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Zhang J, Cao Y, Mo H, Feng R. The association between different types of physical activity and smoking behavior. BMC Psychiatry 2023; 23:927. [PMID: 38082223 PMCID: PMC10712079 DOI: 10.1186/s12888-023-05416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Smoking is harmful, which has become a major public health burden. Physical activity may be related to smoking. Physical activity is one of the current methods for smoking control and smoking cessation. Different types of physical activity may have different effect on smoking behavior. OBJECTIVE The purpose of this study was to identify the direction and extent of the impact of different types of physical activity above moderate intensity (including work physical activity, recreational physical activity, commuter physical activity and sedentary behavior) on smoking behavior. MATERIALS AND METHODS In this study, a total of 2,015 individuals (1,233 males and 782 females, mean age 54.02±17.31 years) was selected from the representative population aged 20 and above in the National Health and Nutrition Survey of the United States from 2017 to 2018. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) ; the tobacco use questionnaire (SMQ) was used to determine whether the sample had smoking behavior at this stage. Binary Logistic regression analysis was performed with various physical activities as independent variables and smoking behavior as dependent variables. All data were analyzed through Statistical Product and Service Solutions (SPSS) 26.0. RESULTS After adjusted for all confounding variables, physical activity at work was close to significantly associated with smoking behavior (P=0.053), odds ratio (OR) =1.135 (95%Cl: 0.999-1.289). Recreational physical activity was significantly associated with smoking behavior (P < 0.001), OR=0.729 (95%Cl: 0.639-0.832). Commuting physical activity was significantly associated with smoking behavior (P < 0.001), OR=1.214 (95%Cl:1.048-1.405). Sedentary behavior was significantly associated with smoking behavior (P < 0.001), OR=1.363 (95%Cl: 1.154-1.611). CONCLUSIONS Given that different types of physical activity have different associations with smoking behavior. Therefore, when physical activity is used as a tobacco control measurement, it is necessary to pay attention to the type and environment of physical activity. Recreational physical activities should be appropriately increased, sedentary behavior should be reduced, and smoking prohibit environment should be expanded as far as possible to achieve better clinical intervention effects.
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Affiliation(s)
- Jipeng Zhang
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Yiwen Cao
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Hongfei Mo
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, P.R. China.
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China.
| | - Rui Feng
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, P.R. China.
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Stockton MB, Ward KD, McClanahan BS, Vander Weg MW, Coday M, Wilson N, Relyea G, Read MC, Connelly S, Johnson KC. The Efficacy of Individualized, Community-Based Physical Activity to Aid Smoking Cessation: A Randomized Controlled Trial. J Smok Cessat 2023; 2023:5535832. [PMID: 37273658 PMCID: PMC10238145 DOI: 10.1155/2023/5535832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023] Open
Abstract
Objective The efficacy of individualized, community-based physical activity as an adjunctive smoking cessation treatment to enhance long-term smoking cessation rates was evaluated for the Lifestyle Enhancement Program (LEAP). Methods The study was a two-arm, parallel-group, randomized controlled trial. All participants (n = 392) received cessation counseling and a nicotine patch and were randomized to physical activity (n = 199; YMCA membership and personalized exercise programming from a health coach) or an equal contact frequency wellness curriculum (n = 193). Physical activity treatment was individualized and flexible (with each participant selecting types of activities and intensity levels and being encouraged to exercise at the YMCA and at home, as well as to use "lifestyle" activity). The primary outcome (biochemically verified prolonged abstinence at 7-weeks (end of treatment) and 6- and 12-months postcessation) and secondary outcomes (7-day point prevalent tobacco abstinence (PPA), total minutes per week of leisure time physical activity and strength training) were assessed at baseline, 7 weeks, 6 months, and 12 months. Results Prolonged abstinence in the physical activity and wellness groups was 19.6% and 25.4%, respectively, at 7-weeks, 15.1% and 16.6% at 6-months, and 14.1% and 17.1% at 12 months (all between-group P values >0.18). Similarly, PPA rates did not differ significantly between groups at any follow-up. Change from baseline leisure-time activity plus strength training increased significantly in the physical activity group at 7 weeks (P = 0.04). Across treatment groups, an increase in the number of minutes per week in strength training from baseline to 7 weeks predicted prolonged abstinence at 12 months (P ≤ 0.001). Further analyses revealed that social support, fewer years smoked, and less temptation to smoke were associated with prolonged abstinence over 12 months in both groups. Conclusions Community-based physical activity programming, delivered as adjunctive treatment with behavioral/pharmacological cessation treatment, did not improve long-term quit rates compared to adjunctive wellness counseling plus behavioral/pharmacological cessation treatment. This trial is registered with https://beta.clinicaltrials.gov/study/NCT00403312, registration no. NCT00403312.
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Affiliation(s)
| | - Kenneth D. Ward
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Mark W. Vander Weg
- Departments of Community and Behavioral Health, Internal Medicine, and Psychological and Brain Sciences, University of Iowa, Iowa City, IA and Iowa City VA Health Care System, Iowa City, IA, USA
| | - Mace Coday
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nancy Wilson
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - George Relyea
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Mary C. Read
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Karen C. Johnson
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
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Vogel EA, Ramo DE. Smoking cessation, metabolic risk behaviors, and stress management over time in a sample of young adult smokers. Transl Behav Med 2021; 11:189-197. [PMID: 31595303 DOI: 10.1093/tbm/ibz139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Smoking cessation may support changes in metabolic risk behaviors (e.g., high-fat diet, physical inactivity, poor sleep, low fruit and vegetable consumption [FVC]). We examined the association between smoking cessation and metabolic risk behavior profiles, mediated by readiness to change risk behaviors and moderated by stress management. Participants were young adult smokers in a randomized controlled trial of a Facebook smoking cessation intervention. Measures included stage of change for five metabolic risk behaviors: FVC, diet, physical activity, sleep hygiene, and stress management. Moderated mediation was used to examine relationships between smoking cessation at T1 (predictor), readiness to change metabolic risk behaviors at T2 (mediators), stress management at T3 (moderator), and metabolic risk behavior profile at T3 (outcome) over 9 months. T1 smoking abstinence was associated with greater readiness to increase FVC at T2, which predicted lower likelihood of T3 metabolic risk (β = -0.22, 95% confidence interval [CI] [-0.53, -0.03]). This indirect effect was moderated by stress management such that greater readiness to increase FVC at T2 was associated with lower T3 metabolic risk for participants with unmanaged stress (β = -0.90, 95% CI [-1.32, -0.49], p < .001), but not for participants with well-managed stress (β = -.22, 95% CI [-0.48, 0.04], p = .096). Young adults who quit smoking subsequently had lower metabolic risk behaviors. Among participants with unmanaged stress, those who quit smoking had greater readiness to increase FVC and lower likelihood of subsequent metabolic risk. Smoking cessation interventions could aim to teach broadly applicable behavior change skills and build confidence for decreasing metabolic risk.
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Affiliation(s)
- Erin A Vogel
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,Hopelab, San Francisco, CA, USA
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Maugeri A, Barchitta M, Kunzova S, Bauerova H, Agodi A, Vinciguerra M. The association of social and behavioral factors with dietary risks in adults: Evidence from the Kardiovize Brno 2030 study. Nutr Metab Cardiovasc Dis 2020; 30:896-906. [PMID: 32249142 DOI: 10.1016/j.numecd.2020.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS Uncovering the main determinants of diet quality is one of the greatest challenges for Public Health, since it could guide future strategies and interventions against cardiovascular diseases (CVDs). The present cross-sectional analysis of the Kardiovize cohort evaluates the prevalence of dietary risk factors for CVDs and their association with social and behavioural characteristics in a random sample of 1536 adults (aged 25-64 years) from Brno, Czech Republic. METHODS AND RESULTS A face-to-face health interview guided by structured questionnaires was carried out on socio-demographic characteristics (age, sex, educational level, employment, marital status, income, and household size) and behaviours (smoking status, physical activity, and sleep habits). Twelve dietary risk factors covered by the Global Burden of Diseases comparative risk assessment framework were assessed using a Food Frequency Questionnaire. In general, we observed that the consumption of nearly all healthy foods and nutrients was suboptimal, and that it was also aggravated by high intake of foods and nutrients that constituted dietary risk factors. Moreover, we found several associations of social and behavioural characteristics with specific dietary risk factors. Particularly, being male (β = 0.466; SE = 0.079; p < 0.001), increasing household size (β = 0.130; SE = 0.047; p = 0.006), low income (β = 0.192; SE = 0.091; p = 0.035), and decreasing physical activity level (β = 0.172; SE = 0.054; p = 0.002) were associated with increasing number of dietary risk factors. CONCLUSION Thus, our study raises an urgent need for Public Health strategies promoting healthy eating in adulthood, which should be based on traditional and novel determinants of dietary risk.
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Affiliation(s)
- A Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy; International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic.
