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Maleki A, Daniali SS, Shahnazi H, Hassanzadeh A. Application of the Protection Motivation Theory (PMT) in Teaching Skin Cancer Prevention Behaviors in Male Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:497-504. [PMID: 35147905 PMCID: PMC8853144 DOI: 10.1007/s13187-022-02145-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 05/20/2023]
Abstract
Adolescents are at high risk of skin cancer. Since protecting the skin from the sun's ultraviolet rays is an important way to prevent this disease, the present study aimed to evaluate the effectiveness of teaching skin cancer prevention behaviors using the Protection Motivation Theory (PMT) in male students in Isfahan. An intervention study examined change in attitudes and behaviors among 104, 13-year-old male students from two schools in Isfahan, Iran. The schools were randomized to either receive or not receive a 5-session skin cancer prevention curriculum based in PMT theory. Data were collected using a validated questionnaire that included demographic, PMT, and behavior construct variables. Questionnaires were completed by both groups before and 2 months after the intervention. Data were analyzed using SPSS 20, chi-square test, Mann-Whitney test, paired t-test, and McNemar's test. The results indicated that the mean scores of all constructs of PMT increased in the intervention group compared to the baseline assessment, except for the response cost (P < 0.001). The mean score of students' skin cancer preventive behaviors was 39.6 (21.4) in the intervention group, and it increased to 74.7 (23.5) after educational intervention, while the control group did not exhibit any significant behavior change. The intervention certainly shows the potential for being effective over the short-term. Therefore, it is recommended that PMT-based educational interventions be designed to teach and promote social health, particularly at an early age.
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Affiliation(s)
- Afsaneh Maleki
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyedeh Shahrbanoo Daniali
- Child Growth and Development Research Center, Research Institute for Primordial Prevention From None-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Lima-Serrano M, Fernández-León P, Mercken L, Martínez-Montilla JM, de Vries H. An Animation- Versus Text-Based Computer-Tailored Game Intervention to Prevent Alcohol Consumption and Binge Drinking in Adolescents: Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9978. [PMID: 34639280 PMCID: PMC8508351 DOI: 10.3390/ijerph18199978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this paper is to describe the protocol for the design, implementation, and evaluation of an animation- versus text-based computer tailoring game intervention aimed at preventing alcohol consumption and binge drinking (BD) in adolescents. A cluster-randomized controlled trial (CRCT) is carried out in students aged 14-19 enrolled in 24 high schools from Andalusia (Spain), which are randomized either to experimental (EC-1, EC-2) or waiting-list control conditions (CC). EC-1 receives an online intervention (Alerta Alcohol) with personalized health advice, using textual feedback and several gamification techniques. EC-2 receives an improved version (Alerta Alcohol 2.0) using animated videos and new gamification strategies. Both programs consist of nine sessions (seven taking place at high school and two at home): session 1 or baseline, sessions 2 and 3 that provide tailored advice based on the I-Change Model; sessions 4, 5, 7, and 8 are booster sessions, and sessions 6 and 9 are follow-up questionnaires at six and twelve months. The CC completes the baseline and the evaluation questionnaires. The primary outcome is BD within 30 days before post-test evaluations, and as secondary outcomes we assess other patterns of alcohol use. The findings should help the development of future alcohol drinking prevention interventions in adolescents.
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Affiliation(s)
- Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Pablo Fernández-León
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 HA Maastricht, The Netherlands; (L.M.); (H.d.V.)
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 HA Maastricht, The Netherlands; (L.M.); (H.d.V.)
- Department of Health Psychology, Open University Heerlen, 6419 AT Heerlen, The Netherlands
| | | | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 HA Maastricht, The Netherlands; (L.M.); (H.d.V.)
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Panahi H, Salehi L, Mahmoodi Z. A predictive model of the sunscreen use in the paddy workers based on the health action process approach model: a path analysis. J Egypt Public Health Assoc 2020; 95:23. [PMID: 32955668 PMCID: PMC7505911 DOI: 10.1186/s42506-020-00053-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 08/27/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Skin cancer is considered as one of the most common cancers in the world. There is little information about identifying factors affecting sunscreen use among paddy workers and their protective behavior. The present study aimed to determine a predictive model of the sunscreen use in the paddy workers based on the health action process approach model (HAPA). METHODS This cross-sectional study was conducted on 177 paddy workers who engaged in agricultural work in the north of Iran in 2018. Convenience sampling methods was used. Inclusion criteria were being a farmer for 5 years, working under the sunshine more than 2 h per day, and above the age of 30 years. A multi-sectional questionnaire (intention, risk perception (RP), outcome expectation (OE), action self-efficacy (ASE), action planning (AP), coping planning (CP), coping SE (CSE), self-monitoring (SM), and sunscreen use) was used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software. RESULTS The mean age of participants was 47.78 ± 12.66 years. The final path model fitted well (comparative fit index (CFI) = 0.98, RMSEA = 0.000), only coping self-efficacy (CSE) from both direct and indirect paths had an impact on sunscreen use (B = 0.73). Among the variables which are influenced only in one direction, coping planning (CP) had the most direct influence (B = 0.30) on behavior, and action planning had the lowest influence (B = 0.24). CONCLUSION Coping self-efficacy was the most important factor which had influence on the use of sunscreen, and it should be considered when designing interventional programs related to sunscreen use among paddy workers.
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Affiliation(s)
- Hadiseh Panahi
- Department of Health Education & Promotion, School of Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Leili Salehi
- Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran. .,Department of Health Education & Promotion, Alborz University of Medical Sciences, Karaj, Iran.
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Midwifery, school of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Vargas-Martínez AM, Trapero-Bertran M, Lima-Serrano M, Anokye N, Pokhrel S, Mora T. Measuring the effects on quality of life and alcohol consumption of a program to reduce binge drinking in Spanish adolescents. Drug Alcohol Depend 2019; 205:107597. [PMID: 31590139 DOI: 10.1016/j.drugalcdep.2019.107597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/06/2019] [Accepted: 07/22/2019] [Indexed: 10/25/2022]
Abstract
AIM To present a comparison between the effects on health due to a reduction in binge drinking (BD) and health-related quality of life (HRQoL), as a result of ALERTA ALCOHOL, an intervention aimed at reducing BD in Spanish adolescents. METHODS A two-arm cluster randomized controlled trial was conducted with an intervention and a control group, randomized at the school level, following individuals over four months. The study population consisted of Andalusian adolescents aged 15 to 19 years who were enrolled in urban public high schools (n = 1247). Participants were assigned randomly to receive the intervention. The main outcomes studied were the number of occasions of BD in the last 30 days, which was directly obtained from the answers given by the adolescents, and HRQoL measured with the EQ-5D-5 L questionnaire. The model of estimation was the generalized estimating equations (GEE) approach. RESULTS The program showed a BD reduction at the 4-month follow-up, although it was not shown to significantly increase the HRQoL in adolescents who reduced the number of occasions of BD and had received the intervention. However, it was shown that those who would predictably reduce the number of occasions of BD controlled by several sociodemographic variables perceived a higher HRQoL, as did those who had a greater adherence to the program. CONCLUSIONS Higher adherence to a web-based computer-tailored intervention to prevent BD in adolescents has a positive effect on decreasing the number of occasions of BD in adolescents as well as on increasing participants' HRQoL, although this second effect is very small, which could be due to the short follow-up time. This fact is quite important and should be assessed extensively to corroborate the results and translate into health policy.
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Affiliation(s)
- Ana Magdalena Vargas-Martínez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain; Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Marta Trapero-Bertran
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Marta Lima-Serrano
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
| | - Nana Anokye
- Health Economics Research Group (HERG), Brunel University, Uxbridge, London, UK.
| | - Subhash Pokhrel
- Health Economics Research Group (HERG), Brunel University, Uxbridge, London, UK.
| | - Toni Mora
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain.
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The influence of pre-motivational factors on behavior via motivational factors: a test of the I-Change model. BMC Psychol 2019; 7:7. [PMID: 30786921 PMCID: PMC6381617 DOI: 10.1186/s40359-019-0283-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/13/2019] [Indexed: 02/03/2023] Open
Abstract
Background The I-Change Model for explaining motivational and behavioral change postulates that an awareness phase precedes the motivation phase of a person, and that effects of pre-motivational factors on behavior are partially mediated by motivational factors. This study tests this assumption with regard to physical activity. Methods Observational longitudinal survey study (baseline, three months, six months) amongst Dutch adults (N = 2434). Structural equation modelling was used to investigate whether the influence of (1) knowledge, (2) cognizance, (3) cues, and (4) risk perception separately on intention and physical activity were mediated by motivational factors (i.e. attitudes, self-efficacy and social influence). Subsequently, a comprehensive model including all pre-motivational factors was estimated to test the same assumption for all pre-motivational factors simultaneously. Results The results indicate that the associations of cognizance, risk perception and cues with behavior were fully mediated by motivational factors when tested separately. When tested simultaneously only the effect of cognizance remained. Cognizance was most strongly associated with positive attitudes β = .13, p < .01, self-efficacy β = .13, p < .01, and intention β = .14, p < .01. No direct link with behavior was found. Conclusion The results suggest that pre-motivational factors are important to form a motivation; however, they do not directly influence behavior. The inclusion of factors such as risk perception and cognizance would help to get a better understanding of motivation formation and behavior.
