1
|
Cameron DB, Grage L, Van Wyck R, Edwards A, Chavez Mapaye J, Cheng A, Garcia G. Identifying trusted local sources and predicting behavior change pathways according to COVID-19 vaccination status: Results of a 2022 statewide survey of Alaskan adults. Vaccine 2024; 42:2592-2607. [PMID: 38490821 PMCID: PMC11005074 DOI: 10.1016/j.vaccine.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs. METHODS We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status. FINDINGS Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice. CONCLUSIONS These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.
Collapse
Affiliation(s)
- Drew B Cameron
- Department of Health Policy and Management, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States.
| | - Laura Grage
- Information Insights, PO Box 83070, Fairbanks, AK 99708, United States.
| | - Rebecca Van Wyck
- DPHS Institute for Circumpolar Health Sciences, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Alexandra Edwards
- Institute for Social and Economic Research, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States; Center for Behavioral Health Research & Services, University of Alaska, Anchorage, 3211 Providence Dr., Anchorage, AK 99508, United States.
| | - Joy Chavez Mapaye
- Department of Journalism and Public Communications, Fine Arts Building, 3211 Providence Drive, Anchorage, AK 99508, United States.
| | - Ann Cheng
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06502, United States; L&M Policy Research, 1743 Connecticut Ave NW, Suite 200, Washington, DC 20009, United States.
| | - Gabriel Garcia
- Division of Population Health Sciences, University of Alaska, 3211 Providence Dr., PSB 206J, Anchorage, AK 99508, United States.
| |
Collapse
|
2
|
Douma ER, Kop WJ, Kupper N. Associations Between Psychological Factors and Adherence to Health Behaviors After Percutaneous Coronary Intervention: The Role of Cardiac Rehabilitation. Ann Behav Med 2024; 58:328-340. [PMID: 38431284 PMCID: PMC11008588 DOI: 10.1093/abm/kaae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) participation after percutaneous coronary intervention (PCI) for coronary heart disease lowers the disease burden and risk of recurrent cardiac events. Examining psychological factors may improve post-PCI health behavior adherence. PURPOSE To determine whether psychological factors are associated with post-PCI health behavior adherence, and the role of CR participation. METHODS Data from 1,682 patients (22.1% female, Mage = 64.0, SDage = 10.5 years) from the THORESCI cohort were included. Adjusted mixed models were used to examine associations between psychological factors and the 1-year course of health behaviors, using interactions to test for moderation by CR participation. RESULTS Psychological factors were associated with the trajectories of adherence to medical advice, exercise, and diet. The strongest association found was between optimism and the trajectory of dietary adherence (B: = -0.09, p = .026). Patients with high optimism levels had a worse trajectory of dietary adherence compared to patients with low to middle optimism levels. Participation in CR buffered the associations of high anxiety, pessimism, and low to middle resilience, but strengthened the associations of high stress in the past year with the probability of smoking. CONCLUSIONS Psychological factors are associated with post-PCI health behavior adherence, but the pattern of associations is complex. Patients with high levels of anxiety, pessimism, and low to middle resilience levels may disproportionately benefit from CR. Cardiac rehabilitation programs could consider this to improve post-PCI health behavior adherence. CLINICAL TRIALS REGISTRATION # NCT02621216.
Collapse
Affiliation(s)
- Emma R Douma
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Willem J Kop
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Nina Kupper
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
3
|
Zimmermann M, Greenberg L, Breland JY. Engagement and Use of a Blended mHealth Intervention for Health Behavior Change. Int J Behav Med 2024; 31:284-291. [PMID: 37217635 DOI: 10.1007/s12529-023-10182-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Blended mHealth interventions (mHealth interventions including a facilitator) promote user engagement and increase effectiveness of health behavior change interventions. Little is known about how blended mHealth interventions are used outside the research context. METHODS In the present work, we characterized patterns of app use among users of a blended mHealth intervention in real-world conditions. Program users were Veterans Health Administration (VHA) primary care patients (n = 56) who received an invite code for a blended mHealth intervention between 2019 and 2021. Cluster analysis was used to examine user engagement with health coach visits and program features. RESULTS Of patients who received an invite code, 34% initiated the program. Most users were men (63%) and white (57%). The mean number of health conditions was 5 (68% with obesity). The mean age was 55. Cluster analysis suggested that most users did sustain engagement at either moderate (57%) or very high levels (13%). The remaining 30% of users were low engaged users. Users completing any health coach visit (about half) reported more overall engagement than their counterparts who did not. Weight was the most frequently tracked metric. Of users entering weights in the first and last month of the program (n = 18), the mean percent body weight change was 4.0% (SD = 3.6). CONCLUSIONS A blended mHealth intervention may be a scalable option to extend the reach of health behavior change interventions for those that use it. However, a significant portion of users do not initiate these interventions, choose not to use the health coach feature, or engage at lower levels. Future research should examine the role of health coaching visits in promoting sustained engagement.
Collapse
Affiliation(s)
- Martha Zimmermann
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA.
- Department of Psychiatry, UMass Chan Medical School, 222 Maple Ave, Shrewsbury, MA, 01545, USA.
| | - Lauren Greenberg
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
| | - Jessica Y Breland
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
| |
Collapse
|
4
|
Douma ER, Wirtz S, Fernandez MS, Schäfer H, Widdershoven JW, Habibović M, Gil CP, Bosch JA, Schmitz B, Kop WJ. Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators. Internet Interv 2024; 35:100728. [PMID: 38405384 PMCID: PMC10883827 DOI: 10.1016/j.invent.2024.100728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
Background Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR to patient preferences is needed to further enhance CR. Purpose To identify preferred behavior change techniques (BCTs) as well as barriers and facilitators for the different health behaviors targeted in eHealth-based CR among patients who have been referred to CR. Methods Thirty-nine patients were interviewed in nine focus groups in The Netherlands, Germany, and Spain. A thematic analysis, using a combined deductive and inductive approach to coding, was conducted to identify BCTs and barriers and facilitators to behavior change. Behaviors under investigation included physical activity, medication adherence, eating a cardiac healthy-diet, stress reduction and smoking cessation. Results The perceived helpfulness of BCTs depended on the specific behavior targeted. Common barriers were negative emotional state and physical limitations. A desire to feel physically or mentally well and having experienced a cardiac life event were the most common facilitators across health behaviors. Specific BCTs, barriers and facilitators were found for each of the health behavior. Conclusions Behavior change techniques that patients preferred for each health behavior targeted in eHealth-based CR were identified. A negative emotional state, experiencing a life event, and improving physical functioning are important barriers and facilitators in multiple behaviors targeted in eHealth-based CR programs. Additional tailoring of interventions to patient preferences for BCTs and patient-specific barriers and facilitators per health behavior could lead to further improvement of eHealth-based CR.
Collapse
Affiliation(s)
- Emma R. Douma
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands
| | - Svenja Wirtz
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Manuela Sestayo Fernandez
- Hospital Universitario de Santiago de Compostela, Servizo Galego De Saude, Santiago de Compostela, Spain
| | - Hendrik Schäfer
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Jos W.M.G. Widdershoven
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands
- Elisabeth-TweeSteden Hospital, Department of Cardiology, Tilburg, the Netherlands
| | - Mirela Habibović
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands
| | - Carlos Peña Gil
- Hospital Universitario de Santiago de Compostela, Servizo Galego De Saude, Santiago de Compostela, Spain
| | - Jos A. Bosch
- University of Amsterdam, Faculty of Social and Behavioral Sciences, Amsterdam, the Netherlands
| | - Boris Schmitz
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Willem J. Kop
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands
| |
Collapse
|
5
|
Porath J, Schmidt LI, Möckel J, Dold C, Hennerkes L, Haussmann A. What it takes to reduce sitting at work: a pilot study on the effectiveness and correlates of a multicomponent intervention. Int Arch Occup Environ Health 2024; 97:9-21. [PMID: 37950069 DOI: 10.1007/s00420-023-02020-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/14/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This study aimed to assess the feasibility and effects of a simple-to-implement multicomponent intervention to reduce sedentary time of office workers. METHODS Six groups of eight to ten office workers took part in the two-week Leicht Bewegt intervention. Participants completed questionnaires at baseline (T0, n = 52), after 2 weeks (T1, n = 46), and after 5 weeks (T2, n = 38), including subjective sedentary measures and social-cognitive variables based on the health action process approach (HAPA). Objective sedentary measures were obtained using activPAL trackers. RESULTS The intention to reduce sedentary behavior during work increased significantly from T0 to T1. Participants' objective and subjective sitting time decreased significantly from T0 to T1, corresponding to an average decrease per 8-h-workday of 55 min (d = - .66) or 74 min (d = - 1.14), respectively. This reduction persisted (for subjective sitting time) at T2 (d = - 1.08). Participants indicated a high satisfaction with the intervention. CONCLUSIONS The Leicht Bewegt intervention offers a feasible and effective opportunity to reduce sedentary behavior at work. Randomized controlled trials including longer follow-up time periods are needed to validate its benefits in different workplaces.
Collapse
Affiliation(s)
- Jannik Porath
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Laura I Schmidt
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Juliane Möckel
- Department for Prevention and Health Promotion, Heidelberg University of Education, Heidelberg, Germany
| | - Chiara Dold
- Department for Prevention and Health Promotion, Heidelberg University of Education, Heidelberg, Germany
| | - Lisa Hennerkes
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Alexander Haussmann
- Institute of Psychology, Heidelberg University, Heidelberg, Germany.
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DFKZ), Heidelberg, Germany.
| |
Collapse
|
6
|
Nyman SJ, Vogel ME, Heller GM, Hella JR, Illes RA, Kirkpatrick HA. Development and Evaluation of a Health Behavior Change Clinic in Primary Care: An Interdisciplinary Partnership. J Clin Psychol Med Settings 2023; 30:909-923. [PMID: 36869987 PMCID: PMC9985097 DOI: 10.1007/s10880-023-09945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/05/2023]
Abstract
Providing effective healthy behavior change interventions within primary care presents numerous challenges. Obesity, tobacco use, and sedentary lifestyle negatively impact the health quality of numerous medical patients, particularly in underserved patient populations with limited resources. Primary Care Behavioral Health (PCBH) models, which incorporate a Behavioral Health Consultant (BHC), can offer point-of-contact psychological consultation, treatment, and also provide opportunities for interdisciplinary psychologist-physician clinical partnerships to pair a BHC's health behavior change expertise with the physician's medical care. Such models can also enhance medical training programs by providing resident physicians with live, case-based learning opportunities when partnered with a BHC to address patient health behaviors. We will describe the development, implementation, and preliminary outcomes of a PCBH psychologist-physician interdisciplinary health behavior change clinic within a Family Medicine residency program. Patient outcomes revealed significant reductions (p < .01) in weight, BMI, and tobacco use. Implications and future directions are discussed.
Collapse
Affiliation(s)
- Scott J. Nyman
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
- Department of Psychology, Ascension Genesys Family Health Center, 1460 N. Center Rd, Burton, MI 48509 USA
| | - Mark E. Vogel
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
| | - Grant M. Heller
- Spectrum Health Lakeland, Saint Joseph, MI USA
- Department of Psychiatry, Michigan State University College of Osteopathic Medicine, Lansing, MI USA
| | - Jennifer R. Hella
- Department of Research, Ascension Genesys Hospital, Grand Blanc, MI USA
| | - Rose A. Illes
- Florida State University Family Medicine Residency Program at Lee Health, Fort Myers, FL USA
| | - Heather A. Kirkpatrick
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
| |
Collapse
|
7
|
Abstract
Achieving maximal health outcomes via health promotion and disease prevention requires the adoption of healthy behaviors. Brief action planning (BAP) is a method for patient self-management, health behavior change, and health coaching with potentially broad implications for and clinical applications in health and health care contexts. This scoping review presents 5 major findings about the literature on BAP: the principal geographic locations and the clinical contexts of its application, the types of research evaluations that it has undergone to date, the theoretic frameworks in which it is grounded, and the fidelity of its use in clinical practice.
