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de la Torre-Cruz MJ, Rusillo-Magdaleno A, Solas-Martínez JL, Moral García JE. Physical Activity and Subjective Vitality in Female University Students: The Mediating Role of Decisional Balance and Enjoyment of the Activity. Behav Sci (Basel) 2024; 14:685. [PMID: 39199081 PMCID: PMC11352169 DOI: 10.3390/bs14080685] [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: 06/27/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/01/2024] Open
Abstract
Regular physical activity (PA) improves the psychological well-being of those who practice it. However, female university students are a risk group due to their low level of PA. Based on the transtheoretical model of behavioural change, the main aim of this study was to examine whether the relationship between PA and subjective vitality was mediated by cognitive-emotional variables such as decisional balance (perceived benefits and barriers) and enjoyment associated with PA in a group of female university students. Participants were asked to complete self-administered questionnaires, which were available for one month via a Google Form. The results showed the existence of a statistically significant, relative, and indirect effect between the stage of change and subjective vitality via both mediating variables. Compared to females in the pre-contemplation stage, those in the action and maintenance stages achieved higher subjective vitality scores as a result of the effect of being in a more advanced stage on decisional balance and enjoyment of PA. It is concluded that female university students who reported regular PA found the activity to be more revitalising, stimulating, and exciting; all positive feelings and cognitions that translated into a more energetic and vital perception of themselves.
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Affiliation(s)
- Manuel Jesús de la Torre-Cruz
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain; (M.J.d.l.T.-C.); (J.L.S.-M.); (J.E.M.G.)
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain
| | - Alba Rusillo-Magdaleno
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain; (M.J.d.l.T.-C.); (J.L.S.-M.); (J.E.M.G.)
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain
| | - José Luis Solas-Martínez
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain; (M.J.d.l.T.-C.); (J.L.S.-M.); (J.E.M.G.)
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain
| | - José Enrique Moral García
- Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain; (M.J.d.l.T.-C.); (J.L.S.-M.); (J.E.M.G.)
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Education Sciences, University of Jaen, Las Lagunillas s/n, 23071 Jaén, Spain
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Murray AN, Monahan K, Sacco A, Paiva A, Redding C, Robbins M. Development and Validation of a Measure of Self-Efficacy for Advance Care Planning. Am J Hosp Palliat Care 2024; 41:873-881. [PMID: 37879089 DOI: 10.1177/10499091231210504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
Medical care received at end-of-life is often not aligned with individuals' values and care preferences. Much can get in the way of an individual communicating and documenting their preferences to care providers and close others, even if it is a goal to do so. The objective of this work was to develop a measure of Advance Care Planning Self-Efficacy (ACP SE) focused on three important behaviors: completing a living will, documenting a healthcare agent, and discussing quality versus quantity of life issues. Measure development was framed by the Transtheoretical Model (TTM) of behavior change. Following the completion of focus groups and formative qualitative work, an independent sample (N = 310, adults aged 50+) was randomly split into two halves for exploratory and confirmatory factor analyses (EFA/CFA). Multivariate analyses examined relationships between ACP SE and other TTM constructs. Results of the CFA demonstrated excellent internal consistency (α = .95) and good model fit (CFI = .89, RMSEA = .13). Self-efficacy was framed by the TTM as situation-specific confidence. Through the measure development process, it was found that confidence to do ACP was impacted by various situational and attitudinal variables. ACP Self-Efficacy was found to differ significantly by Stage of Change. This study produced a reliable and valid measure of situation-specific confidence for ACP grounded within the TTM that could enhance future interventions aimed at increasing participation in ACP.
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Affiliation(s)
- Alexandra N Murray
- Digestive Disease & Surgical Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Katie Monahan
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Allegra Sacco
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea Paiva
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Collen Redding
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Mark Robbins
- Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
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Monahan K, Paiva A, Blissmer B, Sacco A, Robbins M. Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population. Am J Health Promot 2024; 38:186-196. [PMID: 37955178 DOI: 10.1177/08901171231213692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
PURPOSE To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). DESIGN Cross-sectional, split-half measure development. SETTING Online survey in the US. SUBJECTS 450 Black and/or Hispanic/Latinx adults. MEASURES Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. ANALYSIS Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. RESULTS EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. CONCLUSION This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.
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Affiliation(s)
- Katie Monahan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Andrea Paiva
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Bryan Blissmer
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Allegra Sacco
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Mark Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Monahan K, Sacco A, Fenn N, Reyes C, Lindsey H, Paiva A, Robbins M. Development of transtheoretical model measures for assessing decisional balance and temptation to vape. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38227915 DOI: 10.1080/07448481.2023.2299412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Introduction: Vaping is common among young adults in the United States. The Transtheoretical Model (TTM) has demonstrated success in smoking cessation efforts; however, it has not been comprehensively applied to vaping cessation, and core TTM vaping measures have not been developed. Method: A cross-sectional survey including measures of stage of change (SOC), temptation to vape, and decisional balance (DCBL) was disseminated (n = 459). Items were adapted from TTM smoking scales. The sample was split for exploratory and confirmatory factor analyses (EFA/CFA). Analyses of variance assessed relationships between constructs and SOC. Results: EFA/CFA resulted in one Temptation scale (CFI = .95; α = .87) and two DCBL scales (CFI = .91; Pros α = .72; Cons α = .72). Temptation to vape and Pros of vaping decreased significantly across SOC, while Cons increased significantly. Conclusions: TTM vaping measures for two key TTM constructs were developed utilizing a college sample. Results suggest that the developed measures map well onto the TTM framework.
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Affiliation(s)
- Katie Monahan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Allegra Sacco
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Natalie Fenn
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Hayley Lindsey
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Andrea Paiva
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Mark Robbins
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Lipschitz JM, Pike CK, Hogan TP, Murphy SA, Burdick KE. The engagement problem: A review of engagement with digital mental health interventions and recommendations for a path forward. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2023; 10:119-135. [PMID: 38390026 PMCID: PMC10883589 DOI: 10.1007/s40501-023-00297-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 02/24/2024]
Abstract
Purpose of the review Digital mental health interventions (DMHIs) are an effective and accessible means of addressing the unprecedented levels of mental illness worldwide. Currently, however, patient engagement with DMHIs in real-world settings is often insufficient to see clinical benefit. In order to realize the potential of DMHIs, there is a need to better understand what drives patient engagement. Recent findings We discuss takeaways from the existing literature related to patient engagement with DMHIs and highlight gaps to be addressed through further research. Findings suggest that engagement is influenced by patient-, intervention- and systems-level factors. At the patient-level, variables such as sex, education, personality traits, race, ethnicity, age and symptom severity appear to be associated with engagement. At the intervention-level, integrating human support, gamification, financial incentives and persuasive technology features may improve engagement. Finally, although systems-level factors have not been widely explored, the existing evidence suggests that achieving engagement will require addressing organizational and social barriers and drawing on the field of implementation science. Summary Future research clarifying the patient-, intervention- and systems-level factors that drive engagement will be essential. Additionally, to facilitate improved understanding of DMHI engagement, we propose the following: (a) widespread adoption of a minimum necessary 5-element engagement reporting framework; (b) broader application of alternative clinical trial designs; and (c) directed efforts to build upon an initial parsimonious conceptual model of DMHI engagement.
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Affiliation(s)
- Jessica M Lipschitz
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Chelsea K Pike
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
| | - Timothy P Hogan
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA
- Peter O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, TX
| | | | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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Strässner AM, Hartmann C. Gradual behaviour change towards meat reduction: Development and validation of a novel decisional balance scale. Appetite 2023; 186:106537. [PMID: 36933833 DOI: 10.1016/j.appet.2023.106537] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/12/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Meat reduction is gaining attention among consumers, marketers, policymakers and scientists. Yet little is known about decision-making processes and behaviour change towards meat reduction. This paper explores the applicability of the decisional balance (DB) framework to the field of meat reduction. A novel DB scale to measure the perceived importance of beliefs about meat reduction at different stages of behaviour change was developed and validated in two studies with German meat eaters. In Study 1 (N = 309), the item inventory was tested using an exploratory factor analysis and then validated in Study 2 (N = 809). The results yielded two higher-order DB factors (pros and cons), which were subdivided into five lower-order factors (perceived benefits of a plant-based diet, downsides of factory farming, health barriers, legitimation barriers and feasibility barriers). The pros and cons were summarised in a DB index. All DB factors and the DB index were tested for internal consistency (Cronbach's alpha ≥.70) and aspects of validity. The typical DB pattern of the pros and cons of behaviour change was confirmed: the cons outweighed the pros for consumers who did not intend to reduce meat consumption, while the pros outweighed the cons for consumers who intended to reduce meat consumption. The new DB scale for meat reduction has proven to be a suitable measure to gain insights into consumers' decision making and could be used to develop targeted meat reduction interventions.
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Affiliation(s)
- Anna-Maria Strässner
- Zurich University of Applied Sciences, School of Management and Law, Institute of Marketing Management, Switzerland.
| | - Christina Hartmann
- ETH Zurich, Department of Environmental Systems Science, Consumer Behaviour, Switzerland.
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Gerlach-Houck H, Rodgers NH. The good, the bad, and the ugly: Unpacking the pros and cons associated with change for adults who stutter. JOURNAL OF FLUENCY DISORDERS 2022; 73:105924. [PMID: 35947913 DOI: 10.1016/j.jfludis.2022.105924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/08/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of the current study was to document the pros and cons that adults who stutter may consider when deciding to change how they live with stuttering. METHODS Semi-structured interviews were conducted with 11 adults who stutter and 12 speech-language pathologists who specialize in stuttering therapy. Participants were asked to identify and discuss the advantages and disadvantages of making a change to how they live with stuttering. Reflexive thematic analysis was used to generate multilevel themes. RESULTS Meaningful units were extracted from interview transcripts to develop 37 discrete pros and 15 discrete cons. The pros of change clustered into five organizing themes: enriching one's social relationships, feeling better in social interactions, developing a healthier sense of self, gaining autonomy, and communicating easier. The cons of change clustered into three organizing themes: experiencing discomfort, expending resources, and recognizing that some things may not change. CONCLUSION This study documented why adults who stutter may or may not seek change. Identifying the pros and cons of behavior change is an important step in understanding why some clients who stutter are ambivalent about, or resistant to, the therapeutic process.