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Lima-Serrano M, Martínez-Montilla JM, Lima-Rodríguez JS, Mercken L, de Vries H. Design, implementation and evaluation of a web-based computer-tailored intervention to prevent binge drinking in adolescents: study protocol. BMC Public Health 2018; 18:449. [PMID: 29618331 PMCID: PMC5885294 DOI: 10.1186/s12889-018-5346-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 03/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation and evaluation of the first web-based computer tailored intervention aimed at the prevention of binge drinking in Spanish adolescents. METHODS The Alerta Alcohol program is based on the I-Change Model. First, feedback from focus and Delphi groups are used for cultural adaptation and to obtain further information on the items to be included on the program. A pilot study is then conducted to assess feasibility and to identify strengths and weaknesses. Second, a Cluster Randomized Controlled Trial is conducted to test the effectiveness of Alerta Alcohol in students aged 16 to 18 years. The study is performed in 16 high schools from Andalusia (southern Spain), which are randomized either to the experimental or the control condition (EC and CC). The EC receives the Alerta Alcohol intervention, which consists of four sessions at school (baseline questionnaire, two sessions in three scenarios: at home, celebrations, and public places, and a final evaluation). The adolescents are provided with answers related to their views of each scenario; this information is used to provide highly specific feedback regarding their knowledge, risk perception, self-esteem, attitude, social influence, and self-efficacy. In addition, two booster sessions are given at home to reinforce the previous messages. The CC just completes the baseline and the final evaluation questionnaires and then they are allowed to receive the intervention as well (as a waiting list). Evaluation takes place after four months. The primary endpoint is binge drinking within 30 days prior to the evaluation and alcohol use in the previous week. It is expected that Alerta Alcohol reduce the prevalence of binge drinking by 10%. Follow up analyses are carried out to determine the differences in effectiveness according to the compliance of the program (quality of the implementation). DISCUSSION The results are expected to be applicable and may incorporate improvements in the practice of the Healthcare and Education Systems. If the program proves to be effective, regional and eventual national implementation should be considered. TRIAL REGISTRATION Trial registration number (ClinicalTrials.gov): NCT03288896 . This study was retrospectively registered on 19/09/2017.
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Affiliation(s)
- Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - José Manuel Martínez-Montilla
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain. .,Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, The Netherlands.
| | - Joaquín S Lima-Rodríguez
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Liesbeth Mercken
- Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, School for Public Health and Primary Care CAPHRI, Maastricht, The Netherlands
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Mingoia J, Hutchinson AD, Gleaves DH, Corsini N, Wilson C. Use of social networking sites and associations with skin tone dissatisfaction, sun exposure, and sun protection in a sample of Australian adolescents. Psychol Health 2017; 32:1502-1517. [PMID: 28691513 DOI: 10.1080/08870446.2017.1347788] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Previous research has indicated that greater exposure to traditional media (i.e. television, film, and print) predicted skin cancer risk factors in adolescents; however, the relationship between social media usage and these outcomes remains unexplored. We examined whether social networking site (SNS) usage, and the particular manner of this use, was associated with skin tone dissatisfaction, sun exposure and sun protection among Australian adolescents. We also explored sex differences in SNS usage related to tanning. METHOD A total of 1856 South Australian secondary school students completed the Australian School Students Alcohol and Drug 2014 survey. SNS usage related to tanning comprised posting pictures, posting text, viewing pictures, viewing text and liking or sharing posts. RESULTS Adolescents spent 214.56 minutes, on average, per day using SNSs. Behaviours related to tanning that involved pictures (i.e. viewing pictures, posting pictures, and liking or sharing content) were significantly associated with more skin tone dissatisfaction, more sun exposure and less sun protection. Females performed all SNS-linked behaviours more frequently than did males, with the exception of posting text. CONCLUSION Australian adolescents spend a considerable amount of time using SNSs, and their behaviours related to tanning on these SNSs are significantly associated with skin cancer risk factors.
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Affiliation(s)
- John Mingoia
- a School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , Australia
| | - Amanda D Hutchinson
- a School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , Australia
| | - David H Gleaves
- a School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , Australia
| | - Nadia Corsini
- b Cancer Council South Australia , Eastwood , Australia
| | - Carlene Wilson
- b Cancer Council South Australia , Eastwood , Australia.,c Flinders Centre for Innovation in Cancer, Flinders University , Bedford Park , Australia.,d School of Psychology and Counselling, La Trobe University , Melbourne , Australia
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Koch S, Pettigrew S, Hollier LP, Slevin T, Strickland M, Minto C, Jalleh G, Lin C. Trends in Australian adolescents' sun-protection behaviours: implications for health campaigns. Aust N Z J Public Health 2016; 40:468-473. [PMID: 27523880 DOI: 10.1111/1753-6405.12561] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/01/2016] [Accepted: 04/01/2016] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Protecting the skin from ultraviolet (UV) radiation is critical during adolescence to reduce the risk of developing skin cancer later in life, but adolescents tend to be less likely to engage in sun-protective behaviours than adults. The present study examined changes and trends (2001/02-2011/12) in sun-protection behaviours among adolescents living in Western Australia - a region with high levels of UV radiation. METHODS A cross-sectional survey was conducted during 10 summers between 2001/02 and 2011/12 to investigate how often adolescents engaged in various sun-protection behaviours, including outdoor protective measures (wearing a hat, wearing protective clothing, using sunscreen, wearing sunglasses, seeking shade) and avoidance of UV radiation by staying inside. RESULTS Hat use significantly decreased between 2001/02 and 2011/12, whereas use of sunscreen and wearing covering clothes were unchanged in most survey years relative to 2001/02. Use of sunglasses peaked in 2006/07 and 2007/08, but returned to first survey year levels in 2011/12, while staying inside was more frequently reported from 2006/07 onwards. CONCLUSIONS New approaches are needed to minimise reactance responses in adolescents while fostering favourable attitudes to sun protection. Implications and opportunities for interventions to promote better sun-protection practices among adolescents are provided.
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Affiliation(s)
| | | | | | - Terry Slevin
- Curtin University, Western Australia.,Cancer Council Western Australia
| | | | | | | | - Chad Lin
- Curtin University, Western Australia
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Hubbard G, Munro J, O’Carroll R, Mutrie N, Kidd L, Haw S, Adams R, Watson AJM, Leslie SJ, Rauchhaus P, Campbell A, Mason H, Manoukian S, Sweetman G, Treweek S. The use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial with embedded feasibility study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BackgroundColorectal cancer (CRC) survivors are not meeting the recommended physical activity levels associated with improving their chances of survival and quality of life. Rehabilitation could address this problem.ObjectivesThe aims of the Cardiac Rehabilitation In Bowel cancer study were to assess whether or not cardiac rehabilitation is a feasible and acceptable model to aid the recovery of people with CRC and to test the feasibility and acceptability of the protocol design.DesignIntervention testing and feasibility work (phase 1) and a pilot randomised controlled trial with embedded qualitative study (phase 2), supplemented with an economic evaluation. Randomisation was to cardiac rehabilitation or usual care. Outcomes were differences in objective measures of physical activity and sedentary behaviour, self-reported measures of quality of life, anxiety, depression and fatigue. Qualitative work involved patients and clinicians from both cancer and cardiac specialties.SettingThree colorectal cancer wards and three cardiac rehabilitation facilities.ParticipantsInclusion criteria were those who were aged > 18 years, had primary CRC and were post surgery.ResultsPhase 1 (single site) – of 34 patient admissions, 24 (70%) were eligible and 4 (17%) participated in cardiac rehabilitation. Sixteen clinicians participated in an interview/focus group. Modifications to trial procedures were made for further testing in phase 2. Additionally, 20 clinicians in all three sites were trained in cancer and exercise, rating it as excellent. Phase 2 (three sites) – screening, eligibility, consent and retention rates were 156 (79%), 133 (67%), 41 (31%) and 38 (93%), respectively. Questionnaire completion rates were 40 (97.5%), 31 (75%) and 25 (61%) at baseline, follow-up 1 and follow-up 2, respectively. Forty (69%) accelerometer data sets were analysed; 20 (31%) were removed owing to invalid data.Qualitative studyCRC and cardiac patients and clinicians were interviewed. Key themes were benefits and barriers for people with CRC attending cardiac rehabilitation; generic versus disease-specific rehabilitation; key concerns of the intervention; and barriers to participation (CRC participants only).Economic evaluationThe average out-of-pocket expenses of attending cardiac rehabilitation were £50. The costs of cardiac rehabilitation for people with cancer are highly dependent on whether it involves accommodating additional patients in an already existing service or setting up a completely new service.Limitations and conclusionsThe main limitation is that this is a small feasibility and pilot study. The main novel finding is that cardiac rehabilitation for cancer and cardiac patients together is feasible and acceptable, thereby challenging disease-specific rehabilitation models.Future workThis study highlighted important challenges to doing a full-scale trial of cardiac rehabilitation but does not, we believe, provide sufficient evidence to reject the possibility of such a future trial. We recommend that any future trial must specifically address the challenges identified in this study, such as suboptimal consent, completion, missing data and intervention adherence rates and recruitment bias, and that an internal pilot trial be conducted. This should have clear ‘stop–proceed’ rules that are formally reviewed before proceeding to the full-scale trial.Trial registrationCurrent Controlled Trials ISRCTN63510637.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 4, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Gill Hubbard
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Julie Munro
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Ronan O’Carroll
- School of Natural Sciences, University of Stirling, Stirling, UK
| | - Nanette Mutrie
- Institute for Sport, Physical Education and Health Sciences, Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Lisa Kidd
- Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK
| | - Sally Haw
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
| | - Richard Adams
- Cardiff University School of Medicine, Velindre Hospital, Cardiff, UK
| | - Angus JM Watson
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
- NHS Highland, Raigmore Hospital, Inverness, UK
| | - Stephen J Leslie
- School of Health Sciences, University of Stirling (Highland Campus), Centre for Health Science, Inverness, UK
- NHS Highland, Raigmore Hospital, Inverness, UK
| | - Petra Rauchhaus
- Tayside Clinical Trials Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Anna Campbell
- Edinburgh Napier University, Faculty of Life Science, Sport and Social Sciences, Edinburgh, UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Sarkis Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | | | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Mirzaei F, Dehdari T, Malehi AS. Prevention of Esophageal Cancer: Experience of an Educational Campaign for Reducing Hot Tea Consumption in Iran. Asian Pac J Cancer Prev 2016; 17:305-10. [DOI: 10.7314/apjcp.2016.17.1.305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Davis R, Loescher LJ, Rogers J, Spartonos D, Snyder A, Koch S, Harris RB. Evaluation of Project Students are Sun Safe (SASS): A University Student-Delivered Skin Cancer Prevention Program for Schools. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:736-742. [PMID: 25417824 DOI: 10.1007/s13187-014-0742-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Skin cancer is the most common cancer in the USA and is increasing in children and young adults. Adolescents are an important target population for sun-safety interventions with ultraviolet radiation as the strongest risk factor for developing skin cancer. Schools are an ideal setting to intervene with adolescents. A novel Arizona skin cancer prevention in-class education-activity program, Project 'Students are Sun Safe' (SASS), was designed to be delivered by university students for middle school and high school students. Participant students completed the pre- and post-program tests and a satisfaction questionnaire; teachers completed reviews. The evaluation examined the program's influence on participants' sun-safety knowledge, perceptions, and behaviors; satisfaction with the program; and intent to change. After exposure to Project SASS, participants were more likely to perceive a high risk of skin cancer, report negative attitudes toward tanned skin, and answer knowledge-based questions correctly. There were minimal differences in self-reported sun-safety behaviors, though participants did report intent to change. Both participants and teachers were satisfied with the program. Project SASS appears to be an effective sun-safety program for middle school and high school students for knowledge and perceptions, and the results confirm that appropriately tailoring program components to the target population has strong potential to impact adolescent perceived susceptibility, knowledge, and behavioral intent. The strengths and weaknesses of Project SASS have many implications for public health practice, and Project SASS may hold promise to be a model for skin cancer prevention in adolescents.
