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He Z, Hassan MA, Saiz-González P, Ryu S, Wang R, Gao Z. Smartphone app-based interventions on physical activity behaviors and psychological correlates in healthy young adults: A systematic review. PLoS One 2024; 19:e0301088. [PMID: 38578729 PMCID: PMC10997080 DOI: 10.1371/journal.pone.0301088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/09/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The issue of low physical activity (PA) levels among the youth is a longstanding concern. Smartphone applications offer a promising avenue for delivering interventions that are both accessible and engaging. Up to now, there appears to be a gap in the literature, with no systematic reviews assessing the efficacy of smartphone apps in encouraging increased physical activity among healthy young adults. OBJECTIVE To synthesize the effects of a smartphone app-based intervention on PA and PA-related psychological correlates in healthy young adults (18-35 years old). METHODS A search was conducted on eighteen databases: PubMed, Medline, Web of Science, SPORTDiscus, Scopus, Academic Search Premier, Communication and Mass Media Complete, Article First, Biomed Central, BioOne, EBSCOHost, JSTOR, ProQuest, SAGE Reference Online, ScienceDirect, SpringerLink, Taylor&Francis, and Wiley Online. The search covered the period up until December 2023. This research included all randomized controlled trials (RCTs) that evaluated the effectiveness of smartphone app-based interventions on PA and PA related psychological outcomes in healthy young adults. The overall impact was determined by vote counting based on the direction of effect and aggregating p values. The quality of the evidence was evaluated using an 8-item scale. This study has been registered in the PROSPERO database with the identification number CRD42023390033. RESULTS A total of 8403 articles were retrieved, and based on the predefined inclusion and exclusion criteria, seven articles were selected for inclusion. Among these articles, four high-quality RCTs were identified, and the results of vote counting and combining p values methods suggested that smartphone-based app interventions did not demonstrate significant effectiveness in improving PA and PA-related psychological outcomes. However, some improvements were observed. The analysis results, which were categorized into fitness apps and health apps based on the characteristics of the interventions, also failed to demonstrate significant intervention effects. CONCLUSION The findings indicate that, currently, there are no significant effects of smartphone app interventions on improving PA and PA-related psychological outcomes in healthy young adults aged 18-35 years. It is important to note that these findings should be interpreted with caution due to the limited number of included studies. Future research should focus on employing high-quality study designs to determine the true effects of interventions and analyze various smartphone app interventions. These analyses should encompass different app characteristics (e.g., fitness app and health app), various combinations (e.g., fitness app alone and fitness app in combination with other interventions), diverse intervention goals (e.g., PA and PA along with other outcomes), and multiple intervention characteristics (e.g., frequency and duration).
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Affiliation(s)
- Zihao He
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Mohamed A. Hassan
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
- Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo, Egypt
| | - Pablo Saiz-González
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Suryeon Ryu
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
| | - Ronghui Wang
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Tennessee, United States of America
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Escobar-Soler C, Berrios R, Peñaloza-Díaz G, Melis-Rivera C, Caqueo-Urízar A, Ponce-Correa F, Flores J. Effectiveness of Self-Affirmation Interventions in Educational Settings: A Meta-Analysis. Healthcare (Basel) 2023; 12:3. [PMID: 38200909 PMCID: PMC10779329 DOI: 10.3390/healthcare12010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/30/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
School and university can be stressful contexts that can become an important source of identity threats when social prejudices or stereotypes come into play. Self-affirmation interventions are key strategies for mitigating the negative consequences of identity threat. This meta-analysis aims to provide an overview of the effectiveness of self-affirmation interventions in educational settings. A peer-reviewed article search was conducted in January 2023. A total of 144 experimental studies that tested the effect of self-affirmation interventions in educational contexts among high school and university students from different social and cultural backgrounds were considered. The average effect of self-affirmation interventions was of low magnitude (dIG+ = 0.41, z = 16.01, p < 0.00), with a 95% confidence interval whose values tended to lie between 0.36 and 0.45 (SE = 0.0253). In addition, moderators such as identity threat, participants' age, and intervention procedure were found. Through a meta-analysis of the impact of self-affirmation interventions in educational contexts, this study suggests that interventions are effective, resulting in a small mean effect size. Thus, self-affirmation interventions can be considered useful, brief, and inexpensive strategies to improve general well-being and performance in educational settings.
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Affiliation(s)
- Carolang Escobar-Soler
- Programa de Doctorado en Psicología, Universidad de Tarapacá y Universidad Católica del Norte, Arica 1000000, Chile; (G.P.-D.); (C.M.-R.); (F.P.-C.)
- Centro de Justicia Educacional (CJE), Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Raúl Berrios
- Departamento de Administración, Facultad de Administración y Economía, Universidad de Santiago de Chile, Santiago 7820436, Chile;
| | - Gabriel Peñaloza-Díaz
- Programa de Doctorado en Psicología, Universidad de Tarapacá y Universidad Católica del Norte, Arica 1000000, Chile; (G.P.-D.); (C.M.-R.); (F.P.-C.)
| | - Carlos Melis-Rivera
- Programa de Doctorado en Psicología, Universidad de Tarapacá y Universidad Católica del Norte, Arica 1000000, Chile; (G.P.-D.); (C.M.-R.); (F.P.-C.)
| | | | - Felipe Ponce-Correa
- Programa de Doctorado en Psicología, Universidad de Tarapacá y Universidad Católica del Norte, Arica 1000000, Chile; (G.P.-D.); (C.M.-R.); (F.P.-C.)
| | - Jerome Flores
- Centro de Justicia Educacional (CJE), Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
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Favieri F, French MN, Casagrande M, Chen EY. Physical activity interventions have a moderate effect in increasing physical activity in university students-a meta-analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2823-2834. [PMID: 35044891 DOI: 10.1080/07448481.2021.1998070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 08/16/2021] [Accepted: 10/17/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The transition to college is associated with changes in physical activity. This meta-analysis aims to quantify the effect of interventions on increasing physical activity in healthy university students. METHODS We conducted a literature search (up to 2/3/2020) to identify randomized controlled trials with healthy undergraduate or graduate students enrolled in a college degree program. Moderator analyses were conducted to examine the effects of intervention modality delivery (delivered in-person or remotely) and the type of outcome measure (self-report or objective measures). RESULTS 18 publications were included. Interventions had a medium effect on physical activity (Cohen's d = 0.52). Moderator analyses revealed no differences. CONCLUSION Suggestions of how to improve the quality of physical activity intervention studies in college students are given. The moderate effect size of physical activity interventions in college students highlights the importance of developing and testing new interventions to promote physical activity in emerging adults. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1998070 .
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Affiliation(s)
- Francesca Favieri
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Melanie N French
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology, and Health studies, "Sapienza" University of Rome, Rome, Italy
| | - Eunice Y Chen
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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Cerolini S, Zagaria A, Franchini C, Maniaci VG, Fortunato A, Petrocchi C, Speranza AM, Lombardo C. Psychological Counseling among University Students Worldwide: A Systematic Review. Eur J Investig Health Psychol Educ 2023; 13:1831-1849. [PMID: 37754472 PMCID: PMC10528000 DOI: 10.3390/ejihpe13090133] [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: 07/22/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.
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Affiliation(s)
- Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (C.L.)
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (C.L.)
| | - Costanza Franchini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (C.F.); (V.G.M.); (A.F.); (A.M.S.)
| | - Vito Giuseppe Maniaci
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (C.F.); (V.G.M.); (A.F.); (A.M.S.)
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (C.F.); (V.G.M.); (A.F.); (A.M.S.)
| | - Chiara Petrocchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, 00185 Rome, Italy; (C.F.); (V.G.M.); (A.F.); (A.M.S.)
| | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (C.L.)
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Park E, Zhou Y, Chen C, Chacko T, Mahoney M, Chang YP. Systematic review: interventions to quit tobacco products for young adults. BMC Public Health 2023; 23:1233. [PMID: 37365562 PMCID: PMC10294369 DOI: 10.1186/s12889-023-15900-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Young adulthood is an important period for smoking cessation; however, there is limited evidence of smoking-cessation interventions for young adults. The aims of this study were to identify evidence-based smoking-cessation strategies for young adults, examine gaps in the literature regarding smoking cessation among young adults, and discuss methodological issues/challenges related to smoking-cessation studies for young adults. METHODS Studies tested interventions for smoking cessation among young adults (18 to 26 years old), excluding pilot studies. Five main search engines were used, including PubMed, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, PsycINFO, and Web of Science. The search was conducted for articles published from January 2009 to December 2019. Intervention characteristics and cessation outcomes were reviewed, and methodological quality was evaluated. RESULTS A total of 14 articles met inclusion criteria, including randomized controlled studies and repeated cross-sectional studies. Interventions included the following: text messaging (4/14, 28.6%), social media use (2/14, 14.3%), web-or app-based intervention (2/14, 14.3%), telephone counseling (1/14, 7.1%), in-person counseling (3/14, 21.4%), pharmacological (1/14, 7.1%), and self-help booklet (1/14, 7.1%). The intervention duration and frequency of contact with participants differed and yielded varied outcomes. CONCLUSIONS Multiple interventions have been examined to aid young adults in achieving smoking cessation. While several approaches seem promising, at the present time, the published literature is inconclusive about the type of intervention that is most effective for young adults. Future studies should compare the relative effectiveness of these intervention modalities.
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Affiliation(s)
- Eunhee Park
- University at Buffalo, School of Nursing, 3435 Main St, 14214-8013, Buffalo, NY, US.
| | - Yanjun Zhou
- University at Buffalo, School of Nursing, 3435 Main St, 14214-8013, Buffalo, NY, US
| | - Chiahui Chen
- University at Buffalo, School of Nursing, 3435 Main St, 14214-8013, Buffalo, NY, US
| | - Thomas Chacko
- University at Buffalo, School of Nursing, 3435 Main St, 14214-8013, Buffalo, NY, US
| | - Martin Mahoney
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, US
| | - Yu-Ping Chang
- University at Buffalo, School of Nursing, 3435 Main St, 14214-8013, Buffalo, NY, US
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Roh M, Won Y. Impact of Online-Delivered eHealth Literacy Intervention on eHealth Literacy and Health Behavior Outcomes among Female College Students during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2044. [PMID: 36767409 PMCID: PMC9915326 DOI: 10.3390/ijerph20032044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
This study examined the effects of a novel online-delivered eHealth literacy intervention to improve eHealth literacy and positive health behaviors among female college students during COVID-19. Female college students taking a physical education class were allocated to either an online-based eHealth literacy intervention group (n = 62) or a physical education class (n = 58). Weekly two-hour sessions were implemented through Zoom videoconferencing over six weeks. We measured eHealth literacy, exercise self-schemata, and health behavior outcomes (eating, sleep, and exercise) before and after the intervention. A two-way repeated measures ANOVA was conducted to examine within- and between-group differences in all outcomes. The ANOVA (2 × 2) for the interaction effect of group and time showed a statistical significance in eHealth literacy and cognitive-emotional exercise self-schemata. There was a marginally significant interaction effect for exercise but none for eating and sleep. This was the first trial to examine the impact of the online eHealth literacy intervention on eHealth literacy and health behavior outcomes for college students during COVID-19. Preliminary findings indicated that the intervention showed promising effectiveness for improving eHealth literacy and promoting health behaviors among female college students.