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Affiliation(s)
- Hope Gerlach-Houck
- Dept of Speech, Language & Hearing Sciences, Western Michigan University, USA.
| | - Naomi H Rodgers
- Dept of Special Education & Communication Disorders, University of Nebraska-Lincoln, USA
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Suijkerbuijk Y, Nieuwenhuijsen K. Identification of the return-to-work mode in unemployed workers with mental health issues: A focus group study among occupational health professionals. Work 2022; 74:891-906. [PMID: 35527604 DOI: 10.3233/wor-210434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Return-to-work (RTW) perceptions and attitudes are predictive for future work participation in workers with mental health issues. OBJECTIVE: To identify what RTW perceptions and attitudes occupational health professionals recognize in sick-listed unemployed workers with mental health issues and how these perceptions and attitudes can be systematically assessed. METHODS: Four focus group sessions, each involving five-six different occupational health professionals, were held. The audio records were transcribed verbatim and coded by two researchers independently. A thematic analysis was conducted. RESULTS: Professionals recognized RTW perceptions and attitudes in sick-listed unemployed workers with mental health issues. These perceptions and attitudes were described as characteristics of three modes in a process regarding RTW: the passive, ambivalent and active RTW mode. A passive RTW mode includes perceptions about not being able to work and an expectant attitude. The ambivalent RTW mode is characterized by uncertainty and ambivalence regarding RTW with a desire for occupational support. Workers in an active RTW mode have positive RTW perceptions and show job search behavior. A main theme was the flexible nature of RTW attitudes and perceptions, with workers switching between the passive, ambivalent and active RTW modes. For the assessment of the RTW mode, the professionals preferred personal contact, possibly with support of a tool. This enables them to ask specific questions and to observe non-verbal signs. CONCLUSIONS: Recurring assessments of the RTW mode can be helpful in identifying unemployed workers with mental health issues at risk of long-term sickness absence and for starting targeted RTW interventions.
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Affiliation(s)
- Yvonne Suijkerbuijk
- Amsterdam UMC, Location University of Amsterdam, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Research Center for Insurance Medicine, Meibergdreef 9, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, Location University of Amsterdam, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Research Center for Insurance Medicine, Meibergdreef 9, Amsterdam, The Netherlands
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Growing pains: Lessons learned from a failed mobile mindfulness clinical trial for patients with complex care needs. Contemp Clin Trials Commun 2022; 26:100858. [PMID: 35079658 PMCID: PMC8777278 DOI: 10.1016/j.conctc.2021.100858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
Abstract
This paper discusses lessons learned from a failed clinical trial investigating the use of a mobile application (app) to deliver a mindfulness intervention to middle-aged and older adults receiving services at a rehabilitation hospital in Ontario, Canada. A randomized controlled trial with 82 participants was planned, with the experimental group receiving access to a mindfulness app and a wait-list control group receiving access to the app after 4 weeks; however, the study could not be completed due to low recruitment rates. This implementation failure was considered from the perspective of the PARIHS framework. More specifically, Three key recruitment challenges were identified, and recommendations for future research provided. Firstly, the increasingly complex care needs of the study population appeared to influence eligibility; it would be beneficial for future research to consider adopting strategies to better understand the needs of the target population. Secondly, participants’ stage of care and readiness of change likely negatively influenced compliance and retention in this study, and should be assessed in future research. Finally, a lack of clinician integration into the research team negatively impacted recruitment in this study; future studies should consider integrating direct service providers into the research team as this may increase buy-in and referral rates. The challenges and recommendations outlined can inform design and implementation of future studies in this area.
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Galovan AM, Hawkins AJ, Harris SM, Simpson DM. What are they doing? A national survey of help-seeking and relationship-repair behavior of individuals who are thinking about divorce. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:371-390. [PMID: 33405252 DOI: 10.1111/jmft.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Guided by the Stages of Change (SOC) model, we explored relationship-repair behaviors among those thinking about divorce, employing a recent national longitudinal survey of married individuals (N = 745). Person-centered analyses explored whether there were distinct typologies of relationship-repair behaviors. We found four distinct classes: Intense Seekers (6%), who engaged at high levels of all kinds of repair behaviors, including professional services; Moderate-fading Seekers (14%), who engaged in moderate levels of various repair behaviors, including professional services, but did not sustain that behavior over a year; and Minimal-private Seekers (42%) and Private-sustained Seekers (38%), who eschewed professional services and engaged in low-to-moderate personal and private repair behaviors. We discuss possible applications of the SOC model to the divorce decision-making process and conclude with implications for practice, including the need to allocate greater attention to personal and self-help interventions that match the way most people try to repair their relationships.
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Affiliation(s)
- Adam M Galovan
- Department of Human Ecology, University of Alberta, Edmonton, AB, Canada
| | - Alan J Hawkins
- School of Family Life, Brigham Young University, Provo, UT, USA
| | - Steven M Harris
- Department of Family Social Sciences, University of Minnesota, St. Paul, MN, USA
| | - David M Simpson
- School of Family Life, Brigham Young University, Provo, UT, USA
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Rodgers NH. Meet Them Where They're At: Maximizing Adolescents' Engagement in Stuttering Therapy. Semin Speech Lang 2022; 43:161-172. [PMID: 35697037 DOI: 10.1055/s-0042-1742450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Adolescents who stutter often pose a unique clinical challenge for clinicians. They are a population simultaneously striving for independence from adults and social connection with their peers at a time when social fears surge and lifelong habits take root. It is a time when they may seem "unmotivated" to learn and utilize new communication or coping skills related to stuttering. How can clinicians maximize adolescents' engagement in stuttering therapy to improve meaningful outcomes? The purpose of this article is to describe a transtheoretical approach to assessing adolescents' readiness to make positive changes to living with stuttering, and to provide motivational interviewing strategies that clinicians can employ to help propel adolescents toward personally significant change. These principles will be applied to the case study of a 14-year-old who stutters to demonstrate how clinicians can put this approach to work as they meet their adolescent clients "where they're at."
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Affiliation(s)
- Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska
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Chang CF, Wang JY, Kuo TH, Lin YL, Yang SY. Stages of Change in Dairy Intake among Older Adults: Application of the Transtheoretical Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031146. [PMID: 35162169 PMCID: PMC8835001 DOI: 10.3390/ijerph19031146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023]
Abstract
Adequate dairy product intake can reduce the risk of chronic disease, mortality, low quality of life, and healthcare expenditure. However, the insufficient consumption of dairy products is a serious issue in Eastern societies. To the authors’ knowledge, few studies have explored dairy intake among Taiwanese older adults, especially using the transtheoretical model. The study aims were to address the following unknowns: (i) the distribution of dairy product intake behavior on stages of change (SOC); (ii) differences in variables (intake knowledge (IK), intake cons (IC), intake pros (IP), and intake self-efficacy (ISE)) among SOCs; (iii) discriminative abilities of variables on SOCs; and (iv) predictive ability of variables (IK, IC, IP, and ISE) for dairy product intake behavior on SOC for older adults. An explorative cross-sectional study was conducted to collect data from northern Taiwan using a questionnaire. A total of 342 older adults were recruited. Data were analyzed using multivariate analysis of variance, discriminant analysis, and multiple linear regression. There was a significant difference between the variables and SOCs. There was a better discriminant among the five SOCs. Dairy product intake behaviors were significantly associated with knowledge and self-efficacy in the pre-action stage, and with cons, pros, and self-efficacy in the post-action stage. In conclusion, appropriate nutritional empowerment could benefit older adults by improving dairy intake among the different SOCs.
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Affiliation(s)
- Cheng-Fen Chang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan; (C.-F.C.); (J.-Y.W.)
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung 203301, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan; (C.-F.C.); (J.-Y.W.)
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404332, Taiwan
| | - Tien-Ho Kuo
- Department of Leisure Management, Tungnan University, New Taipei City 222304, Taiwan;
| | - Ying-Lien Lin
- Department of Industrial and Information Management, National Cheng Kung University, Tainan 701401, Taiwan;
| | - Shang-Yu Yang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan; (C.-F.C.); (J.-Y.W.)
- Correspondence: ; Tel.: +886-4-23323456
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Ge J, Wang L, Peng X, Zhang C, Zhao S, Zhou M, Tang S, You H. Behaviour model integrated by protection motivation theory and information-motivation-behavioural skills model applying in pregnancy weight management (PrInMAMa): a study protocol for a randomised controlled trial in China. BMJ Open 2022; 12:e051275. [PMID: 35022170 PMCID: PMC8756262 DOI: 10.1136/bmjopen-2021-051275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Excessive gestational weight gain poses a significant threat to maternal and child health. The healthy behaviour theory has been increasingly applied to weight management during pregnancy, but research is still insufficient. The successful application of the protection motivation theory (PMT) and the information-motivation-behavioural skills (IMB) model in the field of healthy behaviour laid the foundation for this intervention study. The overall aim of this study is to test the effectiveness of interventions based on the behaviour model integrated with the PMT and IMB model (PMT-IMB model) on weight management and provide feasible methods for weight management during pregnancy. METHODS AND ANALYSIS This prospective, single-centre, randomised controlled trial involves two steps. First, based on the PMT-IMB model, evaluation tools and intervention materials will be developed. Second, more than 800 women in the first trimester of pregnancy will be randomly assigned to two groups and will be followed until 1 week after delivery. The control group will receive standardised antenatal care (ANC), whereas the experimental group will receive both standardised ANC and interventions based on the PMT-IMB model. After three surveys (at enrolment, at 28 weeks of gestation, and on the day of hospitalisation for delivery), primary outcomes (scores of the subscales of the PMT-IMB model, scores of the pregnancy weight management strategy scale, and gestational weight gain) and secondary outcomes (pregnancy outcomes and pregnancy complications) will be obtained. Differences in outcomes between the two groups will be analysed to evaluate the effectiveness of the intervention. ETHICS AND DISSEMINATION The study protocol has been approved by the ethics committee of Nanjing Medical University. All participants will sign an informed consent form prior to enrolment. The findings of the study will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER ChiCTR2100043231.