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Affiliation(s)
- Raeann Davis
- Zuckerman College of Public Health, The University of Arizona, 1295 N. Martin Tucson, Arizona, AZ, 85724, USA.
- University of California Davis, 1 Shields Ave, Davis, CA, 95616, USA.
| | - Lois J Loescher
- Zuckerman College of Public Health, The University of Arizona, 1295 N. Martin Tucson, Arizona, AZ, 85724, USA.
- College of Nursing, The University of Arizona, 1305 N. Martin Tucson, Arizona, AZ, 85721, USA.
| | - Jillian Rogers
- Scottsdale Healthcare, Arizona State University, 4629 E. Charleston Ave. Phoenix, Arizona, 85032, USA
| | - Denise Spartonos
- Skin Cancer Institute, The University of Arizona Cancer Center, 1515 N Campbell Ave. Tucson, Arizona, AZ, 85724, USA
| | - Aimee Snyder
- Zuckerman College of Public Health, The University of Arizona, 1295 N. Martin Tucson, Arizona, AZ, 85724, USA
| | - Stephanie Koch
- Zuckerman College of Public Health, The University of Arizona, 1295 N. Martin Tucson, Arizona, AZ, 85724, USA
- Skin Cancer Institute, The University of Arizona Cancer Center, 1515 N Campbell Ave. Tucson, Arizona, AZ, 85724, USA
| | - Robin B Harris
- Zuckerman College of Public Health, The University of Arizona, 1295 N. Martin Tucson, Arizona, AZ, 85724, USA
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Dehbari SR, Dehdari T, Dehdari L, Mahmoudi M. Predictors of Sun-Protective Practices among Iranian Female College Students: Application of Protection Motivation Theory. Asian Pac J Cancer Prev 2015; 16:6477-80. [PMID: 26434862 DOI: 10.7314/apjcp.2015.16.15.6477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Given the importance of sun protection in the prevention of skin cancer, this study was designed to determine predictors of sun-protective practices among a sample of Iranian female college students based on protection motivation theory (PMT) variables. MATERIALS AND METHODS In this cross-sectional study, a total of 201 female college students in Iran University of Medical Sciences were selected. Demographic and PMT variables were assessed with a 67-item questionnaire. Multiple linear regression was used to identify demographic and PMT variables that were associated with sun-protective practices and intention. RESULTS one percent of participants always wore a hat with a brim, 3.5% gloves and 15.9% sunglasses while outdoors. Only 10.9% regularly had their skin checked by a doctor. Perceived rewards, response efficacy, fear, self-efficacy and marital status were the five variables which could predict 39% variance of participants intention to perform sun-protective practices. Also, intention and response cost explained 31% of the variance of sun-protective practices. CONCLUSIONS These predictive variables may be used to develop theory-based education interventions interventions to prevent skin cancer among college students.
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Affiliation(s)
- Samaneh Rooshanpour Dehbari
- Department of Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran E-mail :
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Schenk E, Butterfield P, Postma J, Barbosa-Leiker C, Corbett C. Creating the Nurses’ Environmental Awareness Tool (NEAT). Workplace Health Saf 2015. [DOI: 10.1177/2165079915592071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute care delivery creates secondary health risks to patients, health care workers, and the environment through a complex waste stream, intensive energy use, and frequent use of harmful chemicals. Nurses are among the most affected by these risks and are also pivotal change agents in reducing the negative impacts of health care delivery. Assessing nurses’ understanding of health care–associated environmental health risks is essential if care is to be delivered in an environmentally safe and healthy manner, as indicated by published professional standards of nursing practice. However, psychometrically sound instruments that measure nurses’ awareness of the environmental impacts of nursing practice are not available. To address this gap, a prototype of the Nurse’s Environmental Awareness Tool (NEAT) was developed. Seven content experts in environmental health nursing and/or psychometrics were asked to review draft items. Comments were analyzed and applied to the scale items. Several revisions from the original item pool were made. The resulting draft NEAT includes six subscales, in three paired subsets. This article provides a summary of the process of item development and scale design. These findings, although preliminary, provide a foundation for subsequent psychometric testing. The result of this study is the creation of an instrument to measure nurses’ awareness of and behaviors associated with the environmental impact of their practices.
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Janssen E, van Kann D, de Vries H, Lechner L, van Osch L. Sun protection during snow sports: an analysis of behavior and psychosocial determinants. HEALTH EDUCATION RESEARCH 2015; 30:380-387. [PMID: 25838552 DOI: 10.1093/her/cyv013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 03/08/2015] [Indexed: 06/04/2023]
Abstract
This study investigated sun protective behavior during snow sports and its psychosocial determinants. A longitudinal study was conducted among 418 Dutch adults who planned to go on a ski holiday. Participants were asked to fill in a questionnaire before and after their ski trip. In the baseline questionnaire several psychosocial factors were measured (i.e. knowledge, risk perception, worry, attitude, social influence, self-efficacy and intention). At follow-up, sunscreen use and frequency of sunburns were measured. The results showed that, despite their generally high intention, a substantial part of the respondents (40%) did not use sunscreen adequately during their ski holiday. Furthermore, one-fourth of the respondents reported at least one sunburn during their ski holiday. Men and younger respondents used sunscreen less frequently and were sunburnt more often. Sunscreen use was predicted by a positive attitude, high self-efficacy levels, high intention, high knowledge and high perceived risk. The background and psychosocial variables explained 32% of the total variance of sunscreen use. Suggestions for future research and interventions are discussed.
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Affiliation(s)
- Eva Janssen
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, The Netherlands and Faculty of Psychology and Educational Sciences, School for Public Health and Primary Care (Caphri), Open University of the Netherlands, Heerlen, The Netherlands
| | - Dave van Kann
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, The Netherlands and Faculty of Psychology and Educational Sciences, School for Public Health and Primary Care (Caphri), Open University of the Netherlands, Heerlen, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, The Netherlands and Faculty of Psychology and Educational Sciences, School for Public Health and Primary Care (Caphri), Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, The Netherlands and Faculty of Psychology and Educational Sciences, School for Public Health and Primary Care (Caphri), Open University of the Netherlands, Heerlen, The Netherlands
| | - Liesbeth van Osch
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (Caphri), Maastricht University, Maastricht, The Netherlands and Faculty of Psychology and Educational Sciences, School for Public Health and Primary Care (Caphri), Open University of the Netherlands, Heerlen, The Netherlands
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Chen YC(Y, Ohanehi DC, Redican KJ. An Evaluation of UV-Monitoring Enhanced Skin Cancer Prevention Among Farm Youth in Rural Virginia. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2014.999966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Van Osch L, Reubsaet A, Lechner L, Candel M, Mercken L, De Vries H. Predicting parental sunscreen use: Disentangling the role of action planning in the intention-behavior relationship. Psychol Health 2014; 23:829-47. [PMID: 25160883 DOI: 10.1080/08870440701596577] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Structural equation modeling was used to examine antecedents of parental sunscreen use (N = 436) in a longitudinal design. The influence of a volitional planning cognition was assessed in several path models, investigating potential mediation and moderation of the intention-behavior relationship. Premotivational and motivational variables accounted for 55.1% of the variance in intention to use sunscreen. Intention emerged as the most powerful predictor of behavior, followed by action planning and self-efficacy expectations, together explaining 35.4% of parental sunscreen use after five months. Strong support was found for both mediating and moderating influences of action planning on the intention-behavior relationship. Action planning also partially mediated the impact of self-efficacy on behavior. The results support theoretical considerations to add postintentional cognitions to current health behavior models. Although action planning is an important component in the transition from intention to behavior, the impact of intention and of other premotivational and motivational variables should not be overlooked when developing health educational interventions.
