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Romaioli D. Framing the tendency to betray one's good intentions Akrasia as a dialogical dynamic. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2023. [DOI: 10.1111/jtsb.12375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Diego Romaioli
- Department of Philosophy, Sociology, Education and Applied Psychology University of Padova Padova Italy
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Doran EM, Doidge M, Aytur S, Wilson RS. Understanding farmers' conservation behavior over time: A longitudinal application of the transtheoretical model of behavior change. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 323:116136. [PMID: 36095987 DOI: 10.1016/j.jenvman.2022.116136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
Global waterbodies are experiencing increased risk of eutrophication and harmful algal blooms due to excess nutrients including phosphorus and nitrogen discharged from human activity on the landscape and as a result of climate change. Despite modeling that suggests the efficacy of best management practices in agricultural systems to be sufficient to address the problem, adoption by farmers remains far below the levels needed to achieve significant water quality improvements and new approaches to encourage and sustain adoption are urgently needed. In this work, we apply a modified transtheoretical model (TTM) of behavior change to a longitudinal dataset (N = 584) of farmers' adoption decisions and stated intentions to use cover crops, collected in the Maumee Basin of Lake Erie, USA in 2016 and 2018. The TTM posits that behavior changes over time and is influenced by different social-psychological processes at each stage of change. Our findings confirm past research into the importance of many of the factors investigated, while providing new insight into their role in specific stages of the change process with potential implications for the design of interventions for farmers in different stages. Several factors investigated (mean environmental concern, education, information from conservation groups and off-farm income) were uniquely important to a particular stage. Other factors (response efficacy at the field level, total farm size and risks of spring planting interference) were important at both an earlier and later stage, but less important in predicting middle stages of change. A third set of factors (self-efficacy, proportion rented, no-till adoption and uncertain long-term paybacks) were statistically important across each stage of the TTM model. In applying the TTM longitudinally, we found evidence that farmers in a more advanced stage of cover crop adoption, in the first wave of data collection (2016) were more likely to have adopted cover crops in the second wave (2018), a result not predicted by individual factors alone. We report findings for cover crops but see the potential for the transtheoretical model of behavior change to be applied to other best management practice adoption decisions and to diverse populations of farmers to generate similarly novel insight and utility for intervention design and targeting.
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Affiliation(s)
- Elizabeth Mb Doran
- Civil and Environmental Engineering Department, University of Vermont, Burlington, VT, USA; Gund Institute of Environment, University of Vermont, Burlington, VT, USA.
| | - Mary Doidge
- Department of Natural Resource Sciences, McGill University, Montreal, Canada
| | - Semra Aytur
- Department of Health Management and Policy, University of New Hampshire, Durham, NH, USA
| | - Robyn S Wilson
- School of Environment and Natural Resources, Ohio State University, Columbus, OH, USA
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Kosowan L, Katz A, Halas G, Singer A. Patient perspectives on tablet-based technology to collect risk factor information in primary care. BMC FAMILY PRACTICE 2021; 22:103. [PMID: 34039256 PMCID: PMC8157443 DOI: 10.1186/s12875-021-01443-7] [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: 03/01/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary care provides an opportunity to introduce prevention strategies and identify risk behaviours. Algorithmic information technology such as the Risk Factor Identification Tool (RFIT) can support primary care counseling. This study explores the integration of the tablet-based RFIT in primary care clinics to support exploration of patient risk factor information. METHODS Qualitative study to explore patients' perspectives of RFIT. RFIT was implemented in two primary care clinics in Manitoba, Canada. There were 207 patients who completed RFIT, offered to them by eight family physicians. We conducted one-on-one patient interviews with 86 patients to capture the patient's perspective. Responses were coded and categorized into five common themes. RESULTS RFIT had a completion rate of 86%. Clinic staff reported that very few patients declined the use of RFIT or required assistance to use the tablet. Patients reported that the tablet-based RFIT provided a user-friendly interface that enabled self-reflection while in the waiting room. Patients discussed the impact of RFIT on the patient-provider interaction, utility for the clinician, their concerns and suggested improvements for RFIT. Among the patients who used RFIT 12.1% smoked, 21.2% felt their diet could be improved, 9.3% reported high alcohol consumption, 56.4% reported less than 150 min of PA a week, and 8.2% lived in poverty. CONCLUSION RFIT is a user-friendly tool for the collection of patient risk behaviour information. RFIT is particularly useful for patients lacking continuity in the care they receive. Information technology can promote self-reflection while providing useful information to the primary care clinician. When combined with practical tools and resources RFIT can assist in the reduction of risk behaviours.
