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Balla J, Polet J, Kokko S, Hirvensalo M, Vasankari T, Lintunen T, Hagger MS. Predicting Adolescents' Physical Activity Intentions: Testing an Integrated Social Cognition Model. Int J Behav Med 2024; 31:41-54. [PMID: 36949326 PMCID: PMC10032623 DOI: 10.1007/s12529-023-10156-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Few adolescents meet guideline levels of physical activity associated with good health, highlighting the need for intervention. Interventions promoting adolescents' physical activity should be guided by research applying behavioral theory to identify potentially modifiable correlates and associated processes. We applied an integrated social cognition model to identify theory-based constructs and processes that relate to physical activity intentions in a secondary analysis of two samples of Finnish adolescents using a correlational design. METHOD Participants in the first sample (n = 455) completed self-report measures of social cognition constructs from theory of planned behavior, habit, self-discipline, and past and current physical activities. Participants in the second sample (n = 3878) completed identical measures plus measures of socio-structural and socio-environmental factors. Participants from the first sample also wore accelerometers for 1 week. Hypothesized model effects were tested using variance-based structural equation modeling in data from the first sample and subsequently confirmed in a pre-registered analysis of data from the second sample. RESULTS Across both samples, habit, attitude, perceived behavioral control, and self-reported past behavior were associated with physical activity intention. Effects of self-reported past physical activity on intention were partially mediated by social cognition constructs. Effects of accelerometer-based physical activity were small by comparison. Effects of socio-structural and socio-environmental factors on intention in the second sample were partially mediated by the social cognition constructs. CONCLUSION Results corroborate beliefs and habit as consistent correlates of adolescents' physical activity intentions and provide preliminary evidence that social cognition constructs account for effects of socio-structural and socio-environmental factors on intentions.
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Affiliation(s)
- Jessica Balla
- Department of Psychological Sciences, University of California, Merced, USA
| | - Juho Polet
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014, Jyväskylän Yliopisto, Finland
- Department of Psychology, University of Jyväskylä, Jyväskylän Yliopisto, Finland
- Centre of Excellence in Learning Dynamics and Intervention Research (InterLearn), Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014, Jyväskylän Yliopisto, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014, Jyväskylän Yliopisto, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Taru Lintunen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014, Jyväskylän Yliopisto, Finland
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, USA.
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014, Jyväskylän Yliopisto, Finland.
- School of Applied Psychology, Griffith University, Brisbane, Australia.
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Conner M, Norman P. Understanding the intention-behavior gap: The role of intention strength. Front Psychol 2022; 13:923464. [PMID: 35992469 PMCID: PMC9386038 DOI: 10.3389/fpsyg.2022.923464] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
This manuscript overviews recent research on the intention-behavior gap, focusing on moderators of the intention-behavior relationship. The manuscript draws on the concept of intention strength to make two important points. First, strong intentions provide better predictions of behavior, thereby reducing the intention-behavior gap. However, strong intentions have the additional features of being more stable over time, less pliable in the face of interventions to change them, and more likely to bias information processing about engaging in the behavior. These four features of intention strength are not independent. For example, stable intentions are likely to provide better predictions of behavior. Second, various predictors of strength (e.g., importance, certainty, extremity) may also constitute important, but little studied, moderators of the intention-behavior relationship. Moreover, the effects of these moderators of the intention-behavior relationship may be mediated through intention stability (and perhaps other features of intention strength). Future research on the intention-behavior gap would benefit from a more systematic consideration of a broad range of moderators of the intention-behavior relationship both individually and in combination. In addition, future research could usefully explore how these moderating effects might be explained. Such a systematic approach may further our understanding of the intention-behavior gap in relation to physical activity and other behaviors.
