Social cognitive determinants of betel quid chewing among college students in southern Taiwan: a revised Attitudes-Social Influence-Efficacy Model

Sociodemographic Factors, Attitudes, and Tobacco use among Adolescent Areca-Nut Users in Mumbai, India

Introduction

Areca nut, initiated in adolescence, is considered a gateway for tobacco use and an important cause of oral cancers in India. This study examined differences in sociodemographic factors, attitudes and beliefs, and tobacco use between current (last 30 days) areca nut users and past users, who have ever used areca but not in the last 30 days.

Material and Methods

A cross-sectional survey with school students attending grades 7, 8, 9 provided data to compare differences in age, gender, beliefs, attitudes, and concurrent tobacco use among self-reported areca users. Of 1909 participants surveyed, 641 (33.57%) reported use of areca nut; of which 355 (55.38%) current users had consumed it in the last 30 days.

Results

A logistic regression model revealed that male gender, using tobacco concurrently, inability to refuse a friend's request to use, and intention to use areca nuts in the next 12 months were significant predictors of current areca use.

Conclusion

More research is needed to understand adolescent areca-nut use, including different types of users such as experimenters and those with established habits. This will help design targeted areca-nut prevention and cessation programs.

Using the Theory of Planned Behavior to Explain and Predict Areca Nut Use Among Adolescents in India: An Exploratory Study

Context

Areca nut, used alone or in combination with tobacco, contributes to the high oral cancer burden in India. Used widely by adolescents, who perceive it as a harmless substance, areca nut is addictive and considered a precursor to tobacco use. Given its serious implications for addictiveness and physical health, urgent preventive interventions for areca nut use are required in India and South-East Asia. Studies examining the role of health behavior theory in explaining and predicting areca nut use and for development of its prevention among adolescents are scarce.

Aim

This study explored the role of the components of Theory of Planned Behavior (TPB) such as attitudes, subjective norms, perceived behavioral control, and intention in predicting areca nut use among adolescents.

Settings and Design

Observational study with cross-sectional design conducted with 1884 male and female adolescents attending low-income schools in Mumbai, India.

Methods and Material

Self-administered surveys were used to gather data on age, gender, behavioral factors and areca nut use.

Statistical Analysis Used

Chi-square and Mann Whitney test for bivariate and logistic regression for multivariate analysis.

Results

Around 27.2% of 1884 participants were areca nut users. The mean age of users was 13.75 years. Intention-to-use and perceived behavioral control were statistically significant predictors of actual areca nut use (p<0.001). The components of TPB such as attitude, perceived subjective social norms, and perceived behavioral control had a statistically significant effect on the intention-to-use areca nut (p<0.05).

Conclusion

This exploratory study indicates that constructs from TPB could help us understand and predict areca nut use. However, more rigorous future research is required to generate insights that help craft effective theory-based behavioral interventions for areca nut prevention and cessation in adolescents.

Self-Confidence, Not Self-Awareness, Is Negatively Associated With Areca Nut Dependence

Areca nut is the fourth most commonly used addictive substance globally. Therefore, this study aimed to examine correlations among areca nut self-awareness, areca nut cessation self-confidence, and areca nut dependence in the Taiwanese population. This was a descriptive study in which 120 areca nut chewers who sought medical attention at a regional hospital and were residents of the Yunlin-Chiayi area, were recruited as study subjects. A structured questionnaire was used for data collection, which included demographic data, an areca nut self-awareness scale, an areca nut cessation self-confidence scale, and an areca nut dependence scale. A Pearson correlation analysis revealed that areca nut self-awareness and areca nut cessation self-confidence were not significantly correlated (r = 0.16, p = 0.069). Areca nut self-awareness and areca nut dependence also did not have a significant correlation (r = −0.06, p = 0.511). However, we found that areca nut cessation self-confidence and areca nut dependence were significantly negatively correlated (r = −0.37, p < 0.001), that is, the higher the areca nut cessation self-confidence, the lower the areca nut dependence. In addition, areca nut self-awareness showed significant correlations by age (r = 4.54, p = 0.005), occupation (r = 2.91, p = 0.02), and family support (r = 3.83, p = 0.03). Scheffe's post-hoc test revealed significant differences that subjects whose family members were extremely supportive of areca nut cessation had higher areca nut self-awareness. In conclusion, areca nut cessation self-confidence and areca nut dependence showed a significant negative correlation. Areca nut self-awareness revealed significant correlations by age, occupation, and family support. The results of this study can be used to provide a reference for implementing areca nut cessation policies in the future.

