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Reinders MJ, Battjes-Fries MCE, Bouwman EP, Meeusen-van Onna MJG. Effectively implementing healthy and sustainable food practices in out-of-home food service locations: The perspective of the catering staff members. Appetite 2024; 193:107152. [PMID: 38070742 DOI: 10.1016/j.appet.2023.107152] [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: 04/21/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/01/2024]
Abstract
Restaurants, canteens, residential care, hospitals and other out-of-home food service locations can play an important role in improving people's diet quality by offering healthier and more sustainable food choices. However, the effectiveness of implementing sustainable and healthy food practices at these locations is, at least partly, dependent on the extent to which they are accepted and implemented by the staff members. This study aims to assess staff members' motivation, perceived capability, perceived opportunity and their readiness to change their behaviour (i.e., stages of change) in offering more healthy and sustainable food options to their customers or patients. Eleven out-of-home locations that wanted to adjust their assortment towards more healthy and sustainable product offerings participated in this study and were able to distribute a comparable questionnaire among their staff members to assess their perceived readiness to change. Results among 268 participants show that staff members find both a healthy and sustainable food assortment important and also seem to be motivated to improve their food assortment regarding health and sustainability. Perceived opportunity seems to be the largest barrier for staff members, although there is also room for improvement regarding their perceived capability. In addition, personal motivation seems to play the dominant role in staff members' readiness to change the health of the assortment, whereas perceived capability seems to play the dominant role in their perceived readiness to change the sustainability of the assortment. This study shows that taking into account the perspective of the catering staff members may help to effectively implement healthy and sustainable food practices in out-of-home food service locations.
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Affiliation(s)
- Machiel J Reinders
- Wageningen University & Research, Wageningen Economic Research, P.O. Box 29703, 2502 LS, The Hague, the Netherlands.
| | | | - Emily P Bouwman
- Wageningen University & Research, Wageningen Economic Research, P.O. Box 35, 6700 AA, Wageningen, the Netherlands
| | - Marieke J G Meeusen-van Onna
- Wageningen University & Research, Wageningen Economic Research, P.O. Box 29703, 2502 LS, The Hague, the Netherlands
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2
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Strässner AM, Hartmann C. Gradual behaviour change towards meat reduction: Development and validation of a novel decisional balance scale. Appetite 2023; 186:106537. [PMID: 36933833 DOI: 10.1016/j.appet.2023.106537] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/12/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Meat reduction is gaining attention among consumers, marketers, policymakers and scientists. Yet little is known about decision-making processes and behaviour change towards meat reduction. This paper explores the applicability of the decisional balance (DB) framework to the field of meat reduction. A novel DB scale to measure the perceived importance of beliefs about meat reduction at different stages of behaviour change was developed and validated in two studies with German meat eaters. In Study 1 (N = 309), the item inventory was tested using an exploratory factor analysis and then validated in Study 2 (N = 809). The results yielded two higher-order DB factors (pros and cons), which were subdivided into five lower-order factors (perceived benefits of a plant-based diet, downsides of factory farming, health barriers, legitimation barriers and feasibility barriers). The pros and cons were summarised in a DB index. All DB factors and the DB index were tested for internal consistency (Cronbach's alpha ≥.70) and aspects of validity. The typical DB pattern of the pros and cons of behaviour change was confirmed: the cons outweighed the pros for consumers who did not intend to reduce meat consumption, while the pros outweighed the cons for consumers who intended to reduce meat consumption. The new DB scale for meat reduction has proven to be a suitable measure to gain insights into consumers' decision making and could be used to develop targeted meat reduction interventions.
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Affiliation(s)
- Anna-Maria Strässner
- Zurich University of Applied Sciences, School of Management and Law, Institute of Marketing Management, Switzerland.
| | - Christina Hartmann
- ETH Zurich, Department of Environmental Systems Science, Consumer Behaviour, Switzerland.
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Hlongwane TMAG, Pattinson RC, Bergh AM. Implementation of continuous-wave Doppler ultrasound to detect the high-risk foetus in the low-risk mother: lessons from South Africa. BMC Pregnancy Childbirth 2023; 23:393. [PMID: 37245002 DOI: 10.1186/s12884-023-05721-3] [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: 11/23/2022] [Accepted: 05/20/2023] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Detecting the risk of stillbirth during pregnancy remains a challenge. Continuous-wave Doppler ultrasound (CWDU) can be used to screen for placental insufficiency, which is a major cause of stillbirths in low-risk pregnant women. This paper describes the adaptation and implementation of screening with CWDU and shares critical lessons for further rollout. Screening of 7088 low-risk pregnant women with Umbiflow™ (a CWDU device) was conducted in 19 antenatal care clinics at nine study sites in South Africa. Each site comprised a catchment area with a regional referral hospital and primary healthcare antenatal clinics. Women with suspected placental insufficiency as detected by CWDU were referred for follow-up at the hospital. A 35-43% reduction in stillbirths was recorded. METHODS The authors followed an iterative reflection process using the field and meeting notes to arrive at an interpretation of the important lessons for future implementation of new devices in resource-constrained settings. RESULTS Key features of the implementation of CWDU screening in pregnancy combined with high-risk follow-up are described according to a six-stage change framework: create awareness; commit to implement; prepare to implement; implement; integrate into routine practice; and sustain practice. Differences and similarities in implementation between the different study sites are explored. Important lessons include stakeholder involvement and communication and identifying what would be needed to integrate screening with CWDU into routine antenatal care. A flexible implementation model with four components is proposed for the further rollout of CWDU screening. CONCLUSIONS This study demonstrated that the integration of CWDU screening into routine antenatal care, combined with standard treatment protocols at a higher-level referral hospital, can be achieved with the necessary resources and available maternal and neonatal facilities. Lessons from this study could contribute to future scale-up efforts and help to inform decisions on improving antenatal care and pregnancy outcomes in low- and middle-income countries.
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Affiliation(s)
- Tsakane M A G Hlongwane
- Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
| | - Robert C Pattinson
- Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa
| | - Anne-Marie Bergh
- Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa.
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa.
- Department of Obstetrics and Gynaecology, University of Pretoria, Private Bag X323 Gezina, Pretoria, 0031, South Africa.
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Buchmann M, Jordan S, Loer AKM, Finger JD, Domanska OM. Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany. BMC Public Health 2023; 23:331. [PMID: 36788515 PMCID: PMC9930360 DOI: 10.1186/s12889-023-15219-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Health literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy. METHODS Analyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status. RESULTS High compared to low health literacy was associated with a 1.65-times (95% CI = 1.39-1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75-0.95). The associations persisted after adjusting for covariates. CONCLUSION High health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.
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Affiliation(s)
- Maike Buchmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
| | - Susanne Jordan
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Anne-Kathrin Mareike Loer
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Jonas David Finger
- Senate Department for Higher Education and Research, Long-Term Care and Gender Equality, Department of Health, Oranienstraße 106, 10969 Berlin, Germany
| | - Olga Maria Domanska
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
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Zegers AD, Coenen P, Bültmann U, van Hummel R, van der Beek AJ, Duijts SFA. Tailoring work participation support for cancer survivors using the stages of change: perspectives of (health care) professionals and survivors. J Cancer Surviv 2022. [PMID: 35275360 DOI: 10.1007/s11764-022-01196-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Interventions to support work participation in cancer survivors (CSs) have shown limited effectiveness. Applying a behavioral change framework (e.g., stages of change) could make work participation interventions for CSs more timely and tailored. We aimed to explore the application of the stages of change framework to work participation support for CSs and to generate stage-specific intervention content. METHODS Eighteen experts (e.g., occupational physicians, reintegration consultants) were individually interviewed, and three focus groups with CSs (n = 6, n = 5, n = 4) were conducted. Data were analyzed along the six work-related behavioral change stages purported by the readiness for return to work framework, which is based on the stages of change. RESULTS The following themes were identified: (1) pre-contemplation: emotional support and staying connected-encourage contact with the employer/colleagues; (2) contemplation: considering return to work is stressful-facilitate the deliberation process; (3) preparation self-evaluative: assess current capabilities-seek guidance from, e.g., occupational physicians; (4) preparation behavioral: planning return to work-allow for personalized solutions and encourage supervised return to work; (5) uncertain maintenance: guard against overload-train self-efficacy strategies and communication tactics; and (6) proactive maintenance: accept and prepare for the long term. CONCLUSIONS Our results support the potential utility of tailoring CSs' work participation support along the stages of change. IMPLICATIONS FOR CANCER SURVIVORS We provided recommendations for intervention content and developed a stage-specific work participation intervention for CSs, the effectiveness of which will be evaluated in an upcoming randomized controlled trial.
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Lee MK. Decisional balance, self-leadership, self-efficacy, planning, and stages of change in adopting exercise behaviors in patients with stomach cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 56:102086. [PMID: 34942589 DOI: 10.1016/j.ejon.2021.102086] [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: 03/16/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Previous studies have suggested the benefits of regular exercise in motivating the survivors of cancer; however, most survivors are insufficiently active, showing high rates of nonadherence to physical activity guidelines. Using the I-Change model, this study sought to determine the association of decisional balance and self-efficacy for exercise, planning, and self-leadership with the stages of change in exercise behavior among patients with stomach cancer. METHODS This cross-sectional study was conducted in February 2021 and included 145 patients diagnosed with primary stomach cancer via quota sampling in South Korea. Sociodemographics, comorbidity, decisional balance for exercise, self-efficacy for exercise, planning, self-leadership, and stages of change in exercise behavior were assessed. RESULTS Of the participants, 4% were in the precontemplation stage of exercise behavior, 10% contemplation, 37% preparation, 23% action, and 27% maintenance. The male sex (p = 0.043), higher self-efficacy for resisting relapse (p < 0.0001), higher coping planning (p = 0.029), and higher self-leadership for behavior awareness and volition (p = 0.023) were associated with more readiness for changes in exercise behavior. CONCLUSIONS From the results obtained using the I-Change model, self-efficacy for resisting relapse to previous habits, coping planning, and behavior awareness and volition were associated with more readiness for changes in exercise behavior. These findings may help reduce stomach cancer survivors' nonadherence to physical activity guidelines.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
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Gill KK, van der Moolen S, Bilal S. Phenomenological insight into the motivation to quit smoking. J Subst Abuse Treat 2021; 131:108583. [PMID: 34535321 DOI: 10.1016/j.jsat.2021.108583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Quitting tobacco is often viewed as a difficult experience as the dependence includes sets of behavioral, cognitive, social, and physiologic phenomena that prevent most smokers from having a successful first attempt of quitting. The aim of this qualitative study was to gain insight into and understand the motivation for attempts to quit smoking in relation to the stages of the behavior change model. METHOD The study team based this qualitative study on Alfred Schütz's social phenomenology framework. The study team planned for fourteen in-depth interviews with patients registered at a Quit Smoking Clinic. Each in-depth session lasted 45-60 min and we audio recorded them with consent. Following full verbatim transcription, the study team carried out detailed thematic analysis using Nvivo software. RESULTS Out of a total of 14 patients, 10 agreed to participate (response rate 71.4%). Seven participants (70%) had successfully quit smoking, while the remaining 30% relapsed after the first quit attempt. The study team extracted from the data three key themes with eight child nodes: barriers to quitting smoking, reasons for quit attempt, and how to quit. Unsuccessful attempts were related to tobacco addiction and successful attempts were based on the need to improve one's health and family. The study explored two intrinsic (self-realization and healthy lifestyle) and two extrinsic motivations (family's health and role model for children) for attempting to quit. CONCLUSION The study highlights the importance of psychological support in successful quit attempts. Treatment providers should encourage behavior change through intrinsic goals, as such goals, compared to extrinsic goals, have a long-term and positive impact because they can activate autonomous motivation.