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - S Kunzova
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - H Bauerova
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M Vinciguerra
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
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Bonnesen CT, Toftager M, Madsen KR, Wehner SK, Jensen MP, Rosing JA, Laursen B, Rod NH, Due P, Krølner RF. Study protocol of the Healthy High School study: a school-based intervention to improve well-being among high school students in Denmark. BMC Public Health 2020; 20:95. [PMID: 31969134 PMCID: PMC6977303 DOI: 10.1186/s12889-020-8194-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/10/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The prevalence of low well-being, perceived stress and unhealthy behaviours is high among high school students, but few interventions have addressed these problems. The aim of this paper is to present a study protocol of a cluster randomised controlled trial evaluating the Healthy High School (HHS) intervention programme. The intervention programme is designed to improve well-being (primary outcome) by preventing 1) stress and promoting 2) sleep, 3) sense of community, 4) physical activity (PA) and 5) regular and healthy meals among high school students in Denmark. METHODS The development of the HHS study was guided by the Intervention Mapping protocol. The intervention comprises four components: 1) a teaching material, 2) a smartphone app, 3) a catalogue focusing on environmental changes, and 4) a peer-led innovation workshop aiming at inspiring students to initiate and participate in various movement activities. The HHS study employs a cluster-randomised controlled trial design. Thirty-one high schools across Denmark were randomly allocated to intervention (16 schools) or control (15 schools) groups. The study included all first-year students (~ 16 years of age) (n = 5976 students). Timeline: Intervention: August 2016 - June 2017. Collection of questionnaire data: Baseline (August 2016), 1st follow-up (May 2017) and 2nd follow-up (April 2018). All students were invited to participate in a monthly sub-study about perceived stress using text messages for data collection (September 2016 - June 2017). PA was objectively assessed among a sub-sample of students using accelerometers (Axivity, AX3) in August 2016 and May 2017. PRIMARY OUTCOME MEASURES Student well-being measured by the Cantril Ladder and the five item World Health Organisation Well-being Index (individual level outcomes). SECONDARY OUTCOME MEASURES Stress (10-item Perceived Stress Scale), sleep (quantity and quality), PA (hours of moderate-to-vigorous PA per week, hours of daily sedentary time and average daily PA), meal habits (daily intake of breakfast, lunch, snacks and water), and strong sense of community in class and at school, respectively (individual level outcomes). The study encompasses process and effect evaluation as well as health economic analyses. TRIAL REGISTRATION ISRCTN ISRCTN43284296, 28 April 2017, retrospectively registered.
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Affiliation(s)
- Camilla Thørring Bonnesen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Mette Toftager
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Katrine Rich Madsen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Stine Kjær Wehner
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Marie Pil Jensen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Johanne Aviaja Rosing
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Bjarne Laursen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Bartholinsgade 6Q, 1356 Copenhagen, Denmark
| | - Pernille Due
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Rikke Fredenslund Krølner
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
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Miller JE, Windschitl PD, Treat TA, Scherer AM. Comparisons as Predictors of People’s Beliefs About the Importance of Changing Their Health Behaviors. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The current study tested relative strengths of different comparison beliefs for predicting people’s self-assessments of whether they should increase their health-relevant behaviors (exercise, sleep, and fruit and vegetable consumption). Comparison beliefs relevant to three standards (perceived global, local, expert standards) were evaluated. Data were combined from three similar studies (total N = 744) that had a cross-sectional, within-subject design. Participants completed importance-of-change scales regarding the three health behaviors and reported comparison beliefs and absolute behavior frequencies/amounts. Results were consistent across the three behaviors. Comparison beliefs predicted ratings of importance of changing one’s behavior, even beyond what is predicted by reports of absolute behavior frequency. Expert comparisons were consistently most predictive above and beyond the absolute estimates and the other comparison standards. There was no evidence of a local dominance effect when examining local versus global comparisons. Comparison beliefs have unique utility for predicting people’s perceived importance of changing their heath behavior. The fact that expert comparisons were consistently most predictive (and local comparisons the least) may have implications for interventions designed for encouraging behavior change.
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Affiliation(s)
- Jane E. Miller
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Paul D. Windschitl
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Teresa A. Treat
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Aaron M. Scherer
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Ussher MH, Faulkner GEJ, Angus K, Hartmann‐Boyce J, Taylor AH. Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2019; 2019:CD002295. [PMID: 31684691 PMCID: PMC6819982 DOI: 10.1002/14651858.cd002295.pub6] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Taking regular exercise, whether cardiovascular-type exercise or resistance exercise, may help people to give up smoking, particularly by reducing cigarette withdrawal symptoms and cravings, and by helping to manage weight gain. OBJECTIVES To determine the effectiveness of exercise-based interventions alone, or combined with a smoking cessation programme, for achieving long-term smoking cessation, compared with a smoking cessation intervention alone or other non-exercise intervention. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register for studies, using the term 'exercise' or 'physical activity' in the title, abstract or keywords. The date of the most recent search was May 2019. SELECTION CRITERIA We included randomised controlled trials that compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme alone or another non-exercise control group. Trials were required to recruit smokers wishing to quit or recent quitters, to assess abstinence as an outcome and have follow-up of at least six months. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Smoking cessation was measured after at least six months, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of comparison, as either smoking cessation or relapse prevention. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. MAIN RESULTS We identified 24 eligible trials with a total of 7279 adult participants randomised. Two studies focused on relapse prevention among smokers who had recently stopped smoking, and the remaining 22 studies were concerned with smoking cessation for smokers who wished to quit. Eleven studies were with women only and one with men only. Most studies recruited fairly inactive people. Most of the trials employed supervised, group-based cardiovascular-type exercise supplemented by a home-based exercise programme and combined with a multi-session cognitive behavioural smoking cessation programme. The comparator in most cases was a multi-session cognitive behavioural smoking cessation programme alone. Overall, we judged two studies to be at low risk of bias, 11 at high risk of bias, and 11 at unclear risk of bias. Among the 21 studies analysed, we found low-certainty evidence, limited by potential publication bias and by imprecision, comparing the effect of exercise plus smoking cessation support with smoking cessation support alone on smoking cessation outcomes (RR 1.08, 95% CI 0.96 to 1.22; I2 = 0%; 6607 participants). We excluded one study from this analysis as smoking abstinence rates for the study groups were not reported. There was no evidence of subgroup differences according to the type of exercise promoted; the subgroups considered were: cardiovascular-type exercise alone (17 studies), resistance training alone (one study), combined cardiovascular-type and resistance exercise (one study) and type of exercise not specified (two studies). The results were not significantly altered when we excluded trials with high risk of bias, or those with special populations, or those where smoking cessation intervention support was not matched between the intervention and control arms. Among the two relapse prevention studies, we found very low-certainty evidence, limited by risk of bias and imprecision, that adding exercise to relapse prevention did not improve long-term abstinence compared with relapse prevention alone (RR 0.98, 95% CI 0.65 to 1.47; I2 = 0%; 453 participants). AUTHORS' CONCLUSIONS There is no evidence that adding exercise to smoking cessation support improves abstinence compared with support alone, but the evidence is insufficient to assess whether there is a modest benefit. Estimates of treatment effect were of low or very low certainty, because of concerns about bias in the trials, imprecision and publication bias. Consequently, future trials may change these conclusions.
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Affiliation(s)
- Michael H Ussher
- St George's, University of LondonPopulation Health Research InstituteCranmer TerraceLondonUKSW17 0RE
- University of StirlingInstitute for Social MarketingStirlingUK
| | - Guy E J Faulkner
- University of British ColumbiaSchool of Kinesiology2146 Health Sciences MallVancouverCanadaV6T 1Z3
| | - Kathryn Angus
- University of StirlingInstitute for Social MarketingStirlingUK
| | - Jamie Hartmann‐Boyce
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Adrian H Taylor
- University of PlymouthFaculty of Health: Medicine, Dentistry and Human SciencesRoom N32, ITTC Building, Tamar Science ParkDerrifordPlymouthUKPL6 8BX
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Blair CK, McDougall JA, Chiu VK, Wiggins CL, Rajput A, Harding EM, Kinney AY. Correlates of poor adherence to a healthy lifestyle among a diverse group of colorectal cancer survivors. Cancer Causes Control 2019; 30:1327-1339. [PMID: 31655944 DOI: 10.1007/s10552-019-01241-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/10/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Lifestyle factors may have a synergistic effect on health. We evaluated the correlates of poor adherence to a healthy lifestyle among a diverse sample of colorectal cancer (CRC) survivors to inform future lifestyle promotion programs. METHODS Lifestyle questions from a cross-sectional survey were completed by 283 CRC survivors (41% Hispanic, 40% rural, 33% low income). Adherence to recommendations (yes/no) for physical activity, fruit and vegetable servings/day, avoiding tobacco, and healthy weight was summed to create an overall lifestyle quality score. Polytomous logistic regression was used to evaluate correlates of good (reference group), moderate, and poor overall lifestyle quality. Potential correlates included sociodemographic characteristics, cancer-related factors, and indicators of health and well-being. RESULTS CRC survivors with poor adherence were 2- to 3.4-fold significantly more likely to report multiple comorbidities, poor physical functioning, fatigue, anxiety/depressive symptoms, and poor social participation. In multivariable analyses, poor physical functioning was the only significant correlate of poor adherence to lifestyle recommendations, compared to good adherence [OR (95% CI) 3.4 (1.8-6.4)]. The majority of survivors, 71% and 78%, indicated interest in receiving information on exercise and eating a healthy diet, respectively. CONCLUSION Future lifestyle promotion programs for CRC survivors should carefully consider indicators of physical and psychosocial health and well-being, especially poor physical functioning, in the design, recruitment, and implementation of these health programs.
