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Let's Disseminate Effectively: Review of Dardig and Heward's Let's Make a Contract: A Positive Way to Change Your Child's Behavior. Behav Anal Pract 2022. [DOI: 10.1007/s40617-022-00723-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Lederer AM, Stolow JA. Will Student Contracts Keep Campuses Safe From COVID-19? A Behavioral Science Perspective. Public Health Rep 2021; 136:274-280. [PMID: 33617386 DOI: 10.1177/0033354921994899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alyssa M Lederer
- 25812 Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jeni A Stolow
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, USA
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Ziser K, Resmark G, Giel KE, Becker S, Stuber F, Zipfel S, Junne F. The effectiveness of contingency management in the treatment of patients with anorexia nervosa: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2018; 26:379-393. [PMID: 29577487 DOI: 10.1002/erv.2590] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 11/08/2022]
Abstract
Contingency management in stipulating weight gain is routinely used in the treatment of anorexia nervosa, however, empirical investigations concerning its effectiveness have been scarce. This systematic review was conducted according to the PRISMA statement. Of N = 973 hits, 42 full-texts were included in the qualitative synthesis (11 theoretical texts, 19 case reports, 12 descriptive, cohort, and controlled trials). A central topic in the included publications concerns the enhancement of patients' autonomy through participation in the contingency management process. This heightened autonomy is achieved by using contingency contracts. Positive short-term effects on weight gain were shown, whereas follow-up results were heterogeneous. Although contingency contracts are widely used in clinical practice, our systematic review shows that empirical evidence on underlying mechanisms and efficacy is still scarce. Using an explicit treatment contract can enhance patients' motivation, compliance, and autonomy. Clinical practice should see further development including innovative motivation enhancing and conflict dissolving techniques in addressing the pronounced ambivalence often shown by patients with anorexia nervosa.
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Affiliation(s)
- Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Gaby Resmark
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Sandra Becker
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
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4
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Singleton SP, Neale AV, Scott RO, Hess JW. Cholesterol Reduction among Volunteers in a Health Promotion Project. Am J Health Promot 2016. [DOI: 10.4278/0890-1171-2.4.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral contracting was used with moderate success as a primary intervention strategy in an urban clinic-based health promotion program designed to reduce serum cholesterol. Of the 223 adults screened, 144 had high serum cholesterol. One hundred and eighteen attended an interpretation/education session, and 51 participants agreed to sign a behavioral contract. Among those who signed contracts, adherence to American Heart Association dietary guidelines was significantly related to serum cholesterol changes. Eleven of the 46 adults who returned for the six-month clinical assessment reduced their cholesterol levels to recommended levels.
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5
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Becker MH, Janz NK. The Health Belief Model Applied to Understanding Diabetes Regimen Compliance. THE DIABETES EDUCATOR 2016. [DOI: 10.1177/014572178501100108] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inadequate adherence to prescribed treatment plans is perhaps the most serious obstacle to achieving success ful therapeutic outcomes, and non compliance by diabetic patients is no exception. This is partly based on pa tients' realization that compliance does not necessarily result in lack of illness. A psychosocial framework for under standing patient compliance is the Health Belief Model, which is based upon the value an individual places on the identified goal and the likelihood that compliance will achieve that goal. This Model has been useful to explain noncompliance, to make an "educa tional diagnosis," and for designing compliance-enhancing interventions.
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Affiliation(s)
- Marshall H. Becker
- Department of Health Behavior and Health Education School of Public Health The University of Michigan Ann Arbor, Michigan
| | - Nancy K. Janz
- Department of Health Behavior and Health Education School of Public Health The University of Michigan Ann Arbor, Michigan
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6
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Singleton SP, Neale AV, Hess JW, Dupuis MH. Behavioral Contracting in an Urban Health Promotion Project. Eval Health Prof 2016. [DOI: 10.1177/016327878701000404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A health promotion project involving 223 participants was conducted by the Department of Family Medicine at Wayne State University in Detroit, Michigan. Participants were screenedforfive cardiovascular riskfactors: blood lipids, obesity, smoking, blood pressure and physical fitness; they were reassessed at six-month and two-year intervals. Following the initial screening, participants were asked to meet with the project health educator to sign one or more "behavioral contracts" to make behavior or life-style changes designed to improve risk factor status. Individual and group interventions were provided to all interested clients. Of the individuals screened, 179 of the 223 returned for at least one health counseling session. Contractors were most successful in improving exercise habits and making dietary changes to reduce cholesterol. These changes were reflected in improved treadmill performance and significant reductions in serum cholesterol. Smokers and the overweight showed poor success rates, few smokers were willing to sign a smoking cessation contract, and there was a high dropout ratefrom weightcontrol counseling.