Collapse
Affiliation(s)
- Yuri Jadotte
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Northeast Institute for Evidence Synthesis and Translation, Division of Nursing Science, School of Nursing, Rutgers University, Newark NJ, USA.
| | - Benjamin Buchholz
- Sickle Cell Center of Excellence, College of Medicine, Howard University, Washington, DC, USA
| | - William Carroll
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles CA, USA
| | - Deirdra Frum-Vassallo
- Health Promotion Disease Prevention, Northport VA Medical Center, Northport, NY, USA
| | | | - Steven Cole
- BAP Professional Network, US; Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Scientific Education, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker SOM at Hofstra/Northwell, Hempstead, NY, USA
| |
Collapse
|
8
|
Williams KN, Quinn A, North H, Wang J, Pillarisetti A, Thompson LM, Díaz-Artiga A, Balakrishnan K, Thangavel G, Rosa G, Ndagijimana F, Underhill LJ, Kirby MA, Puzzolo E, Hossen S, Waller LA, Peel JL, Rosenthal JP, Clasen TF, Harvey SA, Checkley W. Fidelity and adherence to a liquefied petroleum gas stove and fuel intervention: The multi-country Household Air Pollution Intervention Network (HAPIN) trial. Environ Int 2023; 179:108160. [PMID: 37660633 PMCID: PMC10512198 DOI: 10.1016/j.envint.2023.108160] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/24/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Reducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels. METHODS The Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n = 1,590), with controls expected to continue cooking with biomass fuels (n = 1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant's first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs). RESULTS Fidelity and adherence to the HAPIN intervention were high. Median time required to refill LPG cylinders was 1 day (interquartile range 0-2). Although 26% (n = 410) of intervention participants reported running out of LPG at some point, the number of times was low (median: 1 day [Q1, Q3: 1, 2]) and mostly limited to the first four months of the COVID-19 pandemic. Most repairs were completed on the same day as problems were reported. Traditional stove use was observed in only 3% of observation visits, and 89% of these observations were followed up with behavioral reinforcement. According to SUMs data, intervention households used their traditional stove a median of 0.4% of all monitored days, and 81% used the traditional stove < 1 day per month. Traditional stove use was slightly higher post-COVID-19 (detected on a median [Q1, Q3] of 0.0% [0.0%, 3.4%] of days) than pre-COVID-19 (0.0% [0.0%, 1.6%] of days). There was no significant difference in intervention adherence pre- and post-birth. CONCLUSION Free stoves and an unlimited supply of LPG fuel delivered to participating homes combined with timely repairs, behavioral messaging, and comprehensive stove use monitoring contributed to high intervention fidelity and near-exclusive LPG use within the HAPIN trial.
Collapse
Affiliation(s)
- Kendra N Williams
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Hayley North
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Jiantong Wang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ajay Pillarisetti
- Division of Environmental Health Sciences, University of California at Berkeley, Berkeley, CA, USA
| | - Lisa M Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Anaité Díaz-Artiga
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Kalpana Balakrishnan
- ICMR Center for Advanced Research on Air Quality, Climate and Health, Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Gurusamy Thangavel
- ICMR Center for Advanced Research on Air Quality, Climate and Health, Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Ghislaine Rosa
- Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | | | - Lindsay J Underhill
- Cardiovascular Division, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, MO, USA
| | - Miles A Kirby
- Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, MA, USA
| | - Elisa Puzzolo
- Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Shakir Hossen
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Joshua P Rosenthal
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Steven A Harvey
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| |
Collapse
|
9
|
Materia FT, Smyth JM, Puoane T, Tsolekile L, Goggin K, Kodish SR, Fox AT, Resnicow K, Werntz S, Catley D. Implementing text-messaging to support and enhance delivery of health behavior change interventions in low- to middle-income countries: case study of the Lifestyle Africa intervention. BMC Public Health 2023; 23:1526. [PMID: 37563595 PMCID: PMC10416414 DOI: 10.1186/s12889-023-16388-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
The prevalence of non-communicable diseases, such as diabetes and cardiovascular disease, is rising in low- and middle-income countries (LMICs). Health behavior change (HBC) interventions such as the widely used Diabetes Prevention Program (DPP) are effective at reducing chronic disease risk, but have not been adapted for LMICs. Leveraging mobile health (mHealth) technology such as text messaging (SMS) to enhance reach and participant engagement with these interventions has great promise, yet we lack evidence-informed approaches to guide the integration of SMS specifically to support HBC interventions in LMIC contexts. To address this gap, we integrated guidance from the mHealth literature with expertise and first-hand experience to establish specific development steps for building and implementing SMS systems to support HBC programming in LMICs. Specifically, we provide real-world examples of each development step by describing our experience in designing and delivering an SMS system to support a culturally-adapted DPP designed for delivery in South Africa. We outline eight key SMS development steps, including: 1) determining if SMS is appropriate; 2) developing system architecture and programming; 3) developing theory-based messages; 4) developing SMS technology; 5) addressing international SMS delivery; 6) testing; 7) system training and technical support; and 8) cost considerations. We discuss lessons learned and extractable principles that may be of use to other mHealth and HBC researchers working in similar LMIC contexts.Trial registration Clinicaltrials.gov, NCT03342274 . Registered 10 November 2017.
Collapse
Affiliation(s)
- Frank T Materia
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
| | - Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Lungiswa Tsolekile
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
- School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
- School of Pharmacy, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Stephen R Kodish
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Andrew T Fox
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Delwyn Catley
- School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| |
Collapse
|
10
|
Parmet T, Yusufov M, Braun IM, Pirl WF, Matlock DD, Sannes TS. Willingness toward psychosocial support during cancer treatment: a critical yet challenging construct in psychosocial care. Transl Behav Med 2023; 13:511-517. [PMID: 36940406 PMCID: PMC10465092 DOI: 10.1093/tbm/ibac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Psychosocial distress screening, mandated by the American College Surgeons' Commission on Cancer, continues to be implemented across cancer centers nationwide. Although measuring distress is critical to identifying patients who may benefit from additional support, several studies suggest that distress screening may not actually increase patients' utilization of psychosocial services. While various investigators have identified barriers that may impede effective implementation of distress screening, we posit that patients' intrinsic motivation, which we term patients' willingness, may be the biggest predictor for whether cancer patients choose to engage with psychosocial services. In this commentary, we define patient willingness towards psychosocial services as a novel construct, distinct from the intention toward a certain behavior described across pre-existing models of health behavior change. Further, we offer a critical perspective of models of intervention design that focus on acceptability and feasibility as preliminary outcomes thought to encompass the willingness construct described herein. Finally, we summarize several health service models that successfully integrate psychosocial services alongside routine oncology care. Overall, we present an innovative model that acknowledges barriers and facilitators and underscores the critical role of willingness in health behavior change. Consideration of patients' willingness toward psychosocial care will move the field of psychosocial oncology forward in clinical practice, policy initiatives, and study design.
Collapse
Affiliation(s)
- Tamar Parmet
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Miryam Yusufov
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Ilana M Braun
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - William F Pirl
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
| | - Daniel D Matlock
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Veteran Affairs (VA) Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Timothy S Sannes
- Harvard Medical School, Boston, MA, 02215, USA
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, 02215, USA
- University of Massachusetts Medical School/UMass Memorial Hospital, Worcester, MA, USA
| |
Collapse
|
11
|
McMahon SK, Macheledt K, Choma EA, Lewis BA, Guan W, Wyman JF, Rothman AJ. Rethinking how and when to report descriptions of behavior change content within interventions: a case study of an ongoing physical activity trial (ready steady 3.0). Transl Behav Med 2023; 13:368-379. [PMID: 36757385 PMCID: PMC10255763 DOI: 10.1093/tbm/ibac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Specifications of what and how much health behavior change (BC) content within research interventions are needed to advance BC science, its implementation, and dissemination. We analyzed the types and dosages of the smallest potentially active BC ingredients and associated behavioral prescriptions intended to be delivered in an ongoing physical activity optimization trial for older adults (Ready Steady 3.0 [RS3]). We defined BC types as behavior change techniques (BCT) and behavioral prescriptions. Our protocol integrated the BCT Taxonomy coding procedures with BCT roles (primary or secondary) and, when relevant, linkages to behavioral prescriptions. Primary BCTs targeted theoretical mechanisms of action, whereas secondary BCTs supported primary BCT delivery. Behavioral prescriptions represented what participants were encouraged to do with each primary BCT in RS3 (ascertain, practice, implement). We assessed dosage parameters of duration, frequency, and amount in each BCT and prescription. Results provided a catalog of in-depth, multidimensional content specifications with 12 primary BCTs, each supported by 2-7 secondary BCTs, with dosages ranging from 2 to 8 weeks, 1 to 8 contacts, and 5 to 451 minutes. Minutes spent on behavioral prescriptions varied: ascertain (1 to 41), practice (5 to 315), and implement (0 to 38). Results can be organized and summarized in varied ways (e.g., by content component) to strengthen future assessments of RS3 fidelity and intervention refinement. Results highlight potential benefits of this early, integrated approach to analyzing BC content and frames questions about how such information might be incorporated and disseminated with reporting research outcomes.
Collapse
Affiliation(s)
| | - Kait Macheledt
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Elizabeth A Choma
- DPT Doctor of Physical Therapy Program, Whitworth University, Spokane, WA, USA
| | | | - Weihua Guan
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
12
|
Simonsen SE, Sunada GR, Digre K, Stark LA, Mukundente V, Napia E, Tavake-Pasi F, Villalta J, Lee D, Davis F, Sanchez-Birkhead A, Brown BH, Baron KG. Short sleep duration and interest in sleep improvement in a multi-ethnic cohort of diverse women participating in a community-based wellness intervention: an unmet need for improvement. BMC Womens Health 2023; 23:188. [PMID: 37081433 PMCID: PMC10120218 DOI: 10.1186/s12905-023-02341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Disparities in sleep duration are a modifiable contributor to increased risk for cardiometabolic disorders in communities of color. We examined the prevalence of short sleep duration and interest in improving sleep among a multi-ethnic sample of women participating in a culturally tailored wellness coaching program and discussed steps to engage communities in sleep health interventions. METHODS Secondary analysis of data from a randomized trial were used. The wellness coaching trial utilized a Community-Based Participatory Research (CBPR) approach. Data were from the baseline survey and baseline wellness coaching notes. Short sleep duration was defined as < 7 h of self-reported sleep. Participants were prompted to set a goal related to healthy eating/physical activity and had the opportunity to set another goal on any topic of interest. Those who set a goal related to improving sleep or who discussed a desire to improve sleep during coaching were classified as having an interest in sleep improvement. Analyses utilized multivariable models to evaluate factors contributing to short sleep and interest in sleep improvement. We present our process of discussing results with community leaders and health workers. RESULTS A total of 485 women of color participated in the study. Among these, 199 (41%) reported short sleep duration. In adjusted models, Blacks/African Americans and Native Hawaiians/Pacific Islanders had higher odds of reporting < 7 h of sleep than Hispanics/Latinas. Depression symptoms and self-reported stress management scores were significantly associated with short sleep duration. Interest in sleep improvement was noted in the wellness coaching notes of 52 women (10.7%); sleep was the most common focus of goals not related to healthy eating/physical activity. African Immigrants/Refugees and African Americans were less likely to report interest in sleep improvement. Community leaders and health workers reported lack of awareness of the role of sleep in health and discussed challenges to obtaining adequate sleep in their communities. CONCLUSION Despite the high prevalence of short sleep duration, interest in sleep improvement was generally low. This study highlights a discrepancy between need and interest, and our process of community engagement, which can inform intervention development for addressing sleep duration among diverse women.