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Affiliation(s)
- Miyoung Roh
- College of General Education, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul 02707, Republic of Korea
| | - Yoonkyung Won
- Department of Physical Education, Yonsei University, Seoul 03722, Republic of Korea
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Cooke R, McEwan H, Norman P. The effect of forming implementation intentions on alcohol consumption: A systematic review and meta-analysis. Drug Alcohol Rev 2023; 42:68-80. [PMID: 36173203 PMCID: PMC10087331 DOI: 10.1111/dar.13553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 01/10/2023]
Abstract
ISSUES Meta-analysis was used to estimate the effect of forming implementation intentions (i.e., if-then plans) on weekly alcohol consumption and heavy episodic drinking (HED). Sample type, mode of delivery, intervention format and timeframe were tested as moderator variables. APPROACH Cochrane, EThOS, Google Scholar, PsychArticles, PubMed and Web of Science were searched for relevant publications to 31 March 2021. Random-effects meta-analysis was used to estimate the effect size difference (d) between individuals forming versus not forming implementation intentions on weekly consumption and HED. KEY FINDINGS Sixteen studies were included in meta-analyses. The effect size difference for forming implementation intentions on weekly alcohol consumption was d+ = -0.14 confidence interval (CI) [-0.24; -0.03]. Moderator analyses highlighted stronger effects for: (i) community (d+ = -0.38, CI [-0.58; -0.18]) versus university (d+ = -0.04, CI [-0.13; 0.05]) samples; (ii) paper (d+ = -0.26, CI [-0.43; -0.09]) versus online (d+ = -0.04, CI [-0.14; 0.06]) mode of delivery; and (iii) volitional help sheet (d+ = -0.34, CI [-0.60; -0.07]) versus implementation intention format (d+ = -0.07, CI [-0.16; 0.02]). In addition, effects diminished over time (B = 0.02, SE = 0.01, CI [0.03; 0.01]). Forming implementation intentions had a null effect on HED, d+ = -0.01 CI [-0.10; 0.08]. IMPLICATIONS Forming implementation intentions reduces weekly consumption but has no effect on HED. CONCLUSION This review identifies boundary conditions on the effectiveness of implementation intentions to reduce alcohol consumption. Future research should focus on increasing the effectiveness of online-delivered interventions and integrating implementation intention and motivational interventions.
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Affiliation(s)
- Richard Cooke
- School of Health, Wellbeing and Science, Staffordshire University, Stoke on Trent, UK
| | - Helen McEwan
- School of Psychology, University of Worcester, Worcester, UK
| | - Paul Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
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Peng S, Yuan F, Othman AT, Zhou X, Shen G, Liang J. The Effectiveness of E-Health Interventions Promoting Physical Activity and Reducing Sedentary Behavior in College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:318. [PMID: 36612643 PMCID: PMC9819541 DOI: 10.3390/ijerph20010318] [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: 09/22/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: − 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.
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Affiliation(s)
- Sanying Peng
- Physical Education Department, Hohai University, Nanjing 210024, China
- School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia
| | - Fang Yuan
- College of International Languages and Cultures, Hohai University, Nanjing 210024, China
| | | | - Xiaogang Zhou
- School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia
| | - Gang Shen
- School of Physical Education, Changzhou University, Changzhou 213164, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
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Hutchesson MJ, Whatnall MC, Yazin N, Fenton S, Duncan MJ, Kay-Lambkin FJ, Burrows TL. Health behavior interventions for university students measuring mental health outcomes: A scoping review. Front Public Health 2022; 10:1063429. [PMID: 36568797 PMCID: PMC9771454 DOI: 10.3389/fpubh.2022.1063429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Many university students have poor mental health, and co-occurring health risk behaviors. Targeting health behavior change in this population may improve mental health outcomes. This scoping review describes the extent and range of randomized controlled trials (RCT) evaluating interventions targeting health risk behaviors and measuring a mental health outcome, among university students. Methods Six electronic databases were searched for RCTs published until the 18th May 2021. Eligible RCTs included university students, evaluated interventions that promoted health behavior change (i.e., dietary intake, physical activity, sedentary behavior, alcohol and drug use, smoking, and sleep), and measured a mental health-related outcome. Results Fifty-nine RCTs met the inclusion criteria that were published from 2000 to 2021, and over half (n = 33) were conducted in the United States. Interventions evaluated within the RCTs (n = 92) predominantly targeted changes to dietary intake (n = 41 interventions), physical activity (n = 39), or alcohol intake (n = 35). Most interventions targeted one (n = 51) or two (n = 27) health behaviors only. Included RCTs considered mental ill health outcomes (n = 24), psychological wellbeing outcomes (n = 20), or both (n = 15). Discussion This scoping review identified a moderate volume of experimental research investigating the impact of health behavior interventions on university students' mental health. There is scope for further research examining health behavior interventions targeting university students, particularly interventions taking a multi-behavioral approach.
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Affiliation(s)
- Melinda J. Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia,*Correspondence: Melinda J. Hutchesson
| | - Megan C. Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Nazish Yazin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Mitch J. Duncan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Frances J. Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Tracy L. Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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Petróczi A, Cruyff M, de Hon O, Sagoe D, Saugy M. Hidden figures: Revisiting doping prevalence estimates previously reported for two major international sport events in the context of further empirical evidence and the extant literature. Front Sports Act Living 2022; 4:1017329. [PMID: 36544544 PMCID: PMC9760848 DOI: 10.3389/fspor.2022.1017329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
Background High levels of admitted doping use (43.6% and 57.1%) were reported for two international sport events in 2011. Because these are frequently referenced in evaluating aspects of anti-doping, having high level of confidence in these estimates is paramount. Objectives In this study, we present new prevalence estimates from a concurrently administered method, the Single Sample Count (SSC), and critically review the two sets of estimates in the context of other doping prevalence estimates. Methods The survey featuring the SSC model was completed by 1,203 athletes at the 2011 World Championships in Athletics (WCA) (65.3% of all participating athletes) and 954 athletes at the 2011 Pan-Arab Games (PAG) (28.2% of all participating athletes). At WCA, athletes completed both UQM and SSC surveys in randomised order. At PAG, athletes were randomly allocated to one of the two surveys. Doping was defined as "having knowingly violated anti-doping regulations by using a prohibited substance or method." Results Estimates with the SSC model for 12-month doping prevalence were 21.2% (95% CI: 9.69-32.7) at WCA and 10.6% (95% CI: 1.76-19.4) at PAG. Estimated herbal, mineral, and/or vitamin supplements use was 8.57% (95% CI: 1.3-16.11) at PAG. Reliability of the estimates were confirmed with re-sampling method (n = 1,000, 80% of the sample). Survey non-compliance (31.90%, 95%CI: 26.28-37.52; p < 0.0001) was detected in the WCA data but occurred to a lesser degree at PAG (9.85%, 95% CI: 4.01-15.69, p = 0.0144 and 11.43%, 95% CI: 5.31-11.55, p = 0.0196, for doping and nutritional supplement use, respectively). A large discrepancy between those previously reported from the UQM and the prevalence rate estimated by the SSC model for the same population is evident. Conclusion Caution in interpreting these estimates as bona fide prevalence rates is warranted. Critical appraisal of the obtained prevalence rates and triangulation with other sources are recommended over "the higher rate must be closer to the truth" heuristics. Non-compliance appears to be the Achilles heel of the indirect estimation models thus it should be routinely tested for and minimised. Further research into cognitive and behaviour aspects, including motivation for honesty, is needed to improve the ecological validity of the estimated prevalence rates.
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Affiliation(s)
- Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Health, Science, Social Care and Education, Kingston University, London, United Kingdom,Department of Movement Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit (KU) Leuven, Leuven, Belgium,Willibald Gebhardt Research Institute, University of Münster, Münster, Germany,*Correspondence: Andrea Petróczi
| | - Maarten Cruyff
- Faculty of Social Sciences, Utrecht University, Utrecht, Netherlands
| | - Olivier de Hon
- Doping Authority Netherlands, Capelle aan den IJssel, Netherlands
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Martial Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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11
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Investigating Web-Based Nutrition Education Interventions for Promoting Sustainable and Healthy Diets in Young Adults: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031691. [PMID: 35162714 PMCID: PMC8835600 DOI: 10.3390/ijerph19031691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/20/2022] [Accepted: 01/29/2022] [Indexed: 12/04/2022]
Abstract
Background: Our current rapidly growing food systems are imposing a heavy burden on both environmental sustainability and human health. Sustainable and healthy diets aim to promote optimal health and have a minimal environmental impact. This study aimed to critically review and synthesise the evidence on the effectiveness of web-based nutrition education interventions aiming to promote sustainable and healthy diets among young adults. Methods: A systematic search of four databases (Medline, PsycINFO, Scopus, and Embase) was conducted in March 2021. Studies were included if they used an online platform to deliver the intervention to young adults and measured at least one aspect of sustainable and healthy diets, such as plant-based food intake, food waste, and local and seasonal produce. Of the 2991 studies, a total of 221 full-text articles were assessed for eligibility of which 22 were included in the final review. Results: A majority of the studies (82%) targeted fruit and vegetable consumption, and close to a quarter of studies (23%) targeted other aspects of a sustainable and healthy diet, such as red meat intake. Only one study included multiple aspects of a sustainable and healthy diet. Program delivery outcomes reported overall positive feedback and engagement. Conclusion: This review suggests that web-based interventions may be effective in promoting some sustainable diet-related outcomes in young adults. However, there is a need for developing and evaluating future programs to promote sustainable diets more comprehensively in order to help young adults make healthy and sustainable food choices.
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12
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Duan Y, Liang W, Wang Y, Lippke S, Lin Z, Shang B, Baker JS. The Effectiveness of Sequentially Delivered Web-Based Interventions on Promoting Physical Activity and Fruit-Vegetable Consumption Among Chinese College Students: Mixed Methods Study. J Med Internet Res 2022; 24:e30566. [PMID: 35080497 PMCID: PMC8829698 DOI: 10.2196/30566] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/21/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023] Open
Abstract
Background Web-based interventions for multiple health behavior change (MHBC) appear to be a promising approach to change unhealthy habits. Limited research has tested this assumption in promoting physical activity (PA) and fruit-vegetable consumption (FVC) among Chinese college students. Moreover, the timing of MHBC intervention delivery and the order of components need to be addressed. Objective This study aims to examine the effectiveness of 2 sequentially delivered 8-week web-based interventions on physical activity, FVC, and health-related outcomes (BMI, depression, and quality of life) and the differences in the intervention effects between the 2 sequential delivery patterns. The study also aims to explore participants’ experiences of participating in the health program. Methods We conducted a randomized controlled trial, in which 552 eligible college students (mean 19.99, SD 1.04 years, 322/552, 58.3% female) were randomly assigned to 1 of 3 groups: PA-first group (4 weeks of PA followed by 4 weeks of FVC intervention), FVC-first group (4 weeks of FVC followed by 4 weeks of PA intervention), and a control group (8 weeks of placebo treatment unrelated to PA and FVC). The treatment content of two intervention groups was designed based on the Health Action Process Approach (HAPA) framework. A total of four web-based assessments were conducted: at baseline (T1, n=565), after 4 weeks (T2, after the first behavior intervention, n=486), after 8 weeks (T3, after the second behavior intervention, n=420), and after 12 weeks (T4, 1-month postintervention follow-up, n=348). In addition, after the completion of the entire 8-week intervention, 18 participants (mean 19.56, SD 1.04 years, 10/18, 56% female) who completed the whole program were immediately invited to attend one-to-one and face-to-face semistructured interviews. The entire study was conducted during the fall semester of 2017. Results The quantitative data supported superior effects on physical activity, FVC, and BMI in the 2 sequential intervention groups compared with the control group. There were no significant differences in physical activity, FVC, and health-related outcomes between the 2 intervention groups after 8 weeks. The FVC-first group contributed to more maintenance of FVC compared with the PA-first group after 12 weeks. Four major themes with several subthemes were identified in the qualitative thematic analysis: PA and FVC behavior, health-related outcomes, correlates of behavior change, and contamination detection. Conclusions This study provides empirical evidence for the effectiveness of sequentially delivered, web-based MHBC interventions on PA and FVC among Chinese college students. The timing issue of MHBC intervention delivery was preliminarily addressed. Qualitative findings provide an in-depth understanding and supplement the quantitative findings. Overall, this study may contribute considerably to future web-based MHBC interventions. Trial Registration ClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-7438-1
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Affiliation(s)
- Yanping Duan
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).,Center for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Wei Liang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).,Center for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Yanping Wang
- The National Physical Fitness Lab, Hubei Institute of Sport Science, Wuhan, China
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Zhihua Lin
- Sport Section, Wuhan University, Wuhan, China
| | - Borui Shang
- Department of Social Sciences, Hebei Sport University, Shijiazhuang, China
| | - Julien Steven Baker
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).,Center for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
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13
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Tzelepis F, Mitchell A, Wilson L, Byrnes E, Haschek A, Leigh L, Oldmeadow C. The Long-Term Effectiveness of Internet-Based Interventions on Multiple Health Risk Behaviors: Systematic Review and Robust Variance Estimation Meta-analysis. J Med Internet Res 2021; 23:e23513. [PMID: 34931990 PMCID: PMC8734928 DOI: 10.2196/23513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/09/2020] [Accepted: 11/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Smoking tobacco, poor nutrition, risky alcohol use, and physical inactivity (SNAP) behaviors tend to cluster together. Health benefits may be maximized if interventions targeted multiple health risk behaviors together rather than addressing single behaviors. The internet has wide reach and is a sustainable mode for delivery of interventions for multiple health behaviors. However, no systematic reviews have examined the long-term effectiveness of internet-based interventions on any combination of or all SNAP behaviors in adults aged 18 years or older. Objective This systematic review examined, among adults (aged ≥18 years), the effectiveness of internet-based interventions on SNAP behaviors collectively in the long term compared with a control condition. Methods The electronic databases Medline, PsycINFO, Embase, CINAHL, and Scopus were searched to retrieve studies describing the effectiveness of internet-based interventions on ≥2 SNAP behaviors published by November 18, 2019. The reference lists of retrieved articles were also checked to identify eligible publications. The inclusion criteria were randomized controlled trials or cluster randomized controlled trials with adults examining an internet-based intervention measuring the effect on ≥2 SNAP behaviors at least 6 months postrecruitment and published in English in a peer-reviewed journal. Two reviewers independently extracted data from included studies and assessed methodological quality using the Quality Assessment Tool for Quantitative Studies. A robust variance estimation meta-analysis was performed to examine the long-term effectiveness of internet-based interventions on all 4 SNAP risk behavior outcomes. All SNAP outcomes were coded so they were in the same direction, with higher scores equating to worse health risk behaviors. Results The inclusion criteria were met by 11 studies: 7 studies measured the effect of an internet-based intervention on nutrition and physical activity; 1 study measured the effect on smoking, nutrition, and physical activity; and 3 studies measured the effect on all SNAP behaviors. Compared with the control group, internet-based interventions achieved an overall significant improvement across all SNAP behaviors in the long term (standardized mean difference –0.12 [improvement as higher scores = worse health risk outcomes], 95% CI –0.19 to –0.05; I2=1.5%, P=.01). The global methodological quality rating was “moderate” for 1 study, while the remaining 10 studies were rated as “weak.” Conclusions Internet-based interventions were found to produce an overall significant improvement across all SNAP behaviors collectively in the long term. Internet-based interventions targeting multiple SNAP behaviors have the potential to maximize long-term improvements to preventive health outcomes.