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Affiliation(s)
- Cindy K Blair
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, MSC07-4025, Albuquerque, NM, 87131-0001, USA. .,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
| | - Jean A McDougall
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, MSC07-4025, Albuquerque, NM, 87131-0001, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Vi K Chiu
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, MSC07-4025, Albuquerque, NM, 87131-0001, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Charles L Wiggins
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, MSC07-4025, Albuquerque, NM, 87131-0001, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Ashwani Rajput
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, MSC07-4025, Albuquerque, NM, 87131-0001, USA.,Department of Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Elizabeth M Harding
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Anita Y Kinney
- Department of Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Cox-Martin E, Cox MG, Basen-Engquist K, Bradley C, Blalock JA. Changing multiple health behaviors in cancer survivors: smoking and exercise. PSYCHOL HEALTH MED 2019; 25:331-343. [PMID: 31630537 DOI: 10.1080/13548506.2019.1679849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Research regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants' self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant (r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise ((r = .44, 95% CI [.20, .65]) strenuous); ((r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior (r = -.27, 95% CI [-.46, -.05]), and smoking self-efficacy and smoking behavior (r = -0.41, 95% CI [-.61, -.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..
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Affiliation(s)
- Emily Cox-Martin
- Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew G Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cathy Bradley
- Department of Health Systems, Management, and Policy, and University of Colorado Cancer Center, University of Colorado School of Public Health, Aurora, CO, USA
| | - Janice A Blalock
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Abrantes AM, Farris SG, Minami H, Strong DR, Riebe D, Brown RA. Acute Effects of Aerobic Exercise on Affect and Smoking Craving in the Weeks Before and After a Cessation Attempt. Nicotine Tob Res 2019; 20:575-582. [PMID: 28505303 DOI: 10.1093/ntr/ntx104] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/10/2017] [Indexed: 11/14/2022]
Abstract
Introduction Aerobic exercise may improve smoking abstinence via reductions in craving and negative affect and increases in positive moods. Acute changes in craving and affect before and after structured exercise sessions have not been examined during the weeks prior to and following quit attempts nor has smoking status been examined in relation to these effects. Given that regular cigarette smoking can be perceived as affect enhancing and craving reducing, it is not known whether exercise could contribute additional affective benefit beyond these effects. Method Participants (N = 57; 68.4% women) were low-active daily smokers randomized to cessation treatments plus either group-based aerobic exercise (AE) or a health-education control (HEC). Mood, anxiety, and craving were assessed before and after each intervention session for each of the 12 weeks. Carbon monoxide (CO) breath samples ≤ 5ppm indicated smoking abstinence. Results During the prequit sessions, significantly greater decreases in anxiety following AE sessions relative to HEC sessions were observed. Changes in mood and craving were similar after AE and HEC sessions prior to quitting. Postquit attempt, significant reductions in craving and anxiety were observed after AE sessions but not following HEC. During the postquit period, positive mood increased following AE sessions relative to HEC only among individuals who were abstinence on that day. Conclusions AE may be effective in acutely reducing anxiety prior to a quit attempt and both anxiety and craving following the quit attempt regardless of abstinence status. The mood-enhancing effects of AE may occur only in the context of smoking abstinence. Implications The current findings underscore the importance of examining the acute effects of aerobic exercise prior to and after a cessation attempt and as a function of smoking status. Given the equivocal results from previous studies on the efficacy of exercise for smoking cessation, increasing our understanding of how aerobic exercise produces its reinforcing benefits for smokers attempting to quit could potentially inform the refinement (e.g., timing/sequencing) of exercise interventions within smoking cessation programs.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital, Providence, RI.,Alpert Medical School of Brown University, Providence, RI
| | - Samantha G Farris
- Butler Hospital, Providence, RI.,Alpert Medical School of Brown University, Providence, RI.,Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI
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Maugeri A, Barchitta M, Fiore V, Rosta G, Favara G, La Mastra C, La Rosa MC, Magnano San Lio R, Agodi A. Determinants of Adherence to the Mediterranean Diet: Findings from a Cross-Sectional Study in Women from Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162963. [PMID: 31426512 PMCID: PMC6720012 DOI: 10.3390/ijerph16162963] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/16/2019] [Indexed: 11/16/2022]
Abstract
The Mediterranean diet (MD)—the dietary pattern usually consumed by Mediterranean populations—can help promote a favorable health status and better quality of life. Uncovering the main factors associated with the adherence to MD may be useful in understanding and counteracting the global shift toward a Western diet, which has been documented also in the Mediterranean region. Here, we evaluated the adherence to MD and its major social and behavioral determinants in women from Catania, Southern Italy. This cross-sectional study included 841 women, aged 25–64 years, with no history of severe diseases. Adherence to MD was assessed by the Food Frequency Questionnaire and Mediterranean Diet Score (MDS). Associations between variables were tested by multivariable logistic regression analysis and expressed as an odds ratio (OR) with a 95% confidence interval (CI). Among social factors, medium and high educational levels were associated with an ideal intake of alcohol (OR = 4.059; 95%CI = 1.311–12.570; p = 0.015; OR = 4.258 95%CI = 1.068–16.976; p = 0.040; respectively), living in a couple with ideal intake of cereals (OR = 2.801 95%CI = 1.188–6.602; p = 0.018), and having children with an ideal intake of fruits (OR = 3.149; 95%CI = 1.245–7.762; p = 0.015). With respect to behaviors, current smoking was negatively associated with an ideal intake of meat (OR = 0.449; 95%CI = 0.0220–0.917; p = 0.028), while more engagement in physical activity was associated with an ideal intake of vegetables (OR = 6.148; 95%CI = 1.506–25.104; p = 0.011) and legumes (OR = 5.832; 95%CI = 1.414–24.063; p = 0.015). In line with these findings, moderately or highly physically active women were more likely to show medium or high adherence to MD than those who performed less physical activity (OR = 6.024; 95%CI = 1.192–30.440; p = 0.040; OR = 9.965 95%CI = 1.683–58.993; p = 0.011; respectively). Our results confirm an urgent need for public health strategies, which should take into account determinants of diet quality. Particularly, our study indicates that more engagement in physical activity is a major positive determinant of the adherence to MD.
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Affiliation(s)
- Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Valerio Fiore
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Giuliana Rosta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Giuliana Favara
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Claudia La Mastra
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Maria Clara La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Roberta Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
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Implicit theories of smoking and association with interest in quitting among current smokers. J Behav Med 2019; 43:544-552. [DOI: 10.1007/s10865-019-00058-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
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Smoking behaviour and sensations during the pre-quit period of an exercise-aided smoking cessation intervention. Addict Behav 2018; 81:143-149. [PMID: 29454814 DOI: 10.1016/j.addbeh.2018.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Previous research has shown reductions in cigarette consumption during the pre-quit period of exercise-aided smoking cessation interventions. Smoking topography and sensation patterns during this period is unknown and may provide valuable insight into compensation and cessation readiness. METHODS Female smokers (N = 236, M age = 43, M cigarettes/day = 17.0) enrolled in an exercise-aided smoking cessation intervention self-reported daily cigarette use and cigarette sensory experiences. Breath carbon monoxide and smoking topography data were collected during the period leading up to the targeted quit date (i.e., baseline, week 1, and week 3), which was set for week 4. RESULTS Repeated measures ANOVAs revealed that cigarette consumption (p < 0.001, eta = 0.32), carbon monoxide (p < 0.001, eta = 0.14), puff duration (p = 0.01, eta = 0.05), smoking satisfaction (p < 0.001, eta = 0.34), psychological reward (p < 0.001, eta = 0.43), enjoyment of respiratory tract sensations (p < 0.001, eta = 0.29), and craving (p < 0.001, eta = 0.39) decreased, whereas average puff flow (p = 0.01, eta = 0.05) increased. CONCLUSIONS This is the first study to establish that regular exercise during the pre-quit period served as a conduit for facilitating behavioral and sensory harm reduction with cigarettes. Furthermore, the pattern of change observed between cigarette consumption and smoking topography does not support compensation. These findings imply that female smokers who exercise prior to a quit attempt are in a favourable state to achieve cessation.
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Amireault S, Fong AJ, Sabiston CM. Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors. Am J Lifestyle Med 2018; 12:184-199. [PMID: 30202391 PMCID: PMC6124968 DOI: 10.1177/1559827616661490] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/17/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.
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Affiliation(s)
- Steve Amireault
- Steve Amireault, PhD, Department of Health and Kinesiology, Purdue University, 800 West Stadium Avenue, Lambert Fieldhouse, Office 311A, West Lafayette, IN 47907; e-mail:
| | - Angela J. Fong
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
| | - Catherine M. Sabiston
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
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15
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Vander Weg MW, Coday M, Stockton MB, McClanahan B, Relyea G, Read MC, Wilson N, Connelly S, Richey P, Johnson KC, Ward KD. Community-based physical activity as adjunctive smoking cessation treatment: Rationale, design, and baseline data for the Lifestyle Enhancement Program (LEAP) randomized controlled trial. Contemp Clin Trials Commun 2018; 9:50-59. [PMID: 29333504 PMCID: PMC5760189 DOI: 10.1016/j.conctc.2017.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/14/2017] [Accepted: 11/29/2017] [Indexed: 11/24/2022] Open
Abstract
Despite advances in behavioral and pharmacological treatment for tobacco use and dependence, quit rates remain suboptimal. Increasing physical activity has shown some promise as a strategy for improving cessation outcomes. However, initial efficacy studies focused on intensive, highly structured exercise programs that may not be applicable to the general population of smokers. We describe the rationale and study design and report baseline participant characteristics from the Lifestyle Enhancement Program (LEAP), a two-group, randomized controlled trial. Adult smokers who engaged in low levels of leisure time physical activity were randomly assigned to treatment conditions consisting of an individualized physical activity intervention delivered by health fitness instructors in community-based exercise facilities or an equal contact wellness control. All participants received standard cognitive behavioral smoking cessation counseling combined with nicotine replacement therapy. The primary outcomes are seven-day point prevalence abstinence at seven weeks, six- and 12 months. Secondary outcomes include self-reported physical activity, dietary intake, body mass index, waist circumference, percent body fat, and nicotine withdrawal symptoms. Participants consist of 392 sedentary smokers (mean [standard deviation] age = 44.6 [10.2] = years; 62% female; 31% African American). Results reported here provide information regarding experiences recruiting smokers willing to change multiple health behaviors including smoking and physical activity.
