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Monzani D, Pancani L, Rusconi P, Pravettoni G. Perceived Onset Time of Medical Conditions: The Interplay Between Subjective Fear and Risk in Four Lifestyle Domains. Psychol Rep 2021; 125:2981-3005. [PMID: 34324370 DOI: 10.1177/00332941211036028] [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: 11/17/2022]
Abstract
Engaging in unhealthy behaviors (e.g., smoking, drinking) and not engaging in healthy ones (e.g., exercising, consuming fruit and vegetables) are both relatively prevalent among individuals despite the available information about their risks for health. People's perception of an event's time course can be used to gauge their risk perception for that event thus casting light on any possible misperception and suggesting directions for health-promoting interventions. This study investigates people's perception of the time of onset of 5 noncommunicable diseases (e.g., "having high blood pressure") associated with 4 health-related behaviors: Smoking, drinking, exercising, and eating fruit and vegetable. Participants from Italy (N = 214) and the UK (N = 151) gave onset time estimates of how long they thought it would take for 5 noncommunicable diseases to occur in the life of an 18-year-old person who starts or stops adopting those health-related behaviors. Results showed that participants who rated the noncommunicable diseases as more likely to themselves perceived the onset time of these diseases as more temporally proximal. Participants who were more afraid of developing the noncommunicable diseases estimated their onset time as delayed.
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Affiliation(s)
- Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milano - Bicocca, Italy
| | - Patrice Rusconi
- School of Psychology, University of Surrey, UK; Department of Cognitive Sciences, Psychology, Education and Cultural Studies, 18980University of Messina, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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2
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Martinez-Harvell G, Goluboff F, Rodriguez P, Castro G, Barengo NC. Predictors of adherence to physical activity guidelines in patients with diabetes mellitus in the US in 2017: An exploratory analysis. Prim Care Diabetes 2020; 14:645-653. [PMID: 32561381 DOI: 10.1016/j.pcd.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/26/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
AIMS To identify if there is an association between socio-economic or demographic factors, lifestyle habits, or chronic conditions and meeting the current exercise recommendations for adult patients with Diabetes Mellitus 2 in the United States. METHODS This secondary analysis of a cross sectional study used data from participants who reported having diabetes and answered questions regarding physical activity in the 2017 Behavioral Risk Factor Surveillance System survey (n=37,204; 42% women; 30%<60 years-of-age). Respondents were dichotomized according to physical activity adherence. Predictors tested included socioeconomic and demographic characteristics, lifestyle habits, and chronic conditions. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Our data showed that 46.5% of participants with diabetes adhered to the physical activity guidelines. Daily smokers were 25% less likely to adhere to the physical activity recommendations (95% CI 0.59-0.95), patients with obesity were 37% less likely (95% CI 0.53-0.74), and those with chronic kidney disease were 24% (95% CI 0.61-0.94) less likely to do so. The odds of adhering to exercise guidelines were reduced by 20% (95% CI 0.70-0.92), 42% (95% CI 0.49-0.68), and 47% (95% CI 0.32-0.57) in good, fair, and poor health respectively. CONCLUSION Patients with poor health, daily smoking, obesity, or kidney disease may benefit from targeted interventions to accomplish their physical activity recommendations.
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Affiliation(s)
- Greisy Martinez-Harvell
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Florencia Goluboff
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
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Chevance G, Golaszewski NM, Baretta D, Hekler EB, Larsen BA, Patrick K, Godino J. Modelling multiple health behavior change with network analyses: results from a one-year study conducted among overweight and obese adults. J Behav Med 2020; 43:254-261. [PMID: 31997127 PMCID: PMC7861046 DOI: 10.1007/s10865-020-00137-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/23/2020] [Indexed: 02/07/2023]
Abstract
This study examined the between-person associations of seven health behaviors in adults with obesity participating in a weight loss intervention, as well as the covariations between these behaviors within-individuals across the intervention. The present study included data from a 12-month weight loss trial (N = 278). Seven health behaviors (physical activity, sedentary behavior, sleep duration, and consumption of fruits, vegetables, total fat and added sugar) were measured at baseline, 6- and 12-months. Between- and within-participants network analyses were conducted to examine how these behaviors were associated through the 12-month intervention and covaried across months. At the between-participants level, associations were found within the different diet behaviors and between total fat and sedentary behaviors. At the within-participants level, covariations were found between sedentary and diet behaviors, and within diet behaviors. Findings suggest that successful multiple health behaviors change interventions among adults with obesity will need to (1) simultaneously target sedentary and diet behaviors; and (2) prevent potential compensatory behaviors in the diet domain.
