/05/2022] Open
Abstract
Effective behavioral interventions are essential to address urgent societal challenges. Over the past decade, nudging interventions (i.e., arranging the environment to promote adaptive behavioral choices) have surged in popularity. Importantly, effective application of the nudging approach requires clear guiding principles with a firm basis in behavioral science. We present a framework for nudging interventions that builds on evidence about the goal-directed inferential processes underlying behavior (i.e., processes that involve context-dependent inferences about goals and the actions available to achieve these goals). We used this framework to develop nudging interventions that target context-relevant cognitive inferences. We examined the effectiveness of these inference nudging interventions for promoting two important types of societal behavior: pro-environmental actions and adherence to COVID-19 guidelines. As predicted, two online studies revealed that inference nudging interventions successfully increased energy conservation (Study 1) as well as social distancing during the COVID-19 crisis (Study 2). A field experiment found that inference nudging interventions increased hand disinfection in a real-life store during the COVID-19 crisis (Study 3). Our findings highlight the importance of applying state-of-the-art insights about the (inferential) determinants of behavior in behavior change interventions.
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Do Post-Corona European Economic Policies Lift Growth Prospects? Exploring an ML-Methodology. JOURNAL OF RISK AND FINANCIAL MANAGEMENT 2022. [DOI: 10.3390/jrfm15030120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This article explores the determinants of people’s growth prospects in survey data as well as the impact of the European recovery fund to future growth. The focus is on the aftermath of the Corona pandemic, which is a natural limit to the sample size. We use Eurobarometer survey data and macroeconomic variables, such as GDP, unemployment, public deficit, inflation, bond yields, and fiscal spending data. We estimate a variety of panel regression models and develop a new simulation-regression methodology due to limitation of the sample size. We find the major determinant of people’s growth prospect is domestic GDP per capita, while European fiscal aid does not significantly matter. In addition, we exhibit with the simulation-regression method novel scientific insights, significant outcomes, and a policy conclusion alike.
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Quaife SL, Waller J, Dickson JL, Brain KE, Kurtidu C, McCabe J, Hackshaw A, Duffy SW, Janes SM. Psychological Targets for Lung Cancer Screening Uptake: A Prospective Longitudinal Cohort Study. J Thorac Oncol 2021; 16:2016-2028. [PMID: 34403828 DOI: 10.1016/j.jtho.2021.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Low uptake of low-dose computed tomography lung cancer screening by high-risk groups compromises its effectiveness and equity as a population-level early detection strategy. Numerous psychological factors are implicated qualitatively or retrospectively, but prospective data are needed to validate their associations with uptake behavior and specify psychological targets for intervention. METHODS This is a prospective, longitudinal cohort study evaluating psychological correlates of lung cancer screening uptake. Ever-smokers (aged 55-77 y) were invited to a lung health check, at which low-dose computed tomography screening was offered through the SUMMIT Study-a multicenter screening implementation trial. One week after their screening invitation, 44,000 invitees were mailed the self-regulatory questionnaire for lung cancer screening. Regression analyses evaluated the constructs' associations with uptake (telephoning for an appointment) and sociodemographic characteristics. RESULTS Higher odds of uptake were associated with both positive and negative perceptions. Positive perceptions included lung cancer controllability, benefits of early diagnosis, improved survival when lung cancer is detected early, willingness to be treated, and believing smoking cessation is effective in reducing risk. Negative perceptions included a higher lung cancer risk perception, negative beliefs about the consequences of lung cancer, perceiving lung cancer as stigmatized, and a negative emotional response. Although current smokers held the highest risk perceptions, they also reported negative perceptions that could undermine how they behave in response to their risk. CONCLUSIONS Interventions to improve uptake should focus on changing perceptions that affect how an individual reacts when they believe their risk of lung cancer is high.
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Affiliation(s)
- Samantha L Quaife
- Wolfson Institute of Population Health, Barts, and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Jennifer L Dickson
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, United Kingdom
| | - Kate E Brain
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - Clara Kurtidu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - John McCabe
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, United Kingdom
| | - Allan Hackshaw
- Cancer Research UK and UCL Cancer Trials Centre, Cancer Institute, University College London, London, United Kingdom
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Barts, and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Samuel M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, United Kingdom
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13
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French DP, Miles LM, Elbourne D, Farmer A, Gulliford M, Locock L, Sutton S, McCambridge J. Reducing bias in trials from reactions to measurement: the MERIT study including developmental work and expert workshop. Health Technol Assess 2021; 25:1-72. [PMID: 34553685 DOI: 10.3310/hta25550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Measurement can affect the people being measured; for example, asking people to complete a questionnaire can result in changes in behaviour (the 'question-behaviour effect'). The usual methods of conduct and analysis of randomised controlled trials implicitly assume that the taking of measurements has no effect on research participants. Changes in measured behaviour and other outcomes due to measurement reactivity may therefore introduce bias in otherwise well-conducted randomised controlled trials, yielding incorrect estimates of intervention effects, including underestimates. OBJECTIVES The main objectives were (1) to promote awareness of how and where taking measurements can lead to bias and (2) to provide recommendations on how best to avoid or minimise bias due to measurement reactivity in randomised controlled trials of interventions to improve health. METHODS We conducted (1) a series of systematic and rapid reviews, (2) a Delphi study and (3) an expert workshop. A protocol paper was published [Miles LM, Elbourne D, Farmer A, Gulliford M, Locock L, McCambridge J, et al. Bias due to MEasurement Reactions In Trials to improve health (MERIT): protocol for research to develop MRC guidance. Trials 2018;19:653]. An updated systematic review examined whether or not measuring participants had an effect on participants' health-related behaviours relative to no-measurement controls. Three new rapid systematic reviews were conducted to identify (1) existing guidance on measurement reactivity, (2) existing systematic reviews of studies that have quantified the effects of measurement on outcomes relating to behaviour and affective outcomes and (3) experimental studies that have investigated the effects of exposure to objective measurements of behaviour on health-related behaviour. The views of 40 experts defined the scope of the recommendations in two waves of data collection during the Delphi procedure. A workshop aimed to produce a set of recommendations that were formed in discussion in groups. RESULTS Systematic reviews - we identified a total of 43 studies that compared interview or questionnaire measurement with no measurement and these had an overall small effect (standardised mean difference 0.06, 95% confidence interval 0.02 to 0.09; n = 104,096, I2 = 54%). The three rapid systematic reviews identified no existing guidance on measurement reactivity, but we did identify five systematic reviews that quantified the effects of measurement on outcomes (all focused on the question-behaviour effect, with all standardised mean differences in the range of 0.09-0.28) and 16 studies that examined reactive effects of objective measurement of behaviour, with most evidence of reactivity of small effect and short duration. Delphi procedure - substantial agreement was reached on the scope of the present recommendations. Workshop - 14 recommendations and three main aims were produced. The aims were to identify whether or not bias is likely to be a problem for a trial, to decide whether or not to collect further quantitative or qualitative data to inform decisions about if bias is likely to be a problem, and to identify how to design trials to minimise the likelihood of this bias. LIMITATION The main limitation was the shortage of high-quality evidence regarding the extent of measurement reactivity, with some notable exceptions, and the circumstances that are likely to bring it about. CONCLUSION We hope that these recommendations will be used to develop new trials that are less likely to be at risk of bias. FUTURE WORK The greatest need is to increase the number of high-quality primary studies regarding the extent of measurement reactivity. STUDY REGISTRATION The first systematic review in this study is registered as PROSPERO CRD42018102511. FUNDING Funded by the Medical Research Council UK and the National Institute for Health Research as part of the Medical Research Council-National Institute for Health Research Methodology Research Programme.
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Affiliation(s)
- David P French
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Lisa M Miles
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Martin Gulliford
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Stephen Sutton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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14
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Meaders CL, Senn LG, Couch BA, Lane AK, Stains M, Stetzer MR, Vinson E, Smith MK. Am I getting through? Surveying students on what messages they recall from the first day of STEM classes. INTERNATIONAL JOURNAL OF STEM EDUCATION 2021; 8:49. [PMID: 34395162 PMCID: PMC8344324 DOI: 10.1186/s40594-021-00306-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/27/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND The first day of class helps students learn about what to expect from their instructors and courses. Messaging used by instructors, which varies in content and approach on the first day, shapes classroom social dynamics and can affect subsequent learning in a course. Prior work established the non-content Instructor Talk Framework to describe the language that instructors use to create learning environments, but little is known about the extent to which students detect those messages. In this study, we paired first day classroom observation data with results from student surveys to measure how readily students in introductory STEM courses detect non-content Instructor Talk. RESULTS To learn more about the instructor and student first day experiences, we studied 11 introductory STEM courses at two different institutions. The classroom observation data were used to characterize course structure and use of non-content Instructor Talk. The data revealed that all instructors spent time discussing their instructional practices, building instructor/student relationships, and sharing strategies for success with their students. After class, we surveyed students about the messages their instructors shared during the first day of class and determined that the majority of students from within each course detected messaging that occurred at a higher frequency. For lower frequency messaging, we identified nuances in what students detected that may help instructors as they plan their first day of class. CONCLUSIONS For instructors who dedicate the first day of class to establishing positive learning environments, these findings provide support that students are detecting the messages. Additionally, this study highlights the importance of instructors prioritizing the messages they deem most important and giving them adequate attention to more effectively reach students. Setting a positive classroom environment on the first day may lead to long-term impacts on student motivation and course retention. These outcomes are relevant for all students, but in particular for students in introductory STEM courses which are often critical prerequisites for being in a major. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s40594-021-00306-y.