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Affiliation(s)
- Leanne Kosowan
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- Manitoba Centre for Health Policy and Departments of Community Health Science & Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, 408-727 McDermot Ave., Winnipeg, Manitoba, R3E 3P5, Canada.
| | - Gayle Halas
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alexander Singer
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Kosowan L, Katz A, Halas G, LaBine L, Singer A. Using Information Technology to Assess Patient Risk Factors in Primary Care Clinics: Pragmatic Evaluation. JMIR Form Res 2021; 5:e24382. [PMID: 33528376 PMCID: PMC7886616 DOI: 10.2196/24382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Tobacco use, physical inactivity, and poor diet are associated with morbidity and premature death. Health promotion and primary prevention counseling, advice, and support by a primary care provider lead to behavior change attempts among patients. However, although physicians consider preventative health important, there is often a larger focus on symptom presentation, acute care, and medication review. OBJECTIVE This study evaluated the feasibility, adoption, and integration of the tablet-based Risk Factor Identification Tool (RFIT) that uses algorithmic information technology to support obtainment of patient risk factor information in primary care clinics. METHODS This is a pragmatic developmental evaluation. Each clinic developed a site-specific implementation plan adapted to their workflow. The RFIT was implemented in 2 primary care clinics located in Manitoba. Perceptions of 10 clinic staff and 8 primary care clinicians informed this evaluation. RESULTS Clinicians reported a smooth and fast transfer of RFIT responses to an electronic medical record encounter note. The RFIT was used by 207 patients, with a completion rate of 86%. Clinic staff reported that approximately 3%-5% of patients declined the use of the RFIT or required assistance to use the tablet. Among the 207 patients that used the RFIT, 22 (12.1%) smoked, 39 (21.2%) felt their diet could be improved, 20 (12.0%) reported high alcohol consumption, 103 (56.9%) reported less than 150 minutes of physical activity a week, and 6 (8.2%) patients lived in poverty. Clinicians suggested that although a wide variety of patients were able to use the tablet-based RFIT, implemented surveys should be tailored to patient subgroups. CONCLUSIONS Clinicians and clinic staff positively reviewed the use of information technology in primary care. Algorithmic information technology can collect, organize, and synthesize individual health information to inform and tailor primary care counseling to the patients' context and readiness to change. The RFIT is a user-friendly tool that provides an effective method for obtaining risk factor information from patients. It is particularly useful for subsets of patients lacking continuity in the care they receive. When implemented within a context that can support practical interventions to address identified risk factors, the RFIT can inform brief interventions within primary care.
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Affiliation(s)
- Leanne Kosowan
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, Winnipeg, MB, Canada
| | - Gayle Halas
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa LaBine
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alexander Singer
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
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Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Rahimi A, Hashemzadeh M, Zare-Farashbandi F, Alavi Naeini AM, Hasanzadeh A. The effect of nutrition education course on awareness of obese and overweight female 1 st-year High School students of Isfahan based on transtheoretical model of behavioral change. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:76. [PMID: 29963569 PMCID: PMC6009135 DOI: 10.4103/jehp.jehp_120_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/04/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND/AIM Today, the problem of obesity is a chronic condition that affects all age groups in developed and developing countries. Since adolescence is a transitional period and behavioral patterns formed in this period affect people in their adult years, attention to obesity and extra weight in this age group is more important than other groups. Therefore, this study aims to investigate the effects of nutrition education course on awareness of female 1st-year high school students of Isfahan based on transtheoretical model ( TTM) of behavioral change. MATERIALS AND METHODS In this semi-empirical study, 64 female 1st-year high school students with weight problem were selected using nonpercent stratified sampling and divided into two control and test groups. Data gathering was carried out using researcher-made nutrition awareness and stages of change questionnaire whose validity and reliability was confirmed. Participants in the test group participated in a 2-month education with sessions every 2 weeks and received one brochure and 3 educational massages each week. Data were analyzed using independent t-test and Mann-Whitney test. RESULTS The results showed that the average nutrition awareness score of students in test group was significantly higher than control group after intervention. Students in test group were also in higher stages of change compared to control group after intervention. CONCLUSION The results show that TTM was effective in changing nutritional behavior in students.