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Affiliation(s)
- Mark W. Vander Weg
- Iowa City VA Health Care Center, Center for Comprehensive Access & Delivery Research & Evaluation (CADRE) and Veterans Rural Health Resource Center – Central Region, Iowa City, IA, USA
- Departments of Internal Medicine and Psychological and Brain Sciences and Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Mace Coday
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | | | | | - George Relyea
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Mary C. Read
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Nancy Wilson
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | - Phyllis Richey
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Karen C. Johnson
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kenneth D. Ward
- School of Public Health, The University of Memphis, Memphis, TN, USA
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Beard E, West R, Michie S, Brown J. Association between smoking and alcohol-related behaviours: a time-series analysis of population trends in England. Addiction 2017; 112:1832-1841. [PMID: 28556467 PMCID: PMC5600127 DOI: 10.1111/add.13887] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/20/2017] [Accepted: 05/19/2017] [Indexed: 11/28/2022]
Abstract
AIMS This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England. DESIGN Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face-to-face surveys of representative samples of ~1700 adults in England. MEASUREMENTS Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high-risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption. FINDINGS Mean smoking prevalence over the study period was 18.6% and high-risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high-risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = -0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = -0.026, 95% CI = -1.348 to 1.296, P = 0.969). CONCLUSION Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high-risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption.
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Affiliation(s)
- Emma Beard
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Robert West
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Susan Michie
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Jamie Brown
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
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Garey L, Manning K, Jardin C, Leventhal AM, Stone M, Raines AM, Pang RD, Neighbors C, Schmidt NB, Zvolensky MJ. Smoking Consequences Questionnaire: A reevaluation of the psychometric properties across two independent samples of smokers. Psychol Assess 2017; 30:678-692. [PMID: 28782978 DOI: 10.1037/pas0000511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Drug use outcome expectancies are a central construct to psychosocial theories of addictive disorders. In tobacco literature, the Smoking Consequences Questionnaire (SCQ; Brandon & Baker, 1991) is a tool used to assess this construct. Despite its common use, the SCQ has received little psychometric evaluation. In the current report, samples from 2 studies were used to examine the assumed SCQ structure, develop a novel truncated scale, and evaluate the psychometric properties of the novel scale. In Study 1, the 4-factor SCQ structure was examined using data from 343 (32.4% female; Mage = 43.7; SD = 10.8) adult nontreatment-seeking smokers. Results from Study 1 indicated that the 4-factor SCQ structure did not adequately explain covariance between items. Instead, results provided evidence for a 5-factor structure that tapped into outcome expectancies related to (a) immediate negative consequences (IC), (b) long-term negative consequences (LTC), (c) sensory satisfaction (SS), (d) negative affect reduction, and (e) appetite-weight control (AW). In Study 2, the 5-factor structure of the SCQ was confirmed and the construct validity was evaluated in 582 (48.2% female; Mage = 36.9; SD = 13.5) treatment-seeking adult smokers. Study 2 found evidence for measurement invariance across sex and overtime of the 5-factor structure as well as substantial construct validity. Results from 2 independent samples challenge the traditional 4-factor model of the SCQ, and instead, provide evidence for a novel 5-factor SCQ structure with strong validity and reliability. Alternate scoring algorithms for the SCQ, including a 5-subscale scheme, warrant consideration to ensure optimal measurement precision and construct differentiation. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Adam M Leventhal
- Departments of Preventive Medicine and Psychology, University of Southern California
| | - Matthew Stone
- Departments of Preventive Medicine and Psychology, University of Southern California
| | | | - Raina D Pang
- Departments of Preventive Medicine and Psychology, University of Southern California
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Impact of an Offline Pain Management Protocol on Prehospital Provider Self-Efficacy: A Randomized Trial. Pediatr Emerg Care 2017; 33:388-395. [PMID: 27077996 DOI: 10.1097/pec.0000000000000657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pain in children is inadequately treated in the prehospital setting despite the reported recognition by prehospital providers (PHPs) of pain treatment as an important part of patient care. The impact of pediatric pain management protocol (PPP) implementation on PHP self-efficacy (SE), a measure congruent with performance, is unknown. OBJECTIVE The aim of this study was to evaluate the impact of PPP implementation and pain management education on PHP SE. METHODS This was a prospective study evaluating the change in PHP SE after a PPP was implemented. Prehospital providers were randomized to 3 groups: protocol introduction alone, protocol introduction with education, and protocol introduction with education and a 3-month interim review. Prehospital provider SE was assessed for pain management given 3 age-based scenarios. Self-efficacy was measured with a tool that uses a ranked ordinal scale ranging from "certain I cannot do it" (0) to "completely certain I can do it" (100) for 10 pain management actions: pain assessment (3), medication administration (4), dosing (1), and reassessment (2). An averaged composite score (0-100) was calculated for each of the 3 age groups (adult, child, toddler). Paired-sample t tests compared post-PPP and 13-month scores to pre-PPP scores. RESULTS Of 264 PHPs who completed initial surveys, 142 PHPs completed 13-month surveys. Ninety-three (65%) received education with protocol review, and 49 (35%) had protocol review only. Self-efficacy scores increased over the study period, most notably for pain assessment. This increase persisted at 13 months for child (6.6 [95% confidence interval {CI}, 1.4-11.8]) and toddler pain assessment (22.3 [95% CI, 16.4-28.3]). Composite SE scores increased immediately for all age groups (adult, 3.1 [95% CI, 1.3-4.9]; child, 6.1 [95% CI, 3.8-8.5]; toddler, 12.0 [95% CI, 9.5-14.5]) and persisted at 13 months for the toddler group alone (7.0 [95% CI, 4.3-9.7]). There was no difference between groups who received protocol review alone compared with those with education or education plus a 3-month interim review. CONCLUSIONS After a pain management protocol was introduced, SE scores among PHPs increased immediately and remained elevated for some individual actions involved in pain management, most notably pain assessment. Prehospital provider pain assessment SE scores declined 13 months after protocol introduction for adults, but remained elevated compared with baseline for the pediatric age groups.
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Giatras N, Wanninkhof E, Leontowitsch M, Lewis B, Taylor A, Cooper S, Ussher M. Lessons learned from the London Exercise and Pregnant (LEAP) Smokers randomised controlled trial process evaluation: implications for the design of physical activity for smoking cessation interventions during pregnancy. BMC Public Health 2017; 17:85. [PMID: 28095827 PMCID: PMC5240296 DOI: 10.1186/s12889-017-4013-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/02/2017] [Indexed: 11/10/2022] Open
Abstract
Background The challenges of delivering interventions for pregnant smokers have been poorly documented. Also, the process of promoting a physical activity intervention for pregnant smokers has not been previously recorded. This study describes the experiences of researchers conducting a randomised controlled trial of physical activity as an aid to smoking cessation during pregnancy and explores how the effectiveness of future interventions could be improved. Methods Two focus groups, with independent facilitators, were conducted with six researchers who had enrolled pregnant smokers in the LEAP trial, provided the interventions, and administered the research measures. Topics included recruitment, retention and how the physical activity intervention for pregnant smokers was delivered and how it was adapted when necessary to suit the women. The focus groups were audio-recorded, transcribed verbatim and subjected to thematic analysis. Results Five themes emerged related to barriers or enablers to intervention delivery: (1) nature of the intervention; (2) personal characteristics of trial participants; (3) practical issues; (4) researchers’ engagement with participants; (5) training and support needs. Researchers perceived that participants may have been deterred by the intensive and generic nature of the intervention and the need to simultaneously quit smoking and increase physical activity. Women also appeared hampered by pregnancy ailments, social deprivation, and poor mental health. Researchers observed that their status as health professionals was valued by participants but it was challenging to maintain contact with participants. Training and support needs were identified for dealing with pregnant teenagers, participants’ friends and family, and post-natal return to smoking. Conclusions Future exercise interventions for smoking cessation in pregnancy may benefit by increased tailoring of the intervention to the characteristics of the women, including their psychological profile, socio-economic background, pregnancy ailments and exercise preferences. Delivering an effective physical activity intervention for smoking cessation in pregnancy may require more comprehensive training for those delivering the intervention, particularly with regard to dealing with teenage smokers and smokers’ friends and family, as well as for avoiding post-natal return to smoking. Trial registration ISRCTN48600346, date of registration: 21/07/2008. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4013-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nikoletta Giatras
- City University London, Cass Business School, 106 Bunhill Row, London, EC1Y 8TZ, UK
| | - Elisabeth Wanninkhof
- St George's University of London, Population Health Research Institute, Cranmer Terrace, London, SW17 0RE, UK
| | - Miranda Leontowitsch
- Interdisciplinary Ageing Research, Department of Education, Goethe University, Frankfurt am Main, 60323, Germany
| | - Beth Lewis
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Adrian Taylor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, UK
| | - Sue Cooper
- Division of Primary Care, The University of Nottingham, School of Medicine, University Park, Nottingham, NG7 2RD, UK
| | - Michael Ussher
- St George's University of London, Population Health Research Institute, Cranmer Terrace, London, SW17 0RE, UK.