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Affiliation(s)
- Jinjin Ge
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li Wang
- Department of Gynaecology and Οbstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu, China
| | - Xueqing Peng
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shiqi Zhao
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Meng Zhou
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shaowen Tang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hua You
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, Jiangsu, China
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Abrash Walton A, Nageotte NL, Heimlich JE, Threadgill A. Facilitating behavior change: Introducing the Transtheoretical Model of Behavior Change as a conservation psychology framework and tool for practitioners. Zoo Biol 2022; 41:386-397. [PMID: 35608042 PMCID: PMC9790313 DOI: 10.1002/zoo.21704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/02/2022] [Accepted: 05/10/2022] [Indexed: 12/30/2022]
Abstract
The primary opportunities for improved conservation and sustainability outcomes are through changing human behavior. Zoos, aquariums, and other public-facing biodiversity conservation institutions offer an important space for environmental learning and facilitating proenvironmental behavior change. We have focused, in this review, on examining common behavior change models as well as the Transtheoretical Model (TTM) of Behavior Change, a widely regarded model within the health fields and, recently, in the fields of environmental and leadership studies, with new research applying the TTM specifically in a zoo setting. We have discussed critiques of the TTM and rebuttals to those critiques. We have presented examples of TTM applications in a zoo setting. Our objective has been to explore the TTM as a possible "best fit" framework and tool for zoo and aquarium practitioners in facilitating proenvironmental behavior. Key findings include that (a) the TTM differs significantly from other proenvironmental behavior theoretical models, including those that are prevalent in the conservation psychology literature and applied by zoos and aquariums, in terms of the TTM stages of change and processes of change constructs; (b) the TTM appears to overlap significantly with the 10 interventions or treatments identified by researchers as the most effective approaches to facilitating proenvironmental behavior; and (c) there is nascent and promising application of TTM constructs in zoo and aquarium programming. We remain impressed by the potential of the TTM to address a critical question within the conservation psychology research field concerning proenvironmental behavior: what specific tools to employ and when.
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Affiliation(s)
- Abigail Abrash Walton
- Department of Environmental StudiesAntioch University New EnglandKeeneNew HampshireUSA
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15
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Lee MK. Decisional balance, self-leadership, self-efficacy, planning, and stages of change in adopting exercise behaviors in patients with stomach cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 56:102086. [PMID: 34942589 DOI: 10.1016/j.ejon.2021.102086] [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: 03/16/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Previous studies have suggested the benefits of regular exercise in motivating the survivors of cancer; however, most survivors are insufficiently active, showing high rates of nonadherence to physical activity guidelines. Using the I-Change model, this study sought to determine the association of decisional balance and self-efficacy for exercise, planning, and self-leadership with the stages of change in exercise behavior among patients with stomach cancer. METHODS This cross-sectional study was conducted in February 2021 and included 145 patients diagnosed with primary stomach cancer via quota sampling in South Korea. Sociodemographics, comorbidity, decisional balance for exercise, self-efficacy for exercise, planning, self-leadership, and stages of change in exercise behavior were assessed. RESULTS Of the participants, 4% were in the precontemplation stage of exercise behavior, 10% contemplation, 37% preparation, 23% action, and 27% maintenance. The male sex (p = 0.043), higher self-efficacy for resisting relapse (p < 0.0001), higher coping planning (p = 0.029), and higher self-leadership for behavior awareness and volition (p = 0.023) were associated with more readiness for changes in exercise behavior. CONCLUSIONS From the results obtained using the I-Change model, self-efficacy for resisting relapse to previous habits, coping planning, and behavior awareness and volition were associated with more readiness for changes in exercise behavior. These findings may help reduce stomach cancer survivors' nonadherence to physical activity guidelines.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
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16
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Rodgers NH, Gerlach H, Paiva AL, Robbins ML, Zebrowski PM. Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part II. Exploratory Scale Validation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2510-2527. [PMID: 34637348 DOI: 10.1044/2021_ajslp-21-00108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This article is the second in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. The purpose of this article was to apply and explore the validity of newly developed Transtheoretical measures for adolescents who stutter. Method The online survey was completed by a national sample of 173 adolescents who stutter between the ages of 13 and 21 years. The multipart survey included a Stage of Change scale, Decisional Balance scale, and Situational Self-Efficacy scale. Participants also completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), either the teenage or adult version depending on the participant's age, so preliminary construct validity of the new scales could be examined. Exploratory factor analyses were conducted to determine model fit and reduce the scales to the most meaningful items. External validity of the three-part survey was examined by comparing OASES scores across stage of change as well as evaluating the functional relations between the three scales. Results Adolescents' readiness to manage stuttering could be clearly described with five discrete stages, although most of the respondents reported being in the Maintenance stage. The pros of managing stuttering reliably predicted stage placement. Internal consistency of the scales ranged from good to excellent. OASES scores differed across stages of readiness in complex but predictable ways. Conclusions These findings suggest that the Transtheoretical Model fits the target behaviors involved stuttering management among adolescents. Further examination of the application of the model to validate a stage-based framework for change among individuals who stutter is warranted.
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Affiliation(s)
- Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln
| | - Hope Gerlach
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Andrea L Paiva
- Department of Psychology, University of Rhode Island, Kingston
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston
| | - Patricia M Zebrowski
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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17
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Yusufov M, Orchowski LM. Readiness to engage in assertive responding, self-protective dating behaviors, and sexual communication: A transtheoretical model-based analysis of college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:959-970. [PMID: 32027242 DOI: 10.1080/07448481.2020.1719111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 12/27/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
Objective: Most sexual assault prevention approaches are universal in nature. The present study evaluated a Transtheoretical Model (TTM)-based Stages of Change (SOC) measure assessing readiness to utilize sexual assault risk reduction skills. The measure was evaluated with regard to Decisional Balance and Self-Efficacy. Participants: Survey data were collected from 300 college women (Mage=18.5, SD = 0.79). Methods: Three SOC measures were developed and evaluated for using: 1) assertive responding; 2) self-protective dating behaviors; and 3) open sexual communication. Item development was followed by exploratory, confirmatory, and external validation analyses. Results: Exploratory Factor Analysis (EFA) indicated two, six-item factors (Positive Outcomes α=.91; Negative Outcomes α=.85) for Decisional Balance. Confirmatory Factor Analyses (CFA) supported a two-factor correlated model, χ2(66)=2101.70, p<.001, CFI=.946, RMSEA=.083. For Self-Efficacy, EFA indicated one, six-item factor (α=.81). Conclusions: These readiness assessments may guide understanding of factors influencing sexual assault risk reduction program outcomes and aid in tailoring program content.
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Affiliation(s)
- Miryam Yusufov
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Deparment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsay M Orchowski
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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18
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Fenn N, Reyes C, Monahan K, Robbins ML. How Ready Are Young Adults to Participate in Community Service? An Application of the Transtheoretical Model of Behavior Change. Am J Health Promot 2021; 36:64-72. [PMID: 34296641 DOI: 10.1177/08901171211034742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Engaging in community service, or unpaid work intended to help people in a community, is generally associated with greater overall well-being. However, the process of beginning and maintaining community service engagement has been sparsely examined. The current study applied the Transtheoretical Model (TTM) of behavior change to understanding community service readiness among young adults. DESIGN Cross-sectional design using an online survey. SETTING Participants were undergraduate students recruited at a mid-sized Northeastern US university in Spring 2018. SAMPLE Participants (N = 314) had a mean age of 20.36 years (SD = 3.69), were primarily White (78%), female (72%), and from moderately high socioeconomic backgrounds (as measured by parental level of education). MEASURES Socio-demographics including age, gender, race-ethnicity, and parental level of education; readiness, pros, cons, and self-efficacy for community service; civic engagement behavior; well-being. ANALYSIS Participants were classified into very low (n = 62), low (n = 59), moderate (n = 92), high (n = 46), and very high (n = 55) readiness for community service groupings. A MANOVA was conducted to assess relationships between groupings and community service TTM constructs, civic engagement, and well-being. RESULTS There were significant differences between readiness groupings on all main outcome variables, F(20, 1012) = 10.34, p < .001; Wilks' Λ = 0.54, η2 = .14. Post-hoc Games-Howell tests showed that those exhibiting higher levels of readiness reported fewer cons, greater pros, higher self-efficacy, more overall civic engagement, and greater well-being compared to lower readiness individuals. CONCLUSION Consistent with previous TTM applications, self-efficacy and the importance of pros increased across readiness groupings while the importance of cons decreased. Study findings may be used to inform readiness-tailored interventional work for increasing community service. This area of study would benefit from longitudinal research examining community service readiness beyond the college environment.
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Affiliation(s)
- Natalie Fenn
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Kathleen Monahan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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19
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Sakane N, Oshima Y, Kotani K, Suganuma A, Takahashi K, Sato J, Suzuki S, Izumi K, Kato M, Noda M, Kuzuya H. Impact of telephone support programme using telemonitoring on stage of change towards healthy eating and active exercise in people with prediabetes. J Telemed Telecare 2021; 27:307-313. [PMID: 33966526 DOI: 10.1177/1357633x211010981] [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: 11/16/2022]
Abstract
INTRODUCTION This study evaluated the impact of a telephone support programme with telemonitoring on changes in healthy eating and active exercise in adults with prediabetes using the stage of change framework. METHODS We performed a post hoc analysis using data from the Japan Diabetes Outcome Trial-1. A total of 2607 participants aged 20-65 years with impaired fasting glucose were recruited from the workplace/community in Japan and randomized to a one year telephone support programme intervention arm (n = 1240) or self-directed control arm (n = 1367). Participants in both arms received monthly data feedback from a weight scale and pedometer. The main outcome measure was the stages of change toward healthy eating and active exercise. The secondary outcome was fasting plasma glucose (FPG). RESULTS After the one year intervention, the adjusted odds ratio of progressing to the action/maintenance stage in the intervention vs. control arm for healthy eating was 1.31 (95% confidence interval (CI) 1.21-1.43; p < 0.001), but that for active exercise was 1.07 (95% CI 0.99-1.15; p = 0.062). The intervention decreased FPG levels in participants in the contemplation stage, but not in the precontemplation, preparation and action/maintenance stages. DISCUSSION These findings suggest that the telephone support programme by healthcare providers advanced the stage of changes toward healthy eating in people with prediabetes. In particular, it decreased FPG levels in the contemplation stage.
