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Sharma M, Batra K, Chen CC, Dai CL, Batra R, Cappelli DP. Predicting Flossing through the Application of the Multi-Theory Model (MTM) of Health Behavior Change among Minority Adolescents in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15106. [PMID: 36429824 PMCID: PMC9690246 DOI: 10.3390/ijerph192215106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Adolescents from minority groups are particularly susceptible to poor oral hygiene behaviors, including lack of daily flossing. This cross-sectional study aimed to conduct an exploratory behavioral research to identify evidence-based (theory-based) approaches to promote flossing behavior among African American/Black and Latinx/Hispanic (minority) adolescents. A 39-item psychometrically valid web-based questionnaire was used to collect responses from a nationwide sample of minority adolescents aged 10-17 years residing in the United States. The data were analyzed using bivariate and multivariate statistical methods. Of 520 minority adolescents (260 African American/Black and 260 Latinx/Hispanic adolescents), the proportion of flossing was nearly equally split in the sample. A significantly higher proportion of minority adolescents who were flossing had access to floss as opposed to those who were not flossing (86.8% vs. 69.8%, p < 0.001). A significantly higher proportion of minority adolescents who were not flossing did not visit the dentist over the past year as opposed to those who floss (25.2% vs. 14.7%, p < 0.001). Among the participants who were not flossing, gender, grade level, instruction in school regarding flossing, and multi-theory model (MTM) of health behavior change constructs were the significant predictors (p < 0.001) of initiating and sustaining flossing. The findings of this study will serve as baseline data for developing and evaluating effective evidence-based interventions using the MTM.
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Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Ching-Chen Chen
- Department of Counselor Education, School Psychology, and Human Services, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Chia-Liang Dai
- Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Ravi Batra
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Information Technology, Coforge Ltd., Atlanta, GA 30338, USA
| | - David P. Cappelli
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89102, USA
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Sharma M, Asare M, Lakhan R, Kanekar A, Nahar VK, Moonie S. Can the Multi-Theory Model (MTM) of Health Behavior Change Explain the Intent for People to Practice Meditation? J Evid Based Integr Med 2021; 26:2515690X211064582. [PMID: 34898284 PMCID: PMC8671666 DOI: 10.1177/2515690x211064582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Meditation is gaining popularity as adjuvant therapy for many chronic ailments, mental well-being, and spiritual growth. Behavioral theories have been underutilized in understanding meditation behavior. This study aimed to test if a fourth-generation multi-theory model (MTM) could explain the intent for starting and maintaining meditation behavior in a sample of US adults. A face and content valid 48-item instrument based on MTM was administered in a cross-sectional design through an online survey (n = 330). Internal consistency (Cronbach's alpha > 0.70) and construct validation using structural equation modeling of the subscales were all acceptable. Hierarchical multiple regression revealed that, after controlling for demographic covariates, the MTM constructs of participatory dialogue (β = 0.153; P = .002) and behavioral confidence (β = 0.479; P < .001) were statistically significant in predicting intent for starting meditation behavior and accounted for 32.9% of the variance. Furthermore, after controlling for demographic covariates, the MTM constructs of emotional transformation (β = 0.390; P < .001) and changes in the social environment (β = 0.395; P < .001) were statistically significant and accounted for 52.9% of the variance in the intent for maintaining meditation behavior. Based on this study, it can be concluded that MTM offers a pragmatic framework to design, implement, and evaluate evidence-based (theory-based) meditation behavior change interventions.
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Affiliation(s)
| | | | | | | | - Vinayak K Nahar
- 8083The University of Mississippi Medical Center, Jackson, USA
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Sharma M, Batra K, Singh TP, Dua R, Ickes M, Batra R, Nahar VK. Explaining Screen-Time Behavior Among Preschoolers in Northern India Using Multi Theory Model: A Parental Cross-Sectional Survey. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 43:95-104. [PMID: 33765887 DOI: 10.1177/0272684x211006604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Screen-time (ST) is the time spent on digital media. The American Academy of Pediatrics recommends the daily ST of less than an hour for preschoolers. However, increased ST among preschoolers is becoming a public health concern. OBJECTIVE This study assessed the multi-theory model (MTM)'s applicability in explaining the ST behavior change among preschoolers through parents. METHODS A quota sample of 72 parents was drawn from Northern India. Data were analyzed using multiple regression. RESULTS Behavioral confidence (p < 0.001) and changes in the physical environment (p < 0.001) significantly predicted the initiation of reducing ST. The sustenance of limiting ST was significantly predicted by the emotional transformation (p < 0.001), practice for change (p < 0.001), and changes in the social environment (p = 0.001). CONCLUSIONS The study highlights the usability of the MTM model in designing and testing interventions for parents to limit ST among their children.
