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Snoeck-Krygsman SP, Donker-Cools BHPM, Jansen LP, Hoving JL, Schaafsma FG. Designing an evidence-based working method for medical work disability prognosis evaluation-an intervention mapping approach. Front Public Health 2023; 11:1112683. [PMID: 37744493 PMCID: PMC10516134 DOI: 10.3389/fpubh.2023.1112683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose Performing evidence-based work disability prognosis evaluation (WDPE) of clients on sick leave is a difficult task for physicians. The aim was to develop a working method to support physicians in performing evidence-based WDPE and to improve WDPE quality. Materials and methods Intervention Mapping (IM) supplemented with elements of the Behavior Change Wheel (BCW) guided project planning for developing the working method. This approach allowed combination with other frameworks and, e.g., behavior change theories. WDPE quality challenges were analyzed on various ecological levels, e.g., the individual (i.e., the physician), interpersonal (i.e., the client) and organizational level, culminating into a multilevel logic model of the problem. Determinants that contributed to this problem, e.g., lack of physicians' knowledge on performing evidence-based WDPE, were identified. Performance objectives were formulated that could contribute to a desired change in WDPE quality. From the performance objectives and determinants (e.g., knowledge), change objectives were derived. In order to achieve these change objectives, suitable intervention functions (e.g., education) and policy categories (e.g., service provision) were identified, allowing the formulation of intervention components. Behavior change techniques (e.g., feedback on outcomes of a behavior) were selected to serve the intervention functions to deliver the desired change. This led to the conceptualization of an intervention plan. Results The intervention "Prognosable" is presented. It consists of a stepwise working method (SWM) for evidence-based WDPE. The SWM offers an overview of important aspects (e.g., medical condition, clients' confidence in return-to-work) to consider in individual clients' WDPE. The SWM helps physicians to identify crucial functional limitations, find and appraise evidence-based information, weigh all relevant prognostic aspects and it supports physicians to conclude with an evidence-based WDPE, tailored to the individual client. The intervention "Prognosable" was designed, which also includes an educational program and a supportive software tool to enable implementation of the SWM. Conclusion IM combined with BCW elements guided the development of a SWM for evidence-based WDPE. The SWM will be delivered through an educational program for physicians supported by a digital tool. The SWM, educational program and digital tool are ready to be implemented and evaluated in practice as the intervention "Prognosable."
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Affiliation(s)
- Sylvia P. Snoeck-Krygsman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
- Department of Social Medical Affairs (SMZ), The Dutch Social Security Institute, The Institute for Employee Benefits Schemes (UWV), Amsterdam, Netherlands
| | - Birgit H. P. M. Donker-Cools
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
- Department of Social Medical Affairs (SMZ), The Dutch Social Security Institute, The Institute for Employee Benefits Schemes (UWV), Amsterdam, Netherlands
| | - Lyanne P. Jansen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
| | - Jan L. Hoving
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
- Research Center for Insurance Medicine (KCVG), Collaboration between AMC–UMCG–UWV–VUmc, Amsterdam, Netherlands
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Abraham C, Borland R, McNeill I. The need for a personalized, core digital resource to facilitate health self-management. Prev Med 2023; 173:107569. [PMID: 37290726 DOI: 10.1016/j.ypmed.2023.107569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/08/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023]
Abstract
High quality healthcare is becoming increasingly unaffordable and inaccessible. To reverse this trend, people need to self-manage as much of their health as possible. They need to take appropriate preventive actions and use health services in a timely and efficient manner. Yet health self-management is challenging in an increasingly complex environment that involves competing demands and sometimes contradictory advice as well as increasingly fragmented delivery of health services. Digital tools have added a new dimension to healthcare and hold the potential to help bridge these challenges. Unfortunately, much of the potential benefit of digital resources is not being realized, partly because of difficulties people face in identifying appropriate and effective resources in a haystack of mainly unevaluated and often poorly conceived resources. Underuse and failure to maintain use of resources found to be effective also retards progress. Furthermore, people need more help to understand their needs and establish priorities around their health self-management. We argue that these needs can be met with a person-centered, digital self-management core resource that supports people to better understand their needs and priorities and has links to find the resources they need to manage their health, alone or by judicious use of health services.
