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Jormand H, Mohammadi N, Khani Jeihooni A, Afzali Harsini P. Self-care behaviors in older adults suffering from knee osteoarthritis: Application of theory of planned behavior. Front Public Health 2022; 10:958614. [PMID: 36408046 PMCID: PMC9672679 DOI: 10.3389/fpubh.2022.958614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Osteoarthritis is one of the main reasons causing disablement. Educational intervention for self-care behaviors of patients suffering from knee osteoarthritis is important because its effect on quality of patient life decreases the economic burden of disorder on society and family. This study aimed to investigate the effect of educational intervention based on the theory of planned behavior (TPB) on promoting self-care behaviors in elderly patients suffering from knee osteoarthritis. Methods This quasi-experimental study was performed on 200 elderlies suffering from knee osteoarthritis in the rheumatology clinics of Shiraz, Iran, in 2019. The subjects were divided into two groups (100 experimental and 100 control). Before and after 4 months, both experimental and control groups filled a questionnaire. After administering a pre-test to both groups, only the experimental group was trained based on the TPB constructs on self-care behaviors in elderly people suffering from knee osteoarthritis in eight sessions by presenting educational films and images, power points, and group discussions for solving problems. Results The mean age of the experimental group was 67.25 ± 3.64, and the mean age of the control group was 66.12 ± 3.50. The average scores of attitudes, subjective norms, perceived behavioral control, intention, and behavior before the educational intervention did not have significant differences in experimental and control groups, however, 4 months after the educational intervention, the paired t-test indicated significant enhancement in every construct in the experimental group, but no significant changes in the control group. Conclusion According to the results, the educational intervention increased the self-care behaviors of patients suffering from knee osteoarthritis based on the theory of planned behavior. Therefore, the results of this study can be used in theory-based intervention strategies for self-care behaviors of patients suffering from knee osteoarthritis.
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Affiliation(s)
- Hanieh Jormand
- Autism Spectrum Disorders Research Center and Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasim Mohammadi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran,*Correspondence: Ali Khani Jeihooni
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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St Quinton T, Trafimow D. The unappreciated relevance of auxiliary assumptions for evaluating theory-based interventions in health psychology. THEORY & PSYCHOLOGY 2022. [DOI: 10.1177/09593543221113263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of theory in health behavior change interventions has been recently questioned with mixed results found for theory-based intervention effectiveness. But theory testing in intervention depends on not only theoretical assumptions, but on auxiliary assumptions too. Specifically, auxiliary assumptions are required to traverse the distance from nonobservational terms in theories and observational terms at the level of the empirical hypotheses in interventions. We believe intervention failures are often due to flaws in auxiliary assumptions rather than assumptions at the theoretical level. We use the theory of planned behavior to illustrate how the consideration of these auxiliary assumptions is important to appraise the effectiveness of interventions informed by theory. We hope that bringing attention to the importance of auxiliary assumptions provides a more nuanced and accurate appraisal of theory utility.
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Shadi M, Peyman N, Taghipour A, Jafari A, Tehrani H. Can Social Media be Used to Control Academic Stress? An Application of the Theory of Planned Behavior. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2022. [DOI: 10.32604/ijmhp.2021.017343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Rezaei H, Negarandeh R, Pasheypoor S, Kazemnejad A. Effect of Educational Program based on the Theory of Planned Behavior on Prostate Cancer Screening: A Randomized Clinical Trial. Int J Prev Med 2020; 11:146. [PMID: 33209216 PMCID: PMC7643565 DOI: 10.4103/ijpvm.ijpvm_137_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/14/2019] [Indexed: 11/29/2022] Open
Abstract
Background and Aims: Prostate cancer screening applied for early diagnosis of prostate cancer. But it is not usually pursued by men. This study was conducted to determine the effect of educational program based on the Theory of Planned Behavior (TPB) on prostate cancer screening. Methods: A randomized clinical trial was carried out on 68 middle-aged men referring to community houses in Iran. Samples were selected consecutively considering the inclusion criteria. Then block randomization was used to assign the participants into two groups. Data collection included demographic characteristics, knowledge and construct of TPB (Attitude towards the behavior, Subjective norms, Perceived behavioral control, behavioral intention) and behavior. The participants in the intervention group attended a theory based program 4 session twice per week. The participants were evaluated before and two month after the intervention. P <0.05 was considered statistically significant. Results: After the 2 months intervention, the pretest-posttest changes in the intervention group compared to the control group were in the Knowledge 9.26 ± 3.5 vs. 0.03 ± 1.68, Attitude 11.46 ± 3.5 vs. -0.16 ± 1.39, Subjective norms 3.16 ± 2.6 vs. 0.29 ± 1.3, Behavioral control 6.76 ± 4 vs. 0.12 ± 1.60 and Behavioral intention 1.4 ± 1.54 vs. 0.00 ± 1.00 (P < 0.05). While none of the subjects in control group performed the prostate screening, 10 people (33.2%) performed it in the intervention group. (P < 0.001). Conclusions: Educational program based on TPB has a positive effect on prostate cancer screening. It is recommended to set up regular training programs based on TPB to encourage middle-aged men for prostate cancer screening.
