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Wald ER, Ewing LJ, Moyer SCL, Eickhoff JC. An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children. Clin Pediatr (Phila) 2018; 57:547-557. [PMID: 29067819 PMCID: PMC10360456 DOI: 10.1177/0009922817733703] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This prospective, randomized, controlled trial for parents of overweight and obese 3- to 7-year-olds was performed to assess the feasibility of a program promoting healthy eating and lifestyle by targeting parents as agents of change. The intervention was composed of 6-in-person group sessions and a customized website over 12 months. The control group received customary care. The primary outcome was feasibility of the intervention to promote healthy behavior change measured by attendance. The secondary outcome was effectiveness assessed by attaining reduced body mass index (BMI) z scores, healthy behavior changes and increased parent self-efficacy. Seventy-three child-parent dyads were enrolled; 14 parents never attended any sessions. Participation in follow-up assessments did not meet the hypothesized level. Ultimate BMI z scores did not differ between control and intervention groups. Parenting skills did not improve in the intervention group. This intervention to achieve healthy lifestyle changes in children via their parents as "change agents" was unsuccessful.
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Affiliation(s)
- Ellen R Wald
- 1 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Linda J Ewing
- 2 University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Jens C Eickhoff
- 1 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Hamilton G, O'Connell M, Cross D. Adolescent Smoking Cessation: Development of a School Nurse Intervention. J Sch Nurs 2016; 20:169-74. [PMID: 15147225 DOI: 10.1177/10598405040200030701] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine the feasibility of a range of strategies to engage and to enhance secondary school nurse involvement in teenage smoking prevention and cessation. School nurses were willing to assist students to quit smoking, but they felt unprepared. Information provided by nurses involved in a three-stage review, pilot-testing, and trial design resulted in the development of a resource for nurses. This resource comprised individual student approaches (brief intervention based on motivational interviewing and written activities designed to help students examine their smoking behavior), approaches to assist parents (letter of support for parents of students who smoke), and school newsletter items. Each component of the resource was found by school nurses to be appropriate, useful, and complementary to their other school-wide approaches to assist adolescents to quit smoking. Nurses also reported an interest to expand or to enhance their smoking cessation role in the school.
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Affiliation(s)
- Greg Hamilton
- Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, New Zealand
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Vodopivec-Jamsek V, de Jongh T, Gurol-Urganci I, Atun R, Car J. Mobile phone messaging for preventive health care. Cochrane Database Syst Rev 2012; 12:CD007457. [PMID: 23235643 PMCID: PMC6486007 DOI: 10.1002/14651858.cd007457.pub2] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Preventive health care promotes health and prevents disease or injuries by addressing factors that lead to the onset of a disease, and by detecting latent conditions to reduce or halt their progression. Many risk factors for costly and disabling conditions (such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases) can be prevented, yet healthcare systems do not make the best use of their available resources to support this process. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), could offer a convenient and cost-effective way to support desirable health behaviours for preventive health care. OBJECTIVES To assess the effects of mobile phone messaging interventions as a mode of delivery for preventive health care, on health status and health behaviour outcomes. SEARCH METHODS We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009).We also reviewed grey literature (including trial registers) and reference lists of articles. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies with at least three time points before and after the intervention. We included studies using SMS or MMS as a mode of delivery for any type of preventive health care. We only included studies in which it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions. DATA COLLECTION AND ANALYSIS Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third author. Primary outcomes of interest were health status and health behaviour outcomes. We also considered patients' and providers' evaluation of the intervention, perceptions of safety, health service utilisation and costs, and potential harms or adverse effects. Because the included studies were heterogeneous in type of condition addressed, intervention characteristics and outcome measures, we did not consider that it was justified to conduct a meta-analysis to derive an overall effect size for the main outcome categories; instead, we present findings narratively. MAIN RESULTS We included four randomised controlled trials involving 1933 participants.For the primary outcome category of health, there was moderate quality evidence from one study that women who