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Affiliation(s)
- Mark Conner
- School of Psychology, University of Leeds, Leeds, United Kingdom
- *Correspondence: Mark Conner,
| | - Paul Norman
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
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Ebdrup NH, Riis AH, Ramlau-Hansen CH, Bay B, Lyngsø J, Rytter D, Jørgensen MJ, Knudsen UB. Healthcare Use in the Five Years Before a First Infertility Diagnosis: A Danish Register-Based Case–Control Study in the CROSS-TRACKS Cohort. Clin Epidemiol 2022; 14:677-688. [PMID: 35586868 PMCID: PMC9109896 DOI: 10.2147/clep.s360292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Infertility may affect somatic and mental health later in life. Nevertheless, health status before diagnosed infertility is sparsely studied in women. We aimed to describe healthcare use in primary and secondary care before a first infertility diagnosis and compare use between cases and controls. Materials and Methods The case–control study was based on register data and used incidence density sampling. From the CROSS-TRACKS Cohort, we included women residing in the Horsens area in Denmark in 2012–2018 (n = 54,175). Eligible women were aged 18–40 years, nulliparous, and living in heterosexual relationships. Cases were women with a first infertility diagnosis in the Danish National Patient Registry (index date). Five controls were matched on age, birth year, and calendar time. Through linkage to Danish national health registries, we identified general practitioner (GP) attendance, paraclinical examinations, hospital contacts, diagnoses, and redeemed prescriptions. Healthcare use from one year to five years before index date was compared with conditional logistic regression. Results We identified 711 cases and 3555 controls. At one year before index date, cases consulted their GP (odds ratio (OR) = 5.2, 95% confidence interval (CI): 3.2, 8.3) and visited hospital (OR = 1.2, 95% CI: 1.0, 1.4) and redeemed prescriptions (OR = 2.3 95% CI: 1.9, 2.7) more often compared to controls. Cases more often had blood and hemoglobin tests performed, redeemed more drugs related to genitourinary and hormonal diseases, and were more often diagnosed with endocrine and genitourinary diseases in the year before a first infertility diagnosis compared to controls. Cases and controls had comparable healthcare use from five years to one year before a first infertility diagnosis. Conclusion Cases and controls had similar healthcare use from five years to one year before a first infertility diagnosis. However, cases had a higher healthcare use in the year preceding a first infertility diagnosis compared to controls.
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Affiliation(s)
- Ninna Hinchely Ebdrup
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Correspondence: Ninna Hinchely Ebdrup, Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Sundvej 30, Horsens, 8700, Denmark, Tel +45 28 47 21 11, Email
| | - Anders Hammerich Riis
- Department of Research, Regional Hospital Horsens, Horsens, Denmark
- Enversion A/S, Aarhus, Denmark
| | | | - Bjørn Bay
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Maigaard Fertility Clinic, Aarhus, Denmark
| | - Julie Lyngsø
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Dorte Rytter
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ulla Breth Knudsen
- Department of Obstetrics and Gynecology, Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Kraft P, Kraft B, Hagen T, Espeseth T. Subjective Socioeconomic Status, Cognitive Abilities, and Personal Control: Associations With Health Behaviours. Front Psychol 2022; 12:784758. [PMID: 35153907 PMCID: PMC8831894 DOI: 10.3389/fpsyg.2021.784758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo examine subjective and objective socioeconomic status (SSES and OSES, respectively) as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours.DesignA cross-sectional study including 197 participants aged 30–50 years, recruited from the crowd-working platform, Prolific.Main Outcome MeasureThe Good Health Practices Scale, a 16-item inventory of health behaviours.ResultsSSES was the most important predictor of health behaviours (beta = 0.19, p < 0.01). Among the OSES indicators, education (beta = 0.16, p < 0.05), but not income, predicted health behaviours. Intelligence (r = −0.16, p < 0.05) and memory (r = −0.22, p < 0.01) were negatively correlated with health-promoting behaviours, and the effect of memory was upheld in the multivariate model (beta = −0.17, p < 0.05). Personal control perceptions (mastery and constraints) did not act as mediators.ConclusionSSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours.
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Affiliation(s)
- Pål Kraft
- Department of Psychology, University of Oslo, Oslo, Norway
- Oslo New University College, Oslo, Norway
- *Correspondence: Pål Kraft,
| | - Brage Kraft
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Thomas Hagen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Espeseth
- Department of Psychology, University of Oslo, Oslo, Norway
- Oslo New University College, Oslo, Norway
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Ushula TW, Lahmann PH, Mamun A, Wang WYS, Williams GM, Najman JM. Lifestyle correlates of dietary patterns among young adults: evidence from an Australian birth cohort. Public Health Nutr 2021; 25:1-12. [PMID: 34486516 PMCID: PMC9991692 DOI: 10.1017/s1368980021003864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Previous studies of sociodemographic and lifestyle correlates of dietary patterns among young adults have primarily focused on physical activity and smoking, with inconclusive results. This study aims to examine the associations between a broader range of lifestyles of young adults and their patterns of food consumption. DESIGN Cross-sectional. SETTING Brisbane, Australia. PARTICIPANTS The data set are from a long running birth cohort study which commenced in 1981. Details of dietary intake and sociodemographic and lifestyle factors were from the 21-year follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) birth cohort. The effective cohort (n 2665, 57 % women) is of young adult offspring. Usual dietary intake was assessed using a Food Frequency Questionnaire (FFQ). Data on sociodemographic and lifestyle variables were obtained from self-reports. RESULTS Western and prudent dietary patterns were identified for the combined cohort of women and men using principal components analysis. Multivariable linear regression models were used to examine the associations between lifestyle variables and dietary patterns adjusting for potential confounders. Results from multivariable adjusted models showed that physical activity, watching TV and smoking were strongly associated with each dietary pattern; alcohol consumption and BMI showed weaker associations (P < 0·05 for all). CONCLUSIONS Our study describes a clustering of unhealthy lifestyles in young adults. Young adults with unhealthy lifestyles less often adhere to a healthy prudent dietary pattern and more often an unhealthy Western pattern. Dietary preferences are enmeshed in a lifestyle matrix which includes physical activity, sedentary activity, smoking and alcohol consumption of young adults.