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Affiliation(s)
- Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Louise Wilson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Alexandra Haschek
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia.,The Cooperative Research Centre for Living with Autism, Brisbane, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, Australia
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14
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Luo M, Allman-Farinelli M. Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020. Nutrients 2021; 13:nu13114161. [PMID: 34836417 PMCID: PMC8623843 DOI: 10.3390/nu13114161] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.
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Affiliation(s)
- Man Luo
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310020, China
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Correspondence: ; Tel.: +61-2-90367045
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15
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Nutrition and physical activity interventions for the general population with and without cardiometabolic risk: a scoping review. Public Health Nutr 2021; 24:4718-4736. [PMID: 34030758 DOI: 10.1017/s1368980021002184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature examining interventions to improve or maintain nutrition and physical activity-related outcomes? Sub-topics included: (1) behaviour counseling or coaching from a dietitian/nutritionist or exercise practitioner, (2) mobile applications to improve nutrition and physical activity and (3) nutritional ergogenic aids. DESIGN The current study is a scoping review. A literature search of the Medline Complete, CINAHL Complete, Cochrane Database of Systematic Reviews and other databases was conducted to identify articles published in the English language from January 2005 until May 2020. Data were synthesised using bubble charts and heat maps. SETTING Out-patient, community and workplace. PARTICIPANTS Adults with or without cardiometabolic risk factors living in economically developed countries. RESULTS Searches resulted in 19 474 unique articles and 170 articles were included in this scoping review, including one guideline, thirty systematic reviews (SR), 134 randomised controlled trials and five non-randomised trials. Mobile applications (n 37) as well as ergogenic aids (n 87) have been addressed in several recent studies, including SR. While primary research has examined the effect of individual-level nutrition and physical activity counseling or coaching from a dietitian/nutritionist and/or exercise practitioner (n 48), interventions provided by these practitioners have not been recently synthesised in SR. CONCLUSION SR of behaviour counseling or coaching provided by a dietitian/nutritionist and/or exercise practitioner are needed and can inform practice for practitioners working with individuals who are healthy or have cardiometabolic risk.
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16
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Seaman EL, Robinson CD, Crane D, Taber JM, Ferrer RA, Harris PR, Klein WMP. Association of Spontaneous and Induced Self-Affirmation With Smoking Cessation in Users of a Mobile App: Randomized Controlled Trial. J Med Internet Res 2021; 23:e18433. [PMID: 33666561 PMCID: PMC7980123 DOI: 10.2196/18433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/21/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
Background Most smokers attempt to stop using cigarettes numerous times before successfully quitting. Cigarette cravings may undermine perceived competence to quit and thus constitute psychological threats to the individual’s self-concept. Self-affirmation may promote smoking cessation by offsetting these threats. Objective This study examines whether self-affirmation is associated with smoking cessation in the context of a cessation app. Two types of self-affirmation are examined: tendency to spontaneously self-affirm, and self-affirmation inductions added to a publicly available smoking cessation app (Smoke-Free Quit Smoking Now). In addition, this study explores whether optimism and emotional states (happiness, anger, anxiousness, hopefulness, sadness) predict smoking cessation. Methods All users who met the inclusion criteria, provided consent to participate, and completed a baseline assessment, including all individual difference measures, were randomized to 1 of 4 conditions. Half of the participants were randomly assigned to complete a self-affirmation induction upon study entry. Orthogonally, half of the participants were randomly assigned to receive self-affirming text notifications during their quit attempt or to receive conventional notifications. The induction and the text notifications were fully automated, and all data were collected through self-assessments in the app. Self-reported smoking cessation was assessed 1 month and 3 months following study entry. Results The study enrolled 7899 participants; 647 completed the 1-month follow-up. Using an intent-to-treat analysis at the 1-month follow-up, 7.2% (569/7899) of participants self-reported not smoking in the previous week and 6.4% (503/7899) self-reported not smoking in the previous month. Greater tendency to spontaneously self-affirm predicted a greater likelihood of cessation (P<.001) at 1 month after controlling for smoking-related variables. Neither self-affirmation induction influenced cessation. In addition, spontaneous self-affirmation did not moderate the relationship between self-affirmation inductions and cessation. Greater baseline sadness was associated with a lower likelihood of reporting successful cessation. Optimism predicted past-week cessation at the 1-month follow-up, and both happiness and anger predicted past-month cessation at the 1-month follow-up; however, none of these potential predictors moderated the relationship between self-affirmation conditions and successful cessation. Conclusions Spontaneous self-affirmation may be an important psychological resource for managing threats to self-concept during the smoking cessation process. Sadness may hinder quit attempts. Future research can explicate how spontaneous versus induced self-affirmation can promote smoking cessation and examine boundary conditions for the effectiveness of disseminated self-affirmation interventions. Trial Registration ISRCTN Registry 56646695; https://www.isrctn.com/ISRCTN56646695
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Affiliation(s)
| | - Cendrine D Robinson
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | | | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, United States
| | - Rebecca A Ferrer
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Peter R Harris
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - William M P Klein
- Behavioral Research Program (BRP), Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
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17
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Lareyre O, Gourlan M, Stoebner-Delbarre A, Cousson-Gélie F. Characteristics and impact of theory of planned behavior interventions on smoking behavior: A systematic review of the literature. Prev Med 2021; 143:106327. [PMID: 33227344 DOI: 10.1016/j.ypmed.2020.106327] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/14/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
Theoretical frameworks such as the theory of planned behavior (TPB) can be applied to design and evaluate smoking behavior interventions. The present systematic review aimed to: (i) determine the characteristics of TPB-based interventions and their reported impact on smoking behavior and TPB variables, (ii) evaluate the level of methodological quality in the included studies, and (iii) assess the quality of the theoretical implementation. Studies were eligible for inclusion if the intervention targeted smoking behavior, was explicitly based on the TPB, and if smoking behavior or intention was measured at least at post-intervention. Relevant articles were identified through searches on databases and internet search engines, responses to messages sent on thematic forums, consultation of prominent authors, and manual searches on key websites and key TPB-publications. Seventeen studies met the inclusion criteria. A majority of studies (65%) targeted the student population (i.e., elementary school, high school, university). Interventions minimally included the provision of health messages. The proportion of studies that reported a significant impact on smoking behavior, intention, attitude, subjective norm, or PBC ranged between 42% and 50%. Regarding methodological quality, unclear or high risks of bias were notably found regarding the selection of participants, data collection methods, withdrawal and drop-outs, and blinding. Regarding theoretical implementation, the reciprocal link between intervention techniques and TPB variables targeted remain unclear for a majority of studies. To better inform tobacco prevention and TPB research, future studies should more systematically use rigorous methods when designing, implementing, and reporting TPB-based interventions.
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Affiliation(s)
- Olivier Lareyre
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Mathieu Gourlan
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Anne Stoebner-Delbarre
- Onco-Addiction and Patient Education Unit - Supportive Care Department, Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Florence Cousson-Gélie
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
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18
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Cooke R, Bailey O, Jennings J, Yuen C, Gardner B. Do preparatory behaviours predict alcohol consumption among UK university students? Br J Health Psychol 2020; 26:343-359. [PMID: 33111469 DOI: 10.1111/bjhp.12489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/09/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study explored whether the frequency and habitual nature of engagement in three behaviours that may serve as preparation for alcohol consumption on a night out with friends - that is, contacting friends to arrange a night out, buying alcohol, drinking alone at home before going out - predicted consumption on such nights. DESIGN Prospective correlational design. METHODS One hundred and twenty UK university students (68 female, 50 male, two non-binary, mean age = 20.78 years, SD = 1.52) completed a survey comprising intentions, habits, and frequency and habit for the three preparatory behaviours. One week later, a second survey measured the number of nights out with friends on which alcohol was drunk (i.e., drinking frequency) and the number on which four or more alcoholic drinks were consumed (i.e, excessive drinking). Regression models were run to predict drinking frequency and excessive drinking. RESULTS Drinking frequency was predicted only by frequency of contacting friends (B = .28, SE = .12, p = .02), and habitually drinking alone before going out (B = .20, SE = .09, p = .03). Excessive drinking was only predicted by alcohol consumption habit (B = .67, SE = .23, p = .003). CONCLUSIONS Preceding actions may influence the frequency of alcohol consumption on nights out, independently of intentions and habits relating to alcohol consumption. While interventions to reduce consumption quantity in a single session might focus on disrupting the habits that sustain drinking episodes, efforts to reduce alcohol consumption frequency on nights out might focus on disrupting behaviours that precede alcohol consumption.