received prenatal support via mobile phone messages had significantly higher satisfaction than those who did not receive the messages, both in the antenatal period (mean difference (MD) 1.25, 95% confidence interval (CI) 0.78 to 1.72) and perinatal period (MD 1.19, 95% CI 0.37 to 2.01). Their confidence level was also higher (MD 1.12, 95% CI 0.51 to 1.73) and anxiety level was lower (MD -2.15, 95% CI -3.42 to -0.88) than in the control group in the antenatal period. In this study, no further differences were observed between groups in the perinatal period. There was low quality evidence that the mobile phone messaging intervention did not affect pregnancy outcomes (gestational age at birth, infant birth weight, preterm delivery and route of delivery).For the primary outcome category of health behaviour, there was moderate quality evidence from one study that mobile phone message reminders to take vitamin C for preventive reasons resulted in higher adherence (risk ratio (RR) 1.41, 95% CI 1.14 to 1.74). There was high quality evidence from another study that participants receiving mobile phone messaging support had a significantly higher likelihood of quitting smoking than those in a control group at 6 weeks (RR 2.20, 95% CI 1.79 to 2.70) and at 12 weeks follow-up (RR 1.55, 95% CI 1.30 to 1.84). At 26 weeks, there was only a significant difference between groups if, for participants with missing data, the last known value was carried forward. There was very low quality evidence from one study that mobile phone messaging interventions for self-monitoring of healthy behaviours related to childhood weight control did not have a statistically significant effect on physical activity, consumption of sugar-sweetened beverages or screen time.For the secondary outcome of acceptability, there was very low quality evidence from one study that user evaluation of the intervention was similar between groups. There was moderate quality evidence from one study of no difference in adverse effects of the intervention, measured as rates of pain in the thumb or finger joints, and car crash rates.None of the studies reported the secondary outcomes of health service utilisation or costs of the intervention. AUTHORS' CONCLUSIONS We found very limited evidence that in certain cases mobile phone messaging interventions may support preventive health care, to improve health status and health behaviour outcomes. However, because of the low number of participants in three of the included studies, combined with study limitations of risk of bias and lack of demonstrated causality, the evidence for these effects is of low to moderate quality. The evidence is of high quality only for interventions aimed at smoking cessation. Furthermore, there are significant information gaps regarding the long-term effects, risks and limitations of, and user satisfaction with, such interventions.
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Affiliation(s)
- Vlasta Vodopivec-Jamsek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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Abstract
OBJECTIVE: Mobile technology has the potential to radically improve addiction treatment and continuing care by offering emotional and instrumental support anywhere and just in time. This is particularly important in addiction because timing is critical to preventing relapse. Although most experts consider alcoholism to be a chronic disease, providers do not typically offer ongoing support for relapse prevention after patients complete treatment, even though a central characteristic of alcoholism and other addictive behaviors is their chronically relapsing nature. A-CHESS is a smartphone-based system for preventing relapse to heavy drinking among people leaving active alcohol dependence treatment. A-CHESS is designed to improve competence, social relatedness, and motivation, the three tenets of Self-Determination Theory. This paper reports on the relative impact and use of A-CHESS four months after patients entered the study and discusses implications of the results on treating addiction and chronic diseases generally. METHODS: A total of 349 individuals with alcohol dependence leaving residential treatment were randomly assigned to either receive A-CHESS+Treatment as Usual or Treatment as Usual (standard aftercare). Patients came from two treatment agencies, one in the Midwest and one in the Northeast. Patients assigned to A-CHESS received a smartphone for 8 months and were followed for 12. The authors analyzed use patterns during the first 4 months of use by those receiving A-CHESS. RESULTS: Participants used A-CHESS heavily and sustained their use over time. Ninety-four percent of A-CHESS participants used the application during the first week after residential treatment. At week 16, almost 80% continued to access A-CHESS. Participants with alcohol and drug-dependence showed higher levels of system use than those with alcohol dependence only. Participants with a mental health diagnosis had slightly lower levels of use at the end of the intervention period (week 16), although more than 70% still accessed the system. CONCLUSIONS: These findings illustrate that patients with alcohol dependence, alcohol and drug dependence, and mental health issues will use smartphone applications such as A-CHESS for ongoing support, resources and information, thus extending patient care if given the opportunity. Further analysis is needed to determine if sustained A-CHESS use improves outcomes.
