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Sheng J, Lei H, Wu HS, Abshire DA, Wirth MD, Heiney SP. Physical Activity and Breast Cancer Prevention Among Chinese American Women: A Qualitative Descriptive Study. QUALITATIVE HEALTH RESEARCH 2023; 33:1218-1231. [PMID: 37696001 DOI: 10.1177/10497323231197372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Physical inactivity is a modifiable behavioral risk factor for breast cancer. Chinese American women have an increased breast cancer incidence and a low prevalence of meeting physical activity (PA) recommendations, yet little is known about their knowledge and experience regarding PA and breast cancer prevention. Given the significant cultural differences between Eastern and Western societies, effective interventions to promote PA among Chinese American women require understanding their knowledge levels regarding PA in breast cancer prevention and their PA experiences through a cultural lens. This qualitative descriptive study used virtual semi-structured individual interviews to explore Chinese American women's knowledge and perception of PA, their understanding of the role of PA in breast cancer prevention, and influence of culture and acculturation on PA experience. Twenty-one Chinese American women residing in eight states were interviewed. Using thematic analysis, four themes emerged: A limited appreciation of the preventability of breast cancer, variability in PA perception, Chinese culture norms and lifestyles influencing PA behavior, and the influence of the process of acculturation on PA behavior. Chinese American women had a limited understanding of PA in breast cancer prevention. Chinese culture, lifestyles, and traditional Chinese medicine positively and negatively influence Chinese American women's PA behaviors. When exposed to American culture, Chinese American women tended to adopt new PA behaviors, including increasing leisure-time PA while decreasing occupation- and transportation-related PA. Interventions to increase PA and reduce breast cancer risk among Chinese American women should address cultural factors and acculturation along with education and behavioral change strategies.
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Affiliation(s)
- Jingxi Sheng
- University of South Carolina College of Nursing, Columbia, SC, USA
| | - Hao Lei
- University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Horng-Shiuann Wu
- Michigan State University College of Nursing, East Lansing, MI, USA
| | | | - Michael D Wirth
- University of South Carolina College of Nursing, Columbia, SC, USA
- Michigan State University College of Nursing, East Lansing, MI, USA
| | - Sue P Heiney
- University of South Carolina College of Nursing, Columbia, SC, USA
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Tjahjadi B, Soewarno N, Adibah Wan Ismail W, Kustiningsih N, Nasihatun Nafidah L. Community behavioral change and management of COVID-19 Pandemic: Evidence from Indonesia. JOURNAL OF KING SAUD UNIVERSITY. SCIENCE 2023; 35:102451. [PMID: 36415666 PMCID: PMC9673074 DOI: 10.1016/j.jksus.2022.102451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 05/28/2023]
Abstract
Objectives This study aims to investigate the effect of information and motivation on behavioral change related to the COVID-19 pandemic management in Indonesia. It also examines the role of behavioral skills in mediating the information-behavioral change relationship and the motivation-behavioral change relationship. Method This study employs the partial least squares structural equation modeling (PLS-SEM) to test the research hypotheses. Using the online survey method to collect data, 845 responses were obtained from several main islands of Indonesia. Results The results of the study show that information and motivation positively influence people's behavior changes. Behavioral skills mediate the influence of information and motivation on behavioral change. This study contributes to the development of the information-motivation-behavior model (IMB-Model). It also provides additional knowledge on pandemic management in the research setting of Indonesia as a country that has complex characteristics in terms of religion and belief, demography, culture, economy, and politics. Conclusions This study concludes that the success of Indonesia in dealing with the pandemic greatly depends on the success of changing the community behavior. Providing reliable and consistent information enhances people's motivation to build their behavioral skills. With increased behavioral skills, people have changed their behavior in fighting against COVID-19 by obeying health protocols, participating in vaccination programs, and practicing a healthier lifestyle.
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Affiliation(s)
- Bambang Tjahjadi
- Faculty of Economics and Business, Universitas Airlangga, Surabaya, Indonesia
| | - Noorlailie Soewarno
- Faculty of Economics and Business, Universitas Airlangga, Surabaya, Indonesia
| | | | - Nanik Kustiningsih
- Faculty of Economics and Business, Universitas Airlangga, Surabaya, Indonesia
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You H, Wang YY, Zhang C, Walker AN, Ge JJ, Zhao SQ, Peng XQ. Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention. BMC Public Health 2023; 23:130. [PMID: 36653762 PMCID: PMC9848710 DOI: 10.1186/s12889-023-15067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model. METHODS A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model. RESULTS The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (β = 0.325, p < 0.05) and indirectly (β = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (β = 0.461, p < 0.05) effects on GWM, and has indirect (β = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (β = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI. CONCLUSION Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.
