Prediction of stage transitions in fruit and vegetable intake

Psychosocial Factors Predicting HIV Disclosure Stage Transitions: An Evaluation of A Theory-Based Parental HIV Disclosure Intervention among Parents Living with HIV in China

Appropriate parental HIV disclosures (i.e., parents living with HIV [PLH] tell their HIV diagnosis to their children) benefit parents, children, and family relations. Psychosocial factors could influence the decision-making process of parental HIV disclosure. Using the Health Action Process Approach to frame stages (pre-intention, intention, and action) in the decision-making process, this study aimed to investigate how psychosocial factors predict HIV disclosure stage transitions among PLH in China. Data were collected from a randomized clinical trial of a theory-based parental HIV disclosure intervention among 791 PLH. The predictive effects of psychosocial factors on disclosure stage transitions were examined using a Markov chain model matrix. Results showed that action self-efficacy and action planning were significant predictors of parental HIV disclosure stage transitions. Considering stage-specific psychosocial predictors may contribute to effective interventions to promote appropriate HIV disclosure among PLH in China.

Effectiveness of a motivated, action-based intervention on improving physical activity level, exercise self-efficacy and cardiovascular risk factors of patients with coronary heart disease in Sri Lanka: A randomized controlled trial protocol

BACKGROUND

Coronary heart disease (CHD), is the major contributor to cardiac-associated mortality worldwide. Lifestyle modification, including physical activity, is highly recommended for secondary prevention for patients with CHD. However, many people in Sri Lanka with CHD do not engage in adequate physical activity.

OBJECTIVE

To develop a culture-specific, motivated, and action-based intervention and examine its effects on physical activity level, exercise self-efficacy, and cardiovascular risk factors among patients with CHD.

METHODS AND MATERIALS

This is an assessor-blinded randomized controlled trial that will recruit 150 patients with CHD from the inpatients cardiac unit of a hospital in Batticaloa, Sri Lanka, and will randomly assign them either to the intervention group or the control group. The participants in the intervention group will receive a culture-specific and motivated, action-based intervention in addition to the usual care, while participants in the control will only receive the usual care. The intervention consists of a face-to-face preparatory session and 12-week motivated, action-based sessions which were developed based on the health action process approach (HAPA) framework. The face-to-face preparatory session will identify the health needs of the participants, develop a goal-oriented patient-centered action plan, and provide knowledge and an overview of the program. The 12-week motivated, action-based sessions consist of three monthly group education and center-based group exercises, followed by three 20-min individualized telephone follow-ups. Outcomes will be assessed immediately after the intervention and at one-month post-intervention.

DISCUSSION

This protocol proposes a supervised centered-based group exercise with group education, and individualized telephone follow-ups guided by the HAPA framework to improve the physical activity level, exercise self-efficacy, and cardiovascular risk factors of patients with CHD. Results from this study will inform the effectiveness of a motivated, action-based intervention in a low-resource setting and provide information on the feasibility, barriers, and facilitators for lifestyle modification in Sri Lanka.

TRIAL REGISTRATION

ClinicalTrial.gov.org PRS: NCT05051774; Date of registration: September 21, 2021.

Predictors of lapse and relapse in physical activity and dietary behaviour: a systematic search and review on prospective studies

OBJECTIVE

Behaviour change maintenance seems to be difficult for many people. To prevent people from relapsing, insight into determinants of relapse is needed. We synthesized the evidence on predictors of lapse and relapse in physical activity and dietary behaviour change.

DESIGN

Prospective studies in adults aged ≥18 years were identified from systematic searches in PsycINFO, PubMed and Cinahl. Methodological quality was analysed, and data were synthesized narratively.

MAIN OUTCOME MEASURES

Lapse and relapse in physical activity and dietary behaviour.

RESULTS

37 articles were included. For several predictors, evidence for an association was found, with self-efficacy as the only consistent predictor across the different outcomes, predicting both lapse and relapse in physical activity, and relapse in dietary behaviour. For most other variables, evidence for prospective relationships with lapse and relapse was insufficient.

CONCLUSION

Most predictors on lapse and relapse were not examined frequently enough to draw conclusions from; many predictors were studied only once or had inconclusive evidence. To be able to provide more substantiated conclusions, more high-quality research is needed. Practitioners and intervention programs could focus on sustainability of behaviour change, by targeting the outcome of interest and its relevant predictors by using behaviour change techniques that have proven effective.

