Optimizing drug adherence in hypertension: More than a mind game

Poor drug adherence to prescribed drug treatments and lifestyle recommendations is a major determinant of poor blood pressure control reported around the World. Prevalence rates of antihypertensive medication nonadherence are highly variable depending on the studied population and may reach up to 40%. Remarkably, the phenomenon stays often undiagnosed and unaddressed mainly because physicians have limited tools to perform a reliable diagnosis. In this review oriented toward practicality, 5 principal aspects of nonadherence will be addressed with a special emphasis on psychological factors influencing adherence patterns, both from a patient's and physician's perspectives.

Psychological determinants of consumption of reusable containers for takeaway food and drinks

Using food and drink disposable containers has heavy environmental and economic consequences. The widespread adoption of reusable containers is a challenge that requires understanding the psychological determinants and barriers of the behaviour. Two studies were conducted: one with a sample from the general public (study 1, N = 302) and one with respondents having access to a reusable container system at work (study 2, N = 737). Online surveys measured self-reported use of single-use and reusable containers for food and drinks takeaway (studies 1 and 2) and for food delivery (study 1). Stages of change and psychological determinants were also measured to provide behavioural levers. Results indicate that in study 1, most of the sample is aware of the issue associated with single-use containers but has not switched to reusable. In study 2, most respondents say they are already using few single-use and are willing to continue, particularly for drinks to go. Thus, accessibility at the workplace to a reusable container system is associated with higher stages of change. However, many respondents are also in the preactional phase for food takeaway, that is, willing to change but have not started yet. In both studies, perception of control on the behaviour and volitional variables are positively associated with stages of change. This suggests that making reusable containers easier to use and helping individuals plan how and when they can do it could encourage behaviour change.

Predictors of well-being, future anxiety, and multiple recurrent health complaints among university students during the COVID-19 pandemic: the role of socioeconomic determinants, sense of coherence, and digital health literacy. An Italian cross-sectional study

The pandemic deeply changed young adults' life. Lockdown period and the social restrictions dramatically affected university students' mental health. The aim of our cross-sectional study was to describe psychological well-being, future anxiety (FA), and health complaints (HCs) in a sample of 3,001 students of the University of Florence in the middle of the first two pandemic waves. We assessed the role of subjective social status, chronic diseases, sense of coherence (SoC), and digital health literacy (DHL) as predictors of psychological well-being, FA, and HCs. Students expressed high levels of FA and reported being disturbed by not being able to achieve their desired future goals. About 40% reported a low or a very low well-being and 19.1% experienced two or more subjective health complaints more than once a week. The likelihood of having a better mental health status significantly increased with increasing SoC and among males. Subjective Social Status proved to be a predictor for FA. Enhancing SoC could improve the health status of the university students during the pandemic and beyond.

Effect of psychological factors on COVID-19 vaccine hesitancy

BACKGROUND

Vaccine hesitancy can prevent full immunization against coronavirus infectious disease-19 (COVID-19). We hypothesized that multiple factors, including an individual's personality and psychological factors, are associated with vaccine hesitancy.

METHODS

A total of 275 non-vaccinated individuals were recruited for this study. Participants completed a self-report questionnaire including sociodemographic factors, health status, COVID-19 literacy and psychological factors (depressive symptoms, generalized anxiety, somatization, illness anxiety, temperament and character). In a hierarchical logistic regression analysis, a discrete set of hierarchical variables with vaccine acceptance or hesitancy as the dependent variable was added to the demographic factors for Model 1; Model 1 + health status for Model 2; Model 2 + COVID-19 literacy for Model 3 and Model 3 + psychological factors for Model 4.

RESULTS

Models 3 and 4 could predict vaccine hesitancy. High scores on the Generalized Anxiety Disorder-7 and the Illness Attitude Scale, low confidence, low collective responsibility and low reward dependence were risk factors for vaccine hesitancy.

CONCLUSIONS

The present study demonstrates that psychological factors play critical roles in vaccine hesitancy. In addition to conventional policies that emphasize COVID-19 vaccines' safety and efficacy and the collective benefits of vaccination, a more individualized approach that considers an individual's emotions and personality is necessary.