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Affiliation(s)
- Clara L. Meaders
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, CA 92093 USA
| | - Lillian G. Senn
- Department of Ecology and Evolutionary Biology, Cornell University, E145 Corson Hall, Ithaca, NY 14853 USA
| | - Brian A. Couch
- School of Biological Sciences, University of Nebraska, Lincoln, NE 68588 USA
| | - A. Kelly Lane
- Department of Biology Teaching and Learning, University of Minnesota, Minneapolis, MN 55455 USA
| | - Marilyne Stains
- Department of Chemistry, University of Virginia, Charlottesville, VA 22904 USA
| | - MacKenzie R. Stetzer
- Department of Physics and Astronomy, University of Maine, Orono, ME 04469 USA
- Maine Center for Research in STEM Education, University of Maine, Orono, ME 04469 USA
| | - Erin Vinson
- Maine Center for Research in STEM Education, University of Maine, Orono, ME 04469 USA
| | - Michelle K. Smith
- Department of Ecology and Evolutionary Biology, Cornell University, E145 Corson Hall, Ithaca, NY 14853 USA
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Translational Research in Cancer Screening: Long-Term Population-Action Bridges to Diffuse Adherence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157883. [PMID: 34360176 PMCID: PMC8345519 DOI: 10.3390/ijerph18157883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022]
Abstract
The population-level implementation of innovative, evidence-based medical recommendations for adopting health-behaviors depends on the last link in the translation chain: the users. “User-friendly” medical interventions aimed at engaging users to adopt recommended health behaviors are best developed in a collaborative bio-medical and social sciences setting. In the 1990s, National Breast and Colorectal Cancer Early Detection Programs were launched at the Israeli Department of Community Medicine and Epidemiology. Operating under the largest HMO (Health Maintenance Organization) in Israel (“Clalit Health Services”), the department had direct access to HMO community primary-care clinics’ teams, insured members, and medical records. Academically affiliated, the department engaged in translational research. In a decades-long translational process, this multi-disciplinary unit led a series of interventions built upon basic and applied behavioral/social science phenomena such as framing, “Implementation Intentions,” and “Question-Behavior-Effect”. A heterogeneous team of disciplinary specialists created an integrated scientific environment. In order to enhance screening, the team focused on the establishment of a systematic mechanism actively inviting programs’ “users” (average-risk targeted individuals on the national level), and continuously applied social and health psychology concepts to study individuals’ perceptions, expectations, and needs related to cancer screening. The increase in adherence to screening recommendations was slow and incremental. A decrease in late-stage breast and colorectal cancer diagnoses was observed nationally, but participation was lower than expected. This paper positions screening adherence as a unique challenge and proposes new social and network avenues to enhance future participation.
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16
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Ferguson E, Edwards ARA, Masser BM. Simple Reciprocal Fairness Message to Enhance Non-Donor's Willingness to Donate Blood. Ann Behav Med 2021; 56:89-99. [PMID: 34050653 DOI: 10.1093/abm/kaab026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Against a background of declining blood donor numbers, recruiting new donors is critical for the effective operations of healthcare providers. Thus, interventions are needed to recruit new blood donors. PURPOSE We provide initial evidence for Voluntary Reciprocal Altruism (VRA) to enhance nondonors' willingness to become blood donors. VRA interventions involve asking two questions: one on accepting a blood transfusion if needed and one on willingness to donate. As early trials often use self-reports of willingness to perform blood donation behavior, we derive a correction factor to better estimate actual behavior. Finally, we explore the effect of VRA interventions on two prosocial emotions: gratitude and guilt. METHODS Across three experiments (two in the UK and one in Australia: Total N = 1,208 nondonors) we manipulate VRA messages and explore how they affect both reported willingness to make a one-off or repeat blood donation and influence click through to blood donation, organ donation and volunteering registration sites (behavioral proxies). We report data from a longitudinal cohort (N = 809) that enables us to derive a correction for self-reported behavioral willingness. RESULTS Across the three experiments, we show that exposure to a question that asks about accepting a transfusion if needed increased willingness to donate blood with some spillover to organ donor registration. We also show that gratitude has an independent effect on donation and report a behavioral correction factor of .10. CONCLUSIONS Asking nondonors about accepting a transfusion if needed is likely to be an effective strategy to increase new donor numbers.
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Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham NG7 2RD, UK
| | - Abigail R A Edwards
- School of Psychology, The University of Queensland, St Lucia 4067, Australia
| | - Barbara M Masser
- School of Psychology, The University of Queensland, St Lucia 4067, Australia.,Australia and Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne 3004, Australia
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Shimazaki T, Iio M, Uechi H, Takenaka K. Emotional experiences of reading health educational manga encouraging behavioral changes: a non-randomized controlled trial. Health Psychol Behav Med 2021; 9:398-421. [PMID: 34104567 PMCID: PMC8159205 DOI: 10.1080/21642850.2021.1921583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/20/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Educational health manga are used to promote health behavior change. This study thus seeks to achieve the following objectives: identify the emotional experience of reading educational health manga, understand the effects of facilitating the psychological mediators of behavior change through emotional experiences, and compare the effectiveness of educational health manga with conventional materials. DESIGN A non-randomized controlled trial with six conditions was conducted. Target behaviors were physical activity and healthy diet. Individuals aged 20-69 years (n = 1,680) were assigned three manga intervention conditions and three control conditions (visual image-based, narrative text, and general text material). MAIN OUTCOME MEASURES Participants were asked about their emotional experience while reading either intervention material or control material and its perceived positive influence on enhancing psychological mediators. RESULTS Four factors relevant to emotional experiences were identified: risk perception, familiarity, satisfaction, and realism. Emotional experience strongly predicted the psychological mediators of behavior change. Analysis of differences among the six conditions revealed that exposure to educational health manga led to greater satisfaction and increased knowledge. Participants assigned manga conditions experienced superior emotional experiences and outcomes. CONCLUSIONS Those assigned manga conditions experienced superior emotional experiences and outcomes. The efficacy of educational health manga in encouraging psychological mediators of change was confirmed.Trial registration: UMIN Japan identifier: UMIN000034369.
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Affiliation(s)
- Takashi Shimazaki
- Department of Health & Physical Education, Faculty of Humanities, Sophia University, Tokyo, Japan
| | - Misa Iio
- College of Nursing, Kanto-Gakuin University, Yokohama, Japan
| | - Hiroaki Uechi
- Faculty of Education, Yamaguchi University, Yamaguchi, Japan
| | - Koji Takenaka
- Faculty of Human Sciences, Waseda University, Tokyo, Japan
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18
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Hernar I, Graue M, Richards DA, Strandberg RB, Nilsen RM, Rekdal M, Løvaas KF, Madsen TV, Tell GS, Haugstvedt A. Use of patient-reported outcome measures (PROMs) in clinical diabetes consultations: the DiaPROM randomised controlled pilot trial. BMJ Open 2021; 11:e042353. [PMID: 33853796 PMCID: PMC8054082 DOI: 10.1136/bmjopen-2020-042353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/17/2020] [Accepted: 03/31/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To pilot test the proposed DiaPROM trial components and address uncertainties associated with conducting a full-scale randomised controlled trial (RCT) to evaluate whether such a trial is feasible. DESIGN Two-arm pilot RCT. PARTICIPANTS Adults aged ≥18-39 years, with minimum 1 year type 1 diabetes duration, attending outpatient follow-up. Exclusion criteria were pregnancy, severe cognitive, somatic or psychiatric conditions and impaired vision. RANDOMISATION AND INTERVENTION All participants completed electronic Patient-Reported Outcome Measures (PROMs) prior to the annual diabetes consultation. Using computer-generated block-randomisation without blinding, we assigned participants in a 1:1 ratio stratified by sex to receive standard care or an intervention. Physicians reviewed diabetes distress scores (Problem Areas In Diabetes scale) and referred individuals with scores ≥30 or single item(s) ≥3 to minimum two diabetes nurse consultations where reported problems were reviewed and discussed. OUTCOMES Recruitment and retention rates; participants perceptions about intervention components. Variance and estimated between-group differences in follow-up scores (Diabetes Distress Scale (DDS), WHO 5-Well-being Index, Perceived Competence for Diabetes Scale and glycaemic control) and DDS correlation with baseline scores, to assist sample size calculations. RESULTS We randomised 80 participants to the control or intervention arm (one participant was later excluded). 23/39 intervention arm participants qualified for additional consultations and 17 attended. 67/79 attended the 12-month follow-up (15.2% attrition); 5/17 referred to additional consultations were lost to follow-up (29.4% attrition). Participants reported PROMs as relevant (84.6%) and acceptable (97.4%) but rated the usefulness of consultations as moderate to low. Baseline mean±SD DDS score was 2.1±0.69; DDS SD was 0.71 (95% CI: 0.60 to 0.86) at follow-up; correlation between baseline and follow-up DDS scores was 0.8 (95% CI: 0.7 to 0.9). CONCLUSIONS The pilot trial revealed need for intervention modifications ahead of a full-scale trial to evaluate use of PROMs in diabetes consultations. Specifically, participant acceptability and intervention implementation need further investigation.