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Gustafson DH, Shaw BR, Isham A, Baker T, Boyle MG, Levy M. Explicating an evidence-based, theoretically informed, mobile technology-based system to improve outcomes for people in recovery for alcohol dependence. Subst Use Misuse 2011; 46:96-111. [PMID: 21190410 PMCID: PMC3179272 DOI: 10.3109/10826084.2011.521413] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Post-treatment relapse to uncontrolled alcohol use is common. Currently available communication technology can use existing models for relapse prevention to cost-effectively improve long-term relapse prevention. This paper describes: (1) research-based elements of alcohol consumption-related relapse prevention and how they can be encompassed in self-determination theory (SDT) and Marlatt's cognitive behavioral relapse prevention model, (2) how technology could help address the needs of people seeking recovery, (3) a technology-based prototype, organized around sexual transmitted disease and Marlatt's model, and (4) how we are testing a system based on the ideas in this article and related ethical and operational considerations.
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Affiliation(s)
- David H. Gustafson
- Network for the Improvement of Addiction Treatment, University of Wisconsin-Madison
| | - Bret R. Shaw
- Department of Life Sciences Communication, 316 Hiram Smith Hall, 1545 Observatory Drive, University of Wisconsin–Madison, Madison, WI 53706, Tel: 608-890-1878
| | - Andrew Isham
- Network for the Improvement of Addiction Treatment, University of Wisconsin–Madison
| | - Timothy Baker
- Department of Psychology, University of Wisconsin–Madison
| | | | - Michael Levy
- CAB Health & Recovery Services, Peabody, Massachusetts
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Villarruel AM, Loveland-Cherry CJ, Ronis DL. Testing the Efficacy of a Computer-Based Parent-Adolescent Sexual Communication Intervention for Latino Parents. FAMILY RELATIONS 2010; 59:533-543. [PMID: 21116466 PMCID: PMC2992327 DOI: 10.1111/j.1741-3729.2010.00621.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The efficacy of a computer-based intervention to increase parent-adolescent communication among Latino parents and adolescents was tested in a randomized controlled trial. Parents assigned to receive the 2-session intervention reported greater general communication, sexual communication, and comfort with communication at 3 month follow-up than did parents assigned to the wait-list control condition. Adolescents, whose parents received the intervention, reported higher sexual communication than did adolescents whose parents were in the wait-list control condition. Results provide support for the efficacy of brief parent interventions designed to maximize adolescent support systems. The acceptability of the computer-based format for an underserved population provides an important venue for the delivery and use of health information.
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Hong O, Csaszar P. Audiometric testing and hearing protection training through multimedia technology. Int J Audiol 2009; 44:522-30. [PMID: 16238183 DOI: 10.1080/14992020500190029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this paper is to present the development process of a computer-based audiometric testing and tailored intervention program, and assess its feasibility by obtaining users' feedback. The program was implemented for 397 operating engineers at their union training center, and its feasibility was evaluated by obtaining quantitative and qualitative feedback from the participants through a survey and focus group. Over 96% of the participants indicated they liked receiving a hearing test by computer; the computer-based test worked smoothly; and the computer-based training was well organized, effective and held their interests. Almost all (more than 99%) said they would recommend this program to other workers. This project is considered as one of the first ones incorporating multimedia computer technology with self-administered audiometric testing and tailored training. Participants' favorable feedback strongly supported the continued utilization of this approach for designing and developing health screening and intervention to promote healthy behaviors.
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Affiliation(s)
- OiSaeng Hong
- School of Nursing, University of Michigan, Ann Arbor, Michigan 48109-0482, USA.
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8
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Abstract
We propose evaluation of a multi-component home automated telemanagement system providing integrated support to both clinicians and patients in implementing hypertension treatment guidelines. In a randomized clinical study, 550 blacks with hypertension are followed for 18 months. The major components of the intervention and control groups are identical and are based on the current standard of care. For the purpose of this study, we define "standard of care" as the expected evidence-based care provided according to the current hypertension treatment guidelines. Although intervention and control groups are similar in terms of their care components, they differ in the mode of care delivery. For the control group the best attempt is made to deliver all components of a guideline-concordant care in a routine clinical environment whereas for the intervention group the routine clinical environment is enhanced with health information technology that assists clinicians and patients in working together in implementing treatment guidelines. The home automated telemanagement system guides patients in following their individualized treatment plans and helps care coordination team in monitoring the patient progress. The study design is aimed at addressing the main question of this trial: whether the addition of the information technology-enhanced care coordination in the routine primary care setting can improve delivery of evidence-based hypertension care in blacks. The outcome parameters include quality of life, medical care use, treatment compliance, psychosocial variables, and improvement in blood pressure control rates. The trial will provide insight on the potential impact of information technology-enhanced care coordination in blacks with poorly controlled hypertension.