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Affiliation(s)
- Liesbeth Van Osch
- a School for Public Health and Primary Care (Caphri) , Department of Health Education and Health Promotion , Maastricht University , The Netherlands
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Lau SCM, Chen L, Cheung WY. Protective skin care behaviors in cancer survivors. ACTA ACUST UNITED AC 2014; 21:e531-40. [PMID: 25089104 DOI: 10.3747/co.21.1893] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Research suggests that physicians neglect preventive care for cancer survivors. A survivor's self-motivation with respect to preventive care is unknown. Using protective skin care as a proxy, our aims were to characterize preventive care in cancer survivors and to identify factors associated with appropriate prevention. METHODS Using data from the 2009 U.S. Health Information National Trends Survey, we compared preventive skin care patterns in cancer survivors and non-cancer patients. Primary endpoints were the use of sunscreens, long-sleeved shirts, hats, and shade. RESULTS We identified 179 early cancer survivors (<5 years), 242 intermediate cancer survivors (5-10 years), 412 long-term cancer survivors (>10 years), and 5951 non-cancer patients. The use of sunscreens (60%), long-sleeved shirts (88%), hats (58%), and shade (68%) was suboptimal. Overall, cancer survivors were not more likely to adhere to preventive care (p = 0.89). A composite score showed a significant difference between the cancer survivor groups (p < 0.01) whereby intermediate survivors reported the best preventive practices. CONCLUSIONS A prior diagnosis of cancer does not appear to increase personal compliance with cancer prevention. Reasons for this poor engagement are not clear. Targeted strategies to increase self-motivation might improve preventive practices in cancer survivors.
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Affiliation(s)
- S C M Lau
- University of British Columbia, Vancouver, BC
| | - L Chen
- BC Cancer Agency, Vancouver, BC
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Saridi MI, Rekleiti MD, Toska AG, Souliotis K. Assessing a Sun Protection Program Aimed at Greek Elementary School Students for Malign Melanoma Prevention. Asian Pac J Cancer Prev 2014; 15:5009-18. [DOI: 10.7314/apjcp.2014.15.12.5009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yilmaz M, Yavuz B, Subasi M, Kartal A, Celebioglu A, Kacar H, Adana F, Ozyurek P, Altiparmak S. Skin cancer knowledge and sun protection behavior among nursing students. Jpn J Nurs Sci 2014; 12:69-78. [DOI: 10.1111/jjns.12049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/04/2014] [Indexed: 01/17/2023]
Affiliation(s)
- Medine Yilmaz
- Faculty of Health Sciences; Izmir Katip Celebi University; Cigli-Izmir Turkey
| | - Betul Yavuz
- High School of Health; Dumlupinar University; Kutahya Turkey
| | - Media Subasi
- Mugla High School of Health; Mugla University; Mugla Turkey
| | - Asiye Kartal
- Denizli High School of Health; Department of Nursing; Pamukkale University; Denizli Turkey
| | | | - Halime Kacar
- Usak High School of Health; Usak University; Usak Turkey
| | - Filiz Adana
- Aydin High School of Health; Adnan Menderes University; Aydin Turkey
| | - Pakize Ozyurek
- High School of Health; Afyon Kocatepe University; Afyon Turkey
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Day AK, Wilson C, Roberts RM, Hutchinson AD. The Skin Cancer and Sun Knowledge (SCSK) Scale. HEALTH EDUCATION & BEHAVIOR 2014; 41:440-8. [DOI: 10.1177/1090198114529129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Increasing public knowledge remains one of the key aims of skin cancer awareness campaigns, yet diagnosis rates continue to rise. It is essential we measure skin cancer knowledge adequately so as to determine the nature of its relationship to sun-related behaviors. This study investigated the psychometric properties of a new measure of skin cancer knowledge, the Skin Cancer and Sun Knowledge (SCSK) scale. A total of 514 Western young adults (females n = 320, males n = 194) aged 18 to 26 years completed measures of skin type, skin cancer knowledge, tanning behavior, sun exposure, and sun protection. Two-week test–retest of the SCSK was conducted with 52 participants. Internal reliability of the SCSK scale was acceptable (KR-20 = .69), test–retest reliability was high ( r = .83, n = 52), and acceptable levels of face, content, and incremental validity were demonstrated. Skin cancer knowledge (as measured by SCSK) correlated with sun protection, sun exposure, and tanning behaviors in the female sample, but not in the males. Skin cancer knowledge appears to be more relevant to the behavior of young women than that of young males. We recommend that future research establish the validity of the SCSK across a range of participant groups.
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Affiliation(s)
- Ashley K. Day
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Carlene Wilson
- Cancer Council South Australia, Australia
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, South Australia, Australia
| | - Rachel M. Roberts
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Amanda D. Hutchinson
- School of Psychology, Social Work & Social Policy, University of South Australia, Australia
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Munro J, Adams R, Campbell A, Campbell S, Donaldson C, Godwin J, Haw S, Kidd L, Lane C, Leslie SJ, Mason H, Mutrie N, O'Carroll R, Taylor C, Treweek S, Watson A, Hubbard G. CRIB--the use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial (RCT) with embedded feasibility study. BMJ Open 2014; 4:e004684. [PMID: 24549168 PMCID: PMC3931997 DOI: 10.1136/bmjopen-2013-004684] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Patients with colorectal cancer report ongoing physical and psychological impairments and a high proportion of these patients are overweight, insufficiently active and high-risk drinkers, putting them at risk of poor recovery and risk of recurrence and comorbidities. A challenge is implementing sustainable and effective rehabilitation as part of routine care for this group. METHODS AND ANALYSIS A two-arm pilot randomised controlled trial (RCT) with embedded feasibility study undertaken as a phased programme of work. The intervention involves an existing cardiac rehabilitation programme for cardiac patients accepting colorectal cancer patient referrals. The intervention consists of supervised exercise sessions run by a cardiac physiotherapist and information sessions. Phase 1 will involve one research site enrolling 12 patients to assess intervention and study design processes. Semistructured interviews with patients with colorectal cancer and cardiac patients and clinicians will be used to gather data on acceptability of the intervention and study procedures. Phase 2 will involve three sites enrolling 66 patients with colorectal cancer randomised to control or intervention groups. Outcome measures will be taken preintervention and postintervention, for phases 1 and 2. The primary outcome is accelerometer measured physical activity; secondary outcomes are self-report physical activity, quality of life, anxiety, depression, symptoms including fatigue. The following variables will also be examined to determine if these factors influence adherence and outcomes: self-efficacy, risk perception and treatments. ETHICS AND DISSEMINATION Full ethical approval was granted by NRES Committees-North of Scotland (13/NS/0004; IRAS project ID: 121757) on 22 February 2013. The proposed work is novel in that it aims to test the feasibility and acceptability of using an evidence-based and theory driven existing cardiac rehabilitation service with patients with colorectal cancer. Should this model of rehabilitation prove to be clinically and cost effective we aim to conduct a randomised controlled trial of this intervention to measure effectiveness. TRIAL REGISTRATION REFERENCE ISRCTN63510637; UKCRN id 14092.
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Affiliation(s)
- Julie Munro
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Richard Adams
- Cardiff University, School of Medicine, Velindre Hospital, Cardiff, UK
| | - Anna Campbell
- Institute of Sport and Exercise, University of Dundee, UK
| | | | - Cam Donaldson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jon Godwin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sally Haw
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Lisa Kidd
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | | | - Helen Mason
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Nanette Mutrie
- Moray House School of Education, The University of Edinburgh, Edinburgh, UK
| | - Ronan O'Carroll
- School of Natural Sciences, University of Stirling, Stirling, UK
| | - Cara Taylor
- NHS Tayside, Level 10, Ninewells Hospital, Dundee, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen, UK
| | | | - Gill Hubbard
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
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Eggers SM, Aarø LE, Bos AER, Mathews C, de Vries H. Predicting condom use in South Africa: a test of two integrative models. AIDS Behav 2014; 18:135-45. [PMID: 23392911 DOI: 10.1007/s10461-013-0423-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study tested two integrative socio-cognitive models, namely the information-motivation-behavioral skills model (IMB) and the I-Change model (ICM), to assess their hypothesized motivational pathways for the prediction of condom use during last sexual intercourse. Students (N = 1066) from Cape Town, South Africa, filled out questionnaires at three different time points. Structural equation modeling demonstrated that self-efficacy did not predict behavior directly but indirectly via intention. Knowledge of how to use a condom and how STIs are transmitted directly predicted behavior when modeled as hypothesized by the IMB model, but indirectly when the factors attitude, subjective norms and self-efficacy were included as mediators, as hypothesized by the ICM. It is concluded that the ICM and IMB are similar in terms of model fit and explained variance, but that the ICM had a higher proportion of significant pathways.