Collapse
Affiliation(s)
- Sara E Simonsen
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA.
| | - Grant R Sunada
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
| | - Kathleen Digre
- Departments of Neurology, Ophthalmology, and Obstetrics and Gynecology, University of Utah, 175 N Medical Dr E Rm 5001, Salt Lake City, UT, 84132, USA
| | - Louisa A Stark
- University of Utah Genetic Science Learning Ctr, 515 E 100 S Rm 300, Salt Lake City, Utah, 84112, USA
| | | | - Ed Napia
- Urban Indian Center of Salt Lake, 120 West 1300 South, Salt Lake City, Utah, 84115, USA
| | - Fahina Tavake-Pasi
- National Tongan American Society, 3007 South West Temple #H, Salt Lake City, Utah, 84115, USA
| | - Jeannette Villalta
- Hispanic Health Care Task Force, 5280 Commerce Dr. Suite E140, Murray, Utah, 84107, USA
| | - Doriena Lee
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - France Davis
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - Ana Sanchez-Birkhead
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA
| | - B Heather Brown
- University of Utah Center for Clinical and Translational Science, 515 East 100 South, Salt Lake City, Utah, 84102, USA
| | - Kelly G Baron
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
| |
Collapse
|
13
|
Sheeran P, Suls J, Bryan A, Cameron L, Ferrer RA, Klein WMP, Rothman AJ. Activation Versus Change as a Principle Underlying Intervention Strategies to Promote Health Behaviors. Ann Behav Med 2023; 57:205-215. [PMID: 36082928 PMCID: PMC10305802 DOI: 10.1093/abm/kaac045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Interventions are effective in promoting health behavior change to the extent that (a) intervention strategies modify targets (i.e., mechanisms of action), and (b) modifying targets leads to changes in behavior. To complement taxonomies that characterize the variety of strategies used in behavioral interventions, we outline a new principle that specifies how strategies modify targets and thereby promote behavior change. We distinguish two dimensions of targets-value (positive vs. negative) and accessibility (activation level)-and show that intervention strategies operate either by altering the value of what people think, feel, or want (target change) or by heightening the accessibility of behavior-related thoughts, feelings, and goals (target activation). METHODS AND RESULTS We review strategies designed to promote target activation and find that nudges, cue-reminders, goal priming, the question-behavior effect, and if-then planning are each effective in generating health behavior change, and that their effectiveness accrues from heightened accessibility of relevant targets. We also identify several other strategies that may operate, at least in part, via target activation (e.g., self-monitoring, message framing, anticipated regret inductions, and habits). CONCLUSIONS The Activation Vs. Change Principle (AVCP) offers a theoretically grounded and parsimonious means of distinguishing among intervention strategies. By focusing on how strategies modify targets, the AVCP can aid interventionists in deciding which intervention strategies to deploy and how to combine different strategies in behavioral trials. We outline a research agenda that could serve to further enhance the design and delivery of interventions to promote target activation.
Collapse
Affiliation(s)
- Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jerry Suls
- Center for Personalized Health, Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
| | - Angela Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Linda Cameron
- Psychological Sciences, School of Social Sciences, University of California, Merced, Merced CA, USA
| | - Rebecca A Ferrer
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | | |
Collapse
|
14
|
de Buisonjé DR, Brosig F, Breeman LD, Bloom EL, Reijnders T, Janssen VR, Kraaijenhagen RA, Kemps HMC, Evers AWM. Put your money where your feet are: The real-world effects of StepBet gamified deposit contracts for physical activity. Internet Interv 2023; 31:100610. [PMID: 36873308 PMCID: PMC9982638 DOI: 10.1016/j.invent.2023.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
Background Gamification and deposit contracts (a financial incentive in which participants pledge their own money) can enhance effectiveness of mobile behavior change interventions. However, to assess their potential for improving population health, research should investigate implementation of gamified deposit contracts outside the research setting. Therefore, we analyzed data from StepBet, a smartphone application originally developed by WayBetter, Inc. Objective To perform a naturalistic evaluation of StepBet gamified deposit contracts, for whom they work best, and under which conditions they are most effective to help increase physical activity. Methods WayBetter provided data of StepBet participants that participated in a stepcount challenge between 2015 and 2020 (N = 72,974). StepBet challenges were offered on the StepBet smartphone application. The modal challenge consisted of a $40 deposit made prior to a 6-week challenge period during which participants needed to reach daily and weekly step goals in order to regain their deposit. Participants who met their goals also received additional earnings which were paid out from the money lost by those who failed their challenge. Challenge step goals were tailored on a 90-day historic step count retrieval that was also used as the baseline comparison for this study. Primary outcomes were increase in step count (continuous) and challenge success (dichotomous). Results Overall, average daily step counts increased by 31.2 % (2423 steps, SD = 3462) from 7774 steps (SD = 3112) at baseline to 10,197 steps (SD = 4162) during the challenge. The average challenge success rate was 73 %. Those who succeeded in their challenge (n = 53,281) increased their step count by 44.0 % (3465 steps, SD = 3013), while those who failed their challenge (n = 19,693) decreased their step count by -5.3 % (-398 steps, SD = 3013). Challenges started as a New Year's resolution were slightly more successful (77.7 %) than those started during the rest of the year (72.6 %). Discussion In a real-world setting, and among a large and diverse sample, participating in a gamified deposit contract challenge was associated with a large increase in step counts. A majority of challenges were successful and succeeding in a challenge was associated with a large and clinically relevant increase in step counts. Based on these findings, we recommend implementing gamified deposit contracts for physical activity where possible. An interesting avenue for future research is to explore possible setback effects among people who fail a challenge, and how setbacks can be mitigated. Pre-registration Open Science Framework (doi:10.17605/OSF.IO/D237C).
Collapse
Affiliation(s)
- David R de Buisonjé
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Fiona Brosig
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Linda D Breeman
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | | | - Thomas Reijnders
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Department of Human-Centered Design, Faculty of Industrial Design Engineering, TU Delft, Delft, the Netherlands
| | - Veronica R Janssen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Hareld M C Kemps
- Department of Cardiology, Máxima Medical Center, Veldhoven, the Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Medical Delta, Leiden University, TU Delft, and Erasmus University, the Netherlands
| |
Collapse
|
15
|
Cole SA, Sannidhi D, Jadotte YT, Rozanski A. Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Prog Cardiovasc Dis 2023; 77:86-94. [PMID: 36842453 DOI: 10.1016/j.pcad.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
Lifestyle medicine practice can be enhanced with interpersonal communication skills to help patients adopt and maintain positive health behaviors, such as improving diet or initiating exercise. We review two approaches that incorporate evidenced-based skills for this purpose: motivational interviewing and brief action planning (BAP). Motivational interviewing involves four processes conducted in a climate of compassion, acceptance, partnership, and empowerment. First, "engaging" (or connecting) with patients uses "relational" skills of active listening and empathic communication. Second, "focusing" elicits patients' full spectrum of concerns, expectations, and desires to negotiate a collaborative agenda. Third, "evoking motivation," utilizes uniquely innovative skills (e.g., "softening sustain talk" and "cultivating change talk") to increase intrinsic motivation of patients with ambivalence (or resistance) to become more open to choosing healthier behaviors for themselves. Fourth, "planning for change," uses collaborative goal-setting skills to help patients specify concrete action plans for health. To this end, brief action planning (BAP) has been developed as a specific pragmatic algorithmic approach, utilizing collaborative "SMART" (specific, measurable, achievable, relevant, and time-based) action planning, encouragement of patient commitment statements, scaling for confidence, problem-solving to reduce barriers for change, fostering patient accountability, and emphasizing follow-up. BAP can be introduced at any point in a patient encounter when patients are ready or nearly ready for change.
Collapse
Affiliation(s)
- Steven A Cole
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States of America; Depaertments of Scientific Education and Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States of America.
| | - Deepa Sannidhi
- UC San Diego Health, Department of Family Medicine and Public Health, Division of Family Medicine and Division of Preventive Medicine, United States of America
| | - Yuri Tertilus Jadotte
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States of America; Northeast Institute for Evidence Synthesis and Translation, School of Nursing, Rutgers University, Newark NJ USA
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| |
Collapse
|
16
|
Derksen ME, Jaspers MWM, Kunst AE, Fransen MP. Usage of digital, social and goal-setting functionalities to support health behavior change: A mixed methods study among disadvantaged women during or after pregnancy and their healthcare professionals. Int J Med Inform 2023; 170:104981. [PMID: 36603389 DOI: 10.1016/j.ijmedinf.2022.104981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/26/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We aimed to gain insight into how and to what extent social (i.e. private/group chat) and goal-setting (e.g. rewards) functionalities in digital interventions for health behavior change were used by clients and nurses in a preventive care program for disadvantaged women during or after pregnancy, and which factors influenced usage. METHODS We collected quantitative and qualitative data on usage of these functionalities in 'Kindle', a mHealth intervention to prepare for health behavior change. RESULTS We found that nurses (n = 5) and clients (n = 20) scarcely used both functionalities. They sent 862 messages in the social functionality whose security they appreciated, but habitually used WhatsApp likewise. Moreover, nurses were hesitant to let their clients interact in the group chat. Clients formulated 59 personal goals, which they found difficult to do. Nurses rewarded 846 points for clients' progress on goal attainment, but found it hard to determine how many points to reward. Clients and nurses indicated that the functionality made it more fun and easy to discuss clients' personal goals. CONCLUSIONS To conclude, digital, social and goal-setting functionalities were used to a limited extent by nurses and clients, and need optimization before implementation to support disadvantaged groups to change their health behavior.
Collapse
Affiliation(s)
- M E Derksen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
| | - M W M Jaspers
- Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - A E Kunst
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - M P Fransen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| |
Collapse
|
17
|
Magness CS, Stern K, Burnside A, Masterson D, Finkelstein S, Kramer A, Smith PK, Foster CJE. Changes in Gatekeeper Beliefs Following ASIST and Relation to Subsequent Gatekeeper Suicide Prevention Behaviors. Community Ment Health J 2023; 59:1013-1020. [PMID: 36607521 DOI: 10.1007/s10597-022-01084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/22/2022] [Indexed: 01/07/2023]
Abstract
This study examines relations between suicide prevention gatekeeper beliefs and actual helping behaviors following participation in Applied Suicide Intervention Skills Training (ASIST). Participants (n = 434) completed measures examining suicide-related beliefs and behaviors using a naturalistic pre-post design. All beliefs demonstrated significant change from pre- to posttest. Regression analyses indicate that beliefs about perceived barriers to action and the controllability of suicide predicted identification of high-risk youth; perceived barriers to action were also negatively related to helping responses and referrals 6-9 months post training. Self-efficacy was not related to suicide prevention behaviors at follow-up. The importance of anchoring training curriculums and measurement to health behavior change theories is discussed.
Collapse
Affiliation(s)
- Christina S Magness
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA.
| | - Karlin Stern
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Amanda Burnside
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Devyn Masterson
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Seth Finkelstein
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Anne Kramer
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Patricia K Smith
- Injury & Violence Prevention Section, Michigan Department of Health and Human Services, PO Box 30195, Lansing, MI, 48909, USA
| | - Cynthia J Ewell Foster
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| |
Collapse
|
18
|
Gregory EF, Maddox AI, Levine LD, Fiks AG, Lorch SA, Resnicow K. Motivational interviewing to promote interconception health: A scoping review of evidence from clinical trials. Patient Educ Couns 2022; 105:3204-3212. [PMID: 35870992 PMCID: PMC9529865 DOI: 10.1016/j.pec.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/07/2022] [Accepted: 07/15/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Promoting interconception health can improve birth outcomes and long-term women's health. Motivational Interviewing (MI) is an evidence-based behavior change strategy that can address interconception health behaviors and health care engagement. OBJECTIVE This scoping review assessed the evidence for using MI to promote interconception health and assessed features of successful MI interventions. METHODS We searched PubMed, CHINAL, and Cochrane databases for clinical trials that involved an MI intervention and at least one comparison group published by 8/31/2021. Interventions occurred during pregnancy or within three months postpartum and outcomes were measured between birth and one year postpartum. We abstracted data on trial characteristics including outcome, population, interventionist training, MI fidelity monitoring, intervention dose, and comparison condition. We examined whether trials that demonstrated statistically significant improvement in outcomes had common features. RESULTS There were 37 included studies. Interventions addressed breastfeeding, teen contraception, tobacco, alcohol, or substance use, vaccine acceptance, nutrition, physical activity, and depression. No trials addressed more than one topic. Nineteen studies demonstrated improved outcomes. Interventions during the perinatal or postnatal periods were more likely to demonstrate improved interconception outcomes than interventions in the prenatal period. No other trial characteristics were consistently associated with demonstrating improved outcomes. DISCUSSION MI has been applied to a variety of interconception health behaviors, with some promising results, particularly for interventions in the perinatal or postpartum period. Outcomes were not clearly attributable to any other differences in intervention or study design. Further exploring context or implementation may help maximize the potential of MI in interconception health promotion. PRACTICAL VALUE MI may be implemented across a range of clinical settings, patient groups, and time points around pregnancy. Interventions on health topics relevant to the interconception period should incorporate perinatal or postpartum components.
