Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

How does physical activity improve adolescent resilience? Serial indirect effects via self-efficacy and basic psychological needs

Background

Resilience is vital for improving mental health and well-being during adolescence, which is an important yet vulnerable period. Previous research has indicated that physical activity enhances individual resilience. However, limited studies have examined underlying psychological mechanisms between them. The current study aimed to investigate the effect of physical activity on adolescent resilience via self-efficacy and basic psychological needs.

Methods

A cross-sectional survey was conducted with 1,732 high school students aged 16 to 20 years old (mean age: 16.51 ± 0.77 years), with nearly equal number of boys (47.63%) and girls (52.37%). They each completed the Physical Exercise Questionnaire, Basic Psychological Needs in Exercise Scale, General Self-Efficacy Scale, and Resilience Scale, respectively. A serial indirect model was constructed to examine how physical activity influences resilience.

Results

Structural equation model analysis revealed that physical activity significantly and directly predicted resilience. When self-efficacy and basic psychological needs were included in the model, both direct and indirect effects were observed. Specifically, the positive relationship between physical activity and resilience was partially mediated by self-efficacy and basic psychological needs. In addition, basic psychological needs and self-efficacy were found to serially mediate the direct relathonship between physical activity and resilience.

Conclusions

The present study provides novel theoretical insights into sports psychology by establishing a link between basic psychological needs and self-efficacy. The findings have implications for school administrators and physical education instructors in designing targeted interventions to promote adolescent resilience. These interventions may involve creating supportive environment conductive to fulfilling students' basic psychological needs, implementing strategies to enhance self-efficacy beliefs, and providing opportunities for skill development and mastery experiences in sports and physical activities.

Measurement Invariance and Psychometric Evaluation of the Tendency to Avoid Physical Activity and Sport Scale (TAPAS) Among Mainland Chinese University Students

Introduction

Preventative factors in young people's physical inactivity require further understanding, including related psychosocial factors (eg, body image and weight stigma). The Tendency to Avoid Physical Activity and Sport Scale (TAPAS) is a recently developed instrument to address this issue and the present study examined its psychometric properties among Chinese university students particularly in relation to patterns across sex, physical activity (PA) level, and weight status.

Methods

Using a convenience sample of 3142 students (mean age = 19.8 years; 56% female) in mainland China, data were collected using an online survey between August and October 2022. Psychometric instruments including the Weight Bias Internalization Scale, 21-item Depression, Anxiety and Stress Scale, and International Physical Activity Questionnaire Short Form were administered along with the TAPAS to assess convergent and discriminant validity. Multi-group confirmatory factor analysis (CFA) assessed the measurement invariance across specific groups.

Results

The unidimensional structure of the scale was confirmed through CFA (CFI=0.995; RMSEA=0.046). All configural, metric and scalar models of invariance indicated that the scale was invariant across sex, PA level, and weight status. Acceptable convergent and discriminant validity for the scale were found.

Conclusion

The TAPAS is a suitable instrument to assess body image and weight stigma concerns for avoiding physical activity and sport among Chinese university students.

Managing type 2 diabetes in children and young people: challenges and solutions

Growing numbers of children and young people are diagnosed with type 2 diabetes, partly due to the obesogenic environment they grow up in. The increasing prevalence of type 2 diabetes is seen particularly in adolescent girls and in children and young people of non-white ethnic backgrounds. There are numerous challenges relating to the diagnosis, treatment and management of type 2 diabetes in children and young people, notably the fact that the condition can lead to serious complications and often triggers high levels of anxiety and stress in patients and families. This article outlines the challenges faced by children and young people with type 2 diabetes, their families and carers, and suggests ways in which nurses can support them with the aim of achieving optimal management and self-management.