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Affiliation(s)
- Guillaume Chevance
- Center for Wireless and Population Health Systems, University of California, San Diego, USA.
- Exercise and Physical Activity Resource Center, University of California, San Diego, USA.
- Family Medicine and Public Health, University of California, San Diego, USA.
- Qualcomm Institute, University of California San Diego, Atkinson Hall, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Natalie M Golaszewski
- Center for Wireless and Population Health Systems, University of California, San Diego, USA
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Dario Baretta
- Center for Wireless and Population Health Systems, University of California, San Diego, USA
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Eric B Hekler
- Center for Wireless and Population Health Systems, University of California, San Diego, USA
- Exercise and Physical Activity Resource Center, University of California, San Diego, USA
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Britta A Larsen
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Kevin Patrick
- Center for Wireless and Population Health Systems, University of California, San Diego, USA
- Family Medicine and Public Health, University of California, San Diego, USA
| | - Job Godino
- Center for Wireless and Population Health Systems, University of California, San Diego, USA
- Exercise and Physical Activity Resource Center, University of California, San Diego, USA
- Family Medicine and Public Health, University of California, San Diego, USA
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Cox-Martin E, Cox MG, Basen-Engquist K, Bradley C, Blalock JA. Changing multiple health behaviors in cancer survivors: smoking and exercise. PSYCHOL HEALTH MED 2019; 25:331-343. [PMID: 31630537 DOI: 10.1080/13548506.2019.1679849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Research regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants' self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant (r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise ((r = .44, 95% CI [.20, .65]) strenuous); ((r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior (r = -.27, 95% CI [-.46, -.05]), and smoking self-efficacy and smoking behavior (r = -0.41, 95% CI [-.61, -.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..
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Affiliation(s)
- Emily Cox-Martin
- Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew G Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cathy Bradley
- Department of Health Systems, Management, and Policy, and University of Colorado Cancer Center, University of Colorado School of Public Health, Aurora, CO, USA
| | - Janice A Blalock
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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5
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Future directions of multiple behavior change research. J Behav Med 2016; 40:194-202. [DOI: 10.1007/s10865-016-9809-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
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Garrett NA, Alesci NL, Schultz MM, Foldes SS, Magnan SJ, Manley MW. The Relationship of Stage of Change for Smoking Cessation to Stage of Change for Fruit and Vegetable Consumption and Physical Activity in a Health Plan Population. Am J Health Promot 2016; 19:118-27. [PMID: 15559712 DOI: 10.4278/0890-1171-19.2.118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. Design. The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). Setting. This study was conducted at a mixed-model health plan with approximately 1 million adult members. Subjects. Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. Measures. The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. Results. Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (χ2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (χ2 = 89.7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. Conclusions. This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.
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Affiliation(s)
- Nancy A Garrett
- Health Services Analysis and Reporting at HealthPartners in Minneapolis, Minnesota 54410-1309, USA.