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Affiliation(s)
- Richard Cooke
- Department of Psychology, Liverpool Centre for Alcohol Research, University of Liverpool, UK
| | | | | | - Chun Yuen
- Department of Psychology, King's College London, UK
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19
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Dick S, Vasiliou VS, Davoren MP, Dockray S, Heavin C, Linehan C, Byrne M. A Digital Substance-Use Harm Reduction Intervention for Students in Higher Education (MyUSE): Protocol for Project Development. JMIR Res Protoc 2020; 9:e17829. [PMID: 32851980 PMCID: PMC7484779 DOI: 10.2196/17829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/08/2020] [Accepted: 05/27/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Digital interventions have been identified as a possible tool for reducing the harm caused by illicit drug use among students attending higher education (ie, college students). However, the success of interventions in this area has been hampered by a lack of user involvement and behavior change theory in their design. The My Understanding of Substance use Experiences (MyUSE) project combines a rigorous user-centered design (UCD) methodology and a robust behavioral change framework to develop a digitally delivered harm reduction intervention for illicit drug use among students in higher education. OBJECTIVE This project aims to design and develop a digital intervention that targets drug use-related harm among students in higher education. METHODS The MyUSE project will take place over 3 phases. The first phase was exploratory in nature, involving 3 systematic reviews, a large survey, and student workshops to gather a comprehensive evidence base to guide the project. The second phase is the development stage of the project, involving the use of the Behavior Change Wheel theoretical framework to determine the behavior change techniques of the intervention and the use of the UCD methodology to guide the development of the digital intervention. The third phase is the evaluation stage, whereby the intervention will undergo a 5-stage evaluation process to comprehensively evaluate its impacts. RESULTS The exploratory phase 1 of the MyUSE project was completed in December 2018. Phase 2 is currently underway, and phase 3 is due to begin in September 2020. CONCLUSIONS Higher education institutions (HEIs) are ideally placed to intervene and support students in the area of illicit drug use but are constrained by limited resources. Current digital interventions in this area are sparse and have several weaknesses. The MyUSE project combines a UCD approach with a robust behavior change framework to develop a digitally delivered intervention that is economically viable, effective in changing behavior, usable and acceptable to students, and able to sustain long-term implementation in HEIs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17829.
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Affiliation(s)
- Samantha Dick
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Martin P Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ciara Heavin
- Health Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Michael Byrne
- Student Health Department, University College Cork, Cork, Ireland
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20
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Tomazic T, Jerkovic OS. Online Interventions for the Selective Prevention of Illicit Drug Use in Young Drug Users: Exploratory Study. J Med Internet Res 2020; 22:e17688. [PMID: 32319962 PMCID: PMC7203615 DOI: 10.2196/17688] [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] [Received: 01/04/2020] [Revised: 01/31/2020] [Accepted: 02/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background Digital technologies have a major impact on the daily lives of young people and are also used to seek information on and help with drug-related issues online. Objective The aim of this article was to analyze current online interventions for young drug users in Slovenia, with the purpose of contributing to the development of guidelines and key recommendations for effective online interventions. Methods This study was part of the project Click for Support. We performed a keyword search, received input from national experts in the field of drug prevention, and conducted an assessment of recognized national online interventions through workshop-based discussions with the target group of 20 young drug users. Results The current online intervention services in Slovenia are satisfactory but are still not sufficiently recognized. The most important issues for young drug users were the design and functionality of the online intervention, presence of a clear structure, possibility of using it on smartphones, comprehensive and quick professional feedback, and data security. Playful elements and the ability to share (experiences) with other or former users were also recognized as important. Conclusions With effective online interventions, we can include more young drug users, facilitate access to a more affordable service, provide quick professional feedback on patterns of consumption, increase knowledge about the effects and consequences of drugs, and support the reduction or cessation of drug use. From the public health perspective, it is challenging to provide drug interventions broadly to the target group and, hence, decrease inequities.
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Affiliation(s)
- Tina Tomazic
- Institute of Media Communications, Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Olivera Stanojevic Jerkovic
- Medical Faculty, Department of Public Health, University of Maribor, Maribor, Slovenia.,National Institute of Public Health, Maribor, Slovenia
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21
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Bolinski F, Boumparis N, Kleiboer A, Cuijpers P, Ebert D, Riper H. The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials. Internet Interv 2020; 20:100321. [PMID: 32382515 PMCID: PMC7201188 DOI: 10.1016/j.invent.2020.100321] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mental health symptoms are common among college and university students and these can affect their academic performance. E-mental health interventions have proven effective in addressing mental health complaints but their effect on academic performance has not been synthesized yet. OBJECTIVES To synthesize the evidence from randomized controlled trials for the effectiveness of e-mental health interventions on academic performance in college and university students compared to inactive controls. DATA SOURCES AND ELIGIBILITY CRITERIA We searched six databases (PubMed, Cochrane library, CINAHL, ERIC, PsycINFO, Web of Science) during the period January 2000 until September 2019 for randomized controlled trials that reported on e-mental health interventions (guided or unguided) for college and university students and measured academic performance (e.g. grade point average). STUDY APPRAISAL AND SYNTHESIS METHODS Study and participant characteristics and the academic performance measures at post-intervention were extracted. The latter were pooled and Hedges' g was calculated as the effect size. Heterogeneity and publication bias were investigated. RESULTS Six studies containing 2428 participants were included in the meta-analysis. These focussed on either mood and anxiety or alcohol and tobacco use. The pooling of data resulted in a small but non-significant effect of g = 0.26 (95% CI, -0.00, 0.52; p = .05) on academic performance, favouring e-mental health interventions over inactive controls. Interventions had positive effects on depression (g = -0.24) and anxiety (g = -0.2). Heterogeneity was high. DISCUSSION Despite the small and non-significant effect, our meta-analysis points to a promising direction for the effectiveness of e-mental health interventions on academic performance. Yet, these results must be interpreted with caution, as heterogeneity was high and few studies on the effectiveness of e-mental health interventions for students reported academic performance measures.
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Affiliation(s)
- F. Bolinski
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - N. Boumparis
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - A. Kleiboer
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - P. Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - D.D. Ebert
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Germany
| | - H. Riper
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
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22
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Newby K, Teah G, Cooke R, Li X, Brown K, Salisbury-Finch B, Kwah K, Bartle N, Curtis K, Fulton E, Parsons J, Dusseldorp E, Williams SL. Do automated digital health behaviour change interventions have a positive effect on self-efficacy? A systematic review and meta-analysis. Health Psychol Rev 2019; 15:140-158. [PMID: 31847702 DOI: 10.1080/17437199.2019.1705873] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Self-efficacy is an important determinant of health behaviour. Digital interventions are a potentially acceptable and cost-effective way of delivering programmes of health behaviour change at scale. Whether behaviour change interventions work to increase self-efficacy in this context is unknown. This systematic review and meta-analysis sought to identify whether automated digital interventions are associated with positive changes in self-efficacy amongst non-clinical populations for five major health behaviours, and which BCTs are associated with that change. A systematic literature search identified 20 studies (n = 5624) that assessed changes in self-efficacy and were included in a random-effects meta-analysis. Interventions targeted: healthy eating (k = 4), physical activity (k = 9), sexual behaviour (k = 3) and smoking (k = 4). No interventions targeting alcohol use were identified. Overall, interventions had a small, positive effect on self-efficacy (g¯=0.190,CI[0.078;0.303]). The effect of interventions on self-efficacy did not differ as a function of health behaviour type (Q-between = 7.3704, p = .061, df = 3). Inclusion of the BCT 'information about social and environmental consequences' had a small, negative effect on self-efficacy (Δg¯=-0.297,Q=7.072,p=.008). Whilst this review indicates that digital interventions can be used to change self-efficacy, which techniques work best in this context is not clear.
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Affiliation(s)
- Katie Newby
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Grace Teah
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Richard Cooke
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Xinru Li
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Katherine Brown
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | | | - Kayleigh Kwah
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Naomi Bartle
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Kristina Curtis
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Emmie Fulton
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Joanne Parsons
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
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23
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Kim HN, Seo K. Smartphone-Based Health Program for Improving Physical Activity and Tackling Obesity for Young Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010015. [PMID: 31861359 PMCID: PMC6982141 DOI: 10.3390/ijerph17010015] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 12/19/2022]
Abstract
The need for physical activity for health promotion is recognized, yet young adults still perform insufficient physical activity. Smartphone health programs can be applied easily without time and space constraints, and various mobile health programs based on smartphone applications have recently been developed and applied. This study aimed to measure the effects of mobile smartphone-based health programs on physical activity and obesity outcomes in young adults through a systematic review and meta-analysis. We searched publications in English through electronic databases up to May 2019. Studies were included that provided interventions to improve physical activity using smartphone applications for young adults. After assessing study quality, data were extracted and synthesized concerning whether smartphone interventions affect health outcomes including physical activity and weight using Meta-Analysis software. Four randomized controlled studies and a quasi-experimental study were analyzed. They provided information related to health management, diet, physical activity, and personalized feedback using smartphone applications. The meta-analysis showed that smartphone-based health interventions significantly affect weight loss and increase physical activity. This study provides modest evidence for using smartphone health programs to improve young adults’ physical activity, weight control, and body mass index (BMI). Future research is needed to understand long-term effects and the reliability of increasing physical activity through smartphone health programs.
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Affiliation(s)
- Han-Na Kim
- Department of Dental Hygiene, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea;
| | - Kyoungsan Seo
- Department of Nursing, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea
- Correspondence: ; Tel.: +82-43-229-8353
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24
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Dick S, Whelan E, Davoren MP, Dockray S, Heavin C, Linehan C, Byrne M. A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. BMC Public Health 2019; 19:1244. [PMID: 31500618 PMCID: PMC6734361 DOI: 10.1186/s12889-019-7583-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 09/02/2019] [Indexed: 11/12/2022] Open
Abstract
Background Illicit substance misuse is a growing public health problem, with misuse peaking among 18–25 year-olds, and attendance at third-level education identified as a risk factor. Illicit substance misuse has the potential to harm mental and physical health, social relationships, and impact on academic achievements and future career prospects. Digital interventions have been identified as a vehicle for reaching large student populations and circumventing the limited capacity of student health services for delivering face-to-face interventions. Digital interventions have been developed in the area of alcohol and tobacco harm reduction, reporting some effectiveness, but the evidence for the effectiveness of digital interventions targeting illicit substance misuse is lacking. This review aims to systematically identify and critically appraise studies examining the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. Methods We systematically searched ten databases in April 2018 using keywords and database specific terms under the pillars of “mHealth,” “substance misuse,” and “student.” To be eligible for inclusion, papers had to present a measure of illicit substance misuse harm reduction. Included articles were critically appraised and included in the qualitative synthesis regardless of quality. Results A total of eight studies were included in the qualitative synthesis. Studies reported harm reduction in terms of substance misuse or initiation, as consequences or problems associated with substance misuse, or as correction of perceived social norms. Overall, five out of the eight studies reported at least one positive outcome for harm reduction. The critical appraisal indicated that the study quality was generally weak, predominantly due to a lack of blinding of study participants, and the use of self-reported substance misuse measures. However, results suggest that digital interventions may produce a modest reduction in harm from illicit substance misuse. Conclusions The results of this review are positive, and support the need for further high-quality research in this area, particularly given the success of digital interventions for alcohol and tobacco harm reduction. However, very few studies focused solely on illicit substances, and those that did targeted only marijuana. This suggests the need for further research on the effectiveness of this type of intervention for other illicit substances. Trial registration This review is registered on PROSPERO, ID number: CRD42018097203.
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Affiliation(s)
- Samantha Dick
- School of Public Health, University College Cork, Cork, Ireland.
| | - Eadaoin Whelan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Martin P Davoren
- School of Public Health, University College Cork, Cork, Ireland.,Sexual Health Centre, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ciara Heavin
- Health Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Michael Byrne
- Student Health Department, University College Cork, Cork, Ireland
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25
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Belogianni K, Baldwin C. Types of Interventions Targeting Dietary, Physical Activity, and Weight-Related Outcomes among University Students: A Systematic Review of Systematic Reviews. Adv Nutr 2019; 10:848-863. [PMID: 31181143 PMCID: PMC6743817 DOI: 10.1093/advances/nmz027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A plethora of studies aiming to improve dietary, physical activity (PA), and weight-related (WR) outcomes among university students have been implemented and summarized in a series of systematic reviews, with unclear conclusions regarding their effectiveness. This overview aims to identify systematic reviews and meta-analyses of studies aiming to improve health outcomes in university students, to assess their methodological quality, to identify the different types of interventions used and outcomes assessed, and to estimate their overall effect. Four electronic databases were searched until 19 March, 2018 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The identified reviews were described and their methodological quality was rated. The studies of reviews were investigated to identify the different types of interventions used and outcomes assessed. Effectiveness was assessed by measuring the overall number of improved outcomes out of the total number of outcomes reported. As a result, 8 reviews were identified targeting food sales (n = 2), dietary (n = 3), PA (n = 1), WR (n = 1), or all outcomes (n = 1). The methodological quality of the reviews was moderate (n = 5) to low (n = 3). In all, the reviews included 122 studies, of which 36 used an environmental, 51 a face-to-face, 30 an e-intervention, and 5 a combined approach. Environmental interventions improved a moderate number of food sales (32 of 61) and dietary intake (22 of 47) outcomes. Face-to-face interventions improved a high number of dietary cognitive outcomes (15 of 18), a moderate number of dietary intake (28 of 65) and WR (11 of 18) outcomes, and a low number of PA behavioral (22 of 69) and cognitive (2 of 14) outcomes. E-interventions improved a high number of dietary cognitive variables (11 of 16) but had a low effect (≤33%) on the other types of outcomes. In conclusion, face-to-face and e-interventions improved cognitive variables toward diet or PA but were less effective in changing actual behaviors. Environmental interventions favorably changed food sales. Face-to-face and e-interventions moderately affected WR outcomes. Future research should focus on long-term studies.