Goal Orientations of Secondary School Students and Their Intention to Practise Physical Activity in Their Leisure Time: Mediation of Physical Education Importance and Satisfaction

The aim of this study was to analyse the mediating role of Physical Education importance and satisfaction/fun between the dispositional goal orientations of secondary school students and their intention to partake in leisure time physical activity. The research design was descriptive, cross-sectional, and non-randomized. In total, 2102 secondary school students participated (M_age = 14.87; SD = 1.39) (1024 males; 1078 females). The scales used were the Perception of Success Questionnaire, Importance of Physical Education, Satisfaction with Physical Education, and Intention to Participate in Leisure Time Physical Activity. Structural equation models with the latent variables were also calculated. The results highlight that Physical Education satisfaction/fun has a mediating effect between task orientation and the intention to practice physical activity during leisure time.

Temporal associations between physical activity and three types of problematic use of the internet: A six-month longitudinal study

Background and aims

Internet use has become an important part of daily living. However, for a minority it may become problematic. Moreover, problematic use of the Internet/smartphone (PUIS) has been associated with low physical activity. The present study investigated the temporal associations between three types of PUIS (i.e., problematic smartphone use [PSPU], problematic social media use [PSMU] and problematic gaming [PG]) and physical activity among Taiwanese university students.

Methods

A six-month longitudinal survey study comprising three time points for assessments was conducted. From the original 974 participants, a total of 452 completed all three waves of an online survey comprising the International Physical Activity Questionnaire Short Form (IPAQ-SF) assessing physical activity level, Smartphone Application-Based Addiction Scale (SABAS) assessing PSPU, Bergen Social Media Addiction Scale (BSMAS) assessing PSMU, and Internet Gaming Disorder Short Form (IGDS9-SF) assessing PG.

Results

The linear mixed effects model found positive temporal associations of PSMU and PG with physical activity level (PSMU: B = 85.88, SE = 26.24; P = 0.001; PG: B = 36.81, SE = 15.17; P = 0.02). PSPU was not associated with physical activity level (B = 40.54, SE = 22.99; P = 0.08). Additionally, the prevalence rates were 44.4% for at-risk/PSPU, 24.6% for at-risk/PSMU, and 12.3% for at-risk/PG.

Discussion and Conclusions

PSMU and PG unexpectedly demonstrated correlations with higher physical activity level. The nature of these relationships warrants additional investigation into the underlying mechanisms in order to promote healthy lifestyles among university students.

The Muscularity Bias Internalization Scale: Development and initial validation in Chinese adult men

The present study developed the Muscularity Bias Internalization Scale (MBIS), a measure of muscularity bias internalization, which assesses the extent to which an individual endorses muscularity-based stereotypes and engages in negative self-evaluations due to muscularity. In Study 1, a pool of candidate items was developed. By using exploratory factor analysis (EFA) on a sample of 300 Chinese adult men (M_age = 29.98 years, SD = 7.81), 14 items from the item pool were retained. The 14-item MBIS contained three factors. In Study 2, a second sample of 300 Chinese adult men (M_age = 29.50 years, SD = 7.50) was used to confirm the factor structure of the MBIS, as well as to examine its reliability and validity. Confirmatory factor analysis (CFA) further confirmed the three-factor structure of the MBIS with a good model fit. The MBIS showed high internal consistency reliability and high two-week test-retest reliability. The MBIS also showed good construct validity with measures of drive for muscularity, muscularity-oriented disordered eating, and muscle dysmorphia symptoms. The newly developed MBIS may help understand the role of muscularity bias internalization in the development and maintenance of muscularity-oriented body image and muscularity-oriented disordered eating.