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Imeri H, Toth J, Arnold A, Barnard M. Use of the transtheoretical model in medication adherence: A systematic review. Res Social Adm Pharm 2021; 18:2778-2785. [PMID: 34275751 DOI: 10.1016/j.sapharm.2021.07.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Medication nonadherence is an important public health issue that has individual and system-level implications. Nonadherence can lead to negative health outcomes and illness, which in turn produce increased healthcare costs for both the individual and system. The transtheoretical model of change (TTM) can be a useful basis for interventions, as it can identify patients' current stages of change and guide them from nonadherence to adherence. OBJECTIVE The objective of this systematic review was to determine the utilization of the TTM to predict or improve medication adherence in patients with chronic conditions. METHODS A systematic review of current literature was conducted to obtain an overview of the use of TTM-informed interventions for medication adherence in chronic conditions. PubMed, Embase, PsycInfo and CINAHL databases were searched in July 2020. The methodological quality of the studies was evaluated using the Downs and Black checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for data extraction, analysis, and reporting. RESULTS Ten studies were included in the final data synthesis of this review. Eight of the reviewed studies supported the utility of TTM to predict or improve medication adherence in patients with chronic conditions, while two studies did not find any significant improvement in medication adherence after using a TTM-based intervention. The Downs and Black checklist revealed the overall methodological quality of the included studies to be fair [mean (SD) = 16.3 (4.5) of a possible maximum score of 28]. CONCLUSION This systematic review provides an overview of the utility of TTM in predicting and improving medication adherence in patients with chronic conditions. Although TTM-based interventions in patients with low or moderate medication adherence were effective, there were few studies identified, suggesting the need for further research.
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Affiliation(s)
- Hyllore Imeri
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
| | - Jennifer Toth
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
| | - Austin Arnold
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
| | - Marie Barnard
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
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Noar SM, Willoughby JF, Crosby R, Webb EM, Van Stee SK, Feist-Price S, Davis E. Acceptability of a Computer-Tailored Safer Sex Intervention for Heterosexually Active African Americans Attending an STI Clinic. J Prim Prev 2021; 41:211-227. [PMID: 32157623 DOI: 10.1007/s10935-020-00585-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Since African Americans are disproportionately affected by HIV/AIDS, interventions that increase correct and consistent condom use are urgently needed. We report baseline acceptability data from a randomized controlled trial (RCT) testing the Tailored Information Program for Safer Sex, a computer-tailored intervention designed to increase correct and consistent condom use among low income, heterosexually active African Americans attending an urban sexually transmitted infection (STI) clinic. We enrolled 274 participants at baseline in an RCT-147 in the intervention group. The intervention had high acceptability, with a mean acceptability of 4.35 on a 5-point scale. We conducted a multiple regression analysis examining demographic, structural, and sexual risk characteristics that revealed only sex to be significantly (p < .01) associated with intervention acceptability. While women were more likely than men to find the intervention acceptable, overall the results indicated broad acceptability of this intervention to the target audience. eHealth interventions are a viable option for HIV prevention among African Americans visiting a publicly-funded STI clinic. We discuss implications of these results for the future application of such programs.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, 382 Carroll Hall, Campus Box 3365, Chapel Hill, NC, 27599-3365, USA. .,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | | | - Richard Crosby
- College of Public Health, University of Kentucky, Lexington, USA
| | - Elizabeth M Webb
- Department of Communication, University of South Carolina Aiken, Aiken, USA
| | - Stephanie K Van Stee
- Department of Communication and Media, University of Missouri-St. Louis, St. Louis, USA
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van Cappellen-van Maldegem SJM, Mols F, Horevoorts N, de Kruif A, Buffart LM, Schoormans D, Trompetter H, Beijer S, Ezendam NPM, de Boer M, Winkels R, Kampman E, Schuit J, van de Poll-Franse L, Seidell JC, Hoedjes M. Towards OPtimal TIming and Method for promoting sUstained adherence to lifestyle and body weight recommendations in postMenopausal breast cancer survivors (the OPTIMUM-study): protocol for a longitudinal mixed-method study. BMC Womens Health 2021; 21:268. [PMID: 34229690 PMCID: PMC8258491 DOI: 10.1186/s12905-021-01406-1] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/30/2021] [Indexed: 11/10/2022]
Abstract
Background The majority of postmenopausal breast cancer (PMBC) survivors do not adhere to lifestyle recommendations and have excess body weight. In this group, this is associated with poorer health-related quality of life and an increased risk of type II diabetes mellitus, cardiovascular disease, second primary cancers, cancer recurrences, and mortality. Gaining and maintaining a healthy lifestyle and body composition is therefore important. It is unknown when and how sustained adherence to these recommendations can be promoted optimally in PMBC survivors. Therefore, the OPTIMUM study aims to identify the optimal timing and method for promoting sustained adherence to lifestyle and body weight recommendations in PMBC survivors.
Methods The OPTIMUM-study has a mixed-methods design. To assess optimal timing, a longitudinal observational study will be conducted among approximately 1000 PMBC survivors. The primary outcomes are adherence to lifestyle and body weight recommendations, readiness for change, and need for support. Questionnaires will be administered at 4–6 months after cancer diagnosis (wave 1: during treatment and retrospectively before diagnosis), 1 year after diagnosis (wave 2: after completion of initial treatment), and 1.5 years after diagnosis (wave 3: during follow-up). Wave 2 and 3 include blood sampling, and either wearing an accelerometer for 7 days or completing a 3-day online food diary (randomly assigned at hospital level). To assess the optimal method, behavioural determinants of the primary outcomes will be matched with Behavior Change Techniques using the Behaviour Change Technique Taxonomy. Qualitative research methods will be used to explore perceptions, needs and preferences of PMBC survivors (semi-structured interviews, focus groups) and health care providers (Delphi study). Topics include perceptions on optimal timing to promote adherence; facilitators and motivators of, and barriers towards (sustained) adherence to recommendations; and acceptability of the selected methods. Discussion The OPTIMUM study aims to gain scientific knowledge on when and how to promote sustained adherence to lifestyle and body weight recommendations among PBMC survivors. This knowledge can be incorporated into guidelines for tailored promotion in clinical practice to improve health outcomes.
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Affiliation(s)
- Sandra J M van Cappellen-van Maldegem
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Floortje Mols
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Nicole Horevoorts
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Anja de Kruif
- Department of Epidemiology and Biostatistics, Amsterdam Public Health (APH), VUmc, Amsterdam, the Netherlands.,Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Laurien M Buffart
- Radboudumc, Department of Physiology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Dounya Schoormans
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Hester Trompetter
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Nicole P M Ezendam
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Michiel de Boer
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, the Netherlands.,Department of General Practice and Elderly Care Medicine, UMCG, Groningen, the Netherlands
| | - Renate Winkels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Jantine Schuit
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Lonneke van de Poll-Franse
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.,Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jacob C Seidell
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, the Netherlands
| | - Meeke Hoedjes
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
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Ahmed Tharbe IH, Kamaruddin MKA, Sumari M, Chong IM. Data on the relationship of emotional intelligence and stages of change among Malaysian prison inmates. Data Brief 2021; 35:106804. [PMID: 33604426 PMCID: PMC7873625 DOI: 10.1016/j.dib.2021.106804] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/25/2022] Open
Abstract
The data presented in this article examine the relationship between the subcomponents of emotional intelligence (emotional perception and expression, emotional facilitation of thinking, emotional understanding and emotional management) and the stages of change (pre-contemplation, contemplation, action and maintenance). The final data were obtained from 429 Malaysian inmates (374 male and 55 female) recruited from eight Malaysian prisons in four different zones. The two instruments used were the Self-Rated Malaysian Emotional Intelligence Scale (SRMEIS) and the University Rhodes Island Change Assessment Scale (URICA). Both instruments underwent expert validation through construct and test-retest validity. The researcher randomly distributed a total of 550 questionnaires, of which 429 were accepted and 121 were rejected due to missing data and outliers, resulting in 78% of participants providing data that could be used in the analyses. All participants were informed of the confidentiality of their data, and their participation was voluntary. SPSS and Excel files are provided as supplementary material.
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Affiliation(s)
- Ida Hartina Ahmed Tharbe
- Department of Educational Counseling, Faculty of Education, University Malaya, Kuala Lumpur, Malaysia
| | | | - Melati Sumari
- Department of Educational Counseling, Faculty of Education, University Malaya, Kuala Lumpur, Malaysia
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Singh HK, Kennedy GA, Stupans I. A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension. BMC Fam Pract 2021; 22:35. [PMID: 33583416 PMCID: PMC7883432 DOI: 10.1186/s12875-021-01385-0] [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] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension. METHODS In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants' stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period. RESULTS Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d = - 0.42) in participants who received health coaching. Improvements to medication adherence was also apparent in these participants, evident from the mean scores for the Adherence to Refills and Medications Scale (ARMS), which decreased significantly from a mean of 15.60 to 13.05 (p < 0.05) from session one to four. CONCLUSIONS Pharmacist health coaching produced promising health outcomes in participants with poorly controlled hypertension. Pharmacists were able to facilitate a positive behaviour change in participants. However, larger participant cohorts are needed to explore these findings further. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry ACTRN12618001839291 . Date of registration 12/11/2018.
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Affiliation(s)
- Harjit K Singh
- Discipline of Pharmacy, The School of Health and Biomedical Sciences, RMIT University VIC, Bundoora, VIC, 3083, Australia.
| | - Gerard A Kennedy
- Discipline of Pharmacy, The School of Health and Biomedical Sciences, RMIT University VIC, Bundoora, VIC, 3083, Australia.,School of Health and Life Sciences, Federation University, University Drive, Mount Helen, Ballarat, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, 145 Studley Road, Heidelberg, Melbourne, Australia
| | - Ieva Stupans
- Discipline of Pharmacy, The School of Health and Biomedical Sciences, RMIT University VIC, Bundoora, VIC, 3083, Australia
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Khader WS, Fernandez FX, Seixas A, Knowlden A, Ellis J, Williams N, Hale L, Branas C, Perlis M, Jean-Louis G, Killgore WDS, Alfonso-Miller P, Grandner MA. What makes people want to make changes to their sleep? Assessment of perceived risks of insufficient sleep as a predictor of intent to improve sleep. Sleep Health 2020; 7:98-104. [PMID: 32994153 DOI: 10.1016/j.sleh.2020.07.003] [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: 03/20/2020] [Revised: 07/01/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of the present study is to identify which underlying beliefs about the impact of sleep on health may motivate change in sleep behavior. DESIGN A cross-sectional study conducted between 2012 and 2014. SETTING Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study conducted in Philadelphia, PA, and its surrounding regions. PARTICIPANTS Participants consisted of N = 1007 community-dwelling adults age 22-60. MEASUREMENTS Respondents indicated behaviors they could improve on to facilitate sleep and their corresponding readiness to change. They were also asked items from the Sleep Practices and Attitudes Questionnaire (SPAQ) regarding the degree to which they agree with whether "not getting enough sleep" can impact a variety of health factors. RESULTS In adjusted analyses, stage of change was associated with degree of agreement that insufficient sleep can cause sleepiness (odds ratio [OR] = 1.17, P = .035), weight gain (OR = 1.20, P < .0005), heart disease (OR = 1.21, P = .001), cholesterol (OR = 1.13, P = .047), hypertension (OR = 1.16, P = .014), moodiness (OR = 1.42, P < .0005), decreased energy (OR = 1.30, P = .002), absenteeism (OR = 1.13, P = .007), decreased performance (OR = 1.20, P = .003), concentration/memory problems (OR = 1.23, P = .004), diabetes (OR = 1.14, P = .042), and feeling tired (OR = 1.39, P < .0005). When sleep duration was added to the model, significant associations remained for all except cholesterol. When accounting for insomnia, significant associations were maintained for only weight, moodiness, performance, diabetes, and tiredness. CONCLUSIONS Degree of belief that insufficient sleep can cause outcomes such as moodiness, occupational problems, and health problems may impact whether an individual is contemplating/attempting to change their sleep-related behaviors. Targeting these key messages about the associations between sleep health with moodiness and weight gain in informational material may enhance education/outreach efforts aimed at adults.