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Masood S, Cappelli C, Li Y, Tanenbaum H, Chou CP, Spruijt-Metz D, Palmer PH, Johnson CA, Xie B. Cigarette smoking is associated with unhealthy patterns of food consumption, physical activity, sleep impairment, and alcohol drinking in Chinese male adults. Int J Public Health 2015; 60:891-899. [PMID: 26321106 DOI: 10.1007/s00038-015-0730-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 08/11/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES According to a recent national survey, tobacco use is a critical public health issue in China, with more than two-thirds of Chinese males smoking. Findings in Western populations suggest that smoking may cluster with other health-risk behaviors. To explore these relationships in Chinese male adults, we utilized baseline data from the China Seven Cities Study (CSCS). METHODS Male adults (n = 12,122) were included. Smoking status was defined as never smokers, ex-smokers, current smokers, and current heavy smokers. Logistic regression was employed to investigate the association of cigarette smoking and patterns of food consumption, physical activity, and alcohol drinking. RESULTS After controlling for age, socioeconomic status, and city residence, heavy smokers consumed significantly less vegetables, fruits, milk and other dairy products, spent significantly more time watching television, slept and exercised less, and got drunk or engaged in binge drinking more frequently compared to never, ex-, or current smokers (p < 0.05). CONCLUSIONS Findings suggest significant associations of heavy cigarette smoking with other health-risk behaviors in Chinese male adults, underscoring the need for tobacco control interventions for Chinese males.
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Affiliation(s)
- Shabana Masood
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
| | - Christopher Cappelli
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
| | - Yawen Li
- School of Social Work, San Diego State University, San Diego, USA
| | - Hilary Tanenbaum
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
| | - Chih-Ping Chou
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Donna Spruijt-Metz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Paula H Palmer
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
| | - C Anderson Johnson
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, USA
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Fleig L, Küper C, Lippke S, Schwarzer R, Wiedemann AU. Cross-behavior associations and multiple health behavior change: A longitudinal study on physical activity and fruit and vegetable intake. J Health Psychol 2015; 20:525-34. [DOI: 10.1177/1359105315574951] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline. Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals.
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Affiliation(s)
| | | | | | - Ralf Schwarzer
- Australian Catholic University, Australia
- University of Social Sciences and Humanities, Poland
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9
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Durazzo TC, Mattsson N, Weiner MW. Smoking and increased Alzheimer's disease risk: a review of potential mechanisms. Alzheimers Dement 2014; 10:S122-45. [PMID: 24924665 PMCID: PMC4098701 DOI: 10.1016/j.jalz.2014.04.009] [Citation(s) in RCA: 246] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cigarette smoking has been linked with both increased and decreased risk for Alzheimer's disease (AD). This is relevant for the US military because the prevalence of smoking in the military is approximately 11% higher than in civilians. METHODS A systematic review of published studies on the association between smoking and increased risk for AD and preclinical and human literature on the relationships between smoking, nicotine exposure, and AD-related neuropathology was conducted. Original data from comparisons of smoking and never-smoking cognitively normal elders on in vivo amyloid imaging are also presented. RESULTS Overall, literature indicates that former/active smoking is related to a significantly increased risk for AD. Cigarette smoke/smoking is associated with AD neuropathology in preclinical models and humans. Smoking-related cerebral oxidative stress is a potential mechanism promoting AD pathology and increased risk for AD. CONCLUSIONS A reduction in the incidence of smoking will likely reduce the future prevalence of AD.