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Affiliation(s)
- Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozhdeh Hashemzadeh
- Department of Medical Librarianship and Information Science , School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi Naeini
- Department of Community Nutrition and Food Sciences. Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Partridge SR, McGeechan K, Bauman A, Phongsavan P, Allman-Farinelli M. Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention. Appetite 2016; 108:425-433. [PMID: 27818304 DOI: 10.1016/j.appet.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/29/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. PURPOSE First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. METHODS Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. RESULTS Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P < 0.001 and P = 0.012 respectively) compared to controls. Intervention participants' vegetable and physical activity behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. CONCLUSIONS This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults.
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Affiliation(s)
- Stephanie R Partridge
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Kevin McGeechan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Adrian Bauman
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Philayrath Phongsavan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
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Yusufov M, Paiva AL, Redding CA, Lipschitz JM, Gokbayrak NS, Greene G, Rossi JS, Blissmer B, Velicer WF, Prochaska JO. Fat Reduction Efforts. Health Promot Pract 2015; 17:116-26. [DOI: 10.1177/1524839915606423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research examined dynamic transtheoretical model (TTM) constructs for dietary fat reduction. This secondary data analysis pooled three large population-based TTM-tailored school, worksite, medical, and home-based intervention studies and examined use of constructs across three groups organized by longitudinal progress (dynatypes): Maintainers, Relapsers, and Stable Non-Changers. The criteria for successful change, at the time, were that less than 30% of calories came from fat. A total of 2,718 adults met criteria for an unhealthy diet at baseline. The majority of participants were female, White, married, and middle-aged. Demographics, Stage of Change, Processes of Change, Decisional Balance, and Temptations were measured. Dynatype groups were assessed with reliable and valid scales assessing constructs at baseline and 6, 12, and 24 months. Analyses included a multivariate analysis of variance followed by a series of analyses of variance, with Tukey follow-up tests assessing differences in use of TTM constructs across the three groups at each time point. Relapsers and Maintainers were similar in their use of all TTM Processes of Change at baseline, with the exception of Self-Liberation (η2 = 0.15, p < .001) and Reinforcement Management (η2 = 0.01, p < .001). Although Relapsers reverted to an unhealthy diet, their overall greater use of Processes of Change suggests that their behaviors and strategy use remain better than that of the Stable Non-Changer group. Results suggest that specific cognitive and behavioral constructs may contribute differentially to intervention outcomes.
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DiClemente CC, Delahanty JC, Havas SW, Van Orden OR. Understanding self-reported staging of dietary behavior in low-income women. J Health Psychol 2015; 20:741-53. [DOI: 10.1177/1359105315580213] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined self-reported staging for the goal of eating a low-fat diet and several specific dietary consumption behaviors to understand better readiness for dieting. Self-assessed motivation, food frequency measures, and psychosocial variables were obtained from 2057 low-income women enrolled in the Maryland Food for Life Program. Results indicated that staging of specific dietary consumption behaviors was significantly related to staging for the global goal of eating a low-fat diet. Women evaluate their motivation about eating low-fat diets based on perceived efforts and specific activities related to dietary consumption with important implications for dietary behavior change measurement and interventions.