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Affiliation(s)
- Joseph Finkelstein
- Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
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9
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Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change. Simul Healthc 2009; 1:151-9. [PMID: 19088584 DOI: 10.1097/01.sih.0000244456.22457.e8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.
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Woodruff SI, Conway TL, Edwards CC, Elliott SP, Crittenden J. Evaluation of an Internet virtual world chat room for adolescent smoking cessation. Addict Behav 2007; 32:1769-86. [PMID: 17250972 DOI: 10.1016/j.addbeh.2006.12.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Revised: 11/07/2006] [Accepted: 12/08/2006] [Indexed: 01/21/2023]
Abstract
The goal of this longitudinal study was to test an innovative approach to smoking cessation that might be particularly attractive to adolescent smokers. The study was a participatory research effort between academic and school partners. The intervention used an Internet-based, virtual reality world combined with motivational interviewing conducted in real-time by a smoking cessation counselor. Participants were 136 adolescent smokers recruited from high schools randomized to the intervention or a measurement-only control condition. Those who participated in the program were significantly more likely than controls to report at the immediate post-intervention assessment that they had abstained from smoking during the past week (p<or=.01), smoked fewer days in the past week (p<or=.001), smoked fewer cigarettes in the past week (p<or=.01), and considered themselves a former smoke (p<or=.05). Only the number of times quit was statistically significant at a one-year follow-up assessment (p<or=.05). The lack of longer-term results is discussed, as are methodological challenges in conducting a cluster-randomized smoking cessation study.
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Affiliation(s)
- Susan I Woodruff
- Graduate School of Public Health, San Diego State University, 9245 Sky Park Ct, Ste 120, San Diego, CA 92123, United States.
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Hong O, Ronis DL, Lusk SL, Kee GS. Efficacy of a computer-based hearing test and tailored hearing protection intervention. Int J Behav Med 2006; 13:304-14. [PMID: 17228988 DOI: 10.1207/s15327558ijbm1304_5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Advances in computer technology and accessibility enable researchers to provide individually tailored interventions for behavioral change. Using multimedia technology, this study developed and tested a computer-based hearing test and a tailored intervention. The purpose of this study was to evaluate, using a randomized experimental design, the efficacy of the intervention to increase workers' use of hearing protection. The tailored intervention developed by the research team showed more significant short-term effect measured immediately after the intervention than the control intervention. For the long-term effect measured 1 year after the intervention, both tailored and control groups showed significant increase in their reported use (7% vs. 6%) from preintervention to postintervention, but no significant difference between the two groups. The change accomplished in this study was small progress toward the desired level of 100% use of hearing protection to prevent noise-induced hearing loss. This finding showed that changing workers' hearing protection behavior is difficult.
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Affiliation(s)
- OiSaeng Hong
- School of Nursing, University of Michigan, Ann Arbor, Michigan 48109-0482, USA.
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Walters ST, Wright JA, Shegog R. A review of computer and Internet-based interventions for smoking behavior. Addict Behav 2006; 31:264-77. [PMID: 15950392 DOI: 10.1016/j.addbeh.2005.05.002] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2005] [Accepted: 05/04/2005] [Indexed: 11/27/2022]
Abstract
This article reviews studies of computer and Internet-based interventions for smoking behavior, published between 1995 and August 2004. Following electronic and manual searches of the literature, 19 studies were identified that used automated systems for smoking prevention or cessation, and measured outcomes related to smoking behavior. Studies varied widely in methodology, intervention delivery, participant characteristics, follow-up period, and measurement of cessation. Of eligible studies, nine (47%) reported statistically significant or improved outcomes at the longest follow-up, relative to a comparison group. Few patterns emerged in terms of subject, design or intervention characteristics that led to positive outcomes. The "first generation" format, where participants were mailed computer-generated feedback reports, was the modal intervention format and the one most consistently associated with improved outcomes. Future studies will need to identify whether certain patients are more likely to benefit from such interventions, and which pharmacological and behavioral adjuncts can best promote cessation.
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Affiliation(s)
- Scott T Walters
- University of Texas School of Public Health, 5323 Harry Hines Blvd, V8.112, Dallas, TX 75390-9128, United States.