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Affiliation(s)
- Hua You
- grid.89957.3a0000 0000 9255 8984School of Public Health, Nanjing Medical University, Nanjing, China ,grid.89957.3a0000 0000 9255 8984Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China ,grid.89957.3a0000 0000 9255 8984School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yuan-Yuan Wang
- Jiangsu Health Development Research Center, Nanjing, China
| | - Chi Zhang
- grid.89957.3a0000 0000 9255 8984School of Nursing, Nanjing Medical University, Nanjing, China
| | - Anita Nyarkoa Walker
- grid.89957.3a0000 0000 9255 8984School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jin-Jin Ge
- grid.89957.3a0000 0000 9255 8984School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shi-Qi Zhao
- grid.89957.3a0000 0000 9255 8984School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xue-Qing Peng
- School of Public Health, Nanjing Medical University, Nanjing, China. .,Chengdu Center for Disease Control and Prevention, 4 Longxiang Road, Wuhou District, Chengdu, 610041, China.
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Dai Z, Jing S, Liu X, Zhang H, Wu Y, Wang H, Xiao W, Huang Y, Fu J, Chen X, Gao L, Su X. Development and validation of the diabetic self-management scale based on information-motivation-behavioral skills theory. Front Public Health 2023; 11:1109158. [PMID: 36908406 PMCID: PMC9998917 DOI: 10.3389/fpubh.2023.1109158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
Background Self-management is important for the blood sugar control of middle-aged and elderly Type 2 diabetes mellitus (T2DM) patients, of which diet, exercise, and drug compliance are the most common components. The Information-Motivation-Behavioral Skills Model (IMB) has been widely used in health behavior management and intervention. Objective The purpose of this study is to develop and validate the Diabetic Self-Management Scale (DSMS) based on the IMB model. Methods Self-report survey data was collected from middle-aged and elderly T2DM patients in Zhongmu City, Henan Province, China in November 2021 using convenience sampling. The original DSMS was developed through a literature review and summary of previous similar scales using an inductive approach. Item modification was finished by a panel of specialists. Exploratory factor analysis and confirmatory factor analysis were used to evaluate the reliability, convergent validity, discriminant validity, and criterion validity of DSMS. Results Four hundred and sixty nine T2DM patients completed the questionnaire survey. The final DSMS consists of 22 items with three dimensions, including information (five items), motivation (eight items), and behavior skills (nine items). The results of simple factor analysis showed that the KMO value was 0.839, Bartlett spherical test 2 = 3254.872, P < 0.001. The results of confirmatory factor analysis showed that 2/df = 2.261, RMSEA = 0.073, CFI = 0.937, TLI = 0.930, and SRMR = 0.096. The standardized factor loadings of 22 DSMS items were all above 0.6, and the CR values of 3 dimensions were all higher than 0.9. In addition, DSMS also showed good discriminant and criterion validity. Conclusion The 22-item DSMS has good reliability and validity, and can be used to make diabetic self-management assessment regarding diet, physical activity, and medication among middle-aged and elderly Chinese T2DM patients. DSMS is of moderate length and easy to understand. It can be promoted in China in the future to understand the self-management status of middle-aged and elderly T2DM patients in China.
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Affiliation(s)
- Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyang Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haoran Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yijin Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weijun Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiman Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaqi Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Gao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Hubert PA, Fiorenti H, Duffy VB. Feasibility of a Theory-Based, Online Tailored Message Program to Motivate Healthier Behaviors in College Women. Nutrients 2022; 14:nu14194012. [PMID: 36235664 PMCID: PMC9572712 DOI: 10.3390/nu14194012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to test the feasibility of an online survey and tailored message program in young women. Recruited from college campuses, women (n = 189) completed an online survey assessing preference for and behaviors toward diet and physical activity as well as theory-based influencers of these behaviors (knowledge/information, motivation, and confidence). Health messages were tailored to the participant’s survey responses and learning style to address misconceptions and motivate or reinforce healthy physical activity and dietary behaviors. Most women reported the survey as relevant (92%) and useful for reflecting on their health (83%), with survey responses variable in level of nutrition and physical activity knowledge, motivation, and confidence. Each woman received four tailored messages—most reported the messages as relevant (80%) and learning new information (60%). Across all messages, nearly half of the participants (~48%) reported willingness to try or maintain healthier behaviors and confidence in their ability. Body size discrepancy and dietary restraint had small effects message responses of information learned, and the motivation and confidence in trying healthier behaviors. In summary, these data support the feasibility of this online tailored message program. The college women found the tailored message program acceptable and useful to motivate healthier behaviors. The findings provide direction for behaviorally focused interventions to improve dietary and physical activity behaviors.