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Affiliation(s)
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Australia
| | - Ilona McNeill
- School of Psychology, Deakin University, Australia; Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Australia; Department of Psychological Sciences, Swinburne University of Technology, Australia
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Rahman T, Weatherall A, Kennedy M, Baker AL, Gould GS. My quitting stories: A qualitative study exploring Aboriginal women's experiences of smoking cessation and preventing relapse in the context of pregnancy. Women Birth 2023; 36:e237-e245. [PMID: 35918279 DOI: 10.1016/j.wombi.2022.07.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/24/2022] [Accepted: 07/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Most women who give up smoking during pregnancy relapse to smoking postnatally. Evidence on strategies that are helpful in maintaining smoking cessation during and beyond pregnancy is limited. AIM This paper aims to explore Aboriginal women's experiences of quitting smoking, relapsing, and preventing relapse, focusing on the strategies they applied for attaining and maintaining abstinence and the support they received. METHODS Qualitative interviews were conducted between October 2020 and June 2021, in urban New South Wales, Australia, with 12 Aboriginal women who either smoked tobacco or quit smoking and had been pregnant in the last five years. Aboriginal Research Assistants recruited participants, participated in data collection and data analysis. Data were thematically analysed. RESULTS Major themes that emerged from the data include: a) aspiration to be abstinent; b) strong mindset; c) strategies to stay smoke-free; d) supports received; and e) service and policy recommendations. Protecting children from second-hand smoke had salience for the maintenance of abstinence. Having a strong mindset was perceived as a prerequisite to staying smoke-free. Use of multiple coping strategies in combination was frequently expressed. Knowledge about tobacco-related harms, the way nicotine dependence works, and the available support options was empowering and enabled informed decision making and actions around smoking cessation. CONCLUSION This qualitative study conducted with 12 Aboriginal women revealed that Aboriginal women employ multiple strategies (cognitive, behavioural and social) to quit smoking and stay smoke-free. The strategies warrant further exploration with different Aboriginal communities across Australia and consideration of inclusion in smoking cessation care.
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Affiliation(s)
- Tabassum Rahman
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; Indigenous Epidemiology and Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, VIC 3053, Australia.
| | - Alyce Weatherall
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
| | - Gillian S Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2450, Australia.
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Do number of smoking friends and changes over time predict smoking relapse? Findings from the International Tobacco Control Four-Country Survey. J Subst Abuse Treat 2022; 138:108763. [DOI: 10.1016/j.jsat.2022.108763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/26/2022] [Accepted: 02/23/2022] [Indexed: 11/21/2022]
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Borland R, Le Grande M, Heckman BW, Fong GT, Bickel WK, Stein JS, East KA, Hall PA, Cummings KM. The Predictive Utility of Valuing the Future for Smoking Cessation: Findings from the ITC 4 Country Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020631. [PMID: 35055452 PMCID: PMC8776177 DOI: 10.3390/ijerph19020631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 02/01/2023]
Abstract
Background: Delay discounting (DD) and time perspective (TP) are conceptually related constructs that are theorized as important determinants of the pursuit of future outcomes over present inclinations. This study explores their predictive relationships for smoking cessation. Methods: 5006 daily smokers at a baseline wave provided 6710 paired observations of quitting activity between two waves. Data are from the International Tobacco Control (ITC) smoking and vaping surveys with samples from the USA, Canada, England, and Australia, across three waves conducted in 2016, 2018 and 2020. Smokers were assessed for TP and DD, plus smoking-specific predictors at one wave of cessation outcomes defined as either making a quit attempt and/or success among those who tried to quit which was ascertained at the subsequent survey wave. Results: TP and DD were essentially uncorrelated. TP predicted making quit attempts, both on its own and controlling for other potential predictors but was negatively associated with quit success. By contrast, DD was not related to making quit attempts, but high DD predicted relapse. The presence of financial stress at baseline resulted in some moderation of effects. Conclusions: Understanding the mechanisms of action of TP and DD can advance our understanding of, and ability to enhance, goal-directed behavioural change. TP appears to contribute to future intention formation, but not necessarily practical thought of how to achieve goals. DD is more likely an index of capacity to effectively generate competing future possibilities in response to immediate gratification.