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de Nooijer J, Lechner L, Candel M, de Vries H. Short- and long-term effects of tailored information versus general information on determinants and intentions related to early detection of cancer. Prev Med 2004; 38:694-703. [PMID: 15193889 DOI: 10.1016/j.ypmed.2003.12.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since it is widely accepted that the earlier cancer is detected, the better the chances of treatment and survival, people should be encouraged to create positive intentions toward early detection of several types of cancer, for instance, skin cancer, breast cancer, and colon cancer. This can be done by being alert to the warning signs of cancer and seeking help once a cancer symptom is detected. METHODS A randomized controlled study (n = 1,500) assessed the effects of computer-tailored information and general information on determinants and intentions to engage in early detection behaviors (i.e., passive detection and help seeking) compared with those in a control group. Possible negative side effects, like increased chronic fear of cancer and more fatalistic attitudes toward cancer, were studied as well. RESULTS Shortly after the intervention, differences between the study groups were found in intention, several social psychological determinants, and knowledge. Six months after the intervention, there were still differences between the tailored information group and the control group in intentions toward help seeking. Neither of the interventions resulted in increased chronic fear nor more fatalistic attitudes toward cancer. CONCLUSIONS It is concluded that there were positive effects of the tailored intervention on determinants, passive detection, and help-seeking intentions in the short-term, but additional research is needed to assess ways of maintaining these effects in the long-term.
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Affiliation(s)
- Jascha de Nooijer
- Department of Health Promotion and Health Education, Maastricht University, Maastricht, The Netherlands.
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Nagy S, Watts GF, Nagy MC. Scales measuring psychosocial antecedents of coital initiation among adolescents in a rural southern state. Psychol Rep 2003; 92:981-90. [PMID: 12841475 DOI: 10.2466/pr0.2003.92.3.981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The psychometric properties of psychosexual scales designed to examine intentions toward sexual intercourse were examined. Participants from 22 schools in central Alabama provided data on demographics, knowledge, attitudes, beliefs, and intentions toward sexual intercourse. Theoretical constructs from Theory of Reasoned Action and Social Cognitive Theory guided the development of items assessing psychosocial aspects of sexual intercourse. Findings indicated that approximately half of the conceptual items (13 items) loaded on four factors. The four scales were (a) Coital Intentions, (b) Attitudes toward Negative Sexual Outcomes, (c) Social Norms toward Premature Sex, and (d) Self-efficacy of Sexual Refusal Skills. These factors showed adequate independence and explained 46% of the variance in the data. Cronbach alpha ranged from .69 to .78. Scales show acceptable evidence for evaluation; however, additional research from other geographical districts and other ethnic groups is needed to confirm their generalizability.
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Affiliation(s)
- Stephen Nagy
- Department of Health Science, The University of Alabama, Tuscaloosa 35487-0311, USA.
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Coleman CL. Examining influences of pharmacists' communication with consumers about antibiotics. HEALTH COMMUNICATION 2003; 15:79-99. [PMID: 12553778 DOI: 10.1207/s15327027hc1501_4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A national study was conducted of community pharmacists to examine influences on their communication with consumers about antibiotics and antibiotic resistance. The objective was twofold: to explore the nature of barriers that might be changed to allow pharmacists greater participation in educational campaigns, and to discover which variables would best predict communication using a modification of the Theory of Reasoned Action model. Whereas most pharmacists agreed that their role in educating patients is important, they also noted several barriers prevent them from engaging in campaigns, such as time constraints, lack of educational materials, and fear of harming relations with physicians. Pharmacists' discussion about antibiotics in general was predicted primarily by attitudes about their role and efficacy, by their autonomy, and by enabling measures-such as pamphlets-that would better aid them in participating in a judicious antibiotic use campaign. Discussion about resistance was predicted by attitudes and enabling measures.
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Rhodes SD, Bowie DA, Hergenrather KC. Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 2003; 57:68-73. [PMID: 12490652 PMCID: PMC1732282 DOI: 10.1136/jech.57.1.68] [Citation(s) in RCA: 286] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. METHODS This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. RESULTS The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. CONCLUSIONS Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.
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Affiliation(s)
- S D Rhodes
- The Department of Health Behavior and Health Education, University of North Carolina School of Public Health, Chapel Hill, NC 27599, USA.