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Affiliation(s)
- Waliuddin S Khader
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona College of Medicine, Tucson, Arizona, USA
| | | | - Azizi Seixas
- Department of Population Health, NYU Langone Health Center, New York, New York, USA
| | - Adam Knowlden
- Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA
| | - Jason Ellis
- Department of Psychology, Northumbria Sleep Research Laboratory, Northumbria University, Northumbria, UK
| | - Natasha Williams
- Department of Population Health, NYU Langone Health Center, New York, New York, USA
| | - Lauren Hale
- Program in Public Health, Stony Brook University, Stony Brook, New York, USA
| | - Charles Branas
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Michael Perlis
- Department of Psychiatry, Behavioral Sleep Medicine Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Girardin Jean-Louis
- Department of Population Health, NYU Langone Health Center, New York, New York, USA
| | - William D S Killgore
- Department of Psychiatry, SCAN Lab, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Pamela Alfonso-Miller
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona College of Medicine, Tucson, Arizona, USA; Department of Psychology, Northumbria Sleep Research Laboratory, Northumbria University, Northumbria, UK
| | - Michael A Grandner
- Department of Psychiatry, Sleep and Health Research Program, University of Arizona College of Medicine, Tucson, Arizona, USA.
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Sanford-Opatz L, Woodward D, O'Reilly C, Brooks E, Limbert C. To contemplate or not to contemplate evaluating a preliminary intervention proposal in an outpatient setting: the contemplation therapy group. Eat Weight Disord 2020; 25:389-98. [PMID: 30414075 DOI: 10.1007/s40519-018-0610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 08/24/2017] [Accepted: 10/26/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The concept for the contemplation group intervention was derived from motivational interviewing (MI) to support people suffering from an eating disorder who are reluctant to engage with treatment. This evaluation focuses on the contemplation group run by the eating disorder services in the Cardiff and Vale area between 2012 and 2016 to investigate the outcomes for participants and implications for working with people suffering from an eating disorder who are ambivalent about change. METHOD Quantitative measures were used to assess eating disorder symptomatology, motivation to change and location within the stages of change model. A brief qualitative evaluation of client experiences was also included. RESULTS While dropout was high, a number of patients displayed increased readiness for treatment at the end of the group or even started to engage in change-focussed therapy. Participants who completed the group described it as challenging but helpful. CONCLUSIONS This evaluation shows that explorative contemplation of their ambivalence towards their eating disorder and treatment was helpful for the participants of the group and supported them in achieving more clarity and decisiveness regarding whether to engage in treatment or not. Further research is needed to evaluate long-term outcomes for patients who feel ambivalent towards treatment, and to explore what interventions can be used to help them. EVIDENCE LEVEL Level IV: Evidence obtained from multiple time series with or without the intervention.
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Sampaio LANPC, de Carvalho Mesquita Ayres JR. Critique of the concept of motivation and its implications for healthcare practices. Philos Ethics Humanit Med 2019; 14:14. [PMID: 31640739 PMCID: PMC6805419 DOI: 10.1186/s13010-019-0083-6] [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: 08/25/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Motivation is a crucial and widespread theme within medicine. From clinical to surgical scenarios, acquiescence in taking a pill or coming to a consultation is imperative for medical treatment to thrive. The "decade of the brain" gave practitioners substantial neuroscientific data on human behavior, helped to explain why people do what they do and created the concept of "motivated brain". Findings from empirical psychology stratified motivation into stages of change, which became more complex over the decades. This research seeks to improve the understanding of how people make decisions about their health, and how to better understand strategies and techniques to help them resolve ambivalence in an effective goal-oriented way. METHODS We establish a dialogue with Ricoeur's phenomenology of the will in order to understand the meaning of these scientific findings. Starting from Husserlian phenomenology, Paul Ricoeur developed his thoughts away from transcendental idealism, through emancipating the intentional structures of the will from the realm of perception. RESULTS Through introducing the concepts of the voluntary and the involuntary, Ricoeur deviated from Cartesian dualism, which renders the body as an object body, a target of natural vicissitudes. The new dualism of the voluntary and the involuntary is dealt with by reference to what Ricoeur called the central mystery of incarnate existence, which considers man "double in humanity, simple in vitality". This duality makes it possible to consider the brain to be the natural organ of behavior in the human body, and to use empirical psychology as a path to escape from shallow subjectivations of concepts. CONCLUSIONS Paul Ricoeur's simplicity (or unity) of existence provides an invitation for medicine to rethink some of its philosophical assumptions, such that patients can be considered to be autonomous subjects with authorial life projects. Ricoeurian anthropology has a deep ethical impact on how medicine should use technology, which arises from empirical psychology findings. The usage of this new knowledge also needs to be thoroughly inspected, since it shifts the social role of medical science.
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Affiliation(s)
- Leonardo Augusto Negreiros Parente Capela Sampaio
- Department of Preventive Medicine, University of São Paulo Medical School, Av. Dr. Arnaldo, 455, 2° andar, São Paulo, Brazil
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Jalilian H, Pezeshki MZ, Janati A, Najafipour F, Sarbakhsh P, Zarnaq RK. Readiness for weight change and its association with diet knowledge and skills, diet decision making and diet and exercise barriers in patients with type 2 diabetes. Diabetes Metab Syndr 2019; 13:2889-2895. [PMID: 31425953 DOI: 10.1016/j.dsx.2019.07.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022]
Abstract
AIMS this study aimed to investigate stages of weight change in type 2 diabetics and its associations with diet knowledge and skills, diet decision making, diet and exercise barriers. MATERIALS AND METHODS This was a cross-sectional study of 1139 patients with type 2 diabetes aged>18 years in East Azerbaijan, Iran. Data were collected using the Personal Diabetes Questionnaire (PDQ) and were analyzed using SPSS software (version 22) and descriptive statistics, Chi-square and one-way ANOVA tests. RESULTS 48.1% of the patients were in the pre-contemplation stage. 7.5%, 14.6% and 29.8% of patients were in the stages of contemplation, preparation and action, respectively. Patients with a higher score in diet knowledge and skills and diet decision making were more likely to be involved in the action stage of weight loss process, while those who had more eating problems and exercise barriers were less likely to be involved in the action stage of weight loss. CONCLUSION The results of this study showed that a substantial percentage of patients are at the pre-contemplation stage, so proper measures are needed to inform patients about the consequences of obesity and overweight. It is also necessary to focus on people with poor incomes and education status and those living in rural areas. Improve diet knowledge and skills and diet decision making and the reduction of barriers to exercise can help patients to take action to lose weight.
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Affiliation(s)
- Habib Jalilian
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Zakarya Pezeshki
- Social Determinants of Health Research Center, Department of Community and Family Medicine, Tabriz Medical School, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Janati
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Rahim Khodayari Zarnaq
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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Jalilian H, Pezeshki MZ, Janati A, Najafipour F, Imani A, Zozani MA, Khodayari Zarnaq R. Readiness for diet change and its association with diet knowledge and skills, diet decision making and diet barriers in type 2 diabetic patients. Diabetes Metab Syndr 2019; 13:2933-2938. [PMID: 31425959 DOI: 10.1016/j.dsx.2019.07.065] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022]
Abstract
AIMS to investigate stages of change for dietary in type 2 diabetics and its associations with diet knowledge and skills, diet decision making and diet barriers. MATERIALS AND METHODS This was a cross-sectional study which was conducted on 1139 diabetics aged>18 years in East Azerbaijan, Iran. Data were collected through a Personal Diabetes Questionnaire (PDQ) and analyzed through SPSS version 22 software using descriptive statistics, Chi-square and one-way ANOVA tests. Tukey's HSD post hoc tests were applied to illustrate ANOVA findings. RESULTS 59.3% of patients do not follow a diet plan to control their blood glucose. 44.7%, 5.5%, 13%, and 36.8% of patients, respectively, were in the stages of pre-contemplation, contemplation, preparation and action. Patients who had shorter disease duration and those whose current treatment was lifestyle change were more likely within the action stage. Also, patients who had a higher score in diet knowledge and skills and diet decision making and those who had a lower score in diet barriers were more likely in the action stage of change. CONCLUSION Based on the results of this study, a considerable proportion of diabetic patients were in the pre-contemplation stage. Diet knowledge and skills, diet decision making and diet barriers were factors contributing to diet readiness to change. Therefore, taking necessary measures to increase diet knowledge, skills and diet decision-making and a reduction in diet barriers can help people with type 2 diabetes to change diet.
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Affiliation(s)
- Habib Jalilian
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Zakarya Pezeshki
- Social Determinants of Health Research Center, Department of Community and Family Medicine, Tabriz Medical School, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Janati
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Imani
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Morteza Arab Zozani
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Rahim Khodayari Zarnaq
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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McGarragle KM, Hare C, Holter S, Facey DA, McShane K, Gallinger S, Hart TL. Examining intrafamilial communication of colorectal cancer risk status to family members and kin responses to colonoscopy: a qualitative study. Hered Cancer Clin Pract 2019; 17:16. [PMID: 31391872 PMCID: PMC6595615 DOI: 10.1186/s13053-019-0114-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/21/2018] [Accepted: 06/03/2019] [Indexed: 01/21/2023] Open
Abstract
Background First-degree relatives (FDRs) of probands with colorectal cancer (CRC) may be at increased risk of CRC and require colonoscopy. Proband disclosure about this risk and need for colonoscopy is essential for FDRs to take appropriate action. Low colonoscopy rates are reported among FDRs and little is known about the proband disclosure process. A better understanding of the barriers surrounding colonoscopy and disclosure is needed. Methods CRC probands (n = 16) and FDRs (n = 9), recruited from a Canadian CRC Consortium, completed interviews to determine barriers to disclosure and colonoscopy, respectively. Interviews were analyzed using thematic analysis and participants’ motivation to disclose to FDRs or undertake colonoscopy was categorized into Stages of Change (i.e., Precontemplation, Contemplation, Preparation, Action, or Maintenance) using the transtheoretical model. Results 25% of probands had not disclosed to any first-degree kin and were categorized in the Precontemplation or Contemplation Stage of Change. Barriers to disclosure included lack of information, negative expectations about familial reaction, assuming FDRs were aware of risk or already being screened, dysfunctional family dynamics, and cultural barriers. 75% of FDRs were categorized in the Precontemplation or Contemplation Stage of Change. Barriers included negative perceptions about colonoscopy, health-care provider related factors, practical concerns, and lack of information about CRC, risk, and colonoscopy. Conclusions In the absence of barriers such as cost and accessibility, this Canadian sample still reported several challenges to disclosure and colonoscopy adherence. Future research should explore interventions such as motivational interviewing to improve proband disclosure and to increase FDR adherence to colonoscopy.