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Bronner K, Mesters I, Weiss-Meilik A, Geva R, Rozner G, Strul H, Inbar M, Halpern Z, Kariv R. Determinants of adherence to screening by colonoscopy in individuals with a family history of colorectal cancer. PATIENT EDUCATION AND COUNSELING 2013; 93:272-281. [PMID: 23916675 DOI: 10.1016/j.pec.2013.06.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 06/19/2013] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Although first-degree relatives (FDRs) of colorectal cancer (CRC) patients, as a high-risk population, have the most to gain from colonoscopy screening, their adherence is suboptimal. Thus, an assessment of the determinants of adherence to screening is of potential importance. METHODS A cross-sectional study was conducted among 318 FDRs of 164 CRC patients treated at Tel-Aviv Sourasky Medical Center. Interviews were conducted with a questionnaire using I-Change Model. RESULTS Adherence to interval colonoscopy was low with only 73 FDRs (23.0%). Greater adherence was associated with socio-demographic variables (older age, siblings, having spouse, higher level of education and income) and behavioral variables (healthier lifestyle, utilization of preventive health services). Family physicians and kin were identified as the most influential figures on uptake. Intention, affective barriers, positive attitudes, social support, cues to action, age, and health maintenance were the strongest determinants of participation in CRC screening. CONCLUSION Adherence to colonoscopy is determined by multiple variables. Medical staff can play a key role in increasing adherence to colonoscopy. PRACTICE IMPLICATIONS Future interventions should focus on fostering positive attitudes, overcoming barriers, enhancing social support and providing a medical recommendation. Special efforts should be invested in young FDRs, those of low socio-economic status and those who underutilize preventive medicine.
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Affiliation(s)
- Karen Bronner
- The Department of Gastroenterology and Liver Diseases, The Tel Aviv Sourasky Medical Center, Israel.
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Day AK, Wilson CJ, Hutchinson AD, Roberts RM. The role of skin cancer knowledge in sun-related behaviours: A systematic review. J Health Psychol 2013; 19:1143-62. [DOI: 10.1177/1359105313485483] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Skin cancer is the most commonly diagnosed cancer in many Western countries. This systematic review provides a comprehensive overview of the relationship between skin cancer knowledge and sun-protective, exposure and tanning behaviours in the general population. A total of 34 studies, published in peer-reviewed journals over three decades, were reviewed and synthesised. Sun-protective behaviour was positively associated with skin cancer knowledge in most cases. Findings were inconsistent regarding other sun-related behaviours. Heterogeneity in measurement compromised the capacity to definitively link knowledge and sun-related behaviours. There is a need for development and utilisation of a standardised skin cancer knowledge scale, and guidelines are suggested.
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Affiliation(s)
| | - Carlene J Wilson
- Flinders University, Australia
- Cancer Council South Australia, Australia
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The importance of affectively-laden beliefs about health risks: the case of tobacco use and sun protection. J Behav Med 2012; 37:11-21. [PMID: 23073599 DOI: 10.1007/s10865-012-9462-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 10/05/2012] [Indexed: 12/28/2022]
Abstract
Affect is gaining prominence in health behavior research. However, little is known about the relative influence on behavior of specific affectively-laden beliefs about health risks (affective likelihood, worry, anticipated regret), particularly in comparison to cognitive likelihood beliefs. We investigated this issue in relation to two very different cancer-related behaviors. In two prospective studies [tobacco use (N = 1,088); sunscreen use (N = 491)], hierarchical linear and logistic regression analyses revealed that affectively-laden risk beliefs predicted intentions and behaviors more strongly than cognitive likelihood beliefs. Cognitive likelihood contributed independently only for sunscreen use intentions. Smoking-related outcomes were most strongly associated with anticipated regret. Sunscreen-related outcomes were most strongly associated with affective likelihood. Affectively-laden beliefs might be stronger predictors of some cancer-related behaviors than traditional cognitive likelihood measures. Including affective aspects of health risk beliefs in health behavior interventions and theoretical models, including investigating their interrelationships in different behavioral contexts, could advance both theory and practice.
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Janssen E, van Osch L, de Vries H, Lechner L. The influence of narrative risk communication on feelings of cancer risk. Br J Health Psychol 2012; 18:407-19. [PMID: 23025465 DOI: 10.1111/j.2044-8287.2012.02098.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 06/25/2012] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Evidence is accumulating for the importance of feelings of risk in explaining cancer preventive behaviours, but best practices for influencing these feelings are limited. The aim of this experimental study was to compare the effects of narrative and non-narrative risk communication about sunbed use on ease of imagination and feelings of cancer risk. DESIGN AND METHODS A total of 233 female sunbed users in the general Dutch population were randomly assigned to one of three conditions: a narrative message (i.e., personal testimonial), a non-narrative cognitive message (i.e., factual risk information using cognitive-laden words), or a non-narrative affective message (i.e., factual risk information using affective-laden words). Ease of imagination and feelings of risk were assessed directly after the risk information was given (T1). Three weeks after the baseline session, feelings of risk were measured again (T2). RESULTS The results revealed that sunbed users who were exposed to narrative risk information could better imagine themselves developing skin cancer and reported higher feelings of skin cancer risk at T1. Moreover, ease of imagination mediated the effects of message type on feelings of risk at T1 and T2. CONCLUSION The findings provide support for the effects of narrative risk communication in influencing feelings of cancer risk through ease of imagination. Cancer prevention programmes may therefore benefit from including narrative risk information. Future research is important to investigate other mechanisms of narrative information and their most effective content and format. STATEMENT OF CONTRIBUTION What is already known on this subject? Evidence is growing for the importance of feelings of risk in explaining cancer preventive behaviours. Narratives have increasingly been considered as an effective format for persuasive risk messages and studies have shown narrative risk communication to be effective in influencing cognitive risk beliefs. What does this study add? Increasing understanding of how feelings of cancer risk can be influenced since best practices for influencing these feelings are limited. Extending knowledge about the underlying mechanisms of narrative effects on feelings of cancer risk (i.e., the mediating role of ease of imagination) using a non-student sample. The findings provide support for the effects of narrative risk communication in influencing feelings of cancer risk through ease of imagination.
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Affiliation(s)
- Eva Janssen
- Department of Health Promotion, school CAPHRI, Maastricht University, the Netherlands.
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Craciun C, Schüz N, Lippke S, Schwarzer R. Enhancing planning strategies for sunscreen use at different stages of change. HEALTH EDUCATION RESEARCH 2012; 27:857-867. [PMID: 22907532 DOI: 10.1093/her/cys091] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
To promote sun safety by implementing different plans for sunscreen use, different psychological interventions are compared. Self-regulatory strategies such as action planning and coping planning are seen as proximal predictors of actual behavior. The study compares a pure planning intervention with a broader resource communication and examines differential effects at different stages of change. A sun safety online study was designed with two intervention groups (resource communication versus planning) and one control group at two assessment points, 2 weeks apart. Participants (N = 292) were grouped post hoc according to their stage of change, resulting in 51 pre-intenders (no intention to use sunscreen), 102 intenders (high intention but no regular use of sunscreen) and 139 actors (sunscreen use on a regular basis). No overall treatment effects on planning, but an interaction between time, stage and intervention emerged. The resource communication was more effective for pre-intenders, whereas the planning intervention proved more effective for intenders. A planning treatment was more beneficial in motivated individuals, whereas a broader approach was better for unmotivated ones. Findings highlight the potential that stage-matched interventions might have in the context of sun safety promotion.
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Affiliation(s)
- Catrinel Craciun
- Department of Psychology, Babes-Bolyai University, Republicii 37, 400015, Cluj-Napoca, Romania.
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Cremers HP, Mercken L, Oenema A, de Vries H. A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol. BMC Public Health 2012; 12:277. [PMID: 22490110 PMCID: PMC3372447 DOI: 10.1186/1471-2458-12-277] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. METHODS & DESIGN This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled 'Fun without Smokes'. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils' smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the 'Fun without Smokes' website. The main outcome measures will be ever smoking and the utilisation of the 'Fun without Smokes' website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. DISCUSSION The present study protocol describes the purpose, intervention design and study protocol of 'Fun without Smokes'. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only. TRIAL REGISTRATION Dutch Trial Register NTR3116.