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Affiliation(s)
- Hesam Rezaei
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Department of Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pasheypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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French DP, Banafa R, Williams S, Taylor C, Brown LJE. How Does the Understanding, Experience, and Enactment of Self-Regulation Behaviour Change Techniques Vary with Age? A Thematic Analysis. Appl Psychol Health Well Being 2020; 13:239-260. [PMID: 33075200 DOI: 10.1111/aphw.12243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-regulatory behaviour change techniques (BCTs) appear less effective in promoting physical activity amongst older than younger adults. This study aimed to identify reasons for this by examining how participants of different ages understand, experience, and use these BCTs. METHODS Twelve participants (aged 39-75) in a walking intervention study were interviewed twice: immediately post-intervention and 3 months later to examine understanding and enactment of self-regulation BCTs. Thematic analysis was used, organised using the framework approach. RESULTS Participants acknowledged the importance of setting realistic goals and found pedometers useful. In older adults, the use of goal setting was influenced by previous experience in work settings of this BCT. Occupational status appeared to influence the participants' responses to action planning, irrespective of age, with retired participants preferring not to restrict themselves to specific times. Self-monitoring with diaries appeared to be more useful in assisting the memory of older adults. For most BCTs, differences in understanding and enactment were apparent according to participant age. CONCLUSIONS Problems with using self-regulation BCTs were apparent, which appeared more common with older adults. Occupational status, cognitive status, or a perceived lack of value of physical activity or of some BCTs are all promising explanations that warrant further investigation.
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Affiliation(s)
| | - Rehab Banafa
- University of Manchester, UK.,Jeddah Institute for Speech and Hearing and Medical Rehabilitation, Saudi Arabia
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Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010064. [PMID: 31861769 PMCID: PMC6981798 DOI: 10.3390/ijerph17010064] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023]
Abstract
A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients' weight-related concerns.
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Williams SL, McSharry J, Taylor C, Dale J, Michie S, French DP. Translating a walking intervention for health professional delivery within primary care: A mixed-methods treatment fidelity assessment. Br J Health Psychol 2019; 25:17-38. [PMID: 31746091 PMCID: PMC7003875 DOI: 10.1111/bjhp.12392] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/24/2019] [Indexed: 01/26/2023]
Abstract
Objectives Existing fidelity studies of physical activity interventions are limited in methodological quality and rigour, particularly those delivered by health care providers in clinical settings. The present study aimed to enhance and assess the fidelity of a walking intervention delivered by health care providers within general practice in line with the NIH Behavior Change Consortium treatment fidelity framework. Design Two practice nurses and six health care assistants delivered a theory‐based walking intervention to 63 patients in their own practices. A cross‐sectional mixed‐methods study assessed fidelity related to treatment delivery and treatment receipt, from the perspectives of health care providers and patients. Methods All providers received training and demonstrated delivery competence prior to the trial. Delivery of intervention content was coded from audio‐recordings using a standardized checklist. Qualitative interviews with 12 patients were conducted to assess patient perspectives of treatment receipt and analysed using framework analysis. Results Overall, 78% of intervention components were delivered as per the protocol (range 36–91%), with greater fidelity for components requiring active engagement from patients (e.g., completion of worksheets). The qualitative data highlighted differences in patients’ comprehension of specific intervention components. Understanding of, and engagement with, motivational components aimed at improving self‐efficacy was poorer than for volitional planning components. Conclusions High levels of fidelity of delivery were demonstrated. However, patient‐, provider‐, and component‐level factors impacted on treatment delivery and receipt. We recommend that methods for the enhancement and assessment of treatment fidelity are consistently implemented to enhance the rigour of physical activity intervention research. Statement of contribution What is already known on this subject? Physical activity interventions delivered within primary care by health professionals have so far demonstrated limited impact on behaviour change initiation and maintenance. Treatment fidelity enhancement and assessment strategies can support the successful translation of behaviour change interventions into real‐life settings. Few studies have examined treatment fidelity within the context of physical activity interventions, particularly within clinical settings, and existing fidelity studies are limited by methodological quality and rigour.