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Affiliation(s)
| | - Crystal Hare
- 1Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Spring Holter
- 2Zane Cohen Centre for Digestive Diseases, Sinai Health System, Box 24-60 Murray Street, Toronto, ON M5T 3L9 Canada
| | - Dorian Anglin Facey
- 2Zane Cohen Centre for Digestive Diseases, Sinai Health System, Box 24-60 Murray Street, Toronto, ON M5T 3L9 Canada
| | - Kelly McShane
- 1Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Steven Gallinger
- 2Zane Cohen Centre for Digestive Diseases, Sinai Health System, Box 24-60 Murray Street, Toronto, ON M5T 3L9 Canada.,3Department of General Surgery, Toronto General Hospital, 200 Elizabeth St., 10EN, Room 206, Toronto, ON M5G 2C4 Canada
| | - Tae L Hart
- 1Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada.,2Zane Cohen Centre for Digestive Diseases, Sinai Health System, Box 24-60 Murray Street, Toronto, ON M5T 3L9 Canada.,4Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8 Canada
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Lee IS, Lee M, Kim HK, Lee EJ. Effectiveness of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. Arch Psychiatr Nurs 2019; 33:189-195. [PMID: 30927989 DOI: 10.1016/j.apnu.2018.12.001] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/22/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to examine the effects of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. This study used a quasi-experimental nonequivalent control design. This study was performed from March 2015 to July 2015. The drinking-reduction program was conducted once per week for 11 weeks. This program improved drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in the experimental group compared to the control group (p < .05, n = 34). The drinking-reduction program can be used as a nursing intervention for people with moderate alcohol use disorder.
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Arafat Y, Mohamed Ibrahim MI, Awaisu A, Colagiuri S, Owusu Y, Morisky DE, AlHafiz M, Yousif A. Using the transtheoretical model's stages of change to predict medication adherence in patients with type 2 diabetes mellitus in a primary health care setting. ACTA ACUST UNITED AC 2019; 27:91-99. [PMID: 30729403 DOI: 10.1007/s40199-019-00246-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Qatar is currently experiencing a worrying increase in the prevalence of diabetes mellitus (DM). One of the most common reasons for uncontrolled DM is non-adherence to medications. The socio-behavioral intervention has proven effective in some chronic illnesses. OBJECTIVES To assess the stages of change (SOC) and medication adherence scores of type 2 diabetes mellitus (T2DM) patients visiting primary healthcare institutions in Qatar, and to evaluate the cause and effect relationship between SOC and adherence to antidiabetic medications. METHODS The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence, and a 2-item SOC questionnaire was utilized to classify the SOC. The analysis to determine if the SOC could predict medication adherence while controlling for demographic characteristics, total number of prescribed medications and disease duration was done using hierarchical multiple regression. RESULTS The final analysis included 387 patients. In relation to medication adherence, majority of the patients were in the maintenance stage (76.7%), followed by the preparation stage (14.7%), the action stage (3.9%), the contemplation stage (3.4%) and the precontemplation stage (1.3%). Most of the patients were in high adherence towards antidiabetic medications (50.3%) followed by low level (26.4%) and medium level (23.3%). SOC was significant and positively predicted medication adherence, which accounted for around 58 to 60% (p < 0.001) while controlling for covariates. CONCLUSIONS SOC was significant and positively predicted medication adherence. The study recommends that the SOC questionnaire could potentially be used to identify patients at risk for low adherence.
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Affiliation(s)
- Yara Arafat
- Clinical Pharmacy and Practice Section, College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Ahmed Awaisu
- Clinical Pharmacy and Practice Section, College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Yaw Owusu
- Clinical Pharmacy and Practice Section, College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Ahmed Yousif
- Pharmacy Department, Westbay Healthcare Center, Doha, Qatar
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Rios LE, Herval ÁM, Ferreira RC, Freire MDCM. Prevalences of Stages of Change for Smoking Cessation in Adolescents and Associated Factors: Systematic Review and Meta-Analysis. J Adolesc Health 2019; 64:149-57. [PMID: 30447952 DOI: 10.1016/j.jadohealth.2018.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Received: 04/02/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To synthesize evidence on the prevalences of stages of change (Transtheoretical Model) for smoking cessation in adolescents and associated factors. METHODS A systematic search of Web of Science (Thomson Reuters), SCOPUS (Elsevier), MEDLINE/PubMed, CINAHL (EBSCO) and PsycINFO (APA) was conducted to identify eligible studies. Two calibrated reviewers selected studies independently, extracted data, and appraised studies. A qualitative synthesis of the findings and meta-analysis of the prevalences of the stages of change for smoking cessation were carried out. A quality effects model was used to estimate the pooled prevalences. RESULTS Eleven studies (N = 6469 adolescents) from five middle- to high-income countries were included in the review. Precontemplators accounted for 41% of smokers in earlier stages of change (95%CI: 34%-49%). In such a group, a lowered decisional balance, the lowest self-efficacy, and highest nicotine dependence were found (p < .05). CONCLUSIONS A higher overall prevalence of adolescents in precontemplation stage for smoking cessation was observed. Such group displayed more unfavorable smoking-related behaviors and characteristics than adolescents in other stages. The evidence is limited due to the lack of studies in adolescents living in low-income countries.
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Salinas-Martínez AM, Castañeda-Vásquez DE, García-Morales NG, Oliva-Sosa NE, de-la-Garza-Salinas LH, Núñez-Rocha GM, Ramírez-Aranda JM. Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries. J Cancer Educ 2018; 33:1230-1238. [PMID: 28612325 DOI: 10.1007/s13187-017-1236-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (n = 240), contemplation (n = 243), action (n = 205), maintenance (n = 311), and relapse (n = 348). We only considered those ≥40 years with no cancer history. We measured the pros, cons, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (p < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.
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Affiliation(s)
- Ana María Salinas-Martínez
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Ave. Lincoln S/N esquina Ma. Jesús Candia. Col. Valle Verde, 2° sector, Monterrey, N.L., CP 64360, Mexico.
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico.
| | | | | | - Norma Edith Oliva-Sosa
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Ave. Lincoln S/N esquina Ma. Jesús Candia. Col. Valle Verde, 2° sector, Monterrey, N.L., CP 64360, Mexico
| | | | | | - José Manuel Ramírez-Aranda
- School of Medicine, Family Medicine Department, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico
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Lueck JA. Respecting the 'stages' of depression: Considering depression severity and readiness to seek help. Patient Educ Couns 2018; 101:1276-1282. [PMID: 29475726 DOI: 10.1016/j.pec.2018.02.007] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Despite knowing the value of message customization, empirical results have failed to provide clear indicators of what make a depression help-seeking message effective. The present research examines stages of depression in response to a prominent communication strategy, gain versus loss framing, to inform possibilities for effective message customization. METHODS Two experimental studies were conducted with a student (N = 126) and U.S. adult (N = 738) sample that tested the effects of gain versus loss framing at different stages of depression. RESULTS A persuasive gain-frame advantage was found for those with mild and severe depression, whereas a boomerang effect was found for both gain and loss framing among those with moderately severe depression. With regards to intention to seek help, neither gain nor loss framing was found to influence intentions. Stages of depression was a strong predictor, with strongest intentions to seek help observed among those with either minor or severe symptoms of depression. CONCLUSION Effective health messaging must be matched with unique characteristics and needs of individuals at each 'stage' of depression in order to produce favorable outcomes. PRACTICE IMPLICATIONS 'Stages' of depression should be known and carefully assessed before the creation and launch of communication interventions.
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Koo KM, Park CH, Kim CJ. Development of strategies for changing in physical activity behaviors on older adults with disabilities. J Exerc Rehabil 2018; 13:676-683. [PMID: 29326900 PMCID: PMC5747203 DOI: 10.12965/jer.1735144.572] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/09/2017] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to develop strategies for promoting physical activity for the disabled older adults who were in the transtheoretical model of precontemplation, contemplation, and preparation stages about participating physical activities for promoting healthy life-styles. In order to achieve this goal, we developed a preliminary strategy for promoting physical activity for the elderly with disabilities based on the data gathered through the ground-work studies and the results of the research on the changes of the exercise behavior directly investigated from the elderly with disabilities. Then the strategies were verified to completion of the final promoting strategies. The elderly with disabilities in the three stages of precontemplation, contemplation, and preparation should develop strategies to think positively about themselves and their surroundings as well as strengthen their appropriate healthy behaviors. Additionally, families, physicians, and healthy seniors who spent time with disabled older adults could help to promote physical activities. However, overall administrative support, in-stitutional system construction, and public policy support were needed and it suggested that multifaceted supports and a variety of cooperation were necessary to improve a quality of life among older adults with disabilities.
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Affiliation(s)
- Kyo-Man Koo
- Department of Adapted Physical Education, Baekseok University, Cheonan, Korea
| | - Chae-Hee Park
- Department of Sport and Healthy Aging, Korea National Sport University, Seoul, Korea
| | - Chun-Jong Kim
- Department of Special Physical Education, Yeungnam University, Gyeongsan, Korea
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Abula K, Gröpel P, Chen K, Beckmann J. Does knowledge of physical activity recommendations increase physical activity among Chinese college students? Empirical investigations based on the transtheoretical model. J Sport Health Sci 2018; 7:77-82. [PMID: 30356484 PMCID: PMC6180551 DOI: 10.1016/j.jshs.2016.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/10/2016] [Accepted: 10/08/2016] [Indexed: 06/08/2023]
Abstract
BACKGROUND Based on the transtheoretical model, the current study investigated whether awareness of physical activity (PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students. METHODS In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations, PA stage distribution, and self-reported PA level were surveyed. Pearson's χ 2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups, students' PA stages and PA level were examined before the test and then 4 months post-test. McNemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention. RESULTS Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior (χ 2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations (t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test (χ 2(1) = 112.06, p < 0.001; χ 2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed (t(139) < 1, p = 0.89). CONCLUSION The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.
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Affiliation(s)
- Kahar Abula
- Technical University of Munich, München 80992, Germany
| | - Peter Gröpel
- Technical University of Munich, München 80992, Germany
| | - Kai Chen
- South West Jiao Tong University, Chengdu 611756, China
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Romain AJ, Bortolon C, Gourlan M, Carayol M, Decker E, Lareyre O, Ninot G, Boiché J, Bernard P. Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials. J Sport Health Sci 2018; 7:50-57. [PMID: 30356472 PMCID: PMC6180552 DOI: 10.1016/j.jshs.2016.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 05/24/2016] [Accepted: 08/25/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE The aim of this study was to examine whether the efficacy of transtheoretical model (TTM)-based interventions on physical activity (PA) varied according to the following criteria: (1) interventions targeted the actual stages of change (SOCs) or did not; (2) participants were selected according to their SOC or were not; and (3) its theoretical constructs (decisional balance, temptation, self-efficacy, processes of change). METHODS Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified. RESULTS The between-group heterogeneity statistic (Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not (Qb = 1.48, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not (Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC (Cohen's d = 0.36; 95% confidence interval (CI): 0.22-0.49) or not (d = 0.23; 95%CI: 0.09-0.38) and whether they selected their participants according to their SOC (d = 0.33; 95%CI: 0.13-0.53) or not (d = 0.32; 95%CI: 0.19-0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention (Qb = 8.82, p = 0.003), the use of self-efficacy (Qb = 6.09, p = 0.01), and the processes of change (Qb = 3.51, p = 0.06). CONCLUSION TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs.