Intervention to enhance adherence to mandibular advancement appliance in patients with obstructive sleep apnoea: study protocol for a randomised clinical trial

Background

Obstructive sleep apnoea (OSA) is a sleep-related breathing disorder characterised by the repeated episodic collapse of the upper airway during sleep, resulting in sleep deprivation, giving rise to apnoeas and hypopnoeas. Based on the severity of OSA, there are two primary treatment modalities, continuous positive airway pressure (CPAP) and mandibular advancement appliances (MAA); both are adherence-dependent. MAA is offered to those with mild to moderate OSA and is prescribed as an alternative to patients intolerable to CPAP. However, adherence to MAA treatment is variable and declines over time. Hence, the current study aims to assess the effectiveness of the stage-matched intervention, the Health Action Process Approach (HAPA), on adherence to MAA in patients with OSA.

Methods

A single-centre randomised clinical trial will be undertaken at Bart’s Health NHS Trust. Fifty-six participants with newly diagnosed OSA are planned to be enrolled in the study and randomised to intervention care (IC) and standardised care (SC) groups. Participants in the SC group will receive routine care whilst participants in the IC group will receive the stage-matched intervention, developed using the HAPA model. Data indicating MAA adherence will be collected both objectively and subjectively, from micro-sensors embedded in the MAA design and sleep diaries, respectively at 3, 6, 18 and 36 months. In addition, a range of questionnaires designed to assess risk perception, outcome expectancy, and self-efficacy (SEMSA) and quality of sleep (PSQI and ESS) and life (EQ-5DL), socio-economic and social support scales will be used.

Discussion

The currently available treatments for obstructive sleep apnoea depend entirely on the patient’s acceptance and use. There are several factors that affect cooperation and wear for example patients’ awareness of their condition, social support and psychological behaviour. In addition, mood, such as anxiety, stress, and depression, may affect wear. At the same time, we know that interventions involving more education and behaviour approaches can help patients adapt more easily to some treatments. As a result, the present trial aims to explore the potential role of these factors to maximise treatment success and minimise side effects.

Trial registration

ClinicalTrials.gov NCT04092660. Registered on September 6, 2019

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05582-1.

An 8-Week Study on Social-Cognitive Variables for Physical Activity and Fruit and Vegetable Intake: Are there Stage Transitions?

BACKGROUND

Health behavior change can be modelled in terms of stages, and outcomes of transitions between stages can be categorized into progression, regression, and stagnation. Based on the Health Action Process Approach this study tested whether changes in social-cognitive variables are associated with transitions between stages regarding physical activity (PA) and fruit and vegetable intake (FVI).

METHODS

N = 132 participants (M = 50.86 years, SD = 13.17, 61.4% women) were assessed at baseline and 8 weeks later. Data were analysed using multivariate analyses of variance (MANOVA) and post-hoc comparisons.

RESULTS

Changes in motivational self-efficacy (η²  = 0.081), maintenance self-efficacy (η²  = 0.119), and recovery self-efficacy (η²  = 0.049) as well as positive outcome expectancies (η²  = 0.070), negative outcome expectancies (η²  = 0.055), and coping planning (η²  = 0.065) were associated with FVI stage progression. For PA, changes were not associated with stage progression.

CONCLUSION

To facilitate behavior change effectively, at least for FVI, it is essential to consider underlying mechanisms such as several aspects of self-efficacy in performing the desired health behaviors, outcome expectations, and planning how to overcome barriers. Additionally, the adoption of a stage approach may be a useful starting point to develop stage-matched interventions.

Determinants of effective nurse-patient communication based on the health action process approach in Yazd hospitals

Background Nurse-patient communication is one of the most important care relationships that affects the treatment process. The health action process approach (HAPA) has been used to explain a number of behaviors. However, this approach has not been used to explain nurse-patient communication. Therefore, this study was conducted to investigate effective nurse-patient communication using this approach. Materials and methods In this cross-sectional study, 300 nurses from public hospitals in the center of Iran were enrolled in the study. A researcher-developed questionnaire was used to measure the HAPA constructs. The data were analyzed using Pearson's correlation coefficient and one-way analysis of variance with least significant difference (LSD) post hoc tests in SPSS as well as structural equation modeling using AMOUS software. Results In the motivation phase, risk perception, outcome expectancies and task self-efficacy predicted 19% of variance in intention to communicate effectively. In the volitional phase, planning and action self-efficacy predicted 22% of variance in effective communication. The scores of HAPA constructs were different depending on the levels of effective communication. Conclusions The model can serve as a reference framework to promote effective nurse-patient communication.