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Affiliation(s)
- Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Yoshitake Oshima
- Faculty of Humanities and Social Sciences, University of Marketing and Distribution Scienc,Hyogo Japan
| | - Kazuhiko Kotani
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan.,Division of Community and Family Medicine, Jichi Medical University, Japan
| | - Akiko Suganuma
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Kaoru Takahashi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan.,Hyogo Health Service Association, Japan
| | - Juichi Sato
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Kazuo Izumi
- National Center for Global Health and Medicine, Japan
| | | | - Mitsuhiko Noda
- Ichikawa Hospital, International University of Health and Welfare, Japan
| | - Hideshi Kuzuya
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan.,Koseikai Takeda Hospital, Japan
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Bozdağ N, Çuhadar D. Internalized stigma, self-efficacy and treatment motivation in patients with substance use disorders. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Neslihan Bozdağ
- Medicine Faculty, Şahinbey Research and Practice Hospital, Gazantep University, Gaziantep, Turkey
| | - Döndü Çuhadar
- Health Science Faculty, Psychiatric Nursing Department, Gaziantep University, Gaziantep, Turkey
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Tabak RG, Bauman AA, Holtrop JS. Roles dissemination and implementation scientists can play in supporting research teams. Implement Sci Commun 2021; 2:9. [PMID: 33451364 PMCID: PMC7811259 DOI: 10.1186/s43058-020-00107-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
The field of dissemination and implementation (D&I) science is rapidly growing, with many scientists seeking to apply D&I science to enhance and expand the impact of their work. As the D&I field grows and collaborations of implementation scientists with other fields flourish, a description for the roles for D&I scientists as they collaborate with researchers from other fields could be beneficial. This paper exemplifies how the D&I scientist/researcher collaborative process might work and important elements to consider in doing so, as well as provide an outline on how collaborations might progress for different project needs. This is discussed through example scenarios to consider an implementation scientists' engagement in a research project and describe potential roles for implementation scientists in supporting research teams. We then discuss characteristics to consider when incorporating a D&I expert into a team and considerations in navigating the scenarios.
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Affiliation(s)
- Rachel G Tabak
- Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA.
- Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Ana A Bauman
- Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Jodi Summers Holtrop
- Department of Family Medicine and Dissemination and Implementation Research Program of the Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA
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22
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Hong JM, Lee W. The stages‐of‐change approach for prosocial behavior: Message tailoring to encourage blood donation. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/jasp.12727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ji Mi Hong
- School of Global Convergence Studies INHA University Incheon South Korea
| | - Wei‐Na Lee
- F.J. Heyne Centennial Professor Emerita in Communication Stan Richards School of Advertising & Public Relations Moody College of CommunicationThe University of Texas at Austin Austin TX USA
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23
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Xu Z, Geng J, Zhang S, Zhang K, Yang L, Li J, Li J. A Mobile-Based Intervention for Dietary Behavior and Physical Activity Change in Individuals at High Risk for Type 2 Diabetes Mellitus: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e19869. [PMID: 33141092 PMCID: PMC7671838 DOI: 10.2196/19869] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intensive lifestyle modifications have proved effective in preventing type 2 diabetes mellitus (T2DM), yet the efficiency and effectiveness of these modifications need to be improved. Emerging social media interventions are considered useful in promoting these lifestyles; nevertheless, few studies have investigated the effectiveness of combining them with behavior theory. OBJECTIVE This study aims to examine the effectiveness of a 6-month mobile-based intervention (DHealthBar, a WeChat applet) combined with behavioral theory compared with a printed intervention in improving dietary behaviors, physical activity, and intention to change these behaviors among populations at high risk for T2DM. METHODS Participants aged 23 to 67 years were recruited offline in Beijing, China, and were randomized into the intervention group or the control group, which received educational content via DHealthBar or a printed handbook, respectively. Educational materials were culturally tailored recommendations on improving dietary behaviors, physical activity, and intention to change based on the transtheoretical model. Participants in the intervention arm received push notifications twice per week on WeChat and had access to the educational content for the 6-month study period. Participants in the control arm received the same intervention content through printed materials. The outcomes of participants' behavior change, intention to change behavior, and anthropometric characteristics were collected via online measuring tools at baseline, 3 months, and 6 months. RESULTS In this study, 79 enrolled individuals completed baseline information collection (control: n=38 vs intervention: n=41), and 96% (76/79) completed the 6-month follow-up visit. Attrition rates did not differ significantly between the 2 groups (χ21=0.0, P=.61). Baseline equivalence was found. Participants in both groups reported a statistically significant decrease in energy intake at the 2 follow-up assessments compared with baseline (3 months, control: exp[β]=0.83, 95% CI 0.74-0.92 vs intervention: exp[β]=0.76, 95% CI 0.68-0.85; 6 months, control: exp[β]=0.87, 95% CI 0.78-0.96 vs intervention: exp[β]=0.57, 95% CI 0.51-0.64). At 6 months, a significantly larger decrease was observed in the intervention group in energy, fat, and carbohydrate intake, accompanied with a significantly larger increase in moderate-intensity physical activity compared with the control group (energy: exp[β]=0.66, 95% CI 0.56-0.77; fat: exp[β]=0.71, 95% CI 0.54-0.95; carbohydrates: exp[β]=0.83, 95% CI 0.66-1.03; moderate-intensity physical activity: exp[β]=2.05, 95% CI 1.23-3.44). After 6 months of the intervention, participants in the intervention group were more likely to be at higher stages of dietary behaviors (exp[β]=26.80, 95% CI 3.51-204.91) and physical activity (exp[β]=15.60, 95% CI 2.67-91.04) than the control group. CONCLUSIONS DHealthBar was initially effective in improving dietary behavior, physical activity, and intention to change these behaviors among populations who were at high risk of developing T2DM, with significant differences in the changes of outcomes over the 6-month intervention period. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000032323; https://tinyurl.com/y4h8q4uf.
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Affiliation(s)
- Zidu Xu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Ji Geng
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Shuai Zhang
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Kexin Zhang
- Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Yang
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Jiao Li
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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24
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Sannes TS, Pirl WF, Rossi JS, Grebstein L, Redding CA, Ferszt GG, Prochaska JO, Braun IM, Yusufov M. Identifying patient-level factors associated with interest in psychosocial services during cancer: A brief report. J Psychosoc Oncol 2020; 39:686-693. [PMID: 33107411 DOI: 10.1080/07347332.2020.1837329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Uptake of psychosocial services during cancer treatment remains relatively low. To use these services efficiently, novel approaches - based on evidence-based theory - are needed to understand cancer patients' readiness to seek psychosocial services. Guided by the transtheoretical model (TTM), we investigated individuals' readiness to use psychosocial services by assessing decisional conflict (pros/cons) and self-efficacy, which are established as the most important constructs of predicting a specific behavior. METHODS In these secondary analyses, we examined demographic and treatment-related factors in a national sample of adult cancer patients and survivors in the United States as predictors of decisional balance (pros/cons) and self-efficacy (i.e., two core TTM constructs) of engaging in psychosocial services. Participants were recruited through an online survey. In addition to examining demographic factors (age, sex, race, and marital status) as independent variables using t tests and correlations, treatment-related variables, such as having multiple cancers, type of cancer, type of treatment, and treatment setting were included. RESULTS Four hundred and sixty-six participants completed the survey. The sample was primarily Caucasian (79%) and female (54.7%); average age was 47.9 (SD = 14.8). While no significant relationships emerged for self-efficacy, younger age and non-Caucasian race were significantly related to greater cons of seeking psychosocial care. Finally, those with multiple cancers versus reporting only one malignancy endorsed more cons of seeking psychosocial care. CONCLUSIONS These data highlight the importance of measuring the cons of seeking psychosocial care during cancer treatment, with younger age, non-Caucasian, and those reporting experience with multiple cancers endorsing greater cons. This may impact eventual uptake of available services. Future research should identify individuals at risk for declining services based on perceived cons of seeking psychosocial care during cancer.
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Affiliation(s)
- Timothy S Sannes
- Division of Adult Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - William F Pirl
- Division of Adult Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph S Rossi
- Department of Psychology, The University of Rhode Island, Kingston, Rhode Island, USA
| | | | - Colleen A Redding
- Department of Psychology, The University of Rhode Island, Kingston, Rhode Island, USA
| | - Ginette G Ferszt
- Department of Psychology, The University of Rhode Island, Kingston, Rhode Island, USA
| | - James O Prochaska
- Department of Psychology, The University of Rhode Island, Kingston, Rhode Island, USA
| | - Ilana M Braun
- Division of Adult Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Division of Adult Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
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25
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Tessaro VCZ, Silva AMR, Loch MR. Stages of change for leisure time physical activity in Brazilian adults: longitudinal study. CIENCIA & SAUDE COLETIVA 2020; 26:2969-2980. [PMID: 34378690 DOI: 10.1590/1413-81232021268.18022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze the maintenance of and movement between stages of change for leisure time physical activity (LTPA) after four years and the association with sociodemographic characteristics. A cross-sectional population-based study was conducted with 1,180 individuals aged 40 years or over in 2011. In 2015, 885 participants were reinterviewed. The dependent variables were the maintenance of and movement between stages of change for LTPA behavior. The data was analyzed using adjusted Poisson regression. We found that around 40% of the study participants were still at the same stage they were at in the first assessment, while 31.6% had relapsed and 27% had advanced at least one stage. The stages that showed the highest frequencies were remained in precontemplation and maintenance. The risk of remaining at the precontemplation stage was higher among men (RR=1.59; 95%CI:1.21-2.11), respondents aged ≥60 years (RR=1.35; 95%CI:1.03-1.78), those with a lower level of education (RR=1.24; 95%CI:1.04-2.33), and those from economic classes C and D/E (RR=1.71; 95%CI:1.17-2.49 and RR=1.88; 95%CI:1.12-3.18, respectively). The frequency of individuals who remained at the maintenance stage was significantly lower in economic classes D/E than in classes A/B (RR=0.35; 95%CI:0.14-0.87).
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Affiliation(s)
- Valéria Cristina Zamataro Tessaro
- Programa de Pós-Graduação em Fisioterapia, Universidade Estadual de Londrina. Av. Robert Koch 60 Caixa Postal 791, Bairro Cervejaria. 86038-440 Londrina PR Brasil.
| | - Ana Maria Rigo Silva
- Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual de Londrina. Londrina PR Brasil
| | - Mathias Roberto Loch
- Departamento de Fundamentos da Educação Física, Centro de Educação Física e Desportos, Universidade Estadual de Londrina. Londrina PR Brasil
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Redding CA, Goldberg D, Weber KM, Yin HQ, Paiva AL, Burke-Miller J, Cohen MH, Rossi JS. Cross-validation of transtheoretical model smoking cessation measures in Chicago WIHS women smokers with and at risk for HIV. Transl Behav Med 2020; 10:457-468. [PMID: 30715533 PMCID: PMC7237546 DOI: 10.1093/tbm/ibz001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
People with and at risk for HIV have high rates of smoking, increasing their morbidity and mortality. Effective cessation interventions are needed for this group. Transtheoretical model (TTM)-tailored interventions have demonstrated efficacy, but measures need cross-validation in this population. TTM cessation measures were evaluated in women smokers with and at risk for HIV (N = 111) from Chicago Women's Interagency HIV Study (WIHS). Confirmatory factor analyses evaluated measurement models. MANOVAs examined relationships between constructs and stage subgroups. For decisional balance, the two-factor uncorrelated model was best (χ2(20) = 13.96; comparative fit index [CFI], 1.0; root mean square error of approximation [RMSEA] = .00), with good (pros α = .78) and fair (cons α = .55) four-item alphas. The one-factor temptations model (α = .90) showed reasonable fit (χ2(18) = 80.22; CFI = .89; RMSEA = .177). Processes of change subscales had fair to good two-item alphas (α = .49-.77) and fit a 10-factor fully correlated model (χ2(125) = 222.72; CFI = .88; RMSEA = .084). MANOVAs by stage of change replicated expected patterns for the pros, overall temptations, and two process subscales with medium-sized effects (η2 = .06-.18). Contrary to expectations, no differences by stage were found for cons or temptation negative affect subscales. The structures of these TTM measures replicated with good internal and external validity, except for the cons, which needs refinement. Negative affect temptations was structurally sound, but did not vary by stage group potentially reflecting this sample's moderate depression levels and/or their reliance on smoking to deal with negative affect. Results support the use of most TTM measures in research and tailored interventions to increase smoking cessation among women smokers with and at risk for HIV and highlight the importance of managing negative affect in cessation materials targeting this group.