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Affiliation(s)
- Ahmed Jerôme Romain
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- University of Montreal Hospital Research Centre, Montreal, Quebec H2X 0A9, Canada
| | - Catherine Bortolon
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Unit of Adult Psychiatry, La Colombière, University Hospital of Montpellier, Montpellier 34295, France
| | - Mathieu Gourlan
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Prevention Department of Institut Regional du Cancer de Montpellier, Epidaure, Montpellier 34298, France
| | - Marion Carayol
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Emmanuelle Decker
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Olivier Lareyre
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Prevention Department of Institut Regional du Cancer de Montpellier, Epidaure, Montpellier 34298, France
| | - Grégory Ninot
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Julie Boiché
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Paquito Bernard
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Research Centre of the University Hospital of Quebec, Quebec G1R 2J6, Canada
- Cancer Research Centre, University of Laval, Quebec G1R 3S3, Canada
- School of Psychology, University of Laval, Quebec G1C 0A6, Canada
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Lacey SJ, Street TD. Measuring healthy behaviours using the stages of change model: an investigation into the physical activity and nutrition behaviours of Australian miners. Biopsychosoc Med 2017; 11:30. [PMID: 29213300 PMCID: PMC5715498 DOI: 10.1186/s13030-017-0115-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 08/21/2017] [Accepted: 10/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background Obesity is one of the fastest growing modern day epidemics affecting preventable disease and premature deaths. Healthy lifestyle behaviours, such as physical activity and nutritional consumption, have been shown to reduce the likelihood of obesity and obesity related health risks. Originally designed for measurement of unhealthy behaviours, the Stages of Change model, describes 'precontemplators' as individuals who engage in the unhealthy behaviour, are unaware that their behaviour is problematic, and are resistant to change. The aim of this study was to refine and assess the measures of the Stages of Change model in order to achieve a concise and reliable classification of precontemplators, in the context of healthy behaviours. Methods Eight hundred and ninety-seven employees participated in a health survey measuring current health behaviours and stage of change. This study compared a traditional precontemplation measure to a modified version in the assessment of two healthy behaviours: physical activity and fruit and vegetable consumption. Results The modified measure was more accurate and captured fewer individuals currently meeting the guideline for both physical activity and nutrition, compared to the traditional measure of stages of change. However, across all stages of change, the measure incorrectly classified some employees with regards to meeting health guidelines. Conclusions When applied to healthy behaviours, the stages of change measure for precontemplation should be further refined to reflect knowledge that the behaviour is unhealthy, and apathy to change. Additionally, measures should define health guidelines to increase reliable classification across all stages of change. The findings can be applied to inform the design and implementation of health promotion strategies targeting obesity related lifestyle behaviours in the general population.
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Affiliation(s)
- Sarah J Lacey
- Wesley Medical Research, PO Box 499, Toowong, QLD 4066 Australia
| | - Tamara D Street
- Wesley Medical Research, PO Box 499, Toowong, QLD 4066 Australia
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Ali B, Green KM, Daughters SB, Lejuez C. Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention. Addict Behav 2017; 73:99-104. [PMID: 28500908 DOI: 10.1016/j.addbeh.2017.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/24/2017] [Accepted: 04/26/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Our understanding of the conditions that influence substance abuse treatment retention in urban African American substance users is limited. This study examined the interacting effect of circumstances, motivation, and readiness (CMR) with distress tolerance to predict substance abuse treatment retention in a sample of urban African American treatment-seeking substance users. METHODS Data were collected from 81 African American substance users entering residential substance abuse treatment facility in an urban setting. Participants completed self-reported measures on CMR and distress tolerance. In addition, participants were assessed on psychiatric comorbidities, substance use severity, number of previous treatments, and demographic characteristics. Data on substance abuse treatment retention were obtained using administrative records of the treatment center. RESULTS Logistic regression analysis found that the interaction of CMR and distress tolerance was significant in predicting substance abuse treatment retention. Higher score on CMR was significantly associated with increased likelihood of treatment retention in substance users with higher distress tolerance, but not in substance users with lower distress tolerance. CONCLUSIONS Findings of the study indicate that at higher level of distress tolerance, favorable external circumstances, higher internal motivation, and greater readiness to treatment are important indicators of substance abuse treatment retention. The study highlights the need for assessing CMR and distress tolerance levels among substance users entering treatment, and providing targeted interventions to increase substance abuse treatment retention and subsequent recovery from substance abuse among urban African American substance users.
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Orouji MA, Shojaeizadeh D, Sadeghi R, Rafiei M. Effects of a theory-driven educational package and social support on durability of cigarette smoking cessation behavior: A community-based program. Electron Physician 2017; 9:5331-5338. [PMID: 29038718 PMCID: PMC5633234 DOI: 10.19082/5331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/20/2022] Open
Abstract
Background According to a World Health Organization (WHO) report, the prevalence of smoking in Iranian individuals aged 15–64 is up to 12%. Objective The aim of the current study was to determine the durability of smoking cessation behavior based on a trans-theoretical model. Methods This educational experimental study was conducted on smokers in Khomein City, Iran, in 2015. Sampling was done through a public announcement and then a random allocation of participants into two study group (50 persons) and control group (60 persons). Tools to gather data were as follows: an individual characteristics form and DiClemente’s stages of change, Velicer’s self-efficacy, Prochaska’s processes of change, Velicer’s decisional balance, and Fagerstrom’s nicotine dependency questionnaires. The study group received five sessions of 45-minute individual counseling each and were followed-up three and six months later. Data were analyzed by SPSS version 16, using paired-samples t-test, independent-samples t-test, and chi-square. Results Within six months of follow-up, 20 persons (40%) of the intervention group reached the maintenance stage of smoking cessation, while no one from controls managed to do that. Except for the perceived barriers and benefits of smoking cessation, all other constructs of the trans-theoretical model (cognitive and behavioral processes and smoking temptation) showed significant changes among the intervention group during six months’ follow-up (p<0.05). There was no significant relationship between variables of having smoker friends, occupation, marital status, education status, and success or failure in cigarette smoking cessation (p>0.05). Conclusion According to our study, selection of cigarette smokers who are willing to quit, delivery of individual counseling according to specific personal characteristics, and also provision of free nicotine replacement therapies should be taken into account in cigarette smoking cessation programs.
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Affiliation(s)
- Mohammad Ali Orouji
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rafiei
- Ph.D. of Biostatistics, Professor, Department of Biostatistics and epidemiology, School of medicine, Arak University of Medical Sciences, Arak, Iran
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Menezes MCD, Mingoti SA, Mendonça RDD, Lopes ACS. Mistaken perception of lipid intake and its effects: a randomized trial. BMC Nutr 2017; 3:77. [PMID: 32153854 PMCID: PMC7050849 DOI: 10.1186/s40795-017-0193-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/18/2016] [Accepted: 08/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background Although the Transtheoretical Model (TTM) is promising for behavioral interventions, it may be limited by an inability to understand perceptions of food consumption. The following questions and gaps presented by the scientific community prompted this study: What is the concordance between perceived and actual food consumption? What proportions of individuals are in the pseudo-maintenance (PM) stage (overly optimistic perception of fat consumption)? What is the proportion of individuals in the non-reflective action stages (adequate fat intake but do not recognize it)? Is it necessary to develop specific strategies for individuals in these stages? Therefore, the present study aimed to identify the proportion of “pseudo-respondents,” or those in the PM and non-reflective action stages, and to explore subgroup effects by PM classification. Methods In a previously conducted randomized controlled trial, participants in the usual care group (UCG) and the TTM-intervention group (TM-IG) were post-hoc classified as “true respondents” or “pseudo-respondents”; the latter included those in the PM (mistakenly perceived their lipid intake as adequate) or non-reflective action (did not recognize the adequacy of their lipid intake) stage. The 6-month TTM-based intervention for fat consumption was performed with a sample of Public Health Service users. Results Seventy-one women completed all of the phases. About half of the participants were in the PM stage (UCG: 14 of 31; TM-IG: 19 of 40), and only two were in the non-reflective action stage. Post-intervention, PM individuals in the TM-IG evolved differently, with greater progression to later stages of change and reduced calorie intake, weight, and body mass index (p < 0.05). Conclusions Owing to the high proportion of participants in the PM stage and the differing performance, this stage is important. The intervention had a previously unreported differential effect on the progression of the stage of change and nutritional status by PM classification. Trial registration RBR-5TDHZY (retrospectively registered in August 2017 in Brazilian Registry of Clinical Trials). Electronic supplementary material The online version of this article (10.1186/s40795-017-0193-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mariana Carvalho de Menezes
- 1Department of Nutrition, Research Group in Nutrition Interventions, University of Minas Gerais, 190 Alfredo Balena ave. Escola de Enfermagem, Santa Efigênia, Belo Horizonte, MG 30190-100 Brazil
| | - Sueli Aparecida Mingoti
- 2Department of Statistics, University of Minas Gerais, Antônio Carlos ave. 6627 Campus Pampulha, Belo Horizonte, MG 30161-970 Brazil
| | - Raquel de Deus Mendonça
- 1Department of Nutrition, Research Group in Nutrition Interventions, University of Minas Gerais, 190 Alfredo Balena ave. Escola de Enfermagem, Santa Efigênia, Belo Horizonte, MG 30190-100 Brazil
| | - Aline Cristine Souza Lopes
- 1Department of Nutrition, Research Group in Nutrition Interventions, University of Minas Gerais, 190 Alfredo Balena ave. Escola de Enfermagem, Santa Efigênia, Belo Horizonte, MG 30190-100 Brazil
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Woo T, Lee KH. Factors affecting vegetable preference in adolescents: stages of change and social cognitive theory. Nutr Res Pract 2017; 11:340-346. [PMID: 28765781 PMCID: PMC5537544 DOI: 10.4162/nrp.2017.11.4.340] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/05/2017] [Accepted: 06/13/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND/OBJECTIVES Despite the importance of consuming sufficient amounts of vegetables, daily vegetable intake among adolescents in Korea is lower than the current dietary recommendation. The objective of this study was to examine determinants affecting vegetable preference in order to suggest a stage-tailored education strategy that can promote vegetable consumption in adolescents. SUBJECTS/METHODS Adolescents (n = 400, aged 16-17 years) from two high schools participated in a cross-sectional study. Survey variables were vegetable preference, the social cognitive theory (SCT) and stages of change (SOC) constructs. Based on vegetable preference, subjects were classified into two groups: a low-preference group (LPG) and a high-preference group (HPG). SOC was subdivided into pre-action and action/maintenance stages. To compare SCT components and SOC related to vegetable preference, chi-squared and t-tests, along with stepwise multiple-regression analysis, were applied. RESULTS In the LPG, a similar number of subjects were classified into each stage. Significant differences in self-efficacy, affective attitudes, and vegetable accessibility at home and school were detected among the stages. Subjects in the HPG were mainly at the maintenance stage (81%), and there were significant differences among the stages regarding self-efficacy, affective attitudes, and parenting practice. In the predictions of vegetable preference, self-efficacy and parenting practice had a significant effect in the “pre-action” stage. In the action/maintenance stage, outcome expectation, affective attitudes, and vegetable accessibility at school had significant predictive value. In predicting the vegetable preference for all subjects, 42.8% of the predictive variance was accounted for by affective attitudes, self-efficacy, and vegetable accessibility at school. CONCLUSION The study revealed that different determinants affect adolescent vegetable preference in each stage. Self-efficacy and affective attitudes are important determinants affecting vegetable preference. Additionally, school-based nutrition intervention that focuses on enhancing affective attitudes, self-efficacy, and vegetable exposure may constitute an effective education strategy for promoting vegetable consumption among adolescents.