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Future directions of multiple behavior change research. J Behav Med 2016; 40:194-202. [DOI: 10.1007/s10865-016-9809-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
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Haukkala A, Laaksonen M, Uutela A. Smokers who do not want to quit - Is consonant smoking related to lifestyle and socioeconomic factors? Scand J Public Health 2016. [DOI: 10.1177/14034948010290031401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: To examine whether consonant smokers (who say they would not like to quit) differ from dissonant smokers (who would like to quit) in other forms of health-related behaviour and socioeconomic background. Methods: The participants included 2,709 male and 1,774 female smokers (aged 25-64 years old) from six annual population-based samples, examined between 1989 and 1994 via a mailed questionnaire. Results : Consonant male smokers were more likely to be heavy drinkers, use mostly butter on bread, and to not eat vegetables. Particularly in the middle educational and income groups, consonant male smokers were more likely to be heavy drinkers. Consonant female smokers were more often heavy drinkers and more sedentary than dissonant female smokers. If a male smoker belonged to the lower income group he was more likely to be a consonant smoker. Conclusions: Consonant male smokers had more adverse health behaviours compared to dissonant smokers, but nearly half of them did not have any other adverse health behaviours. However, a negative attitude towards smoking cessation was associated with other adverse health behaviours. There were no socioeconomic differences in willingness to quit smoking among female smokers and those differences between male smoker groups were small. Factors other than motivation to quit should be targeted to diminish socioeconomic differences in smoking cessation.
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Affiliation(s)
- Ari Haukkala
- Department of Social Psychology, University of Helsinki,
| | - Mikko Laaksonen
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
| | - Antti Uutela
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
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Mildestvedt T, Meland E. Examining the ``Matthew Effect'' on the motivation and ability to make lifestyle changes in 217 heart rehabilitation patients. Scand J Public Health 2016; 35:140-7. [PMID: 17454917 DOI: 10.1080/14034940600881930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Aims: Those who are socioeconomically disadvantaged and people with emotional problems have a poorer prognosis for cardiovascular disease. The authors wanted to examine: (1) what effect household income, emotional status, high-risk smoking status, and severity of heart disease had on the ability of individuals to make dietary and exercise improvements after heart disease and (2) to what extent unfavourable lifestyle outcomes among disadvantaged people were mediated by motivational problems. Methods: A two-year follow-up study of the combined cohorts of a randomized controlled trial. Level of exercise and present dietary habits were measured at inclusion and after 6 and 24 months. Different motivational factors and emotional distress were measured during rehabilitation. Results: Autonomous self-regulation was lowest among smokers (b=-0.31, p=0.02) and female participants (b=0.39, p=0.004). Participants with high scores of emotional distress predicted lower motivation for all the measures. We found no association between socioeconomic status (household income) and the ability to perform lifestyle changes. Current smoking status predicted lower ability to obtain lifestyle changes on all measures. Emotional distress was related to lower ability to increase physical activity at 6 months' but not at 24 months' follow-up. The mediating effects of motivational factors were insignificant. Conclusions: The results of this study do not support the suspicion that preventive efforts accentuate the socioeconomic differences in cardiovascular health. Health-promotive efforts after heart disease should safeguard that high-risk groups such as smokers are not discouraged from improving their lifestyle in other areas.
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Affiliation(s)
- Thomas Mildestvedt
- Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, Norway.
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Garrett NA, Alesci NL, Schultz MM, Foldes SS, Magnan SJ, Manley MW. The Relationship of Stage of Change for Smoking Cessation to Stage of Change for Fruit and Vegetable Consumption and Physical Activity in a Health Plan Population. Am J Health Promot 2016; 19:118-27. [PMID: 15559712 DOI: 10.4278/0890-1171-19.2.118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. Design. The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). Setting. This study was conducted at a mixed-model health plan with approximately 1 million adult members. Subjects. Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. Measures. The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. Results. Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (χ2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (χ2 = 89.7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. Conclusions. This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.
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Affiliation(s)
- Nancy A Garrett
- Health Services Analysis and Reporting at HealthPartners in Minneapolis, Minnesota 54410-1309, USA.
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Agrawal G, Patel SK, Agarwal AK. Lifestyle health risk factors and multiple non-communicable diseases among the adult population in India: a cross-sectional study. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0727-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Abstract
In the theory of syndemics, diseases are hypothesized to co-occur in particular temporal or geographical contexts due to harmful social conditions (disease concentration) and to interact at the level of populations and individuals, with mutually enhancing deleterious consequences for HIV risk (disease interaction). Since its original elaboration more than 20 years ago, the epidemiological literature on syndemic problems has followed a questionable trajectory, stemming from the use of a specific type of regression model specification that conveys very little information about the theory of syndemics. In this essay we critically review the dominant approaches to modeling in the literature on syndemics; highlight the stringent assumptions implicit in these models; and describe some meaningful public health implications of the resulting analytical ambiguities. We conclude with specific recommendations for empirical work in this area moving forward.
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Affiliation(s)
- Alexander C Tsai
- MGH Global Health, Massachusetts General Hospital, 125 Nashua Street, Ste. 722, Boston, MA, 02114, USA.
- Harvard Center for Population and Development Studies, Cambridge, MA, USA.
- Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Atheendar S Venkataramani
- MGH Global Health, Massachusetts General Hospital, 125 Nashua Street, Ste. 722, Boston, MA, 02114, USA
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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Loprinzi PD, Wolfe CD, Walker JF. Exercise facilitates smoking cessation indirectly via improvements in smoking-specific self-efficacy: Prospective cohort study among a national sample of young smokers. Prev Med 2015; 81:63-6. [PMID: 26303372 DOI: 10.1016/j.ypmed.2015.08.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/08/2015] [Accepted: 08/13/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to examine whether exercise is associated with 2-year follow-up smoking status through its influence on smoking-specific self-efficacy. METHODS Longitudinal data from the 2003-2005 National Youth Smoking Cessation Survey were used, including 1,228 participants (16-24 years). A questionnaire was used to examine baseline exercise levels, baseline smoking-specific self-efficacy, follow-up smoking status, and the covariates. RESULTS Baseline exercise was associated with baseline self-efficacy (β=0.04, p<0.001) after adjusting for age category, sex, race-ethnicity, education, and nicotine dependence. Baseline self-efficacy, in turn, was associated with 2-year smoking status (β=0.23, p<0.001) after adjustments. There was no adjusted direct effect of baseline exercise on 2-year smoking status (β=0.001, p=0.95); however, the adjusted indirect effect of baseline self-efficacy on the relationship between exercise and 2-year smoking status was significant (β=0.008, bootstrapped lower and upper CI: 0.002-0.02; p<0.05). The mediation ratio was 0.837, which indicates that smoking-specific self-efficacy mediates 84% of the total effect of exercise on smoking status. CONCLUSIONS Among daily smokers, exercise may help to facilitate smoking cessation via exercise-induced increases in smoking-specific self-efficacy.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, United States.
| | - Christy D Wolfe
- Department of Psychology, Bellarmine University, Louisville, KY 40205, United States
| | - Jerome F Walker
- Department of Respiratory Therapy, Bellarmine University, Louisville, KY 40205, United States
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James EL, Stacey FG, Chapman K, Boyes AW, Burrows T, Girgis A, Asprey G, Bisquera A, Lubans DR. Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial. BMC Cancer 2015; 15:710. [PMID: 26471791 PMCID: PMC4608129 DOI: 10.1186/s12885-015-1775-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 10/10/2015] [Indexed: 12/19/2022] Open
Abstract
Background Physical activity and consuming a healthy diet have clear benefits to the physical and psychosocial health of cancer survivors, with guidelines recognising the importance of these behaviors for cancer survivors. Interventions to promote physical activity and improve dietary behaviors among cancer survivors and carers are needed. The aim of this study was to determine the effects of a group-based, face-to-face multiple health behavior change intervention on behavioral outcomes among cancer survivors of mixed diagnoses and carers. Methods The Exercise and Nutrition Routine Improving Cancer Health (ENRICH) intervention was evaluated using a two-group pragmatic randomized controlled trial. Cancer survivors and carers (n = 174) were randomly allocated to the face-to-face, group-based intervention (six, theory-based two-hour sessions delivered over 8 weeks targeting healthy eating and physical activity [PA]) or wait-list control (after completion of 20-week data collection). Assessment of the primary outcome (pedometer-assessed mean daily step counts) and secondary outcomes (diet and alcohol intake [Food Frequency Questionnaire], self-reported PA, weight, body mass index, and waist circumference) were assessed at baseline, 8-and 20-weeks. Results There was a significant difference between the change over time in the intervention group and the control group. At 20 weeks, the intervention group had increased by 478 steps, and the control group had decreased by 1282 steps; this represented an adjusted mean difference of 1761 steps (184 to 3337; P = 0.0028). Significant intervention effects for secondary outcomes, included a half serving increase in vegetable intake (difference 39 g/day; 95 % CI: 12 to 67; P = 0.02), weight loss (kg) (difference -1.5 kg; 95 % CI, -2.6 to -0.3; P = 0.014) and change in body mass index (kg/m2) (difference -0.55 kg/m2; 95 % CI, -0.97 to -0.13; P = 0.012). No significant intervention effects were found for self-reported PA, total sitting time, waist circumference, fruit, energy, fibre, alcohol, meat, or fat consumption. Conclusions The ENRICH intervention was effective for improving PA, weight, body mass index, and vegetable consumption even with the inclusion of multiple cancer types and carers. As an example of successful research translation, the Cancer Council NSW has subsequently adopted ENRICH as a state-wide program. Trial registration Australian New Zealand Clinical Trials Register identifier: ANZCTRN1260901086257.