Collapse
Affiliation(s)
- Emily F Gregory
- Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia Research Institute, Philadelphia, USA.
| | - Adya I Maddox
- Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia Research Institute, Philadelphia, USA
| | - Lisa D Levine
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA
| | - Alexander G Fiks
- Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia Research Institute, Philadelphia, USA
| | - Scott A Lorch
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia Research Institute, Philadelphia, USA; Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia. Philadelphia, USA
| | - Kenneth Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, USA
| |
Collapse
|
19
|
Triantafyllidis A, Alexiadis A, Elmas D, Gerovasilis G, Votis K, Tzovaras D. A social robot-based platform for health behavior change toward prevention of childhood obesity. Univers Access Inf Soc 2022; 22:1-11. [PMID: 36211232 PMCID: PMC9526206 DOI: 10.1007/s10209-022-00922-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Childhood obesity is a major public health challenge which is linked with the occurrence of diseases such as diabetes and cancer. The COVID-19 pandemic has forced changes to the lifestyle behaviors of children, thereby making the risk of developing obesity even greater. Novel preventive tools and approaches are required to fight childhood obesity. We present a social robot-based platform which utilizes an interactive motivational strategy in communication with children, collects self-reports through the touch of tangible objects, and processes behavioral data, aiming to: (a) screen and assess the behaviors of children in the dimensions of physical activity, diet, and education, and (b) recommend individualized goals for health behavior change. The platform was integrated through a microservice architecture within a multi-component system targeting childhood obesity prevention. The platform was evaluated in an experimental study with 30 children aged 9-12 years in a real-life school setting, showing children's acceptance to use it, and an 80% success rate in achieving weekly personal health goals recommended by the social robot-based platform. The results provide preliminary evidence on the implementation feasibility and potential of the social robot-based platform toward the betterment of children's health behaviors in the context of childhood obesity prevention. Further rigorous longer-term studies are required.
Collapse
Affiliation(s)
- Andreas Triantafyllidis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Anastasios Alexiadis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Dimosthenis Elmas
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Georgios Gerovasilis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Konstantinos Votis
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| | - Dimitrios Tzovaras
- Information Technologies Institute, Centre for Research and Technology Hellas (CERTH), 57001 Thessaloníki, Greece
| |
Collapse
|
20
|
Smith SR, Hagger MS, Keech JJ, Moyers SA, Hamilton K. Improving Hand Hygiene Behavior Using a Novel Theory-Based Intervention During the COVID-19 Pandemic. Ann Behav Med 2022; 56:1157-1173. [PMID: 36099420 PMCID: PMC9635998 DOI: 10.1093/abm/kaac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one’s face with unwashed hands, is important for limiting the spread of infections. Purpose We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one’s face with unwashed hands to reduce the spread of COVID-19. Methods We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention. Results Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2. Conclusions Results indicate high adoption of avoiding touching one’s face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.
Collapse
Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Martin S Hagger
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Department of Psychological Sciences, University of California, Merced, CA, USA.,Health Sciences Research Institute, University of California, Merced, CA, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jacob J Keech
- School of Applied Psychology, Griffith University, Brisbane, Australia.,School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Susette A Moyers
- Oklahoma State University Center for Health Sciences, National Center for Wellness and Recovery, Tulsa, Oklahoma
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.,Health Sciences Research Institute, University of California, Merced, CA, USA
| |
Collapse
|
21
|
Tooley EM, Kolahi A. Motivating Behavioral Change. Med Clin North Am 2022; 106:627-639. [PMID: 35725229 DOI: 10.1016/j.mcna.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Motivational interviewing (MI) allows medical providers and patients to have more productive conversations about changing health behaviors. MI helps patients talk themselves into changing by evoking discussion around change, thus resolving natural ambivalence. MI practitioners cultivate a spirit of MI and use specific skills and strategies to develop discrepancy between the patient's current behavior and their goals or values. This article discusses the flow of MI, the spirit and method of MI including specific skills and strategies, and important considerations in implementing MI.
Collapse
Affiliation(s)
- Erin M Tooley
- Department of Psychology & Public Health, Roger Williams University, Bristol, RI, USA.
| | - Anjani Kolahi
- University of California, Irvine Medical Center, Family Medicine Department, Orange, CA, USA
| |
Collapse
|
22
|
Edwards EJ, Arora B, Green P, Bannatyne AJ, Nielson T. Teaching brief motivational interviewing to medical students using a pedagogical framework. Patient Educ Couns 2022; 105:2315-2319. [PMID: 35090803 DOI: 10.1016/j.pec.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/07/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Medical schools are charged with assisting medical students to acquire the confidence, knowledge and skills for behavior change conversations in primary healthcare. The present study evaluated teaching brief motivational interviewing (MI) to pre-clinical medical students. METHODS Forty-six students participated in an educational intervention premised on the Learn, See, Practice, Prove, Do, Maintain pedagogical framework, comprising 2 × 2-h lectures, a 2-h role-play triad session, and 3 × 2-h small group simulated patient encounters supported by scaffolding strategies. Measures of brief MI knowledge (MI Knowledge and Attitudes Test & Multiple-Choice Knowledge Test) and confidence (MI Confidence Scale) were taken at baseline, post-training, and 3-month follow-up, and skills (Behavior Change Counseling Index) were assessed at three intervals during simulated patient encounters. RESULTS Students who received brief MI training improved in knowledge and confidence from baseline to post-training and gains remained at 3-months. Brief MI skills improved across the simulation sessions. CONCLUSION Pre-clinical medical students can attain knowledge, confidence and skills in brief MI after participation in a short intervention and improvements are sustainable. PRACTICE IMPLICATIONS Our results support the use of an evidence-based pedagogical framework for teaching brief MI in pre-clinical years of medical curricula and our scaffolding strategy affords promise.
Collapse
Affiliation(s)
| | - Bharti Arora
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Patricia Green
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Amy J Bannatyne
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Tracy Nielson
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4229, Australia
| |
Collapse
|
23
|
Stenlund S, Koivumaa-Honkanen H, Sillanmäki L, Lagström H, Rautava P, Suominen S. Changed health behavior improves subjective well-being and vice versa in a follow-up of 9 years. Health Qual Life Outcomes 2022; 20:66. [PMID: 35449057 PMCID: PMC9027415 DOI: 10.1186/s12955-022-01972-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background Previous research on health behavior and subjective well-being has mainly focused on interindividual differences or explored certain domains of health behavior. Good health behavior and subjective well-being at baseline can predict each other after a follow-up. In the present cohort study, we explored the outcomes of change for an individual i.e., how changed health behavior is reflected in subsequent subjective well-being and vice versa. Methods Data (n = 10,855) originates from a population-based Health and Social Support (HeSSup) study on working-age Finns in 2003 and 2012. A composite measure of health behavior included physical activity, dietary habits, alcohol consumption, and smoking status (range 0–4, worst–best) and a composite measure of subjective well-being (with reversed scoring) included three life assessments, i.e., interest, happiness, and ease in life, and perceived loneliness (range 4–20, best–worst). Different multiple linear regression models were used to study how changes in health behavior predict subjective well-being and the opposite, how changes in subjective well-being predict health behavior. Results A positive change in health behavior from 2003 to 2012 predicted better subjective well-being (i.e., on average 0.31 points lower subjective well-being sum score), whereas a negative change predicted poorer subjective well-being (i.e., 0.37 points higher subjective well-being sum score) (both: p < 0.001) compared to those study subjects who had no change in health behavior. Similarly, when a positive and negative change in subjective well-being was studied, these figures were 0.071 points better and 0.072 points worse (both: p < 0.001) health behavior sum score, respectively. When the magnitude of the effect of change was compared to the range of scale of the outcome the effect of health behavior change appeared stronger than that of subjective well-being. Conclusion Changes in health behavior and subjective well-being have long-term effects on the level of the other, the effect of the first being slightly stronger than vice versa. These mutual long-term benefits can be used as a motivator in health promotion on individual and societal levels. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01972-4.
Collapse
Affiliation(s)
- Säde Stenlund
- Department of Public Health, University of Turku, 20014, Turku, Finland. .,Research Services, Turku University Hospital, 20014, Turku, Finland.
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, 70211, Kuopio, Finland.,Mental Health and Wellbeing Center, Kuopio University Hospital, 70029, Kuopio, Finland
| | - Lauri Sillanmäki
- Department of Public Health, University of Turku, 20014, Turku, Finland.,Research Services, Turku University Hospital, 20014, Turku, Finland.,Department of Public Health, University of Helsinki, 00014, Helsinki, Finland
| | - Hanna Lagström
- Department of Public Health, University of Turku, 20014, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, 20014, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, 20014, Turku, Finland.,Research Services, Turku University Hospital, 20014, Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, 20014, Turku, Finland.,Research Services, Turku University Hospital, 20014, Turku, Finland.,School of Health Sciences, University of Skövde, 54128, Skövde, Sweden
| |
Collapse
|
24
|
Gadaire CB, Armstrong LM, Levens SM. Development and validation of the Child Weight Risk Questionnaire. Eat Weight Disord 2022; 27:525-534. [PMID: 33860465 DOI: 10.1007/s40519-021-01181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/24/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The study objective was to develop and validate a measure of parent perception of child weight-related risk, the Child Weight Risk Questionnaire (CWRQ), among a sample of US parents. METHODS A cross-sectional survey was conducted in a sample of 216 parents of 6- to 12-year-old children who were overweight. The CWRQ was used to assess parent beliefs about their child's susceptibility to physical, social-emotional, and behavioral health problems due to weight. RESULTS Confirmatory factor analysis supported the three-factor structure of the CWRQ and acceptable fit was achieved. The internal consistency of the measure was excellent. Convergent, discriminant, and incremental validity analyses provided initial evidence for CWRQ validity. CONCLUSION The CWRQ is a reliable and valid instrument for assessing parent perception of child weight-related risk. This measure could be utilized in research and applied settings to capture the multifaceted nature of parent risk perception and support efforts to tailor family weight interventions in ways that align with parent beliefs. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
Collapse
Affiliation(s)
- Cecily B Gadaire
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA. .,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Laura Marie Armstrong
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA. .,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Sara M Levens
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA.,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA
| |
Collapse
|
25
|
Ratz T, Pischke CR, Voelcker-Rehage C, Lippke S. Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis. Eur Rev Aging Phys Act 2022; 19:1. [PMID: 34986783 PMCID: PMC8903622 DOI: 10.1186/s11556-021-00281-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023] Open
Abstract
Background This study aimed to identify latent moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) trajectories in older adults participating in a randomized intervention trial and to explore associations with baseline social-cognitive predictors. Methods Data were assessed at baseline (T0, participants were inactive or had recently become active), after a ten-week physical activity intervention (T1), and a second 24-week intervention phase (T2). Latent class growth analysis was used on accelerometer-assessed weekly MVPA and daily SB, respectively (n = 215 eligible participants). Activity changes within trajectory classes and baseline social-cognitive predictor differences between trajectory classes were analyzed. Results A “stable insufficient MVPA” (n = 197, p for difference in MVPA level at T0 and T2 (pT0-T2) = .789, effect size (Cohen’s d) = .03) and a “stable high MVPA” trajectory (n = 18, pT0-T2 = .137, d = .39), as well as a “slightly decreasing high SB” (n = 63, p for difference in SB (pT0-T2) = .022, d = .36) and a “slightly increasing moderate SB” trajectory (n = 152, pT0-T2 = .019, d = .27) emerged. Belonging to the “stable high MVPA” trajectory was associated with higher action planning levels compared to the “stable insufficient MVPA” trajectory (M = 5.46 versus 4.40, d = .50). Belonging to the “decreasing high SB” trajectory was associated with higher action self-efficacy levels compared to the “increasing moderate SB” trajectory (M = 5.27 versus 4.72, d = .33). Conclusions Change occurred heterogeneously in latent (not directly observed) subgroups, with significant positive trajectories only observed in the highly sedentary. Trial registration German Registry of Clinical Trials, DRKS00016073, Registered 10 January 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00281-x.