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Affiliation(s)
- Taejung Woo
- Department of Food and Nutrition, Changwon National University, 20 Changwondaehak-ro, Uichanggu, Gyeongnam 51140, Korea
| | - Kyung-Hea Lee
- Department of Food and Nutrition, Changwon National University, 20 Changwondaehak-ro, Uichanggu, Gyeongnam 51140, Korea
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Pietrabissa G, Sorgente A, Rossi A, Simpson S, Riva G, Manzoni GM, Prochaska JO, Prochaska JM, Cattivelli R, Castelnuovo G. Stages of change in obesity and weight management: factorial structure of the Italian version of the University of Rhode Island Change Assessment Scale. Eat Weight Disord 2017; 22:361-367. [PMID: 27165047 DOI: 10.1007/s40519-016-0289-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 11/11/2015] [Accepted: 04/23/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To examine the factorial structure of the University of Rhode Island Change Assessment Scale (IT-URICA) for weight management in a sample of Italian overweight and obese patients enrolled in a nutritional rehabilitation program. METHODS 334 inpatients completed the translated and adjusted version of the IT-URICA at admission to the hospital. Psychometric testing included confirmatory factor analysis and internal consistency (Cronbach's α). RESULTS The IT-URICA for weight management was successfully translated into Italian, and the factorial analysis confirmed the four-factor solution of the commonly accepted version of the measure. CONCLUSION High levels of RTC are considered critical to the long-term success of weight management, and the IT-URICA may be an appropriate measure of motivational readiness for use among Italian overweight and obese patients. Its use is, therefore, recommended for clinical and research purposes.
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Affiliation(s)
- Giada Pietrabissa
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Oggebbio, Verbania, Italy. .,Department of Psychology, Catholic University of Milan, Milan, Italy.
| | - Angela Sorgente
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Rossi
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Oggebbio, Verbania, Italy
| | - Susan Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
| | - Giuseppe Riva
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Oggebbio, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Como, Italy
| | - James O Prochaska
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Roberto Cattivelli
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Oggebbio, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Oggebbio, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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Smith AL, Carter SM, Dunlop SM, Freeman B, Chapman S. Measured, opportunistic, unexpected and naïve quitting: a qualitative grounded theory study of the process of quitting from the ex-smokers' perspective. BMC Public Health 2017; 17:430. [PMID: 28490317 PMCID: PMC5426051 DOI: 10.1186/s12889-017-4326-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 10/27/2016] [Accepted: 04/27/2017] [Indexed: 11/17/2022] Open
Abstract
Background To better understand the process of quitting from the ex-smokers’ perspective, and to explore the role spontaneity and planning play in quitting. Methods Qualitative grounded theory study using in-depth interviews with 37 Australian adult ex-smokers (24–68 years; 15 males, 22 females) who quit smoking in the past 6–24 months (26 quit unassisted; 11 used assistance). Results Based on participants’ accounts of quitting, we propose a typology of quitting experiences: measured, opportunistic, unexpected and naïve. Two key features integral to participants’ accounts of their quitting experiences were used as the basis of the typology: (1) the apparent onset of quitting (gradual through to sudden); and (2) the degree to which the smoker appeared to have prepared for quitting (no evidence through to clear evidence of preparation). The resulting 2 × 2 matrix of quitting experiences took into consideration three additional characteristics: (1) the presence or absence of a clearly identifiable trigger; (2) the amount of effort (cognitive and practical) involved in quitting; and (3) the type of cognitive process that characterised the quitting experience (reflective; impulsive; reflective and impulsive). Conclusions Quitting typically included elements of spontaneity (impulsive behaviour) and preparation (reflective behaviour), and, importantly, the investment of time and cognitive effort by participants prior to quitting. Remarkably few participants quit completely out-of-the-blue with little or no preparation. Findings are discussed in relation to stages-of-change theory, catastrophe theory, and dual process theories, focusing on how dual process theories may provide a way of conceptualising how quitting can include elements of both spontaneity and preparation. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4326-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Smith
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Sally M Dunlop
- Cancer Screening and Prevention, Cancer Institute NSW, Eveleigh, NSW, 2015, Australia
| | - Becky Freeman
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Simon Chapman
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
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Stonerock GL, Blumenthal JA. Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity. Prog Cardiovasc Dis 2017; 59:455-462. [PMID: 27640186 PMCID: PMC5350064 DOI: 10.1016/j.pcad.2016.09.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [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: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 01/22/2023]
Abstract
Although healthy lifestyles (HL) offer a number of health benefits, nonadherence to recommended lifestyle changes remains a frequent and difficult obstacle to realizing these benefits. Behavioral counseling can improve adherence to an HL. However, individuals' motivation for change and resistance to altering unhealthy habits must be considered when developing an effective approach to counseling. In the present article, we review psychological, behavioral, and environmental factors that may promote adherence and contribute to nonadherence. We discuss two established models for counseling, motivational interviewing and the transtheoretical model of behavior change, and provide an example of how these approaches can be used to counsel patients to exercise and increase their levels of physical activity.
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Affiliation(s)
- Gregory L Stonerock
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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Tseng HM, Liao SF, Wen YP, Chuang YJ. Stages of change concept of the transtheoretical model for healthy eating links health literacy and diabetes knowledge to glycemic control in people with type 2 diabetes. Prim Care Diabetes 2017; 11:29-36. [PMID: 27595215 DOI: 10.1016/j.pcd.2016.08.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 07/15/2016] [Accepted: 08/09/2016] [Indexed: 02/07/2023]
Abstract
AIMS Health literacy has been recognized as a key construct associated with clinical outcomes; however, few studies have explored the mechanism underlying the association. The transtheoretical model (TTM) has long been considered a useful conceptualization in the process of intentional behavior change. Stages of change lies at the heart of the TTM as studies of change have found that people move through a series of stages when modifying behavior. This study focuses on the role of knowledge and stages of change (SOC) as serial mediators linking health literacy to glycemic control. METHODS In this cross-sectional survey, a total of 232 patients with type 2 diabetes participated in this study. Participants completed questionnaires for assessing health literacy, readiness to consume healthy foods, and a dietary knowledge test specific to diabetes. RESULTS Low health literacy was significantly associated with worse glycemic control. Statistical evaluation supported the serial mediation model, in which knowledge and SOC formed a serial mediation chain that accounted for the indirect effect of health literacy on glycemic control. In other words, dietary knowledge significantly motivated participants to move into the later stages of behavior change, which in turn improved the outcome of glycemic control. CONCLUSIONS The results indicate that the ordering of mediators in the pathway between health literacy and health outcome may be complex, help explain the conflicting results of the past, and form a basis for the development of interventions promoting self-management of diabetes through glycemic control.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers/blood
- Blood Glucose/metabolism
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/diet therapy
- Diabetes Mellitus, Type 2/psychology
- Diet, Diabetic
- Diet, Healthy
- Feeding Behavior
- Female
- Health Behavior
- Health Knowledge, Attitudes, Practice
- Health Literacy
- Humans
- Male
- Middle Aged
- Models, Psychological
- Nutritional Status
- Patient Compliance
- Self Care
- Surveys and Questionnaires
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Affiliation(s)
- Hsu-Min Tseng
- Department of Health Care Management, Chang Gung University, 259 Wen-Hwa 1st Rd., Kwei-Shan Area, Taoyuan City, Taiwan; Research Centre for Medical Education, Chang Gung Memorial Hospital, Taiwan.
| | - Shu-Fen Liao
- Department of Education & Research, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei City, Taiwan
| | - Yu-Ping Wen
- Department of Health Care Management, Chang Gung University, 259 Wen-Hwa 1st Rd., Kwei-Shan Area, Taoyuan City, Taiwan; Research Centre for Medical Education, Chang Gung Memorial Hospital, Taiwan
| | - Yuh-Jue Chuang
- Department of Health Care Management, Chang Gung University, 259 Wen-Hwa 1st Rd., Kwei-Shan Area, Taoyuan City, Taiwan; Research Centre for Medical Education, Chang Gung Memorial Hospital, Taiwan
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Schwarzer R, Fleig L, Warner LM, Gholami M, Serra-Majem L, Ngo J, Roman-Viñas B, Ribas-Barba L, Distante A, Ntzani E, Giannakis G, Brandi ML. Who benefits from a dietary online intervention? Evidence from Italy, Spain and Greece. Public Health Nutr 2017; 20:938-47. [PMID: 27829475 DOI: 10.1017/S1368980016002913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The traditional Mediterranean diet includes high consumption of fruits, vegetables, olive oil, legumes, cereals and nuts, moderate to high intake of fish and dairy products, and low consumption of meat products. Intervention effects to improve adoption of this diet may vary in terms of individuals' motivational or volitional prerequisites. In the context of a three-country research collaboration, intervention effects on these psychological constructs for increasing adoption of the Mediterranean diet were examined. DESIGN An intervention was conducted to improve Mediterranean diet consumption with a two-month follow-up. Linear multiple-level models examined which psychological constructs (outcome expectancies, planning, action control and stage of change) were associated with changes in diet scores. SETTING Web-based intervention in Italy, Spain and Greece. SUBJECTS Adults (n 454; mean age 42·2 (sd 10·4) years, range 18-65 years; n 112 at follow-up). RESULTS Analyses yielded an overall increase in the Mediterranean diet scores. Moreover, there were interactions between time and all four psychological constructs on these changes. Participants with lower levels of baseline outcome expectancies, planning, action control and stage of change were found to show steeper slopes, thus greater behavioural adoption, than those who started out with higher levels. CONCLUSIONS The intervention produced overall improvements in Mediterranean diet consumption, with outcome expectancies, planning, action control and stage of change operating as moderators, indicating that those with lower motivational or volitional prerequisites gained more from the online intervention. Individual differences in participants' readiness for change need to be taken into account to gauge who would benefit most from the given treatment.
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Jerant A, Lichte M, Kravitz RL, Tancredi DJ, Magnan EM, Hudnut A, Franks P. Physician training in self-efficacy enhancing interviewing techniques (SEE IT): Effects on patient psychological health behavior change mediators. Patient Educ Couns 2016; 99:1865-1872. [PMID: 27423177 PMCID: PMC5069145 DOI: 10.1016/j.pec.2016.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/01/2016] [Revised: 06/28/2016] [Accepted: 07/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To explore how physician training in self-efficacy enhancing interviewing techniques (SEE IT) affects patient psychological health behavior change mediators (HBCMs). METHODS We analyzed data from 131 patients visiting primary care physicians ≥4 months after the physicians participated in a randomized controlled trial. Experimental arm physicians (N=27) received SEE IT training during three ≤20min standardized patient instructor (SPI) visits. Control physicians (N=23) viewed a diabetes medications video during one SPI visit. Physicians were blinded to patient participation. Outcomes were self-care self-efficacy, readiness, and health locus of control (Internal, Chance, Powerful Others), examined as a summary HBCM score (average of standardized means) and individually. Analyses adjusted for pre-visit values of the dependent variables. RESULTS Patients visiting SEE IT-trained physicians had higher summary HBCM scores (+0.42, 95% CI 0.07-0.77; p=0.021). They also had greater self-care readiness (AOR 3.04, 95% CI 1.02-9.03, p=0.046) and less Chance health locus of control (-0.27 points, 95% CI -0.50-0.04, p=0.023), with no significant differences in other HBCMs versus controls. CONCLUSION Improvement in psychological HBCMs occurred among patients visiting SEE IT-trained physicians, PRACTICE IMPLICATIONS: If further research shows the observed HBCM effects improve health behaviors and outcomes, SEE IT training might be offered widely to physicians.