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Affiliation(s)
- Timothy C Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
| | - Niklas Mattsson
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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10
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Durazzo TC, Meyerhoff DJ, Nixon SJ. Interactive effects of chronic cigarette smoking and age on hippocampal volumes. Drug Alcohol Depend 2013; 133:704-11. [PMID: 24051060 PMCID: PMC3870586 DOI: 10.1016/j.drugalcdep.2013.08.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 08/23/2013] [Accepted: 08/23/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous cross-sectional MRI studies with healthy, young-to-middle-aged adults reported no significant differences between smokers and non-smokers on total hippocampal volume. However, these studies did not specifically test for greater age-related volume loss in the total hippocampus or hippocampal subregions in smokers, and did they did not examine relationships between hippocampal and subfield volumes and episodic learning and memory performance. METHODS Healthy, young-to-middle-aged (45 ± 12 years of age) smokers (n=39) and non-smokers (n=43) were compared on total hippocampal and subfield volumes derived from high-resolution 4 Tesla MRI, emphasizing testing for greater age-related volume losses in smokers. Associations between hippocampal volumes and measures of episodic learning and memory were examined. RESULTS Smokers showed significantly smaller volumes, as well as greater volume loss with increasing age than non-smokers in the bilateral total hippocampus and multiple subfields. In smokers, greater pack-years were associated with smaller volumes of the total hippocampus, presubiculum, and subiculum. In the entire cohort, performance on measures of learning and memory was related to larger total hippocampal and several subfield volumes, predominately in the left hemisphere. CONCLUSIONS Chronic cigarette smoking in this young-to-middle aged cohort was associated with smaller total hippocampal and subfield volumes, which were exacerbated by advancing age. Findings also indicated an adverse smoking dose/duration response (i.e., pack-years) with total hippocampal and select subfield volumes. These hippocampal volume abnormalities in smokers may be related to the deficiencies in episodic learning and memory in young-to-middle-aged smokers reported in previous studies.
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Affiliation(s)
- Timothy C. Durazzo
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA,Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA,Please send correspondence to: Timothy C. Durazzo, Center for Imaging of Neurodegenerative Diseases (114M), San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, USA, Office: 415-221-4810 x4157, Fax: 415-668-2864,
| | - Dieter J. Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA,Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Sara Jo Nixon
- Departments of Psychiatry and Psychology, University of Florida, Gainesville. FL
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Lippke S, Nigg CR, Maddock JE. Health-promoting and health-risk behaviors: theory-driven analyses of multiple health behavior change in three international samples. Int J Behav Med 2012; 19:1-13. [PMID: 21234735 PMCID: PMC3277822 DOI: 10.1007/s12529-010-9135-4] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Co-occurrence of different behaviors was investigated using the theoretical underpinnings of the Transtheoretical Model, the Theory of Triadic Influence and the concept of Transfer. Purpose To investigate relationships between different health behaviors' stages of change, how behaviors group, and whether study participants cluster in terms of their behaviors. Method Relationships across stages for different behaviors were assessed in three studies with N = 3,519, 965, and 310 individuals from the USA and Germany by telephone and internet surveys using correlational analyses, factor analyses, and cluster analyses. Results Consistently stronger correlations were found between nutrition and physical activity (r = 0.16–0.26, p < 0.01) than between non-smoking and nutrition (r = 0.08–0.16, p < 0.03), or non-smoking and physical activity (r = 0.01–0.21). Principal component analyses of investigated behaviors indicated two factors: a “health-promoting” factor and a “health-risk” factor. Three distinct behavioral patterns were found in the cluster analyses. Conclusion Our results support the assumption that individuals who are in a higher stage for one behavior are more likely to be in a higher stage for another behavior as well. If the aim is to improve a healthy lifestyle, success in one behavior can be used to facilitate changes in other behaviors—especially if the two behaviors are both health-promoting or health-risky. Moreover, interventions should be targeted towards the different behavioral patterns rather than to single behaviors. This might be achieved by addressing transfer between behaviors.
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Affiliation(s)
- Sonia Lippke
- Health Psychology/ Health Promotion, Freie Universität Berlin & Maastricht University, Habelschwerdter Allee 45, 14195, Berlin, Germany.