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Affiliation(s)
- Ingvild Hernar
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - David A Richards
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Institute for Health Research, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ragnhild B Strandberg
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Roy Miodini Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | | | - Karianne Fjeld Løvaas
- Norwegian Diabetes Register for Adults, Norwegian Organisation for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Tone V Madsen
- Norwegian Diabetes Register for Adults, Norwegian Organisation for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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19
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Ferguson E. Inequality averse and compassionate blood donor: implication for interventions. Vox Sang 2021; 116:862-871. [PMID: 33835505 DOI: 10.1111/vox.13088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Blood donors, compared to non-donors, are more likely to show a preference to help others either by sharing resources to directly compensate those in need or indirectly by punishing those who act unfairly. Knowing the dominant cooperative preference for blood donors will inform the development of targeted interventions. We test which preference dominates and an initial intervention based on these findings. MATERIALS AND METHODS We report two studies. The first compares compensation and punishment preferences in blood donors and non-donors (N = 372) using a third-party-compensation-and-punishment game. Based on the results of Study 1, Study 2 (N = 151) is a feasibility experiment of an intervention based on advantageous inequality aversion ('As a healthy person, you can give blood and help those less healthy than you'.). RESULTS Blood donors, compared to non-donors, have a preference for compensation. Organ donors have a preference for punishment. Those exposed to the advantageous inequality aversion intervention, compared to control conditions, show a greater behavioural propensity to donate blood (this was especially the case for non-donors). CONCLUSION Blood donors have a clear preference for direct helping through compensation that can be translated into a simple effective intervention to enhance blood donor recruitment and retention.
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Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
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20
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Ye X, Zhu D, Chen S, Shi X, Gong R, Wang J, Zuo H, Zhang M, He P. Impact and cost-effectiveness evaluation of a community-based rehabilitation intervention on quality of life among Chinese adults with hearing loss: study protocol for a randomized controlled trial. Trials 2021; 22:258. [PMID: 33827631 PMCID: PMC8028700 DOI: 10.1186/s13063-021-05228-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 03/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background Hearing loss is quite prevalent and can be related to people’s quality of life. To our knowledge, there are limited studies assessing the efficacy of hearing interventions on quality of life in adults. Therefore, we aim to conduct a randomized controlled trial (RCT) to determine the impact and cost-effectiveness of community-based hearing rehabilitation on quality of life among Chinese adults with hearing loss. Methods/design In this two-arm feasibility study, participants aged 16 and above with some degree of hearing loss (n = 464) will be recruited from Linyi City, Shandong Province. They are randomly assigned to the treatment group or the control group. Those in the treatment group are prescribed with hearing aids, while those in the control group receive no intervention. Reinstruction in use of devices is provided for the treatment group during booster visits held 12 months post-randomization or unscheduled interim visits when necessary. Data are collected at baseline and the follow-up 20 months later. The primary outcome is changes in quality of life over a 20-month study period. Secondary outcomes include sub-dimensions in quality of life, physical functioning, chronic diseases, cognitive function, depression, social support, hospitalizations, falls, and healthcare costs. Finally, we will evaluate whether hearing aids intervention is cost-effective to apply in a large scale. Discussion The trial is designed to evaluate the impact and cost-effectiveness of a community-based rehabilitation intervention on quality of life among Chinese adults with hearing loss. We hope that it would help improve the well-being for Chinese adults and provide references in policy and practice for China and other countries. Trial registration Chinese Clinical Trial Registry ChiCTR1900024739. Registered on 26 July 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05228-2.
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Affiliation(s)
- Xin Ye
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Siyuan Chen
- School of Public Health, Peking University, Beijing, China.,China Center for Health Development Studies, Peking University, Beijing, China
| | - Xuefeng Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, China.,National Institute of Chinese Medicine Department and Strategy, Beijing University of Chinese Medicine, Beijing, China
| | - Rui Gong
- China Rehabilitation Research Center for Hearing and Speech Impairment, Beijing, China
| | - Juncheng Wang
- Linyi Center for Disease Control and Prevention, Linyi, Shandong, China
| | - Huibin Zuo
- Linyi Center for Disease Control and Prevention, Linyi, Shandong, China
| | - Mei Zhang
- Linyi Rehabilitation Hospital, Linyi, Shandong, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China.
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21
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Petersen B, Vesper I, Pachwald B, Dagenbach N, Buck S, Waldenmaier D, Heinemann L. Diabetes management intervention studies: lessons learned from two studies. Trials 2021; 22:61. [PMID: 33461624 PMCID: PMC7812736 DOI: 10.1186/s13063-020-05017-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Several clinical studies investigated improvements of patient outcomes due to diabetes management interventions. However, chronic disease management is intricate with complex multifactorial behavior patterns. Such studies thus have to be well designed in order to allocate all observed effects to the defined intervention and to exclude effects of other confounders as well as possible. This article aims to provide challenges in interpreting diabetes management intervention studies and suggests approaches for optimizing study implementation and for avoiding pitfalls based on current experiences. Main body Lessons from the STeP and ProValue studies demonstrated the difficulty in medical device studies that rely on behavioral changes in intervention group patients. To successfully engage patients, priority should be given to health care professionals being engaged, operational support in technical issues being available, and adherence being assessed in detail. Another difficulty is to avoid contamination of the control group with the intervention; therefore, strict allocation concealment should be maintained. However, randomization and blinding are not always possible. A limited effect size due to improvements regarding clinical endpoints in the control group is often caused by the Hawthorne effect. Improvements in the control group can also be caused with increased attention paid to the subjects. In order to reduce improvements in the control group, it is essential to identify the specific reasons and adjust study procedures accordingly. A pilot phase is indispensable for this. Another option is to include a third study arm to control for enhanced standard of care and study effects. Furthermore, retrospective data collection could be a feasible option. Adaptive study designs might reduce the necessity of a separate pilot study and combine the exploratory and confirmatory stages of an investigation in one single study. Conclusion There are several aspects to consider in medical device studies when using interventions that rely on changes in behavior to achieve an effective implementation and significant study results. Improvements in the control group may reduce effect sizes and limit statistical significance; therefore, alternatives to the traditional randomized controlled trials may be considered.
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Affiliation(s)
| | | | | | | | - Sina Buck
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Lise-Meitner-Strasse 8/2, 89081, Ulm, Germany.
| | - Delia Waldenmaier
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Lise-Meitner-Strasse 8/2, 89081, Ulm, Germany
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Ego or Eco? Neither Ecological nor Egoistic Appeals of Persuasive Climate Change Messages Impacted Pro-Environmental Behavior. SUSTAINABILITY 2020. [DOI: 10.3390/su122310064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Based on the ‘Inclusion Model of Environmental Concern’, we tested whether daily messaging intervention increases participants’ pro-environmental behavior (PEB). In a two (time: pre vs. post, repeated measure) × three (condition: egoistic appeals, ecological appeals, control group) experimental design, two hundred and eighteen individuals received either daily messages containing egoistic appeals for action to prevent climate change (e.g., preventing personal consequences of released diseases in melting arctic ice), ecological appeals (e.g., ecological consequences of melting glaciers), or no messages (control). PEB was assessed via self-reports and donations to an environmental organization. Neither of the appeals had an effect on the two dependent measures. Irrespective of experimental conditions, self-reported PEB was higher in the post- compared with the pre-test. Overall, the present results do not provide support for the effectiveness of a daily messaging technique. Instead, it appears that ‘being observed’ is the more effective ‘intervention’. Implications for how to foster PEB are discussed.
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23
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P3b as an electroencephalographic index of automatic associations of exercise-related images. Int J Psychophysiol 2020; 158:114-122. [DOI: 10.1016/j.ijpsycho.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 12/16/2022]
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Unintended consequences: a qualitative study exploring the impact of collecting implementation process data with phone interviews on implementation activities. Implement Sci Commun 2020; 1:101. [PMID: 33292848 PMCID: PMC7643400 DOI: 10.1186/s43058-020-00093-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/25/2020] [Indexed: 12/03/2022] Open
Abstract
Background Qualitative data are crucial for capturing implementation processes, and thus necessary for understanding implementation trial outcomes. Typical methods for capturing such data include observations, focus groups, and interviews. Yet little consideration has been given to how such methods create interactions between researchers and study participants, which may affect participants’ engagement, and thus implementation activities and study outcomes. In the context of a clinical trial, we assessed whether and how ongoing telephone check-ins to collect data about implementation activities impacted the quality of collected data, and participants’ engagement in study activities. Methods Researchers conducted regular phone check-ins with clinic staff serving as implementers in an implementation study. Approximately 1 year into this trial, 19 of these study implementers were queried about the impact of these calls on study engagement and implementation activities. The two researchers who collected implementation process data through phone check-ins with the study implementers were also interviewed about their perceptions of the impact of the check-ins. Results Study implementers’ assessment of the check-ins’ impact fell into three categories: (1) the check-ins had no effect on implementation activities, (2) the check-ins served as a reminder about study participation (without relating a clear impact on implementation activities), and (3) the check-ins caused changes in implementation activities. The researchers similarly perceived that the phone check-ins served as reminders and encouraged some implementers’ engagement in implementation activities; their ongoing nature also created personal connections with study implementers that may have impacted implementation activities. Among some study implementers, anticipation of the check-in calls also improved their ability to recount implementation activities and positively affected quality of the data collected. Conclusion These results illustrate the potential impact of qualitative data collection on implementation activities during implementation science trials. Mitigating such effects may prove challenging, but acknowledging these consequences—or even embracing them, perhaps by designing data collection methods as implementation strategies—could enhance scientific rigor. This work is presented to stimulate debate about the complexities involved in capturing data on implementation processes using common qualitative data collection methods. Trial registration ClinicalTrials.gov, NCT02325531. Registered 15 December 2014.