Associations of Problematic Internet Use, Weight-Related Self-Stigma, and Nomophobia with Physical Activity: Findings from Mainland China, Taiwan, and Malaysia

Insufficient physical activity is a common problem for university students because they may engage in sedentary lifestyle owing to excessive time spent on their smartphones and social media use. This may result in problematic internet use (PIU) and nomophobia (fear of not having a mobile phone). Moreover, prior evidence shows that weight-related self-stigma is an important factor contributing to low physical activity. Therefore, the present study examined the associations between PIU, nomophobia, and physical activity among university students across mainland China, Taiwan, and Malaysia. Participants (3135 mainland Chinese, 600 Taiwanese, and 622 Malaysian) completed the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), Nomophobia Questionnaire (NMPQ), Weight Self-Stigma Questionnaire (WSSQ), and International Physical Activity Questionnaire Short Form (IPAQ-SF). The measurement invariance of the assessed questionnaires was supported across the three regions. The present findings analyzed using partial least squares structural equation modeling showed that (i) greater nomophobia was associated with higher levels of physical activity, (ii) greater weight-related self-stigma was associated with higher levels of physical activity, and (iii) greater nomophobia was associated with greater weight-related self-stigma. Although the present findings suggest the possibility that experiencing some level of nomophobia or weight-related self-stigma appears to help improve physical activity, it is not recommended that these be encouraged, but reducing PIU should be targeted as a means to improve physical activity.

The relationship between weight bias internalization and healthy and unhealthy weight control behaviours

PURPOSE

Weight bias internalization (WBI) is associated with disordered eating symptomology and motivation to control weight. The relationship between WBI and specific weight control behaviours and how these behaviours differ between men and women is not well understood. The objectives of this study are to determine (1) the relationship between WBI and weight control behaviours, (2) whether weight perception is independently associated with weight control behaviours, and (3) whether these relationships differ between men and women.

METHODS

Canadian adults (N = 161; 52.8% women; body mass index [BMI] = 26.5 ± 4.99 kg/m²) completed questionnaires pertaining to WBI, weight control behaviours (healthy, unhealthy, extreme) and weight perception (accurate, under-, or over-estimation compared with objectively measured BMI). The cross-sectional relationship between (1) WBI or (2) weight perception with the total number of healthy and unhealthy or extreme weight control behaviours, and likelihood of performing specific weight control behaviours were assessed with linear, and logistic regression models, respectively. All analyses were conducted adjusting for age, gender, and race. Subsequent analyses were stratified by sex.

RESULTS

WBI was associated with an increased likelihood of performing exercise for weight loss (OR 2.28, p < 0.05); increased likelihood of skipping meals in women (OR 2.57, p < 0.01), and consuming little amounts of food and food substitutes in men (OR 2.28, p < 0.01 and OR 2.17, p < 0.05, respectively). Weight perception was not associated with weight control behaviours.

CONCLUSIONS

WBI was associated with various weight control behaviours. This study highlights the importance of assessing WBI in clinical practice with patients seeking to manage their weight. Future longitudinal research should be conducted to further understand the behavioural and health effects from WBI.

LEVEL V

Cross-sectional descriptive study.

Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma

Background

Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era.

Methods

University students (N = 3,135; 1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA; mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning; independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0).

Results

Weight-related self-stigma (β = −0.06; p = 0.03), time spent on outdoor activity (β = 0.21; p < 0.001), time spent on social media (β = 0.07; p = 0.02), time spent on online learning (β = 0.06; p = 0.03), and nomophobia (β = −0.07; p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07; p = 0.01), time spent on outdoor activity (β = 0.27; p < 0.001), and time spent on online learning (β = 0.10; p = 0.002) were all significant factors explaining PA among male participants.

Conclusion

Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.