The Psychological Antecedents to COVID-19 Vaccination among Community Pharmacists in Khartoum State, Sudan

Background and Objectives: Little is known regarding the 5C psychological antecedents to COVID-19 vaccination among pharmacists in low- and middle-income countries. This study aimed to assess the acceptance of COVID-19 vaccination and its psychological antecedents among community pharmacists in Khartoum State, Sudan. Materials and Methods: A cross-sectional study was conducted from July to September 2022. A self-administered questionnaire was used to collect data about sociodemographic and health status characteristics, vaccine acceptance, and the 5C psychological antecedents to vaccination. Stepwise logistic regression analysis was conducted, and results were presented using odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A total of 382 community pharmacists participated in the current study, with a mean age of 30.4 ± 5.6 years. Nearly two-thirds of the participants (65.4%) were females, and the majority (74.9%) have received or intended to receive the COVID-19 vaccination. Vaccine acceptance was significantly associated with the following psychological antecedents to vaccination: confidence, complacency, constraints, and calculation (p < 0.001). Results of the logistic regression showed that confidence in vaccines [OR = 6.82 (95% CI = 3.14-14.80)], conspiracy beliefs [OR = 0.44 (95% CI = 0.23-0.85)], and constraints to vaccination [OR = 0.18 (95% CI = 0.06-0.56)] were the significant determinants of vaccine acceptance. Conclusion: The study revealed important predictors of COVID-19 vaccine acceptance that can be used to guide policymakers in designing target-oriented interventions that can improve the vaccine acceptance rate among community pharmacists in Sudan. These findings suggest that interventions to promote vaccine acceptance among pharmacists should focus on building confidence in vaccines and providing accurate information about the safety and efficacy of the COVID-19 vaccine, and reducing constraints to vaccination.

Determinants of social distancing adherence

Introduction

Governments and public health authorities across many jurisdictions implemented social (physical) distancing measures to contain the spread of the 2019 novel coronavirus disease (COVID-19). Adherence to these measures is variable and likely influenced by various factors. This study aimed to 1) identify the individual sociodemographic, COVID-19 and social distancing related, and psychological determinants of social distancing adherence, and 2) explore regional differences in social distancing adherence in the United States (U.S.) and English-speaking Canada based on each region's discrepant response to social distancing restrictions.

Methods

A web-based repeated cross-sectional survey was conducted in 4,942 English-speaking participants from the four most populous U.S. states, specifically New York, California, Texas, and Florida, and Canada (www.covid19-database.com). The study was conducted at two timepoints, from May 1 to 5, 2020 (n = 1,019, Canadian participants only) and from July 6 to 10, 2020 (n = 3,923). Separate univariate models were computed for individual sociodemographic, COVID-19 and social distancing related, and psychological determinants of social distancing adherence. To determine the total variance explained, a univariate analysis including all of the determinants was performed. Regional differences in social distancing were compared between the four U.S. states and Canada, and between the U.S. as a whole and Canada.

Results

Adherence to social distancing was higher in May (mean = 4.4/5.0±0.7) compared to July (mean = 4.3/5.0±0.7) [t ₍₄₉₄₀₎ = 6.96, p < 0.001], likely a reflection of relaxing restrictions. There were no regional differences in adherence. Sociodemographic, COVID-19 and social distancing related, and psychological determinants explained 10, 36, and 23% of the variance of social distancing adherence, respectively. Higher perceived seriousness of COVID-19 [β (SE) = 0.39 (0.01), p < 0.001, partial η² = 0.22], lower risk propensity [β (SE) = -0.15 (0.01), p < 0.001, partial η² = 0.06], germ aversion [β (SE) = 0.12 (0.01), p < 0.001, partial η² = 0.03], age [β (SE) = 0.01 (0.00), p < 0.001, partial η² = 0.02], and greater social support [β (SE) = 0.03 (0.00), p < 0.001, partial η² = 0.02] had the largest effects on social distancing adherence.