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Affiliation(s)
- Ron Borland
- School of Psychological Sciences, University of Melbourne, Parkville 3010, Australia;
- Correspondence:
| | - Michael Le Grande
- School of Psychological Sciences, University of Melbourne, Parkville 3010, Australia;
| | - Bryan W. Heckman
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (B.W.H.); (K.M.C.)
- Center for the Study of Social Determinants of Health, Meharry Medical College, Nashville, TN 37208, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.A.E.); (P.A.H.)
- Ontario Institute for Cancer Research, Toronto, ON N2L 3G1, Canada
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (W.K.B.); (J.S.S.)
| | - Jeff S. Stein
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (W.K.B.); (J.S.S.)
| | - Katherine A. East
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.A.E.); (P.A.H.)
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Peter A. Hall
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.A.E.); (P.A.H.)
| | - Kenneth Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (B.W.H.); (K.M.C.)
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Le Grande M, Borland R, Yong HH, McNeill A, Fong G, Cummings KM. Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020). Nicotine Tob Res 2021; 24:679-689. [PMID: 34755869 PMCID: PMC9122748 DOI: 10.1093/ntr/ntab230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND This paper explores whether plans to quit, wanting to quit, and quit efficacy add predictive value over measures of habit strength and dependence in making quit attempts and/or attaining smoking abstinence. AIMS AND METHODS We used three waves of the International Tobacco Control (ITC) Four Country Smoking and Vaping Survey conducted in 2016, 2018, and 2020. Baseline daily smokers (N = 6710) who provided data for at least one wave-to-wave transition (W1 to W2, N = 3511 or W2 to W3, N = 3199) and provided outcome data at the next wave (follow-up) formed the analytic sample. Generalized estimating equations (GEE) logistic regression analyses examined predictors of quit attempts and abstinence at follow-up (1- and 6-month sustained abstinence). RESULTS Wanting and planning to quit were significantly positively associated with making quit attempts, but negatively associated with smoking abstinence. A significant interaction between the Heaviness of Smoking Index and age warranted an age-stratified analysis for both abstinence outcomes. Lower HSI predicted abstinence in only the younger smokers Motivation and plans to quit were positively associated with abstinence in younger smokers, but surprisingly were negatively associated with abstinence in older smokers. Quit efficacy was associated with abstinence in the older, but not the younger smokers. CONCLUSIONS Models of smoking abstinence are significantly improved by including motivational predictors of smoking. Age was an important moderator of the association between abstinence for both dependence and motivational variables. IMPLICATIONS The findings from this large cohort study indicate there are age-related differences in predictors of smoking abstinence but not quit attempts. These associations may reflect differential experiences of older and younger cohorts of smokers, which may have implications for interventions to motivate and assist smokers in quitting.