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Bernard P, Ninot G, Guillaume S, Fond G, Courtet P, Christine Picot M, Quantin X. Physical Activity as a Protective Factor in Relapse Following Smoking Cessation in Participants with a Depressive Disorder. Am J Addict 2012; 21:348-55. [DOI: 10.1111/j.1521-0391.2012.00242.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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The role of physical therapists in smoking cessation: opportunities for improving treatment outcomes. Phys Ther 2012; 92:757-66. [PMID: 22228603 DOI: 10.2522/ptj.20110304] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Klemenc-Ketis Z, Bulc M, Kersnik J. Attitudes of Slovenian family practice patients toward changing unhealthy lifestyle and the role of family physicians: cross-sectional study. Croat Med J 2011; 52:205-11. [PMID: 21495204 PMCID: PMC3081219 DOI: 10.3325/cmj.2011.52.205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 04/07/2011] [Indexed: 11/17/2022] Open
Abstract
AIM To assess patients' attitudes toward changing unhealthy lifestyle, confidence in the success, and desired involvement of their family physicians in facilitating this change. METHODS We conducted a cross-sectional study in 15 family physicians' practices on a consecutive sample of 472 patients (44.9% men, mean age(±standard deviation) 49.3±10.9 years) from October 2007 to May 2008. Patients were given a self-administered questionnaire on attitudes toward changing unhealthy diet, increasing physical activity, and reducing body weight. It also included questions on confidence in the success, planning lifestyle changes, and advice from family physicians. RESULTS Nearly 20% of patients planned to change their eating habits, increase physical activity, and reach normal body weight. Approximately 30% of patients (more men than women) said that they wanted to receive advice on this issue from their family physicians. Younger patients and patients with higher education were more confident that they could improve their lifestyle. Patients who planned to change their lifestyle and were more confident in the success wanted to receive advice from their family physicians. CONCLUSION Family physicians should regularly ask the patients about the intention of changing their lifestyle and offer them help in carrying out this intention.
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Affiliation(s)
- Zalika Klemenc-Ketis
- Department of Family Medicine, Medical School, University of Maribor, Maribor, Slovenia.
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Panaretto K, Coutts J, Johnson L, Morgan A, Leon D, Hayman N. Evaluating performance of and organisational capacity to deliver brief interventions in Aboriginal and Torres Strait Islander medical services. Aust N Z J Public Health 2010; 34:38-44. [PMID: 20920103 DOI: 10.1111/j.1753-6405.2010.00471.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study assessed brief intervention (BI) activity and organisation capacity for smoking, nutrition, alcohol and physical activity (SNAP framework) and key clinical prevention activities in four Aboriginal and Torres Strait Islander medical services in Queensland. METHODS A mixed methods design was used including: staff surveys of knowledge and attitudes (n=39), focus groups to discuss perceived barriers and enablers and chart audits (n=150) to quantify existing BI activity. RESULTS Of 50 clinical staff, 46 participated in the staff survey and focus groups across the four sites. BI was perceived to be important. There was significant variation in completion of records for SNAP risk factors, key clinical and BI activities across the sites. At least one SNAP factor status was recorded in 130/150 (86.7%) patient charts audited and there was a significant trend of increased recording of SNAP factors with increasing number of patient visits. Of those identified at risk 78% received at least one BI. Where risk was identified 65/96 (67.7%) patients required multiple BIs. BI for tobacco use was consistently high across all sites. Only one site recorded regular care planning and Adult Health Checks. Impacting factors included leadership, high staff turnover, multiple medical records and staff health status. CONCLUSIONS Inflexible staff training, competing health priorities and high levels of staff turnover were identified as key barriers to the delivery of BI in clinical settings. The data suggests a good base of existing BI activity for smoking and key clinical activities which may improve with further support.
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Affiliation(s)
- Katie Panaretto
- Centre for Indigenous Health, University of Queensland, Queensland.