A Study on the Applicability of the Health Action Process Approach to the Dietary Behavior of University Students in Shanxi, China

OBJECTIVE

To confirm the applicability of the Health Action Process Approach in predicting and explaining the healthy dietary behavior of college students.

DESIGN

Cross-sectional survey. The data were collected though the self-administrated questionnaires.

SETTING

Eight universities in Shanxi province, China.

PARTICIPANTS

A total of 1,933 undergraduates were randomly selected using random cluster sampling from Shanxi, China (92.0% response; 31.7% males).

MAIN OUTCOME MEASURES

Each variable was measured using questionnaires.

ANALYSIS

Data were analyzed by 2-sample t test, linear correlation, and path analysis. Significance was set at P < .05.

RESULTS

Risk perception, self-efficacy, and positive expectancy began functioning during the intention formation stage (P < .01). Outcome expectancy, self-efficacy, and behavioral intentions had a predictive role in plan formation (P < .001). Action planning, positive expectancy, and self-efficacy were effective predictors of dietary behavior (P < .001). An action plan was a mediator between behavioral intention and dietary behavior; the mediation effect was 0.086.

CONCLUSIONS AND IMPLICATIONS

As a first step, application of Health Action Process Approach to the dietary behavior of Chinese college students was confirmed. Future research expanding on this study could consider including additional sociodemographic factors in the model structure using a broader study population.

Applying Instructional Design Strategies and Behavior Theory to Household Disaster Preparedness Training

CONTEXT

Interventions and media campaigns promoting household disaster preparedness have produced mixed results in affecting behaviors. In large part, this is due to the limited application of instructional design strategies and behavior theory, such as the Transtheoretical Model (TTM). This study describes the development and evaluation of Ready CDC, an intervention designed to increase household disaster preparedness among the Centers for Disease Control and Prevention (CDC) workforce.

OBJECTIVES

(1) Describe the instructional design strategies employed in the development of Ready CDC and (2) evaluate the intervention's impact on behavior change and factors influencing stage progression for household disaster preparedness behavior.

DESIGN

Ready CDC was adapted from the Federal Emergency Management Agency's (FEMA's) Ready campaign. Offered to CDC staff September 2013-November 2015, it consisted of a preassessment of preparedness attitudes and behaviors, an in-person training, behavioral reinforcement communications, and a 3-month follow-up postassessment.

RESULTS

Ready CDC employed well-accepted design strategies, including presenting stimulus material and enhancing transfer of desired behavior. Excluding those in the TTM "maintenance" stage at baseline, this study determined 44% of 208 participants progressed at least 1 stage for developing a written disaster plan. Moreover, assessment of progression by stage found among participants in the "precontemplation" (n = 16), "contemplation" (n = 15), and "preparation" (n = 125) stages at baseline for assembling an emergency kit, 25%, 27%, and 43% moved beyond the "preparation" stage, respectively. Factors influencing stage movement included knowledge, attitudes, and community resiliency but varied depending on baseline stage of change.

CONCLUSIONS

Employing instructional strategies and behavioral theories in preparedness interventions optimizes the potential for individuals to adopt preparedness behaviors. Study findings suggest that stage movement toward household preparedness was not spurious but rather associated with the intervention. Therefore, Ready CDC was successful in moving staff along the continuous process of adopting household disaster preparedness behaviors, thus providing a model for future interventions. The TTM suggests factors such as knowledge, beliefs, and self-efficacy will differ by stage and may differentially predict progression towards behavior adoption. Thus, tailoring interventions based on an individual's stage of change optimizes the potential for individuals to adopt desired behaviors.

Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery

BACKGROUND

To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function).

PURPOSE

Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated.

METHOD

Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support.

RESULTS

Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy.