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Affiliation(s)
- Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,Corresponding Author: Michael Le Grande, MPH, Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, 7th floor Redmond Barry Building, Parkville Campus, Melbourne, VIC 3010, Australia. Telephone/Fax: +61 434884121; E-mail:
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Denmark Hill, London, UK,Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM) Consortium, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Geoffrey Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON,Canada,Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Grech LB, Hunter A, das Nair R, Borland R, Marck CH. Improving smoking cessation support for people with multiple sclerosis: A qualitative analysis of clinicians' views and current practice. Mult Scler Relat Disord 2021; 56:103289. [PMID: 34610568 DOI: 10.1016/j.msard.2021.103289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
Introduction Smoking is a key modifiable risk factor in multiple sclerosis (MS). MS healthcare providers have a central role informing people of the deleterious effects of smoking on MS progression and promote smoking cessation, yet there is limited information about smoking cessation and support provided by these providers. This study aimed to gain an understanding of MS healthcare providers current practices, barriers and facilitators related to providing smoking cessation support for people with MS. Methods A total of 13 MS nurses and 6 neurologists working in public and private MS clinics across Australia were recruited through professional networks and MS organisations. Telephone interviews were conducted, transcribed and evaluated using framework analysis. Results MS nurses and neurologists reported that they routinely assess smoking status of people with MS at initial appointments and less regularly also at follow-up appointments. Clinicians considered it important to provide information about smoking impact on MS health outcomes and advise to cease smoking, but the content and delivery varies. Beyond this, some clinicians offer referral for smoking cessation support, while others stated this was not their responsibility, especially in light of competing priorities. Many were unsure about referral pathways and options, requiring more information, training and resources. Conclusion Results of this research indicate that there is potential to improve support for MS clinicians to promote smoking cessation among people with MS. Smoking cessation support may include tailored patient resources, clinician training and stronger collaboration with smoking cessation service providers.
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Affiliation(s)
- Lisa B Grech
- Medicine Monash Health, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 3800, Australia; Department of Health Sciences, Swinburne University, Melbourne, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Assunta Hunter
- Disability and Health Unit, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, United Kingdom; Institute of Mental Health, Nottingham, United Kingdom
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; The Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Claudia H Marck
- Disability and Health Unit, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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King B, Borland R, Morphett K, Gartner C, Fielding K, O'Connor RJ, Romijnders K, Talhout R. 'It's all the other stuff!' How smokers understand (and misunderstand) chemicals in cigarettes and cigarette smoke. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2021; 30:777-796. [PMID: 33627027 DOI: 10.1177/0963662521991351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Many people understand chemicals as entities that do not occur naturally, and which are also invariably toxic. Tobacco control messages liberally use the term 'chemicals' to evoke these meanings and create concern among smokers. This may reinforce misunderstandings, potentially leading to smokers making harmful choices. To investigate smokers' understandings of chemicals, we conducted qualitative research using 18 individual interviews and three focus groups with Australian smokers and recently quit smokers. The research was guided by the 'mental models' framework and the recently developed Context, Executive, and Operational Systems theory. We discerned two clusters of mental models: the first cluster focused on combustion as the overarching cause of harm (and were largely consistent with the science) and the second cluster focused on additives as causes of harm. We found most participants displayed limited knowledge of the causes of harm from smoking and some held mutually incompatible beliefs. Most participants believed that cigarettes differ significantly in harmfulness according to whether or not they were believed to contain additives. Only a minority understood that the bulk of the toxicants to which smokers are exposed are combustion products. These findings are directly relevant to tobacco control but also have broader relevance to risk communications about toxic exposures.