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Chronic cigarette smoking: implications for neurocognition and brain neurobiology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:3760-91. [PMID: 21139859 PMCID: PMC2996190 DOI: 10.3390/ijerph7103760] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 09/29/2010] [Accepted: 10/09/2010] [Indexed: 12/02/2022]
Abstract
Compared to the substantial volume of research on the general health consequences associated with chronic smoking, little research has been specifically devoted to the investigation of its effects on human neurobiology and neurocognition. This review summarizes the peer-reviewed literature on the neurocognitive and neurobiological implications of chronic cigarette smoking in cohorts that were not seeking treatment for substance use or psychiatric disorders. Studies that specifically assessed the neurocognitive or neurobiological (with emphasis on computed tomography and magnetic resonance-based neuroimaging studies) consequences of chronic smoking are highlighted. Chronic cigarette smoking appears to be associated with deficiencies in executive functions, cognitive flexibility, general intellectual abilities, learning and/or memory processing speed, and working memory. Chronic smoking is related to global brain atrophy and to structural and biochemical abnormalities in anterior frontal regions, subcortical nuclei and commissural white matter. Chronic smoking may also be associated with an increased risk for various forms of neurodegenerative diseases. The existing literature is limited by inconsistent accounting for potentially confounding biomedical and psychiatric conditions, focus on cross-sectional studies with middle aged and older adults and the absence of studies concurrently assessing neurocognitive, neurobiological and genetic factors in the same cohort. Consequently, the mechanisms promoting the neurocognitive and neurobiological abnormalities reported in chronic smokers are unclear. Longitudinal studies are needed to determine if the smoking-related neurobiological and neurocognitive abnormalities increase over time and/or show recovery with sustained smoking cessation.
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Kremers SPJ. Theory and practice in the study of influences on energy balance-related behaviors. PATIENT EDUCATION AND COUNSELING 2010; 79:291-298. [PMID: 20371159 DOI: 10.1016/j.pec.2010.03.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 03/02/2010] [Accepted: 03/04/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This paper aims to provide an overview of different theoretical approaches in the study of determinants of energy balance-related behaviors (EBRBs). METHODS The Environmental Research framework for weight Gain prevention (EnRG) is used as a general framework to guide the overview. RESULTS Theoretical approaches in the integrated study of EBRBs are discussed, as well as theories addressing environmental factors, mediating factors, moderating factors and automatic environment-behavior links. CONCLUSION Five distinct topics should be deliberated when researchers conceptualize their research model: (1) to apply a theory-based approach in their determinants study within the broader perspective of systematic obesity prevention, (2) to incorporate the notion of potential clustering of (motives to engage in) EBRBs, (3) to accompany research towards environmental determinants of EBRBs with the operationalization of factors that may mediate the environmental influence, (4) to hypothesize both mediated and unmediated paths in environment-behavior relations, and (5) to incorporate potential moderators of the studied influences on EBRBs in the research design. PRACTICE IMPLICATIONS The choice for change objectives and subsequent obesity prevention intervention strategies may be optimized when relevant determinants are interpreted as either primary (direct) causal factors, mediated determinants, mediating determinants or as moderators of causal factors.
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Affiliation(s)
- Stef P J Kremers
- NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Health Promotion, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Physical activity as a strategy for maintaining tobacco abstinence: a randomized trial. Prev Med 2008; 47:215-20. [PMID: 18572233 PMCID: PMC2536696 DOI: 10.1016/j.ypmed.2008.05.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 05/05/2008] [Accepted: 05/06/2008] [Indexed: 11/27/2022]
Abstract
OBJECTIVES For smoking cessation, physical activity (PA) may help manage withdrawal symptoms, mood, stress, and weight; yet studies of PA as an aid for smoking cessation have been mixed. This study examined: (1) the impact of an extended relapse prevention program on increasing moderate to vigorous PA (MVPA) in adults enrolled in a tobacco cessation treatment trial; (2) whether changes in MVPA were associated with sustained abstinence from smoking; and (3) mechanisms by which MVPA may support sustained abstinence from smoking. METHODS In a randomized controlled trial conducted from 2003-2006 in San Francisco, California, 407 adult smokers received a 12 week group-based smoking cessation treatment with bupropion and nicotine patch with the quit date set at week 3. At week 12, participants were randomized to no further treatment or to 40 weeks of bupropion or placebo with or without an 11-session relapse prevention intervention of which 2 sessions (held at weeks 16 and 20) focused on PA. Participants receiving the PA intervention (n=163) received a pedometer, counseling to increase steps 10% biweekly towards a 10,000 steps/day goal, and personalized reports graphing progress with individualized goals. The International Physical Activity Questionnaire assessed weekly minutes of MVPA at baseline and weeks 12 and 24. Sustained abstinence from tobacco at week 24 was validated with expired carbon monoxide. RESULTS In a repeated mixed model analysis, intervention participants significantly increased their MVPA relative to control participants, F(1,475)=3.95, p=.047. Pedometer step counts also increased significantly, t(23)=2.36, p=.027, though only 15% of intervention participants provided 6 weeks of pedometer monitoring. Controlling for treatment condition, increased MVPA predicted sustained smoking abstinence at week 24, odds ratio=1.84 (95% CI: 1.07, 3.05). Among participants with sustained abstinence, increased MVPA was associated with increased vigor (r=0.23, p=.025) and decreased perceived difficulty with staying smoke-free (r=-0.21, p=.038). CONCLUSION PA promotion as an adjunct to tobacco treatment increases MVPA levels; changes in MVPA predict sustained abstinence, perhaps by improving mood and self-efficacy.