Conclusion

Public service initiatives to emphasize the serious consequences of infection and targeted interventions toward certain sociodemographic groups, such as younger adults and vulnerable individuals in greater need of social support, may help enhance the public's adherence to social distancing measures during subsequent waves of COVID-19 and future pandemics.

Emotional Temperament and Character Dimensions and State Anger as Predictors of Preference for Rap Music in Italian Population

The objective of the current work was to examine the relationships between affective temperaments dimensions, trait anger, and the preference for rap music in a sample of Italian adults. An online survey was administered to 662 subjects. We assessed preference for rap music using a Likert scale. Ina addition, we investigated the sample' affective temperament traits using the Memphis, Pisa, Paris, and San Diego (TEMPS-A) short scale and the trait anger by using the Trait Anger component of the State Trait Anger Expression Inventory 2 (STAXI-2). Multiple linear regression indicated that cyclothymic temperament score, hyperthymic temperament score, and trait anger scores were positive predictors while older age, and depressive temperament and higher education score were negative predictors of preference for rap music. The results expand previous literature on personality and music preference indicating the association of high energy/high activity temperaments and trait anger to preference for rap music.

A Mediation Model on How Conspiracy Beliefs Concerning the Corona-Crisis Are Related to Corona-Related Behaviours

Background: The endorsement of Conspiracy Beliefs concerning corona (CBc) may make people reject information from the general media, leading them to not follow recommendations on prevention behaviours, getting tested, and getting vaccinated. The aim of the present study was to understand the relationship between CBc and engaging in these corona-related behaviours.

Method: Two samples of participants (N = 1,004 and N = 159) were recruited independently. Participants filled in a survey that assessed four indicators of the three behaviours, four general psychological determinants (e.g., the seriousness of COVID-19), five behaviour-specific psychological determinants (e.g., test reliability, vaccine effectiveness), and CBc.

Results: The explained variances of the different models with regard to the four indicators of behaviour ranged from 3.9 to 75%. Mediation analyses using Hayes PROCESS model 4 showed significant mediation by general determinants in both samples, and mediation by several behaviour-specific determinants in one sample.

Discussion: Conspiracy Beliefs concerning corona may lead to rejection of general media information, and this may lead to states of psychological determinants that do not stimulate to engage in prevention behaviours, testing, or vaccination. The present study shedS some light on how CBc could be related to corona-related behaviours.

Chronic pain and depressive symptoms are related to food insecurity among urban food bank users

BACKGROUND

Food bank users suffer high food insecurity. Food insecurity increases risk for chronic health conditions. However, chronic pain and its relation to food insecurity among food bank users is unknown. Knowledge about populations with chronic pain is important to direct appropriate public health nutritional strategies.

METHODS

Participants completed a survey including sleep, pain, depressive symptoms and food insecurity measures. Descriptive statistics characterized the burden of chronic pain among the sample, and a series of chi-square and t-tests assessed for demographic differences between food bank users who reported pain compared to those who did not. Logistic regression tested for variables predicting food insecurity.

RESULTS

Within the sample (N = 207), 53% reported a chronic pain diagnosis. Adults with pain were more likely to receive food stamps and to have a mental health condition than those without pain. Regression analyses revealed that depressive symptoms and chronic pain significantly predicted food insecurity when controlling for age and gender.

CONCLUSIONS

Exploring the link between depression, pain and nutritional resources may enhance understanding of causal relationships driving food insecurity. Public health officials should address nutritional needs of adults including those with chronic pain who use food bank services.

Attachment, Personality and Locus of Control: Psychological Determinants of Risk Perception and Preventive Behaviors for COVID-19

Background: The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions. Methods: An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures. Results: Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception. Conclusions: Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures.