Collapse
Affiliation(s)
- Tiara Ratz
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany.
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| |
Collapse
|
26
|
Mott M, Mott B, Rowe J, Ozer E, Giovanelli A, Berna M, Pugatch M, Tebb K, Penilla C, Lester J. "What's Important to You, Max?": The Influence of Goals on Engagement in an Interactive Narrative for Adolescent Health Behavior Change. Interact Storytell (2021) 2021; 13138:379-392. [PMID: 36354310 PMCID: PMC9639365 DOI: 10.1007/978-3-030-92300-6_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Interactive narrative technologies for preventive health care offer significant potential for promoting health behavior change in adolescents. By improving adolescents' knowledge, personal efficacy, and self-regulatory skills these technologies hold great promise for realizing positive impacts on adolescent health. These potential benefits are enabled through story-centric learning experiences that provide opportunities for adolescents to practice strategies to reduce risky health behaviors in engaging game-based environments. A distinctive feature of interactive narrative that promotes engagement is players' ability to influence the story through the choices they make. In this paper, we present initial work investigating engagement in an interactive narrative that focuses on reducing adolescents' risky behaviors around alcohol use. Specifically, we consider how the short-term and long-term goals adolescents choose as being important to the protagonist character relates to their engagement with the interactive narrative. Leveraging interaction log data from a pilot study with 20 adolescents, we conduct a cluster-based analysis of the goals players selected. We then examine how engagement differs between the identified clusters. Results indicate that adolescents' choices for the protagonist's short-term and long-term goals can significantly impact their engagement with the interactive narrative.
Collapse
Affiliation(s)
- Megan Mott
- University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Elizabeth Ozer
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Mark Berna
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Kathleen Tebb
- University of California, San Francisco, San Francisco, CA, USA
| | - Carlos Penilla
- University of California, San Francisco, San Francisco, CA, USA
| | - James Lester
- North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
27
|
Feig EH, Harnedy LE, Golden J, Thorndike AN, Huffman JC, Psaros C. A Qualitative Examination of Emotional Experiences During Physical Activity Post-metabolic/Bariatric Surgery. Obes Surg 2021. [PMID: 34800251 DOI: 10.1007/s11695-021-05807-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/24/2022]
Abstract
Purpose Physical activity is critical for weight loss maintenance and cardiometabolic disease prevention after metabolic/bariatric surgery (MBS), but few patients meet recommended levels. While difficulties meeting physical activity recommendations are common in the general population, those who have undergone MBS may have unique psychological barriers to activity that impede success, including negative associations with physical activity that are related to a long history with obesity, weight stigma, and physical limitations. This qualitative study aimed to better understand the positive and negative emotional experiences of post-MBS patients with regard to physical activity to inform the development of an emotion-focused intervention to increase physical activity after MBS. Methods Adults who had MBS in the past 2 years completed semi-structured interviews and psychological/behavioral questionnaires. After transcription, a codebook was developed using inductive and deductive methods. Coded data were analyzed using content analysis. Results Participants were 23 adults (78% female). Contexts that contributed to positive emotions during physical activity included an enjoyable type of exercise, social interaction, mindfulness during exercise, and mastery. Contexts that contributed to negative affect were more unique to the MBS population, including all-or-nothing thinking about exercise, using distraction, depression, negative body image, exercising only for weight loss, and the COVID-19 pandemic. Conclusion For most participants, emotional factors were relevant in the decision to be physically active and in their ability to maintain their habits. An intervention that encourages factors that lead to positive affect and addresses factors that lead to negative affect could be effective in increasing physical activity following MBS. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05807-x.
Collapse
|
28
|
Schwaninger P, Berli C, Lüscher J, Scholz U. Cultivation or enabling? Day-to-day associations between self-efficacy and received support in couples. Soc Sci Med 2021; 287:114330. [PMID: 34455336 DOI: 10.1016/j.socscimed.2021.114330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 07/23/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Theories and empirical findings identify social support and self-efficacy as important variables for behavior change. Two competing hypotheses describe the bidirectional relationship of these two constructs: The cultivation hypothesis assumes that self-efficacy facilitates social support, whereas the enabling hypothesis assumes that social support fosters self-efficacy. To shed more light on the interplay of interpersonal and intrapersonal factors in the behavior change context in daily life, the present study aims to investigate these hypotheses at the within-person level. METHODS In total, 99 overweight heterosexual couples intending to increase their physical activity participated in this dyadic intensive longitudinal study. Both partners independently reported on their self-efficacy and their support receipt from their partner in smartphone-based end-of-day diaries across 14 days. To investigate the competing hypotheses prospective lagged multilevel models were applied. RESULTS For both partners, higher-than-average levels of self-efficacy on a given day predicted higher support receipt the next day, confirming the cultivation hypothesis. We found no effect of higher-than-average levels of support receipt on a given day on self-efficacy the next day, disconfirming the enabling hypothesis. Same-day support receipt and previous day self-efficacy were positively related to daily physical activity. CONCLUSIONS This is the first study investigating the cultivation and the enabling hypothesis on a day-to-day basis using a dyadic intensive longitudinal approach. Findings support the cultivation hypothesis at the within-person level, suggesting that self-efficacy may help to facilitate support receipt close in time. Future studies should use within-person experimental designs and ecological momentary assessments within days to increase our understanding of the temporal dynamics of the cultivation and enabling effect.
Collapse
Affiliation(s)
- Philipp Schwaninger
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14/ Box 14, 8050, Zurich, Switzerland.
| | - Corina Berli
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14/ Box 14, 8050, Zurich, Switzerland.
| | - Janina Lüscher
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14/ Box 14, 8050, Zurich, Switzerland.
| | - Urte Scholz
- Department of Psychology, University of Zurich, Binzmuehlestrasse 14/ Box 14, 8050, Zurich, Switzerland.
| |
Collapse
|
29
|
Du L, La X, Zhu L, Jiang H, Xu B, Chen A, Li M. Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China. BMC Pregnancy Childbirth 2021; 21:491. [PMID: 34233653 PMCID: PMC8262048 DOI: 10.1186/s12884-021-03940-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners. METHODS A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception. RESULTS Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45-4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48-5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03-4.39, P = 0.041] before conception. CONCLUSIONS Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.
Collapse
Affiliation(s)
- Li Du
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China
| | - Xuena La
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
- Shanghai Municipal Center for Disease Control and Prevention, No.1380 West Zhongshan Road, Shanghai, 200336, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China.
| | - Hong Jiang
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Biao Xu
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA Institute), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, FI-02150, Espoo, Finland
| | - Mu Li
- School of Public Health, China Studies Centre, University of Sydney, Room 313, Edward Ford Building, Sydney, 2006, Australia
| |
Collapse
|
30
|
Abstract
The growing burden of atrial fibrillation health care resource utlization has created an urgent need to develop preventative strategies and opportunities to improve outcomes in the prevalent population. Modifiable risk factors contribute to both disease development and progression. In the prevalent atrial fibrillation population, modifying cardiovascular risk factors has decreased disease burden and progression. However, further research is required to determine the role of comprehensive cardiovascular risk factor modification programs in primary prevention. An understanding of strategies required to facilitate health behavior change is crucial to the effective implementation of cardiovascular risk factor management programs.
Collapse
Affiliation(s)
- Celine Gallagher
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia
| | - Melissa E Middeldorp
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia
| | - Jeroen M Hendriks
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia; College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia 5042 Australia
| | - Dennis H Lau
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia
| | - Prashanthan Sanders
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia.
| |
Collapse
|
31
|
Fortuna KL, Ferron J, Bianco CL, Santos MM, Williams A, Williams M, Mois G, Pratt SI. Loneliness and its Association with Health Behaviors in People with a Lived Experience of a Serious Mental Illness. Psychiatr Q 2021; 92:101-6. [PMID: 32458342 DOI: 10.1007/s11126-020-09777-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To explore the association between loneliness and efficacy to engage in health behaviors that are known to reduce the risk of early mortality in people with serious mental illness (SMI). This secondary data analysis was based on a cross-sectional study of 113 participants with SMI residing in New Hampshire. Ordinary Least Squares regressions were used to examine bivariate relationships between variables of interest. Participants had a primary mental health diagnosis of major depressive disorder (37.2%), schizophrenia spectrum disorder (28.3%), bipolar disorder (29.2%), or posttraumatic stress disorder (5.3%). High levels of loneliness were associated with low levels of self-efficacy to manage chronic diseases (p = 0.0001), as well as low levels of self-efficacy to manage psychological well-being (R2 = .31; F = 9.49, p = 0.0001; RMSE = 1.66). Loneliness may serve as a barrier to healthy behaviors, and thus, contribute to early mortality among people with SMI. The growing body of literature that demonstrates the importance of addressing loneliness in people with SMI should stimulate policymakers and researchers to target loneliness as a mechanism to address early mortality in people with SMI.
Collapse
|
32
|
Michaelsen MM, Esch T. Motivation and reward mechanisms in health behavior change processes. Brain Res 2021; 1757:147309. [PMID: 33524377 DOI: 10.1016/j.brainres.2021.147309] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
With increasing prevalence of lifestyle-related chronic diseases worldwide, understanding health behavior change and the development of successful interventions to support lifestyle modification is gaining increasing interest among politicians, scientists, therapists and patients alike. A number of health behavior change theories have been developed aiming at explaining health behavior change and understanding the domains that make change more likely. Until now, only few studies have taken into account automatic, implicit or non-cognitive aspects of behavior, including emotion and positive affect. Recent progress in the neuroscience of motivation and reward systems can provide further insights into the relevance of such domains. In this integrative review, we present a description of the possible motivation and reward systems (approach/wanting = pleasure; aversion/avoiding = relief; assertion/non-wanting = quiescence) involved in behavior change. Therefore, based on established theories encompassing both initiation and maintenance of behavior change, we create a flexible seven-stage behavior change process with three engagement phases (non-engagement, motivational engagement, executive engagement) and relate the motivation and reward systems to each of these stages. We propose that either appetitive (preferably) or aversive motivational salience is activated during motivational engagement, that learning leads to continued behavior and that assertive salience prevails when the new behavior has become habitual. We discuss under which circumstances these mechanisms and reward-motivation pathways are likely to occur and address potential shortcomings of our proposed theoretical framework. We highlight implications for future interventions aiming at lifestyle modification.
Collapse
Affiliation(s)
- Maren M Michaelsen
- Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Alfred-Herrhausen-Str. 44, 58455 Witten, Germany.