Effects of Weight-Related Self-Stigma and Smartphone Addiction on Female University Students' Physical Activity Levels

Physical inactivity is a common health problem in female college students, and factors such as weight self-stigma and smartphone addiction may negatively impact physical activity in this population. The aim of the current study was to investigate the associations between these variables and identify the moderating effects of smartphone addiction between weight stigma and physical activity. Using a cross-sectional study, information on the level of physical activity in the past week, weight-related self-stigma, and smartphone addiction, as well as demographics, were collected via an online survey from 391 female college students in Taiwan. Participants in two groups of moderate to high and low physical activity were compared using a zero-order bivariate correlation in terms of independent variables. A moderated mediation model using Model 14 in the Hayes’ PROCESS macro with 1000 bootstrapping resamples was applied to assess moderation effects. There were significant differences in terms of weight status, smartphone addiction, and weight stigma between active and inactive groups (p < 0.001). All independent variables except for age were positively correlated (0.14 < r < 0.45). Multivariate regression models indicated that weight status was associated with weight stigma (odds ratio [OR] = 9.13, p < 0.001; 95% CI = 6.90, 11.35). Weight status (OR = 0.47, p = 0.03; 95% CI = 0.23, 0.93), weight stigma (OR = 0.96, p = 0.03; 95% CI = 0.922, 0.997), and smartphone addiction (OR = 0.11, p = 0.003; 95% CI = 0.03, 0.47) were associated with physical activity. The moderating role of smartphone addiction on the association between weight stigma and physical activity was also identified (OR = 1.05, p = 0.049; 95% CI = 1.0001, 1.1004). The moderating effect of smartphone addiction on the association between weight stigma and physical activity suggests that designing interventions to address the negative impacts of both weight stigma and smartphone addiction may help to improve physical activity in female college students.

The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport

Participation in physical activity and sport is on the decline and there is a poor understanding of the psychosocial factors that contribute to people's reluctance to participate. We examined whether there were relationships between factors such as weight stigma, weight bias internalization, appearance evaluation, and fears of negative appearance evaluations, and enjoyment and avoidance of physical activity and sport. Undergraduate students (N = 579) completed a survey assessing demographics, and the variables described above. In hierarchal multivariate regression models, weight stigma (β = -0.16, p < 0.001), appearance evaluation (β = 0.19, p = 0.001), and weight bias internalization (β = -0.19, p = 0.003) were associated with lower enjoyment of physical activity and sport. Weight stigma (β = 0.46, p = 0.001), weight bias internalization (β = 0.42, p = 0.001), and fear of negative appearance evaluations (β = 0.16, p = 0.000) were also significantly associated with the tendency to avoid physical activity and sport. Serial mediation analysis showed the relationship between weight stigma and enjoyment of physical activity and sport was through appearance evaluation and weight bias internalization (indirect effect = -0.007, SE = 0.002, 95% CI = -0.01, -0.02). Similarly, the relationship between weight stigma and avoidance of physical activity and sport was through weight bias internalization and fear of negative appearance evaluations (indirect effect = 0.11, SE = 0.03, 95% CI = 0.05, 0.16). These results suggest that weight stigma and concerns about one's physical appearance influence people's enjoyment and reasoning for avoiding physical activity and sport. Research is needed to identify ways to reduce body-related stigma and increase enjoyment and participation in physical activity and sport.

Establishing the relevance of psychological determinants regarding physical activity in people with overweight and obesity

To identify the most relevant determinants involved in Physical Activity (PA) changes in the EVIDENT 3 study population, measured by the International PA Questionnaire (IPAQ) and the Actigraph GT3X accelerometer.

METHOD

Exploratory study. Data used were collected from EVIDENT 3 study (N = 650). Items to measure psychological determinants were chosen from the baseline questionnaires. PA minutes/week were assessed by an accelerometer and IPAQ. The sample was analyzed by the control group (CG), the intervention group (IG) and Body Mass Index, using Confidence Interval-Based Estimation of Relevance (CIBER) analyses.

RESULTS

486 participants, (IG: n = 251, CG: n = 235) were included. IG shows a positive association between PA assessed by accelerometer and self-efficacy. In IG, the overweight sample shows a positive association between PA assessed by accelerometer and motivation and self-efficacy. PA assessed by accelerometer obtained a higher explained variance (R2 ) in IG, both people with overweight (.10 - .55) and obesity (.03 - .19). In CG, IPAQ reached better results in people with overweight (.12 - .49).