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Affiliation(s)
- Anthony Jerant
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
| | - Melissa Lichte
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
| | - Richard L Kravitz
- Department of Internal Medicine, University of California Davis, Sacramento, USA.
| | - Daniel J Tancredi
- Department of Pediatrics and Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
| | - Elizabeth M Magnan
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
| | | | - Peter Franks
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
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Stotts AL, Klawans MR, Northrup TF, Villarreal Y, Hovell MF. Understanding motivation to implement smoking bans among mothers with a hospitalized infant. Addict Behav 2016; 58:60-7. [PMID: 26914262 DOI: 10.1016/j.addbeh.2016.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/05/2016] [Accepted: 02/09/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Secondhand smoke exposure (SHSe) poses risks to hospitalized children upon discharge and no uniformly effective interventions have been identified. Understanding change-related processes and social-contextual factors related to motivation for implementing home and car smoking bans may inform interventions to reduce infant SHSe among mothers with a hospitalized infant. METHODS In this cross-sectional, secondary analysis, mothers of neonatal ICU infants who reported smoking or living with a smoker (N=205) were assigned to stages of change (pre-contemplation, contemplation, preparation, or action) based on behaviors and intentions for establishing smoking bans in their homes and cars. Processes of change (POC) for SHSe reduction practices, self-efficacy, depressive symptoms, generalized anxiety, and social support for not smoking in the home were examined across all four stages. RESULTS The majority of mothers were in the action stage for having a home smoking ban in place (55%); only 35% of participants were in action for a car smoking ban. POC use differed across the stages of change for having a home ban (p=0.004) and car ban (p=0.02), with earlier stages using fewer overall and relatively fewer cognitive/affective processes. Earlier stage women also reported lower self-efficacy to change, less familial and partner support for in-home smoking bans, and more depressive symptoms. CONCLUSIONS Novel intervention targets were identified, including cognitive/affective change processes, mental health, and familial/social contingencies for implementing SHSe protective practices. Creative ways in which to affect change at the individual and household level are needed in order to fully address the complexity of child SHSe.
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Redding CA, Jones D, Zulu R, Chitalu N, Cook R, Weiss SM. Stages of Change for Voluntary Medical Male Circumcision and Sexual Risk Behavior in Uncircumcised Zambian Men: The Spear and Shield Project. Int J Behav Med 2016; 22:799-806. [PMID: 25896876 DOI: 10.1007/s12529-015-9485-z] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dissemination and scale up of voluntary medical male circumcision (VMMC) programs is well supported by evidence that VMMC reduces HIV risk in populations with high HIV prevalence and low rates of circumcision, as is the case in Zambia. PURPOSE At both individual and population levels, it is important to understand what stages of change for VMMC are associated with, especially across cultures. This study evaluated VMMC knowledge, misinformation, and stages of change for VMMC of uncircumcised men and boys (over 18 years), as well as the concurrent relationship between VMMC stages of change and sexual risk behaviors. METHOD Uncircumcised (N = 800) adult men and boys (over 18) were screened and recruited from urban community health centers in Lusaka, Zambia, where they then completed baseline surveys assessing knowledge, attitudes, HIV risk behaviors, and stages of change for VMMC. A series of analyses explored cross-sectional relationships among these variables. RESULTS VMMC was culturally acceptable in half of the sample; younger, unmarried, and more educated men were more ready to undergo VMMC. Stage of change for VMMC was also related to knowledge, and those at greater HIV risk reported greater readiness to undergo VMMC. CONCLUSIONS Efforts to increase VMMC uptake should address the role of perceived HIV risk, risk behaviors, readiness, accurate knowledge, cultural acceptance, and understanding of the significant degree of HIV protection conferred as part of the VMMC decision making process. These results support incorporating comprehensive HIV risk reduction in VMMC promotion programs.
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Affiliation(s)
- Colleen A Redding
- University of Rhode Island, 130 Flagg Rd., Kingston, RI, 02881, USA.
| | - Deborah Jones
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Zulu
- University of Zambia School of Medicine, Lusaka, Zambia
| | | | - Ryan Cook
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen M Weiss
- University of Miami Miller School of Medicine, Miami, FL, USA
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Abstract
Obesity continues to be the most prevalent nutritional problem of dogs and cats as well as one of the most frustrating conditions to treat successfully. Educating and assigning roles to all members of the health care team will improve staff engagement and the consistency and effectiveness of nutritional counseling for preventive care and weight loss treatment plans. Excellent communication skills can be used to assess the client's ability to change and implement a weight loss plan at the right time in the right way to achieve better adherence and improve patient health.
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Affiliation(s)
- Julie Churchill
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, C-339, 1352 Boyd Avenue, Saint Paul, MN 55108, USA.
| | - Ernie Ward
- Association for Pet Obesity Prevention, E3 Management, LLC, Ocean Isle Beach, NC 28469, USA
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Sujic R, Beaton DE, Bogoch ER; Ontario Osteoporosis Strategy Fracture Clinic Screening Program Evaluation Team. Patient acceptance of osteoporosis treatment: Application of the stages of change model. Maturitas 2016; 88:70-5. [PMID: 27105702 DOI: 10.1016/j.maturitas.2016.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/08/2016] [Accepted: 03/22/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine whether a commonly used model of behaviour change, stages of change, is helpful in understanding osteoporosis treatment initiation in a cohort of fragility fracture patients. STUDY DESIGN This longitudinal cohort study used data from a provincial osteoporosis screening program targeting fragility fracture patients age 50 and over. Logistic regression was used to identify baseline factors associated with patients moving from the first, pre-contemplation stage at baseline to the more advanced stages of action/maintenance at follow-up, when treatment is initiated and maintained. MAIN OUTCOME MEASURE Patient's stage-of-change readiness to accept osteoporosis treatment. RESULTS At baseline, 91% of patients were in the pre-contemplation stage. Of these, 74.1% remained at the same stage at follow-up, 2.7% moved to contemplation and preparation while 23.2% moved to action/maintenance. The adjusted analysis showed that those who moved from pre-contemplation to action/maintenance were more likely to have a previous fracture OR 1.5 (1.1-2.0), history of oral steroid use OR 2.1 (1.3-3.5), higher perceived benefits to osteoporosis drug treatment OR 1.2 (1.0-1.3), perception of bones as "thin" OR 2.8 (2.0-4.0) and were less likely to perceive that they were taking too many medications OR 0.6 (0.5-0.9). CONCLUSIONS With the majority of patients in the pre-contemplation and the action/maintenance stages, our results suggest an existence of a two-stage model. The baseline factors that we identified can be used to predict which patients are less likely to initiate treatment, which in turn, can be used to inform post-fracture interventions and facilitate behaviour change.
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Viau KS, Jones JL, Murtaugh MA, Gren LH, Stanford JB, Bilder DA. Phone-based motivational interviewing to increase self-efficacy in individuals with phenylketonuria. Mol Genet Metab Rep 2016; 6:27-33. [PMID: 27014576 PMCID: PMC4789343 DOI: 10.1016/j.ymgmr.2016.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/10/2016] [Accepted: 01/10/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To measure change in patient activation and self-efficacy in individuals with phenylketonuria (PKU) before and after a 6-month phone-based motivational interviewing (MI) intervention and determine the feasibility of implementing dietary counseling for PKU using an MI approach. METHODS Participants (n = 31) included preadolescents (7-12 years), adolescents (13-17 years), and adults (18-35 years) with early-treated PKU. Participants completed online questionnaires assessing self-reported stage of change (SOC), patient activation, and self-efficacy for PKU self-management behaviors. The intervention included monthly phone-based dietary counseling using MI during which participants set monthly goals. RESULTS Patient activation and self-efficacy were significantly different by age group (both p < 0.01) with higher scores in older participants. Self-efficacy significantly increased from baseline to month 6 among adolescents and adults (7.4 ± 1.9 and 8.6 ± 1.3, respectively, p = 0.002). Preadolescents did not have a significant change in self-efficacy (p = 0.79). There was no increase in patient activation for preadolescents or adolescents/adults (p = 0.19 and p = 0.24, respectively). Indicators of learning problems were not significantly associated with self-efficacy (p = 0.33) or patient activation (p = 0.83). CONCLUSION These results demonstrate the feasibility of implementing phone-based dietary counseling for PKU using MI. This study also supports further investigation of MI as an intervention approach to improving self-efficacy and self-management behaviors in adolescents and adults with PKU.
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Affiliation(s)
- Krista S. Viau
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108, USA
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
| | - Jessica L. Jones
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
| | - Maureen A. Murtaugh
- Department of Internal Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Lisa H. Gren
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
| | - Joseph B. Stanford
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
| | - Deborah A. Bilder
- Department of Psychiatry, University of Utah, 650 Komas Drive, Suite 200, Salt Lake City, UT 84108, USA
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Serafini K, Shipley L, Stewart DG. Motivation and substance use outcomes among adolescents in a school-based intervention. Addict Behav 2016; 53:74-9. [PMID: 26458191 DOI: 10.1016/j.addbeh.2015.10.004] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 08/03/2015] [Accepted: 10/03/2015] [Indexed: 11/16/2022]
Abstract
The stages of change (Precontemplation, Contemplation, Preparation, Action, and Maintenance) have been well studied in adult populations. However, fewer studies have examined how the stages of change are related to adolescent substance use. Furthermore, there have been no studies that have examined how the stages of change relate to outcomes in a school-based intervention. To better capture adolescent motivation, we added an additional group to the Transtheoretical Model of Change, which we titled Coerced Action, to represent adolescents that made changes to their substance use despite low problem recognition (representing the internal motivation of Precontemplation and the change behaviors of the Action group). We then examined how the stages of change were related to a thorough assessment of substance use at baseline and corresponding treatment outcomes. Our sample consisted of 264 adolescents (mean age: 16.1, 44.5% Caucasian, 37.5% female) who participated in an 8-week, school-based Motivational Enhancement intervention. Results indicated significant group differences across the stages of change in substance use patterns (alcohol use, negative consequences, affective dysregulation), as well as treatment outcomes (alcohol use and negative consequences). For instance, adolescents in the Action group demonstrated more negative consequences at 16weeks follow-up than those in Precontemplation and Coerced Action, F(1, 3)=8.23, p<.001. The Coerced Action group reported the most alcohol use at 16weeks follow-up, although the finding was not significant when post-hoc tests were conducted. This study provides meaningful support for the assessment of motivation among adolescent substance users within school-based settings.