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Affiliation(s)
- Katerina Belogianni
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, United Kingdom,Address correspondence to KB (e-mail: )
| | - Christine Baldwin
- Department of Nutritional Sciences, King's College London, London, United Kingdom
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26
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Liang W, Duan YP, Shang BR, Wang YP, Hu C, Lippke S. A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial. BMC Public Health 2019; 19:1097. [PMID: 31409381 PMCID: PMC6692951 DOI: 10.1186/s12889-019-7438-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022] Open
Abstract
Background This study aimed to describe the design and present the baseline characteristics of a web-based lifestyle intervention program, which comprises of sequentially and simultaneously delivered intervention modules targeting physical activity (PA) and fruit and vegetable consumption (FVC) in Chinese college students. Methods The study adopted a randomized placebo-controlled trial, using the Health Action Process Approach (HAPA) and the Compensatory Carry-Over Action Model (CCAM) as the theoretical backdrops. 556 Chinese college students participated in the 8-week web-based lifestyle intervention program. All eligible participants were randomly assigned to one of four groups: 1) the PA-first arm which received a 4-week intervention addressing PA followed by a 4-week intervention addressing FVC; 2) the FVC-first arm which received a 4-week intervention addressing FVC followed by a 4-week intervention addressing PA; 3) the PA + FVC simultaneous arm that received an 8-week intervention addressing both PA and FVC at the same time; and 4) the placebo-control arm that received 8 weeks of general health information, which is not relevant for changing actual PA and FVC behaviors. Data collection includes four time-points: at the beginning and end of the intervention, and a 3-month and 12-month follow-up after the intervention. Results At baseline, 41.7% of participants were male and 58.3% were female. 41.0% of the participants did not meet the standard PA-recommendations, while 69.6% did not adhere to the standard FVC-recommendations. In total, only 19.6% of participants met both PA and FVC recommendations. Baseline characteristics across the four groups had no significant differences (all P = .17–.99), indicating successful randomization. Conclusions The preliminary results indicate a high prevalence of unhealthy lifestyles in college students in China, which further supports the need for web-based health intervention programs. This is also the first study that examines the comparative effectiveness of simultaneously and sequentially delivered lifestyle interventions in the Chinese population. These findings may contribute to the creation of future web-based health behavior change interventions. Trial registration ClinicalTrails.gov: NCT03627949, 14 August, 2018. Electronic supplementary material The online version of this article (10.1186/s12889-019-7438-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei Liang
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Yan Ping Duan
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
| | - Bo Rui Shang
- Department of Kinesiology, Hebei Institute of Physical Education, Shijiazhuang, China
| | - Yan Ping Wang
- The National Physical Fitness Lab, Hubei Institute of Sport Science, Wuhan, China
| | - Chun Hu
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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27
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Willmott T, Pang B, Rundle-Thiele S, Badejo A. Reported theory use in electronic health weight management interventions targeting young adults: a systematic review. Health Psychol Rev 2019; 13:295-317. [PMID: 31161877 DOI: 10.1080/17437199.2019.1625280] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This review assesses the extent of reported theory use in electronic health weight management interventions targeting young adults aged 18-35 years. Twenty-four eligible studies were identified. Two independent reviewers extracted data and coded for theory use using the Theory Coding Scheme. Overall, the mean total use of theory score was 6/23 (SD = 5; Min. = 0, Max. = 17); 17 studies were classified as having weak application of theory, five as moderate, and two as strong. The majority (N = 18) of studies mentioned theory, however, most (N = 14) did not report how intervention techniques related to theoretical base. No study used theory to select intervention recipients and only four used theory to tailor intervention techniques to recipients. Limited studies reported theory testing (N = 6) and no study used intervention results to build and/or refine theory. Results indicate that weight-related outcomes may be enhanced when at least one or more theoretical constructs are explicitly linked to an intervention technique and when theoretical constructs are included in evaluations. Increases in theory application and reporting are needed to assist the scientific research community in systematically identifying which theories work, for whom, how, why, and when; thereby delivering an advanced understanding of how best to apply theory to enhance intervention outcomes.
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Affiliation(s)
- Taylor Willmott
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Bo Pang
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Sharyn Rundle-Thiele
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
| | - Abi Badejo
- a Social Marketing @ Griffith, Griffith Business School, Griffith University , Queensland , Australia
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28
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Taber JM, McQueen A, Simonovic N, Waters EA. Adapting a self-affirmation intervention for use in a mobile application for smokers. J Behav Med 2019; 42:1050-1061. [PMID: 30903442 DOI: 10.1007/s10865-019-00028-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/12/2019] [Indexed: 12/15/2022]
Abstract
Self-affirmation interventions can reduce defensive responses to threats to the self, but have had limited reach to the general population. We sought to create an effective and feasible version of the Kindness Questionnaire self-affirmation intervention for use on a mobile device outside the traditional university laboratory setting and by non-student participants. In an online experiment, 603 cigarette smokers (Mage= 37.5 years, SD = 10.2) were randomly assigned to one of six conditions in a 2 (Self-Affirmation: Self-Affirmation, No Self-Affirmation Control) × 3 (Example Type: Written, Imagined, No Examples) fully-crossed design. Participants read a message about the health harms of smoking. None of the self-affirmation variations were effective or feasible: the self-affirmation showed null effects on the primary outcomes of message acceptance, perceived message effectiveness, and reactance. It also backfired by reducing intentions to quit smoking and risk perceptions. Participants spent little time reading the health message, and those in the written self-affirmation condition infrequently provided detailed responses. Translating interventions developed and tested for efficacy in laboratory settings to "real-world" settings is necessary but challenging.
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Affiliation(s)
- Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242-0001, USA.
| | - Amy McQueen
- School of Medicine, Washington University in Saint Louis, Saint Louis, MO, 63110, USA
| | - Nicolle Simonovic
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242-0001, USA
| | - Erika A Waters
- School of Medicine, Washington University in Saint Louis, Saint Louis, MO, 63110, USA
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29
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Mo D, Xiang M, Luo M, Dong Y, Fang Y, Zhang S, Zhang Z, Liang H. Using Gamification and Social Incentives to Increase Physical Activity and Related Social Cognition among Undergraduate Students in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E858. [PMID: 30857261 PMCID: PMC6427787 DOI: 10.3390/ijerph16050858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 12/18/2022]
Abstract
Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p <0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p <0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.
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Affiliation(s)
- Dandan Mo
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Mengyun Luo
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
- School of Public Health, and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | - Yuanyuan Dong
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Yue Fang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | | | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Huigang Liang
- College of Business, East Carolina University, Greenville, NC 27858, USA.
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30
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Murphy JJ, Woods CB, Murphy MH, Murphy N, Byrne N, Mac Donncha C. Student Activity and Sport Study Ireland: Protocol for a Web-Based Survey and Environmental Audit Tool for Assessing the Impact of Multiple Factors on University Students' Physical Activity. JMIR Res Protoc 2019; 8:e10823. [PMID: 30789352 PMCID: PMC6403525 DOI: 10.2196/10823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 11/19/2022] Open
Abstract
Background Increasing proportions of the global population transition through a university setting, a setting associated with engagement in behaviors that diminish health such as high levels of physical inactivity. Increasing physical activity (PA) is a key element of health promotion strategies in many countries, but a better understanding of students’ PA and how it is associated with personal, behavioral, and environmental factors is needed. Studies provide protocols to collect information regarding these factors separately; however, none have developed a validated systematic approach to gather information pertaining to all across a whole country. Objective The purpose of this project is to examine students’ physical activity and how it is associated with personal, behavioral, and environmental factors. Methods Student Activity and Sport Study Ireland (SASSI) is a university-based cross-sectional study that was carried out across the island of Ireland in 2014. A novel and comprehensive Web-based environmental audit tool (EAT) gathered information pertaining to the environment provided by universities for physical activity. A Web-based student survey (SS) collected information about physical activity beliefs, attitudes, motivations, and behaviors of students. The audit tool and SS were developed through rigorous consultation processes involving international experts. An institutional champion volunteered at each university to recruit, administer, and ensure the completion of both assessments. Results Data collection was undertaken between May and December 2014. A total of 80% (33/41) of universities completed the EAT, whereas 88.31% (8122/9197) of students (49.10% [3966/8122] male; mean 23.17 [SD 6.75], years) completed the SS sufficiently. Studies are currently underway with the data collected using this protocol. Conclusions SASSI provides a novel and comprehensive protocol for systematically assessing the PA of students and the related personal, behavioral, and actual environmental factors. The strengths of the SASSI study are presented and include high response rates and a unique dataset that can provide information to relevant stakeholders and policy makers, along with aiding the development of university environments and interventions that promote PA involvement. The weaknesses of the protocol are recognized with suggestions given to overcome them in future research. This protocol is applicable for other countries and has great potential to create harmonization of data, which would allow for direct comparisons across nations. International Registered Report Identifier (IRRID) RR1-10.2196/10823
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Affiliation(s)
- Joseph J Murphy
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Catherine B Woods
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
| | - Niamh Murphy
- Department of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Neal Byrne
- Department of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Ciaran Mac Donncha
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
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31
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Willmott TJ, Pang B, Rundle-Thiele S, Badejo A. Weight Management in Young Adults: Systematic Review of Electronic Health Intervention Components and Outcomes. J Med Internet Res 2019; 21:e10265. [PMID: 30724736 PMCID: PMC6381405 DOI: 10.2196/10265] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 01/11/2023] Open
Abstract
Background Young adulthood is a vulnerable period for unhealthy lifestyle adoption and excess weight gain. Scant attention has been focused on developing and evaluating effective weight gain prevention strategies for this age group. Electronic health (eHealth) offers potential as a cost-effective means of delivering convenient, individually-tailored, and contextually-meaningful interventions at scale. Objective The primary aim of this systematic review was to locate and synthesize the evidence on eHealth weight management interventions targeting young adults, with a particular focus on (eHealth) intervention components and outcomes. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was executed across the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EBSCO, EMBASE, Emerald, Education Resources Information Center, Medical Literature Analysis and Retrieval System Online, Ovid, ProQuest, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science. Furthermore, 2 reviewers independently assessed records for eligibility: peer-reviewed, published in English, and report evaluations of eHealth weight management interventions targeting healthy young adults (aged 18-35 years). Data were then extracted from studies that met the criteria for inclusion. The methodological quality of studies was independently assessed by 2 reviewers using the Effective Public Health Practice Project’s (EPHPP) quality assessment tool. A comprehensive narrative evidence synthesis was then completed. Results Out of the 1301 studies assessed for eligibility, 24 met the criteria for inclusion. According to the EPHPP quality assessment tool, overall, 19 studies were as rated weak, 5 as moderate, and none as strong. The narrative synthesis of intervention outcomes found 8 studies reported positive weight-related outcomes, 4 reported mixed outcomes, and 12 did not report any significant changes in weight-related outcomes. The narrative synthesis of (eHealth) intervention components led to 3 levels of classification. A total of 14 studies were classified as Web-based, 3 as mobile-based, and 7 as multicomponent interventions. Following the narrative synthesis, 5 key strategies were thematically identified: self-regulation (goal setting and self-monitoring), tailored or personalized feedback, contact with an interventionist, social support, and behavioral prompts (nudges and reminders) and booster messages. Conclusions Findings highlight the limited evidence base for eHealth weight management interventions targeting young adults. The complex nature of weight management presents an ongoing challenge for interventionists to identify what works, for whom, how, and when. The quality of the evidence in this review was generally assessed as weak; however, assessment tools such as the EPHPP are principally concerned with what should be and this is seldom equivalent to what works. Thus, while sampling, study design and retention rates will remain key determining factors of reliability and validity, further research attention directed toward the development of guiding tools for community trials is warranted.