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Geraee N, Kaveh MH, Shojaeizadeh D, Tabatabaee HR. Impact of media literacy education on knowledge and behavioral intention of adolescents in dealing with media messages according to Stages of Change. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2015; 3:9-14. [PMID: 25587549 PMCID: PMC4291508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 05/19/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Mass media influence the health behaviors of adolescents. Evidence shows that traditional strategies such as censorship or limitation are no longer efficient; therefore, teaching media literacy is the best way to protect adolescents from harmful effects. The aim of this pilot study was to evaluate the effects of a media literacy training program on knowledge and behavioral intention of a sample of female students according to the stages of change in dealing with media messages. METHODS The study was conducted based on a pre-test and post-test control group design. Some 198 female students including 101 in the intervention group and 97 in the control group participated in this study. The educational program was run using interactive teaching-learning techniques. Data collection was performed using a validated and reliable self-administered questionnaire in three phases including a pre-test, post-test, 1 and post-test, 2. The research data was analyzed through SPSS statistical software, version 14 using both descriptive and inferential statistics. RESULTS The results of the study showed a significant increase (p=0.001) in the intervention group's knowledge mean scores after the training program. On the other hand, the difference was not significant in the control group (p=0.200). A considerable percentage of the participants, in the intervention and control groups, were in pre contemplation and contemplation stages in the pre-test (64 and 61, respectively). After the intervention, however, a significant improvement (p=0.001) was observed in the intervention group's stages of change compared to that in the control group. The distribution of the control group students regarding the stages of change was similar to that in the pre-test. CONCLUSION The study findings revealed that the planned education programs are efficient to improve the adolescents' knowledge and behavioral intention in dealing with mass media messages.
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Affiliation(s)
- Narjes Geraee
- Department of health education and promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Department of health education and promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davod Shojaeizadeh
- Department of health education and promotion, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Tabatabaee
- Department of epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Webb FJ, Khubchandani J, Doldren M, Balls-Berry J, Blanchard S, Hannah L, Stanford J, Webster-Bass S. African-American Womens’ Eating Habits and Intention to Change: a Pilot Study. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0026-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ribeiro RQC, Alves L. Comparison of two school-based programmes for health behaviour change: the Belo Horizonte Heart Study randomized trial. Public Health Nutr 2014; 17:1195-204. [PMID: 23438441 PMCID: PMC10282417 DOI: 10.1017/s1368980013000189] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 11/09/2012] [Accepted: 01/02/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the efficacy of two school-based programmes to promote students' willingness to engage in lifestyle changes related to eating habits and physical activity behaviours. DESIGN Elementary school-based health promotion intervention, designed as a multicomponent experimental study, based on a behavioural epidemiological model. SETTING Nine intervention and eight comparative public and private elementary schools. SUBJECTS The goal was to determine the impact on the longitudinally assessed outcomes of two programmes that addressed healthy nutrition and active living in a cohort of 2038 children. The evaluations used pre-intervention and follow-up student surveys that were based on the Transtheoretical Model of the stages of behaviour change. RESULTS In the intervention group, there were significant (P < 0·001) differences between the pre- and post-intervention times in the stages of change, with a reduction in the percentage of children at the pre-contemplation and contemplation stages and increased percentages at the preparation, action and maintenance stages, leading to healthier behaviours in fatty food consumption, fruit and vegetable consumption, physical activity and time spent in sedentary activities. The determinants of the behaviour stage were the intervention programme, the type of school and the presence of motivated teachers. The comparison group did not show significant differences between the pre- and post-intervention times for any of the stages of behaviour. CONCLUSIONS The intervention programme encouraged the students to make healthy lifestyle choices related to eating habits and physical activity behaviours.