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Affiliation(s)
- Kelly Serafini
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States.
| | - Leandra Shipley
- VA Puget Sound Health Care System, Seattle, WA 98108, United States
| | - David G Stewart
- Seattle Pacific University, Department of Clinical Psychology, Seattle, WA 98119, United States
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Webb FJ, Khubchandani J, Hannah L, Doldren M, Stanford J. The Perceived and Actual Physical Activity Behaviors of African American Women. J Community Health 2016; 41:368-75. [PMID: 26487441 DOI: 10.1007/s10900-015-0106-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Lack of physical activity is a leading contributor to obesity in the US. The unusually high rates of obesity in African-American (AA) women corroborate with lack of recommended levels of exercise in this population. The purpose of this study was to describe exercise behaviors and intention to change using the stages of change (SOC) model in a sample of AA women. A population-based observational study was conducted with 292 AA women in Florida. Outcome variables were engaging in aerobic, strength-based, and stretching exercise. More than half (61.25 %) did not engage in strength-based exercise, more than a third (37.7 %) did not engage in aerobic exercise, and a little less than half (45.9 %) did not participate in stretching exercise. SOC was the main independent variable. Women in action and maintenance SOC were significantly more likely to engage in aerobic exercise (OR 16.1, 95 % CI 7.09-25.7), strength-based exercise (OR 15.4, 95 % CI 6.58-22.7), and stretching exercise (OR 3.80, 95 % CI 1.91-7.52). The SOC is reflective of actual exercise behavior in AA women. A large number of AA women do not engage in regular recommended levels of exercise. Understanding SOC can be essential to developing culturally appropriate and motivation matched interventions for improving AA women's exercise habits.
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Mohammed A, Harrell JP, Makambi KH, Campbell AL, Sloan LR, Carter-Nolan PL, Taylor TR. Factors Associated with Exercise Motivation among African-American Men. J Racial Ethn Health Disparities 2015; 3:457-65. [PMID: 27294741 DOI: 10.1007/s40615-015-0158-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/04/2015] [Revised: 08/01/2015] [Accepted: 08/07/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The primary aims of this study were to: (1) characterize exercise stages of change among a sample of African-American men, (2) determine if exercise motivation was associated with self-reported exercise behavior, and (3) examine if groups of personal (i.e., age, BMI, income, educational attainment, and perceived health), psycho-social (i.e., exercise self-efficacy, personality type, social influence), and environmental factors (i.e., neighborhood safety) predicted stages of change for physical exercise among African-American men. METHODS One hundred seventy African-American male participants were recruited for this study (age: 47.63(10.23) years). Participants completed a self-report questionnaire assessing study variables. Multinomial logistic regression models were used to examine the association of exercise stages of change with an array of personal, psychosocial, and environmental factors. RESULTS BMI, exercise self-efficacy, and nighttime neighborhood safety were entered as independent variables in the full model. BMI and exercise self-efficacy continued to be significant predictors of exercise stages of change in the full model. Obese men had a 9.24 greater odds of being in the action stage of change than in the maintenance stage. Also, men reporting greater exercise self-efficacy had lower odds of being in the lower stages of change categories (pre-preparation, preparation, and action) than in the maintenance stage. CONCLUSION Our results confirmed that using an ecological framework explained more of the variance in exercise stages of change than any of the individual components alone. Information gleaned from this study could inform interventionists of the best ways to create tailored exercise programs for African-American men.
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Affiliation(s)
- Alana Mohammed
- Department of Psychology, Howard University, Washington, DC, USA
| | - Jules P Harrell
- Department of Psychology, Howard University, Washington, DC, USA
| | - Kepher H Makambi
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
| | | | - Lloyd Ren Sloan
- Department of Psychology, Howard University, Washington, DC, USA
| | | | - Teletia R Taylor
- Department of Psychology, Howard University, Washington, DC, USA. .,College of Medicine, Howard University, Washington, DC, USA.
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Yusufov M, Rossi JS, Redding CA, Yin HQ, Paiva AL, Velicer WF, Greene GW, Blissmer B, Robbins ML, Prochaska JO. Transtheoretical Model Constructs' Longitudinal Prediction of Sun Protection Over 24 Months. Int J Behav Med 2016; 23:71-83. [PMID: 26163352 DOI: 10.1007/s12529-015-9498-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This research examined dynamic transtheoretical model (TTM) constructs for adopting sun protection practices. This secondary data analysis pooled four large population-based TTM-tailored intervention studies and examined use of constructs across three groups, organized by longitudinal progress: maintainers, relapsers, and stable non-changers. METHODS A total of 3463 adults, in the USA, who met criteria for unsafe sun exposure at baseline received a TTM-tailored computerized intervention at baseline, 6 months, and 12 months. The final analytic sample consisted of 1894 participants; the majority were female, White, married, and middle-aged. The three groups were assessed with reliable and valid scales assessing use of TTM constructs at baseline, 6 months, 12 months, and 24 months. Analyses included a MANOVA followed by a series of ANOVAs, with Tukey follow-up tests assessing differences in use of TTM constructs across the three groups at each timepoint. RESULTS Findings demonstrated that relapsers and maintainers were similar in their use of most TTM processes of change at baseline, with the exception of Consciousness Raising, Stimulus Control, Reinforcement Management, and Self-Liberation. CONCLUSIONS These findings suggest that although relapsers reverted to unsafe sun practices, their overall greater use of processes of change indicates that their change efforts remain better than that of stable non-changers.
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Fast HV, Kennett DJ. Development and practical implications of the Exercise Resourcefulness Inventory. Patient Educ Couns 2015; 98:627-632. [PMID: 25727284 DOI: 10.1016/j.pec.2015.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/02/2014] [Revised: 12/19/2014] [Accepted: 02/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the validity and reliability of the Exercise Resourcefulness Inventory (ERI) designed to assess the self-regulatory strategies used to promote regular exercise. METHODS In Study 1, the inventory's relationship with other established scales in the exercise behavior change field was examined. In Study 2, the test-retest reliability and predictive validity of the ERI was established by having participants from Study 1 complete the inventory a second time. RESULTS Internal consistency, and convergent, discriminant, and concurrent validity were supported in both studies. The test-retest correlation of the ERI was .80. As well, participants scoring higher on the ERI in Study 1 were more likely to be at a higher stage of change in Study 2, and greater increases in exercise resourcefulness over time were predictive of advancement to higher stages of change. CONCLUSIONS ERI is a reliable and valid measure to assess the self-regulatory strategies used to promote regular exercise. PRACTICAL IMPLICATIONS Facilitators may want to tailor exercise programs for individuals scoring lower in resourcefulness to prevent them from relapsing.
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Affiliation(s)
- Hilary V Fast
- Department of Psychology, Trent University, Peterborough, Canada
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Prugger C, Wellmann J, Heidrich J, De Bacquer D, De Backer G, Périer MC, Empana JP, Reiner Ž, Fras Z, Jennings C, Kotseva K, Wood D, Keil U. Readiness for smoking cessation in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey. Eur J Prev Cardiol 2014; 22:1212-9. [PMID: 25516535 DOI: 10.1177/2047487314564728] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 07/07/2014] [Accepted: 11/28/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Readiness for smoking cessation is an important predictor of quit attempts and cessation success. We aimed to investigate the prevalence and correlates of readiness for smoking cessation in coronary heart disease (CHD) patients. DESIGN The EUROpean Action on Secondary and Primary Prevention by Intervention to Reduce Events III (EUROASPIRE III) survey is a cross-sectional study conducted in 2006-2007 among CHD patients <80 years of age from 22 European regions. METHODS Patients were interviewed on average 15 months after hospital admission for an acute coronary event or procedure. Readiness for smoking cessation was assessed using the smoking stages of change (SSC) short form questionnaire. Breath carbon monoxide was measured to validate self-reported non-smoking. RESULTS Among 2585 patients who were smoking prior to hospital admission, 25.6%, 16.8%, 8.1%, 5.6% and 44.0% were in the precontemplation (no intention to quit), contemplation (thinking of quitting), preparation (planning to quit), action (having quit within six months) and maintenance (having quit more than six months ago) stages, respectively. Significant multivariable correlates of advancement in SSC showed positive associations of older age and attended cardiac rehabilitation and negative associations of severe depressive symptoms, longer smoking duration and environmental tobacco smoke (ETS) exposure. CONCLUSIONS One-quarter of CHD patients across Europe who were smoking prior to hospitalisation have no intention to quit, and an additional quarter is thinking of quitting or planning to quit. Patients who are younger, do not attend cardiac rehabilitation, have severe depressive symptoms, have been smoking for longer periods of time and are exposed to ETS may need to be specifically targeted in cessation interventions.
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Affiliation(s)
- Christof Prugger
- INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
| | - Jan Heidrich
- Institute of Epidemiology and Social Medicine, University of Münster, Germany Epidemiological Cancer Registry North Rhine-Westphalia, Germany
| | | | - Guy De Backer
- Department of Public Health, University of Ghent, Belgium
| | - Marie-Cécile Périer
- INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France
| | - Jean-Philippe Empana
- INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France
| | - Željko Reiner
- Department of Internal Medicine, University of Zagreb, Croatia
| | - Zlatko Fras
- Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia
| | | | | | - David Wood
- Cardiovascular Medicine, Imperial College London, UK
| | - Ulrich Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
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Cooper CM, Ahmed S, Winch PJ, Pfitzer A, McKaig C, Baqui AH. Findings from the use of a narrative story and leaflet to influence shifts along the behavior change continuum toward postpartum contraceptive uptake in Sylhet District, Bangladesh. Patient Educ Couns 2014; 97:376-82. [PMID: 25306103 DOI: 10.1016/j.pec.2014.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 02/13/2014] [Revised: 07/28/2014] [Accepted: 09/10/2014] [Indexed: 05/16/2023]
Abstract
OBJECTIVES Postpartum women face uncertainty about timing of return to fecundity. Many women wait to use contraception until menses return, resulting in unintended pregnancies. This study explored the use of behavior change communication to address perceptions of postpartum return to fecundity and contraceptive adoption. METHODS This study, which took place in Sylhet District in Bangladesh, explored knowledge and perceptions about postpartum return to fecundity and used the Steps to Behavior Change framework to assess the reported influence of a leaflet and fictional story ("Asma's Story") incorporated within community health activities. The study relied on in- depth interviews and focus group discussions. RESULTS The study revealed nearly universal exposure to Asma's Story. Reported shifts in perceived susceptibility to pregnancy, benefits of pregnancy spacing, and increased social support for postpartum family planning (PPFP) were noted. However, only approximately one third of women were using a modern contraceptive method. CONCLUSIONS Using a fictional story offers a promising approach for motivating shifts along the continuum. PRACTICE IMPLICATIONS It is recommended that Asma's Story be incorporated within future efforts to scale up PPFP in Bangladesh, and that similar approaches be tailored and tested in other countries.
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Affiliation(s)
| | - Salahuddin Ahmed
- Jhpiego, Baltimore, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Peter J Winch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Chee Yen W, Mohd Shariff Z, Kandiah M, Mohd Taib MN. Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors. Nutr Res Pract 2014; 8:297-303. [PMID: 24944775 PMCID: PMC4058564 DOI: 10.4162/nrp.2014.8.3.297] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/03/2014] [Accepted: 03/06/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Understanding individual's intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers. SUBJECTS/METHODS This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used. RESULTS Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation. CONCLUSION Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.
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Affiliation(s)
- Wong Chee Yen
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Mirnalini Kandiah
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Nasir Mohd Taib
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
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