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Affiliation(s)
- Taylor Jade Willmott
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Bo Pang
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Abi Badejo
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
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Scott S, Beyer F, Parkinson K, Muir C, Graye A, Kaner E, Stead M, Power C, Fitzgerald N, Bradley J, Wrieden W, Adamson A. Non-Pharmacological Interventions to Reduce Unhealthy Eating and Risky Drinking in Young Adults Aged 18⁻25 Years: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E1538. [PMID: 30340361 PMCID: PMC6213108 DOI: 10.3390/nu10101538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 01/26/2023] Open
Abstract
Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This review aimed to systematically evaluate the effectiveness of preventative targeted interventions focused on reducing unhealthy eating behavior and linked alcohol use in 18⁻25-year-olds. Twelve electronic databases were searched from inception to June 2018 for trials or experimental studies, of any duration or follow-up. Eight studies (seven with student populations) met the inclusion criteria. Pooled estimates demonstrated inconclusive evidence that receiving an intervention resulted in changes to self-reported fruit and vegetable consumption (mean change/daily servings: 0.33; 95% CI -0.22 to 0.87) and alcohol consumption (mean reduction of 0.6 units/week; CI -1.35 to 0.19). There was also little difference in the number of binge drinking episodes per week between intervention and control groups (-0.01 sessions; CI -0.07 to 0.04). This review identified only a small number of relevant studies. Importantly, included studies did not assess whether (and how) unhealthy eating behaviors and alcohol use link together. Further exploratory work is needed to inform the development of appropriate interventions, with outcome measures that have the capacity to link food and alcohol consumption, in order to establish behavior change in this population group.
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Affiliation(s)
- Stephanie Scott
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough TS1 3BA, UK.
- Fuse-The Centre for Translational Research in Public Health, a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence, Newcastle upon Tyne NE2 4AX, UK.
| | - Fiona Beyer
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Kathryn Parkinson
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Cassey Muir
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Alice Graye
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Eileen Kaner
- Fuse-The Centre for Translational Research in Public Health, a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence, Newcastle upon Tyne NE2 4AX, UK.
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Martine Stead
- Institute for Social Marketing (ISM), Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.
| | - Christine Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Niamh Fitzgerald
- Institute for Social Marketing (ISM), Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.
| | - Jen Bradley
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Wendy Wrieden
- Fuse-The Centre for Translational Research in Public Health, a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence, Newcastle upon Tyne NE2 4AX, UK.
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Ashley Adamson
- Fuse-The Centre for Translational Research in Public Health, a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence, Newcastle upon Tyne NE2 4AX, UK.
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
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MacArthur G, Caldwell DM, Redmore J, Watkins SH, Kipping R, White J, Chittleborough C, Langford R, Er V, Lingam R, Pasch K, Gunnell D, Hickman M, Campbell R. Individual-, family-, and school-level interventions targeting multiple risk behaviours in young people. Cochrane Database Syst Rev 2018; 10:CD009927. [PMID: 30288738 PMCID: PMC6517301 DOI: 10.1002/14651858.cd009927.pub2] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Engagement in multiple risk behaviours can have adverse consequences for health during childhood, during adolescence, and later in life, yet little is known about the impact of different types of interventions that target multiple risk behaviours in children and young people, or the differential impact of universal versus targeted approaches. Findings from systematic reviews have been mixed, and effects of these interventions have not been quantitatively estimated. OBJECTIVES To examine the effects of interventions implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people. SEARCH METHODS We searched 11 databases (Australian Education Index; British Education Index; Campbell Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; Embase; Education Resource Information Center (ERIC); International Bibliography of the Social Sciences; MEDLINE; PsycINFO; and Sociological Abstracts) on three occasions (2012, 2015, and 14 November 2016)). We conducted handsearches of reference lists, contacted experts in the field, conducted citation searches, and searched websites of relevant organisations. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster RCTs, which aimed to address at least two risk behaviours. Participants were children and young people up to 18 years of age and/or parents, guardians, or carers, as long as the intervention aimed to address involvement in multiple risk behaviours among children and young people up to 18 years of age. However, studies could include outcome data on children > 18 years of age at the time of follow-up. Specifically,we included studies with outcomes collected from those eight to 25 years of age. Further, we included only studies with a combined intervention and follow-up period of six months or longer. We excluded interventions aimed at individuals with clinically diagnosed disorders along with clinical interventions. We categorised interventions according to whether they were conducted at the individual level; the family level; or the school level. DATA COLLECTION AND ANALYSIS We identified a total of 34,680 titles, screened 27,691 articles and assessed 424 full-text articles for eligibility. Two or more review authors independently assessed studies for inclusion in the review, extracted data, and assessed risk of bias.We pooled data in meta-analyses using a random-effects (DerSimonian and Laird) model in RevMan 5.3. For each outcome, we included subgroups related to study type (individual, family, or school level, and universal or targeted approach) and examined effectiveness at up to 12 months' follow-up and over the longer term (> 12 months). We assessed the quality and certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS We included in the review a total of 70 eligible studies, of which a substantial proportion were universal school-based studies (n = 28; 40%). Most studies were conducted in the USA (n = 55; 79%). On average, studies aimed to prevent four of the primary behaviours. Behaviours that were most frequently addressed included alcohol use (n = 55), drug use (n = 53), and/or antisocial behaviour (n = 53), followed by tobacco use (n = 42). No studies aimed to prevent self-harm or gambling alongside other behaviours.Evidence suggests that for multiple risk behaviours, universal school-based interventions were beneficial in relation to tobacco use (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.60 to 0.97; n = 9 studies; 15,354 participants) and alcohol use (OR 0.72, 95% CI 0.56 to 0.92; n = 8 studies; 8751 participants; both moderate-quality evidence) compared to a comparator, and that such interventions may be effective in preventing illicit drug use (OR 0.74, 95% CI 0.55 to 1.00; n = 5 studies; 11,058 participants; low-quality evidence) and engagement in any antisocial behaviour (OR 0.81, 95% CI 0.66 to 0.98; n = 13 studies; 20,756 participants; very low-quality evidence) at up to 12 months' follow-up, although there was evidence of moderate to substantial heterogeneity (I² = 49% to 69%). Moderate-quality evidence also showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50; I² = 0%; n = 4 studies; 6441 participants). We considered observed effects to be of public health importance when applied at the population level. Evidence was less certain for the effects of such multiple risk behaviour interventions for cannabis use (OR 0.79, 95% CI 0.62 to 1.01; P = 0.06; n = 5 studies; 4140 participants; I² = 0%; moderate-quality evidence), sexual risk behaviours (OR 0.83, 95% CI 0.61 to 1.12; P = 0.22; n = 6 studies; 12,633 participants; I² = 77%; low-quality evidence), and unhealthy diet (OR 0.82, 95% CI 0.64 to 1.06; P = 0.13; n = 3 studies; 6441 participants; I² = 49%; moderate-quality evidence). It is important to note that some evidence supported the positive effects of universal school-level interventions on three or more risk behaviours.For most outcomes of individual- and family-level targeted and universal interventions, moderate- or low-quality evidence suggests little or no effect, although caution is warranted in interpretation because few of these studies were available for comparison (n ≤ 4 studies for each outcome).Seven studies reported adverse effects, which involved evidence suggestive of increased involvement in a risk behaviour among participants receiving the intervention compared to participants given control interventions.We judged the quality of evidence to be moderate or low for most outcomes, primarily owing to concerns around selection, performance, and detection bias and heterogeneity between studies. AUTHORS' CONCLUSIONS Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. Results of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field.
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Affiliation(s)
- Georgina MacArthur
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Deborah M Caldwell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - James Redmore
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Sarah H Watkins
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Ruth Kipping
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - James White
- School of Medicine, Cardiff UniversityDECIPHer (Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement), Centre for Trials Research4th Floor Neuadd MeirionnyddCardiffUKCF14 4YS
| | - Catherine Chittleborough
- University of AdelaideSchool of Public HealthLevel 7, 178 North Terrace, Mail Drop DX 650 550AdelaideSouth AustraliaAustralia5005
| | - Rebecca Langford
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Vanessa Er
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Raghu Lingam
- Newcastle UniversityInstitute of Health and SocietyBaddiley‐Clark Building, Richardson RoadNewcastle Upon TyneUKNE2 4AX
| | - Keryn Pasch
- University of TexasDepartment of Kinesiology and Health Education1 University Station, D3700AustinTexasUSA78712
| | - David Gunnell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Matthew Hickman
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Rona Campbell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
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Sinclair PM, Day J, Levett-Jones T, Kable A. Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses. Nephrology (Carlton) 2018; 22:776-782. [PMID: 27436704 DOI: 10.1111/nep.12856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022]
Abstract
AIM Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. METHODS An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. RESULTS Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. CONCLUSION The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.
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Affiliation(s)
- Peter M Sinclair
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jenny Day
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Tracy Levett-Jones
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ashley Kable
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
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Gilbertson RJ, Norton TR, Beery SH, Lee KR. Web-Based Alcohol Intervention in First-Year College Students: Efficacy of Full-Program Administration Prior to Second Semester. Subst Use Misuse 2018; 53:1021-1029. [PMID: 29148929 DOI: 10.1080/10826084.2017.1392979] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Commercially available, web-based interventions for the prevention of alcohol use are being adopted for universal use with first-year college students, yet few have received empirical evaluation. OBJECTIVES This randomized controlled trial investigated the effectiveness of a novel, commercially available, personalized web-based alcohol intervention, Alcohol-Wise (version 4.0, 3rd Millennium Classrooms), on multiple measures of alcohol consumption, alcohol consequences, alcohol expectancies, academic achievement, and adaptation to college in first-year students. METHOD Participants received Alcohol-Wise either prior to first semester or were waitlisted and received the intervention second semester. As longitudinal effectiveness was of interest, follow-up surveys were conducted 10 weeks (n = 76) and 24 weeks (n = 64) following the web-based alcohol intervention. RESULTS Completion of Alcohol-Wise had effects on academic achievement. Specifically, at the 24 week follow-up, academic achievement was higher in participants who received the intervention first semester of their freshman year as compared to the waitlist control. The incremental rise in heavy episodic drinking during the first semester of college was also reduced in waitlisted participants by Alcohol-Wise administration prior to second semester. Conclusion/Importance: Implications for the timing of web-based alcohol interventions to include administration prior to both first and second semesters of the freshman year are discussed.
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Affiliation(s)
- Rebecca J Gilbertson
- a Department of Psychology, University of Minnesota-Duluth , Duluth , Minnesota , USA
| | - Tina R Norton
- b Department of Psychology , Lycoming College , Williamsport , Pennsylvania , USA
| | - Susan H Beery
- b Department of Psychology , Lycoming College , Williamsport , Pennsylvania , USA
| | - Kassandra R Lee
- c Department of Psychology , Illinois State University , Normal , Illinois , USA
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Prosser T, Gee KA, Jones F. A meta-analysis of effectiveness of E-interventions to reduce alcohol consumption in college and university students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:292-301. [PMID: 29452058 DOI: 10.1080/07448481.2018.1440579] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effectiveness and moderators of E-Interventions versus assessment only (AO) controls in the reduction of alcoholic drinks per week (DPW) in university students. STUDY DESIGN AND METHODS Cochrane library, CINAEL, ERIC, MEDLINE, PsycINFO, PubMed, and Web of Science were searched up to June 2017. Studies were included if they were: an RCT, assessed the effectiveness of E-Interventions at reducing DPW, and employed university/college students. 23 studies (N = 7,614) were included and quality was assessed using the JADAD scale. RESULTS Weighted mean effect sizes were calculated using random-effects models. These showed a small, significant effect of E-Interventions at reducing the number of alcoholic DPW. Moderator analysis found a significant advantage for web-based personalised feedback interventions compared to other E-Interventions. CONCLUSIONS E-Interventions show a small, significant effect at reducing mean alcoholic DPW. Personalised feedback E-Interventions showed the strongest effect.