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Rhodes SD, DiClemente RJ, Cecil H, Hergenrather KC, Yee LJ. Risk among men who have sex with men in the United States: a comparison of an Internet sample and a conventional outreach sample. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2002; 14:41-50. [PMID: 11900109 DOI: 10.1521/aeap.14.1.41.24334] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study compared the demographics and risk behaviors of two samples of men who have sex with men (MSM), using cross-sectional data that were collected via the Internet and through conventional bar-based outreach. The Internet sample was significantly older, more likely to identify as "bisexual," and less educated than the bar sample. After controlling for age and education, few differences were observed between the samples. However, three variables that markedly differentiated the samples were history of sexually transmitted disease infection, HIV serostatus, and sources utilized to obtain health information. No difference in Internet use was found. Based on the possible decreased social desirability promoted by the use of electronic data collection methodologies, these findings provide preliminary evidence that Internet and bar respondents are similar and that the Internet may serve as an expedient as well as reliable methodology to increase understanding of risk among MSM.
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Affiliation(s)
- Scott D Rhodes
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, USA.
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Silverman BG, Holmes J, Kimmel S, Branas C, Ivins D, Weaver R, Chen Y. Modeling emotion and behavior in animated personas to facilitate human behavior change: the case of the HEART-SENSE game. Health Care Manag Sci 2001; 4:213-28. [PMID: 11519847 DOI: 10.1023/a:1011448916375] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The goal of this research is to determine whether a computer based training game (HEART-SENSE) can improve recognition of heart attack symptoms and shift behavioral issues so as to reduce pre-hospitalization delay in seeking treatment. Since treatment delay correlates with adverse outcomes, this research could reduce myocardial infarction mortality and morbidity. In Phase I we created and evaluated a prototype virtual village in which users encounter and help convince synthetic personas to deal appropriately with a variety of heart attack scenarios and delay issues. Innovations made here are: (1) a design for a generic simulator package for promoting health behavior shifts, and (2) algorithms for animated pedagogical agents to reason about how their emotional state ties to patient condition and user progress. Initial results show that users of the game exhibit a significant shift in intention to call 9-1-1 and avoid delay, that multi-media versions of the game foster vividness and memory retention as well as a better understanding of both symptoms and of the need to manage time during a heart attack event. Also, results provide insight into areas where emotive pedagogical agents help and hinder user performance. Finally, we conclude with next steps that will help improve the game and the field of pedagogical agents and tools for simulated worlds for healthcare education and promotion.
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Affiliation(s)
- B G Silverman
- Systems Engineering, University of Pennsylvania, Philadelphia 19104-6315, USA.
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Fotheringham MJ, Wonnacott RL, Owen N. Computer use and physical inactivity in young adults: public health perils and potentials of new information technologies. Ann Behav Med 2001; 22:269-75. [PMID: 11253437 DOI: 10.1007/bf02895662] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Physical inactivity contributes to premature mortality and morbidity and increasing prevalences of overweight and obesity in industrialized countries. Computer use is an increasingly common sedentary behaviour, potentially displacing physical activity. Physical activity and computer use were examined in 697 young adults (18-30 years). Energy expenditure estimates were derived from self-reported walking, moderate, and vigorous activity; participants were classified as sedentary, low, moderate, or high in their level of activity. For multivariate analyses, two categories of physical activity were used: inactive (sedentary/low activity; < 800 kcal.week-1) or active (moderate/high activity; > or = 800 kcal.week-1). Time spent in computer-related activities was summed, and computer use tertiles calculated (< 3 hours.week-1; 3-8 hours.week-1; > 8 hours.week-1). Those in the highest tertile of computer use were most likely to be inactive (p = 0.003) and most likely to report computer use as a barrier to physical activity (p < 0.001). The majority of those in the top two tertiles of computer use, and of the inactive, preferred obtaining information from computers than from conventional print media. These findings suggest that computer use plays a significant role in the discretionary time of young adults and is negatively associated with physical activity. Computer-mediated communication has potential in disseminating interventions to increase physical activity in young adults.