CONCLUSION

Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention

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.

Predictors of dyadic planning: Perspectives of prostate cancer survivors and their partners

OBJECTIVES

Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy.

DESIGN

Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months.

METHODS

PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates.

RESULTS

Findings from two-level models nesting repeated assessments in individuals showed that context (patients' incontinence), target person (i.e., positive affect and self-efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients' and partners' accounts of dyadic planning differed.

CONCLUSIONS

Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals. Statement of contribution What is already known on this subject? Dyadic planning has been shown to be linked to health behaviour change. However, its role in behaviour regulation frameworks is not well investigated, especially regarding factors that might be predictive of dyadic planning. What does this study add? A framework of predictors of dyadic planning in the health behaviour change process is presented. The framework is investigated accounting for both planning partners' perspectives. Context, target person, and relationship factors were related to dyadic planning.

Self-Efficacy and Planning as Predictors of Physical Activity in the Context of Workplace Health Promotion

BACKGROUND

Fostering self-efficacy and planning in individuals can support the uptake and maintenance of regular physical activity. This study examined self-efficacy and planning as mechanisms of an online-delivered workplace health promotion intervention to enhance employees' physical activity. A special focus lay on reciprocal interrelations among self-efficacy and planning over time, as previous work predominantly accounted for only one predictive direction at a time.

METHODS

Data from N = 1,063 employees of a pharmaceutical company who reported an intention to increase their physical activity levels were assessed at three measurement points up to 12 weeks following the intervention. Cross-lagged panel analyses were performed to examine effects of self-efficacy and planning on physical activity as well as reciprocal interrelations between self-efficacy and planning.

RESULTS

Findings indicated an increase in self-efficacy, planning, and physical activity following the intervention. Planning was consistently linked to subsequent physical activity, whereas self-efficacy was not associated. Also, reciprocal interrelations among self-efficacy and planning were found across both measurement lags.

CONCLUSIONS

Planning was confirmed as a predictor of physical activity, whereas self-efficacy was not. However, cross-lagged interrelations indicated reciprocal reactivation among self-efficacy and planning over time, suggesting beneficial effects of including strategies that foster both volitional constructs in interventions.

Volitional processes and daily smoking: examining inter- and intraindividual associations around a quit attempt

The Health Action Process Approach (HAPA) assumes that volitional processes are important for effective behavioral change. However, intraindividual associations have not yet been tested in the context of smoking cessation. This study examined the inter- and intraindividual associations between volitional HAPA variables and daily smoking before and after a quit attempt. Overall, 100 smokers completed daily surveys on mobile phones from 10 days before until 21 days after a self-set quit date, including self-efficacy, action planning, action control, and numbers of cigarettes smoked. Negative associations between volitional variables and daily numbers of cigarettes smoked emerged at the inter- and intraindividual level. Except for interindividual action planning, associations were stronger after the quit date than before the quit date. Self-efficacy, planning and action control were identified as critical inter- and intraindividual processes in smoking cessation, particularly after a self-set quit attempt when actual behavior change is performed.

Knowing and actional information in web based weight maintenance services

Purpose

– The purpose of this paper is to increase understanding of the role of information and knowledge in the context of health behaviour change.

Design/methodology/approach

– As internet use in Finland is among the highest in Europe, two Finnish web-based weight management services were analysed regarding their weight maintenance information by using a theoretical approach constructed for the purpose. The approach combines the elements of web-based weight maintenance information and the typologies of knowing and actional information. The approach was tested by examining the services deductively with theory-based content analysis.

Findings

– The approach indicated differences between the profiles of the two analysed information environments, which focus on factual and tailored information and their relation to pragmatic, provisional and contested knowing and the initiation, maintenance and recovery of actional information. Both services support weight maintenance; the other slightly more due to its rich social features.

Research limitations/implications

– The examination was focused on the free content of two Finnish weight management services. Further research should include the role of socially interactive information and further testing of the approach with more services.

Practical implications

– The proposed approach sheds light on the relationship between the types of weight maintenance information and the dimensions of the typologies of knowing and actional information. The approach has the potential to be applied when designing the information environment of new web-based weight management services.

Social implications

– The approach has potential to be applied when designing the information content of new web-based weight management services to support health behaviour change. The approach could be elaborated further by focusing on enabling social support required in long-term weight maintenance.