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Affiliation(s)
- Henricus-Paul Cremers
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Liesbeth Mercken
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Anke Oenema
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
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Buchbinder D, Mertens AC, Zeltzer LK, Leisenring W, Goodman P, Lown EA, Alderfer MA, Recklitis C, Oeffinger K, Armstrong GT, Hudson M, Robison LL, Casillas J. Cancer prevention and screening practices of siblings of childhood cancer survivors: a report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2012; 21:1078-88. [PMID: 22576363 DOI: 10.1158/1055-9965.epi-11-1095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To compare the skin and breast/cervical cancer prevention/screening practices of adult siblings of childhood cancer survivors with controls and to identify modifying factors for these practices. METHODS Cross-sectional, self-report data from 2,588 adult siblings of 5+ year survivors of childhood cancer were analyzed to assess cancer prevention/screening practices. Two age, sex, and race/ethnicity-matched samples (N = 5,915 and N = 37,789) of the Behavioral Risk Factor Surveillance System participants served as the comparison populations. Sociodemographic and cancer-related data were explored as modifying factors for sibling cancer prevention/screening practices through multivariable logistic regression. RESULTS Compared with controls, siblings were more likely to practice skin cancer prevention behaviors: use of protective clothing [OR, 2.85; 95% confidence interval (CI), 2.39-3.39], use of shade (OR, 2.11; 95% CI, 1.88-2.36), use of sunscreen (OR, 1.27; 95% CI, 1.14-1.40), and wearing a hat (OR, 1.77; 95% CI, 1.58-1.98). No differences were noted for breast/cervical cancer screening including mammography and Pap testing. Having less than a high school education and lack of health insurance were associated with diminished cancer prevention/screening behaviors. Survivor diagnosis, treatment intensity, adverse health, chronic health conditions, and second cancers were not associated with sibling cancer prevention/screening behaviors. CONCLUSIONS Siblings of cancer survivors report greater skin cancer prevention practices when compared with controls; however, no differences were noted for breast/cervical cancer screening practices. Access to care and lack of education may be associated with decreased cancer prevention/screening behaviors. Interventions are needed to address these barriers. IMPACT Research should be directed at understanding the impact of the cancer experience on sibling health behaviors.
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Affiliation(s)
- David Buchbinder
- Department of Pediatrics and Division of Hematology at Children's Hospital of Orange County, Orange, CA 92868, USA.
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Willems RA, Willemsen MC, Nagelhout GE, de Vries H. Understanding smokers' motivations to use evidence-based smoking cessation aids. Nicotine Tob Res 2012; 15:167-76. [PMID: 22573725 DOI: 10.1093/ntr/nts104] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Use of evidence-based smoking cessation aids (SCA) is an efficacious way to improve smoking cessation relapse rates. However, use of SCA in the Netherlands is particularly low. This study examined determinants of intention to use SCA in smokers willing to quit. METHODS The Dutch Continuous Survey of Smoking Habits, a cross-sectional population survey, was used. Respondents were smokers (n = 594) wanting to quit sometime in the future and who made at least one quit attempt in the past, categorized as past users of evidence-based SCA, past users of nonevidence-based SCA, and smokers who had never used SCA before (nonusers). Respondents were asked about past SCA use, motivational determinants regarding smoking cessation and SCA use, and intention to use SCA during a future quit attempt. RESULTS Older and more addicted smokers were more likely to have used evidence-based SCA. Evidence-based and nonevidence-based users reported stronger attitudes and perceived social norm as well as lower self-efficacy expectations regarding smoking cessation and SCA use than nonusers. Having positive outcome expectations and perceived social norm regarding SCA use were strong predictors of intention to use SCA. Self-efficacy regarding smoking cessation was negatively related with intention to use SCA. CONCLUSIONS Nonusers, nonevidence-based users, and evidence-based users have different motivations for using evidence-based SCA and should not be treated as a homogenous group in smoking cessation programs. Additionally, it is unclear whether nonusers should be encouraged to use SCA, given that this group is less addicted and more confident about quitting.
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Affiliation(s)
- Roy A Willems
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
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Relationships of sun-protection habit strength with sunscreen use during outdoor sport and physical activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:916-23. [PMID: 22690172 PMCID: PMC3367286 DOI: 10.3390/ijerph9030916] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/02/2012] [Accepted: 03/05/2012] [Indexed: 11/17/2022]
Abstract
The objective of this cross-sectional questionnaire study was to assess associations of a self-report index of sun protection habit strength with sunscreen use in sporting environments and outdoor physical activity. Participants (n = 234) in field hockey, soccer, tennis and surf sports in Queensland, Australia, completed a self-administered survey on sun protection during organized sport, and during general outdoor physical activity during 2005/2006. The sun protection habit strength index was dichotomized into two categories. Multinomial logistic regression analyses assessed the associations of low versus high sun protection habit strength with three categories of sunscreen use (no or rare use; inadequate use; and adequate use). Compared to participants with low sun protection habit strength, those with high sun protection habit strength had significantly greater odds of any sunscreen use during organized sport and during general outdoor physical activity. This association was strongest for adequate sunscreen use in both settings. In conclusion, this study suggests that the measure of sun protection habit strength is a potentially useful assessment tool for future sun protection studies.
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Emond Y, de Groot J, Wetzels W, van Osch L. Internet guidance in oncology practice: determinants of health professionals' Internet referral behavior. Psychooncology 2011; 22:74-82. [PMID: 21957030 DOI: 10.1002/pon.2056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 05/31/2011] [Accepted: 07/21/2011] [Indexed: 01/22/2023]
Abstract
BACKGROUND Many cancer patients turn to the Internet to obtain information on their disease. This digital quest is often motivated by a perceived discrepancy between the information received from health professionals and patients' actual informational needs. This discrepancy may be reduced by supplementing standard patient education with reliable online information sources. This study investigates health professionals' opinions, cognitions, and behavior regarding referring cancer patients to Internet-based information. METHODS Online and written questionnaires were distributed among Dutch oncology nurses and medical specialists, measuring perception of patients' informational needs, prompted and unprompted Internet referral, and socio-cognitive factors regarding referral behavior. RESULTS Health professionals (N = 130) positively appraised Internet use among cancer patients. Despite recognizing patients' needs for additional information (84%) and need for referral to reliable websites (67%), only 20% frequently referred patients to Internet-based information. Prompted Internet referral was higher (64%). Motives for nonreferral included unfamiliarity with websites and uncertainty about information quality. Intentions towards future referral were moderate to high. To translate intentions into referral, health professionals need reminder tools and information on reliability and content of websites. Cognitive determinants of referral behavior included professionals' attitude, self-efficacy, and intentions regarding referral. CONCLUSIONS Recognition of patients' information needs does not culminate in Internet referral among health professionals in cancer care. High intentions to change, however, indicate good prospects for future referral. This study yields valuable insights into behavioral determinants of health professionals' Internet referral behavior. Targeting determinants and barriers in future interventions will provide opportunities for optimization of educational practices.
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Affiliation(s)
- Yvette Emond
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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Correlates of sunscreen use among high school students: a cross-sectional survey. BMC Public Health 2011; 11:679. [PMID: 21884577 PMCID: PMC3179453 DOI: 10.1186/1471-2458-11-679] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 08/31/2011] [Indexed: 11/12/2022] Open
Abstract
Background Adolescents put themselves at risk of later skin cancer development and accelerated photo-aging due to their high rates of ultraviolet radiation exposure and low rates of skin protection. The purpose of the current study was to determine which of the Integrative Model constructs are most closely associated with sunscreen use among high school students. Methods The current study of 242 high school students involved a survey based on the Integrative Model including demographic and individual difference factors, skin protection-related beliefs and outcome evaluations, normative beliefs, self-efficacy, sunscreen cues and availability, intentions, and sunscreen use. Our analyses included multiple linear regressions and bootstrapping to test for mediation effects. Results Sunscreen use was significantly associated with female gender, greater skin sensitivity, higher perceived sunscreen benefits, higher skin protection importance, more favorable sunscreen user prototype, stronger skin protection norms, greater perceived skin protection behavioral control, and higher sunscreen self-efficacy. Intentions to use sunscreen mediated the relationships between most skin protection-related beliefs and sunscreen use. Conclusions The current study identified specific variables that can be targeted in interventions designed to increase sunscreen use among adolescents.
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Janssen E, van Osch L, Lechner L, Candel M, de Vries H. Thinking versus feeling: differentiating between cognitive and affective components of perceived cancer risk. Psychol Health 2011; 27:767-83. [PMID: 21767108 DOI: 10.1080/08870446.2011.580846] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Despite the increased recognition of affect in guiding probability estimates, perceived risk has been mainly operationalised in a cognitive way and the differentiation between rational and intuitive judgements is largely unexplored. This study investigated the validity of a measurement instrument differentiating cognitive and affective probability beliefs and examined whether behavioural decision making is mainly guided by cognition or affect. Data were obtained from four surveys focusing on smoking (N=268), fruit consumption (N=989), sunbed use (N=251) and sun protection (N=858). Correlational analyses showed that affective likelihood was more strongly correlated with worry compared to cognitive likelihood and confirmatory factor analysis provided support for a two-factor model of perceived likelihood instead of a one-factor model (i.e. cognition and affect combined). Furthermore, affective likelihood was significantly associated with the various outcome variables, whereas the association for cognitive likelihood was absent in three studies. The findings provide support for the construct validity of the measures used to assess cognitive and affective likelihood. Since affective likelihood might be a better predictor of health behaviour than the commonly used cognitive operationalisation, both dimensions should be considered in future research.
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Affiliation(s)
- Eva Janssen
- School for Public Health and Primary Care (Caphri), Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
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Novak CB, Young DS, Lipa JE, Neligan PC. Evaluation of sun protection behaviour in patients following excision of a skin lesion. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2011; 15:38-40. [PMID: 19554129 DOI: 10.1177/229255030701500106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present prospective study evaluated sun exposure and sun protection behaviours in patients diagnosed with a precancerous or cancerous skin lesion. Following signed informed consent, patients were given a questionnaire regarding sun protection and sun exposure behaviour. There were 50 patients (27 men, 23 women) with a mean age of 59 years. Following diagnosis of a cancerous or precancerous lesion, there was a significant increase (P<0.001) in sunscreen use, use of sun protection factor greater than 30, wearing a hat and avoidance of sun between 10:00 and 14:00. There were significantly more women who used sunscreen (P=0.04) and limited daily activities (P=0.03). There were significantly more patients with nonmelanoma lesions who wore hats (P<0.04) and more patients with melanoma who limited daily activities (P<0.04). While many patients in the present study did alter their sun protection and exposure behaviour, there were many patients who continued in risk-taking sun behaviour. Therefore, patients with precancerous or cancerous skin lesions who are not compliant with sun protective behaviour may benefit from more comprehensive patient education to encourage better sun protection behaviour.