Positive outcome expectancy mediates the relationship between social influence and Internet addiction among senior high-school students

Background and aims Based on the foundations of Bandura's social cognitive theory and theory of triadic influence (TTI) theoretical framework, this study was designed to examine the mediating role of positive outcome expectancy of Internet use in the relationship between social influence and Internet addiction (IA) in a large representative sample of senior high-school students in Taiwan. Methods Using a cross-sectional design, 1,922 participants were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling, and a comprehensive survey was administered. Results Structural equation modeling and bootstrap analyses results showed that IA severity was significantly and positively predicted by social influence, and fully mediated through positive outcome expectancy of Internet use. Discussion and conclusions The results not only support Bandura's social cognitive theory and TTI framework, but can also serve as a reference to help educational agencies and mental health organizations design programs and create policies that will help in the prevention of IA among adolescents.

A conceptual model of patient-professional communication as a self-management skill: A latent growth change modeling

BACKGROUND

Patient Communication with healthcare professionals is an integral self-management skill. Yet the underlying mechanisms explaining how such communication might be enhanced across time have not been well studied.

OBJECTIVES

Based on the transtheoretical model, the study aimed to develop an across-time Attitude-Social Influence-Efficacy model in order to explain changes in participants' patient-professional communication behaviors in the Chronic Disease Self-management Program (CDSMP). Readiness-to-change construct was hypothesized to be the overall predictors of psychological and behavioral parameters. It was hypothesized that social norm and attitude toward behaviors would be the indirect predictors of communication behavior.

METHODS

One hundred and thirty-six Chinese participants with chronic diseases underwent a 6-week CDSMP. Their attitude toward behavior, self-efficacy, social norm, readiness to change and communication behavior were obtained at 1st, 4th and 6th week of the structured program.

RESULTS

A modified latent growth change curve model yielded satisfactory model fit (χ(2)/df = 1.32; RMSEA = 0.063 (90% CI = 0.018-0.96)). The results showed that readiness to change had a positive influence on attitude and self-efficacy. Both attitude and social norm positively affected self-efficacy. Attitude and self-efficacy in turn positively influenced communication behavior at the beginning of the program. Across 6 weeks, self-efficacy imposed a negative influence on communication behavior while social norm exerted a positive influence on the behavior.

CONCLUSION

This study revealed possible underlying mechanisms influencing CDSMP participants' communication with professionals. The results could shed light on further improvement of the structured program.

An expanded self-medication hypothesis based on cognitive-behavioral determinants for heroin abusers in Taiwan: a cross-sectional study

BACKGROUND

This study proposed and examined an expanded self-medication hypothesis (eSMH) model based on cognitive behavioral determinants, including the direct effects of negative emotional states, positive outcome expectancies and refusal self-efficacy on heroin use, and the mediating roles of positive outcome expectancies and refusal self-efficacy between negative emotional states and heroin use.

METHODS

A total of 360 male heroin abusers were recruited from a drug abuse treatment center in Taiwan. Participants were asked to complete a set of questionnaires on frequency of heroin use, anxious/depressive mood, positive outcome expectancies, and refusal self-efficacy. Structural equation modeling was used to examine the eSMH model.

RESULTS

Results showed that the eSMH model displayed proper goodness-of-fit. Positive outcome expectancies and negative emotional status were significant predictors of heroin use, whereas refusal self-efficacy was not a significant predictor. Additionally, positive self-efficacy was a mediator between negative emotional status and heroin use.

CONCLUSION

Results support a reduced eSMH model and suggest a significant role of positive self-efficacy in the relationship between negative affective states and heroin use. This relationship should be examined in the longitudinal study, and should be given clinical consideration in treatment of individuals struggling with heroin abuse and negative affective states.

The prevalence of and psychosocial risks for suicide attempts in male and female college students in Taiwan

The prevalence of and psychosocial risks for suicide attempts was investigated in college students in Taiwan by gender, after controlling for depressive symptoms. Self-reported data were collected from a nationally representative sample of 2,835 college students; 11.90% of females and 8.87% of males reported they had attempted suicide in the preceding 12 months. After controlling for depression, suicidal ideations were associated with suicide attempts in females, whereas there were fewer positive expectations toward the future associated with suicide attempts in males. Several explanations for the high prevalence of suicide attempts among college students in Taiwan were discussed. In the future, further verification of the findings is necessary.