CONCLUSIONS

Motivation and self-efficacy showed as relevant in increasing PA minutes/week, but only in the people with overweight in IG. There might be other factors not analyzed that could improve the low R2 obtained.

Prevalence of food addiction in children and adolescents: A systematic review and meta-analysis

Food addiction (FA) has been as a construct that is associated with childhood obesity. However, relatively little is known regarding the prevalence of FA among children and adolescents. An instrument designed to assess FA among youth, the Yale Food Addiction Scale for Children and Adolescents (YFAS-C), has been developed and used to estimate FA prevalence among pediatric populations. The present systematic review and meta-analysis aimed to synthesize the results of FA prevalence among youth. Using keywords related to FA and children to search PubMed, Embase, Scopus, and Web of Science, we identified and analyzed 22 cross-sectional studies. No longitudinal studies were identified in the search. Meta-analysis with Freeman-Tukey Double Arcsine transformation was conducted to estimate FA prevalence. Meta-regression was applied to understand whether weight status (i.e., data from community samples vs. overweight/obese samples) is associated with FA. Eligible studies (N = 22) were analyzed using 6,996 participants. The estimated FA prevalence was 15% (95% CI 11-19%) for all samples, 12% (95% CI 8-17%) for community samples, and 19% (95% CI 14-26%) for overweight/obese samples. Meta-regression indicated that weight status was associated with FA severity (p = 0.002) and marginally with FA prevalence (p = 0.056). Healthcare providers should consider and address the high FA prevalence among pediatric population.

A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19

INTRODUCTION

Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep.

METHODS

Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables.

RESULTS

Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life.

CONCLUSION

Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.

Can We Apply WHOQOL-AGE to Asian Population? Verifying Its Factor Structure and Psychometric Properties in a Convenience Sample From Taiwan

Objectives: To translate and validate a recently developed quality of life instrument (WHOQOL-AGE) on geriatric population into Chinese.

Method: Using cross-sectional observational design, the WHOQOL-AGE was conducted among older people through interview. Confirmatory factor analysis (CFA) was used to examine the factor structure and multigroup CFA used to examine the measurement invariance.

Results: Through convenience sampling, 522 older adults (mean age = 73.42) participated in the study. Among them, 194 were males, 213 had an educational level at primary school or below, 398 were residing in the community, and 307 were aged 70 years or above. A bifactor structure (items Q1–Q8 are embedded in the factor 1; items Q9–Q13 embedded in the factor 2; and all the items embedded in an additional construct of QoL) was confirmed by the CFA in both the entire sample (χ² = 25.4; df = 51; p = 0.999) and the subgroup sample with age 70 years or above (χ² = 25.28; df = 51; p = 1.000). Multigroup CFAs results supported the measurement invariance for the WHOQOL-AGE across genders, having different educational levels, living in different settings and age groups. It also shows good known-groups validity.

Conclusions: The promising psychometric properties of the WHOQOL-AGE were found in our convenience sample of older Taiwanese. The supported measurement invariance indicates that the older people in different conditions of gender, educational level, and living setting interpret the WHOQOL-AGE similarly. However, our results should be interpreted with cautious because of the sample representativeness.

Measurement invariance and psychometric properties of Perceived Stigma toward People who use Substances (PSPS) among three types of substance use disorders: Heroin, amphetamine, and alcohol

BACKGROUND

The 8-item self-report Perceived Stigma toward Substance Users Scale (PSAS) is a commonly used instrument to assess stigma for people with substance use disorders. This study aimed to develop and validate the Taiwan version of the PSAS entitled Perceived Stigma toward People who use Substances - Taiwan version (PSPS-TV) among individuals with substance use disorders.