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Affiliation(s)
| | | | | | | | | | | | | | - Reinskje Talhout
- Rijks Instituut voor Volksgezondheid en Milieu (RIVM) (National Institute for Public Health and Environment), The Netherlands
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Using CEOS theory to inform the development of behaviour change implementation and maintenance initiatives for people with multiple sclerosis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Gillman AS, Stevens CJ, Bryan AD. Women's exercise identity increases after a 16-week exercise RCT and is linked to behavior maintenance at follow-up. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 54:101888. [PMID: 33633498 PMCID: PMC7901813 DOI: 10.1016/j.psychsport.2021.101888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Regular exercise is critical for disease prevention, but adherence to public health guidelines is poor. Exercise identity is purported to be associated with exercise behavior maintenance, but the extant literature is largely cross-sectional and of low/modest quality. PURPOSE To examine change in exercise identity after completion of a supervised exercise intervention, as well as associations between change in exercise identity and exercise maintenance at 6-months follow-up. METHODS N = 276 insufficiently physically active women were randomized to a 16-week, supervised exercise training intervention with 4 conditions fully crossed on intensity (vigorous/moderate) and duration (long/short). Exercise identity was measured pre- and post-intervention and assessments of exercise motivation and behavior frequency were collected at 6-months post-intervention follow-up. RESULTS On average, participants experienced a statistically significant change in exercise identity over the course of the intervention, t(128) = 7.94, p < .001, but identity change scores did not differ across training conditions, p = .91. Identity change was significantly positively related to changes in other theory-informed, motivation-based determinants of exercise, and predicted an additional 16.17 minutes of exercise per week, on average, at follow-up, b = 16.76, t(103) = 2.30, p = .023. CONCLUSIONS Participants experienced increased self-identification with exercise after 16-weeks of training, but training volume did not influence the amount of identity change. As expected, greater change in exercise identity was associated with higher levels of exercise behavior at 6-months post-intervention follow-up (ClinicalTrials.gov number NCT02032628).
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Affiliation(s)
| | | | - Angela D. Bryan
- Department of Psychology & Neuroscience, University of Colorado Boulder
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Gan Y. Happy People Live Longer and Better: Advances in Research on Subjective Well-Being. Appl Psychol Health Well Being 2020; 12:3-6. [PMID: 31994837 DOI: 10.1111/aphw.12192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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King B, Borland R, Yong HH, Gartner C, Hammond D, Lewandowsky S, O'Connor R. Understandings of the component causes of harm from cigarette smoking in Australia. Drug Alcohol Rev 2019; 38:807-817. [PMID: 31691407 DOI: 10.1111/dar.12995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/19/2019] [Accepted: 08/26/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS To investigate relationships between smoking-related behaviours and knowledge of the disease risks of smoking and the causes of smoking harms, using a four-way division of 'component causes': nicotine, other substances found in unburned tobacco, combustion products of tobacco and additives. DESIGN AND METHODS The data were collected using an on-line survey in Australia with 1047 participants in three groups; young non-smokers (18 to 25), young smokers (18 to 25) and older smokers (26 and above). RESULTS Most participants agreed that cancer and heart disease are major risks of smoking but only a quarter accurately quantified the mortality risk of lifetime daily smoking. Very few (two of 1047) correctly estimated the relative contributions of all four component causes. Post-hoc analyses reinterpreting responses as expressions of relative concern about combustion products and nicotine showed that 29% of participants rated combustion products above nicotine. We delineated six relative concern segments, most of which had distinctive patterns of beliefs and actions. However, higher levels of concern about combustion products were only weakly positively associated with harm reducing beliefs and actions. DISCUSSION AND CONCLUSIONS Most smokers do not appear to understand the risks of smoking and their causes well enough to be able to think systematically about the courses of action open to them to reduce their health risk. To facilitate informed decision-making, tobacco control communicators may need to better balance the dual aims of creating fear/negative affect about smoking and imparting knowledge about the health harms and their mechanisms.