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Affiliation(s)
- Robespierre QC Ribeiro
- Minas Gerais State Secretariat for Health/Non-communicable Disease, Surveillance Sector, Rua Santa Helena 75, 30.220-240 Belo Horizonte, MG, Brazil
| | - Luciana Alves
- Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Kortrijk HE, Mulder CL, van Vliet D, van Leeuwen C, Jochems E, Staring ABP. Changes in motivation for treatment in precontemplating dually diagnosed patients receiving assertive community treatment. Community Ment Health J 2013; 49:733-41. [PMID: 23288491 DOI: 10.1007/s10597-012-9582-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 12/25/2012] [Indexed: 11/30/2022]
Abstract
In a population of dually diagnosed patients receiving assertive community treatment we used the theoretical framework of the transtheoretical model to establish (a) the proportions and characteristics of patients who were not motivated for treatment for psychiatric symptoms and substance use, (b) the proportion of patients who moved towards behavioral change after about 1 year, and examine how this change was related with clinical outcome; and (c) the sequence of change processes. Chi square tests and T tests were used to compare the patient characteristics and outcomes of patients who remained in precontemplation with those who progressed. During follow-up, 47 % of the patients came out of the precontemplation phase for treatment of psychiatric symptoms and 38 % for substance use behavior. Those who remained in precontemplation benefited less from treatment. Of those who did move forward, most appeared to become motivated for psychiatric treatment before becoming motivated to reduce substance use.
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Affiliation(s)
- H E Kortrijk
- Bavo-Europoort Psychiatric Institute, Prins Constantijnweg 48-54, 3066 TA, Rotterdam, The Netherlands,
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Basic concepts in the taxonomy of health-related behaviors, habits and lifestyle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1963-76. [PMID: 23670578 PMCID: PMC3709359 DOI: 10.3390/ijerph10051963] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/22/2013] [Accepted: 04/28/2013] [Indexed: 11/28/2022]
Abstract
Background: Health-related Habits (HrH) are a major priority in healthcare. However there is little agreement on whether exercise, diet, smoking or dental hygiene are better described as lifestyles, habits or behaviors, and on what is their hierarchical relationship. This research is aimed at representing the basic concepts which are assumed to constitute the conceptual framework enabling us to interpret and organize the field of HrH. Methods: A group of 29 experts with different backgrounds agreed on the definition and hierarchy of HrH following an iterative process which involved framing analysis and nominal group techniques. Results: Formal definitions of health-related behavior, habit, life-style and life-style profile were produced. In addition a series of basic descriptors were identified: health reserve, capital, risk and load. Six main categories of HrH were chosen based on relevance to longevity: diet/exercise, vitality/stress, sleep, cognition, substance use and other risk. Attributes of HrH are clinical meaningfulness, quantifiability, temporal stability, associated morbidity, and unitarity (non-redundancy). Two qualifiers (polarity and stages of change) have also been described. Conclusions: The concepts represented here lay the groundwork for the development of clinical and policy tools related to HrH and lifestyle. An adaptation of this system to define targets of health interventions and to develop the classification of person factors in ICF may be needed in the future.
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Gabbiadini A, Mari S, Volpato C. Virtual users support forum: do community members really want to help you? CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2013; 16:285-92. [PMID: 23530547 DOI: 10.1089/cyber.2012.0412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The survival of a virtual community is guaranteed by the users' creation of content. However, the literature has found that the percentage of users who create innovative content is very modest. The content contribution process can also be interpreted as a social collective action in which we-intentions play a primary role. Nevertheless, some people choose not to participate in the collective action, but to benefit from the community's resources and to maximize individual outcomes. In this study (N=250), we investigated the effects of the free-riding tendency, conceived as the willingness to maximize personal outcomes. The specific setting was a virtual support forum, the most common type of web platform, generally used instrumentally by web users to find information and solutions to specific problems. We used the theory of planned behavior theoretical framework, plus social influence variables to test the effect of the free-riding tendency as a drawback for contributions, considering both the role of individual and we-intentions on the observed behavior. Findings showed that neither we-intentions nor I-intentions predicted the actual contribution behavior. Both types of intentions and contribution behavior were negatively influenced only by the free-riding tendency construct. Considerations and future developments of these results are discussed.