METHODS

Patients with substance use disorders (N = 300; mean age = 45.22; 255 males) completed the PSPS-TV, Self-Stigma Scale-Short (SSS-S), Taiwan Depression Questionnaire (TDQ), and Rosenberg Self-Esteem Scale (RSES). Confirmatory factor analysis was used to test the construct validity and the measurement invariance of the PSPS-TV. Concurrent validity was tested using the correlations between PSPS-TV and SSS-S, TDQ, and RSES scores.

RESULTS

The confirmatory factor analysis supported the construct validity and measurement invariance of the PSPS-TV. SSS-S scores explained 13 %, TDQ scores explained 10 % and RSES scores explained 17 % of the PSPS-TV score variance with moderate standardized coefficients (0.38, 0.32 and -0.42, respectively; all p < 0.001).

CONCLUSIONS

The PSPS-TV is an appropriate instrument to assess perceived stigma for individuals residing in Taiwan who have substance use disorders. Taiwan healthcare providers may thus consider using the PSPS-TV to assess perceived stigma relating to substance use in Taiwan.

Stigma, Health and Well-Being

In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of 24 papers were published and included in the Special Issue. These papers were contributed from different continents and countries, including the Americas (e.g., United States), Europe (e.g., Finland), and Asia (e.g., Saudi Arabia). Therefore, the diversity of ethnicity was ensured in the Special Issue. Moreover, these papers address different stigmatized populations/conditions (e.g., mental illness, obesity, public housing, homosexuality, and transgender). The most discussed populations were those with mental illness and those with obesity/overweight. However, additional evidence on the stigma topic is still needed. Specifically, future studies could consider the following directions to explore in depth the issues of stigma in different populations: (1) using longitudinal designs to understand the temporal or causal relationship between stigma and other related psychosocial factors; (2) designing treatment programs to fight stigma-this could be carried out in healthcare providers, healthcare trainees, the public, caregivers, and the stigmatized populations.

Using an integrated social cognition model to predict COVID-19 preventive behaviours

Objectives

Rates of novel coronavirus disease 2019 (COVID‐19) infections have rapidly increased worldwide and reached pandemic proportions. A suite of preventive behaviours have been recommended to minimize risk of COVID‐19 infection in the general population. The present study utilized an integrated social cognition model to explain COVID‐19 preventive behaviours in a sample from the Iranian general population.

Design

The study adopted a three‐wave prospective correlational design.

Methods

Members of the general public (N = 1,718, M_age = 33.34, SD = 15.77, male = 796, female = 922) agreed to participate in the study. Participants completed self‐report measures of demographic characteristics, intention, attitude, subjective norm, perceived behavioural control, and action self‐efficacy at an initial data collection occasion. One week later, participants completed self‐report measures of maintenance self‐efficacy, action planning and coping planning, and, a further week later, measures of COVID‐19 preventive behaviours. Hypothesized relationships among social cognition constructs and COVID‐19 preventive behaviours according to the proposed integrated model were estimated using structural equation modelling.

Results

The proposed model fitted the data well according to multiple goodness‐of‐fit criteria. All proposed relationships among model constructs were statistically significant. The social cognition constructs with the largest effects on COVID‐19 preventive behaviours were coping planning (β = .575, p < .001) and action planning (β = .267, p < .001).

Conclusions

Current findings may inform the development of behavioural interventions in health care contexts by identifying intervention targets. In particular, findings suggest targeting change in coping planning and action planning may be most effective in promoting participation in COVID‐19 preventive behaviours.

The theory of planned behavior as a behavior change model for tobacco control strategies among adolescents in Botswana

Background

Behavioral intentions (motivational factors), attitudes, subjective norm (social pressures), and perceived behavioral control promote or discourage smoking behavior among adolescents.

Objective

To assess students’ behavioral intentions, attitudes, subjective norms and perceived behavioral control on smoking using the Theory of Planned Behavior. The prevalence of smoking among the adolescents is also calculated.