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Affiliation(s)
| | | | | | - Mary H. Dupuis
- Department of Family Medicine, Wayne State University, Detroit, Michigan
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Peleg S, Drori E, Banai S, Finkelstein A, Shiloh S. Illness perceptions or recurrence risk perceptions: What comes first? A longitudinal cross-lagged examination among cardiac patients. Psychol Health 2015; 31:509-23. [DOI: 10.1080/08870446.2015.1116533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Clark NM, Zimmerman BJ. A social cognitive view of self-regulated learning about health. HEALTH EDUCATION & BEHAVIOR 2015; 41:485-91. [PMID: 25270173 DOI: 10.1177/1090198114547512] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Researchers interested in health-related learning have recently begun to study processes people use to self-regulate their health and their ability to prevent or control chronic disease. This paper represents a social cognitive view of self-regulation that involves three classes of influence on self-regulating behavior: personal, behavioral, and environmental. This triadic model assumes that people self-regulate their health through the use of self-care strategies, setting reasonable health goals, and monitoring feedback concerning the effectiveness of strategies in meeting their goals. People's perceptions of self-efficacy are also assumed to play a major role in motivating them to self-regulate their health functioning. According to social cognitive theory, processes entailed in regulating one's health can be taught through social modeling, supports, and feedback; gradually these external supports are withdrawn as one is able to self-regulate. This paper will analyze self-regulation processes related to controlling or preventing lung disease, specifically management of asthma and eliminating smoking. The educational implications of the triadic model of self-regulation for promoting health and related behavioral functioning will be discussed.
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Affiliation(s)
- Noreen M Clark
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Barry J Zimmerman
- The Graduate School of the City, University of New York, New York, NY, USA
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Bowman-Perrott L, Burke MD, de Marin S, Zhang N, Davis H. A meta-analysis of single-case research on behavior contracts: effects on behavioral and academic outcomes among children and youth. Behav Modif 2014; 39:247-69. [PMID: 25261083 DOI: 10.1177/0145445514551383] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this meta-analysis was to quantitatively summarize the single-case research (SCR) literature on the use of behavior contracts with children and youth. This study examined the efficacy of behavior contracts on problem behaviors and academic behaviors across 18 SCR studies. Academic and behavioral outcomes were examined for 58 children and youth ages 5 to 21 using the TauU effect size index. Results indicated the overall moderate effect of the use of behavior contracts was ES = .57 (95% confidence interval [CI95] = [0.55, 0.58]) with a range of effects across studies (ES = .27 to ES = 1.00). Moderator analyses indicated that behavior contracts are beneficial for students regardless of grade level, gender, or disability status. Findings suggest that the intervention is more effective in reducing inappropriate behaviors than increasing appropriate behaviors, and that academic outcomes are positively affected by behavior contracting.