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Norman P, Webb TL, Millings A, Pechey L. Does the structure (tunneled vs. free-roam) and content (if-then plans vs. choosing strategies) of a brief online alcohol intervention effect engagement and effectiveness? A randomized controlled trial. Transl Behav Med 2020; 9:1122-1130. [PMID: 31287897 DOI: 10.1093/tbm/ibz110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Despite the potential of brief online interventions for reducing alcohol consumption, their effectiveness may be compromised by low levels of engagement and the inclusion of ineffective behavior change techniques. To test whether (i) a tunneled version of an intervention (where the content is delivered in a prespecified order) leads to greater engagement and greater reductions in alcohol consumption than a free-roam version (where the content can be viewed in any order) and (ii) forming if-then plans linking strategies to cut down with high-risk situations leads to greater reductions in alcohol consumption than only choosing strategies to cut down. Participants (N = 286 university staff and students) were randomly allocated to one of four versions of a brief online alcohol intervention in a 2 (structure: tunneled vs. free-roam) by 2 (planning: strategies vs. if-then plans) factorial design. Engagement (pages visited, time) was recorded automatically. Alcohol consumption (weekly units) was assessed at baseline and 1- and 6-month follow-up. Participants who received the tunneled version viewed significantly more pages and spent significantly more time on the website than those who received the free-roam version. Significant reductions in alcohol consumption were observed at follow-up; however, neither the structure of the intervention nor planning had a significant effect on reductions in alcohol consumption. Tunneled online interventions can increase engagement, but this may not translate into greater changes in behavior. Further experimental research using factorial designs is needed to identify the key behavior change techniques to include in brief online interventions.
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Affiliation(s)
- Paul Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Thomas L Webb
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Abigail Millings
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Laura Pechey
- Haringey Advisory Group on Alcohol, London, 0HJ, UK
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26
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Jiang D, Warner LM, Chong AML, Li T, Wolff JK, Chou KL. Promoting Volunteering Among Older Adults in Hong Kong: A Randomized Controlled Trial. THE GERONTOLOGIST 2020; 60:968-977. [PMID: 31228197 DOI: 10.1093/geront/gnz076] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Volunteering has consistently been associated with better mental, physical, and cognitive health in older adulthood. However, the volunteering rate of older adults in Hong Kong is much lower than in Western countries. Few studies have examined whether interventions can be effective in motivating older adults to volunteer in Hong Kong. To fill this gap, we conducted a randomized controlled trial to examine the impact of a theory-based social-cognitive intervention on volunteering. RESEARCH DESIGN AND METHODS A total of 264 community-dwelling older adults in Hong Kong (Mage = 69.95 years, SDage = 6.90 years, 81.06% female) were randomly assigned to either an experimental group or an active control group. Participants in the experimental group received 4 weekly 1-hr face-to-face volunteering intervention sessions. Those in the active control group received parallel sessions targeting physical activity instead of volunteering. The time spent on volunteering per month was self-reported and measured at baseline, 6 weeks, 3 months, and 6 months after the intervention. Self-efficacy, intention, action planning, and self-monitoring of volunteering were measured as mediators. RESULTS Monthly volunteering minutes increased among participants in the experimental group when compared with the active control group at 6-week, 3-month, and 6-month follow-ups. Self-efficacy, intention, and action planning consistently mediated the effect of the intervention on volunteering minutes. DISCUSSION AND IMPLICATIONS The findings demonstrate the effectiveness of the intervention on volunteering behavior in older adults in Hong Kong through well-established behavior change techniques.
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Affiliation(s)
- Da Jiang
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong, China.,Integrated Centre for Wellbeing (I-WELL), The Education University of Hong Kong, Tai Po, Hong Kong, China.,Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong, China
| | - Lisa M Warner
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Alice Ming-Lin Chong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Tianyuan Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong, China.,Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong, China
| | - Julia K Wolff
- Department of Psychology, Friedrich-Alexander-University (FAU) Erlangen-Nuremberg, Institute of Psychogerontology, Nuremberg, Germany
| | - Kee-Lee Chou
- Department of Asian and Policy Studies, The Education University of Hong Kong, Tai Po, Hong Kong, China
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Voigt L, Ullrich A, Baumann S, Dörr M, John U, Ulbricht S. Do sociodemographic variables and cardiometabolic risk factors moderate the mere-measurement effect on physical activity and sedentary time? BMC Cardiovasc Disord 2020; 20:272. [PMID: 32503441 PMCID: PMC7275363 DOI: 10.1186/s12872-020-01551-9] [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] [Received: 06/26/2019] [Accepted: 05/24/2020] [Indexed: 11/28/2022] Open
Abstract
Background Participation in an assessment may change health behavior. This “mere-measurement effect” may be used for prevention purposes. However, little is known about whether individuals’ characteristics moderate the effect. The objective was to explore whether changes of physical activity (PA) and sedentary time (ST) after a cardiovascular assessment depend on sociodemographic variables and cardiometabolic risk factors. Methods A sample of n = 175 adults aged 40 to 65 received baseline assessment including self-administered PA and ST questionnaires and standardized measurement of blood pressure, waist circumference, and blood parameters. After 5 weeks, participants again reported PA and ST without any prior treatment or intervention. Linear regression models were used to analyze the dependence of five-week changes in PA and ST on baseline sociodemographic and cardiometabolic variables. Results Men increased transport-related PA more than women (b = 9.3 MET-hours/week, P = .031). Men with higher triglycerides increased transport-related PA less than men with lower triglycerides (b = − 5.6 MET-hours/week, P = .043). Men with higher systolic blood pressure reduced ST more than those with lower systolic blood pressure (b = − 35.7 min/week, P = .028). However, this linear association ceased to exist at a level of approximately 145 mmHg (b of squared association = 1.0, P = .080). A similar relationship was found for glycated hemoglobin and ST. Conclusions The findings suggest that sex and cardiometabolic risk factors moderate mere-measurement effects on PA and ST. Researchers and practitioners using mere measurement for prevention purposes may address PA and ST according to these individual characteristics. Trial registration ClinicalTrials.govNCT02990039. Registered 7 December 2016. Retrospectively registered.
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Affiliation(s)
- Lisa Voigt
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany. .,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
| | - Antje Ullrich
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Sophie Baumann
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Sabina Ulbricht
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
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28
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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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29
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Swann C, Rosenbaum S, Lawrence A, Vella SA, McEwan D, Ekkekakis P. Updating goal-setting theory in physical activity promotion: a critical conceptual review. Health Psychol Rev 2020; 15:34-50. [PMID: 31900043 DOI: 10.1080/17437199.2019.1706616] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Goal-setting is a widely used and accepted strategy for promoting physical activity. Locke and Latham's goal-setting theory is the primary theoretical framework for setting goals in psychology and plays a prominent role in physical activity promotion. Recently, however, there have been calls to reconsider current goal-setting practice in this field. Therefore, we aimed to critically review and update the application of goal-setting theory in physical activity promotion, by examining core developments in this theory since 1990. Current practice relies on setting specific 'performance' goals as a means of increasing physical activity (e.g., 10,000 steps; national physical activity guidelines). This approach was initially consistent with key tenets of goal-setting theory. However, since 1990 this theory has evolved to differentiate between performance and learning goals. Both goal types are context-dependent and it is now recognised that, in some cases, performance goals can even be detrimental to the achievement of desired outcomes. Consequently, current practice may be theoretically appropriate for physically active individuals but a different approach (e.g., learning goals) may be preferable for inactive individuals who are new to physical activity (i.e., most of the population). We conclude by discussing implications for policy, research, and practice in goal-setting for physical activity promotion.