Psychological Determinants of Attitude to Surgery in Internal Carotid Artery Stenosis Patients

The basic way to prevent cerebral stroke in symptomatic 70–99% stenosis of internal carotid artery (ICA) is an open or endovascular surgical procedure. Psychological research done so far among ICA stenosis patients focused on cognitive functioning changes. The objective was to assess attitude to surgery in relation to self-efficacy, life quality perception, and health locus of control in ICA stenosis patients. Materials and Methods: The study involved 53 asymptomatic ICA stenosis patients, aged from 53 to 81. Four scales were applied: Generalized Self-Efficacy Scale (GSES); Satisfaction With Life Scale (SWLS); Multidimensional Health Locus of Control Scale (MHLC); and a simple scale to examine the attitude to surgery, where “−10” stands for the maximally negative attitude, “0”—neutral, and “+10”—maximally positive. The obtained results were put to statistical analysis. Results: It was found that women and men assessed their attitude to the surgery as positive (M = 7.92; SD = 3.094), though the men estimated it slightly higher (M = 8.03; SD = 3.02) than the women (M = 7.67; SD = 3.37). The mean value of self-efficacy was high (M = 32.53; SD = 6.231), and slightly higher for the men (M = 32.79; SD = 5.576) compared to the women (M = 31.87; SD = 7.836). The patients generally tended to manifest the external personal health locus of control (M = 28.62; SD = 3.17). The runner-up was internal health locus of control (M = 26.02; SD = 3.775), and the next one—external impersonal aspect (chance/luck) (M = 23.57; SD = 4.457). The mean assessment of the patients’ own life quality proved to be above average (M = 23.60) but varied (SD = 5.95). The women perceived the quality of their lives as better (M = 24.33; SD = 6.422) than the men (M = 23.32; SD = 5.818). Very strong positive correlations were found between self-efficacy and life quality assessment (p < 0.001) and between the internal and external personal aspects of health locus of control (p < 0.007) in the women, and positive correlations were found between the attitude to surgery and internal health locus of control (p < 0.021) in the men. Conclusions: When breaking the news of a need to have a surgical intervention due to ICA stenosis, the physician should strongly refer to the value of human life and health. The message should arise from external (in the case of women) or internal (in the case of men) motivation to undergo surgery, and enhance the patient’s conviction that the disease should be considered a challenge which must be taken to reverse their unfavorable situation and improve life quality.

Why Do Students Walk or Cycle for Transportation? Perceived Study Environment and Psychological Determinants as Predictors of Active Transportation by University Students

University students are particularly at risk to suffer from physical and psychological complaints and for not fulfilling health-oriented physical activity (PA) recommendations. Since PA is linked with various benefits for health and educational outcomes, the group of students is of particular interest for PA promotion. Although active commuting has been identified as a relevant domain of PA in order to gain the various benefits of PA, little knowledge is available with respect to university students. This study tested conditions in the study environment, as well as personal motivators and barriers, as determinants for the active transportation of university students. Using a cross-sectional convenience sample of a university in the southwest of Germany (n = 997), we applied factor analyses to bundle relevant information on environmental and psychological determinants (adapted NEWS-G; adapted transport-related items from an Australian university survey) and blockwise hierarchical regressions. The objective was to analyze associations between the bundled determinants and self-reports on PA for transport-related walking and cycling (measured by the EHIS-PAQ). Results revealed associations between transport-related cycling and the perceived study environment (e.g., high automobile traffic) as well as certain personal motivators and barriers (e.g., time effort or weather conditions). The study contributes to the knowledge about determinants that are important for the development and improvement of public health interventions for students in a university setting.

Psychological correlates of arbovirus preventive health behaviour

BACKGROUND

Current arbovirus preventive health interventions do not take social and personality variables into account. Social cognition models posit that people engage in preventive health behaviour (PHB) after an assessment of the perceived risk of disease, an analysis of potential consequences and an evaluation of self-efficacy.

METHODS

In a sample of 385 undergraduate and medical students, we examined the association between social relationships, conscientiousness and mosquito repellent use. Data were analysed in a series of stepwise regression analyses.

RESULTS

Social relationships influenced the association between conscientiousness and mosquito repellent use. As expected, perceptions of positive social relationships and conscientiousness are positively linked with mosquito repellent use. Conversely, perceptions of negative social relationships are linked to an inverse association between conscientiousness and mosquito repellent use.