What does this study add? High levels of fidelity were found for a physical activity intervention delivered in primary care. Patient‐, provider‐, and component‐level factors may impact on treatment delivery and receipt. The implementation of best practice fidelity recommendations can support near‐optimal fidelity.
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Affiliation(s)
| | - Jennifer McSharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland
| | - Claire Taylor
- Public Health Warwickshire, Warwickshire County Council, Warwick, UK
| | - Jeremy Dale
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK
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Evaluation of a Road Safety Education Program Based on Driving Under Influence and Traffic Risks for Higher Secondary School Students in Belgium. SAFETY 2019. [DOI: 10.3390/safety5020034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Road safety education has been recognized as an instrument for reducing road accidents. This study aims to evaluate the road safety education program “Traffic Weeks” among higher secondary school students (age 16–19) in Belgium. The program focuses on driving under influence (DUI) and traffic risks. This study investigates whether the program has an effect on socio-cognitive variables using a questionnaire based on the theory of planned behavior. During the pre-test, 445 students filled in the questionnaire, while 253 students filled in the questionnaire during the post-test. Of these, 175 questionnaires could be matched. The results indicate that the students already had quite a supportive view of road safety at pre-test, with female students showing a more supportive view of road safety than male students. The DUI workshop had a positive effect on most socio-cognitive variables (attitude, subjective norm-friends, and intention) of female students in general education, while the traffic risks workshop only affected perceived behavioral control of female students. In terms of appreciation, students had a significantly higher appreciation of the DUI workshop compared to the traffic risks workshop. During the focus groups, students gave recommendations to improve the program.
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Mo D, Xiang M, Luo M, Dong Y, Fang Y, Zhang S, Zhang Z, Liang H. Using Gamification and Social Incentives to Increase Physical Activity and Related Social Cognition among Undergraduate Students in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E858. [PMID: 30857261 PMCID: PMC6427787 DOI: 10.3390/ijerph16050858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 12/18/2022]
Abstract
Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p <0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p <0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.
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Affiliation(s)
- Dandan Mo
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Mengyun Luo
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
- School of Public Health, and Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | - Yuanyuan Dong
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Yue Fang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | | | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Huigang Liang
- College of Business, East Carolina University, Greenville, NC 27858, USA.
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Marchant G, Chevance G, Boiché J. Intention and automaticity toward physical and sedentary screen-based leisure activities in adolescents: A profile perspective. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:481-488. [PMID: 30450258 PMCID: PMC6226420 DOI: 10.1016/j.jshs.2016.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 07/16/2015] [Accepted: 04/19/2016] [Indexed: 05/13/2023]
Abstract
PURPOSE Physical activity (PA) and sedentary behavior (SB) are increasingly considered independent health behaviors. Additionally, current research suggests that both controlled and automatic determinants account for their adoption. The purpose of this article was to identify intention-automaticity profiles toward PA and screen-based SB and to examine how those profiles are associated with different behavioral patterns. METHOD Two cross-sectional studies based on self-report questionnaires were conducted with French high school students (Study 1: n = 198; Study 2: n = 185). RESULTS In all, 4 distinct motivational profiles appeared. The first 3 clusters emerged in both studies: "PA" (high levels of automaticity and intention for PA, low levels of automaticity and intention for screen-based SB); "screen" (high levels of automaticity and intention for screen-based SB, low levels of automaticity and intention for PA), and "mixed" (high levels of all variables), whereas the fourth cluster was observed only in Study 2: "high control" (below-mean levels of automaticity, high levels of intention toward both PA and screen-based SB). Adolescents with a screen profile displayed the least healthy behavioral pattern, whereas those in the PA profile demonstrated the most favorable behaviors. CONCLUSION Future research is needed to extend these results to other populations using complementary assessment methods of automatic psychological processes and PA and SB behaviors.