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Affiliation(s)
| | | | | | - Nan Zhang
- Texas A&M University, College Station, USA
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11
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Chisholm-Burns MA, Spivey CA, Graff Zivin J, Lee JK, Sredzinski E, Tolley EA. Improving outcomes of renal transplant recipients with behavioral adherence contracts: a randomized controlled trial. Am J Transplant 2013; 13:2364-73. [PMID: 23819827 DOI: 10.1111/ajt.12341] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 01/25/2023]
Abstract
The objective of this randomized controlled trial was to assess the effects of a 1-year behavioral contract intervention on immunosuppressant therapy (IST) adherence and healthcare utilizations and costs among adult renal transplant recipients (RTRs). The sample included adult RTRs who were at least 1 year posttransplant, taking tacrolimus or cyclosporine and served by a specialty pharmacy. Pharmacy refill records were used to measure adherence and monthly questionnaires were used to measure healthcare utilizations. Direct medical costs were estimated using the 2009 Medicare Expenditure Panel Survey. Adherence was analyzed using the GLM procedure and the MIXED procedure of SAS. Rate ratios and 95% confidence intervals were estimated to quantify the rate of utilizing healthcare services relative to treatment assignment. One hundred fifty RTRs were enrolled in the study. Intervention group RTRs (n = 76) had higher adherence than control group RTRs (n = 74) over the study period (p < 0.01). And 76.1% of the intervention group compared with 42.7% of the control group was not hospitalized during the 1-year study period (RR = 1.785; 95% CI: 1.314, 2.425), resulting in cost savings. Thus, evidence supports using behavioral contracts as an effective adherence intervention that may improve healthcare outcomes and lower costs.
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12
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Molgaard CA, Ryden LA, Robin H, Gresham L, Elder JP, Scutchfield FD. A Public Health Evaluation of a Population-Based Colorectal Cancer Education and Screening Program. HEALTH EDUCATION 2013. [DOI: 10.1080/00970050.1990.10616210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | - Louise Gresham
- c Department of Health Services , County of San Diego , San Diego , CA , 92101 , USA
| | - John P. Elder
- a San Diego State University , San Diego , CA , 92182 , USA
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Shiloh S, Wade CH, Roberts JS, Alford SH, Biesecker BB. Associations between risk perceptions and worry about common diseases: a between- and within-subjects examination. Psychol Health 2012; 28:434-49. [PMID: 23121110 PMCID: PMC3566271 DOI: 10.1080/08870446.2012.737464] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The relationships between worry and perceptions of likelihood and severity were evaluated across eight common diseases. Individual and disease variability in worry and perceptions were examined. 294 participants were recruited through the Multiplex Initiative, in which a genetic susceptibility test for eight common diseases was offered to healthy adults. Participants completed a baseline telephone survey and web-based surveys without a commitment to be tested, and then made a choice on testing. Between- and within-subjects analyses yielded the following main findings: (1) worry is more closely related to likelihood perceptions than to severity perceptions; (2) severity perceptions add significantly to explained worry variances above and beyond likelihood perceptions; (3) risk perceptions and worries form two clusters: cancer diseases and cardiovascular-metabolic diseases; and (4) variance in risk perception and worry is explained by a combination of between- and within-subjects variances. Risk perception research should attend to severity perceptions, within-subjects variability and inter-disease differences, and to strategies for grouping conditions.
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Affiliation(s)
- Shoshana Shiloh
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
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Web-site-based tailored advice to promote strength and balance training: an experimental evaluation. J Aging Phys Act 2009; 17:210-22. [PMID: 19451669 DOI: 10.1123/japa.17.2.210] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study evaluated a Web site providing tailored advice to encourage older people to undertake strength and balance training (SBT). Adults age 60-88 (N = 302) were randomized to read either generic advice or advice tailored to their self-perceived balance problems and activity preferences. Between-groups differences in attitudes toward SBT after reading the advice did not quite reach significance (p = .059), but the tailored group reported higher ratings than the generic group that the advice was personally relevant (p = .017) and that the activities would be good for them (p = .047). Within-groups differences in the tailored group showed that completing an action plan increased confidence in undertaking SBT (p = .006). These findings were supported by a meta-analysis that pooled the effect sizes with those of a previous study. Thus, a tailored Web site might be a cost-effective way of encouraging some older people to undertake SBT.