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Affiliation(s)
- Tom Prosser
- a Canterbury Christ Church University, School of Psychology , Canterbury , UK
| | - Kate Ann Gee
- a Canterbury Christ Church University, School of Psychology , Canterbury , UK
| | - Fergal Jones
- b Canterbury Christ Church University, Salomons Centre for Applied Psychology , Tunbridge Wells , UK
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Maselli M, Ward PB, Gobbi E, Carraro A. Promoting Physical Activity Among University Students: A Systematic Review of Controlled Trials. Am J Health Promot 2018; 32:1602-1612. [PMID: 29366334 DOI: 10.1177/0890117117753798] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE University study is often accompanied by a decline in physical activity (PA) levels but can offer the opportunity to promote a lifelong active lifestyle. This review aims to summarize controlled trials of interventions promoting PA among university students, describing the quality of the evidence, effective strategies, and deficiencies in the interventions employed, to provide directions for future research and for practical implementations. DATA SOURCE PubMed, PsychINFO, Cochrane Library, Education Source, and SPORTDiscus. Study Inclusion Criteria: Randomized or nonrandomized controlled trial, describing an intervention to promote PA in university students, where PA was one of the outcomes and results were published in English. DATA EXTRACTION Country, study design, participants' inclusion criteria, participation rate and characteristics, randomization, blinding, theoretical framework, intervention characteristics, participant retention rate and withdrawal reasons, measures employed, data analysis, PA results, and findings regarding PA correlates. DATA SYNTHESIS Data were synthetized considering study characteristics, strategies used, and outcomes. RESULTS Two thousand five hundred eighty-five articles were identified. Twenty-seven studies met the inclusion criteria. Sixteen studies reported an increase in PA levels. CONCLUSION Physical Activity promotion interventions should address a range of behavioral determinants. Personalized approaches and PA sessions should be considered in future studies. The high risk of bias of many studies (mainly due to attrition and poor reporting) and missing information about intervention components limit the strength of conclusions about the most effective strategies and the evidence of effectiveness, highlighting the need for further high-quality studies.
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Affiliation(s)
- Marco Maselli
- 1 Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padua, Padova, Italy
| | - Philip B Ward
- 2 School of Psychiatry, Schizophrenia Research Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Erica Gobbi
- 3 Department of Biomedical Sciences, University of Padua, Padova, Italy
| | - Attilio Carraro
- 3 Department of Biomedical Sciences, University of Padua, Padova, Italy
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Kaner EFS, Beyer FR, Garnett C, Crane D, Brown J, Muirhead C, Redmore J, O'Donnell A, Newham JJ, de Vocht F, Hickman M, Brown H, Maniatopoulos G, Michie S. Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations. Cochrane Database Syst Rev 2017; 9:CD011479. [PMID: 28944453 PMCID: PMC6483779 DOI: 10.1002/14651858.cd011479.pub2] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Excessive alcohol use contributes significantly to physical and psychological illness, injury and death, and a wide array of social harm in all age groups. A proven strategy for reducing excessive alcohol consumption levels is to offer a brief conversation-based intervention in primary care settings, but more recent technological innovations have enabled people to interact directly via computer, mobile device or smartphone with digital interventions designed to address problem alcohol consumption. OBJECTIVES To assess the effectiveness and cost-effectiveness of digital interventions for reducing hazardous and harmful alcohol consumption, alcohol-related problems, or both, in people living in the community, specifically: (i) Are digital interventions more effective and cost-effective than no intervention (or minimal input) controls? (ii) Are digital interventions at least equally effective as face-to-face brief alcohol interventions? (iii) What are the effective component behaviour change techniques (BCTs) of such interventions and their mechanisms of action? (iv) What theories or models have been used in the development and/or evaluation of the intervention? Secondary objectives were (i) to assess whether outcomes differ between trials where the digital intervention targets participants attending health, social care, education or other community-based settings and those where it is offered remotely via the internet or mobile phone platforms; (ii) to specify interventions according to their mode of delivery (e.g. functionality features) and assess the impact of mode of delivery on outcomes. SEARCH METHODS We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, ERIC, HTA and Web of Knowledge databases; ClinicalTrials.com and WHO ICTRP trials registers and relevant websites to April 2017. We also checked the reference lists of included trials and relevant systematic reviews. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated the effectiveness of digital interventions compared with no intervention or with face-to-face interventions for reducing hazardous or harmful alcohol consumption in people living in the community and reported a measure of alcohol consumption. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included 57 studies which randomised a total of 34,390 participants. The main sources of bias were from attrition and participant blinding (36% and 21% of studies respectively, high risk of bias). Forty one studies (42 comparisons, 19,241 participants) provided data for the primary meta-analysis, which demonstrated that participants using a digital intervention drank approximately 23 g alcohol weekly (95% CI 15 to 30) (about 3 UK units) less than participants who received no or minimal interventions at end of follow up (moderate-quality evidence).Fifteen studies (16 comparisons, 10,862 participants) demonstrated that participants who engaged with digital interventions had less than one drinking day per month fewer than no intervention controls (moderate-quality evidence), 15 studies (3587 participants) showed about one binge drinking session less per month in the intervention group compared to no intervention controls (moderate-quality evidence), and in 15 studies (9791 participants) intervention participants drank one unit per occasion less than no intervention control participants (moderate-quality evidence).Only five small studies (390 participants) compared digital and face-to-face interventions. There was no difference in alcohol consumption at end of follow up (MD 0.52 g/week, 95% CI -24.59 to 25.63; low-quality evidence). Thus, digital alcohol interventions produced broadly similar outcomes in these studies. No studies reported whether any adverse effects resulted from the interventions.A median of nine BCTs were used in experimental arms (range = 1 to 22). 'B' is an estimate of effect (MD in quantity of drinking, expressed in g/week) per unit increase in the BCT, and is a way to report whether individual BCTs are linked to the effect of the intervention. The BCTs of goal setting (B -43.94, 95% CI -78.59 to -9.30), problem solving (B -48.03, 95% CI -77.79 to -18.27), information about antecedents (B -74.20, 95% CI -117.72 to -30.68), behaviour substitution (B -123.71, 95% CI -184.63 to -62.80) and credible source (B -39.89, 95% CI -72.66 to -7.11) were significantly associated with reduced alcohol consumption in unadjusted models. In a multivariable model that included BCTs with B > 23 in the unadjusted model, the BCTs of behaviour substitution (B -95.12, 95% CI -162.90 to -27.34), problem solving (B -45.92, 95% CI -90.97 to -0.87), and credible source (B -32.09, 95% CI -60.64 to -3.55) were associated with reduced alcohol consumption.The most frequently mentioned theories or models in the included studies were Motivational Interviewing Theory (7/20), Transtheoretical Model (6/20) and Social Norms Theory (6/20). Over half of the interventions (n = 21, 51%) made no mention of theory. Only two studies used theory to select participants or tailor the intervention. There was no evidence of an association between reporting theory use and intervention effectiveness. AUTHORS' CONCLUSIONS There is moderate-quality evidence that digital interventions may lower alcohol consumption, with an average reduction of up to three (UK) standard drinks per week compared to control participants. Substantial heterogeneity and risk of performance and publication bias may mean the reduction was lower. Low-quality evidence from fewer studies suggested there may be little or no difference in impact on alcohol consumption between digital and face-to-face interventions.The BCTs of behaviour substitution, problem solving and credible source were associated with the effectiveness of digital interventions to reduce alcohol consumption and warrant further investigation in an experimental context.Reporting of theory use was very limited and often unclear when present. Over half of the interventions made no reference to any theories. Limited reporting of theory use was unrelated to heterogeneity in intervention effectiveness.
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Affiliation(s)
- Eileen FS Kaner
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Fiona R Beyer
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Claire Garnett
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - David Crane
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - Jamie Brown
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
| | - Colin Muirhead
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - James Redmore
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Amy O'Donnell
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - James J Newham
- King's College LondonPrimary Care & Public Health SciencesAddison House, Guy's campusLondonUKSE1 1UL
| | - Frank de Vocht
- University of BristolSchool of Social and Community Medicine39 Whatley RoadBristolUKBS8 2PS
| | - Matthew Hickman
- University of BristolSchool of Social and Community Medicine39 Whatley RoadBristolUKBS8 2PS
| | - Heather Brown
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Gregory Maniatopoulos
- Newcastle UniversityInstitute of Health and SocietyRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Susan Michie
- University College LondonResearch Department of Clinical, Educational and Health Psychology1‐19 Torrington PlaceLondonUKWC1E 7HB
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Taylor GMJ, Dalili MN, Semwal M, Civljak M, Sheikh A, Car J. Internet-based interventions for smoking cessation. Cochrane Database Syst Rev 2017; 9:CD007078. [PMID: 28869775 PMCID: PMC6703145 DOI: 10.1002/14651858.cd007078.pub5] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Tobacco use is estimated to kill 7 million people a year. Nicotine is highly addictive, but surveys indicate that almost 70% of US and UK smokers would like to stop smoking. Although many smokers attempt to give up on their own, advice from a health professional increases the chances of quitting. As of 2016 there were 3.5 billion Internet users worldwide, making the Internet a potential platform to help people quit smoking. OBJECTIVES To determine the effectiveness of Internet-based interventions for smoking cessation, whether intervention effectiveness is altered by tailoring or interactive features, and if there is a difference in effectiveness between adolescents, young adults, and adults. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, which included searches of MEDLINE, Embase and PsycINFO (through OVID). There were no restrictions placed on language, publication status or publication date. The most recent search was conducted in August 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs). Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. To be included, studies must have measured smoking cessation at four weeks or longer. DATA COLLECTION AND ANALYSIS Two review authors independently assessed and extracted data. We extracted and, where appropriate, pooled smoking cessation outcomes of six-month follow-up or more, reporting short-term outcomes narratively where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI).We grouped studies according to whether they (1) compared an Internet intervention with a non-active control arm (e.g. printed self-help guides), (2) compared an Internet intervention with an active control arm (e.g. face-to-face counselling), (3) evaluated the addition of behavioural support to an Internet programme, or (4) compared one Internet intervention with another. Where appropriate we grouped studies by age. MAIN RESULTS We identified 67 RCTs, including data from over 110,000 participants. We pooled data from 35,969 participants.There were only four RCTs conducted in adolescence or young adults that were eligible for meta-analysis.Results for trials in adults: Eight trials compared a tailored and interactive Internet intervention to a non-active control. Pooled results demonstrated an effect in favour of the intervention (RR 1.15, 95% CI 1.01 to 1.30, n = 6786). However, statistical heterogeneity was high (I2 = 58%) and was unexplained, and the overall quality of evidence was low according to GRADE. Five trials compared an Internet intervention to an active control. The pooled effect estimate favoured the control group, but crossed the null (RR 0.92, 95% CI 0.78 to 1.09, n = 3806, I2 = 0%); GRADE quality rating was moderate. Five studies evaluated an Internet programme plus behavioural support compared to a non-active control (n = 2334). Pooled, these studies indicated a positive effect of the intervention (RR 1.69, 95% CI 1.30 to 2.18). Although statistical heterogeneity was substantial (I2 = 60%) and was unexplained, the GRADE rating was moderate. Four studies evaluated the Internet plus behavioural support compared to active control. None of the studies detected a difference between trial arms (RR 1.00, 95% CI 0.84 to 1.18, n = 2769, I2 = 0%); GRADE rating was moderate. Seven studies compared an interactive or tailored Internet intervention, or both, to an Internet intervention that was not tailored/interactive. Pooled results favoured the interactive or tailored programme, but the estimate crossed the null (RR 1.10, 95% CI 0.99 to 1.22, n = 14,623, I2 = 0%); GRADE rating was moderate. Three studies compared tailored with non-tailored Internet-based messages, compared to non-tailored messages. The tailored messages produced higher cessation rates compared to control, but the estimate was not precise (RR 1.17, 95% CI 0.97 to 1.41, n = 4040), and there was evidence of unexplained substantial statistical heterogeneity (I2 = 57%); GRADE rating was low.Results should be interpreted with caution as we judged some of the included studies to be at high risk of bias. AUTHORS' CONCLUSIONS The evidence from trials in adults suggests that interactive and tailored Internet-based interventions with or without additional behavioural support are moderately more effective than non-active controls at six months or longer, but there was no evidence that these interventions were better than other active smoking treatments. However some of the studies were at high risk of bias, and there was evidence of substantial statistical heterogeneity. Treatment effectiveness in younger people is unknown.