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Affiliation(s)
- Bill King
- Cancer Council Victoria and School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ron Borland
- Cancer Council Victoria and School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Melbourne, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, Herston University of Queensland, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland and Queensland Alliance for Environmental Health Sciences, Brisbane, Australia
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Stephan Lewandowsky
- School of Psychology, University of Western Australia, Perth, Australia.,School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, USA
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King B, Ndoen E, Borland R. Smokers' risk perceptions and misperceptions of cigarettes, e-cigarettes and nicotine replacement therapies. Drug Alcohol Rev 2018; 37:810-817. [PMID: 29920819 DOI: 10.1111/dar.12829] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS To identify the range and coherence of smokers and recent ex-smokers' general beliefs about the harms associated with smoking and the implications of these beliefs for their assessments of the relative harms and addictiveness of various nicotine containing products. DESIGN AND METHODS The study consisted of 18 single participant interviews with current smokers or vapers (13 M, 5 F) and three focus groups (15 M, 14 F) with current smokers/vapers and recent quitters. Both individual interviews and focus groups included semi-structured discussions of how nicotine and cigarette smoke cause disease and addiction, and a structured task involving rating the relative harmfulness and addictiveness of 17 nicotine products against a reference, popular, cigarette. RESULTS Most participants were able to give adequate accounts of what makes cigarette smoking harmful and addictive but this general knowledge was not consistently applied to making harmfulness and addictiveness judgements about specific products. Many participants applied simple affect-based heuristics to harmfulness and addictiveness judgments, even when they had apparently demonstrated more sophisticated knowledge earlier. Most used binary safe/dangerous thinking, with addictiveness and harmfulness strongly linked and a decoupling of satisfaction and addictiveness. DISCUSSION AND CONCLUSIONS Many smokers appear to have reasonable general knowledge of the risks of smoking but cannot reliably apply this knowledge to practical risk judgements. We need to rethink how we communicate with the public about the risks of smoking, and using other nicotine products, in ways that allow them to make more informed decisions about their smoking.
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Affiliation(s)
- Bill King
- Cancer Council Victoria, Melbourne, Australia
| | - Enjelita Ndoen
- School of Public Health, University of Melbourne, Melbourne, Australia
- Faculty of Public Health, University of Nusa Cendana, Kupang, Indonesia
| | - Ron Borland
- Cancer Council Victoria, Melbourne, Australia
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Borland R. Misinterpreting theory and ignoring evidence: fear appeals can actually work: a comment on Kok et al. (2018). Health Psychol Rev 2018; 12:126-128. [DOI: 10.1080/17437199.2018.1445545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ron Borland
- Nigel Gray Distinguished Fellow in Cancer Prevention, Cancer Council Victoria, Melbourne, Australia
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Ma BH, Yong H, Borland R, McNeill A, Hitchman SC. Factors associated with future intentions to use personal vaporisers among those with some experience of vaping. Drug Alcohol Rev 2018; 37:216-225. [PMID: 28560806 PMCID: PMC5798997 DOI: 10.1111/dar.12574] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Personal vaporisers (PV), including e-cigarettes, may be a harm reduction strategy for tobacco control. This study aims to identify factors associated with future intentions to vape among smokers and ex-smokers in Australia and the UK. DESIGN AND METHODS Cross-sectional data of smokers and ex-smokers (n = 1199, mean age = 45.3 years, 44.8% male), collected in 2014/2015 and divided into four subgroups: smoking past vapers (SPV), smoking vapers (SV), ex-smoking past vapers (ESPV) and ex-smoking vapers (ESV), from the International Tobacco Control Australia and UK surveys were analysed by using regression models. RESULTS Higher vaping satisfaction increased vaping intentions for all groups except ESPV. Perceiving PVs as less harmful predicted intentions to vape for all groups except ESV. The importance of PVs for stopping smoking predicted lower intentions to continue vaping for SV, but higher intentions to initiate vaping for SPV. The importance of PVs for cutting down smoking was a positive predictor only for SPV. Among ex-smokers, importance for maintaining not smoking was a positive predictor for ESPV, but not for ESV. The importance of perceiving vapour being less harmful also depended on vaping status for ex-smokers. The only country interaction was that only in the UK was perceiving PVs as less harmful associated with intention among SPV. DISCUSSION AND CONCLUSION Factors influencing intentions vary by smoking and/or vaping status, with greater differences between the ex-smoker subgroups. This is consistent with PVs being seen as a way of managing smoking, rather than something that has intrinsic value, for all except the ex-smoking vapers. [Ma BH, Yong H-H, Borland R, McNeill A, Hitchman SC. Factors associated with future intentions to use personal vaporisers among those with some experience of vaping. Drug Alcohol Rev 2017;00:000-000].