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Affiliation(s)
- E L James
- School of Medicine and Public Health, Priority Research Centre for Health Behavior, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - F G Stacey
- School of Medicine and Public Health, Priority Research Centre for Health Behavior, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - K Chapman
- Cancer Council New South Wales, Woolloomooloo, NSW, Australia
| | - A W Boyes
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behavior, School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - T Burrows
- School of Health Sciences, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - A Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, UNSW Medicine, Liverpool, NSW, Australia
| | - G Asprey
- Cancer Council New South Wales, Woolloomooloo, NSW, Australia
| | - A Bisquera
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - D R Lubans
- School of Education, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
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Loprinzi PD, Herod SM, Walker JF, Cardinal BJ, Mahoney SE, Kane C. Development of a Conceptual Model for Smoking Cessation: Physical Activity, Neurocognition, and Executive Functioning. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2015; 86:338-346. [PMID: 26391913 DOI: 10.1080/02701367.2015.1074152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Considerable research has shown adverse neurobiological effects of chronic alcohol use, including long-term and potentially permanent changes in the structure and function of the brain; however, much less is known about the neurobiological consequences of chronic smoking, as it has largely been ignored until recently. In this article, we present a conceptual model proposing the effects of smoking on neurocognition and the role that physical activity may play in this relationship as well as its role in smoking cessation. METHODS Pertinent published peer-reviewed articles deposited in PubMed delineating the pathways in the proposed model were reviewed. RESULTS The proposed model, which is supported by emerging research, demonstrates a bidirectional relationship between smoking and executive functioning. In support of our conceptual model, physical activity may moderate this relationship and indirectly influence smoking behavior through physical activity-induced changes in executive functioning. CONCLUSIONS Our model may have implications for aiding smoking cessation efforts through the promotion of physical activity as a mechanism for preventing smoking-induced deficits in neurocognition and executive function.
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Fleig L, Küper C, Lippke S, Schwarzer R, Wiedemann AU. Cross-behavior associations and multiple health behavior change: A longitudinal study on physical activity and fruit and vegetable intake. J Health Psychol 2015; 20:525-34. [DOI: 10.1177/1359105315574951] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline. Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals.
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Affiliation(s)
| | | | | | - Ralf Schwarzer
- Australian Catholic University, Australia
- University of Social Sciences and Humanities, Poland
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Loprinzi PD, Walker JF. Nicotine Dependence, Physical Activity, and Sedentary Behavior among Adult Smokers. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:94-9. [PMID: 25839000 PMCID: PMC4382772 DOI: 10.4103/1947-2714.153920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Research has previously demonstrated an inverse association between smoking status and physical activity; however, few studies have examined the association between nicotine dependence and physical activity or sedentary behavior. AIM This study examined the association between nicotine dependence and accelerometer-determined physical activity and sedentary behavior. MATERIALS AND METHODS Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used. A total of 851 adult (≥20 years) smokers wore an accelerometer for ≥4 days and completed the Fagerstrom Test for Nicotine Dependence scale. Regression models were used to examine the association between nicotine dependence and physical activity/sedentary behavior. RESULTS After adjusting for age, gender, race-ethnicity, poverty level, hypertension, emphysema, bronchitis, body mass index (BMI), cotinine, and accelerometer wear time, smokers 50 + years of age with greater nicotine dependence engaged in more sedentary behavior (β = 11.4, P = 0.02) and less light-intensity physical activity (β = -9.6, P = 0.03) and moderate-to-vigorous physical activity (MVPA; β = -0.14, P = 0.003) than their less nicotine dependent counterparts. CONCLUSION Older adults who are more nicotine dependent engage in less physical activity (both MVPA and light-intensity) and more sedentary behavior than their less nicotine dependent counterparts.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Mississippi, USA
| | - Jerome F Walker
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, Kentucky, USA
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Maraz A, Király O, Urbán R, Griffiths MD, Demetrovics Z. Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS One 2015; 10:e0122866. [PMID: 25803301 PMCID: PMC4372397 DOI: 10.1371/journal.pone.0122866] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/16/2015] [Indexed: 11/18/2022] Open
Abstract
Dancing is a popular form of physical exercise and studies have show that dancing can decrease anxiety, increase self-esteem, and improve psychological wellbeing. The aim of the current study was to explore the motivational basis of recreational social dancing and develop a new psychometric instrument to assess dancing motivation. The sample comprised 447 salsa and/or ballroom dancers (68% female; mean age 32.8 years) who completed an online survey. Eight motivational factors were identified via exploratory factor analysis and comprise a new Dance Motivation Inventory: Fitness, Mood Enhancement, Intimacy, Socialising, Trance, Mastery, Self-confidence and Escapism. Mood Enhancement was the strongest motivational factor for both males and females, although motives differed according to gender. Dancing intensity was predicted by three motivational factors: Mood Enhancement, Socialising, and Escapism. The eight dimensions identified cover possible motives for social recreational dancing, and the DMI proved to be a suitable measurement tool to assess these motives. The explored motives such as Mood Enhancement, Socialising and Escapism appear to be similar to those identified in other forms of behaviour such as drinking alcohol, exercise, gambling, and gaming.
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Affiliation(s)
- Aniko Maraz
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
| | - Róbert Urbán
- Department of Personality and Health Psychology, Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
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Hassandra M, Kolovelonis A, Chroni SA, Olympiou A, Goudas M, Theodorakis Y. Understanding the Experiences of Heavy Smokers after Exercise. Health (London) 2015. [DOI: 10.4236/health.2015.712175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Loprinzi PD, Kane CJ, Mahoney S, Walker JF. Physical activity and nicotine dependence among a national sample of young U.S. adults who smoke daily: evaluation of cross-sectional and longitudinal associations to determine which behavior drives this relationship. Physiol Behav 2014; 139:1-6. [PMID: 25446209 DOI: 10.1016/j.physbeh.2014.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/03/2014] [Accepted: 11/05/2014] [Indexed: 11/28/2022]
Abstract
The association between nicotine dependence and physical activity (PA) is relatively unknown. No study has concurrently examined the cross-sectional and longitudinal associations between PA and nicotine dependence, which was the primary purpose of this study. A secondary purpose was to examine how well nicotine dependence and PA behavior track over a two-year period. Data from the 2003-2005 National Youth Smoking Cessation Survey (NYSCS) were used, with young adults (18-24 yrs; n=1168) being followed over a two-year period. Physical activity was assessed using a questionnaire and nicotine dependence was assessed using the modified Fagerstrom Test for Nicotine Dependence scale. This study identified three notable findings: 1) baseline PA and nicotine dependence demonstrated a bidirectional, cross-sectional association (e.g., β=-0.23; 95% CI: -0.44 to -0.02; p=0.02); 2) when examined longitudinally, nicotine dependence influenced PA (OR=0.90; 95% CI: 0.82-0.99; p=0.04), but there was no evidence of the reverse pathway (i.e., PA influencing 2-year follow-up smoking status [OR=0.95; 95% CI: 0.66-1.39; p=0.82) or nicotine dependence (β=0.05; 95% CI: -0.14 to 0.24, p=0.61]); and 3) both PA (OR=3.52, 95% CI: 2.68-4.69; p<0.001) and nicotine dependence (β=0.52; 95% CI: 0.46-0.58, p<0.001) tracked relatively well over a two-year period during early adulthood. These findings suggest that both behaviors (physical activity and nicotine dependence) track over time, but nicotine dependence appears to be driving the cross-sectional relationship between nicotine dependence and physical activity, as opposed to the reverse pathway.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science, & Recreation Management, School of Applied Sciences, The University of Mississippi, University, MS 38677, United States.
| | - Christy J Kane
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
| | - Sara Mahoney
- Department of Exercise Science, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
| | - Jerome F Walker
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
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deRuiter WK, Cairney J, Leatherdale ST, Faulkner GEJ. A longitudinal examination of the interrelationship of multiple health behaviors. Am J Prev Med 2014; 47:283-9. [PMID: 25145617 DOI: 10.1016/j.amepre.2014.04.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 04/12/2014] [Accepted: 04/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Evaluating the interrelationship of health behaviors could assist in the development of effective public health interventions. Furthermore, the ability to identify cognitive mediators that may influence multiple behavioral changes requires evaluation. PURPOSE To evaluate covariation among health behaviors, specifically alcohol consumption, leisure-time physical activity, and smoking, and examine whether mastery acts as a mediating social-cognitive mechanism that facilitates multiple health behavior change in a longitudinal analysis. METHODS In 2010, secondary data analysis was conducted on the first seven cycles of the Canadian National Population Health Survey. Data collection began in 1994-1995 and has continued biennially. At the time of this analysis, only seven cycles of data (2006-2007) were available. Parallel process growth curve models were used to analyze covariation between health behaviors and the potential mediating effects of perceived mastery. RESULTS Increases in leisure-time physical activity were associated with reductions in tobacco use, whereas declines in alcohol consumption were associated with decreases in tobacco use. Covariation between alcohol consumption and leisure-time physical activity did not reach statistical significance. For the most part, mastery was unsuccessful in mediating the interrelationship of multiple behavioral changes. CONCLUSIONS Health behaviors are not independent but rather interrelated. In order to optimize limited prevention resources, these results suggest that population-level intervention efforts targeting multiple modifiable behavioral risk factors may not need to occur simultaneously.