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Affiliation(s)
- Colleen A Redding
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - David Goldberg
- Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, IL, USA
| | - Kathleen M Weber
- The CORE Center at Cook County Health and Hospital System, Chicago, IL, USA
| | - Hui-Qing Yin
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andrea L Paiva
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Jane Burke-Miller
- The CORE Center at Cook County Health and Hospital System, Chicago, IL, USA
| | - Mardge H Cohen
- Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, IL, USA
- The CORE Center at Cook County Health and Hospital System, Chicago, IL, USA
| | - Joseph S Rossi
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
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Oveisi S, Stein LAR, Babaeepour E, Araban M. The impact of motivational interviewing on relapse to substance use among women in Iran: a randomized clinical trial. BMC Psychiatry 2020; 20:157. [PMID: 32272923 PMCID: PMC7147038 DOI: 10.1186/s12888-020-02561-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women in Iran are in great need of effective substance abuse services. The current study was conducted to investigate the effectiveness of motivational interviewing (MI) for women in treatment for drug use in Iran. METHOD The sample (N = 60) included women in a drug treatment center in Qazvin (Iran) from August to December of 2017. The research sample included 60 female drug users randomly assigned to MI or Standard Care (SC). Prior to randomization women completed a baseline questionnaire and the Relapse Prediction Scale (RPS), which measures desire (urge) to use and probability of using/not using in risky situations (self-efficacy). MI consisted of eight 60-min group sessions over a 1-month period, twice weekly. At 2-months follow-up, data were gathered using a questionnaire similar to baseline. Mixed Model Analysis were used to determine group differences. RESULTS Mean age of participants was 30 years and average addiction duration was 7 years. Although the scores of the desire to use and the probability of drug use were not significant before the intervention, after the intervention, scores on desire to use and probability of use improved about 81.1% (F: 2230.15, P < 0.001, degrees of freedom: 63, 15) and 81.9%, (F: 749.39, P < 0.001, degrees of freedom: 79, 77), respectively, compared to those of control group. CONCLUSION The results showed that motivational interviewing could decrease desire to use and probability of use among female drug users. Motivational interviewing could play an important role in improving women's health in Iran. TRIAL REGISTRATION IRCT registration number: IRCT20140907019077N4 Registration date: 2017-12-12, 1396/09/21 Registration timing: registered_while_recruiting Last update: 2017-12-12, 1396/09/21.
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Affiliation(s)
- Sonia Oveisi
- grid.412606.70000 0004 0405 433XDepartment of Pediatrics, Faculty of Medicine, Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - L. A. R. Stein
- grid.20431.340000 0004 0416 2242Psychology Department, University of RI, Kingston, RI USA ,grid.40263.330000 0004 1936 9094Behavioral & Social Sciences Department, Brown University School of Public Health, Providence, RI USA ,RI Training School, Cranston, RI USA ,grid.40263.330000 0004 1936 9094Center for Prisoner Health & Human Rights, Brown University Medical School, Providence, RI USA
| | - Elham Babaeepour
- grid.412606.70000 0004 0405 433XDepartment of Midwifery, Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Sardi L, Idri A, Carrillo de Gea JM, Toval Á, Fernández-Alemán JL. Applying trans-theoretical model for blood donation among Spanish adults: a cross-sectional study. BMC Public Health 2019; 19:1724. [PMID: 31870328 PMCID: PMC6929449 DOI: 10.1186/s12889-019-8046-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relying solely on altruistic appeals may fail to fulfil the increasing demand for blood supplies. Current research has largely been attempted to determine and understand motives that serve as blood donation drivers. The Trans-Theoretical Model of behaviour change (TTM) can be used to conceptualise the process of intentional blood donation behaviour. METHODS A cross sectional survey of Spanish adults was conducted. The final sample consisted of 504 individuals who were administered a self-report questionnaire including the measures of demographic characteristics, Stages of Change, Processes of Change, Self-efficacy and Decisional Balance. Data were analysed by frequency analysis, MANOVA/ANOVA and correlation analysis. RESULTS Findings indicated that most of the behavioural and cognitive processes of change, self-efficacy and physical cons differentiated participants across the stages of change of blood donation. In contrast, eligibility cons and pros were less influential in stage transitions. Furthermore, significant correlations were observed between TTM constructs except for the physical cons and the processes of change. CONCLUSIONS The present study extensively supports and replicates the applicability of the TTM to blood donation behaviour change and offers important implications for the development of effective stage-matched interventions to increase blood donation.
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Affiliation(s)
- Lamyae Sardi
- Software Project Management research team, ENSIAS, University Mohammed V, Rabat, Morocco.
| | - Ali Idri
- Software Project Management research team, ENSIAS, University Mohammed V, Rabat, Morocco.,Complex Systems Engineering, University Mohamed VI Polytechnic, Ben Guerir, Morocco
| | | | - Ángel Toval
- Department of Human Anatomy and Psychobiology, School of Medicine, University of Murcia, Murcia, Spain.,Institute of Biomedical Research of Murcia (IMIB), Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
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Braganza DJ, Piedmont RL, Fox J, Fialkowski GM, Gray RM. Examining the Clinical Efficacy of Core Transformation: A Randomized Clinical Trial. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Dinesh J. Braganza
- College of Arts and SciencesLoyola University Maryland
- Now at Jnana‐Deepa VidyapeethPontifical Institute of Philosophy and ReligionPune India
| | - Ralph L. Piedmont
- College of Arts and SciencesLoyola University Maryland
- Now at Center for Professional StudiesTimonium Maryland
| | - Jesse Fox
- College of Arts and SciencesLoyola University Maryland
- Now at Department of Counselor EducationStetson University
| | | | - Richard M. Gray
- School of Criminal JusticeFairleigh Dickinson University (retired)
- Now at Research and Recognition ProjectCorning New York
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Stapelfeldt CM, Momsen AMH, Lund T, Grønborg TK, Hogg-Johnson S, Jensen C, Skakon J, Labriola M. Cross-Cultural Adaptation, Reliability and Validity of the Danish Version of the Readiness for Return to Work Instrument. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:325-335. [PMID: 29876726 DOI: 10.1007/s10926-018-9790-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The objective of the present study was to translate and validate the Canadian Readiness for Return To Work instrument (RRTW-CA) into a Danish version (RRTWDK) by testing its test-retest and internal consistency reliability and its structural and construct validity. Cross-cultural adaptation of the six-staged RRTW-CA instrument was performed in a standardised, systematic five-step-procedure; forward translation, panel synthesis of the translation, back translation, consolidation and revision by researchers, and finally pre-testing. This RRTW-DK beta-version was tested for its psychometric properties by intra-class correlation coefficient and standard error of measurement (n = 114), Cronbach's alpha (n = 471), confirmatory factor analyses (n = 373), and Spearman's rank correlation coefficient (n = 436) in sickness beneficiaries from a municipal employment agency and hospital wards. The original RRTW-CA stage structure could not be confirmed in the RRTWDK. The psychometric properties were thus inconclusive. The RRTW-DK cannot be recommended for use in the current version as the RRTW construct is questionable. The RRTW construct needs further exploration, preferably in a population that is homogeneous with regard to cause of sickness, disability duration and age.
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Affiliation(s)
- Christina Malmose Stapelfeldt
- Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.
- DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.
| | - Anne-Mette Hedeager Momsen
- Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
- DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
| | - Thomas Lund
- Centre for Social Medicine, Frederiksberg and Bispebjerg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Arhus C, Denmark
| | - Therese Koops Grønborg
- Section for Biostatistics, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Sheilah Hogg-Johnson
- Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
- Canadian Memorial Chiropractic College, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Chris Jensen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Øya Helsehus, Trondheim, Norway
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Telemark, Norway
| | - Janne Skakon
- Department of Psychology, Work and Organisational Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Merete Labriola
- Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
- DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
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Bredahl TVG, Christensen RS, Justesen JB, Christensen JR. Adherence to physical activity in a workplace setting – A qualitative interview study. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1581446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
| | | | - Just Bendix Justesen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark
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von Sternberg K, DiClemente CC, Velasquez MM. Profiles of behavior change constructs for reducing alcohol use in women at risk of an alcohol-exposed pregnancy. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:749-758. [PMID: 30451517 DOI: 10.1037/adb0000417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using data from Project CHOICES, a randomized controlled trial to test an intervention to prevent alcohol-exposed pregnancies, this study examined process of change profiles composed of Transtheoretical Model of Change (TTM) constructs for alcohol. The primary purpose was to identify a profile of TTM variables associated with reduced drinking. Participants (n = 570) were women at risk of an alcohol-exposed pregnancy recruited from high risk settings. Profile analyses compared end-of-treatment (i.e., 3 months postintake) TTM construct mean profiles for women who reduced drinking to below NIAAA-defined risk levels1 (changers) with women who continued to drink at risk levels (nonchangers) at the 9-month follow-up. TTM construct profiles included experiential and behavioral processes of change, pros and cons for change, confidence to reduce drinking, and temptation to drink above risk levels. Results revealed a parallelism effect or interaction (p < .001) in the end-of-treatment TTM construct profiles for the changers versus the nonchangers at the 9-month follow-up. Changers reported greater pros (p < .001) and lower cons for change (p = .012), greater confidence (p = .030), lower temptation (p < .001) and greater use of the experiential (p < .001) and behavioral processes of change (p < .001). A larger percentage of the women from the CHOICES intervention were in the end-of-treatment profile of the changers (48%) compared with the control condition (39%; p = .042). Interventions can potentially be enhanced by clinicians' understanding what successful change "looks like" for specific clients in terms of their process use, decisional balance, and self-efficacy, allowing for tailored interventions targeted to each client's specific strengths and deficits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Kirk von Sternberg
- Health Behavior Research and Training Institute, The University of Texas at Austin
| | | | - Mary M Velasquez
- Health Behavior Research and Training Institute, The University of Texas at Austin
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Curry M, Marshall B, Crossler RE, Correia J. InfoSec Process Action Model (IPAM). DATA BASE FOR ADVANCES IN INFORMATION SYSTEMS 2018. [DOI: 10.1145/3210530.3210535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
While much of the extant InfoSec research relies on single assessment models that predict intent to act, this article proposes a multi-stage InfoSec Process Action Model (IPAM) that can positively change individual InfoSec behavior. We believe that this model will allow InfoSec researchers to focus more directly on the process that leads to action and develop better interventions that address problematic security behaviors. Building on successful healthcare efforts that resulted in smoking cessation, regular exercise, and a healthier diet, among others, IPAM is a hybrid predictive process approach to behavioral InfoSec improvement. IPAM formulates the motivational antecedents of intent as separate from the volitional drivers of behavior. Singular fear appeals often seen in InfoSec research are replaced by more nuanced treatments appropriately differentiated to support behavioral change as part of a process; phase-appropriate measures of self-efficacy are employed to more precisely assess the likelihood that a participant will act on good intentions; and decisional balance assessment of pro and con perceptions is monitored over time. These notions better align InfoSec research with both leading security practice and successful comparators in healthcare. We believe IPAM can both help InfoSec research models better explain actual behavior and better inform practical security behavior improvement initiatives.