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Affiliation(s)
- Christian Swann
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, Australia.,Centre for Athlete Development, Experience and Performance, Southern Cross University, Coffs Harbour, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia.,Black Dog Institute, Sydney, Australia
| | - Alex Lawrence
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, Australia.,Centre for Athlete Development, Experience and Performance, Southern Cross University, Coffs Harbour, Australia
| | - Stewart A Vella
- Global Alliance for Mental Health and Sport, School of Psychology, Faculty of Social Sciences, University of Wollongong, Australia
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Perski O, Naughton F, Garnett C, Blandford A, Beard E, West R, Michie S. Do Daily Fluctuations in Psychological and App-Related Variables Predict Engagement With an Alcohol Reduction App? A Series of N-Of-1 Studies. JMIR Mhealth Uhealth 2019; 7:e14098. [PMID: 31579022 PMCID: PMC6777278 DOI: 10.2196/14098] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/23/2019] [Accepted: 06/11/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previous studies have identified psychological and smartphone app-related predictors of engagement with alcohol reduction apps at a group level. However, strategies to promote engagement need to be effective at the individual level. Evidence as to whether group-level predictors of engagement are also predictive for individuals is lacking. OBJECTIVE The aim of this study was to examine whether daily fluctuations in (1) the receipt of a reminder, (2) motivation to reduce alcohol, (3) perceived usefulness of the app, (4) alcohol consumption, and (5) perceived lack of time predicted within-person variability in the frequency and amount of engagement with an alcohol reduction app. METHODS We conducted a series of observational N-of-1 studies. The predictor variables were measured twice daily for 28 days via ecological momentary assessments. The outcome variables were measured through automated recordings of the participants' app screen views. A total of nine London-based adults who drank alcohol excessively and were willing to set a reduction goal took part. Each participant's dataset was analyzed separately using generalized additive mixed models to derive incidence rate ratios (IRRs) for the within-person associations of the predictor and outcome variables. Debriefing interviews, analyzed using thematic analysis, were used to contextualize the findings. RESULTS Predictors of the frequency and amount of engagement differed between individuals, and for the variables 'perceived usefulness of the app' and 'perceived lack of time', the direction of associations also differed between individuals. The most consistent predictors of within-person variability in the frequency of engagement were the receipt of a daily reminder (IRR=1.80-3.88; P<.05) and perceived usefulness of the app (IRR=0.82-1.42; P<.05). The most consistent predictors of within-person variability in the amount of engagement were motivation to reduce alcohol (IRR=1.67-3.45; P<.05) and perceived usefulness of the app (IRR=0.52-137.32; P<.05). CONCLUSIONS The utility of the selected psychological and app-related variables in predicting the frequency and amount of engagement with an alcohol reduction app differed at the individual level. This highlights that key within-person associations may be masked in group-level designs and suggests that different strategies to promote engagement may be required for different individuals.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Ann Blandford
- UCL Interaction Centre, University College London, London, United Kingdom
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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CHIP-Family intervention to improve the psychosocial well-being of young children with congenital heart disease and their families: results of a randomised controlled trial. Cardiol Young 2019; 29:1172-1182. [PMID: 31378215 DOI: 10.1017/s1047951119001732] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Children with congenital heart disease and their families are at risk of psychosocial problems. Emotional and behavioural problems, impaired school functioning, and reduced exercise capacity often occur. To prevent and decrease these problems, we modified and extended the previously established Congenital Heart Disease Intervention Program (CHIP)-School, thereby creating CHIP-Family. CHIP-Family is the first psychosocial intervention with a module for children with congenital heart disease. Through a randomised controlled trial, we examined the effectiveness of CHIP-Family. METHODS Ninety-three children with congenital heart disease (age M = 5.34 years, SD = 1.27) were randomised to CHIP-Family (n = 49) or care as usual (no psychosocial care; n = 44). CHIP-Family consisted of a 1-day group workshop for parents, children, and siblings and an individual follow-up session for parents. CHIP-Family was delivered by psychologists, paediatric cardiologists, and physiotherapists. At baseline and 6-month follow-up, mothers, fathers, teachers, and the child completed questionnaires to assess psychosocial problems, school functioning, and sports enjoyment. Moreover, at 6-month follow-up, parents completed program satisfaction assessments. RESULTS Although small improvements in child outcomes were observed in the CHIP-Family group, no statistically significant differences were found between outcomes of the CHIP-Family and care-as-usual group. Mean parent satisfaction ratings ranged from 7.4 to 8.1 (range 0-10). CONCLUSIONS CHIP-Family yielded high program acceptability ratings. However, compared to care as usual, CHIP-Family did not find the same extent of statistically significant outcomes as CHIP-School. Replication of promising psychological interventions, and examination of when different outcomes are found, is recommended for refining interventions in the future. TRIAL REGISTRY Dutch Trial Registry number NTR6063, https://www.trialregister.nl/trial/5780.
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Hunkin H, Turnbull D, Zajac IT. Considering anticipated regret may reduce colorectal cancer screening intentions: a randomised controlled trial. Psychol Health 2019; 35:555-572. [PMID: 31403327 DOI: 10.1080/08870446.2019.1649407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: Regular screening for colorectal cancer (CRC) can substantially improve outcomes. This study investigated how measuring regret expected from failing to screen might lead to stronger screening intentions. Five potential moderators were evaluated: perceived threat, psychological reactance, prior screening participation, concurrently measuring faecal aversion (FA) and anticipated regret (AR). Design: A 2 (AR measured pre/post intention) × 2 (FA measured pre/post intention) single blind parallel randomised controlled trial was used. Australians aged 45 and over completed an online survey measuring AR, FA, intention, theory of planned behaviour variables and potential moderators. Main outcome measures: The primary outcome was CRC screening intention. Results: Eight hundred and three participants were randomised, with 666 analysed. Measuring AR prior to intention unexpectedly resulted in a significantly lower intention to screen (d = 0.18, 95% CI [0.03, 0.33]) compared to measuring after intention. Trait reactance predicted a significantly lower intention when it was at least 0.52 SD above the mean; other moderators were not supported. Conclusion: The processes underlying anticipated regret manipulations must be better understood in order to have practical value in health promotion. More research is required to determine how to minimise or avoid the apparent negative effects of psychological reactance in CRC screening communication. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12618001098224 http://www.ANZCTR.org.au/ACTRN12618001098224.aspx.
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Affiliation(s)
- Hugh Hunkin
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Ian T Zajac
- School of Psychology, University of Adelaide, Adelaide, SA, Australia.,Nutrition and Health Research Program, Commonwealth Scientific & Industrial Research Organisation (CSIRO), Adelaide, SA, Australia
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Theory Content, Question-Behavior Effects, or Form of Delivery Effects for Intention to Become an Organ Donor? Two Randomized Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071304. [PMID: 30979026 PMCID: PMC6479820 DOI: 10.3390/ijerph16071304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 11/21/2022]
Abstract
Eliciting different attitudes with survey questionnaires may impact on intention to donate organs. Previous research used varying numbers of questionnaire items, or different modes of intervention delivery, when comparing groups. We aimed to determine whether intention to donate organs differed among groups exposed to different theoretical content, but similar questionnaire length, in different countries. We tested the effect of excluding affective attitudinal items on intention to donate, using constant item numbers in two modes of intervention delivery. Study 1: A multi-country, interviewer-led, cross-sectional randomized trial recruited 1007 participants, who completed questionnaires as per group assignment: including all affective attitude items, affective attitude items replaced, negatively-worded affective attitude items replaced. Study 2 recruited a UK-representative, cross-sectional sample of 616 participants using an online methodology, randomly assigned to the same conditions. Multilevel models assessed effects of group membership on outcomes: intention to donate (primary), taking a donor card, following a web-link (secondary). In study 1, intention to donate did not differ among groups. Study 2 found a small, significantly higher intention to donate in the negatively-worded affective attitudes replaced group. Combining data yielded no group differences. No differences were seen for secondary outcomes. Ancillary analyses suggest significant interviewer effects. Contrary to previous research, theoretical content may be less relevant than number or valence of questionnaire items, or form of intervention delivery, for increasing intention to donate organs.
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Randomized trial seeking to induce the Hawthorne effect found no evidence for any effect on self-reported alcohol consumption online. J Clin Epidemiol 2019; 108:102-109. [DOI: 10.1016/j.jclinepi.2018.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/17/2018] [Accepted: 11/14/2018] [Indexed: 11/22/2022]
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35
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Wilding S, Conner M, Prestwich A, Lawton R, Sheeran P. Using the question-behavior effect to change multiple health behaviors: An exploratory randomized controlled trial. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2019; 81:53-60. [PMID: 30828108 PMCID: PMC6358049 DOI: 10.1016/j.jesp.2018.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Asking questions about a behavior has been found to influence subsequent performance of that behavior, a phenomenon termed the question-behavior effect (QBE). The present study addressed two under-researched questions concerning the QBE: (1) Can the QBE be used to change multiple health behaviors, and (2) does enhancing dissonance during questionnaire completion increase the magnitude of the QBE? Participants (N = 1534) were randomized to one of three conditions (dissonance-enhanced QBE; standard QBE; control) that targeted three health-protective behaviors (eating fruit and vegetables, physical activity, dental flossing) and three health-risk behaviors (alcohol intake, sedentariness, unhealthy snacking). The dissonance-enhanced intervention comprised a message designed to pressurize participants into forming healthful behavioral intentions. Behavior was assessed via self-reports at four-week follow up. Findings showed significant overall effects of the QBE both in increasing performance of health-protective behaviors (p = .001) and in reducing performance of health-risk behaviors (p = .04). Compared to the standard QBE condition, the dissonance-enhanced QBE intervention increased performance of health-protective behaviors (p = .04) and marginally reduced performance of health-risk behaviors (p = .07). The dissonance-enhanced QBE intervention outperformed the control condition in all analyses. This is the first report that a brief QBE intervention influences performance of multiple health behaviors. Findings supported the idea that magnifying dissonance increases the impact of the QBE.
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Affiliation(s)
| | | | | | | | - Paschal Sheeran
- University of North Carolina at Chapel Hill, United States of America
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36
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Koletić G, Cohen N, Štulhofer A, Kohut T. Does Asking Adolescents About Pornography Make Them Use It? A Test of the Question-Behavior Effect. JOURNAL OF SEX RESEARCH 2019; 56:137-141. [PMID: 30074822 DOI: 10.1080/00224499.2018.1501549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Longitudinal survey design is the preferred method for the robust assessment of outcomes associated with socially undesirable or potentially harmful sexual behaviors. However, repeated measurement may induce the question-behavior effect (QBE)-the phenomenon where asking about a behavior changes the probability of engaging in the behavior in the future. Using an online panel sample of Croatian adolescents (Mage at baseline = 15.8, SD = .50), the present study explored the QBE in the context of adolescent pornography use. To this end we compared the frequency of pornography use six months after the initial survey (T2) between adolescents who participated in both baseline (T1) and T2 survey assessments (n = 1,053; 41% of males) and those who began the study at T2 (n = 130; 42% of males). In line with the findings from a recent Dutch study, we found no evidence that surveying adolescent pornography consumption increased participants' reports of subsequent use. Implications of the findings for studying pornography use in young people are discussed.