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Hebden L, Balestracci K, McGeechan K, Denney-Wilson E, Harris M, Bauman A, Allman-Farinelli M. 'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial. Trials 2013; 14:75. [PMID: 23506013 PMCID: PMC3610110 DOI: 10.1186/1745-6215-14-75] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/07/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Despite international efforts to arrest increasing rates of overweight and obesity, many population strategies have neglected young adults as a target group. Young adults are at high risk for unhealthy weight gain which tends to persist throughout adulthood with associated chronic disease health risks. METHODS/DESIGN TXT2BFiT is a nine month two-arm parallel-group randomized controlled trial aimed at improving weight management and weight-related dietary and physical activity behaviors among young adults. Participants are recruited via general practice (primary medical care) clinics in Sydney, New South Wales, Australia. All participants receive a mailed resource outlining national physical activity and dietary guidelines and access to the study website. Additional resources accessible to the intervention arm via the study website include Smartphone mobile applications, printable handouts, an interactive healthy weight tracker chart, and a community blog. The study consists of two phases: (1) Intensive phase (weeks 1 to 12): the control arm receives four short message service (SMS) text messages; the intervention arm receives eight SMS messages/week tailored to their baseline stage-of-change, one Email/week, and personalized coaching calls during weeks 0, 2, 5, 8, and 11; and (2) Maintenance phase (weeks 14 to 36): the intervention arm receives one SMS message/month, one Email/month and booster coaching calls during months 5 and 8. A sample of N = 354 (177 per arm) is required to detect differences in primary outcomes: body weight (kg) and body mass index (kg/m2), and secondary outcomes: physical activity, sitting time, intake of specific foods, beverages and nutrients, stage-of-change, self-efficacy and participant well-being, at three and nine months. Program reach, costs, implementation and participant engagement will also be assessed. DISCUSSION This mobile phone based program addresses an important gap in obesity prevention efforts to date. The method of intervention delivery is via platforms that are highly accessible and appropriate for this population group. If effective, further translational research will be required to assess how this program might operate in the broader community. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12612000924853.
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Affiliation(s)
- Lana Hebden
- School of Molecular Bioscience, University of Sydney, Sydney, NSW 2006, Australia
| | - Kate Balestracci
- School of Molecular Bioscience, University of Sydney, Sydney, NSW 2006, Australia
| | - Kevin McGeechan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Adrian Bauman
- Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
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Jochems EC, Mulder CL, van Dam A, Duivenvoorden HJ, Scheffer SCM, van der Spek W, van der Feltz-Cornelis CM. Motivation and treatment engagement intervention trial (MotivaTe-IT): the effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness. BMC Psychiatry 2012; 12:209. [PMID: 23176560 PMCID: PMC3536707 DOI: 10.1186/1471-244x-12-209] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 11/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. METHODS/DESIGN The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients' treatment motivation upon the patients' TE. The primary outcome is the patients' TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. DISCUSSION The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment engagement and clinical outcomes. The identification of possible mechanisms through which changes in the outcomes occur, offers a tool for the development of more effective future interventions to improve TM and TE. TRIAL REGISTRATION Current Controlled Trials NTR2968.
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Affiliation(s)
- Eline C Jochems
- Department of Psychiatry, Epidemiological and Social Psychiatric Research institute, Erasmus University Medical Centre, Dr, Molewaterplein 50, Rotterdam, 3015 GE, The Netherlands.