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Nyman SR, Yardley L. Usability and acceptability of a website that provides tailored advice on falls prevention activities for older people. Health Informatics J 2009; 15:27-39. [PMID: 19218310 DOI: 10.1177/1460458208099866] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article presents the usability and acceptability of a website that provides older people with tailored advice to help motivate them to undertake physical activities that prevent falls. Views on the website from interviews with 16 older people and 26 sheltered housing wardens were analysed thematically. The website was well received with only one usability difficulty with the action plan calendar. The older people selected balance training activities out of interest or enjoyment, and appeared to carefully add them into their current routine. The wardens were motivated to promote the website to their residents, particularly those who owned a computer, had balance problems, or were physically active. However, the participants noted that currently a minority of older people use the Internet. Also, some older people underestimated how much activity was enough to improve balance, and others perceived themselves as too old for the activities.
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Affiliation(s)
- Samuel R Nyman
- Institute of Health Sciences University of Reading London Road, Reading RG1 5AQ, UK.
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Abstract
Nine studies met the criteria for inclusion in this systematic review of randomized controlled trials of treatments for obesity and overweight involving the use of financial incentives, with reported follow-up of at least 1 year. All included trials were of behavioural obesity treatments. Justification of sample size and blinding procedure were not mentioned in any study. Attrition was well described in three studies and no study was analysed on an intention to treat basis. Participants were mostly women recruited through media advertisements. Mean age ranged from 35.7 to 52.8 years, and mean body mass index from 29.3 to 31.8 kg m(-2). Results from meta-analysis showed no significant effect of use of financial incentives on weight loss or maintenance at 12 months and 18 months. Further sub-analysis by mode of delivery and amount of incentives although also non-statistically significant were suggestive of very weak trends in favour of use of amounts greater than 1.2% personal disposable income, rewards for behaviour change rather than for weight, rewards based on group performance rather than for individual performance and rewards delivered by non-psychologists rather than delivered by psychologists.
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Bosch-Capblanch X, Abba K, Prictor M, Garner P. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database Syst Rev 2007; 2007:CD004808. [PMID: 17443556 PMCID: PMC6464838 DOI: 10.1002/14651858.cd004808.pub3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Contracts are a verbal or written agreement that a patient makes with themselves, with healthcare practitioners, or with carers, where participants commit to a set of behaviours related to the care of a patient. Contracts aim to improve the patients' adherence to treatment or health promotion programmes. OBJECTIVES To assess the effects of contracts between patients and healthcare practitioners on patients' adherence to treatment, prevention and health promotion activities, the stated health or behaviour aims in the contract, patient satisfaction or other relevant outcomes, including health practitioner behaviour and views, health status, reported harms, costs, or denial of treatment as a result of the contract. SEARCH STRATEGY We searched: the Cochrane Consumers and Communication Review Group's Specialised Register (in May 2004); the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library 2004, issue 1); MEDLINE 1966 to May 2004); EMBASE (1980 to May 2004); PsycINFO (1966 to May 2004); CINAHL (1982 to May 2004); Dissertation Abstracts. A: Humanities and Social Sciences (1966 to May 2004); Sociological Abstracts (1963 to May 2004); UK National Research Register (2000 to May 2004); and C2-SPECTR, Campbell Collaboration (1950 to May 2004). SELECTION CRITERIA We included randomised controlled trials comparing the effects of contracts between healthcare practitioners and patients or their carers on patient adherence, applied to diagnostic procedures, therapeutic regimens or any health promotion or illness prevention initiative for patients. Contracts had to specify at least one activity to be observed and a commitment of adherence to it. We included trials comparing contracts with routine care or any other intervention. DATA COLLECTION AND ANALYSIS Selection and quality assessment of trials were conducted independently by two review authors; single data extraction was checked by a statistician. We present the data as a narrative summary, given the wide range of interventions, participants, settings and outcomes, grouped by the health problem being addressed. MAIN RESULTS We included thirty trials, all conducted in high income countries, involving 4691 participants. Median sample size per group was 21. We examined the quality of each trial against eight standard criteria, and all trials were inadequate in relation to three or more of these standards. Trials evaluated contracts in addiction (10 trials), hypertension (4 trials), weight control (3 trials) and a variety of other areas (13 trials). Sixteen trials reported at least one outcome that showed statistically significant differences favouring the contracts group, five trials reported at least one outcome that showed differences favouring the control group and 26 trials reported at least one outcome without differences between groups. Effects on adherence were not detected when measured over longer periods. AUTHORS' CONCLUSIONS There is limited evidence that contracts can potentially contribute to improving adherence, but there is insufficient evidence from large, good quality studies to routinely recommend contracts for improving adherence to treatment or preventive health regimens.