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Affiliation(s)
| | - Nicole Cohen
- b Department of Psychology , University of Kansas
| | | | - Taylor Kohut
- c Department of Sociology , University of Zagreb and Department of Psychology, University of Western Ontario
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Hagoel L, Stein N, Rennert G, Neter E. Better Ask Than Tell: Responses to mHealth Interrogative Reminders and Associations With Colorectal Cancer Screening Subsequent Uptake in a Prospective Cohort Intervention. JMIR Mhealth Uhealth 2019; 7:e9351. [PMID: 30664486 PMCID: PMC6360382 DOI: 10.2196/mhealth.9351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/05/2018] [Accepted: 09/10/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Text message (short message service, SMS) interrogative reminders were adopted in population screening for the early detection of colorectal cancer (CRC). OBJECTIVE This study aims to examine responses to text message (SMS) reminders and associate responses with senders' characteristics, message type (interrogative/declarative), and subsequent screening uptake. METHODS We conducted a prospective cohort intervention. Text message (SMS) reminders to undergo CRC screening, randomized into interrogative and declarative phrasing, were sent to nonadherent 40,000 women and men (age 50-74 years) at CRC average risk. We analyzed recipient responses by message phrasing, recipient characteristics, and for content, the latter predicting subsequent CRC screening per program database. RESULTS While interrogative text message (SMS) reminders elicited 7.67% (1475/19,227) responses, declarative ones elicited 0.76% (146/19,262) responses. Text message (SMS) responses were content analyzed and grouped into attitudes toward CRC screening (1237/1512, 81.8% positive) and intention to screen (1004/1512, 62.6%). Text message (SMS) respondents screened significantly more than nonrespondents after 6 months (415/1621, 25.6% vs 3322/36,868, 9.0%; χ12=487.5, P<.001); 1 year (340/1621, 21.0% vs 4711/36,868; χ12=91.5, P<.001); and 2 years (225/1621, 13.9% vs 3924/36,868; χ12=16.9, P<.001) following the reminders. In a multivariable logistic regression among text message (SMS) respondents, screening after 6 months was significantly predicted by older age, past sporadic screening, attitudes, and intentions. CONCLUSIONS Interrogative text message (SMS) reminders reached previously uninvolved sectors in the CRC target population-men, sporadic-screenees, and the "never-tested" before. This novel application resulted in a population-level, incrementally enhanced screening. Asking patients about their future health behavior may be relevant for enhancing other health behaviors in preventive medicine and clinical settings.
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Affiliation(s)
- Lea Hagoel
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.,Faculty of Medicine, Technion, Haifa, Israel
| | - Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
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Miles LM, Elbourne D, Farmer A, Gulliford M, Locock L, McCambridge J, Sutton S, French DP. Bias due to MEasurement Reactions In Trials to improve health (MERIT): protocol for research to develop MRC guidance. Trials 2018; 19:653. [PMID: 30477551 PMCID: PMC6258480 DOI: 10.1186/s13063-018-3017-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/24/2018] [Indexed: 01/08/2023] Open
Abstract
Background There is now clear systematic review evidence that measurement can affect the people being measured; much of this evidence focusses on how asking people to complete a questionnaire can result in changes in behaviour. Changes in measured behaviour and other outcomes due to this reactivity may introduce bias in otherwise well-conducted randomised controlled trials (RCTs), yielding incorrect estimates of intervention effects. Despite this, measurement reactivity is not currently adequately considered in risk of bias frameworks. The present research aims to produce a set of guidance statements on how best to avoid or minimise bias due to measurement reactivity in studies of interventions to improve health, with a particular focus on bias in RCTs. Methods The MERIT study consists of a series of systematic and rapid reviews, a Delphi study and an expert workshop to develop guidance on how to minimise bias in trials due to measurement reactivity. An existing systematic review on question-behaviour effects on health-related behaviours will be updated and three new rapid reviews will be conducted to identify (1) existing guidance on measurement reactivity; (2) systematic reviews of studies that have quantified the effects of measurement on outcomes relating to behaviour and affective outcomes in health and non-health contexts and (3) trials that have investigated the effects of objective measurements of behaviour on concurrent or subsequent behaviour itself. A Delphi procedure will be used to combine the views of experts with a view to reaching agreement on the scope of the guidance statements. Finally, a workshop will be held in autumn 2018, with the aim of producing a set of guidance statements that will form the central part of new MRC guidance on how best to avoid bias due to measurement reactivity in studies of interventions to improve health. Discussion Our ambition is to produce MRC guidance on measurement reactions in trials which will be used by future trial researchers, leading to the development of trials that are less likely to be at risk of bias. Electronic supplementary material The online version of this article (10.1186/s13063-018-3017-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisa M Miles
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, UK
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Martin Gulliford
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Stephen Sutton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - David P French
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, UK.
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Steenaart E, Crutzen R, Candel MJJM, de Vries NK. A web-based education program to encourage organ donation registration among lower-educated adolescents in the Netherlands: study protocol for a cluster randomized controlled trial. Trials 2018; 19:532. [PMID: 30285823 PMCID: PMC6167828 DOI: 10.1186/s13063-018-2927-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The gap between the supply and demand of organ donors is substantial, causing patients to suffer from long waiting times. Moreover, the lack of registrations places a burden on family members and medical professionals when an unregistered individual dies. This article describes a cluster randomized controlled trial (CRCT) study to assess the effectiveness and quality of implementation of a web-based program aimed at encouraging lower-educated adolescents to register a well-informed choice about organ donation, regardless of it being as a donor or not. METHODS/DESIGN The program will be delivered by teachers at schools for Intermediate Vocational Education in the Netherlands. The effectiveness will be assessed in a CRCT design with post-test only using self-administered questionnaires for the primary outcome (i.e. intention to register). Classes will be matched to improve equivalence of groups. From each pair of matched classes, one class will be randomly assigned to the experimental condition, and the other assigned to the control condition. Students in the control groups will fill in the questionnaire before receiving the program, while the experimental groups will do this afterwards. A post-test design prevents the risk of testing bias. The required sample size is 14 schools, with 10 classes per school and 13 unregistered students per class. The questionnaire assesses demographics, behavioural determinants (attitude, self-efficacy, knowledge and social outcomes), intention to register (as a donor) and registration status. Six months after delivery, registration status will be assessed again. Additionally, a process evaluation will be conducted to evaluate the quality of implementation using both qualitative (i.e. semi-structured interviews) and quantitative (i.e. logbooks, questionnaires, Google Analytics to track user behaviour at the website) methods. DISCUSSION Findings of the study can help to further improve the program and serve as a basis for a solid dissemination plan. Moreover, the study will provide insight into (change in) determinants of registration and donorship and the translation of research into practice of school-based health promotion interventions, which can serve as an example for others. TRIAL REGISTRATION The Dutch Trial Register, NTR6771 . Registered on 24 October 2017. This is version 2 of the protocol (5 November 2017).
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Affiliation(s)
- Esther Steenaart
- Department of Health Promotion, CAPHRI Maastricht University, Maastricht, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, CAPHRI Maastricht University, Maastricht, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, CAPHRI Maastricht University, Maastricht, The Netherlands
| | - Nanne K de Vries
- Department of Health Promotion, CAPHRI Maastricht University, Maastricht, The Netherlands
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Lion R, Arulogun O, Titiloye M, Shaver D, Jain A, Godwin B, Sidibe M, Adejumo M, Rosseel Y, Schmidt P. The effect of the "Follow in my Green Food Steps" programme on cooking behaviours for improved iron intake: a quasi-experimental randomized community study. Int J Behav Nutr Phys Act 2018; 15:79. [PMID: 30115087 PMCID: PMC6097342 DOI: 10.1186/s12966-018-0710-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutritional iron deficiency is one of the leading factors for disease, disability and death. A quasi-experimental randomized community study in South-West Nigeria explored whether a branded behaviour change programme increased the use of green leafy vegetables (greens) and iron-fortified bouillon cubes in stews for improved iron intake. METHODS A coinflip assigned the intervention to Ile-Ife (Intervention town). Osogbo (Control town) received no information. At baseline 602 mother-daughter pairs (daughters aged 12-18) were enrolled (Intervention: 300; Control: 302). A Food Frequency Questionnaire assessed the addition of cubes and greens to stews, the primary outcome. Secondary outcomes were the addition of cubes and greens to soups and changes in behavioural determinants measured using the Theory of Planned Behaviour. Structural Equation Modelling (SEM) evaluated the impact of the intervention on behavioural determinants and behaviour. RESULTS The data of 527 pairs was used (Intervention: 240; Control: 287). The increase in greens added to stews was larger in the Intervention town compared to the Control town (MIntervention = 0.3 [SE = 0.03]; MControl = 0.0 [SE = 0.04], p < 0.001, r = 0.36). Change in iron-fortified cubes added to stews did not differ between towns (p = 0.07). The increase in cubes added to soups was larger in the Intervention town compared to the Control Town (MIntervention = 0.9 [SE = 0.2] vs MControl = 0.4 [SE = 0.1], p < .0001, r = 0.20). Unexpectedly, change in greens added to soups was larger in the Control town compared to the Intervention town (MIntervention = - 0.1 [SE = 0.1]; MControl = 0.5 [SE = 0.1], p = 0.003, r = 0.15). The intervention positively influenced awareness of anaemia and the determinants of behaviour in the Intervention town, with hardly any change in the Control town. Baseline SEMs could not be established, so no mediation analyses were done. Post-intervention SEMs highlighted the role of habit in cooking stews. CONCLUSIONS The behaviour change programme increased the amount of green leafy vegetables added to stews and iron-fortified cubes added to soups. Future research should assess the long-term impact and the efficacy of the programme as it is scaled up and rolled out.