| | - Cornelis L Mulder
- Department of Psychiatry, Epidemiological and Social Psychiatric Research institute, Erasmus University Medical Centre, Dr. Molewaterplein 50, Rotterdam, 3015 GE, The Netherlands
| | - Arno van Dam
- GGZ Westelijk Noord Brabant, Post Office Box 371, Bergen op Zoom, 4600 AJ, The Netherlands
| | | | - Sylvia CM Scheffer
- GGZ Westelijk Noord Brabant, Post Office Box 371, Bergen op Zoom, 4600 AJ, The Netherlands
| | | | - Christina M van der Feltz-Cornelis
- GGZ Breburg, Post Office Box 770, Tilburg, 5000 AT, The Netherlands,Faculty of Social Sciences, Tilburg University, Post Office Box 90153, Tilburg, 5000 LE, The Netherlands,Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, Utrecht, 3500 AS, The Netherlands
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Di Noia J, Mauriello L, Byrd-Bredbenner C, Thompson D. Validity and reliability of a dietary stages of change measure among economically disadvantaged African-American adolescents. Am J Health Promot 2012; 26:381-9. [PMID: 22747321 DOI: 10.4278/ajhp.100903-quan-302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the construct validity and 2-month test-retest reliability of a staging measure for assessing readiness to consume five or more daily servings of fruits and vegetables among economically disadvantaged African-American adolescents. DESIGN Longitudinal survey. SETTING Youth services agencies serving low-income communities in New York, New Jersey, and Pennsylvania. SUBJECTS African-American adolescents (N = 390) aged 11 to 14 years. MEASURES Self-report measures of stage of change and fruit and vegetable consumption. ANALYSIS Correlation analysis and analysis of covariance were used to examine, cross-sectionally, whether fruit and vegetable consumption differed by stage of change (validity assessment). Correlation analysis and Cohen's kappa (κ) were used to assess the degree of association and level of agreement between stages longitudinally (test-retest reliability assessment). RESULTS Fruit and vegetable consumption was moderately correlated with stage of change (r ≥ .54, p = .000). Consistent with the transtheoretical model, youths' consumption increased from earlier to later stages (p = .000). Forty-six percent of youths were in the same stage at both measurements. The correlation between stages was .26, and Cohen's κ was .20 (p = .000). CONCLUSIONS Despite preliminary evidence of construct validity, the low test-retest reliability found suggests that further research and testing are needed to improve the stability of the measure.
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Affiliation(s)
- Jennifer Di Noia
- Department of Sociology, William Paterson University, Wayne, NJ 07470, USA.
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GIBBISON GODFREYA, JOHNSON CDOUGLAS. Stages of Change in Physical Exercise and Social Support: An Integrated Socio-Psycho-Economic Approach. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2011. [DOI: 10.1111/j.1559-1816.2011.00801.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Silva DAS, Pelegrini A, Grigollo LR, Silva AFD, Petroski EL. Diferenças e similaridades dos estágios de mudança de comportamento para atividade física em adolescentes de duas áreas brasileiras. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000200010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Determinar as diferenças e similaridades dos estágios de mudança de comportamento para atividade física e fatores associados em adolescentes de duas áreas brasileiras. MÉTODOS: Estudo transversal conduzido em escolares de 14 a 17 anos, de escolas públicas, sendo 601 do Meio Oeste Catarinense (SC) e 464 do Norte de Minas (MG). Identificaram-se os estágios de mudança de comportamento para atividade física por meio de questionário padronizado. Coletaram-se informações sociodemográficas, dados de adiposidade corporal e estado nutricional. Foram empregados o teste do qui-quadrado ou exato de Fisher ou teste de comparação entre duas proporções e a regressão multivariável de Poisson com variância robusta, adotando-se nível de significância de 5%. RESULTADOS: A maior parte dos estudantes de Minas Gerais e de Santa Catarina encontrava-se no estágio preparação (32,8%) e manutenção (41,9%). Em ambas as regiões, o sexo feminino apresentou maior probabilidade de ter um comportamento inativo fisicamente (SC: RP=1,25; IC95% 1,04-1,50; MG: RP=1,53; IC95% 1,29-1,80). Outros grupos de risco foram sujeitos com baixo peso em Santa Catarina (RP=1,39; IC95% 1,06-1,81) e com excesso de adiposidade em Minas Gerais (RP=1,21; IC95% 1,02-1,49). CONCLUSÕES: Intervenções de promoção da atividade física que considerem características culturais e econômicas para cada localidade são recomendadas.
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Martín-Matillas M, Ortega FB, Chillon P, Pérez IJ, Ruiz JR, Castillo R, Gómez-Martínez S, Moreno LA, Delgado-Fernández M, Tercedor P, On Behalf of the AVENA Study*. Physical activity among Spanish adolescents: Relationship with their relatives' physical activity – The AVENA Study. J Sports Sci 2011; 29:329-36. [DOI: 10.1080/02640414.2010.523091] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Applying the stages of change to multiple low-fat dietary behavioral contexts. An examination of stage occupation and discontinuity. Appetite 2009; 53:345-53. [DOI: 10.1016/j.appet.2009.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 06/05/2009] [Accepted: 07/18/2009] [Indexed: 11/22/2022]
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