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Sillice MA, Morokoff PJ, Ferszt G, Bickmore T, Bock BC, Lantini R, Velicer WF. Using Relational Agents to Promote Exercise and Sun Protection: Assessment of Participants' Experiences With Two Interventions. J Med Internet Res 2018; 20:e48. [PMID: 29415873 PMCID: PMC5822036 DOI: 10.2196/jmir.7640] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/27/2017] [Accepted: 12/06/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Relational agents (RAs) are electronic computational figures designed to engage participants in the change process. A recent study, Project RAISE, tested the effectiveness of RAs, combined with existing computer-based interventions to increase regular exercise and sun protection behaviors. Results showed these interventions can be effective but need further development. OBJECTIVE The purpose of this study was to examine participants' experiences using RAs to increase participant engagement and promote behavior change . METHODS A qualitative approach was primarily utilized. A 25-question interview guide assessed different components of participants' experiences with the intervention, including motivation, engagement, satisfaction or dissatisfaction, quality of their interaction with the RA, and behavior change. Quantitative assessment of satisfaction was based on a scale of 1 to 10, with 1 representing least satisfied and 10 representing most satisfied. A summative analytic approach was used to assess individuals' qualitative responses. A single analysis of variance (ANOVA) examined levels of satisfaction by gender. RESULTS Of the original 1354 participants enrolled in Project RAISE, 490 of 1354 (36%) were assigned to the RA group. A sample of 216 out of 490 (44%) participants assigned to the RA group completed the interventions, and follow-up assessments were contacted to participate in the semistructured interview. A total of 34 out of 216 (16%) completed the interview. Participants were motivated by, and satisfied with, the intervention. Participants viewed the RA as supportive, informative, caring, and reported positive behavior change in both exercise and sun protection. Some participants (15/34, 44%) noted the RA was less judgmental and less "overbearing" compared with a human counselor; other participants (12/34, 35%) said that the interaction was sometimes repetitive or overly general. The majority of participants (22/34, 65%) viewed the RA as an important contributor to their behavior change for exercise, sun protection, or both. Levels of satisfaction ranged between 7 and 10. There were no gender differences noted in levels of satisfaction (P=.51). CONCLUSIONS RAs provide an innovative and attractive platform to increase exercise and sun protection behaviors and potentially other health behaviors.
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Affiliation(s)
- Marie A Sillice
- Department of of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, RI, United States
| | - Patricia J Morokoff
- College of Arts and Sciences, University of Rhode Island, Kingston, RI, United States
| | - Ginette Ferszt
- College of Nursing, University of Rhode Island, Kingston, RI, United States
| | - Timothy Bickmore
- College of Computer and Information Science, Northeastern University, Boston, MA, United States
| | - Beth C Bock
- Department of of Psychiatry and Human Behavior, The Miriam Hospital, Brown University, Providence, RI, United States
| | - Ryan Lantini
- The Miriam Hospital, Providence, RI, United States
| | - Wayne F Velicer
- Cancer Prevention Research Center, Department of Psychology, University of Rhode Island, Kingston, RI, United States
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Mundorf N, Redding CA, Paiva AL. Sustainable Transportation Attitudes and Health Behavior Change: Evaluation of a Brief Stage-Targeted Video Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010150. [PMID: 29346314 PMCID: PMC5800249 DOI: 10.3390/ijerph15010150] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/09/2018] [Accepted: 01/13/2018] [Indexed: 12/01/2022]
Abstract
Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effective in moving respondents towards increased readiness for ST behavior change, and improving some ST attitudes, significantly reducing the cons of ST. This research program shows that a brief stage-targeted behavior change video can increase readiness and reduce the cons for healthy transportation choices.
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Affiliation(s)
- Norbert Mundorf
- Department of Communication Studies, Harrington School of Communication and Media, University of Rhode Island, Kingston, RI 02881, USA.
| | - Colleen A Redding
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Andrea L Paiva
- Cancer Prevention Research Center, Department of Psychology, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA.
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Munson SO, Barabasz AF, Barabasz M. Ability of Hypnosis to Facilitate Movement Through Stages of Change for Smoking Cessation. Int J Clin Exp Hypn 2018; 66:56-82. [PMID: 29319462 DOI: 10.1080/00207144.2018.1396115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
On the basis of the transtheoretical model of change, we hypothesized that hypnosis would facilitate significantly greater movement through the stages of change toward smoking cessation in contrast to psychoeducation. Thirty participants were pretested for hypnotizability using the Elkins Hypnotizability Scale (EHS). Participants' readiness for change was assessed using the University of Rhode Island Change Assessment scale (URICA). The EHS relaxation induction was used to induce hypnosis. Hypnotic suggestions addressed motivation and ambivalence. The URICA was administered following the intervention and at a 10-day follow-up. Two-factor split-plot ANOVAs showed significant changes within groups on the contemplation subscale (p = .002), action subscale (p = .00007), and the number of cigarettes smoked per day (p = .003).
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Lipschitz JM, Paiva AL, Redding CA, Levesque D, Rossi JS, Weisberg RB, Prochaska JO. Development and Preliminary Psychometric Evaluation of Decisional Balance and Self-Efficacy Measures for Managing Anxiety in a National Sample of Clinically Anxious Adults. Am J Health Promot 2018; 32:215-223. [PMID: 27670270 DOI: 10.1177/0890117116669493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Anxiety is the most common and costly mental illness in the United States. Reducing avoidance is a core element of evidence-based treatments. Past research shows readiness to address avoidance affects outcomes. Investigating avoidance from a transtheoretical model (TTM) perspective could facilitate tailored approaches for individuals with low readiness. This study developed and examined psychometric properties of TTM measures for addressing anxiety-based avoidance. DESIGN Cross-sectional survey. SETTING Community centers, online survey. PARTICIPANTS Five hundred ninety-four individuals aged 18 to 70 with clinically significant anxiety. MEASURES Overall Anxiety Severity Questionnaire, stages of change, decisional balance, and self-efficacy. ANALYSIS The sample was randomly split into halves for principal component analyses (PCAs) and confirmatory factor analyses (CFAs) to test measurement models. Further analyses examined relationships between constructs. RESULTS For decisional balance, PCA indicated two 5-item factors (pros and cons). Confirmatory factor analysis supported a 2-factor correlated model, Satorra-Bentler scaled chi-square [Formula: see text], comparative fit index (CFI = 0.94), root mean square error of approximation (RMSEA = 0.07), pros: α = 0.87, ρ = 0.87, cons: α = 0.75, and ρ = 0.75. For self-efficacy, PCA indicated one 6-item factor supported by CFA, [Formula: see text], P < .01, CFI = 0.98, RMSEA = 0.09, α = 0.90, ρ = 0.87. As hypothesized, significant cross-stage differences were observed for pros and self-efficacy, and significant relationships between anxiety severity and pros, cons, and self-efficacy were found. CONCLUSION Findings show strong psychometric properties and support the application of a readiness-based model to anxiety. In contrast to findings of other behaviors, cons remain high in action and maintenance. These measures provide a solid empirical foundation to develop TTM-tailored interventions to enhance engagement in treatment.
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Affiliation(s)
| | - Andrea L Paiva
- 2 Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA
| | - Colleen A Redding
- 2 Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA
| | - Deborah Levesque
- 2 Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA
| | - Joseph S Rossi
- 2 Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA
| | | | - James O Prochaska
- 2 Cancer Prevention Research Center, University of Rhode Island, Kingston, RI, USA
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Scioli-Salter ER, Smith BN, McSheffrey S, Bair MJ, Sillice MA, Driscoll M, Higgins DM, Allsup K, Amalathas A, Gerber MR. Self-Efficacy for Adoption and Maintenance of Exercise Among Fibromyalgia Patients: A Pilot Study. Am J Lifestyle Med 2017; 14:437-442. [PMID: 33281524 DOI: 10.1177/1559827617745264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective. While multimodal treatment approaches for fibromyalgia (FM), incorporating exercise, have been found most effective, information about factors associated with exercise adoption and maintenance is lacking. Design, Setting, and Methods. Women veterans with FM (N = 19) completed an anonymous Internet survey measuring FM impact (FI), adoption of exercise behavior, and self-efficacy for exercise. Using classifications of behavior specified by the transtheoretical model, the self-efficacy of participants classified in the action or maintenance (AM) stages was compared with those in earlier stages (precontemplation through preparation) of exercise readiness. Multivariate analysis of variance analyses examined differences in FI domains by stage of change. Analysis of covariance examined whether exercise self-efficacy differed by stage of change while controlling for FI. Results. Higher levels of self-efficacy were detected among participants in the AM stages. Participants in the AM stages also reported higher levels of FI symptoms. After controlling for FI, self-efficacy did not differ significantly between the 2 groups; however the effect size was large (η2 = .11). Conclusions. Findings of this pilot study suggest a role for self-efficacy in exercise adoption and maintenance, even in the setting of higher FM symptoms. Replication of this study with a larger sample size is warranted.