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Affiliation(s)
- Tolassa W Ushula
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Petra H Lahmann
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
- The Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Australia
- The Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Australia
| | - William YS Wang
- Faculty of Medicine, The University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - Gail M Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jake M Najman
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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6
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Schüz B, Conner M, Wilding S, Alhawtan R, Prestwich A, Norman P. Do socio-structural factors moderate the effects of health cognitions on COVID-19 protection behaviours? Soc Sci Med 2021; 285:114261. [PMID: 34332252 PMCID: PMC8299154 DOI: 10.1016/j.socscimed.2021.114261] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Adherence to protection behaviours remains key to curbing the spread of the SARS-CoV-2 virus that causes COVID-19, but there are substantial differences in individual adherence to recommendations according to socio-structural factors. To better understand such differences, the current research examines whether relationships between health cognitions based on the Reasoned Action Approach (RAA) and eight COVID-19 protection behaviours vary as a function of participant-level socio-structural factors. METHODS Within-person design with behaviours nested within participants in a two-wave online survey (one week delay) conducted during the UK national lockdown in April 2020. A UK representative sample of 477 adults completed baseline measures from the RAA plus perceived susceptibility and past behaviour for eight protection behaviours, and self-reported behaviour one week later. Moderated hierarchical linear models with cross-level interactions were used to test moderation of health cognitions by socio-structural factors (sex, age, ethnicity, deprivation). RESULTS Sex, ethnicity and deprivation moderated the effects of health cognitions on protection intentions and behaviour. For example, the effects of injunctive norms on intentions were stronger in men compared to women. Importantly, intention was a weaker predictor of behaviour in more compared to less deprived groups. In addition, there was evidence that perceived autonomy was a stronger predictor of behaviour in more deprived groups. CONCLUSION Socio-structural variables affect how health cognitions relate to recommended COVID-19 protection behaviours. As a result, behavioural interventions based on social-cognitive theories might be less effective in participants from disadvantaged backgrounds.
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Affiliation(s)
| | | | | | - Rana Alhawtan
- University of Leeds, UK; Princess Nourah bint Abdulrahman University, Saudi Arabia
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7
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Schüz B, Meyerhof H, Hilz LK, Mata J. Equity Effects of Dietary Nudging Field Experiments: Systematic Review. Front Public Health 2021; 9:668998. [PMID: 34368049 PMCID: PMC8342848 DOI: 10.3389/fpubh.2021.668998] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Dietary behaviours are among the key modifiable risk factors for non-communicable diseases. Importantly, dietary behaviours vary substantially between groups and individuals with different socioeconomic positions, with more disadvantaged groups and individuals being exposed to more dietary risk factors. The goal of this review is to summarise the existing research on equity effects of dietary nudging interventions. Methods: Systematic review of nudging interventions conducted in a field setting that report an observable indicator of dietary behaviour, include a control group, and report effect sizes stratified by indicators of socioeconomic status as outlined in the PROGRESS-Plus framework. Two databases (scopus, Pubmed) were searched (last search June 2021), and 18 articles with 19 studies (k = 46 equity comparisons) were included. Risk of bias was assessed using the ROBINS-I tool. Due to heterogeneity in equity dimensions and study outcomes, a harvest plot was used to summarise data. Results: The majority of equity comparisons (38 out of 46) were available for cognitive nudges. Most of these (22 out of 38 comparisons) found that cognitive nudges worked equally well in more and less disadvantaged populations; however, in 12 out of the 38 comparisons, they favoured those who were less disadvantaged. Two out of four comparisons on behavioural nudges favoured more disadvantaged persons. Conclusions: The differential effects of dietary nudging interventions in this review can contribute to increases in health inequalities. At the same time, a substantial number of interventions showed no equity effects. Importantly, this review suggests that more research on nudging interventions and health equity is needed. Future interventions should report effect sizes stratified by indicators of social inequality. Systematic Review Registration: PROSPERO (CRD42019137469).