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Affiliation(s)
- Wayne K deRuiter
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto; Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto.
| | - John Cairney
- Department of Family Medicine, Psychiatry and Behavioural Neurosciences and Kinesiology, McMaster University, Hamilton
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo
| | - Guy E J Faulkner
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto
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Abstract
BACKGROUND Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. OBJECTIVES To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. SELECTION CRITERIA We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. DATA COLLECTION AND ANALYSIS We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow-up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow-up. Another study reported significantly higher abstinence rates at six month follow-up for a combined exercise and smoking cessation programme compared with brief smoking cessation advice. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow-up but not at the end of treatment or 12-month follow-up. The other studies showed no significant effect for exercise on abstinence. AUTHORS' CONCLUSIONS Only two of the 20 trials offered evidence for exercise aiding smoking cessation in the long term. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which may not have been sufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions in terms of both exercise intensity and intensity of support being provided, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.
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Affiliation(s)
- Michael H Ussher
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK, SW17 0RE
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Fife-Schaw C, de Lusignan S, Wainwright J, Sprake H, Laver S, Heald V, Orton J, Prescott M, Carr H, O'Neill M. Comparing exercise interventions to increase persistence with physical exercise and sporting activity among people with hypertension or high normal blood pressure: study protocol for a randomised controlled trial. Trials 2014; 15:336. [PMID: 25168762 PMCID: PMC4155107 DOI: 10.1186/1745-6215-15-336] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 08/04/2014] [Indexed: 11/13/2022] Open
Abstract
Background Increasing physical activity is known to have health benefits for people with hypertension and related conditions. Current general practitioner referrals for gym-based exercise increase physical activity but meta-analyses show that while these are effective the absolute health risk reduction is small due to patients failing to maintain activity levels over time. This study assesses the effectiveness of two sports-oriented interventions that are intended to bridge the intention-behaviour gap and thus increase the likelihood of sustained increases in physical activity. Methods/design Four-arm randomised controlled trial. The study tests two types of intervention that are intended to increase physical activity among currently inactive 18- to 74-year-old people with hypertension or high-normal blood pressure. This study will assess the effectiveness of a 12-week sports-oriented exercise programme, the efficacy of a web-delivered self-help tool to promote and support sports participation and healthy behaviour change and the effect of these interventions in combination. The control arm will be a standard care general practitioner referral for gym-based exercise. Participants will be allocated using block randomisation. The first author and primary analyst is blinded to participant allocation. The primary outcome measures will be time spent in physical activity assessed in metabolic equivalent minutes per week using the International Physical Activity Questionnaire 1 year after commencement of the intervention. Secondary outcomes include increased involvement in sporting activity and biomedical health outcomes including change in body mass index, and waist and hip measurement and reductions in blood pressure. Discussion If proven to be superior to general practitioner referrals for gym-based exercise, these sports-oriented interventions would constitute low-cost alternatives. The next stage would be a full economic evaluation of the interventions. Trial Registration Current Controlled Trials ISRCTN71952900 (7 June 2013).
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Affiliation(s)
- Chris Fife-Schaw
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK.
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Fortin M, Haggerty J, Almirall J, Bouhali T, Sasseville M, Lemieux M. Lifestyle factors and multimorbidity: a cross sectional study. BMC Public Health 2014; 14:686. [PMID: 24996220 PMCID: PMC4096542 DOI: 10.1186/1471-2458-14-686] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/30/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Lifestyle factors have been associated mostly with individual chronic diseases. We investigated the relationship between lifestyle factors (individual and combined) and the co-occurrence of multiple chronic diseases. METHODS Cross-sectional analysis of results from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Subjects aged 45 years and older. A randomly-selected cohort in the general population recruited by telephone. Multimorbidity (3 or more chronic diseases) was measured by a simple count of self-reported chronic diseases from a list of 14. Five lifestyle factors (LFs) were evaluated: 1) smoking habit, 2) alcohol consumption, 3) fruit and vegetable consumption, 4) physical activity, and 5) body mass index (BMI). Each LF was given a score of 1 (unhealthy) if recommended behavioural targets were not achieved and 0 otherwise. The combined effect of unhealthy LFs (ULFs) was evaluated using the total sum of scores. RESULTS A total of 1,196 subjects were analyzed. Mean number of ULFs was 2.6 ± 1.1 SD. When ULFs were considered separately, there was an increased likelihood of multimorbidity with low or high BMI [Odd ratio (95% Confidence Interval): men, 1.96 (1.11-3.46); women, 2.57 (1.65-4.00)], and present or past smoker [men, 3.16 (1.74-5.73)]. When combined, in men, 4-5 ULFs increased the likelihood of multimorbidity [5.23 (1.70-16.1)]; in women, starting from a threshold of 2 ULFs [1.95 (1.05-3.62)], accumulating more ULFs progressively increased the likelihood of multimorbidity. CONCLUSIONS The present study provides support to the association of lifestyle factors and multimorbidity.
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Affiliation(s)
- Martin Fortin
- Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Québec, Canada.
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Auer R, Vittinghoff E, Kiefe C, Reis JP, Rodondi N, Khodneva YA, Kertesz SG, Cornuz J, Pletcher MJ. Change in physical activity after smoking cessation: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Addiction 2014; 109:1172-83. [PMID: 24690003 PMCID: PMC4088346 DOI: 10.1111/add.12561] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/16/2014] [Accepted: 03/19/2014] [Indexed: 11/30/2022]
Abstract
AIMS To estimate physical activity trajectories for people who quit smoking, and compare them to what would have been expected had smoking continued. DESIGN, SETTING AND PARTICIPANTS A total of 5115 participants in the Coronary Artery Risk Development in Young Adults Study (CARDIA) study, a population-based study of African American and European American people recruited at age 18-30 years in 1985/6 and followed over 25 years. MEASUREMENTS Physical activity was self-reported during clinical examinations at baseline (1985/6) and at years 2, 5, 7, 10, 15, 20 and 25 (2010/11); smoking status was reported each year (at examinations or by telephone, and imputed where missing). We used mixed linear models to estimate trajectories of physical activity under varying smoking conditions, with adjustment for participant characteristics and secular trends. FINDINGS We found significant interactions by race/sex (P = 0.02 for the interaction with cumulative years of smoking), hence we investigated the subgroups separately. Increasing years of smoking were associated with a decline in physical activity in black and white women and black men [e.g. coefficient for 10 years of smoking: -0.14; 95% confidence interval (CI) = -0.20 to -0.07, P < 0.001 for white women]. An increase in physical activity was associated with years since smoking cessation in white men (coefficient 0.06; 95% CI = 0 to 0.13, P = 0.05). The physical activity trajectory for people who quit diverged progressively towards higher physical activity from the expected trajectory had smoking continued. For example, physical activity was 34% higher (95% CI = 18 to 52%; P < 0.001) for white women 10 years after stopping compared with continuing smoking for those 10 years (P = 0.21 for race/sex differences). CONCLUSIONS Smokers who quit have progressively higher levels of physical activity in the years after quitting compared with continuing smokers.
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Affiliation(s)
- Reto Auer
- Department of Epidemiology and Biostatistics, UCSF, San Francisco,
CA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, UCSF, San Francisco,
CA
| | - Catarina Kiefe
- Department of Quantitative Health Sciences, University of
Massachusetts Medical School, Worcester, MA
| | - Jared P. Reis
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, University of
Bern, Bern, Switzerland
| | - Yulia A. Khodneva
- Department of Health Behavior, University of Alabama at Birmingham
School of Public Health, Birmingham, AL, USA
| | - Stefan G. Kertesz
- Department of Health Behavior, University of Alabama at Birmingham
School of Public Health, Birmingham, AL, USA
- Center for Surgical Medical and Acute Care Research at the
Birmingham VA Medical Center, Birmingham, AL
- Division of Preventive Medicine, University of Alabama at Birmingham
School of Medicine, Birmingham, AL
| | - Jacques Cornuz
- Department of Ambulatory and Community Medicine, University
Hospital, Lausanne, Switzerland
| | - Mark J. Pletcher
- Department of Epidemiology and Biostatistics, UCSF, San Francisco,
CA
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Wells K, Makela C, Kennedy C. Co-occurring Health-Related Behavior Pairs in College Students: Insights for Prioritized and Targeted Interventions. AMERICAN JOURNAL OF HEALTH EDUCATION 2014. [DOI: 10.1080/19325037.2014.916637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade PD, Lynch BM, Aitken JF, Meng X, Courneya KS. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial. J Clin Oncol 2013; 31:2313-21. [PMID: 23690410 DOI: 10.1200/jco.2012.45.5873] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. METHODS In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. RESULTS At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. CONCLUSION The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.
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Affiliation(s)
- Anna L Hawkes
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Queensland, Australia.
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Drake BF, Quintiliani LM, Sapp AL, Li Y, Harley AE, Emmons KM, Sorensen G. Comparing strategies to assess multiple behavior change in behavioral intervention studies. Transl Behav Med 2013; 3:114-121. [PMID: 23504621 DOI: 10.1007/s13142-013-0195-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Alternatives to individual behavior change methods have been proposed, however, little has been done to investigate how these methods compare. PURPOSE To explore four methods that quantify change in multiple risk behaviors targeting four common behaviors. METHODS We utilized data from two cluster-randomized, multiple behavior change trials conducted in two settings: small businesses and health centers. Methods used were: (1) summative; (2) z-score; (3) optimal linear combination; and (4) impact score. RESULTS In the Small Business study, methods 2 and 3 revealed similar outcomes. However, physical activity did not contribute to method 3. In the Health Centers study, similar results were found with each of the methods. Multivitamin intake contributed significantly more to each of the summary measures than other behaviors. CONCLUSIONS Selection of methods to assess multiple behavior change in intervention trials must consider study design, and the targeted population when determining the appropriate method/s to use.