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Affiliation(s)
- X Bosch-Capblanch
- International Health Research Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK L35QA.
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Franklin VL, Waller A, Pagliari C, Greene SA. A randomized controlled trial of Sweet Talk, a text-messaging system to support young people with diabetes. Diabet Med 2006; 23:1332-8. [PMID: 17116184 DOI: 10.1111/j.1464-5491.2006.01989.x] [Citation(s) in RCA: 433] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIMS To assess Sweet Talk, a text-messaging support system designed to enhance self-efficacy, facilitate uptake of intensive insulin therapy and improve glycaemic control in paediatric patients with Type 1 diabetes. METHODS One hundred and twenty-six patients fulfilled the eligibility criteria; Type 1 diabetes for > 1 year, on conventional insulin therapy, aged 8-18 years. Ninety-two patients were randomized to conventional insulin therapy (n = 28), conventional therapy and Sweet Talk (n = 33) or intensive insulin therapy and Sweet Talk (n = 31). Goal-setting at clinic visits was reinforced by daily text-messages from the Sweet Talk software system, containing personalized goal-specific prompts and messages tailored to patients' age, sex and insulin regimen. RESULTS HbA(1c) did not change in patients on conventional therapy without or with Sweet Talk (10.3 +/- 1.7 vs. 10.1 +/- 1.7%), but improved in patients randomized to intensive therapy and Sweet Talk (9.2 +/- 2.2%, 95% CI -1.9, -0.5, P < 0.001). Sweet Talk was associated with improvement in diabetes self-efficacy (conventional therapy 56.0 +/- 13.7, conventional therapy plus Sweet Talk 62.1 +/- 6.6, 95% CI +2.6, +7.5, P = 0.003) and self-reported adherence (conventional therapy 70.4 +/- 20.0, conventional therapy plus Sweet Talk 77.2 +/- 16.1, 95% CI +0.4, +17.4, P = 0.042). When surveyed, 82% of patients felt that Sweet Talk had improved their diabetes self-management and 90% wanted to continue receiving messages. CONCLUSIONS Sweet Talk was associated with improved self-efficacy and adherence; engaging a classically difficult to reach group of young people. While Sweet Talk alone did not improve glycaemic control, it may have had a role in supporting the introduction of intensive insulin therapy. Scheduled, tailored text messaging offers an innovative means of supporting adolescents with diabetes and could be adapted for other health-care settings and chronic diseases.
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Affiliation(s)
- V L Franklin
- Maternal and Child Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
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Bosch Capblanch X, Garner P. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2006. [DOI: 10.1002/14651858.cd004808.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hedberg GE, Wikström-Frisén L, Janlert U. Comparison between two programmes for reducing the levels of risk indicators of heart diseases among male professional drivers. Occup Environ Med 1998; 55:554-61. [PMID: 9849543 PMCID: PMC1757619 DOI: 10.1136/oem.55.8.554] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To compare two programmes for reducing the levels of risk indicators of heart diseases among professional drivers. The programmes were focused on changes of lifestyle. The aim of the programmes was to initiate and motivate a process of change within the driver, which in the long term should lead to permanent and sound health habits. One programme was based on health profile assessment and the other was a health examination. METHODS Altogether, 102 subjects were investigated (51 allocated to an intervention group and 51 to a reference group). The programme in the intervention group (health profile assessment) was based on revelatory communication, adjusted to the driver and contained individual and group activities. The reference group went through a health examination. In both groups blood pressure, serum lipid concentrations, body mass index, and estimated maximal oxygen uptake were measured and the lifestyle habits were surveyed by questionnaires at the start and at follow ups of 6 and 18 months. RESULTS The results showed that in the intervention group the maximal oxygen uptake increased, as did exercise habits and the intention to practice good dietary habits. Variable working hours was the most common obstacle to change a health habit. In the reference group the maximal oxygen uptake increased and the concentration of serum total cholesterol and the number of people who perceived stress and loneliness decreased. CONCLUSIONS Both the health profile assessment and the health examination had an effect on the levels of some risk indicators of heart diseases. Both programmes turned out to be useful because of high participation during the entire period and a generally positive attitude among the subjects.