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Affiliation(s)
- Benjamin Schüz
- Faculty 11, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Hannah Meyerhof
- Faculty 11, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Lisa Karla Hilz
- Faculty 11, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Jutta Mata
- Department of Psychology, University of Mannheim, Mannheim, Germany
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Faber JS, Al-Dhahir I, Reijnders T, Chavannes NH, Evers AWM, Kraal JJ, van den Berg-Emons HJG, Visch VT. Attitudes Toward Health, Healthcare, and eHealth of People With a Low Socioeconomic Status: A Community-Based Participatory Approach. Front Digit Health 2021; 3:690182. [PMID: 34713165 PMCID: PMC8521920 DOI: 10.3389/fdgth.2021.690182] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/04/2021] [Indexed: 12/04/2022] Open
Abstract
Low socioeconomic status (SES) is associated with a higher prevalence of unhealthy lifestyles compared to a high SES. Health interventions that promote a healthy lifestyle, like eHealth solutions, face limited adoption in low SES groups. To improve the adoption of eHealth interventions, their alignment with the target group's attitudes is crucial. This study investigated the attitudes of people with a low SES toward health, healthcare, and eHealth. We adopted a mixed-method community-based participatory research approach with 23 members of a community center in a low SES neighborhood in the city of Rotterdam, the Netherlands. We conducted a first set of interviews and analyzed these using a grounded theory approach resulting in a group of themes. These basic themes' representative value was validated and refined by an online questionnaire involving a different sample of 43 participants from multiple community centers in the same neighborhood. We executed three focus groups to validate and contextualize the results. We identified two general attitudes based on nine profiles toward health, healthcare, and eHealth. The first general attitude, optimistically engaged, embodied approximately half our sample and involved light-heartedness toward health, loyalty toward healthcare, and eagerness to adopt eHealth. The second general attitude, doubtfully disadvantaged, represented roughly a quarter of our sample and was related to feeling encumbered toward health, feeling disadvantaged within healthcare, and hesitance toward eHealth adoption. The resulting attitudes strengthen the knowledge of the motivation and behavior of people with low SES regarding their health. Our results indicate that negative health attitudes are not as evident as often claimed. Nevertheless, intervention developers should still be mindful of differentiating life situations, motivations, healthcare needs, and eHealth expectations. Based on our findings, we recommend eHealth should fit into the person's daily life, ensure personal communication, be perceived usable and useful, adapt its communication to literacy level and life situation, allow for meaningful self-monitoring and embody self-efficacy enhancing strategies.
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Affiliation(s)
- Jasper S. Faber
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Isra Al-Dhahir
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Thomas Reijnders
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Niels H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
| | - Andrea W. M. Evers
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jos J. Kraal
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - H. J. G. van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
- Capri Cardiac Rehabilitation, Rotterdam, Netherlands
| | - Valentijn T. Visch
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Kraft P, Kraft B. Explaining socioeconomic disparities in health behaviours: A review of biopsychological pathways involving stress and inflammation. Neurosci Biobehav Rev 2021; 127:689-708. [PMID: 34048858 DOI: 10.1016/j.neubiorev.2021.05.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/12/2021] [Accepted: 05/20/2021] [Indexed: 01/29/2023]
Abstract
The purpose of this article was to explore how individuals' position in a socioeconomic hierarchy is related to health behaviours that are related to socioeconomic disparities in health. We identified research which shows that: (a) low socioeconomic status (SES) is associated with living in harsh environments, (b) harsh environments are related to increased levels of stress and inflammation, (c) stress and inflammation impact neural systems involved in self-control by sensitising the impulsive system and desensitising the reflective system, (d) the effects are inflated valuations of small immediate rewards and deflated valuations of larger delayed rewards, (e) these effects are observed as increased delay discounting, and (f) delay discounting is positively associated with practicing more unhealthy behaviours. The results are discussed within an adaptive evolutionary framework which lays out how the stress response system, and its interaction with the immune system and brain systems for decision-making and behaviours, provides the biopsychological mechanisms and regulatory shifts that make widespread conditional adaptability possible. Consequences for policy work, interventions, and future research are discussed.
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Affiliation(s)
- Pål Kraft
- Department of Psychology, University of Oslo, P.O. Box 1094, Blindern, 0317, Oslo, Norway; Department of Psychology, Bjørknes University College, Lovisenberggata 13, 0456, Oslo, Norway.
| | - Brage Kraft
- Division of Psychiatry, Diakonhjemmet Hospital, P. O. Box 23 Vinderen, 0319, Oslo, Norway.