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Affiliation(s)
- Bernice Hua Ma
- School of Population HealthUniversity of MelbourneMelbourneAustralia
- Department of Public HealthLa Trobe UniversityMelbourneAustralia
| | - Hua‐Hie Yong
- Nigel Gray Fellowship groupCancer Council VictoriaMelbourneAustralia
| | - Ron Borland
- Nigel Gray Fellowship groupCancer Council VictoriaMelbourneAustralia
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
- UK Centre for Tobacco and Alcohol StudiesNottinghamUK
| | - Sara C. Hitchman
- Department of Addictions, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
- UK Centre for Tobacco and Alcohol StudiesNottinghamUK
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Kasila K, Hallman M, Kautiainen H, Vanhala M, Kettunen T. The gap between behavioral risk status and willingness to change behavior among healthcare professionals. Perspect Public Health 2018; 138:311-315. [DOI: 10.1177/1757913917751564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: This study explored behavioral health risk factors among healthcare professionals and investigated the at-risk persons’ satisfaction with their health habits and ongoing change attempts. Methods: The study was based on a cross-sectional web-based survey directed at the nurses and physicians ( N = 1233) in Finnish healthcare. Obesity, low physical activity, smoking, and risky alcohol drinking were used as behavioral health risk factors. Results: In all, 70% of the participants had at least one behavioral risk factor, and a significant number of at-risk persons were satisfied with their health habits and had no ongoing change process. Good self-rated health and good self-rated work ability were significantly associated with whether a participant had a behavioral health risk factor. Conclusion: Overall, unhealthy behaviors and a lack of ongoing change attempts were commonly observed among healthcare professionals. Work in healthcare is demanding, and healthy lifestyles can support coping. Thus, healthy lifestyle programs should also be targeted to healthcare professionals.
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Affiliation(s)
- K Kasila
- Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, FI-40014 University of Jyväskylä, Finland
| | - M Hallman
- Unit of Primary Health Care, Central Finland Health Care District, Jyväskylä, Finland
| | - H Kautiainen
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Turku University Hospital, Turku, Finland
| | - M Vanhala
- Unit of Primary Health Care, Central Finland Health Care District, Jyväskylä, Finland; Unit of Primary Health Care, University of Eastern Finland, Kuopio, Finland
| | - T Kettunen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland; Unit of Primary Health Care, Central Finland Health Care District, Jyväskylä, Finland
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Heather N. Q: Is Addiction a Brain Disease or a Moral Failing? A: Neither. NEUROETHICS-NETH 2017; 10:115-124. [PMID: 28725283 PMCID: PMC5486515 DOI: 10.1007/s12152-016-9289-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 11/05/2022]
Abstract
This article uses Marc Lewis' work as a springboard to discuss the socio-political context of the brain disease model of addiction (BDMA). The claim that promotion of the BDMA is the only way the general public can be persuaded to withhold blame and punishment from addicts is critically examined. After a discussion of public understandings of the disease concept of addiction, it is pointed out that it is possible to develop a scientific account of addiction which is neither a disease nor a moral model but which the public could understand. Evidence is reviewed to suggest that public acceptance of the disease concept is largely lip-service and that the claim the BDMA removes stigma among the public and professionals is unsupported by evidence. Further, there is good evidence that biogenetic explanations of mental/behavioural disorders in general have been counterproductive in the attempt to ally stigma. A model of addiction as a disorder of choice may attract special problems in public-facing communications and risks being misunderstood. However, ways of presenting this model to the public are suggested that may avoid such risks. Lastly, the claim that the BDMA is the only way of ensuring access to treatment and of maintaining research funding for addiction is disputed and a way in which these benefits can be retained under a disorder-of-choice model proposed. The article concludes by enthusiastically endorsing Lewis' call for a third stage in the governing image of addiction.
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Affiliation(s)
- Nick Heather
- Department of Psychology, Northumbria University, 8 Roseworth Terrace, Newcastle on Tyne, NE3 1LU UK
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