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Affiliation(s)
- Gonzalo Marchant
- Laboratory Epsylon “Dynamics of Human Abilities and Health Behavior” (EA 4556), University of Montpellier, 4 Boulevard Henri IV, Montpellier 34000, France
- Laboratory L-ViS (EA 7428), University Claude Bernard Lyon 1, Bâtiment R. Dubois - 27–29 bd du 11 novembre 1918, Villeurbanne cedex 69622, France
| | - Guillaume Chevance
- Laboratory Epsylon “Dynamics of Human Abilities and Health Behavior” (EA 4556), University of Montpellier, 4 Boulevard Henri IV, Montpellier 34000, France
- Clinique du Souffle LaVallonie, 5 Santé Group, 800, Avenue Joseph Vallot, Lodève 34700, France
| | - Julie Boiché
- Laboratory Epsylon “Dynamics of Human Abilities and Health Behavior” (EA 4556), University of Montpellier, 4 Boulevard Henri IV, Montpellier 34000, France
- Corresponding author.
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Shagiwal SS, Schop-Etman A, Bergwerff I, Vrencken W, Denktaş S. The BeHealthyR Study: a randomized trial of a multicomponent intervention to reduce stress, smoking and improve financial health of low-income residents in Rotterdam. BMC Public Health 2018; 18:891. [PMID: 30021551 PMCID: PMC6052714 DOI: 10.1186/s12889-018-5728-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/19/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Compared to higher socioeconomic status (SES) groups, those in lower SES groups are financially strained, experience higher rates of smoking-related morbidity, are in poorer health and have reduced life expectancy. This is especially true for the city of Rotterdam, where a large inequality in health is observed between low and high SES groups. The BeHealthyR study (Dutch: Grip en Gezondheid) is a randomized controlled trial (RCT) which will evaluate the impact of a theory-based multicomponent behavior intervention aiming to reduce stress, smoking, and improve financial health by means of a group-based stress management program combining cognitive and behavioral techniques, and nudges in low-SES residents living in Rotterdam. METHODS The BeHealthyR study is a three-arm RCT. Between February 2018 and July 2019, low-SES participants who perceive stress, smoke, are financially strained and reside in Rotterdam (one of the four largest cities in The Netherlands) are recruited. Subsequently, participants are randomly assigned to either a stress management condition (SM), stress management with a buddy condition (SM-B) or a control condition (CC). Participants in the SM and SM-B conditions will attend four weekly group sessions (1.5 h/session) and a follow-up session eight weeks later. The SM condition includes psychoeducation and exercises, and cognitive and behavioral intervention techniques. Demographic data and objective measures will be collected at baseline (T0), four weeks post-baseline (T1), and twelve weeks post-baseline (T2). Primary outcome measures are to reduce stress, smoking and improve financial health. We hypothesize that low-SES participants in the intervention conditions, compared with those in the control condition, will experience less stress, smoke less and have improved financial health. DISCUSSION This study is a group-based intervention which aims to investigate the effects of a theory-based behavioral change intervention employing several components on reducing stress, smoking, and improving financial health in low-SES residents living in Rotterdam. If effective, the findings from the present study will serve to inform future directions of research and clinical practice with regard to behavioral change interventions for low-SES groups. TRIAL REGISTRATION ClinicalTrials.gov (ID: NCT03553979 ). Registered on January 1 2018.
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Affiliation(s)
- Sara S. Shagiwal
- Department of Social and Behavioral Sciences, Erasmus University College/Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Astrid Schop-Etman
- Department of Social and Behavioral Sciences, Erasmus University College/Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | | | - Semiha Denktaş
- Department of Social and Behavioral Sciences, Erasmus University College/Erasmus University Rotterdam, Rotterdam, The Netherlands
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Cooke AB, Pace R, Chan D, Rosenberg E, Dasgupta K, Daskalopoulou SS. A qualitative evaluation of a physician-delivered pedometer-based step count prescription strategy with insight from participants and treating physicians. Diabetes Res Clin Pract 2018. [PMID: 29530385 DOI: 10.1016/j.diabres.2018.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIMS The integration of pedometers into clinical practice has the potential to enhance physical activity levels in patients with chronic disease. Our SMARTER randomized controlled trial demonstrated that a physician-delivered step count prescription strategy has measurable effects on daily steps, glycemic control, and insulin resistance in patients with type 2 diabetes and/or hypertension. In this study, we aimed to understand perceived barriers and facilitators influencing successful uptake and sustainability of the strategy, from patient and physician perspectives. METHODS Qualitative in-depth interviews were conducted in a purposive sample of physicians (n = 10) and participants (n = 20), including successful and less successful cases in terms of pedometer-assessed step count improvements. Themes that achieved saturation in either group through thematic analysis are presented. RESULTS All participants appreciated the pedometer-based monitoring combined with step count prescriptions. Accountability to physicians and support offered by the trial coordinator influenced participant motivation. Those who increased step counts adopted strategies to integrate more steps into their routines and were able to overcome weather-related barriers by finding indoor alternative options to outdoor steps. Those who decreased step counts reported difficulty in overcoming weather-related challenges, health limitations and work constraints. Physicians indicated the strategy provided a framework for discussing physical activity and motivating patients, but emphasized the need for support from allied professionals to help deliver the strategy in busy clinical settings. CONCLUSION A physician-delivered step count prescription strategy was feasibly integrated into clinical practice and successful in engaging most patients; however, continual support is needed for maximal engagement and sustained use.