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10
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Schüz B. Psychologie und Public Health. Public Health 2021. [DOI: 10.1007/978-3-658-30377-8_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Tang MY, Smith DM, Mc Sharry J, Hann M, French DP. Behavior Change Techniques Associated With Changes in Postintervention and Maintained Changes in Self-Efficacy For Physical Activity: A Systematic Review With Meta-analysis. Ann Behav Med 2020; 53:801-815. [PMID: 30534971 DOI: 10.1093/abm/kay090] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes. PURPOSE This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations. METHODS A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy. RESULTS Small intervention effects were found for postintervention self-efficacy for physical activity (d = 0.26; 95% CI: [0.21, 0.31]; I2 = 75.8 per cent). "Information about social, environmental, and emotional consequences" was associated with higher effect sizes, whereas "social support (practical)" was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity (d = 0.08; CI: [-0.05, 0.21]; I2 = 83.8 per cent). Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity. CONCLUSIONS There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.
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Affiliation(s)
- Mei Yee Tang
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK.,Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Debbie M Smith
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK.,School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - Jennifer Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Mark Hann
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - David P French
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
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12
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Hagger MS, Hamilton K. Effects of socio-structural variables in the theory of planned behavior: a mediation model in multiple samples and behaviors. Psychol Health 2020; 36:307-333. [PMID: 32608265 DOI: 10.1080/08870446.2020.1784420] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Observed variation in health behavior may be attributable to socio-structural variables that represent inequality. We tested the hypothesis that variability related to socio-structural variables may be linked to variation in social cognition determinants of health behavior. A proposed model in which effects of socio-structural variables (age, education level, gender, income) on health behavior participation was mediated by social cognition constructs was tested. Design: Model effects were tested in correlational datasets (k = 13) in different health behaviors, populations, and contexts. Samples included self-report measures of age, highest attained education level, gender, and net household income, and constructs from the theory of planned behavior (attitude, subjective norms, perceived behavioral control, intention). Ten samples provided follow-up self-reports of health behavior. Results: Path analyses supported sample-specific indirect effects of gender and age on health behavior with comparatively few income and education level effects. Meta-analytic structural equation modeling indicated consistent indirect and total effects of gender on intentions and health behavior through social cognition constructs, and a total effect of education level on behavior. Conclusion: Results provide support for the proposed mechanism by which socio-structural variables relate to health behavior. Replication in larger samples and meta-analytic synthesis across multiple health behavior studies is warranted.
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Affiliation(s)
- Martin S Hagger
- Social and Health Psychology Behavioral Research for Prevention and Promotion (SHARPP) Lab, Psychological Sciences, University of California, Merced, Merced, California, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
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Skelton WM, Cardaciotto L, O'Hayer CV, Goldbacher E. The role of self-compassion and shame in persons living with HIV/AIDS. AIDS Care 2020; 33:818-826. [PMID: 32449367 DOI: 10.1080/09540121.2020.1769836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite the connection between self-compassion, shame, and HIV/AIDS health outcomes in the literature, little is known about the relationship among these variables. Shame and self-compassion work independently of each other and experiences of shame can impede one's ability to engage in self-compassionate responses, which could prevent future health declines. Although shame has been found to mediate the relationship between self-compassion and a variety of mental health outcomes, it has not been examined in the context of HIV/AIDS. The purpose of the current study was to examine how shame mediates the relationship of self-compassion and adherence to HIV/AIDS medications, as well as how shame mediates the relationship of self-compassion and health-related quality of life (HRQL) in people living with HIV (PLWH). This is the first study to look at trait-based shame in PLWH in a sample of 34 patients at an urban outpatient integrated care facility for PLWH. Self-compassion was not correlated with HIV adherence behaviors or HRQL, and shame did not mediate the relationship between self-compassion and adherence or HRQL. However as expected, less shame was related to and predicted better HRQL in PLWH. Self-compassion' relationship to shame, adherence, and HRQL may be context dependent.