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Affiliation(s)
- Erica R Scioli-Salter
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Brian N Smith
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Savannah McSheffrey
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Matthew J Bair
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Marie A Sillice
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Mary Driscoll
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Diana M Higgins
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Kelly Allsup
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Aneline Amalathas
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
| | - Megan R Gerber
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (ERS, BNS, DMH, AA).,Research Service, VA Boston Healthcare System, Boston, Massachusetts (ERS, SM, DMH).,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (ERS, BNS, DMH).,Richard L. Roudebush VA Medical Center, Center for Health Information and Communication, Indianapolis, Indiana (MJB).,Indiana University School of Medicine, and Regenstrief Institute, Indianapolis, Indiana (MJB).,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island (MAS).,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (MAS).,VA Connecticut Healthcare System, West Haven, Connecticut (MD).,Yale University School of Medicine, New Haven, Connecticut (MD).,Research Division, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KA).,Women Veterans Program, VA Boston Healthcare System, Boston, Massachusetts (MRG).,Department of Medicine & General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts (MRG)
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Johnson SS, Levesque DA, Broderick LE, Bailey DG, Kerns RD. Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention. JMIR Med Inform 2017; 5:e40. [PMID: 29042341 PMCID: PMC5663948 DOI: 10.2196/medinform.7117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 06/16/2017] [Accepted: 08/04/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic pain is a significant public health burden affecting more Americans than cardiovascular disease, diabetes, and cancer combined. Veterans are disproportionately affected by chronic pain. Among previously deployed soldiers and veterans, the prevalence of chronic pain is estimated between 44% and 60%. OBJECTIVE The objective of this research was to develop and pilot-test Health eRide: Your Journey to Managing Pain, a mobile pain self-management program for chronic musculoskeletal pain for veterans. Based on the transtheoretical model of behavior change, the intervention is tailored to veterans' stage of change for adopting healthy strategies for pain self-management and their preferred strategies. It also addresses stress management and healthy sleep, two components of promising integrated treatments for veterans with pain and co-occurring conditions, including posttraumatic stress disorder (PTSD) and traumatic brain injury. In addition, Health eRide leverages gaming principles, text messaging (short message service, SMS), and social networking to increase engagement and retention. METHODS Pilot test participants were 69 veterans recruited in-person and by mail at a Veterans Health Administration facility, by community outreach, and by a Web-based survey company. Participants completed a mobile-delivered baseline assessment and Health eRide intervention session. During the next 30 days, they had access to a Personal Activity Center with additional stage-matched activities and information and had the option of receiving tailored text messages. Pre-post assessments, administered at baseline and the 30-day follow-up, included measures of pain, pain impact, use of pain self-management strategies, PTSD, and percentage in the Action or Maintenance stage for adopting pain self-management, managing stress, and practicing healthy sleep habits. Global impressions of change and program acceptability and usability were also assessed at follow-up. RESULTS Among the 44 veterans who completed the 30-day post assessment, there were statistically significant pre-post reductions in pain (P<.001) and pain impact (P<.001); there was some reduction in symptoms of PTSD (P=.05). There were significant pre-post increases in the percentage of participants in the Action or Maintenance stage for adopting pain self-management (P=.01) and for managing stress (P<.001) but not for practicing healthy sleep habits (P=.11). The global impressions of change measure showed that a majority had experienced some level of improvement. User ratings of acceptability were quite high; ratings of usability fell slightly below the mean for digital programs. CONCLUSIONS Preliminary data demonstrate the potential impact of the Health eRide program for chronic musculoskeletal pain for veterans. The results underscore that simultaneously addressing other behaviors may be a promising approach to managing pain and comorbid conditions. Additional formative research is required to complete development of the Health eRide program and to address areas of usability requiring improvement. A randomized trial with longer follow-up is needed to demonstrate the program's long-term effects on pain and pain self-management.
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Affiliation(s)
- Sara S Johnson
- Pro-Change Behavior Systems, Inc, South Kingstown, RI, United States
| | | | - Lynne E Broderick
- Pro-Change Behavior Systems, Inc, South Kingstown, RI, United States
| | - Dustin G Bailey
- Pro-Change Behavior Systems, Inc, South Kingstown, RI, United States
| | - Robert D Kerns
- VA Connecticut Healthcare System, Yale University, Research Psychologist, Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, Professor of Psychiatry, Neurology and Psychology, West Haven, CT, United States
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Cheung TWC, Clemson L, O' Loughlin K, Shuttleworth R. Erognomic education on housework for women with upper limb repetitive strain injury (RSI): a conceptual representation of therapists' clinical reasoning. Disabil Rehabil 2017; 40:3136-3146. [PMID: 28922988 DOI: 10.1080/09638288.2017.1378928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ergonomic education in housework that aims to facilitate behavior change is important for women with upper limb repetitive strain injury. Therapists usually conduct such programs based on implicit reasoning. Making this reasoning explicit is important in contributing to the profession's knowledge. AIM To construct a conceptual representation of how occupational therapists make clinical decisions for such program. METHOD Based on a constructivist-grounded theory methodology, data were collected through in-depth interviewing with 14 occupational therapists from a major hospital in Singapore. Interviews were audiotaped and transcribed. Data was analyzed with line by line, focused and axial coding with constant data comparison throughout data collection. RESULTS Therapists made clinical decisions based on their perceptions of their clients' behavior change in three stages: (i) listen; (ii) try; and (iii) persevere, bearing significant similarities to the transtheoretical theory of change. The study also showed that therapists may not have considered the full range of meanings that their clients attach to housework when interacting with them, a gap that needs to be addressed. CONCLUSIONS The present study indicates the importance of therapists' understanding of the meanings that their clients attach to housework. Further research needs to address how to achieve this in a time-pressured clinical environment. Implications for Rehabilitation This study used qualitative research to demonstrate the process of translating therapists' tacit knowledge into an explicit form. It elucidates the following major implications for practice when therapists conduct ergonomic education to facilitate behavior change in housework for female homemakers with upper limb RSI:The conceptual framework of clinical reasoning constructed from the results can be used to increase therapists' awareness of how they make clinical decisions during an intervention. This framework can also be used for training new therapists. It is important for therapists to actively listen to their clients. Active listening will enable the therapists to understand and consider the personal meanings that these women attach to housework in order to facilitate a behavior change. Client-therapist interactions to facilitate clients' willingness to change should become a major focus in such a program. Similar research should be conducted in other clinical areas to develop explicit clinical reasoning frameworks to facilitate learning of novice therapists and reflection of experienced therapists to address any gap in their clinical reasoning.
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Affiliation(s)
- Therma W C Cheung
- a Department of Occupational Therapy , Singapore General Hospital , Singapore
| | - Lindy Clemson
- b Department of Ageing and Health , University of Sydney , Sydney , Australia
| | - Kate O' Loughlin
- b Department of Ageing and Health , University of Sydney , Sydney , Australia
| | - Russell Shuttleworth
- c School of Health and Social Development , Deakin University , Victoria , Australia
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Miragall M, Domínguez-Rodríguez A, Navarro J, Cebolla A, Baños RM. Increasing physical activity through an Internet-based motivational intervention supported by pedometers in a sample of sedentary students: A randomised controlled trial. Psychol Health 2017; 33:465-482. [PMID: 28880576 DOI: 10.1080/08870446.2017.1368511] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to analyse the effect of an Internet-based motivational intervention (IMI) supported by pedometers (in comparison with IMI alone and non-intervention) on increasing daily steps and changing constructs related to physical activity (PA) in a sample of sedentary students. DESIGN A randomised-controlled trial was conducted with 76 sedentary or low-active college students. The purpose of the IMI was to deliver information to increase motivation and set individualised PA goals. It involved a 3-week intervention and a 3-months follow-up. OUTCOME MEASURES Objective measures were used to measure daily steps, and self-report questionnaires to assess different constructs related to PA. RESULTS Results revealed that IMI supported by pedometers condition increased significantly more the daily steps (post-intervention: M = 2069; SD = 1827; follow-up: M = 2227; SD = 2477) and enjoyment than non-intervention condition at both points in time. Moreover, results showed that IMI alone condition increased more the scores in variables involved in PA behaviour than non-intervention condition. CONCLUSIONS This study shows the effectiveness of a self-administered IMI using pedometers in increasing PA and enjoyment, and the effectiveness of the IMI alone in changing different theoretical constructs related to the PA behaviour.
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Affiliation(s)
- Marta Miragall
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Alejandro Domínguez-Rodríguez
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Jessica Navarro
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Ausiàs Cebolla
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain.,c CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III , Spain
| | - Rosa M Baños
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain.,c CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III , Spain
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Theeboom T, Van Vianen AEM, Beersma B. A Temporal Map of Coaching. Front Psychol 2017; 8:1352. [PMID: 28848470 PMCID: PMC5550699 DOI: 10.3389/fpsyg.2017.01352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/24/2017] [Indexed: 11/13/2022] Open
Abstract
Economic pressures on companies, technological developments, and less stable career paths pose potential threats to the well-being of employees (e.g., stress, burn-out) and require constant adaptation. In the light of these challenges, it is not surprising that employees often seek the support of a coach. The role of a coach is to foster change by facilitating a coachees’ movement through a self-regulatory cycle with the ultimate aim of stimulating sustained well-being and functioning. While meta-analytic research indicates that coaching interventions can be effectively applied to assist employees in dealing with change, the current literature on coaching lacks solid theoretical frameworks that are needed to build a cumulative knowledge-base and to inspire evidence-based practice. In this conceptual analysis, we examine the coaching process through a temporal lens. By doing so, we provide an integrated theoretical framework: a temporal map of coaching. In this framework, we link seminal concepts in psychology to the coaching process, and describe which competencies of coachees are crucial in the different stages of change that coaching aims to bring about. During the preparatory contemplation stage, targeting coachees’ awareness by enhancing their mindfulness and environmental receptiveness is important. During the contemplation stage, coachees’ willingness and perceived ability to change are central competencies. We propose that coaches should therefore foster intrinsic goal orientation and self-efficacy during this stage. During the planning stage, coaches should focus on goal-setting and implementation intentions. Finally, during the maintenance/termination stage, stimulating coachees’ reflection is especially important in order to help them to integrate their learning experiences. The framework delineated in this paper contributes to the understanding of coaching as a tool to assist employees in dealing with the challenges of an increasingly dynamic work-environment and yields concrete suggestions for future theory development and research on coaching.