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Grandes G, Sánchez A, Torcal J, Sánchez-Pinilla RO, Lizarraga K, Serra J. Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change. BMC Public Health 2008; 8:172. [PMID: 18498623 PMCID: PMC2412873 DOI: 10.1186/1471-2458-8-172] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 05/22/2008] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Counselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult. OBJECTIVES To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA. METHODS A cross-sectional analysis of 4317 Spanish people aged 20-80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR), PA stage of change, health-related quality of life (SF-36), cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change. RESULTS At least 70% (95% CI: 67.6% to 72.8%) of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3%) had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5%) were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p < 0.05). CONCLUSION The overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and socio-demographic characteristics of patients is suggested in order to prioritise promotion efforts.
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Affiliation(s)
- Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service, Bilbao, Spain
- Unidad de Investigación de Atención Primaria de Bizkaia, Osakidetza, Luis Power 18, 4a planta. 48014 – Bilbao, Spain
| | - Alvaro Sánchez
- Primary Care Research Unit of Bizkaia, Basque Health Service, Bilbao, Spain
| | - Jesús Torcal
- Basauri-Ariz Health Centre, Basque Health Service, Basauri, Spain
| | | | - Kepa Lizarraga
- Sports Medicine Service of the Bizkaia's Provincial Administration, Bilbao, Spain
| | - Javier Serra
- Sports Medicine Service of the Bizkaia's Provincial Administration, Bilbao, Spain
| | - The PEPAF Group
- Preventive Services and Health Promotion Research Network -redIAPP-, Spain
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Vries HD, Kremers S, Smeets T, Reubsaet A. Clustering of diet, physical activity and smoking and a general willingness to change. Psychol Health 2008; 23:265-78. [DOI: 10.1080/14768320701349107] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hein de Vries
- a Department of Health Education and Promotion , Maastricht University , PO Box 616, 6200 MD Maastricht , The Netherlands
| | - Stef Kremers
- a Department of Health Education and Promotion , Maastricht University , PO Box 616, 6200 MD Maastricht , The Netherlands
| | - Tamara Smeets
- a Department of Health Education and Promotion , Maastricht University , PO Box 616, 6200 MD Maastricht , The Netherlands
| | - Astrid Reubsaet
- a Department of Health Education and Promotion , Maastricht University , PO Box 616, 6200 MD Maastricht , The Netherlands
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De Vet E, de Nooijer J, de Vries NK, Brug J. The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants. Int J Behav Nutr Phys Act 2006; 3:13. [PMID: 16784520 PMCID: PMC1557860 DOI: 10.1186/1479-5868-3-13] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Accepted: 06/19/2006] [Indexed: 11/10/2022] Open
Abstract
Background Cardiovascular diseases are caused by multiple behavioral factors, including different dietary factors. We examined to what extent fruit, vegetable and fish consumption are related, and whether behavioral determinants vary across these dietary behaviors from a Transtheoretical model perspective. Methods Data were collected among 1142 participants (T0; response rate 46%) selected from an Internet panel, who were followed-up one-week later (T1; N = 1055, response rate 92%). Mean age was 35.4 (SD = 11.9) years, 35% was male, and most respondents were of Dutch origin (90%). Of the respondents, 13%, 44% and 43% had a low, medium or high level of education, respectively. Electronic questionnaires assessed fruit, vegetable and fish intake (food frequency questionnaires), stages of change, decisional balance and self-efficacy, for each of these three behaviors. Results Stages of change and (changes in) fruit, vegetable and fish intake were only weakly associated; decisional balance and self-efficacy were more strongly associated. Some presumed predictors of stage transitions were similar for fruit, vegetable, and fish intake, i.e., strong pros predicted progress out of precontemplators and low self-efficacy predicted relapse from action/maintenance for all behaviors. However, progress out of contemplation and out of preparation showed different patterns for fruit, vegetable and fish intake. Conclusion The weak associations between intakes and potential determinants for fruit, vegetable, and fish consumption do not warrant an integrated dietary change approach targeting the same determinants for each behavior.