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Affiliation(s)
- William M Skelton
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | | | - C Virginia O'Hayer
- Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Edie Goldbacher
- Department of Psychology, La Salle University, Philadelphia, PA, USA
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Davidson KW, Scholz U. Understanding and predicting health behaviour change: a contemporary view through the lenses of meta-reviews. Health Psychol Rev 2020; 14:1-5. [PMID: 31957549 PMCID: PMC7068962 DOI: 10.1080/17437199.2020.1719368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/18/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Karina W Davidson
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
| | - Urte Scholz
- Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
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15
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Diniz E, Castro P, Bousfield A, Figueira Bernardes S. Classism and dehumanization in chronic pain: A qualitative study of nurses' inferences about women of different socio-economic status. Br J Health Psychol 2019; 25:152-170. [PMID: 31811704 DOI: 10.1111/bjhp.12399] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 11/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Class-based dehumanization in health is poorly investigated. Beliefs about social class are often shared across cultures, with people of lower socio-economic status (SES) being typically dehumanized. This study specifically examined how nurses' perceptions of pain patients' SES were associated with (more or less) dehumanizing inferences about their pain and different treatment recommendations. DESIGN Sequential mixed methods including Similitude Analysis (statistical analysis of qualitative data) and a Thematic Analysis. Fifty female nurses watched short videos of two white women of different SES (low vs. middle) and similar levels of pain behaviours. Afterwards, nurses were asked to complete (1) a Free Association Task (associating characteristics and a profession to the women) and (2) a Story-Completion Task (writing a story describing women's lives, pain, and recommending treatments). Data were analysed with Similitude and Thematic Analysis. RESULTS The women's SES was recognized, linked to distinct professions, and associated with distinct inferences. The middle-SES woman was depicted with both Uniquely Human (e.g., autonomous) and Human Nature (e.g., communicative) traits, positive future prospects, and competence to self-manage pain. The low-SES woman was associated with Human Nature traits (hard-working) but denied Uniquely Human traits associated with competence; she was imagined as passive towards pain, with poor future prospects and referred to psychoeducation. CONCLUSION Findings reveal the role of class-based cultural belief systems in pain care, showing how nurses' recognition of low SES is associated with dehumanizing inferences and recommendations, which may contribute to reproducing pain care disparities. Theoretical implications of these findings for social and health psychology are drawn. Statement of contribution What is already known on the subject? • Psychosocial research on health and pain care disparities has paid more attention to the role of race/racism and gender/sexism than the role of social class/classism; Belief systems about social class are shared across cultures; people from lower SES are often dehumanized by being denied competence, civility, and self-determination; Class-based dehumanization may influence the relational and technical aspects of clinical encounters but little is still known about these processes. What does this study add? Drawing upon a mixed-methods approach, this study provides novel findings on class-based dehumanization inferences made by female nurses on female chronic pain patients; Nurses perceived the lower SES patient with fewer Uniquely Human traits, that is, less competent, with more pain-related disability, and recommended her more psychoeducation. Class-based dehumanization processes may contribute to reproducing pain care disparities and may prove to be important targets for intervention development.
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Affiliation(s)
- Eva Diniz
- Instituto Universitário de Lisboa (ISCTE-IUL) & Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Paula Castro
- Instituto Universitário de Lisboa (ISCTE-IUL) & Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Andréa Bousfield
- Laboratório de Psicologia Social da Comunicação e Cognição (LACCOS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Sónia Figueira Bernardes
- Instituto Universitário de Lisboa (ISCTE-IUL) & Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
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16
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Zhang CQ, Chung PK, Zhang R, Schüz B. Socioeconomic Inequalities in Older Adults' Health: The Roles of Neighborhood and Individual-Level Psychosocial and Behavioral Resources. Front Public Health 2019; 7:318. [PMID: 31709222 PMCID: PMC6823619 DOI: 10.3389/fpubh.2019.00318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Chun-Qing Zhang
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong.,School of Psychology, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Pak-Kwong Chung
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ru Zhang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Schüz
- Institute for Public Health and Nursing, University of Bremen, Bremen, Germany
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17
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Daily stress as link between disadvantage and smoking: an ecological momentary assessment study. BMC Public Health 2019; 19:1284. [PMID: 31606051 PMCID: PMC6790015 DOI: 10.1186/s12889-019-7631-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022] Open
Abstract
Background There is a well-established social gradient in smoking, but little is known about the underlying behavioral mechanisms. Here, we take a social-ecological perspective by examining daily stress experience as a process linking social disadvantage to smoking behavior. Method A sample of 194 daily smokers, who were not attempting to quit, recorded their smoking and information about situational and contextual factors for three weeks using an electronic diary. We tested whether socioeconomic disadvantage (indicated by educational attainment, income and race) exerts indirect effects on smoking (cigarettes per day) via daily stress. Stress experience was assessed at the end of each day using Ecological Momentary Assessment methods. Data were analyzed using random effects regression with a lower-level (2-1-1) mediation model. Results On the within-person level lower educated and African American smokers reported significantly more daily stress across the monitoring period, which in turn was associated with more smoking. This resulted in a small significant indirect effect of daily stress experience on social disadvantage and smoking when using education and race as indicator for social disadvantage. No such effects were found when for income as indicator for social disadvantage. Conclusion These findings highlight the potential for future studies investigating behavioral mechanisms underlying smoking disparities. Such information would aid in the development and improvement of interventions to reduce social inequality in smoking rates and smoking rates in general.