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Affiliation(s)
- Manoj Sharma
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Nevada, United States
| | - Kavita Batra
- Office of Research, School of Medicine, University of Nevada, Las Vegas, Nevada, United States
| | - Tejinder Pal Singh
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Rohini Dua
- Department of Pediatric and Preventive Dentistry, National Dental College and Hospital, Dera Bassi, India
| | - Melinda Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, Kentucky, United States
| | - Ravi Batra
- Department of Information Technology and Testing Center of Excellence, Coforge, Atlanta, Georgia, United States
| | - Vinayak K Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
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Sharma M, Chandra A, Toth R, Nahar VK. Utility of Multi-Theory Model (MTM) to Explain the Intention for PAP Adherence in Newly Diagnosed Sleep Apnea Patients. Nat Sci Sleep 2021; 13:263-271. [PMID: 33688285 PMCID: PMC7935343 DOI: 10.2147/nss.s294183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/12/2021] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The objective of this study was to assess the utility of a fourth-generation multi-theory model (MTM) in explaining the intention for initiation and sustenance of PAP adherence among newly diagnosed sleep apnea patients. PATIENTS AND METHODS For this cross-sectional study, data were collected at a private sleep center located in the Southeastern United States. A total of 138 newly diagnosed patients with sleep apnea who had been prescribed PAP therapy completed a valid and reliable 41-item MTM instrument. Stepwise multiple regression modeling was conducted to assess MTM based explanatory variables of PAP adherence in this study sample. RESULTS MTM constructs namely participatory dialogue (β = 0.17, p = 0.014), behavioral confidence (β = 0.48, p < 0.001), and changes in the physical environment (β = 0.26, p = 0.001) were statistically significant predictors of the intention for initiation of PAP therapy and accounted for 53.5% of the variance. Emotional transformation (β = 0.57, p < 0.001), changes in the social environment (β = 0.16, p = 0.016), and practice for change (β = 0.16, p = 0.047) were statistically significant predictors of the intention for sustenance of PAP therapy and accounted for 60.6% of the variance. CONCLUSION The MTM was found to be a promising theoretical model in explaining the intention for initiation and sustenance of PAP therapy.
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Affiliation(s)
- Manoj Sharma
- Department of Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Anuj Chandra
- Advanced Center for Sleep Disorders, Chattanooga, TN, USA
| | - Ryan Toth
- Advanced Center for Sleep Disorders, Chattanooga, TN, USA
| | - Vinayak K Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.,Department of Preventive Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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Sharma M, Largo-Wight E, Kanekar A, Kusumoto H, Hooper S, Nahar VK. Using the Multi-Theory Model (MTM) of Health Behavior Change to Explain Intentional Outdoor Nature Contact Behavior among College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176104. [PMID: 32825734 PMCID: PMC7504007 DOI: 10.3390/ijerph17176104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 01/14/2023]
Abstract
Nature contact is an emerging health behavior and is defined as the interaction between human beings and animals, plants, natural scenic views, or outdoor activities. Studies have shown that exposure to the outdoors (as a means of contact with nature) reduces perceived stress and promotes health and wellbeing among varying populations in many settings. To date, however, there are few studies exploring the impact of nature contact among college students, especially in the United States. In addition, the determinants of nature contact behavior have not adequately been explored using behavioral theories. The purpose of this study was to use the multi-theory model (MTM) of health behavior change, a contemporary fourth-generation behavioral theory in explaining intentional outdoor nature contact behavior among college students. Using a cross-sectional design, 401 students completed the validated survey based on MTM. Of these, 281 met the inclusion criteria. The mean score for perceived stress based on the Perceived Stress Scale (PSS-10) in the sample was 21.60 (7.08) units, with a possible minimum and maximum scores ranging from 0 to 40 units. Constructs of behavioral confidence (standardized coefficient = 0.591, p < 0.001) and changes in the physical environment (standardized coefficient = 0.271, p < 0.001) from MTM accounted for 57.5% of the variance in the initiation for intentional outdoor nature contact behavior. All the three constructs of MTM—namely, emotional transformation (standardized coefficient = 0.173, p = 0.021), practice for change (standardized coefficient = 0.317, p < 0.001), and changes in the social environment (standardized coefficient = 0.204, p = 0.002)—were statistically significant and contributed substantively toward the variance (31.0%) in sustenance. MTM provides a useful and pragmatic framework for designing interventions to promote intentional nature contact behavior among college students.
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Affiliation(s)
- Manoj Sharma
- Department of Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
| | - Erin Largo-Wight
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Amar Kanekar
- College of Business, Health and Human Services, University of Arkansas at Little Rock, Little Rock, AR 72204, USA;
| | - Hana Kusumoto
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Stephanie Hooper
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Vinayak K. Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Preventive Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Correspondence: ; Tel.: +1-(601)-495-5876
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Brown L, Sharma M, Leggett S, Sung JH, Bennett RL, Azevedo M. Efficacy testing of the SAVOR (Sisters Adding Fruits and Vegetables for Optimal Results) intervention among African American women: A randomized controlled trial. Health Promot Perspect 2020; 10:270-280. [PMID: 32802764 PMCID: PMC7420176 DOI: 10.34172/hpp.2020.41] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/15/2020] [Indexed: 01/09/2023] Open
Abstract
Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a SistersAdding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks).SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (P<0.0001)Statistically significant changes (P<0.05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.
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Affiliation(s)
- LaVonne Brown
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Sophia Leggett
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Jung Hye Sung
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Russell L Bennett
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Mario Azevedo
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
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