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Affiliation(s)
- Tim Theeboom
- Department of Work and Organizational Psychology, University of AmsterdamAmsterdam, Netherlands
| | - Annelies E M Van Vianen
- Department of Work and Organizational Psychology, University of AmsterdamAmsterdam, Netherlands
| | - Bianca Beersma
- Organization Sciences, Vrije Universiteit AmsterdamAmsterdam, Netherlands
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Relationship Between Regular Physical Activity and Transtheoretical Model Components Among Members of Municipality Councils in Selected Districts of Tehran. Asian J Sports Med 2017. [DOI: 10.5812/asjsm.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sillice MA, Babbin SF, Paiva AL, Redding CA, Rossi JS, Velicer WF. Assessing demographic differences in decisional balance for smoking prevention and temptations to try smoking among adolescent subgroups. Tob Prev Cessat 2017; 3:14. [PMID: 32432188 PMCID: PMC7232824 DOI: 10.18332/tpc/70562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 04/10/2017] [Accepted: 04/19/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cigarette smoking initiation remains prevalent in adolescence. Effective prevention methods are needed to dissuade this behavior. Demographic factors are identified as important risk factors in the developmental nature of smoking in adolescence. The current study investigates potential demographic differences for two new trans-theoretical model measures, the Decisional Balance Inventory (pros and cons) for Smoking Prevention and the Temptations to Try Smoking Scale. METHODS A sample of 6th grade Rhode Island students from 20 middle schools (N = 4151) who were participating in a longitudinal and computer-delivered intervention for substance abuse prevention was assessed on these measures at baseline. Three MANOVA tests were conducted to assess the impact of race (White vs. Non-White), ethnicity (Hispanic vs. Non-Hispanic) and gender (male vs female). RESULTS Significant effects for race and ethnicity were found for Decisional Balance and Temptations to Try Smoking. For race, Whites reported lesser pros (p <.0001) and Non-Whites reported higher cons (p <.0001) and temptations to try smoking (p <.0001). Differences for ethnicity showed that Hispanics were higher on pros (p <.0001) and temptations to try smoking (p <.0001) than Non-Hispanics. Non-Hispanics reported higher cons (p <.0001). Gender differences were noted only for temptations to try smoking, and showed females were higher on this construct than males (p <.0001). The effect sizes were .01 or below. CONCLUSIONS The results did not demonstrate a strong association between these demographics and constructs, suggesting that tailored prevention methods based solely on these factors may not dissuade smoking in this group.
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Affiliation(s)
- Marie A. Sillice
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, United States
| | - Steven F. Babbin
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, United States
| | - Andrea L. Paiva
- Cancer Prevention Research Center and Department of Psychology, University of Rhode Island, Kingston, United States
| | - Colleen A. Redding
- Cancer Prevention Research Center and Department of Psychology, University of Rhode Island, Kingston, United States
| | - Joseph S. Rossi
- Cancer Prevention Research Center and Department of Psychology, University of Rhode Island, Kingston, United States
| | - Wayne F. Velicer
- Cancer Prevention Research Center and Department of Psychology, University of Rhode Island, Kingston, United States
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Araban M, Tavafian SS, Zarandi SM, Hidarnia AR, Burri A, Montazeri A. A behavioral strategy to minimize air pollution exposure in pregnant women: a randomized controlled trial. Environ Health Prev Med 2017; 22:26. [PMID: 29165105 PMCID: PMC5664830 DOI: 10.1186/s12199-017-0633-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/25/2017] [Indexed: 12/05/2022] Open
Abstract
Background Pregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women. Methods In this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann–Whitney U test, and chi-squared. Results In all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P < 0.05). Conclusion The findings indicated that the TTM-based intervention was effective in increasing air pollution preventive behaviors among pregnant women. This study provided a framework to modify some psychosocial determinants of air pollution preventive behavior other than knowledge using constructs of Transtheoretical model of behavior change, additionally results suggests the importance of education and makes enlightenment of the air pollution risk knowledge accelerate. Trial registration IRCT2012091010804N1
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Affiliation(s)
- Marzieh Araban
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sedigheh Sadat Tavafian
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saeed Motesaddi Zarandi
- Department of Environmental Health Engineering, Faculty of Health, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Reza Hidarnia
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Andrea Burri
- Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Culture & Science, ACECR, Tehran, Iran.
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Battersby M, Egger G, Litt J. Self-Management in Lifestyle Medicine. LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Motivational interviewing and the decisional balance procedure for cessation induction in smokers not intending to quit. Addict Behav 2017; 64:171-178. [PMID: 27619008 DOI: 10.1016/j.addbeh.2016.08.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/11/2016] [Accepted: 08/30/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The decisional balance (DB) procedure examines the pros and cons of behavior change and was considered a component in early formulations of Motivational Interviewing (MI). However, there is controversy and conflicting findings regarding the use of a DB exercise within the treatment of addictions and a need to clarify the role of DB as a component of MI. METHODS College tobacco smokers (N=82) with no intentions on quitting were randomly assigned to receive a single counseling session of either Motivational Interviewing using only the decisional balance component (MIDB), or health education around smoking cessation (HE). Assessments were obtained at baseline, immediately post-treatment, 1week, and 4weeks. RESULTS Compared to HE, the MIDB sessions scored significantly higher on the Motivational Interviewing Treatment Integrity (MITI) scale (all standardized differences d>1, p<0.001). Unexpectedly, self-report Pros of smoking scores increased for MIDB but decreased for HE (MIDB vs HE standardized difference d=0.5; 95%CI 0.1 to 1.0, p=0.021). Both groups showed significant reductions in smoking rates and increases in motivation to quit, quit attempts, and self-reported abstinence, with no significant group differences. Changes in the Pros of smoking were correlated with MITI scores, but not with cessation outcomes. In contrast, increases in the Cons of smoking and therapeutic alliance were predictive of better cessation outcomes. CONCLUSIONS The decisional balance exercise as formulated by earlier versions of MI may be counter-productive and cautions around its use are warranted. Instead, improved cessation outcomes appear associated with increasing perceived benefits of quitting and positive therapeutic alliance.
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Dobkin BH. Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care. Curr Opin Neurol 2016; 29:693-699. [PMID: 27608301 PMCID: PMC5842701 DOI: 10.1097/wco.0000000000000380] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW Rehabilitation trials and postacute care to lessen impairments and disability after stroke, spinal cord injury, and traumatic brain injury almost never include training to promote long-term self-management of skills practice, strengthening and fitness. Without behavioral training to develop self-efficacy, clinical trials, and home-based therapy may fail to show robust results. RECENT FINDINGS Behavioral theories about self-management and self-efficacy for physical activity have been successfully incorporated into interventions for chronic diseases, but rarely for neurologic rehabilitation. The elements of behavioral training include education about the effects of practice and exercise that are relevant to the person, goal setting, identification of possible barriers, problem solving, feedback about performance, tailored instruction, decision making, and ongoing personal or social support. Mobile health and telerehabilitation technologies offer new ways to remotely enable such training by monitoring activity from wearable wireless sensors and instrumented exercise devices to allow real-world feedback, goal setting, and instruction. SUMMARY Motivation, sense of responsibility, and confidence to practice and exercise in the home can be trained to increase adherence to skills practice and exercise both during and after formal rehabilitation. To optimize motor learning and improve long-term outcomes, self-management training should be an explicit component of rehabilitation care and clinical trials.
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Affiliation(s)
- Bruce H Dobkin
- Geffen School of Medicine at the University of California Los Angeles, Reed Neurologic Research Center, Los Angeles, California, USA
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Shtaynberger J, Krebs P. Associations Between Decisional Balance and Health Behaviors Among Adult Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:749-754. [PMID: 27524376 PMCID: PMC5073008 DOI: 10.1007/s13187-016-1097-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Interventions directed at health behavior change are increasingly being developed for cancer survivors. This study validates decisional balance measures for physical activity and fruit and vegetable (F/V) consumption among adult survivorship population. Participants were N = 86 patients who previously completed primary treatment for breast or prostate cancer for at least 5 years and were enrolled in an e-health intervention that aimed to improve physical activity and nutrition behaviors. Decisional balance, stage of change, F/V consumption, and physical activity were assessed at baseline and 3 months. Factor analysis was used to assess the structure of the decisional balance measures. The relationship between decisional balance, stage, and behavioral outcomes was assessed with mixed model analyses. The two factor structures of each measure were supported. Pros and cons differed across stages of change for both behaviors (p's < .0001). Total Metabolic Equivalent of Task units (METs) were related to decisional balance pros (p = .012) and cons (p = .003). F/V consumption was significantly associated with decisional balance pros (p = .0003), but not cons (p = .112). Overall, findings provide validation for these decisional balance measures as indicators of health behaviors and support the value of using these measures in further research to aid in understanding of behavior change in this population.
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Affiliation(s)
- Jonathan Shtaynberger
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA
| | - Paul Krebs
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA.
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Comello MLG, Qian X, Deal AM, Ribisl KM, Linnan LA, Tate DF. Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program. J Med Internet Res 2016; 18:e237. [PMID: 27658469 PMCID: PMC5054233 DOI: 10.2196/jmir.5976] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/25/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022] Open
Abstract
Background Online interventions providing individual health behavior assessment should deliver feedback in a way that is both understandable and engaging. This study focused on the potential for infographics inspired by the aesthetics of game design to contribute to these goals. Objective We conducted formative research to test game-inspired infographics against more traditional displays (eg, text-only, column chart) for conveying a behavioral goal and an individual’s behavior relative to the goal. We explored the extent to which the display type would influence levels of engagement and information processing. Methods Between-participants experiments compared game-inspired infographics with traditional formats in terms of outcomes related to information processing (eg, comprehension, cognitive load) and engagement (eg, attitudes toward the information, emotional tone). We randomly assigned participants (N=1162) to an experiment in 1 of 6 modules (tobacco use, alcohol use, vegetable consumption, fruit consumption, physical activity, and weight management). Results In the tobacco module, a game-inspired format (scorecard) was compared with text-only; there were no differences in attitudes and emotional tone, but the scorecard outperformed text-only on comprehension (P=.004) and decreased cognitive load (P=.006). For the other behaviors, we tested 2 game-inspired formats (scorecard, progress bar) and a traditional column chart; there were no differences in comprehension, but the progress bar outperformed the other formats on attitudes and emotional tone (P<.001 for all contrasts). Conclusions Across modules, a game-inspired infographic showed potential to outperform a traditional format for some study outcomes while not underperforming on other outcomes. Overall, findings support the use of game-inspired infographics in behavioral assessment feedback to enhance comprehension and engagement, which may lead to greater behavior change.
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Affiliation(s)
- Maria Leonora G Comello
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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