Methods

In this cross-sectional study, structured self-administered questionnaires were used to collect data from adolescents in primary and secondary schools. Data on demographics, behavioral intentions, attitudes, subjective norms, and perceived behavioral control towards smoking were collected. Pearson product moment correlations and logistic regression models were used to determine factors associated with current smoking.

Results

A total sample of 2554 (mean age = 15; Range = 12–18 years) students participated in the study. Twenty-nine percent (n = 728) of the students had tried smoking at least once. Smoking was predicted by attitudes, subjective norms, perceived behavioral control and intention.There was a strong association between having a parent or guardian, caregiver or close friend who smoked (p < 0.001) and being a smoker. The majority of students (57%) conveyed that adults talked to them about the harmful effects of cigarette smoking and 50% had discussed smoking concerns with their friends. Students who had positive attitudes towards smoking like “smoking makes you confident” were more likely to be current smokers (OR: 1.63, 95% CI: 1.03–2.59). The feeling or conviction that they could refuse a cigarette if offered was an impediment from smoking (OR: 0.18, 95% CI: 0.13–0.26).

Conclusions

Attitudes, subjective norms, and perceived behavioral control contributed significantly to the students' smoking. Right attitudes must be cultivated and behavioral control must be strengthened for early effective interventions to curtail smoking among adolescents.

Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience

PURPOSE

The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose a model with two paths: the first through social identification and collective action and the second via resilience.

METHOD

A total of 288 Spanish people with physical disability aged between 18 and 82 years (46.4% males; mean [SD] of age = 45.1 [12.3] responded to the questionnaire. Data were collected for three months through an online survey.

RESULTS

The tested model adequately fit the data. We found that the relationship between internalized stigma and the psychological quality of life of people with physical disability was mediated by resilience. However, neither social identification nor collective action mediated the association between internalized stigma and quality of life among our participants.

CONCLUSIONS

The results confirmed the negative association between internalized stigma and quality of life in the population with physical disability. The results show that some interactive processes, such as resilience, may contribute to decreasing the negative effects of internalized stigma. In contrast, no effects of identification with the group or collective action intention were found.

Mismatches in Suppliers' and Demanders' Cognition, Willingness and Behavior with Respect to Ecological Protection of Cultivated Land: Evidence from Caidian District, Wuhan, China

Cultivated land systems have an enormous ecological function value with respect to water conversation, nutrient circulation and climate regulation. The people's cognition, willingness and behavior may prove to be pivotal in ecologically protecting cultivated land. The purpose of this paper is to explore suppliers' and demanders' cognition, willingness and behavior with respect to the ecological protection of cultivated land. The second-order structural equation model was employed, and a five-point Likert scale was designed. Based on data obtained from a questionnaire surveyed on a sample of 460 (farming and no-farming households) from Caidian district, Wuhan, China, the results show that within/between suppliers and demanders, there are mismatches in willingness as well as behavior to ecologically protect cultivated land. In the suppliers group and in the demanders group, there are mismatches with respect to the interactive mechanism of cognition, willingness and behavior in the ecological protection of cultivated land. Three factors, subjective norms, attitude toward behavior, and perceived behavior control, affect willingness and behavior with respect to protection differently between the suppliers and the demanders. The "intermediary" effects of willingness and behavior in the ecological protection of cultivated land only appear in the demanders model, and are not significant in the suppliers model. In addition, another finding was that farmers' behavior as suppliers and demanders of ecological protection of cultivated land were mismatched. The article contributes firstly to exploring the ecological protection of cultivated land from the perspective of suppliers' and demanders' subjective psychology. Farmers with "dual roles" as suppliers and demanders should pay more attention to the ecological protection of cultivated land. Their cognition and skills in the ecological protection of cultivated land are in need of improvement. It is also necessary to bridge the gap between suppliers and demanders; access to the knowledge of the ecological value of cultivated land will incentivize their behavior with respect to the ecological protection of cultivated land.