CONCLUSIONS

Future interventions designed to increase perceptions of social relationships might be helpful in increasing arbovirus preventive health behaviour such as using mosquito repellents. Since the present study was concurrent correlational in nature, future research would benefit from experimental interventions designed to directly examine the effect of enhancing positive relations and social support on arbovirus preventive health behaviour.

Dispositional optimism is associated with weight status, eating behavior, and eating disorders in a general population-based study

OBJECTIVE

The objective of this cross-sectional study was to assess whether optimism is associated with body mass index (BMI), eating behavior and eating disorders (EDs) in a population-based study.

METHOD

In 2016, a total of 32,805 participants aged ≥18 years from the NutriNet-Santé cohort completed the Life Orientation Test-Revised, assessing dispositional optimism. Height and weight were self-reported. Eating behavior was assessed with the revised 21-item Three-Factor Eating Questionnaire. Risk of EDs was evaluated with the Sick-Control-One-Fat-Food Questionnaire. Linear and Logistic regression was used to analyze the association between optimism, BMI categories, eating behavior and ED risk, controlling for sociodemographic, lifestyle and depressive symptom characteristics.

RESULTS

Our sample was composed of 73.5% women, and the mean age was 55.39 ± 13.70 years. More optimistic participants were less likely to be underweight (OR = 0.82; 95% CI: 0.75, 0.89), or obese, particularly class III obese (BMI ≥40 kg/m² ) (OR = 0.69; 95% CI: 0.56, 0.84) compared with less optimistic individuals. Optimism was negatively associated with cognitive restraint (β = -.07; 95%CI: -0.08; -0.06), emotional eating (β = -.17; 95% CI: -0.19, -0.16) and uncontrolled eating (β = -.10; 95% CI: -0.11, -0.09). In addition, more optimistic participants had a lower risk of EDs (OR = 0.60; 95% CI: 0.56, 0.64).

DISCUSSION

Our findings showed that optimism was associated with weight status, eating behavior and risk of EDs in both women and men. The causal structure of the underlying observed association remains unclear and should be further investigated.

Psychological Determinants of Physical Activity and Development in Early Childhood Among Children With Developmental Delays: The Role of Parent Beliefs Regarding the Benefits of Physical Activity

Among the various psychological determinants of physical activity (PA) in early childhood, relatively little attention has been paid to the role of parent beliefs in the benefits of PA for their child. Believing that PA is beneficial may impact parent behavior, resulting in more opportunities for PA in early childhood, particularly among children with neurodevelopmental disabilities (NDs) who may face more barriers to PA. Greater opportunity for PA may promote the development of motor skills and healthy body composition. This study examined the association between parental beliefs about PA and children's weight status in a sample of 147 children (32 ± 4 months old) with NDs. The proportion of parents with below average (mean − 1SD) perceptions of the benefits of PA whose children were overweight or obese was approximately was 2.5 times (proportion ratio, 2.35; 95% CI, 1.05–5.27) larger than it was for parents with above average (mean + 1SD) perceptions (after adjusting for the confounding effects of ethnicity, marital status, and mothers' self-reported depressive symptoms). Mothers' self-reported depressive symptoms was the only other covariate that was significantly associated with the weight status of these children, though, these data also signal possible (p = 0.07) differences in proportions between Hispanic/Latinx and White children in the sample who were classified as overweight and obese. Our study demonstrates the importance of considering parental or caregiver beliefs in the value of PA as another risk factor that may predict risk for overweight and obesity. Future studies should include parental beliefs in the benefits of PA as a potential psychological determinant of PA and associated health outcomes.

Dispositional pandemic worry and the health belief model: promoting vaccination during pandemic events

Background

Promoting vaccination during pandemics is paramount to public health, yet few studies examined theoretical motivations for vaccination during pandemics. Thus, the relationships between dispositional pandemic worry, constructs of the health belief model (HBM) and vaccination during the H1N1 pandemic were studied.