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Affiliation(s)
- M J Fotheringham
- School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia
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Revere D, Dunbar PJ. Review of computer-generated outpatient health behavior interventions: clinical encounters "in absentia". J Am Med Inform Assoc 2001; 8:62-79. [PMID: 11141513 PMCID: PMC134592 DOI: 10.1136/jamia.2001.0080062] [Citation(s) in RCA: 146] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate evidence of the effectiveness of computer-generated health behavior interventions-clinical encounters "in absentia"-as extensions of face-to-face patient care in an ambulatory setting. DATA SOURCES Systematic electronic database and manual searches of multiple sources (1996-1999) plus search for gray literature were conducted to identify clinical trials using computer-generated health behavior interventions to motivate individuals to adopt treatment regimens, focusing on patient-interactive interventions and use of health behavior models. STUDY SELECTION Eligibility criteria included randomized controlled studies with some evidence of instrument reliability and validity; use of at least one patient-interactive targeted or tailored feedback, reminder, or educational intervention intended to influence or improve a stated health behavior; and an association between one intervention variable and a health behavior. DATA EXTRACTION Studies were described by delivery device (print, automated telephone, computer, and mobile communication) and intervention type (personalized, targeted, and tailored). We employed qualitative methods to analyze the retrieval set and explore the issue of patient interactive computer-generated behavioral intervention systems. DATA SYNTHESIS Studies varied widely in methodology, quality, subject number, and characteristics, measurement of effects and health behavior focus. Of 37 eligible trials, 34 (91.9 percent) reported either statistically significant or improved outcomes. Fourteen studies used targeted interventions; 23 used tailored. Of the 14 targeted intervention studies, 13 (92.9 percent) reported improved outcomes. Of the 23 tailored intervention studies, 21 (91.3 percent) reported improved outcomes. CONCLUSIONS The literature indicates that computer-generated health behavior interventions are effective. While there is evidence that tailored interventions can more positively affect health behavior change than can targeted, personalized or generic interventions, there is little research comparing different tailoring protocols with one another. Only those studies using print and telephone devices reported a theoretic basis for their methodology. Future studies need to identify which models are best suited to which health behavior, whether certain delivery devices are more appropriate for different health behaviors, and how ambulatory care can benefit from patients' use of portable devices.
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Affiliation(s)
- D Revere
- University of Washington, Seattle, WA 98195-7155, USA.
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Fotheringham MJ, Owies D, Leslie E, Owen N. Interactive health communication in preventive medicine: internet-based strategies in teaching and research. Am J Prev Med 2000; 19:113-20. [PMID: 10913902 DOI: 10.1016/s0749-3797(00)00188-4] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Interactive health communication using Internet technologies is expanding the range and flexibility of intervention and teaching options available in preventive medicine and the health sciences. Advantages of interactive health communication include the enhanced convenience, novelty, and appeal of computer-mediated communication; its flexibility and interactivity; and automated processing. We outline some of these fundamental aspects of computer-mediated communication as it applies to preventive medicine. Further, a number of key pathways of information technology evolution are creating new opportunities for the delivery of professional education in preventive medicine and other health domains, as well as for delivering automated, self-instructional health behavior-change programs through the Internet. We briefly describe several of these key evolutionary pathways. We describe some examples from work we have done in Australia. These demonstrate how we have creatively responded to the challenges of these new "information environments," and how they may be pursued in the education of preventive medicine and other health care practitioners and in the development and delivery of health behavior-change programs through the Internet. Innovative and thoughtful applications of this new technology can increase the consistency, reliability, and quality of information delivered.
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Affiliation(s)
- M J Fotheringham
- School of Health Sciences, Deakin University, Victoria, Australia.
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Brug J, Campbell M, van Assema P. The application and impact of computer-generated personalized nutrition education: a review of the literature. PATIENT EDUCATION AND COUNSELING 1999; 36:145-156. [PMID: 10223019 DOI: 10.1016/s0738-3991(98)00131-1] [Citation(s) in RCA: 195] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Computer-tailored nutrition education may be more effective than general nutrition education because messages are tailored to individual behavior, needs and beliefs of subjects. Therefore, the messages are likely to be of more personal relevance and may have stronger motivational effects. Computer-generated nutrition education has been studied for different dietary behaviors, in different target populations, and in different settings. In recent years, eight studies have been published that assessed the impact of comprehensive computer-generated nutrition interventions that were based on behavior change theory. In this article, the process of providing people with computer-tailored nutrition education is described and the studies on the impact of computer-tailored nutrition education are reviewed. The results point to the conclusion that computer-tailored nutrition education is more likely to be read, remembered, and experienced as personally relevant compared to standard materials. Furthermore, computer-tailored nutrition education also appears to have a greater impact in motivating people to change their diet, their fat intake in particular, although at present no definite conclusions can be drawn.
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Affiliation(s)
- J Brug
- Open University, Department of Social Sciences, P.O. Box 2960, 6401 Heerlen DL, Netherlands.
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