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Schüz B, Brick C, Wilding S, Conner M. Socioeconomic Status Moderates the Effects of Health Cognitions on Health Behaviors within Participants: Two Multibehavior Studies. Ann Behav Med 2019; 54:36-48. [DOI: 10.1093/abm/kaz023] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.
Purpose
Current research on SES as moderator of the health cognitions–health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models.
Methods
Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES.
Results
Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES.
Conclusions
Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.
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Affiliation(s)
- Benjamin Schüz
- Institute for Public Health and Nursing, University of Bremen, Bremen, Germany
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Cameron Brick
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Mark Conner
- School of Psychology, University of Leeds, UK
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Li ASW, Figg G, Schüz B. Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta-Analysis Based on the Theory of Planned Behaviour. Appl Psychol Health Well Being 2019; 11:382-406. [PMID: 30884154 DOI: 10.1111/aphw.12154] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dietary behaviours are strongly patterned by socioeconomic status (SES). However, the role of SES in the self-regulation of health promoting dietary behaviours is not fully understood. This systematic review with meta-analysis investigated whether four individual-level measures of SES (income, occupation, education, and ethnicity) moderate the relationships between Theory of Planned Behaviour (TPB) variables and different health promoting dietary behaviours in adults. METHODS A systematic literature search identified 106 studies from 77 articles providing information on TPB variables, SES, and health promoting dietary behaviours-choosing health promoting foods and restricting health compromising foods. Random-effects meta-analyses were conducted to generate pooled correlations corrected for sampling and measurement error, and meta-regression was used to test moderating effects of study-level SES. RESULTS All TPB variables were significantly and positively associated with both health promoting dietary behaviours, with intention having the strongest correlation with behaviour. However, none of the relationships between TPB variables and health promoting dietary behaviours were significantly moderated by study-level SES. CONCLUSIONS Results suggest robust associations between TPB predictors and healthy dietary behaviour that are not patterned by individual-level SES measures.
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Affiliation(s)
| | - Georgia Figg
- University of Tasmania, Hobart, Tasmania, Australia
| | - Benjamin Schüz
- University of Tasmania, Hobart, Tasmania, Australia.,University of Bremen, Bremen, Germany
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20
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Lehne G, Voelcker-Rehage C, Meyer J, Bammann K, Gansefort D, Brüchert T, Bolte G. Equity Impact Assessment of Interventions to Promote Physical Activity among Older Adults: A Logic Model Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E420. [PMID: 30717136 PMCID: PMC6388141 DOI: 10.3390/ijerph16030420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 11/16/2022]
Abstract
Reducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritizing interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA-Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Future work within AEQUIPA will reveal which key elements are most critical for the interventions' equity impacts. Equity impact assessments are beneficial for prioritizing interventions most likely to be effective in reducing health inequalities.
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Affiliation(s)
- Gesa Lehne
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09126 Chemnitz, Germany.
| | - Jochen Meyer
- OFFIS-Institute for Information Technology, 26121 Oldenburg, Germany.