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Affiliation(s)
- René Lion
- Unilever R&D Vlaardingen, Vlaardingen, The Netherlands.
| | - Oyedunni Arulogun
- Department of Health Promotion & Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Musibaau Titiloye
- Department of Health Promotion & Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | | | | | - Mumuni Adejumo
- Department of Environmental Health Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Yves Rosseel
- Department of Data Analysis, University of Ghent, Gent, Belgium
| | - Peter Schmidt
- University of Giessen & Humboldt Research Fellow at Cardinal Wyscinski University Warsaw, Warszawa, Poland
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Knoll N, Hohl DH, Motter S, Keller J, Lange D, Felsenberg D, Martus P, Ertel W, Schwarzer R. Facilitating physical activity and reducing symptoms in patients with knee osteoarthritis: study protocol of a randomized controlled trial to test a theory-based PrevOP-psychological adherence program (PrevOP-PAP). BMC Musculoskelet Disord 2018; 19:221. [PMID: 30021578 PMCID: PMC6052630 DOI: 10.1186/s12891-018-2158-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/26/2018] [Indexed: 01/15/2023] Open
Abstract
Background The present randomized controlled trial, which is crossed with the “PREVenting the impairment of primary Osteoarthritis by high impact long-term Physical exercise regimen” Main Medical Trial (PrevOP-MMT), aims to evaluate a psychological adherence program (PrevOP-PAP), and is designed to support persons with knee osteoarthritis (OAK) in the uptake and maintenance of regular physical activity to reduce OAK symptoms. The PrevOP-PAP is based on the Health Action Process Approach (HAPA), a social-cognitive theory predicting health behavior change in individuals, extended here by social network characteristics and social exchange processes. It is expected that participants with OAK receiving the PrevOP-PAP will maintain higher levels of regular physical activity throughout a 24-month period and consequently report lower levels of OAK symptoms than participants of an active control condition. Methods A total of N = 240 participants with medically verified moderate OAK will be randomly assigned to an intervention condition (PrevOP-PAP-I; 50%) or an active control condition (PrevOP-PAP-CTRL). The PrevOP-PAP-I includes a motivational intervention, repeated self-regulation interventions, and a network creation intervention delivered over 12 months. Modes of intervention delivery include a paper-pencil motivation leaflet with a quiz, a computer-assisted face-to-face intervention, four computer assisted phone-based interventions, and activity calendars. The PrevOP-PAP-CTRL includes the motivational intervention only. Primary outcome will be OAK symptoms. Secondary outcomes include objectively and subjectively measured physical activity and indicators of quality of life. Other outcomes are HAPA-derived self-regulatory indicators as well as proposed social network and social exchange mechanisms of health behavior change. Assessments take place at baseline, 6 months, 12 months, 18 months, and 24 months following baseline. Discussion Based on the extended HAPA, this study seeks to reveal the self-regulatory and social mechanisms of the uptake and maintenance of physical activity and their relation to disease symptoms in persons with OAK. The design and evaluation of this program are intended to become a yardstick for future development and implementation of digitalized psychological adherence programs in this population. Trial registration German Clinical Trials Register; also available at http://apps.who.int/trialsearch/; registration number: DRKS00009677; date of registration: 26 January 2016.
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Affiliation(s)
- Nina Knoll
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Diana Hilda Hohl
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Susannah Motter
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Jan Keller
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Daniela Lange
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Dieter Felsenberg
- Centre for Muscle- and Bone Research, Department of Traumatology and Reconstructive Surgery, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Universitätsklinikum Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
| | - Wolfgang Ertel
- Department of Traumatology and Reconstructive Surgery, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Ralf Schwarzer
- Department of Education and Psychology, Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.,SWPS University of Social Sciences and Humanities, ul. Ostrowskiego 30b, 53-238, Wrocław, Poland
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McDermott L, Cornelius V, Wright AJ, Burgess C, Forster AS, Ashworth M, Khoshaba B, Clery P, Fuller F, Miller J, Dodhia H, Rudisill C, Conner MT, Gulliford MC. Enhanced Invitations Using the Question-Behavior Effect and Financial Incentives to Promote Health Check Uptake in Primary Care. Ann Behav Med 2018; 52:594-605. [PMID: 29860363 PMCID: PMC6361284 DOI: 10.1093/abm/kax048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Uptake of health checks for cardiovascular risk assessment in primary care in England is lower than anticipated. The question-behavior effect (QBE) may offer a simple, scalable intervention to increase health check uptake. Purpose The present study aimed to evaluate the effectiveness of enhanced invitation methods employing the QBE, with or without a financial incentive to return the questionnaire, at increasing uptake of health checks. Methods We conducted a three-arm randomized trial including all patients at 18 general practices in two London boroughs, who were invited for health checks from July 2013 to December 2014. Participants were randomized to three trial arms: (i) Standard health check invitation letter only; (ii) QBE questionnaire followed by standard invitation letter; or (iii) QBE questionnaire with offer of a financial incentive to return the questionnaire, followed by standard invitation letter. In intention to treat analysis, the primary outcome of completion of health check within 6 months of invitation, was evaluated using a p value of .0167 for significance. Results 12,459 participants were randomized. Health check uptake was evaluated for 12,052 (97%) with outcome data collected. Health check uptake within 6 months of invitation was: standard invitation, 590 / 4,095 (14.41%); QBE questionnaire, 630 / 3,988 (15.80%); QBE questionnaire and financial incentive, 629 / 3,969 (15.85%). Difference following QBE questionnaire, 1.43% (95% confidence interval -0.12 to 2.97%, p = .070); following QBE questionnaire and financial incentive, 1.52% (-0.03 to 3.07%, p = .054). Conclusions Uptake of health checks following a standard invitation was low and not significantly increased through enhanced invitation methods using the QBE.
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Affiliation(s)
- Lisa McDermott
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Victoria Cornelius
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Alison J Wright
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Caroline Burgess
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Alice S Forster
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Mark Ashworth
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Bernadette Khoshaba
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Philippa Clery
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
| | - Frances Fuller
- Public Health, Community Services Directorate, Lewisham Borough Council, Laurence House, London, UK
| | - Jane Miller
- Public Health, Community Services Directorate, Lewisham Borough Council, Laurence House, London, UK
| | - Hiten Dodhia
- Public Health Directorate, Lambeth Borough Council, Phoenix House, London, UK
| | - Caroline Rudisill
- Department of Social Policy, London School of Economics and Political Science, Houghton St, London, UK
| | - Mark T Conner
- School of Psychology, University of Leeds, Leeds, UK
| | - Martin C Gulliford
- Department of Primary Care and Public Health Sciences, King’s College London, Addison House, Guy’s Campus, London, UK
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Hospital, Guy’s Hospital, London, UK
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van Steen T, Joinson AN. Self-affirmation and goal difficulty as moderators of the question-behavior effect. JOURNAL OF THEORETICAL SOCIAL PSYCHOLOGY 2018. [DOI: 10.1002/jts5.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A. Increasing Vaccination: Putting Psychological Science Into Action. Psychol Sci Public Interest 2018; 18:149-207. [DOI: 10.1177/1529100618760521] [Citation(s) in RCA: 483] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vaccination is one of the great achievements of the 20th century, yet persistent public-health problems include inadequate, delayed, and unstable vaccination uptake. Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable. The first proposition is that thoughts and feelings can motivate getting vaccinated. Hundreds of studies have shown that risk beliefs and anticipated regret about infectious disease correlate reliably with getting vaccinated; low confidence in vaccine effectiveness and concern about safety correlate reliably with not getting vaccinated. We were surprised to find that few randomized trials have successfully changed what people think and feel about vaccines, and those few that succeeded were minimally effective in increasing uptake. The second proposition is that social processes can motivate getting vaccinated. Substantial research has shown that social norms are associated with vaccination, but few interventions examined whether normative messages increase vaccination uptake. Many experimental studies have relied on hypothetical scenarios to demonstrate that altruism and free riding (i.e., taking advantage of the protection provided by others) can affect intended behavior, but few randomized trials have tested strategies to change social processes to increase vaccination uptake. The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel. These interventions are by far the most plentiful and effective in the literature. To increase vaccine uptake, these interventions build on existing favorable intentions by facilitating action (through reminders, prompts, and primes) and reducing barriers (through logistics and healthy defaults); these interventions also shape behavior (through incentives, sanctions, and requirements). Although identification of principles for changing thoughts and feelings to motivate vaccination is a work in progress, psychological principles can now inform the design of systems and policies to directly facilitate action.
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Affiliation(s)
- Noel T. Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina
| | | | | | - Julie Leask
- Faculty of Nursing and Midwifery, University of Sydney
- Faculty of Medicine, University of Sydney
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine
- Department of Pediatrics, University of Colorado Anschutz Medical Campus
- Department of Pediatrics, Children’s Hospital Colorado, Aurora, Colorado
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45
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Ferguson E, Lawrence C. It is only fair: blood donors are more sensitive to violations of fairness norms than nondonors - converging psychometric and ultimatum game evidence. Vox Sang 2018; 113:242-250. [DOI: 10.1111/vox.12636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/09/2017] [Accepted: 01/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- E. Ferguson
- School of Psychology; University of Nottingham; Nottingham UK
| | - C. Lawrence
- School of Psychology; University of Nottingham; Nottingham UK
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Scheerman JFM, van Meijel B, van Empelen P, Kramer GJC, Verrips GHW, Pakpour AH, Van den Braak MCT, van Loveren C. Study protocol of a randomized controlled trial to test the effect of a smartphone application on oral-health behavior and oral hygiene in adolescents with fixed orthodontic appliances. BMC Oral Health 2018; 18:19. [PMID: 29415697 PMCID: PMC5803887 DOI: 10.1186/s12903-018-0475-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 01/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12-16 with fixed orthodontic appliances. METHODS/DESIGN The RCT has two conditions: an experimental group that will receive the WhiteTeeth app in addition to care as usual, and a control group that will only receive care as usual. Care as usual will include routine oral-health education and instruction at orthodontic check-ups. In the western part of the Netherlands 146 participants will be recruited from four orthodontic clinics. Data will be collected during three orthodontic check-ups: baseline (T0), 6 weeks of follow-up (T1) and 12 weeks of follow-up (T2). The primary study outcomes are the presence of dental plaque (measured with a modified Silness and Loë Plaque Index); and gingival bleeding (measured with the Bleeding on Marginal Probing Index). Secondary outcomes include changes in self-reported oral-health behaviors and its psychosocial factors identified by the HAPA theory, such as outcome expectancies, intention, action self-efficacy, coping planning and action control. DISCUSSION Since the intervention was designed to target psychosocial factors in the motivational and volitional components of the behavior-change process, we hypothesize that the app will cause greater improvements in oral-health behavior and oral hygiene more than traditional oral-health-promotion programs (i.e., care as usual). TRIAL REGISTRATION The trial has been registered with the Dutch Trial Register ( NTR6206 : 20 February 2017).