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Affiliation(s)
- Bettina F Drake
- Department of Surgery, Washington University School of Medicine (Drake), St. Louis, MO; Department of General Internal Medicine, Boston University Medical Center (Quintiliani), Boston, MA; Department of Biostatistics, Harvard School of Public Health (Li), Boston, MA; University of Wisconsin, School of Public Health (Harley), Milwaukee, WI; Center for Community-Based Research, Department of Society, Human Development and Health, Harvard School of Public Health (Sapp, Emmons, Sorensen), Boston, MA
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Hawkes AL, Patrao TA, Green A, Aitken JF. CanPrevent: a telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer. BMC Cancer 2012; 12:560. [PMID: 23181756 PMCID: PMC3529678 DOI: 10.1186/1471-2407-12-560] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 11/22/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This pilot study aimed to test the acceptability and short-term effectiveness of a telephone-delivered multiple health behaviour change intervention for relatives of colorectal cancer survivors. METHODS A community-based sample of 22 first-degree relatives of colorectal cancer survivors were recruited via a media release. Data were collected at baseline and at six weeks (post-intervention). Outcome measures included health behaviours (physical activity, television viewing, diet, alcohol, body mass index, waist circumference and smoking), health-related quality of life (Short Form-36) and perceived colorectal cancer risk. Intervention satisfaction levels were also measured. The intervention included six telephone health coaching sessions, a participant handbook and a pedometer. It focused on behavioural risk factors for colorectal cancer [physical activity, diet (red and processed meat consumption, fruit and vegetable intake), alcohol, weight management and smoking], and colorectal cancer risk. RESULTS From baseline to six weeks, improvements were observed for minutes moderate-vigorous physical activity (150.7 minutes), processed meat intake (-1.2 serves/week), vegetable intake (1 serve/day), alcohol intake (-0.4 standard drinks/day), body mass index (-1.4 kg/m2), and waist circumference (-5.1 cm). Improvements were also observed for physical (3.3) and mental (4.4) health-related quality of life. Further, compared with baseline, participants were more likely to meet Australian recommendations post-intervention for: moderate-vigorous physical activity (27.3 vs 59.1%); fruit intake (68.2 vs 81.8%); vegetable intake (4.6 vs 18.2%); alcohol consumption (59.1 vs 72.7%); body mass index (31.8 vs 45.5%) and waist circumference (18.2 vs 27.3%). At six weeks participants were more likely to believe a diagnosis of CRC was related to family history, and there was a decrease in their perceived risk of developing CRC in their lifetime following participation in CanPrevent. The intervention retention rate was 100%, participants reported that it was highly acceptable and they would recommend it to others at risk of colorectal cancer. CONCLUSIONS Positive behaviour change achieved through this intervention approach has the potential to impact on the progression of CRC and other cancers or chronic diseases. A large scale randomised controlled trial is required to confirm the positive results of this acceptability and short-term effectiveness study. TRIAL REGISTRATION ACTRN12612000516886.
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Affiliation(s)
- Anna L Hawkes
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
| | - Tania A Patrao
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
| | - Anita Green
- The University of Queensland Health Service, The University of Queensland, Brisbane, Australia
| | - Joanne F Aitken
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, Queensland, 4004, Australia
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Koshy P, Mackenzie M, Leslie W, Lean M, Hankey C. Eating the elephant whole or in slices: views of participants in a smoking cessation intervention trial on multiple behaviour changes as sequential or concurrent tasks. BMC Public Health 2012; 12:500. [PMID: 22759785 PMCID: PMC3416689 DOI: 10.1186/1471-2458-12-500] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 07/03/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper explores smoking cessation participants' perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland. METHODS One hundred and thirty-eight participants were recruited from smoking cessation classes in areas of multiple deprivation in Glasgow and randomised to intervention, receiving dietary advice, or to control groups. The primary outcome of the study was to determine the % change in body weight. Semi-structured interviews were conducted with a purposive sample of 15 intervention and 15 control participants at weeks 6 (during the intervention) and 24 (at the end of the intervention). The current paper, though predominantly qualitative, links perceptions of behaviour modification to % weight change and cessation rates at week 24 thereby enabling a better understanding of the mediators influencing multiple behaviour change. RESULTS Our findings suggest that participants who perceive separate behaviour changes as part of a broader approach to a healthier lifestyle, and hence attempt behaviour changes concurrently, may be at comparative advantage in positively achieving dual outcomes. CONCLUSIONS These findings highlight the need to assess participants' preference for attempting multiple behaviour changes sequentially or simultaneously in addition to assessing their readiness to change. Further testing of this hypothesis is warranted. TRIAL REGISTRATION ISRCTN94961361.
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Affiliation(s)
- Preethi Koshy
- Human Nutrition, School of Medicine, University of Glasgow, Glasgow, G4 0SF, UK.
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Bernard P, Ninot G, Guillaume S, Fond G, Courtet P, Christine Picot M, Quantin X. Physical Activity as a Protective Factor in Relapse Following Smoking Cessation in Participants with a Depressive Disorder. Am J Addict 2012; 21:348-55. [DOI: 10.1111/j.1521-0391.2012.00242.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Berg CJ, Thomas JL, An LC, Guo H, Collins T, Okuyemi KS, Ahluwalia JS. Change in smoking, diet, and walking for exercise in Blacks. HEALTH EDUCATION & BEHAVIOR 2012; 39:191-7. [PMID: 22330092 DOI: 10.1177/1090198111432252] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors.
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Affiliation(s)
- Carla J Berg
- Department of Medicine, University of Minnesota, Minneapolis, MN 55414, USA.
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Abstract
BACKGROUND Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. OBJECTIVES To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. SEARCH METHODS In July 2011, we searched the Cochrane Tobacco Addiction Group Specialized Register for studies including the terms 'exercise' or 'physical activity'. We also searched MEDLINE, EMBASE, PsycINFO, Dissertation Abstracts and CINAHL using the terms 'exercise' or 'physical activity' and 'smoking cessation'. SELECTION CRITERIA We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme, recruiting smokers or recent quitters, and with a follow up of six months or more. DATA COLLECTION AND ANALYSIS We extracted data on study characteristics and smoking outcomes. Because of differences in studies we summarized the results narratively, making no attempt at meta-analysis. MAIN RESULTS We identified 15 trials, seven of which had fewer than 25 people in each treatment arm. They varied in the timing and intensity of the smoking cessation and exercise programmes. Three studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow up. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow up but not at the end of treatment or 12-month follow up. The other studies showed no significant effect for exercise on abstinence. AUTHORS' CONCLUSIONS Only one of the 15 trials offered evidence for exercise aiding smoking cessation at a 12-month follow up. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which was insufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.
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Affiliation(s)
- Michael H Ussher
- Division of PopulationHealth Sciences and Education, StGeorge’s,University of London,CranmerTerrace, London, SW17 0RE, UK.
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Selvanayagam M, Thompson C, Taylor SJC, Cummins S, Bourke L. How might the London 2012 Olympics influence health and the determinants of health? Local newspaper analysis of pre-Games pathways and impacts. BMJ Open 2012; 2:bmjopen-2012-001791. [PMID: 23151394 PMCID: PMC3533038 DOI: 10.1136/bmjopen-2012-001791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To conduct a content analysis of pre-Games local media coverage of the potential impact on health and the determinants of health in Newham, the site of the Olympic Park. DESIGN Local newspaper content analysis. SETTING Olympic park host site of the London Borough of Newham. OUTCOME MEASURES Media coverage of employment, physical activity and well-being. RESULTS Three hundred and 51 articles meeting the inclusion criteria were included in the analysis. The overwhelming majority of the articles took a positive perspective on the Olympic Games being hosted in Newham with less than 10% (32/351) addressing potential adverse effects. The frequency of articles reporting on both employment and well-being increased significantly over time (p=0.002 and p=0.006, respectively). A non-significant increasing trend was observed for physical activity (p=0.146). New employment opportunities and the promotion of physical activity in young people were the pathways most frequently reported in the local media. However, much less attention is devoted to understanding the uncertainties about how much of these new opportunities will directly improve the determinants of health in the Newham population. CONCLUSIONS Pre-Games reporting on the impact on health and the determinants of health increased over time in the London Borough of Newham, and is overwhelmingly positive. However, specific uncertainties around the true nature of its impact on local employment and physical activity were articulated. Further evaluation of the tangible impacts on population health, and the determinants of health and health inequalities from the London 2012 Olympics, is required.
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Affiliation(s)
- Marinie Selvanayagam
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Claire Thompson
- School of Geography, Queen Mary University of London, London, UK
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephanie J C Taylor
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Steven Cummins
- School of Geography, Queen Mary University of London, London, UK
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Liam Bourke
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Schulz DN, Kremers SP, van Osch LA, Schneider F, van Adrichem MJ, de Vries H. Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol. BMC Public Health 2011; 11:108. [PMID: 21324181 PMCID: PMC3050747 DOI: 10.1186/1471-2458-11-108] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 02/16/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic) diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. METHODS In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition) and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes). The (difference in) effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally, potential subgroup differences pertaining to gender, age and socioeconomic status regarding the behaviour effects and programme evaluation will be assessed. DISCUSSION Research regarding multiple behaviour change is in its infancy. We study how to offer multiple behaviour change interventions optimally. Using these results could strengthen the effectiveness of web-based computer-tailoring lifestyle programmes. This study will yield new results about the need for differential lifestyle approaches using Internet-based expert systems and potential differences in subgroups concerning the effectiveness and appreciation. TRIAL REGISTRATION Dutch Trial Register NTR2168.
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Affiliation(s)
- Daniela N Schulz
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
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