| | - Karin Bammann
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
- Working Group Epidemiology of Demographic Change, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
| | - Dirk Gansefort
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Tanja Brüchert
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
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21
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Burton D, King A, Bartley J, Petrie KJ, Broadbent E. The surgical anxiety questionnaire (SAQ): development and validation. Psychol Health 2018; 34:129-146. [DOI: 10.1080/08870446.2018.1502770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dominic Burton
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Amy King
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jim Bartley
- Department of Otorhinolaryngology – Head and Neck Surgery, Counties Manukau District Health Board, Otahuhu, Auckland, New Zealand
| | - Keith J. Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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22
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Jahnel T, Ferguson SG, Shiffman S, Thrul J, Schüz B. Momentary smoking context as a mediator of the relationship between SES and smoking. Addict Behav 2018; 83:136-141. [PMID: 29273313 DOI: 10.1016/j.addbeh.2017.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
There is a well-established socioeconomic gradient in smoking behavior: those with lower socioeconomic status smoke more. However, much less is known about the mechanisms explaining how SES is linked to smoking. This study takes a social-ecological perspective by examining whether socioeconomic status affects smoking behavior by differential exposure to places where smoking is allowed. Exposure to smoking restrictions was assessed in real-time using Ecological Momentary Assessment methods. A sample of 194 daily smokers, who were not attempting to quit, recorded their smoking and information about situational and contextual factors for three weeks using an electronic diary. We tested whether a smoker's momentary context mediated the relationship between socioeconomic status (educational attainment) and cigarettes smoked per day (CPD). Momentary context was operationalized as the proportion of random assessments answered in locations where smoking was allowed versus where smoking was not allowed. Data were analysed using multilevel regression (measurements nested within participants) with a lower level mediation model (2-1-1 mediation). Although no significant direct effect of SES on CPD were observed, there was a significant indirect effect of SES on CPD via the momentary context. Compared to participants with higher education, lower educated participants were more likely to encounter places where smoking was allowed, and this in turn, was associated with a higher number of CPD. These findings suggest that SES is associated with smoking at least partially via differential exposure to smoking-friendly environments, with smokers from lower SES backgrounds accessing more places where smoking is allowed. Implications for current smoke-free legislation are discussed.
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Affiliation(s)
- Tina Jahnel
- School of Medicine, University of Tasmania, Private Bag 34, Hobart, Tas 7001, Australia.
| | - Stuart G Ferguson
- School of Medicine, University of Tasmania, Private Bag 34, Hobart, Tas 7001, Australia.
| | - Saul Shiffman
- Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA.
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
| | - Benjamin Schüz
- School of Medicine, University of Tasmania, Private Bag 34, Hobart, Tas 7001, Australia; IPP Institute for Public Health und Nursing Research, University of Bremen, Grazer Str. 2, 28359 Bremen, Germany.
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Slonim-Nevo V, Sarid O, Friger M, Schwartz D, Sergienko R, Pereg A, Vardi H, Singer T, Chernin E, Greenberg D, Odes S. Effect of Social Support on Psychological Distress and Disease Activity in Inflammatory Bowel Disease Patients. Inflamm Bowel Dis 2018; 24:1389-1400. [PMID: 29893949 DOI: 10.1093/ibd/izy041] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Psychological distress increases morbidity in ulcerative colitis (UC) and Crohn's disease (CD). We examined whether social support is associated with distress and disease activity. METHODS There were 110 UC and 147 CD patients who completed sociodemography, economic status, disease activity (UC: Patient Simple Clinical Colitis Activity Index (P-SCCAI), CD: Patient Harvey-Bradshaw Index . (P-HBI), Multidimensional Scale of Perceived Social Support (MSPSS), Brief Symptom Inventory with Global Severity Index (GSI) of psychological distress, and 2 health-related quality-of-life scales (SF-36 Physical Health and Mental Health, and Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Analysis included multiple linear regressions and structural equation modeling. RESULTS Disease activity was mild: UC: P-SCCAI 2.9 ± 3.5, CD: P-HBI 4.7 ± 4.7. Physical Health was better in UC 46.6 ± 11.4 versus CD 43.7 ± 10.9 (P < .02). GSI was lower in UC 0.6 ± 0.7 than CD 0.8 ± 0.7 (P = .002). MSPSS total score was equal in UC (5.9 ± 1.2) and CD (5.9 ± 1.1). MSPSS total correlated with P-SCCAI (correlation coefficient ‒0.240), GSI in UC (‒0.470), and GSI in CD (‒0.333). Economic status correlated with GSI in UC (‒0.408) and CD (‒0.356). MSPSS predicted GSI, Mental Health, and SIBDQ in UC and CD, and predicted P-SCCAI but not P-HBI; economic status predicted all the foregoing. Path analysis depicted GSI as mediating the effects of MSPSS and economic status on disease activity in both UC and CD. MSPSS (UC: β ‒0.34, CD: β ‒0.37) and economic status (UC: β ‒0.38, CD: β ‒0.22) reduced GSI, which then increased the disease activity (UC: β 0.56, CD: β 0.42). CONCLUSIONS Social support and economic status are linked to UC and CD patients' well-being. Interventions addressing these issues should be part of management.
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Affiliation(s)
- Vered Slonim-Nevo
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orly Sarid
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Friger
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Doron Schwartz
- Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avihu Pereg
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Hillel Vardi
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Terri Singer
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Elena Chernin
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dan Greenberg
- Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shmuel Odes
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Osman M, Lin Y, Ashcroft R. Nudging: A Lesson in the Theatrics of Choice. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2017. [DOI: 10.1080/01973533.2017.1375929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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