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Affiliation(s)
- G E Hedberg
- Department of Musculoskeletal Research, National Institute for Working Life, Umeå, Sweden
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DeLaGarza S, Martinez-Rogers N. Community Clinical Sites for Psychiatric Nursing Students. J Nurs Educ 1998; 37:142-3. [PMID: 9535232 DOI: 10.3928/0148-4834-19980301-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- S DeLaGarza
- The University of Texas Health Science Center at San Antonio, School of Nursing, 78284-7951, USA
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Clark NM, McLeroy KR. Creating capacity through health education: what we know and what we don't. HEALTH EDUCATION QUARTERLY 1995; 22:273-89. [PMID: 7591785 DOI: 10.1177/109019819402200303] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Researchers in health education have rarely convened to outline research priorities in the field. This article discusses the results of a meeting to develop a research agenda aimed at creating capacity to promote and maintain health. Salient research findings related to individual and community health are summarized and priority issues for future research are presented.
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Affiliation(s)
- N M Clark
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA
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Schiff RL, Cohen MH, Balson A. What do you do when the blood pressure is up? An approach to the known hypertensive who has an elevated blood pressure. J Gen Intern Med 1991; 6:71-6. [PMID: 1999749 DOI: 10.1007/bf02599397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- R L Schiff
- Department of Medicine, Cook Country Hospital, Chicago, IL
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Leatherman J, Blackburn D, Davidhizar R. How postpartum women explain their lack of obtaining adequate prenatal care. J Adv Nurs 1990; 15:256-67. [PMID: 2332548 DOI: 10.1111/j.1365-2648.1990.tb01812.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The quality of life for infants and children is often dependent on the adequacy of the prenatal care pregnant women receive. From July through to December 1985, 15% of pregnant women in one Midwestern county were identified as having inadequate prenatal care. The purposes of the study were to identify and analyse the reasons women in that county gave for not obtaining adequate prenatal care. In addition, chi-square was used to determine the relationship between the reasons given and the three variables, age, time between knowledge of pregnancy and making an appointment for care, and source of payment. A convenience sample (n = 44) was used in a study over a 5-month period at three locations. The Health Belief Model was the conceptual framework for this study. Insufficient money to pay for care was the primary reason given for not obtaining adequate prenatal care (81%). Other reasons included motivational issues (45%) and access or lack of transportation (19%). There was a significant relationship (P = 0.05) with four reasons to the variable of age and with three reasons to both the variables of time and source of payment. The following recommendations were identified as a result of this research: the need for subsidized prenatal care and the need for a community-wide education campaign regarding the need for adequate prenatal care and the consequences of inadequate care. Prenatal care is sometimes not available to all in the United States in spite of the relationship of infant mortality and the quality of life for infants and children to adequate prenatal care.
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Anderson LA, Halter JB. Diabetes care in older adults: current issues in management and research. ANNUAL REVIEW OF GERONTOLOGY & GERIATRICS 1990; 9:35-73. [PMID: 2514770 DOI: 10.1007/978-3-662-40455-3_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Stoffelmayr B, Hoppe RB, Weber N. Facilitating Patient Participation: The Doctor – Patient Encounter. Prim Care 1989. [DOI: 10.1016/s0095-4543(21)01321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. HEALTH EDUCATION QUARTERLY 1988; 15:175-83. [PMID: 3378902 DOI: 10.1177/109019818801500203] [Citation(s) in RCA: 2586] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Health Belief Model, social learning theory (recently relabelled social cognitive theory), self-efficacy, and locus of control have all been applied with varying success to problems of explaining, predicting, and influencing behavior. Yet, there is conceptual confusion among researchers and practitioners about the interrelationships of these theories and variables. This article attempts to show how these explanatory factors may be related, and in so doing, posits a revised explanatory model which incorporates self-efficacy into the Health Belief Model. Specifically, self-efficacy is proposed as a separate independent variable along with the traditional health belief variables of perceived susceptibility, severity, benefits, and barriers. Incentive to behave (health motivation) is also a component of the model. Locus of control is not included explicitly because it is believed to be incorporated within other elements of the model. It is predicted that the new formulation will more fully account for health-related behavior than did earlier formulations, and will suggest more effective behavioral interventions than have hitherto been available to health educators.