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Affiliation(s)
- Alexandra B Cooke
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Romina Pace
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Deborah Chan
- Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ellen Rosenberg
- Department of Family Medicine, St. Mary's Hospital, McGill University, Montreal, Quebec, Canada
| | - Kaberi Dasgupta
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Stella S Daskalopoulou
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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Flynn M, Hall EE. Prediction of Adherence to a 9-Week Corporate Wellness Walking Program. Health (London) 2018. [DOI: 10.4236/health.2018.1012131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
ABSTRACTPhysical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.
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Lambert JD, Greaves CJ, Farrand P, Cross R, Haase AM, Taylor AH. Assessment of fidelity in individual level behaviour change interventions promoting physical activity among adults: a systematic review. BMC Public Health 2017; 17:765. [PMID: 28969669 PMCID: PMC5625828 DOI: 10.1186/s12889-017-4778-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Behaviour change interventions that promote physical activity have major implications for health and well-being. Measuring intervention fidelity is crucial in determining the extent to which an intervention is delivered as intended, therefore increasing scientific confidence about effectiveness. However, we lack a clear overview of how well intervention fidelity is typically assessed in physical activity trials. METHODS A systematic literature search was conducted to identify peer - reviewed physical activity promotion trials that explicitly measured intervention fidelity. Methods used to assess intervention fidelity were categorised, narratively synthesised and critiqued using assessment criteria from NIH Behaviour Change Consortium (BCC) Treatment Fidelity Framework (design, training, delivery, receipt and enactment). RESULTS Twenty eight articles reporting of twenty one studies used a wide variety of approaches to measure intervention fidelity. Delivery was the most common domain of intervention fidelity measured. Approaches used to measure fidelity across all domains varied from researcher coding of observational data (using checklists or scales) to participant self-report measures. There was considerable heterogeneity of methodological approaches to data collection with respect to instruments used, attention to psychometric properties, rater-selection, observational method and sampling strategies. CONCLUSIONS In the field of physical activity interventions, fidelity measurement is highly heterogeneous both conceptually and methodologically. Clearer articulation of the core domains of intervention fidelity, along with appropriate measurement approaches for each domain are needed to improve the methodological quality of fidelity assessment in physical activity interventions. Recommendations are provided on how this situation can be improved.
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Affiliation(s)
- Jeffrey D. Lambert
- University of Exeter Medical School, St Luke’s Campus, Magdalen Road, Exeter, EX1 2LU UK
| | - Colin J. Greaves
- University of Exeter Medical School, St Luke’s Campus, Magdalen Road, Exeter, EX1 2LU UK
| | - Paul Farrand
- Clinical Education, Development and Research (CEDAR); Psychology, University of Exeter, Exeter, EX4 4QG UK
| | - Rosina Cross
- Department for Health, University of Bath, Wessex House 6.9, Claverton, Bath, BA2 7AY UK
| | - Anne M. Haase
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Adrian H. Taylor
- Plymouth University, N6, ITTC, Tamar Science Park, Plymouth, Devon PL6 8BX UK
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16
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Dombrowski SU, O'Carroll RE, Williams B. Form of delivery as a key 'active ingredient' in behaviour change interventions. Br J Health Psychol 2017; 21:733-740. [PMID: 27709824 DOI: 10.1111/bjhp.12203] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, UK
| | - Brian Williams
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, UK
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