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Alfred-Herrhausen-Str. 44, 58455 Witten, Germany.
| |
Collapse
|
33
|
Clark-Sienkiewicz SM, Caño A, Zeman LL, Lumley MA, Gothe N. Development of a Multicomponent Intervention to Initiate Health Behavior Change in Primary Care: The Kickstart Health Program. J Clin Psychol Med Settings 2021; 28:694-705. [PMID: 33398641 DOI: 10.1007/s10880-020-09755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
There is a growing movement to integrate behavioral health specialists into primary care settings in order to better manage patients' health behaviors. Group interventions in healthcare settings can provide services to multiple individuals simultaneously; however, the participants' experiences taking part in these activities and the logistics of integrating them into clinical settings are largely under-studied. This article describes the development and implementation of a novel group intervention for health behavior change, The Kickstart Health Program, which integrates components of cognitive, behavioral, acceptance, and experiential therapies. Participant feasibility, acceptability, experiences, and treatment course were assessed. Acceptability among a small sample of attendees was high, and initial data on behavior change suggest there were benefits to patients who attended the program. Increases in mindfulness practice and decreases in exercise barriers from baseline to 10-week follow-up were detected as were improvements in overall perceived health and well-being. Participants expressed that the program was acceptable and successful at helping them reach their individual health goals; however, enrollment barriers negatively impacted the feasibility of the program in regard to attendance. Modification to the enrollment process such as embedding referrals into the electronic medical record, encouraging spouse or family co-enrollment, and peer coaching may address these barriers. The Kickstart Health Program has the potential to improve health behaviors and paves the way for unique studies of dissemination and implementation of efficacious behavioral health interventions into real-world healthcare settings.
Collapse
Affiliation(s)
- Shannon M Clark-Sienkiewicz
- Department of Psychology, Wayne State University, Detroit, MI, USA. .,Beaumont Health, Sterling Heights, MI, USA. .,Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, #1950, Salt Lake City, UT, 84112, USA.
| | - Annmarie Caño
- Department of Psychology, Wayne State University, Detroit, MI, USA.,College of Arts and Sciences, Gonzaga University, Spokane, WA, USA
| | | | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Neha Gothe
- Department of Kinesiology & Community Health, University of Illinois At Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
34
|
Zhong B, Huang Y, Liu Q. Mental health toll from the coronavirus: Social media usage reveals Wuhan residents' depression and secondary trauma in the COVID-19 outbreak. Comput Human Behav 2021; 114:106524. [PMID: 32836728 PMCID: PMC7428783 DOI: 10.1016/j.chb.2020.106524] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/08/2020] [Accepted: 08/12/2020] [Indexed: 11/27/2022]
Abstract
This study investigates the possible association between social media usage and the mental health toll from the coronavirus at the peak of Wuhan's COVID-19 outbreak. Informed by the Crisis and Emergency Risk Communication Model and Health Belief Model, it proposes a conceptual model to study how people in Wuhan - the first epicenter of the global COVID-19 pandemic - used social media and its effects on users' mental health conditions and health behavior change. The results show that social media usage was related to both depression and secondary trauma, which also predicted health behavior change. But no relation was detected between health behavior change and mental health conditions. As the virus struck, social media usage was rewarding to Wuhan people who gained informational, emotional, and peer support from the health information shared on social media. An excessive use of social media, however, led to mental health issues. The results imply that taking a social media break may promote well-being during the pandemic, which is crucial to mitigating mental health harm inflicted by the pandemic.
Collapse
Affiliation(s)
- Bu Zhong
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA 16802, USA
| | - Yakun Huang
- School of Journalism and Communication, Jinan University, 601 Huangpu Ave. West, Guangzhou, 510632, China
| | - Qian Liu
- School of Journalism and Communication, National Media Experimental Teaching Demonstration Center, Jinan University, 601 Huangpu Ave. West, Guangzhou, 510632, China
| |
Collapse
|
35
|
Abstract
BACKGROUND Accelerating advances in health behavior change requires releasing the brake, as well as applying the throttle. This paper discusses six challenges or "brakes" that have slowed progress. PURPOSE/METHODS/RESULTS We engage with six issues that limit investigators' ability to delineate and test the strategy-target and target-behavior relations that underlie effective interventions according to the experimental medicine approach. We discuss the need for guidance on how to identify the relevant mechanism of action (target) in an intervention and whether a periodic table of health behavior constructs might aid investigators. Experimental and correlational analyses (prospective surveys and behavior change techniques) have been used to test the validity of targets, and we present evidence that there is little agreement among the findings from different research designs. Whereas target engagement is typically analyzed in terms of increasing scores on constructs that impel behavior change, we discuss the role of impeding targets and the benefits of adopting a broader construal of potential targets and approaches to engagement. There is presently a paucity of competitive tests regarding which strategies best engage targets and we discuss empirical criteria and conceptual developments that could enhance the evidence base. Finally, we highlight the need to take "context" or conditional intervention effects more seriously by leveraging the interplay between questions about why interventions work and questions about when and for whom they work. CONCLUSION Candid appraisal of the challenges facing research on health behavior change can generate new opportunities for theoretical development and offer direction and cumulative impetus for empirical work.
Collapse
Affiliation(s)
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| |
Collapse
|
36
|
Kaasalainen K, Kalmari J, Ruohonen T. Developing and testing a discrete event simulation model to evaluate budget impacts of diabetes prevention programs. J Biomed Inform 2020; 111:103577. [PMID: 32992022 DOI: 10.1016/j.jbi.2020.103577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/14/2020] [Accepted: 09/20/2020] [Indexed: 11/30/2022]
Abstract
Type 2 diabetes (T2D) is one of the most rapidly increasing non-communicable diseases worldwide. Lifestyle interventions are effective in preventing T2D but also resource intensive. This study evaluated with discrete event simulation (DES) the relative budget impacts of three hypothetical diabetes prevention programs (DPP), including group-based contact intervention, digital program with human coaching and fully automated program. The data for simulation were derived from research literature and national health and population statistics. The model was constructed using the iGrafx Process for Six Sigma software and simulations were carried out for 10 years. All simulated interventions produced cost savings compared to the situation without any intervention. However, this was a modeling study and future studies are needed to verify the results in real-life. Decision makers could benefit the predictive models regarding the long-term effects of diabetes prevention interventions, but more data is needed in particular on the usage, acceptability, effectiveness and costs of digital intervention tools.
Collapse
Affiliation(s)
- Karoliina Kaasalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Keskussairaalantie 4, P. O. Box 35 (L), FI-40014 Jyväskylä, Finland.
| | - Janne Kalmari
- Faculty of Information Technology, University of Jyväskylä, Mattilanniemi 2, P.O. Box 35, FI-40014 Jyväskylä, Finland.
| | - Toni Ruohonen
- Faculty of Information Technology, University of Jyväskylä, Mattilanniemi 2, P.O. Box 35, FI-40014 Jyväskylä, Finland.
| |
Collapse
|
37
|
Abstract
Interest in immersive virtual reality (VR) technologies is burgeoning as the hardware becomes less costly and more accessible to users, including researchers and practitioners. This commentary outlines the field of immersive VR and highlights applications of its use relevant to translational behavioral medicine. We describe the challenges facing VR applications for health and medicine, and how the core strengths of behavioral medicine can advance theory, research, and practice using VR. By highlighting potential uses of immersive VR alongside the challenges facing the field, we hope to inspire researchers to apply robust theories, methods, and frameworks to generate stronger evidence about the feasibility, acceptability, efficacy, and effectiveness of using this technology in translational behavioral medicine.
Collapse
Affiliation(s)
- Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Megan A Lewis
- Patient & Family Engagement Research Program, Center for Communication Science, RTI International, Research Triangle Park, NC, USA
| |
Collapse
|
38
|
Diehl M, Nehrkorn-Bailey A, Thompson K, Rodriguez D, Li K, Rebok GW, Roth DL, Chung SE, Bland C, Feltner S, Forsyth G, Hulett N, Klein B, Mars P, Martinez K, Mast S, Monasterio R, Moore K, Schoenberg H, Thomson E, Tseng HY. The Aging PLUS trial: Design of a randomized controlled trial to increase physical activity in middle-aged and older adults. Contemp Clin Trials 2020; 96:106105. [PMID: 32791322 DOI: 10.1016/j.cct.2020.106105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/01/2020] [Accepted: 08/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Negative views of aging (NVOA), low self-efficacy beliefs, and poor goal planning skills represent risk factors that undermine adults' motivation to engage in physical activity (PA). Targeting these three risk factors may motivate adults to become physically active. OBJECTIVE To assess the efficacy of AgingPLUS, a 4-week educational program that explicitly targets NVOA, low self-efficacy beliefs, and poor goal planning skills compared to a 4-week health education program. The study also examines the role of NVOA, self-efficacy beliefs, and goal planning as the mechanisms underlying change in PA. DESIGN This randomized controlled trial (RCT) utilizes the experimental medicine approach to assess change in PA as a function of modifying three risk factors. The RCT recruitment target includes 288 mostly sedentary adults ranging in age from 45 to 75 years. METHODS Eligible middle-aged and older adults are recruited through community sources. Participants are randomized to either the AgingPLUS or the control group. Participants in both groups are enrolled in the trial for 8 months total, with four assessment points: Baseline (pre-test), Week 4 (immediate post-test), Week 8 (delayed post-test), and Month 6 (long-term follow-up). The intervention takes place over 4 consecutive weeks with 2-h sessions each week. PA engagement is the primary outcome variable. Positive changes in NVOA, self-efficacy beliefs, and goal planning are the intervention targets and hypothesized mediators of increases in PA. SUMMARY By utilizing a multi-component approach and targeting a cluster of psychological mechanisms, the AgingPLUS program implements the experimental medicine approach to health behavior change.
Collapse
Affiliation(s)
- Manfred Diehl
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States.
| | - Abigail Nehrkorn-Bailey
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Katherine Thompson
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Diana Rodriguez
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Kaigang Li
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - George W Rebok
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - David L Roth
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Shang-En Chung
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Christina Bland
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Skylar Feltner
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Garrett Forsyth
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Nicholas Hulett
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Berkeley Klein
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Paloma Mars
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Karla Martinez
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Sarah Mast
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Rachel Monasterio
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| | - Kristen Moore
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Hayden Schoenberg
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Elizabeth Thomson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Han-Yun Tseng
- Department of Human Development and Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523-1570, United States
| |
Collapse
|
39
|
Ozer EM, Rowe J, Tebb KP, Berna M, Penilla C, Giovanelli A, Jasik C, Lester JC. Fostering Engagement in Health Behavior Change: Iterative Development of an Interactive Narrative Environment to Enhance Adolescent Preventive Health Services. J Adolesc Health 2020; 67:S34-S44. [PMID: 32718513 PMCID: PMC9575382 DOI: 10.1016/j.jadohealth.2020.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/24/2020] [Accepted: 04/22/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Accidents and unintentional injuries account for the greatest number of adolescent deaths, often involving use of alcohol and other substances. This article describes the iterative design and development of Interactive Narrative System for Patient-Individualized Reflective Exploration (INSPIRE), a narrative-centered behavior change environment for adolescents focused on reducing alcohol use. INSPIRE is designed to serve as an extension to clinical preventive care, engaging adolescents in a theoretically grounded intervention for health behavior change by leveraging 3D game engine and interactive narrative technologies. METHODS Adolescents were engaged in all aspects of the iterative, multiyear development process of INSPIRE through over 20 focus groups and iterative pilot testing involving more than 145 adolescents. Qualitative findings from focus groups are reported, as well as quantitative findings from small-scale pilot sessions investigating adolescent engagement with a prototype version of INSPIRE using a combination of questionnaire and interaction trace log data. RESULTS Adolescents reported that they found INSPIRE to be engaging, believable, and relevant to their lives. The majority of participants indicated that the narrative's protagonist character was like them (84%) and that the narrative featured virtual characters that they could relate to (79%). In the interactive narrative, the goals most frequently chosen by adolescents were "stay in control" (60%) and "do not get in trouble" (55%). CONCLUSIONS With a strong theoretical framework (social-cognitive behavior change theory) and technology advances (narrative-centered learning environments), the field is well positioned to design health behavior change systems that can realize significant impacts on behavior change for adolescent preventive health.