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Benton M, Iman I, Goldsmith K, Forbes A, Ching SM, Papachristou Nadal I, Guess N, Murphy HR, Mohd Yusof BN, Baharom A, Mahamad Sobri NH, Basri NI, Salim MS, Ismail IZ, Hassan F, Ismail K, Chew BH. A Mobile Phone App for the Prevention of Type 2 Diabetes in Malaysian Women With Gestational Diabetes Mellitus: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37288. [PMID: 36074545 PMCID: PMC9501684 DOI: 10.2196/37288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over 50% of women with a history of gestational diabetes mellitus (GDM) will develop type 2 diabetes (T2D) in later life. Asian women experience a disproportionate risk of both GDM and T2D compared to women from other ethnic backgrounds. Lifestyle interventions and behavior change can delay or even prevent the onset of T2D. We have developed a digitalized diabetes prevention intervention for the prevention of T2D in Malaysian women with GDM. OBJECTIVE The protocol describes a randomized controlled trial (RCT) to test the feasibility of undertaking a definitive trial of a diabetes prevention intervention, including a smartphone app and group support. Secondary aims are to summarize anthropometric, biomedical, psychological, and lifestyle outcomes overall and by allocation group, and to undertake a process evaluation. METHODS This is a two-arm parallel feasibility RCT. A total of 60 Malaysian women with GDM will be randomized in the antenatal period to receive the intervention or standard care until 12 months post partum. The intervention is a diabetes prevention intervention delivered via a smartphone app developed based on the Information-Motivation-Behavioral Skills model of behavior change and group support using motivational interviewing. The intervention provides women with tailored information and support to encourage weight loss through adapted dietary intake and physical activity. Women in the control arm will receive standard care. The Malaysian Ministry of Health's Medical Research and Ethics Committee has approved the trial (NMRR-21-1667-60212). RESULTS Recruitment and enrollment began in February 2022. Future outcomes will be published in peer-reviewed health-related research journals and presented at national, regional, or state professional meetings and conferences. This publication is based on protocol version 2, January 19, 2022. CONCLUSIONS To our knowledge, this will be the first study in Malaysia that aims to determine the feasibility of a digital intervention in T2D prevention among women with GDM. Findings from this feasibility study will inform the design of a full-scale RCT in the future. TRIAL REGISTRATION ClinicalTrials.gov NCT05204706; https://clinicaltrials.gov/ct2/show/NCT05204706. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37288.
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Affiliation(s)
- Madeleine Benton
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Iklil Iman
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Kimberley Goldsmith
- Department of Biostatistics & Health Informatics, King's College London, London, United Kingdom
| | - Angus Forbes
- Division of Care in Long-term Conditions, King's College London, London, United Kingdom
| | - Siew Mooi Ching
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Nicola Guess
- Research Centre for Optimal Health, University of Westminster, London, United Kingdom
| | - Helen R Murphy
- Department of Medicine, University of East Anglia, Norfolk, United Kingdom
| | | | - Anisah Baharom
- Department of Community Health, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Irmi Zarina Ismail
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Faezah Hassan
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Boon How Chew
- Department of Family Medicine, Universiti Putra Malaysia, Selangor, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia, Serdang, Malaysia
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Price DM, Gesselman AN, Fikslin RA, Goldberg AJ, Pervez O, Reinka MA, Franklin E. How Can I Get COVID?: Understanding Differences in American Heterosexual and Sexual Minority Men’s Risk Perception. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:203-216. [PMID: 34779976 PMCID: PMC8592071 DOI: 10.1007/s10508-021-02123-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 07/09/2021] [Accepted: 08/01/2021] [Indexed: 05/30/2023]
Abstract
Men are more vulnerable to COVID-19 infections compared to women, but their risk perceptions around COVID-19 are persistently lower. Further, men often engage in less health promotion behavior because self-care in this capacity is seen as weak or less masculine. This combination has consequences for mortality; thus, a better understanding of men’s COVID-19 cognitions and individual difference factors is critical. In a web-based survey conducted during the beginning stages of the pandemic in the U.S., we collected risk perceptions of various sexual and non-sexual behaviors from heterosexual (n = 137) and gay/bisexual men (n = 108). There were no significant sexual orientation differences for perceptions of COVID-19 risk from routine activities or in overall risk estimates. However, gay/bisexual men did report engaging in more precautionary behavior while socializing (i.e., masking, social distancing) and reported higher risk perceptions than did heterosexual men for nearly all intimate and sexual activities. A more nuanced understanding of cognitions around COVID-19 is needed to better understand motivation for—and especially motivation against—pursuing vaccinations and continuing precautionary behavior.
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Affiliation(s)
- Devon M. Price
- Department of Psychology, Hunter College of the City University of New York, New York, NY 10065 USA
| | | | - Rachel A. Fikslin
- Department of Psychology, Hunter College of the City University of New York, New York, NY 10065 USA
- Department of Psychology, Graduate Center of the City, University of New York, New York, NY USA
| | - Alison J. Goldberg
- Department of Psychology, Hunter College of the City University of New York, New York, NY 10065 USA
- Department of Psychology, Graduate Center of the City, University of New York, New York, NY USA
| | - Omaima Pervez
- Department of Psychology, Hunter College of the City University of New York, New York, NY 10065 USA
| | - Mora A. Reinka
- Department of Psychology, Ursinus College, Collegeville, PA USA
| | - Elissia Franklin
- Research Her, LLC, South Holland, IL USA
- Purdue University, West Lafayette, IN USA
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