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Affiliation(s)
- Emely De Vet
- Department of Health Education and Health Promotion, Universiteit Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
- Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jascha de Nooijer
- Department of Health Education and Health Promotion, Universiteit Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Nanne K de Vries
- Department of Health Education and Health Promotion, Universiteit Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Johannes Brug
- Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Abstract
Since the effects of tobacco smoke are so detrimental to health, growing consideration has been given to the development of harm reduction strategies for those smokers who are unable or unwilling to stop using tobacco. The term harm reduction refers to a policy, strategy, or particular intervention that assumes continued use of an undesired behavior and aspires to lower the risk of adverse consequences associated with the continuation of this addictive behavior. Up to this point, tobacco harm reduction interventions have focused on reducing tobacco-related harm through the utilization of innovative tobacco products, reduced tobacco consumption, and pharmaceutical medications. With the possible exception of medicinal nicotine products, these strategies remain unproven and thus far no scientific or medical literature exists to suggest these harm reduction strategies reduce tobacco-related exposure, morbidity, or mortality. Consequently, a need exists for broadening the range of potentially effective harm reduction strategies. This preliminary review suggests that physical activity has the potential to become one such strategy. Of the eight principles that characterize a harm reduction strategy, all are at least partially satisfied by physical activity. Further, emerging evidence indicates that physical activity may delay the occurrence of disease and premature death initiated by tobacco consumption. Significant concerns remain regarding the practicality of physical activity as a harm reduction strategy and the extent to which participation in physical activity may be used to justify continued smoking.
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Akamatsu R, Nakamura M, Shirakawa T. Relationships between smoking behavior and readiness to change physical activity patterns in a community in Japan. Am J Health Promot 2005; 19:406-9. [PMID: 16022203 DOI: 10.4278/0890-1171-19.6.406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between readiness to change exercise behavior and smoking behavior; stratified by gender. METHODS A cross-sectional survey of those inhabitants of Hikami, Japan, who were 30 years of age or older (n = 11,708). The response rate was 82.1%. Chi-squared tests and analysis of variance were used to evaluate differences in characteristics by smoking behavior, and the odds ratio (OR) was calculated to examine the relationship while controlling for possible confounding factors such as age, body mass index, and health consciousness. RESULTS Even when controlling for confounding factors, the relationship between the two behaviors differed according to gender Among males, ex-smokers were more likely to be motivated to exercise (OR, 1.14; 95% confidence interval [CI], .95-1.36), whereas among females, smokers were more likely to be motivated to exercise (OR, .40; 95% CI, .34-.48). DISCUSSION Despite some limitations, the findings suggest that gender should be used as a stratification variable when discussing the relationship between smoking and exercise behaviors.
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Affiliation(s)
- Rie Akamatsu
- Kyoto University Graduate School of Public Health, Kyoto, Japan.
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Kremers SPJ, De Bruijn GJ, Schaalma H, Brug J. Clustering of energy balance-related behaviours and their intrapersonal determinants. Psychol Health 2004. [DOI: 10.1080/08870440412331279630] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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