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Affiliation(s)
- Gemma M. J. Taylor
- University of BristolMRC Integrative Epidemiology Unit, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology12a Priory RoadBristolUKBS8 1TU
| | | | - Monika Semwal
- Lee Kong Chian School of Medicine, Nanyang Technological UniversityCentre for Population Health Sciences (CePHaS)SingaporeSingapore
| | | | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of EdinburghAllergy & Respiratory Research Group and Asthma UK Centre for Applied ResearchTeviot PlaceEdinburghUKEH8 9AG
| | - Josip Car
- Lee Kong Chian School of Medicine, Nanyang Technological UniversityCentre for Population Health Sciences (CePHaS)SingaporeSingapore
- University of LjubljanaDepartment of Family Medicine, Faculty of MedicineLjubljanaSlovenia
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Effect of tailored, gamified, mobile physical activity intervention on life satisfaction and self-rated health in young adolescent men: A population-based, randomized controlled trial (MOPO study). COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.02.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Duan YP, Wienert J, Hu C, Si GY, Lippke S. Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial. J Med Internet Res 2017; 19:e106. [PMID: 28396306 PMCID: PMC5404143 DOI: 10.2196/jmir.7152] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/01/2017] [Accepted: 03/18/2017] [Indexed: 12/15/2022] Open
Abstract
Background Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students. Objective Our objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression). Methods In a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015. Results Significant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η2) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ21=11.75, P=.001) and FVI (χ21=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F3,492=1.23, η2=.03, P=.02). Conclusions This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention. Trial Registration Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1)
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Affiliation(s)
- Yan Ping Duan
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Julian Wienert
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Chun Hu
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Gang Yan Si
- Department of Health & Physical Education, The Education University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Sonia Lippke
- Bremen International Graduate School of Social Sciences, Jacobs University Bremen, Bremen, Germany.,Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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Electronic communication based interventions for hazardous young drinkers: A systematic review. Neurosci Biobehav Rev 2016; 68:880-890. [DOI: 10.1016/j.neubiorev.2016.07.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022]
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Taber JM, Klein WMP, Ferrer RA, Augustson E, Patrick H. A Pilot Test of Self-Affirmations to Promote Smoking Cessation in a National Smoking Cessation Text Messaging Program. JMIR Mhealth Uhealth 2016; 4:e71. [PMID: 27278108 PMCID: PMC4917724 DOI: 10.2196/mhealth.5635] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/28/2016] [Accepted: 04/13/2016] [Indexed: 11/25/2022] Open
Abstract
Background Although effective smoking cessation treatments, including mHealth interventions, have been empirically validated and are widely available, smoking relapse is likely. Self-affirmation, a process through which individuals focus on their strengths and behaviors, has been shown to reduce negative effects of self-threats and to promote engagement in healthier behavior. Objective To assess the feasibility of incorporating self-affirmations into an existing text messaging-based smoking cessation program (Smokefree TXT) and to determine whether self-affirmation led to greater engagement and higher cessation rates than the standard intervention. Methods Data were collected from smokers (n=1261) who subscribed to a free smoking cessation program and met eligibility criteria. The intervention lasted 42 days. The original design was a 2 (Baseline affirmation: 5-item questionnaire present vs absent) × 2 (Integrated affirmation: texts present vs absent) factorial design. Only 17 eligible users completed all baseline affirmation questions and these conditions did not influence any outcomes, so we collapsed across baseline affirmation conditions in analysis. In the integrated affirmation conditions, affirmations replaced approximately 20% of texts delivering motivational content. Results In all, 687 users remained enrolled throughout the 42-day intervention and 81 reported smoking status at day 42. Among initiators (n=1261), self-affirmation did not significantly improve (1) intervention completion, (2) days enrolled, (3) 1-week smoking status, or (4) 6-week smoking status (all Ps>.10); and among the 687 completers, there were no significant effects of affirmation on cessation (Ps>.25). However, among the 81 responders, those who received affirmations were more likely to report cessation at 6 weeks (97.5%; 39 of 40) than those not given affirmations (78.1%; 32 of 41; χ2(1)=7.08, P=.008). Conclusion This proof-of-concept study provides preliminary evidence that self-affirmation can be integrated into existing text-based cessation programs, as the affirmations did not lead to any adverse effects (ie, less engagement or lower rates of cessation). Among those who reported smoking status at the end of the intervention period (6.4% of eligible respondents), affirmations facilitated cessation. This study provides a “proof-of-concept” that brief, low-touch interventions may be integrated into a text messaging program with potential benefits, minimal disruption to the program or users, and little cost. Many questions remain regarding how self-affirmation and similar approaches can promote engagement in population interventions.
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Affiliation(s)
- Jennifer M Taber
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.
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Bradbury D, Upsher R, Chilcot J. A pilot randomised test of a self-affirmation implementation intention intervention to reduce dietary salt intake. J Health Psychol 2016; 23:765-775. [DOI: 10.1177/1359105316650511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Self-affirmation may reduce defensive processing towards health messages. We tested the effects of a self-affirmation implementation intentional intervention with regard to salt risk message acceptance, estimates of daily-recommended intake and self-reported intake. Participants ( n = 65) who consumed over 6 g/day of salt were randomised into three conditions: self-affirmation, self-affirming implementation intention and control. Participants attended the laboratory and completed a 2-week follow-up. There was no effect of the condition on message acceptance, salt estimation and 2-week salt intake. Across conditions, 2-week salt intake was reduced. We found no evidence for either intervention with regard to salt risk message acceptance and behaviour change.
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Affiliation(s)
- Daisy Bradbury
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Rebecca Upsher
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Joseph Chilcot
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
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Turton R, Bruidegom K, Cardi V, Hirsch CR, Treasure J. Novel methods to help develop healthier eating habits for eating and weight disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 61:132-55. [DOI: 10.1016/j.neubiorev.2015.12.008] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 11/12/2015] [Accepted: 12/10/2015] [Indexed: 12/21/2022]
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Cameron D, Epton T, Norman P, Sheeran P, Harris PR, Webb TL, Julious SA, Brennan A, Thomas C, Petroczi A, Naughton D, Shah I. A theory-based online health behaviour intervention for new university students (U@Uni:LifeGuide): results from a repeat randomized controlled trial. Trials 2015; 16:555. [PMID: 26643917 PMCID: PMC4672536 DOI: 10.1186/s13063-015-1092-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/27/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This paper reports the results of a repeat trial assessing the effectiveness of an online theory-based intervention to promote healthy lifestyle behaviours in new university students. The original trial found that the intervention reduced the number of smokers at 6-month follow-up compared with the control condition, but had non-significant effects on the other targeted health behaviours. However, the original trial suffered from low levels of engagement, which the repeat trial sought to rectify. METHODS Three weeks before staring university, all incoming undergraduate students at a large university in the UK were sent an email inviting them to participate in the study. After completing a baseline questionnaire, participants were randomly allocated to intervention or control conditions. The intervention consisted of a self-affirmation manipulation, health messages based on the theory of planned behaviour and implementation intention tasks. Participants were followed-up 1 and 6 months after starting university. The primary outcome measures were portions of fruit and vegetables consumed, physical activity levels, units of alcohol consumed and smoking status at 6-month follow-up. RESULTS The study recruited 2,621 students (intervention n=1346, control n=1275), of whom 1495 completed at least one follow-up (intervention n=696, control n=799). Intention-to-treat analyses indicated that the intervention had a non-significant effect on the primary outcomes, although the effect of the intervention on fruit and vegetable intake was significant in the per-protocol analyses. Secondary analyses revealed that the intervention had significant effects on having smoked at university (self-report) and on a biochemical marker of alcohol use. CONCLUSIONS Despite successfully increasing levels of engagement, the intervention did not have a significant effect on the primary outcome measures. The relatively weak effects of the intervention, found in both the original and repeat trials, may be due to the focus on multiple versus single health behaviours. Future interventions targeting the health behaviour of new university students should therefore focus on single health behaviours. TRIAL REGISTRATION Current Controlled Trials ISRCTN07407344 .
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Affiliation(s)
- David Cameron
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK.
| | - Tracy Epton
- School of Psychological Science, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Paul Norman
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK.
| | - Paschal Sheeran
- Psychology Department, University of North Carolina, 323 Davie Hall, Chapel Hill, NC, 27599-3270, USA.
| | - Peter R Harris
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
| | - Thomas L Webb
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK.
| | - Steven A Julious
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, S1 4DA, UK.
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, S1 4DA, UK.
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, S1 4DA, UK.
| | - Andrea Petroczi
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK.
| | - Declan Naughton
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK.
| | - Iltaf Shah
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK.
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Spinks T, Hamilton K. Investigating key beliefs guiding mothers' dietary decisions for their 2–3 year old. Appetite 2015; 89:167-74. [DOI: 10.1016/j.appet.2015.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/14/2015] [Accepted: 02/02/2015] [Indexed: 12/19/2022]
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Kruger J, Brennan A, Strong M, Thomas C, Norman P, Epton T. The cost-effectiveness of a theory-based online health behaviour intervention for new university students: an economic evaluation. BMC Public Health 2014; 14:1011. [PMID: 25262372 PMCID: PMC4195974 DOI: 10.1186/1471-2458-14-1011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Too many young people engage in unhealthy behaviours such as eating unhealthily, being physically inactive, binge drinking and smoking. This study aimed to estimate the short-term and long-term cost-effectiveness of a theory-based online health behaviour intervention ("U@Uni") in comparison with control in young people starting university. METHODS A costing analysis was conducted to estimate the full cost of U@Uni and the cost of U@Uni roll-out. The short-term cost-effectiveness of U@Uni was estimated using statistical analysis of 6-month cost and health-related quality of life data from the U@Uni randomised controlled trial. An economic modelling analysis combined evidence from the trial with published evidence of the effect of health behaviours on mortality risk and general population data on health behaviours, to estimate the lifetime cost-effectiveness of U@Uni in terms of incremental cost per QALY. Costs and effects were discounted at 1.5% per annum. A full probabilistic sensitivity analysis was conducted to account for uncertainty in model inputs and provide an estimate of the value of information for groups of important parameters. RESULTS To implement U@Uni for the randomised controlled trial was estimated to cost £292 per participant, whereas roll-out to another university was estimated to cost £19.71, both giving a QALY gain of 0.0128 per participant. The short-term (6-month) analysis suggested that U@Uni would not be cost-effective at a willingness-to-pay threshold of £20,000 per QALY (incremental cost per QALY gained = £243,926). When a lifetime horizon was adopted the results suggest that the full implementation of U@Uni is unlikely to be cost-effective, whereas the roll-out of U@Uni to another university is extremely likely to be cost-effective. The value of information analysis suggests that the most important drivers of decision uncertainty are uncertainties in the effect of U@Uni on health behaviours. CONCLUSIONS The study provides the first estimate of the costs and cost-effectiveness of an online health behaviour intervention targeted at new university students. The results suggest that the roll-out, but not the full implementation, of U@Uni would be a cost-effective decision for the UK Department of Health, given a lifetime perspective and a willingness-to pay threshold of £20,000 per QALY. TRIAL REGISTRATION Current Controlled Trials ISRCTN67684181.
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Affiliation(s)
- Jen Kruger
- />School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA United Kingdom
| | - Alan Brennan
- />School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA United Kingdom
| | - Mark Strong
- />School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA United Kingdom
| | - Chloe Thomas
- />School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA United Kingdom
| | - Paul Norman
- />Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP United Kingdom
| | - Tracy Epton
- />Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP United Kingdom
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