Originality/value

– The study adopted a novel approach to studying typologies of knowing and actional information, thus providing new viewpoints in both information behaviour and organisational knowledge. The study enables further research on weight maintenance information use by proposing a theoretical background.

Overcoming challenges to effectiveness of mobile markets in US food deserts

The purpose of this research is to investigate whether mobile food markets may be effective in facilitating healthy food choices in food deserts. We investigate who does and does not use mobile food markets and why, and whether mobile markets have the potential to alter attitudes and food choices, and if so, how? We use a focus group study at four sites in the US to ask groups of mobile market shoppers and non-shoppers about their shopping, cooking, and eating attitudes and behaviors. We find that mobile market shoppers eat significantly more servings of fruits and vegetables, however, both shoppers and non-shoppers perceive fruits and vegetables as luxury items, and both groups lack knowledge about what is a serving and what is the recommended number of servings per day. Both groups identified the following needs for mobile markets to be more successful: increased awareness and advertising; affordability; improved convenience by offering more stops and hours, as well as greater variety of items for one-stop shopping; emphasis on value and service; and building trust within communities.

Using the health action process approach to predict and improve health outcomes in individuals with type 2 diabetes mellitus

BACKGROUND

The purpose of this study was to explore the predictive utility of the Health Action Process Approach (HAPA) and test a HAPA-based healthy eating intervention, in adults with type 2 diabetes mellitus.

MATERIALS AND METHODS

The study employed a prospective, randomized, controlled trial design. The 4-month intervention consisted of self-guided HAPA-based workbooks in addition to two telephone calls to assist participants with the program implementation, and was compared to "treatment as usual". Participants (n=87) completed health measures (diet, body mass index [BMI], waist circumference, blood pressure, blood glucose levels, lipid levels, and diabetes distress) and HAPA measures prior to the intervention and again upon completion 4 months later.

RESULTS

The overall HAPA model predicted BMI, although only risk awareness and recovery self-efficacy were significant independent contributors. Risk awareness, intentions, and self-efficacy were also independent predictors of health outcomes; however, the HAPA did not predict healthy eating. No significant time × condition interaction effects were found for diet or any HAPA outcome measures.

CONCLUSION

Despite the success of HAPA in predicting health outcomes for those with type 2 diabetes mellitus, the intervention was unsuccessful in changing healthy eating or any of the other measured variables, and alternative low-cost health interventions for those with type 2 diabetes mellitus should be explored.

'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial

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.

Toward identifying a broader range of social cognitive determinants of dietary intentions and behaviors

BACKGROUND

Measurement of social cognitive variables is often restricted to long-term and health-related outcomes. A more comprehensive measurement of cognitive determinants would enable evidence-based design of health behavior interventions with a focus on the most relevant targets. The purpose of this study was to examine the relative impact of different social cognitive determinants on fruit and vegetable (FV) and fast food consumption.

METHODS

Finnish male conscripts (N = 855, age M = 20) filled in questionnaires on social cognitive factors when entering the military service, and on food consumption frequency after two months. The data were analysed using structural equation modeling.

RESULTS

Physical well-being expectation and bad taste expectation were most strongly related to both FV and fat avoidance intentions. Perceived weight gain risk predicted fat avoidance intention, whereas perceived risk for other health problems predicted FV intention. Social self-efficacy was associated with FV intention only. Consumption of both FV and fast food was predicted by action planning and intention.

CONCLUSIONS

A more careful evaluation of subtypes of social cognitions sheds light on the specific content behind motivation. Such understanding might help in designing more effective intervention messages.

Changes in social-cognitive variables are associated with stage transitions in physical activity

When it comes to the adoption or maintenance of physical activity, individuals can be placed along a continuum or into stages of change. The Health Action Process Approach proposes three such stages: non-intentional, intentional and actional. Intraindividual differences are reflected by stage transitions: either progression or regression. The present study examines social-cognitive factors of stage transitions: outcome expectancies, self-efficacy and planning. In an online study on physical activity, 660 adults completed questionnaires at baseline and approximately 3 weeks later. Social-cognitive factors were converted into standardized residual change scores to account for changes in outcome expectancies, self-efficacy and planning within the observation period. Discriminant function analyses revealed stage-specific patterns: progression out of non-intentional stage was associated with self-efficacy increases. Out of intentional stage, regression was correlated with decreases in planning, whereas progression was linked to increases in self-efficacy and planning. Regression from action stage was associated with decreases in self-efficacy. Physical activity promotion should focus on improving self-efficacy for non-intending, intending and acting individuals, whereas planning interventions are recommended for intending individuals. Interventions may be more effective by considering specific mechanisms instead of providing generic interventions for all individuals at different stages.