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Affiliation(s)
- Christine B Novak
- Wharton Head & Neck Centre, University Health Network, University of Toronto, Toronto, Ontario
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Craciun C, Schüz N, Lippke S, Schwarzer R. Facilitating sunscreen use in women by a theory-based online intervention: a randomized controlled trial. J Health Psychol 2011; 17:207-16. [PMID: 21752862 DOI: 10.1177/1359105311414955] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study compares a motivational skin cancer prevention approach with a volitional planning and self-efficacy intervention to enhance regular sunscreen use. A randomized controlled trial (RCT) was conducted with 205 women (mean age 25 years) in three groups: motivational; volitional; and control. Sunscreen use, action planning, coping planning and coping self-efficacy were assessed at three points in time. The volitional intervention improved sunscreen use. Coping planning emerged as the only mediator between the intervention and sunscreen use at Time 3. Findings point to the role played by coping planning as an ingredient of sun protection interventions.
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van Keulen HM, Mesters I, Ausems M, van Breukelen G, Campbell M, Resnicow K, Brug J, de Vries H. Tailored print communication and telephone motivational interviewing are equally successful in improving multiple lifestyle behaviors in a randomized controlled trial. Ann Behav Med 2011; 41:104-18. [PMID: 20878293 PMCID: PMC3030742 DOI: 10.1007/s12160-010-9231-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Computer tailoring and motivational interviewing show promise in promoting lifestyle change, despite few head-to-head comparative studies. Purpose Vitalum is a randomized controlled trial in which the efficacy of these methods was compared in changing physical activity and fruit and vegetable consumption in middle-aged Dutch adults. Methods Participants (n = 1,629) were recruited via 23 general practices and randomly received either four tailored print letters, four motivational telephone calls, two of each type of intervention, or no information. The primary outcomes were absolute change in self-reported physical activity and fruit and vegetable consumption. Results All three intervention groups (i.e., the tailored letters, the motivational calls, and the combined version) were equally and significantly more effective than the control group in increasing physical activity (hours/day), intake of fruit (servings/day), and consumption of vegetables (grams/day) from baseline to the intermediate measurement (week 25), follow-up 1 (week 47) and 2 (week 73). Effect sizes (Cohen’s d) ranged from 0.15 to 0.18. Participants rated the interventions positively; interviews were more positively evaluated than letters. Conclusions Tailored print communication and telephone motivational interviewing or their combination are equally successful in changing multiple behaviors. Electronic supplementary material The online version of this article (doi:10.1007/s12160-010-9231-3) contains supplementary material, which is available to authorized users.
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Hilberink SR, Jacobs JE, Breteler MHM, de Vries H, Grol RPTM. General practice counseling for patients with chronic obstructive pulmonary disease to quit smoking: impact after 1 year of two complex interventions. PATIENT EDUCATION AND COUNSELING 2011; 83:120-124. [PMID: 20430565 DOI: 10.1016/j.pec.2010.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 03/17/2010] [Accepted: 04/02/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To evaluate two counseling programs in general practice to help smokers with chronic obstructive pulmonary disease (COPD) to quit smoking. METHODS Cluster randomized controlled trial including 68 general practices (667 patients) using a randomly assigned intervention program with counseling and advice about nicotine replacement therapy (and additional bupropion-SR in one of the programs) or usual care. Usual care consisted of periodic regular check-ups and COPD information. The main outcome measure was biochemically verified point prevalence at 12 months. RESULTS The two intervention groups were treated as one in the analysis because they were equally effective. The intervention resulted in a significantly self-reported higher success rate (14.5%) compared to usual care (7.4%); odds ratio=2.1, 95% confidence interval=1.1-4.1. Biochemically verified quit rates were 7.5% (intervention) and 3.4% (usual care); odds ratio=2.3, 95% confidence interval=0.9-6.0. CONCLUSION The program doubled the cessation rates (statistically nonsignificant). Too few participants used the additional bupropion-SR to prove its effectiveness. PRACTICE IMPLICATIONS The protocols can be used for COPD patients in general practice, but expectations should be modest. If quitting is unsuccessful, a stepped care approach should be considered.
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Affiliation(s)
- Sander R Hilberink
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Janssen E, van Osch L, de Vries H, Lechner L. Measuring risk perceptions of skin cancer: reliability and validity of different operationalizations. Br J Health Psychol 2011; 16:92-112. [PMID: 21226786 DOI: 10.1348/135910710x514120] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Risk perceptions play a pivotal role in health behaviour theories. Accurate measurement is essential in order to investigate the explanatory value and effectiveness of interventions influencing these beliefs. This study investigated the reliability and predictive validity of different risk perception operationalizations related to skin cancer and sunscreen use in order to explain the inconsistent findings in literature regarding the relationship between risk perceptions and (cancer related) behaviours. DESIGN AND METHODS Two on-line surveys were conducted. Study 1 (N= 175) was conducted among university students to investigate the test-retest reliability of different operationalizations of perceived likelihood and perceived severity and to assess their correlations with sunscreen use. Study 2 (N= 418) was a prospective study among Dutch adults and assessed longitudinal correlations between the different operationalizations and sunscreen use. RESULTS Internal consistency (alpha) ranged between .13 and .90 for likelihood measures and between .37 and .88 for severity measures. Test-retest correlations (r/ICC) ranged between .51 and .82 for the likelihood measures and between .58 and .75 for the severity measures. Conditional likelihood estimates, particularly when phrased affectively (feeling at risk), and comparative severity questions were the strongest correlates of behaviour. CONCLUSION Conditional likelihood and comparative severity might be better predictors of health behaviour than commonly used operationalizations of risk perception. These measures may be relevant for use in the development and evaluation of intervention programmes, and should be acknowledged by health behaviour theories. Suggestions for future research are discussed.
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Affiliation(s)
- Eva Janssen
- School for Public Health and Primary Care (Caphri), Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
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Craciun C, Schüz N, Lippke S, Schwarzer R. A Mediator Model of Sunscreen Use: A Longitudinal Analysis of Social-Cognitive Predictors and Mediators. Int J Behav Med 2011; 19:65-72. [DOI: 10.1007/s12529-011-9153-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rosseel JP, Hilberink SR, Jacobs JE, Maassen IM, Plasschaert AJM, Grol RPTM. Are oral health complaints related to smoking cessation intentions? Community Dent Oral Epidemiol 2011; 38:470-8. [PMID: 20545722 DOI: 10.1111/j.1600-0528.2010.00553.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Smoking influences oral health in several ways (such as the occurrence of periodontitis, teeth discolouration and oral cancer); therefore, smoking behaviour should be addressed in dental care. Dentists can play a role in primary and secondary prevention of tobacco dependence. They see their patients repeatedly over time. This study investigates whether oral health complaints can be seized as an opportunity to start smoking cessation counselling. METHODS A structured patient questionnaire in a sample of 1101 smokers (52.1% women, mean age 40.4 years) in a convenience sample of 87 primary care dental practices. The I-change model was used to describe factors influencing behavioural change. Dependent factors such as intention to quit smoking and related factors (attitude, social support and self-efficacy) were analysed in relation to independent factors such as oral health complaints (gingiva problems, gingiva inflammation, oral cancer and discoloured teeth) using a general linear model (univariate analysis), multinomial logistic regression analysis and multiple linear regression analysis. RESULTS A total of 56.3% had discoloured teeth, 27% of the smokers had a problem with their gums and 15.7% had gingiva inflammation. We found no direct relation between oral health complaints and the intention to quit smoking. However, teeth discolouration was positively related to attitudes towards smoking cessation [β, Confidential interval (95%); 1.92 (1.45-2.40 for advantages and -0.86(-1.18 to -0.53) for disadvantages] and negatively to self-efficacy regarding quitting [-2.69 (-3.49 to 1.88)]. CONCLUSIONS We found no direct relation between oral health complaints and the intention to quit smoking, but oral health complaints and especially teeth discolouration were related to factors influencing the quit intention. Patients with discoloured teeth are more likely to have a positive attitude towards smoking cessation but are uncertain to persist smoking cessation. It is suggested that teeth discolouration can be a good entrance for addressing smoking cessation in daily dental practice.