Methods

Participants (N = 1377) completed surveys assessing dispositional pandemic worry, HBM variables and H1N1 vaccination. Principle axis factor analysis and point biserial correlations were conducted. Differences in worry and vaccination were assessed via independent samples t-tests. Relationships between vaccination, demographics and worry were investigated using hierarchical linear regression. PROCESS analysis was conducted to explicate the relationship between worry and vaccination intention.

Results

A two-factor structure of dispositional pandemic worry-worry frequency and worry severity-was confirmed. Dispositional worry was higher among those who intended to and received H1N1 vaccine. Worry frequency and worry severity were positively related to vaccination. Threat, benefits and barriers mediated the impact of worry severity and threat and barriers mediated the impact of worry frequency on vaccination intentions.

Conclusions

Messages increasing dispositional worry and benefits while decreasing barriers may boost vaccination behavior during a pandemic event. Future study of relationships between dispositional worry and HBM variables is warranted.

Perceived barriers to partner notification among sexually transmitted infection clinic patients, Cape Town, South Africa

Background

Public health approaches to sexually transmitted infection (STI) prevention in resource-limited countries rely on patients to self-notify sex partners of their STI. However, a majority of partners go uninformed and remain untreated and infectious.

Methods

Anonymous surveys collected from 776 men and women receiving STI clinic services in Cape Town, South Africa.

Results

Half of patients surveyed intended to inform their partners, while half did not intend to notify partners. Women were more likely than men to intend to notify their partners. Patients who completed formal education were also more likely to indicate intentions to notify partners. There were no associations between numbers of partners patients had or partner types with intentions to notify partners. Among both men and women, concerns about adverse partner reactions were associated with intentions not to notify partners. Multivariable analyses stratified by gender and controlling for confounds showed that intentions to notify partners were significantly related to men's concerns that their partner could react violently against them and women's concerns that their partner may leave them and refuse to see them again.

Conclusions

Interventions that assist patients to develop strategies to safely inform their partners are needed to increase patient-initiated partner notification.

Active Aging in Very Old Age and the Relevance of Psychological Aspects

Background

Active aging encompasses a socially and individually designed mix of different domains that range from personal and familial, to social and professional. In being a key policy concept often focused on the young-old individuals, efforts in studying its dimensions in advanced ages have seldom been made. Nevertheless, there is a recognized need to promote adequate responses to the growing number of individuals reaching advanced ages and to recognize their specific dependability on health-related aspects, services attendance, social interactions, or on psychological characteristics for what it means to “age actively.”

Objective and methods

This study provides a secondary analysis of data and follows the preceding work on the operationalization of the World Health Organization’s (WHO) active aging model by means of an assessment protocol to measure which variables, within the model’s determinants, contribute the most for an active aging process (1). Authors used the achieved model (composed by six factors: health, psychological component, cognitive performance, social relationships, biological component, and personality) and performed multi-group analysis of structural invariance to examine hypothetical differences between age groups (<75 years vs. ≥75 years) and to contrast obtained findings with the originally achieved model for the total sample (1,322 individuals aged 55 +).

Results

The structural covariances for the two age groups were statistically different. The comparison of components between age groups revealed a major relevance of the psychological component for the older age group.

Conclusion

These findings reinforce the importance of psychological functioning in active aging in oldest old, and the need for further research on specific psychological features underlying the subjective meaning of active aging in more advanced ages.

Cognitive and Motivational Factors Associated with Sedentary Behavior: A Systematic Review