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Affiliation(s)
- Janneke F M Scheerman
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands. .,Department of Oral Hygiene, Inholland University, Amsterdam, the Netherlands. .,Department of Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands. .,Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, ACTA University, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands.
| | - Berno van Meijel
- Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, the Netherlands.,Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, the Netherlands
| | - Pepijn van Empelen
- Department of Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Gem J C Kramer
- Department of Orthodontics, Academic Centre of Dentistry Amsterdam, Amsterdam, the Netherlands
| | - Gijsbert H W Verrips
- Department of Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Amir H Pakpour
- Department of Social Determinants of Health, Research Centre (SHD), Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Natural Science and Biomedicine, Centre of Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Matheus C T Van den Braak
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.,Department of Orthodontics, Academic Centre of Dentistry Amsterdam, Amsterdam, the Netherlands
| | - Cor van Loveren
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
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A comparison of the efficacy of three intervention trial types: postal, group, and one-to-one facilitation, prior management and the impact of message framing and repeat messages on the flock prevalence of lameness in sheep. Prev Vet Med 2017; 149:82-91. [PMID: 29290304 DOI: 10.1016/j.prevetmed.2017.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/14/2017] [Accepted: 11/10/2017] [Indexed: 12/20/2022]
Abstract
The aim of this study was to evaluate the effectiveness of three knowledge-transfer intervention trial types (postal, group, one-to-one) to promote best practice to treat sheep with footrot. Further aims were to investigate whether farmer behaviour (i.e. management of lameness) before the trial was associated with uptake of best practice and whether the benefits of best practice framed positively or negatively influenced change in behaviour. The intervention was a message developed from evidence and expert opinion. It was entitled "Six steps to sound sheep" and promoted (1) catch sheep within three days of becoming lame, (2) inspect feet without foot trimming, (3) correctly diagnose the cause, (4) treat sheep lame with footrot or interdigital dermatitis with antibiotic injection and spray without foot trimming, (5) record the identity of treated sheep, (6) cull repeatedly lame sheep. In 2013, 4000 randomly-selected English sheep farmers were sent a questionnaire, those who responded were recruited to the postal (1081 farmers) or one-to-one intervention (32 farmers) trials. A random sample of 400 farmers were invited to join the group trial; 78 farmers participated. A follow-up questionnaire was sent to all participants in summer 2014. There were 72%, 65% and 91% useable responses for the postal, group and one-to-one trials respectively. In both 2013 and 2014, the prevalence of lameness was lower in flocks managed by LC1 farmers than LC2 and LC3 farmers. Between 2013 and 2014, the reduction in geometric mean (95% CI) period prevalence of lameness, proportional between flock reduction in lameness and within flock reduction in lameness was greatest in the one-to-one (7.6% (7.1-8.2%) to 4.3% (3.6-5.0%), 35%, 72%) followed by the group (4.5% (3.9-5.0%) to 3.1% (2.4-3.7%), 27%, 55%) and then the postal trial (from 3.5% (3.3-3.7%) to 3.2% (3.1-3.4%), 21%, 43%). There was a marginally greater reduction in lameness in farmers using most of Six steps but slow to treat lame sheep pre-trial than those not using Six steps at all. There was no significant effect of message framing. The greatest behavioural change was a reduction in therapeutic and routine foot trimming and the greatest attitude change was an increase in negative attitudes towards foot trimming. We conclude that all three intervention trial approaches were effective to promote best practice to treat sheep with footrot with one-to-one facilitation more effective than group and postal intervention trials. Results suggest that farmers' behaviour change was greater among those practising aspects of the intervention message before the trial began than those not practising any aspect.
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Osman M, Lin Y, Ashcroft R. Nudging: A Lesson in the Theatrics of Choice. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2017. [DOI: 10.1080/01973533.2017.1375929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Doherty S, Dolan E, Flynn J, O'Carroll RE, Doyle F. Circumventing the "Ick" Factor: A Randomized Trial of the Effects of Omitting Affective Attitudes Questions to Increase Intention to Become an Organ Donor. Front Psychol 2017; 8:1443. [PMID: 28894429 PMCID: PMC5581398 DOI: 10.3389/fpsyg.2017.01443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/09/2017] [Indexed: 12/05/2022] Open
Abstract
Objectives: Including or excluding certain questions about organ donation may influence peoples’ intention to donate. We investigated the effect of omitting certain affective attitudinal items on potential donors’ intention and behavior for donation. Design: A cross-sectional survey with a subgroup nested randomized trial. Methods: A total of 578 members of the public in four shopping centers were surveyed on their attitudes to organ donation. Non-donors (n = 349) were randomly assigned to one of three groups: Group 1 completed items on affective and cognitive attitudes, anticipated regret, intention, subjective norm and perceived behavioral control. Group 2 completed all items above but excluded affective attitudes. Group 3 completed all items but omitted negatively worded affective attitudes. The primary outcome was intention to donate, taking a donor card after the interview was a secondary behavioral outcome, and both were predicted using linear and logistic regression with group 1 as the reference. Results: Mean (SD) 1–7 intention scores for groups 1, 2 and 3 were, respectively: 4.43 (SD 1.89), 4.95 (SD 1.64) and 4.88 (SD 1.81), with group 2 significantly higher than group 1 (β = 0.518, 95% confidence interval [CI] 0.18 to 0.86).At the end of the interview, people in group 2 (66.7%; OR = 1.40, 95% CI 0.94 to 2.07, p = 0.096) but not those in group 3 (61.7%; OR = 1.10, 95% CI 0.69 to 1.75, p = 0.685), were marginally more likely to accept a donor card from the interviewer than people in group 1 (59.7%). Conclusion: Omitting affective attitudinal items results in higher intention to donate organs and marginally higher rates of acceptance of donor cards, which has important implications for future organ donation public health campaigns.
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Affiliation(s)
- Sally Doherty
- Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in IrelandDublin, Ireland.,Department of Psychology, Royal College of Surgeons in Ireland - Medical University of BahrainBusaiteen, Bahrain
| | - Elizabeth Dolan
- Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in IrelandDublin, Ireland
| | - Jennifer Flynn
- Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in IrelandDublin, Ireland
| | | | - Frank Doyle
- Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in IrelandDublin, Ireland
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50
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Elliston KG, Ferguson SG, Schüz B. Personal and situational predictors of everyday snacking: An application of temporal self-regulation theory. Br J Health Psychol 2017; 22:854-871. [PMID: 28722217 DOI: 10.1111/bjhp.12259] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/30/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aims at testing predictions derived from temporal self-regulation theory (TST) in relation to discretionary food choices (snacks). TST combines a motivational sphere of influence (cognitions and temporal valuations resulting in intentions) with a momentary sphere (encompassing social and physical environmental cues). This dual approach differs from current health behaviour theories, but can potentially improve our understanding of the interplay of personal and environmental factors in health behaviour self-regulation. DESIGN A mixed event-based and time-based (Ecological Momentary Assessment) study in 61 adults aged between 18 and 64, with a BMI range between 18.34 and 39.78 (M = 25.66, SD = 4.82) over two weeks. METHODS Participants recorded their food and drink intake for two weeks in real time using electronic diaries. Participants also responded to non-consumption assessments at random intervals throughout each day. Momentary cues (individual, situational, and environmental factors) were assessed both during food logs and non-consumption assessments. Motivational factors, past behaviour, and trait self-regulation were assessed during baseline. RESULTS Multilevel logistic regression analyses showed that across all snack types, environmental cues and negative affect were associated with an increased likelihood of snacking. Perceiving a cost of healthy eating to occur before eating was associated with an increased likelihood of snacking, whereas intentions and self-regulation were not. CONCLUSIONS Discretionary food intake is largely guided by momentary cues, and motivational-level factors, such as intention and self-regulation, are less important in the initiation of discretionary food intake. Statement of contribution What is already known on this subject? Overweight and obesity are a result of prolonged periods of energy imbalance between energy intake and expenditure (Hill & Peters, ). One of the key behavioural determinants of energy imbalances results from food intake, specifically from discretionary food choices (snacking). Temporal self-regulation theory (Hall & Fong, ) takes into account both deliberate and momentary influences on health behaviour, which is especially relevant to exploring the drivers of snacking. What does this study add? Offers new insight into the application of TST in explaining momentary eating behaviours. Snacking initiation is guided by momentary cues, not person-level factors. Dietary interventions should acknowledge the momentary cues that are associated with snacking.
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Affiliation(s)
- Katherine G Elliston
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Stuart G Ferguson
- The Division of Medicine and Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Benjamin Schüz
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.,The University of Bremen, Institute for Public Health and Nursing Research, Bremen, Free Hanseatic City of Bremen, Germany
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