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Affiliation(s)
- J P Rosseel
- IQ healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Berndt NC, O'Riordan DL, Winkler E, McDermott L, Spathonis K, Owen N. Social Cognitive Correlates of Young Adult Sport Competitors’ Sunscreen Use. HEALTH EDUCATION & BEHAVIOR 2010; 38:6-14. [DOI: 10.1177/1090198110367996] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Young adults participating in outdoor sports represent a high-risk group for excessive sun exposure. The purpose of this study was to identify modifiable social cognitive correlates of sunscreen use among young adult competitors. Participants aged 18 to 30 years who competed in soccer ( n = 65), surf-lifesaving ( n = 63), hockey ( n = 61), and tennis ( n = 48) completed a sun habits survey. Almost half ( n = 113) of the participants used sunscreen inadequately and 30% ( n = 70) reported not using sunscreen. In fully adjusted models, social cognitive attributes significantly ( p < .05) associated with inadequate sunscreen use (vs. nonuse) included skin cancer risk perceptions (OR = 0.6, 95% CI = 0.3, 1.0), perceived barriers to sunscreen use (OR = 0.5, 95% CI = 0.3, 0.9), and stronger personal norms for applying sunscreen (OR = 1.8, 95% CI = 1.0, 3.2). These findings provide insight into the attributes that enable or inhibit the use of sunscreen among young competitors and as a result may be useful in informing behavior change interventions within the sporting context.
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Affiliation(s)
| | | | | | | | | | - Neville Owen
- The University of Queensland, Brisbane, Australia
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Francis K, Dobbinson S, Wakefield M, Girgis A. Solarium use in Australia, recent trends and context. Aust N Z J Public Health 2010; 34:427-30. [PMID: 20649786 DOI: 10.1111/j.1753-6405.2010.00578.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To describe the prevalence of solarium use among representative samples of Australian adolescents (12-17 years) and adults (18-69 years). METHODS In national surveys conducted in 2003/04 and 2006/07 using equivalent methods, n=11,509 Australian adolescents and adults self-reported their use of solaria. RESULTS In 2006/07 10.6% of adults had 'ever' used a solarium, and use was most prevalent among women aged 18 to 24 (17.1%) and 25 to 44 (20.7%). Few adolescents (2.5%) had ever used a solarium. The prevalence of past year use was much lower (0.6% of adolescents, 1.5% of adults) and there was a significant reduction among adults between surveys (OR=0.69, 95% CI=0.52-0.94). Adults' attitudes related to past year solarium use were preference for a suntan (OR=4.68, 95% CI=2.48-8.85); perceived protan attitudes of peers (OR=2.10, 95% CI=1.17-3.77), belief that a suntan looks healthy (OR=1.92, 95% CI=1.09-3.39); and perceiving they have some risk of getting skin cancer (OR=1.69, 95% CI=1.03-2.78). CONCLUSIONS AND IMPLICATIONS Although solarium use in Australia is relatively low, it is highest among young adult women. These data show encouraging downward trends in use, and provide a foundation for monitoring the impact of forthcoming regulatory changes to the solarium industry.
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Affiliation(s)
- Kate Francis
- Problem Gambling Research and Treatment Centre, University of Melbourne, Victoria
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Lemal M, Van den Bulck J. Testing the effectiveness of a skin cancer narrative in promoting positive health behavior: a pilot study. Prev Med 2010; 51:178-81. [PMID: 20450930 DOI: 10.1016/j.ypmed.2010.04.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 04/26/2010] [Accepted: 04/28/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this experiment was to examine the differential impact of a narrative and a non-narrative skin cancer message on health promoting actions and information-seeking behaviors. METHODS Participants were 230 Flemish university students aged 18 to 25 years who participated in a web based experiment in February 2009. Students were randomly assigned to a narrative skin cancer message, a non-narrative message or a no-message control condition. The messages contained identical information about recommended actions to prevent or detect skin cancer. Four weeks after exposure to the stimuli, respondents received a questionnaire assessing their actual health behaviors. RESULTS Multinomial logistic regression results indicated that participants who had been exposed to the narrative message were two to four times more likely to have engaged in health promoting actions, compared to participants in the control group. In contrast, the impact of the non-narrative condition only differed from that of the control group for searching more information about skin cancer. CONCLUSIONS These findings suggest that narrative messages may be a powerful means for promoting positive health actions.
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Affiliation(s)
- Marijke Lemal
- Faculty of Social Sciences, School for Mass Communication Research, Katholieke Universiteit Leuven, Belgium.
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Risk perception moderates how intentions are translated into sunscreen use. J Behav Med 2010; 33:392-8. [DOI: 10.1007/s10865-010-9269-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Accepted: 06/03/2010] [Indexed: 10/19/2022]
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van Stralen MM, Lechner L, Mudde AN, de Vries H, Bolman C. Determinants of awareness, initiation and maintenance of physical activity among the over-fifties: a Delphi study. HEALTH EDUCATION RESEARCH 2010; 25:233-247. [PMID: 18927443 DOI: 10.1093/her/cyn045] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
To develop effective interventions to stimulate physical activity (PA), insight into its underlying variables is needed. The aim of this study was to obtain an overview of the most relevant determinants of awareness, initiation and maintenance of PA among the over-fifties by means of a three-round Delphi study. In the first round, 17 key-experts outlined possible relevant determinants into an open-ended electronic questionnaire. In the second round, 118 experts completed a structured electronic questionnaire that was based on the first round results, in which they scored each determinant on its relevance. In the third round, experts were asked to re-rate the relevance of each determinant, after feedback was given about the group median relevance score. After three rounds, the experts agreed on 30 relevant determinants of the three phases of PA. When compared with longitudinal studies, the Delphi study pointed out new concepts, such as several post-motivational and social and environmental determinants as possible relevant determinants, suggesting that this method has the potential to trace new and promising determinants. The results further showed that next to similarities, much dissimilarity in relevant determinants of awareness, initiation and maintenance of PA was found, suggesting that most determinants could be phase specific.
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Affiliation(s)
- M M van Stralen
- Department of Psychology, Open University of the Netherlands, PO Box 2960, 6401 DL, Heerlen, the Netherlands.
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Mesters I, Jonkman L, Vasen H, de Vries H. Skin self-examination of persons from families with familial atypical multiple mole melanoma (FAMMM). PATIENT EDUCATION AND COUNSELING 2009; 75:251-255. [PMID: 19026513 DOI: 10.1016/j.pec.2008.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2008] [Revised: 09/04/2008] [Accepted: 09/17/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Early detection of melanomas might increase survival chance. Patients can usually see primary lesions while inspecting their skin. Skin self-examination (SSE) is therefore the recommended pre-screening method. To maximize the likelihood that SSE will be performed, it is important to distinguish those factors that increase the chance of performance. The aim is to examine motivational differences between (a) melanoma-prone persons who perform SSE once every 2-3 months, and (b) melanoma-prone persons with a lower SSE frequency. METHODS A survey to assess socio-demographic factors, attitude, social influence, self-efficacy and intention to perform SSE. RESULTS Members (n=71) of 18 familial atypical multiple mole melanoma (FAMMM) families participated; 70% performed SSE at least once every 2-3 months. Adequate performers were more likely to have a partner, had a more positive attitude toward SSE, perceived SSE as less difficult to perform and had a stronger intention to perform SSE compared to poor performers. Logistic regression indicated attitude as the only reliable predictor of SSE performance. CONCLUSION We found that about one third of our genetically predisposed population did not report an adequate frequency of performing SSE. PRACTICE IMPLICATIONS Deficiencies in SSE practices in a genetically predisposed population are indicated.
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Affiliation(s)
- Ilse Mesters
- Department of Health Education, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Linton CP, Jones KD. Ultraviolet Protection Behaviors and Beliefs Among Young Adult Dermatology Patients. JOURNAL OF THE DERMATOLOGY NURSES ASSOCIATION 2009. [DOI: 10.1097/jdn.0b013e3181a822d0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dobbinson S, Wakefield M, Hill D, Girgis A, Aitken JF, Beckmann K, Reeder AI, Herd N, Fairthorne A, Bowles KA. Prevalence and determinants of Australian adolescents' and adults' weekend sun protection and sunburn, summer 2003-2004. J Am Acad Dermatol 2008; 59:602-14. [DOI: 10.1016/j.jaad.2008.06.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Revised: 05/15/2008] [Accepted: 06/02/2008] [Indexed: 10/21/2022]
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Smeets T, Kremers SPJ, Brug J, de Vries H. Effects of tailored feedback on multiple health behaviors. Ann Behav Med 2008; 33:117-23. [PMID: 17447863 DOI: 10.1007/bf02879892] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND The effects of tailored intervention on multiple behaviors and possible moderators of tailoring effects have not yet been sufficiently demonstrated. PURPOSE The purpose of this study was to examine the effectiveness of a computer-tailored intervention on smoking; physical activity; and fruit, vegetable, and fat intake; and to test potential moderators of the effectiveness (BMI, age, SES, gender, motivation, and the number of behaviors for which respondents met the recommendations from national guidelines). METHODS Respondents were randomly assigned to a tailored intervention group, receiving one tailored letter on all of these behaviors, or a control intervention group, receiving one general information letter on all behaviors. RESULTS Three months after the baseline assessment, the tailored intervention group showed significantly better effects than the control group for all behaviors studied, except for smoking. Notably, the intervention did not enhance the health behaviors, but rather reduced a decline in these behaviors during the 3-month study interval. Effect sizes were small. No moderating factors were found, except for the number of behaviors for which recommendations were met in the tailoring intervention group on fruit consumption. The largest effects of the tailored intervention were found for fruit in respondents who did not meet the recommendations for any behavior (Cohen's d = 0.3). CONCLUSIONS A tailored intervention on multiple behaviors had significant, but limited effects when compared to generic information. The number of bad habits influenced the effects of the tailored intervention on fruit consumption.
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Affiliation(s)
- T Smeets
- Department of Health Education and Promotion, Maastricht University, The Netherlands.
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