Fruit and vegetable consumption – the influence of aspects associated with trust in food and safety and quality of food

Objective

To profile adults who eat less than the recommended servings of fruit and vegetables per day.

Design

Australia-wide population telephone survey on a random sample of the Australian population, with results analysed by univariate and multivariate models.

Setting

Australia.

Subjects

One thousand one hundred and eight interviews, respondents’ (49·3 % males) mean age was 45·12 (sd 17·63) years.

Results

Overall 54·8 % and 10·7 % were eating the recommended number of servings of fruit and vegetables. Variables included in the multivariate model indicating low fruit consumption included gender, age, employment, education and those who were less likely to consider the safety and quality of food as important. In regard to low vegetable consumption, people who were more likely to do the food shopping only ‘some of the time’ and have a high level of trust in groups of people such as immediate family, neighbours, doctors and different levels of government were included in the final model. They were also less likely to neither consider the safety and quality of food as important nor trust organisations/institutions such as the press, television and politicians. In the final model depicting both low fruit and low vegetable servings, sex, age and a low level of importance with regard to safety and quality of food were included.

Conclusion

To increase fruit and vegetable consumption, research into a broad range of determinants associated with behaviours should be coupled with a deeper understanding of the process associated with changing behaviours. While levels of trust are related to behaviour change, knowledge and attitudes about aspects associated with safety and quality of food are also of importance.

Testing Stage-Specific Effects of a Stage-Matched Intervention: A Randomized Controlled Trial Targeting Physical Exercise and Its Predictors

Health education interventions can be tailored toward stages of change. This strategy is based on theories that predict at which stage which variables are indicative of subsequent behavior change processes. For example, planning is regarded as being effective in intenders. However, rather few studies have tested whether matched interventions are more successful for stage transitions than mismatched ones. Also very few previous studies have identified specific variables as targets of stage-matched interventions. A 2 (condition) × 2 (stages) experimental study tested the effects of stage-matched interventions for 226 participants. The stage-matched intervention moved significantly more individuals forward to action than did the control condition. Stage-specific effects were found to corroborate 78% of the assumptions. Multiple mediator analyses revealed stage-specific mechanisms, indicating that intention and planning facilitated behavior change in intenders. Thus, health behavior interventions should take stages of change into account.

Förderung von körperlicher Aktivität im betrieblichen Kontext

Zusammenfassung. Theoriebasierte Interventionen zur Förderung von körperlicher Aktivität können auf Stadien der Verhaltensänderung maßgeschneidert werden. Die Grundlage hierfür liefern Stadienmodelle. Diese nehmen an, dass für den erfolgreichen Übergang von einem Stadium zum nächsten unterschiedliche sozial-kognitive Variablen bedeutsam sind. Ziel der Studie war es, stadienspezifische Effekte von stadienpassenden Interventionen auf körperliche Aktivität und sozial-kognitive Prädiktoren im betrieblichen Kontext zu untersuchen. 839 Mitarbeiter eines Großunternehmens wurden randomisiert einer stadienpassenden Intervention und einer stadien-unspezifischen Standardmaßnahme zugewiesen. Vor der Intervention sowie vier Wochen später wurden Zielsetzung, Planung und körperliche Aktivität erfasst. Die Datenanalyse erfolgte mittels Varianzanalyse mit Messwiederholung. Die stadienpassenden Interventionen erhöhten die stadienspezifischen Variablen effektiver als die Standardmaßnahme. Stadienpassende Interventionen scheinen effektiver zu sein als stadien-unspezifische Standardmaßnahmen. Neben Verhaltensmaßen sollten auch Veränderungen in sozial-kognitiven Variablen zur Evaluation von Interventionen herangezogen werden.