Collapse
Affiliation(s)
- Elizabeth M Ozer
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California; Office of Diversity & Outreach, University of California, San Francisco, San Francisco, California.
| | - Jonathan Rowe
- Department of Computer Science, College of Engineering, North Carolina State University, Raleigh, North Carolina
| | - Kathleen P Tebb
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Mark Berna
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Carlos Penilla
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Alison Giovanelli
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - Carolyn Jasik
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, California
| | - James C Lester
- Department of Computer Science, College of Engineering, North Carolina State University, Raleigh, North Carolina
| |
Collapse
|
40
|
Hunt CA, Hoffman MA, Mohr JJ, Williams AL. Assessing Perceived Barriers to Meditation: the Determinants of Meditation Practice Inventory-Revised (DMPI-R). Mindfulness (N Y) 2020; 11:1139-1149. [PMID: 33664878 DOI: 10.1007/s12671-020-01308-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Engaging in meditation on a regular basis has been shown to enhance well-being. However, barriers to adopting it as a health behavior are poorly understood. The Determinants of Meditation Practice Inventory (DMPI) is an existing scale designed to measure perceived barriers to meditation. However, it was developed without factor analyses; thus, the dimensionality and construct validity of overall scale and/or subscale scores are unknown. Using factor analyses and tests of convergent validity, the present study explored the psychometric properties of the DMPI and presents a revised, psychometrically valid scale (The Determinants of Meditation Practice Inventory-Revised; DMPI-R). Methods Adult participants living in the USA (n = 621) provided data through an online survey platform. Extensive exploratory factor analyses were conducted (n = 311) and followed by confirmatory factor analysis (n = 310) on the best-fitting model. Convergent validity was estimated using the full sample data. Results Five items were removed because they demonstrated high residual variances and cross loaded onto multiple factors. Relationships among the remaining items were best explained by a four-factor structure with the following subscales: low perceived benefit, perceived inadequate knowledge, perceived pragmatic barriers, and perceived sociocultural conflict. Convergent validity was evidenced by associations between subscale scores and experiential avoidance, distress tolerance, and curiosity. Conclusions The multifactor structure of the DMPI-R indicates that there are multiple classes of perceived barriers on which people can vary. Validity analyses suggest that the DMPI-R is a promising measure of perceived barriers to meditation among North American adults.
Collapse
Affiliation(s)
- Carly Ann Hunt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Mary Ann Hoffman
- Department of Counseling, Higher Education and Special Education, University of Maryland, College Park, MD, USA
| | - Jonathan J Mohr
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Anna-Leila Williams
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| |
Collapse
|
41
|
Montgomery SC, Donnelly M, Bhatnagar P, Carlin A, Kee F, Hunter RF. Peer social network processes and adolescent health behaviors: A systematic review. Prev Med 2020; 130:105900. [PMID: 31733224 DOI: 10.1016/j.ypmed.2019.105900] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 11/01/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022]
Abstract
Research has highlighted the importance of peers for determining health behaviors in adolescents, yet these behaviors have typically been investigated in isolation. We need to understand common network processes operating across health behaviors collectively, in order to discern how social network processes impact health behaviors. Thus, this systematic review of studies investigated adolescent peer social networks and health behaviors. A search of six databases (CINAHL, Education Resources Information Centre, Embase, International Bibliography of the Social Sciences, Medline and PsycINFO) identified 55 eligible studies. The mean age of the participants was 15.1 years (range 13-18; 51.1% female). Study samples ranged from 143 to 20,745 participants. Studies investigated drinking (31%), smoking (22%), both drinking and smoking (13%) substance use (18%), physical activity (9%) and diet or weight management (7%). Study design was largely longitudinal (n = 41, 73%) and cross-sectional (n = 14, 25%). All studies were set in school and all but one study focused on school-based friendship networks. The Newcastle-Ottawa Scale was used to assess risk of bias: studies were assessed as good (51%), fair (16%) or poor (33%). The synthesis of results revolved around two network behavior patterns: 1) health behavior similarity within a social network, driven by homophilic social selection and/or social influence, and 2) popularity: health behavior engagement in relation to changes in social status; or network popularity predicting health behaviors. Adolescents in denser networks had statistically significant lower levels of harmful behavior (n = 2/2, 100%). Findings suggest that social network processes are important factors in adolescent health behaviors.
Collapse
Affiliation(s)
- Shannon C Montgomery
- UKCRC Centre of Excellence for Public Health (Northern Ireland)/Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
| | - Michael Donnelly
- UKCRC Centre of Excellence for Public Health (Northern Ireland)/Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
| | - Prachi Bhatnagar
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Old Road Campus, OX3 7LF, UK.
| | - Angela Carlin
- Sport and Exercise Sciences Research Institute, Ulster University, Northern Ireland, UK.
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (Northern Ireland)/Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
| | - Ruth F Hunter
- UKCRC Centre of Excellence for Public Health (Northern Ireland)/Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
| |
Collapse
|
42
|
Villalobos A, Alaimo K, Erickson C, Harrall K, Glueck D, Buchenau H, Buchenau M, Coringrato E, Decker E, Fahnestock L, Hamman R, Hebert J, Hurley T, Leiferman J, Li K, Quist P, Litt J. CAPS on the move: Crafting an approach to recruitment for a randomized controlled trial of community gardening. Contemp Clin Trials Commun 2019; 16:100482. [PMID: 31799473 PMCID: PMC6883325 DOI: 10.1016/j.conctc.2019.100482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To describe and evaluate recruitment approaches for a randomized controlled trial (RCT) of community gardening in Denver, Colorado. (ClinicalTrials.gov: NCT03089177). METHODS We used community and staff feedback to adapt our recruitment approach from year 1 to year 2 of a multi-year RCT to address health behaviors related to cancer prevention. In year 2, we added a full-time recruitment coordinator, designed and implemented a tracking spreadsheet, and engaged advisory committee members, local garden leaders, and health partners in planning and outreach. Screening and consent rates, staff time and costs for years 1 and 2 are compared. RESULTS In year 1, recruitment methods yielded 136 initial contacts, 106 screenings and 64 consented participants. In year 2, enhanced staffing and outreach yielded 257 initial contacts, 193 screenings, and 123 consented participants. Personal referrals, health fairs, NextDoor, and fliers yielded the highest percentage of consented participants. School and community meetings yielded the lowest yield for potential participants. Spanish-speaking participants were mostly recruited by direct methods. Compared to year 1 recruitment, which required 707 h of staff time and cost $14,446, year 2 recruitment required 1224 h of staff time and cost $22,992. Average cost for retained participants was $226 (year 1) and $186 (year 2). DISCUSSION Those planning pragmatic clinical trials with recruitment in multi-ethnic communities can use the results from this study to understand the efficacy of techniques, and to budget costs for recruitment. While our culturally-tailored recruitment methods cost more, they provided more effective and efficient ways to reach recruitment goals.
Collapse
Affiliation(s)
| | - K. Alaimo
- Michigan State University, East Lansing, MI, USA
| | - C. Erickson
- University of Colorado Boulder, Boulder, CO, USA
| | - K.K. Harrall
- Colorado School of Public Health, Denver, CO, USA
| | - D.H. Glueck
- University of Colorado School of Medicine, Denver, CO, USA
| | - H. Buchenau
- University of Colorado Boulder, Boulder, CO, USA
| | | | | | - E. Decker
- University of Colorado Boulder, Boulder, CO, USA
| | | | - R.F. Hamman
- Colorado School of Public Health, Denver, CO, USA
- LEAD Center, Colorado School of Public Health, Denver, CO, USA
| | - J.R. Hebert
- University of South Carolina, Charleston, SC, USA
| | - T.G. Hurley
- University of South Carolina, Charleston, SC, USA
| | | | - K. Li
- Colorado State University, Fort Collins, CO, USA
| | - P. Quist
- University of Colorado Boulder, Boulder, CO, USA
| | - J.S. Litt
- University of Colorado Boulder, Boulder, CO, USA
- Colorado School of Public Health, Denver, CO, USA
| |
Collapse
|
43
|
Jimenez DE, Thomas L, Bartels SJ. The role of serious mental illness in motivation, participation and adoption of health behavior change among obese/sedentary Latino adults. Ethn Health 2019; 24:889-896. [PMID: 29124951 PMCID: PMC6224308 DOI: 10.1080/13557858.2017.1390552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
Objective: Serious mental illness (SMI; e.g. schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, severe major depressive disorder, and psychotic disorders) and Latino ethnicity can produce a compounded health disparity, placing individuals at particularly high risk for excess morbidity and premature mortality. In this study we sought to identify the role of SMI in motivation, participation, and adoption of health behavior change among overweight Latino adults. Design: Qualitative, semi-structured interviews were conducted with 20 overweight Latinos with SMI who were enrolled in a randomized trial evaluating the effectiveness of a motivational health promotion intervention adapted for persons with SMI, In SHAPE. The interviews explored the complicated role having an SMI had in the lives of the Latino participants. Results: SMI had both positive and negative impact on Latino participants' health behaviors. The nature of their mental illness along with medication side effects (e.g. lethargy, weight gain, etc.) negatively impacted their ability to making lasting health behavior change. However, the regular appointments with various specialists provided them with structure that they otherwise would have lacked and gave them a reason to get out of the house. Conclusions: This exploratory research provides insight into the experience of overweight Latinos with SMI and the ways in which SMI impacts their participation in health behavior change. An understanding of the positive and negative effects of SMI on health behavior change will inform the development of health promotion interventions targeted at Latinos with SMI.
Collapse
Affiliation(s)
- Daniel E. Jimenez
- Department of Psychiatry and Behavioral Sciences,
University of Miami Miller School of Medicine
- Veterams Affairs Medical Center Miami
| | | | - Stephen J. Bartels
- Dartmouth Centers for Health and Aging, Geisel School of
Medicine at Dartmouth
| |
Collapse
|
44
|
Johnson HM, Sullivan-Vedder L, Kim K, McBride PE, Smith MA, LaMantia JN, Fink JT, Knutson Sinaise MR, Zeller LM, Lauver DR. Rationale and study design of the MyHEART study: A young adult hypertension self-management randomized controlled trial. Contemp Clin Trials 2019; 78:88-100. [PMID: 30677485 PMCID: PMC6387836 DOI: 10.1016/j.cct.2019.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/11/2019] [Accepted: 01/16/2019] [Indexed: 12/25/2022]
Abstract
Young adults (18-39 year-olds) with hypertension have a higher lifetime risk for cardiovascular disease. However, less than 50% of young adults achieve hypertension control in the United States. Hypertension self-management programs are recommended to improve control, but have been targeted to middle-aged and older populations. Young adults need hypertension self-management programs (i.e., home blood pressure monitoring and lifestyle modifications) tailored to their unique needs to lower blood pressure and reduce the risks and medication burden they may face over a lifetime. To address the unmet need in hypertensive care for young adults, we developed MyHEART (My Hypertension Education And Reaching Target), a multi-component, theoretically-based intervention designed to achieve self-management among young adults with uncontrolled hypertension. MyHEART is a patient-centered program, based upon the Self-Determination Theory, that uses evidence-based health behavior approaches to lower blood pressure. Therefore, the objective of this study is to evaluate MyHEART's impact on changes in systolic and diastolic blood pressure compared to usual care after 6 and 12 months in 310 geographically and racially/ethnically diverse young adults with uncontrolled hypertension. Secondary outcomes include MyHEART's impact on behavioral outcomes at 6 and 12 months, compared to usual clinical care (increased physical activity, decreased sodium intake) and to examine whether MyHEART's effects on self-management behavior are mediated through variables of perceived competence, autonomy, motivation, and activation (mediation outcomes). MyHEART is one of the first multicenter, randomized controlled hypertension trials tailored to young adults with primary care. The design and methodology will maximize the generalizability of this study. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03158051.