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Affiliation(s)
- I M Rosenstock
- Center for Health and Behavior Studies, School of Applied Arts and Sciences, California State University, Long Beach 90840
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Wilson M, Boyer C. A contract for change in diabetes self-management: case report. DIABETES EDUCATOR 1988; 14:37-40. [PMID: 3335183 DOI: 10.1177/014572178801400114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Written contracting can be an effective supplement to patient education. This case report demonstrates the development and use of a contract between the diabetes educator and CR, a 34-year-old certified public accountant. CR achieved better glucose control through the process of contracting and insulin adjustment. The contract was designed to be clear, fair, and honest—three essential components of a contract. As CR met each of the specific contractual goals, he was rewarded with an educator's time and praise. Through a systematic process of education, contracting, and follow-up, CR was able to obtain the desired outcome of better glucose control.
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Steele DJ, Blackwell B, Gutmann MC, Jackson TC. The activated patient: dogma, dream, or desideratum? PATIENT EDUCATION AND COUNSELING 1987; 10:3-23. [PMID: 10283624 DOI: 10.1016/0738-3991(87)90059-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this paper we critically review the active patient concept and place it in a broader social and historical context. We argue that as a reflection of core, Western European values, the active patient concept has not been adequately scrutinized. Very little research has been done that explicitly tests the claims that have been advanced on behalf of this ideal model of the clinician-patient relationship. The research that is available is far from definitive and does not support many of the assertions made by advocates of this approach to patienthood. We urge investigators to substitute theory driven research programs for those motivated by advocacy of a particular ideological stance.
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Blalock SJ, Devellis BM. Stereotyping: the link between theory and practice. PATIENT EDUCATION AND COUNSELING 1986; 8:17-25. [PMID: 10276474 DOI: 10.1016/0738-3991(86)90023-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Patient educators have long acknowledged the importance of individualizing educational interventions to the specific needs of individual patients. In this paper, we discuss ways in which stereotyping can interfere with this process. First, we examine stereotyping from the more general perspective of information processing. Biases introduced by stereotyping that affect the way individuals process information are discussed and the concepts of cognitive schemas and behavioral confirmation are described. We then briefly review selected studies that demonstrate stereotyping of patients by health care providers. The paper concludes with a discussion of the implications of stereotyping for patient education and the presentation of four strategies patient educators might employ either to decrease the occurrence of stereotyping or to avoid some of its detrimental effects.
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Elder JP, Hovell MF, Lasater TM, Wells BL, Carleton RA. Applications of behavior modification to community health education: the case of heart disease prevention. HEALTH EDUCATION QUARTERLY 1985; 12:151-68. [PMID: 3997537 DOI: 10.1177/109019818501200203] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Principles of behavior modification increasingly have been applied to community health education and offer considerable promise for public health in general. Behavior modification procedures can be conceptualized in a 2 X 2 framework with desired goals being either to increase and strengthen or decrease and weaken behavior, and procedures producing essentially positive or negative consequences. Modifying specific behavioral risk factors for the prevention of heart disease may include the use of positive reinforcement, shaping, differential reinforcement, negative reinforcement, and "punishment." The use of an adequate "behavior analytic" history, highly acceptable interventions, observable effects, inexpensive materials and procedures, community-owned programs, and other practical guidelines can help optimize the effectiveness of behavior modification for health education in the community.
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