Excessive time spent in sedentary behavior (SB) is associated with numerous health risks. These associations remain even after controlling for moderate-to-vigorous physical activity (PA) and body mass index, indicating that efforts to promote leisure time physical activity alone are insufficient. Cognitive and motivation variables represent potentially modifiable factors and have the potential of furthering our understanding of sedentary behavior. Hence, a systematic review was conducted to synthesize and critique the literature on the relationship between cognitive and motivational factors and sedentary behaviors. In April 2016, four electronic databases (Psych info, Pub Med, SPORTDiscus, Web of Science) were searched and a total of 4866 titles and abstracts were reviewed. After meeting inclusion criteria, study characteristics were extracted and the methodological quality of each study was assessed according to the Downs and Black Checklist. PRISMA guidelines for reporting of systematic reviews were followed. Twenty-five studies (16 cross-sectional, 8 longitudinal and one examining two populations and employing both a cross-sectional and prospective design) assessed 23 different cognitive and motivational factors. Seventeen studies were theory-based and 8 did not employ a theoretical model. Results showed that among SB-related cognitions, risk factors for greater sedentary time included having a more positive attitude towards SB, perceiving greater social support/norms for SB, reporting greater SB habits, having greater intentions to be sedentary, and having higher intrinsic, introjected, and external motivation towards SB. Protective factors associated with lower sedentary time included having greater feelings of self-efficacy/control over SB and greater intentions to reduce SB. Among PA-related cognitions, protective factors for lower SB included a more positive attitude towards PA, having greater social support/norms for PA, greater self-efficacy/control for PA, higher PA intentions, and higher intrinsic and identified motivation towards PA. In addition, feeling more supported and empowered in general was related with lower levels of SB. The average methodological quality score for included studies was 69% (SD = 9.15%; range 35–80%). In conclusion, a number of cognitive and motivational factors were identified that were associated with sedentarism. These findings have come from reasonably high quality studies. To further extend our understanding of the relation between cognitive and motivational factors and SB, more longitudinal, theory-driven studies examining cognitions and motivation from a sedentary perspective are required.

Impulse control disorders in Parkinson's disease: Predominant role of psychological determinants

OBJECTIVES

Impulse Control Disorders (ICDs) in Parkinson's disease (PD) have previously almost exclusively been considered to result from anti-parkinsonian medication. However, this biomedical perspective has failed to achieve a full understanding of the phenomenon and it is argued that a failure to consider psychological factors is a critical omission.

DESIGN

The present study examined the predictive relationship between ICDs in PD and a range of psychological measures, whilst controlling for a number of biomedical determinants.

MAIN OUTCOME MEASURES

One hundred participants with idiopathic PD completed questionnaires that assessed demographic and clinical characteristics, psychological measures and the presence of ICDs (QUIP-RS).

RESULTS

Increased use of a 'negative' coping strategy, stronger illness identity, more emotional illness representations and stress were found to be significant predictors of ICDs, and different psychological predictors were associated with different ICDs. Medication was not found to predict ICDs in the presence of psychological factors, either when total treatment levels were considered or when agonist dose was considered alone.

CONCLUSIONS

This study provides the first quantitative evidence of a predominant predictive relationship between psychological factors and ICDs in PD. The results suggest that psychological interventions may have useful therapeutic role to play for ICDs in PD.

Comparison of uptake and predictors of adherence in primary and secondary prevention of cardiovascular disease in a community-based cardiovascular prevention programme (MyAction Westminster)

BACKGROUND

Despite the benefits of cardiac rehabilitation, uptake and adherence remain suboptimal. With the advent of NHS Health Checks, primary prevention programmes have also been advocated, but little is known about uptake and adherence rates. This study examined rates and predictors of adherence amongst patients with cardiovascular disease (CVD) and those at high multifactorial risk (HRI) attending an innovative programme integrating primary and secondary prevention.

METHODS

Comparison of rates of uptake and adherence and also predictors of adherence between 401 CVD patients and 483 HRI. The outcome was the number of sessions attended and predictor variables included clinical and psychosocial variables. Differences between groups were examined using t-tests and non-parametric tests. Multivariable regression analyses examined predictors of adherence.

RESULTS

Uptake to the assessment (CVD: 97%, HRI: 88%) and the programme (CVD: 78%, HRI: 74%) were high for both groups. An average of 8/12 was attended in both groups. Beliefs about treatment predicted adherence for both groups (P < 0.01). The alcohol causal belief also predicted poorer adherence amongst CVD patients (P < 0.02). Older age also predicted better adherence amongst HRI (P < 0.001).

CONCLUSIONS

Rates of uptake and adherence were high for both HRI and CVD patients. Further research is needed to examine whether interventions targeting predictor variables further improve adherence.