Collapse
Affiliation(s)
- Heather M Johnson
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Madison, WI 53705, USA.
| | - Lisa Sullivan-Vedder
- Aurora Health Care Department of Family Medicine, Family Care Center, 1020 N 12(th) Street, Milwaukee, WI 53233, USA.
| | - KyungMann Kim
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, K6/420 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792-4675, USA.
| | - Patrick E McBride
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA.
| | - Maureen A Smith
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Madison, WI 53705, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, USA; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Court, Madison, WI 53715-1896, USA.
| | - Jamie N LaMantia
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Madison, WI 53705, USA.
| | - Jennifer T Fink
- Department of Health Informatics and Administration, University of Wisconsin-Milwaukee College of Health Sciences, NWQ Building B, Suite #6455, 2025 E. Newport Avenue, Milwaukee, WI 53211-2906, USA.
| | - Megan R Knutson Sinaise
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Madison, WI 53705, USA.
| | - Laura M Zeller
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705-2281, USA; Health Innovation Program, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 210, Madison, WI 53705, USA.
| | - Diane R Lauver
- School of Nursing, University of Wisconsin, Signe Skott Cooper Hall, 701 Highland Avenue, Madison, WI 53705, USA.
| |
Collapse
|
45
|
Win KT, Ramaprasad A, Syn T. Ontological Review of Persuasion Support Systems (PSS) for Health Behavior Change through Physical Activity. J Med Syst 2019; 43:49. [PMID: 30671685 DOI: 10.1007/s10916-019-1159-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/08/2019] [Indexed: 01/05/2023]
Abstract
Persuasion Support Systems (PSS) for health behavior change can play an important role in promoting health and well-being through physical activity. It is an emerging application at the crossroad between information systems, persuasion, and healthcare. We propose an ontology to systematically and systemically describe the construct of PSS for health behavior change. The ontology deconstructs the construct into its constituent dimensions and elements, and assembles them into a complete, parsimonious description of the same. We then map the corpus of literature on PSS for health behavior change through physical activity onto the ontology. The resulting ontological map highlights the research topics that are highly- and lightly-emphasized, as well as those with little or no emphasis. It illuminates the landscape of research in the corpus; it highlights biases in emphases that can help and hinder the advancement of the corpus. It can be used to develop a roadmap for future research.
Collapse
Affiliation(s)
- Khin Than Win
- University of Wollongong, Wollongong, NSW, Australia.
| | - Arkalgud Ramaprasad
- University of Wollongong, Wollongong, NSW, Australia.,University of Illinois - Chicago, Chicago, IL, USA
| | - Thant Syn
- Texas A&M International University, Laredo, TX, USA
| |
Collapse
|
46
|
Kilbourne AM, Smith SN, Choi SY, Koschmann E, Liebrecht C, Rusch A, Abelson JL, Eisenberg D, Himle JA, Fitzgerald K, Almirall D. Adaptive School-based Implementation of CBT (ASIC): clustered-SMART for building an optimized adaptive implementation intervention to improve uptake of mental health interventions in schools. Implement Sci 2018; 13:119. [PMID: 30185192 PMCID: PMC6126013 DOI: 10.1186/s13012-018-0808-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Depressive and anxiety disorders affect 20–30% of school-age youth, most of whom do not receive adequate services, contributing to poor developmental and academic outcomes. Evidence-based practices (EBPs) such as cognitive behavioral therapy (CBT) can improve outcomes, but numerous barriers limit access among affected youth. Many youth try to access mental health services in schools, but school professionals (SPs: counselors, psychologists, social workers) are rarely trained adequately in CBT methods. Further, SPs face organizational barriers to providing CBT, such as lack of administrative support. Three promising implementation strategies to address barriers to school-based CBT delivery include (1) Replicating Effective Programs (REP), which deploys customized CBT packaging, didactic training in CBT, and technical assistance; (2) coaching, which extends training via live supervision to improve SP competence in CBT delivery; and (3) facilitation, which employs an organizational expert who mentors SPs in strategic thinking to promote self-efficacy in garnering administrative support. REP is a relatively low-intensity/low-cost strategy, whereas coaching and facilitation require additional resources. However, not all schools will require all three strategies. The primary aim of this study is to compare the effectiveness of a school-level adaptive implementation intervention involving REP, coaching, and facilitation versus REP alone on the frequency of CBT delivered to students by SPs and student mental health outcomes. Secondary and exploratory aims examine cost-effectiveness, moderators, and mechanisms of implementation strategies. Methods Using a clustered, sequential multiple-assignment, randomized trial (SMART) design, ≥ 200 SPs from 100 schools across Michigan will be randomized initially to receive REP vs. REP+coaching. After 8 weeks, schools that do not meet a pre-specified implementation benchmark are re-randomized to continue with the initial strategy or to augment with facilitation. Discussion EBPs need to be implemented successfully and efficiently in settings where individuals are most likely to seek care in order to gain large-scale impact on public health. Adaptive implementation interventions hold the promise of providing cost-effective implementation support. This is the first study to test an adaptive implementation of CBT for school-age youth, at a statewide level, delivered by school staff, taking an EBP to large populations with limited mental health care access. Trial registration NCT03541317—Registered on 29 May 2018 on ClinicalTrials.gov PRS Electronic supplementary material The online version of this article (10.1186/s13012-018-0808-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Amy M Kilbourne
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA. .,U.S. Department of Veterans Affairs, Quality Enhancement Research Initiative, Washington D.C., USA.
| | - Shawna N Smith
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Seo Youn Choi
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Elizabeth Koschmann
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Celeste Liebrecht
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Amy Rusch
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James L Abelson
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel Eisenberg
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Joseph A Himle
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.,School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel Almirall
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
47
|
Churchill S, Jessop DC, Green R, Harris PR. Self-affirmation improves self-control over snacking among participants low in eating self-efficacy. Appetite 2018; 123:264-268. [PMID: 29307498 DOI: 10.1016/j.appet.2017.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 11/17/2018] [Accepted: 12/28/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Individuals low in eating self-efficacy are at particular risk of engaging in unhealthy eating behaviours, including the consumption of high calorie snacks. The elevated levels of snacking displayed by these individuals can largely be attributed to their experiencing low self-control over the avoidance of such foods (Hankonen, Kinnunen, Absetz, & Jallinoja, 2014). Interventions are thus required to boost self-control over snacking among those low in eating self-efficacy. Self-affirmation has been shown to boost self-control among individuals with depleted resources in other domains (Schmeichel & Vohs, 2009). The purpose of the current study was to test the hypothesis that a self-affirmation manipulation would similarly increase self-control over snacking for individuals low in eating self-efficacy. METHODS At baseline, participants (N = 70) completed measures of dietary restraint and eating self-efficacy. In the main study, participants completed either a self-affirmation or a control task immediately before undertaking a joystick category judgment task that assessed self-control over snacking. RESULTS Hierarchical multiple regression analysis revealed the predicted significant interaction between eating self-efficacy and self-affirmation, demonstrating that self-affirmation moderated the association between eating self-efficacy and self-control over snacking. Johnson-Neyman regions of significance confirmed that for participants low in eating self-efficacy the self-affirmation manipulation resulted in higher levels of self-control. Unexpectedly, however, for participants high in eating self-efficacy the self-affirmation manipulation was found to be associated with lower levels of self-control. CONCLUSIONS Findings supported the hypothesis that a self-affirmation manipulation would boost self-control over snacking among individuals low in eating self-efficacy. Self-affirmation may thus provide a useful technique for strengthening self-control in relation to the avoidance of unhealthy foods among individuals who find it difficult to manage challenging dietary situations.
Collapse
|
48
|
Petzold MB, Bischoff S, Rogoll J, Plag J, Terán C, Brand R, Ströhle A. Physical activity in outpatients with mental disorders: status, measurement and social cognitive determinants of health behavior change. Eur Arch Psychiatry Clin Neurosci 2017; 267:639-650. [PMID: 28194516 DOI: 10.1007/s00406-017-0772-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/23/2017] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Physical activity (PA) can play an important role in improving the mental and physical health in patients with mental disorders but is not well studied in this population. The aim of this study was to assess the status of PA in outpatients with mental disorders, compare the convergence of self-rating and accelerometer measurement and examine the influence of social cognitive variables from the Motivation-Volition (MoVo) model and clinical measures on PA. METHODS Eighty-four patients were recruited from three psychiatric outpatient clinics and local psychiatrists (Distribution of ICD-10-Diagnoses: F3.x = 59.5%, F4.x = 20.2%, F2.x = 17.9%, F1.x = 2.4%). PA, Self-efficacy, Outcome-expectancies, Intention, Self-concordance, Action- and Coping-planning, Health-related Quality of Life (SF-12) and Psychiatric Symptoms (SCL-27) were assessed through questionnaires. PA was assessed objectively by accelerometers. RESULTS Most of the participants did not reach PA recommendations. Subjective and objective measurement of PA showed good accordance for total PA on group level but lower accordance on individual level. Motivational and volitional determinants of health behavior change showed a similar pattern of correlations with PA as in populations without mental disorders. CONCLUSION Outpatients with mental disorders have the ability and are willing to perform PA but a large proportion of our sample did not meet PA recommendations. To assess group levels of PA, subjective and objective measurement seem equally apt, for individual diagnostics, a combination of both should be considered. Social cognitive determinants of health behavior change seem to be as helpful for the design of PA interventions for patients with mental disorders as they are in other populations.
Collapse
Affiliation(s)
- Moritz B Petzold
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sophie Bischoff
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Janina Rogoll
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christina Terán
- Department of Psychiatry, St. Hedwig Klinikum, Große Hamburger Straße 5-11, 10115, Berlin, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| |
Collapse
|
49
|
Altobelli LC. Sharing Histories-a transformative learning/teaching method to empower community health workers to support health behavior change of mothers. Hum Resour Health 2017; 15:54. [PMID: 28835240 PMCID: PMC5569546 DOI: 10.1186/s12960-017-0231-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/07/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND One of the keys to improving health globally is promoting mothers' adoption of healthy home practices for improved nutrition and illness prevention in the first 1000 days of life from conception. Customarily, mothers are taught health messages which, even if simplified, are hard to remember. The challenge is how to promote learning and behavior change of mothers more effectively in low-resource settings where access to health information is poor, educational levels are low, and traditional beliefs are strong. METHODS In addressing that challenge, a new learning/teaching method called "Sharing Histories" is in development to improve the performance of female community health workers (CHWs) in promoting mothers' behaviors for maternal, neonatal and child health (MNCH). RESULTS This method builds self-confidence and empowerment of CHWs in learning sessions that are built on guided sharing of their own memories of childbearing and child care. CHWs can later share histories with the mother, building her trust and empowerment to change. For professional primary health care staff who are not educators, Sharing Histories is simple to learn and use so that the method can be easily incorporated into government health systems and ongoing CHW programs. CONCLUSIONS I present here the Sharing Histories method, describe how it differs from other social and behavior change methods, and discuss selected literature from psychology, communications, and neuroscience that helps to explain how and why this method works as a transformative tool to engage, teach, transform, and empower CHWs to be more effective change agents with other mothers in their communities, thereby contributing to the attainment of the Sustainable Development Goals.
Collapse
Affiliation(s)
- Laura C Altobelli
- Future Generations University, Franklin, USA
- Future Generations, Lima, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
50
|
Abstract
In the Middle East, the prevalence of overweight/obesity is 80%; however, no studies have yet tested the efficacy of interventions to promote weight loss. The aim of the present study was to test the ability of implementation intentions formed using a volitional help sheet to support weight loss among people who were overweight/obese. Participants (N = 216) enrolling in a weight loss program in Kuwait were randomly allocated either to form implementation intentions using a volitional help sheet (intervention group) or to use the volitional help sheet to think about critical situations and appropriate responses but not form implementation intentions (control group). The main outcome measure was weight at 6-month follow-up. Participants in the intervention condition lost significantly more weight (6.15 kg; −6.58% initial body weight) than those in the control condition (3.66 kg; −4.04% initial body weight), Mdiff = 2.55% initial body weight, SEdiff = .92, t(214) = 2.76, p = .006, 95%CI = .73, 4.36, d = .38. The present study is the first to show that implementation intentions work beyond a Western context and that the volitional help sheet could be used in a variety of cultural contexts to enhance weight-loss programs.
Collapse
Affiliation(s)
- Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, Faculty of Biology, Medicine and Health, University of Manchester, Coupland Street, Oxford Road, Manchester, M13 9PL, UK.
| | | | | |
Collapse
|