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Wu Y, Yu Z, Yin X, Li Y, Jiang Y, Liu G, Sun X. Explain the behavior change and maintenance in diabetic patients using MTM-HAPA framework. Front Psychiatry 2024; 15:1497872. [PMID: 39717377 PMCID: PMC11663941 DOI: 10.3389/fpsyt.2024.1497872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 11/12/2024] [Indexed: 12/25/2024] Open
Abstract
Objectives The aim of the study was to to uncover the factors influencing the initiation and maintenance of health behaviors indiabetes mellitus (DM) patients, utilizing baseline data from a randomized controlled trial to construct a structural equation model based on the Multi-Theory Model (MTM) and Health Action Process Approach (HAPA) scales. Methods The study recruited participants with type 2 diabetes, aged between 18 and 75 years, from 45 distinct locations in Beijing, China.Patients [N = 406, n = 232 (57.1%) females, n = 232 (42.9%) males; Mean (SD) age = 56.7(10.9)] completed self-reported questionnaire about constructs from integrated theories concerning health behavior. To test the associations between the variables, structural equation modeling with latent variables was employed. Based on the path coefficients of Structural Equation Modeling(SEM), we verified all the hypotheses. Results Disadvantages, Advantages, Self-efficacy for Initiating Behavior, and Changes in Physical Environment are all prove to have an effect on intention, with the effect of Disadvantages being negative. Intention positively influenced Action Planning and Coping Planning, both of which in turn significantly predicted Initiation of Behavior Change. Practice for change, Emotional Transformation, Changes in Social Environment, and Self-efficacy for Sustaining Behavior were all affected by Outcome Expectancies and Risk Perception positively. Meanwhile, Practice for change, Emotional Transformation, Changes in Social Environment and Self-efficacy for Sustaining Behavior- would have a significant predictive effect on Maintenance of Behavioral Change. Conclusion The empirical evidence from this study robustly validates the majority of its theoretical constructs, affirming that MTM-HAPA possess significant explanatory capability in delineating the factors that underpin both the Maintenance of health-related behaviors and the Initiation of Behavior Changes in individuals suffering from DM.
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Affiliation(s)
- Yibo Wu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Zhenjie Yu
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiaoqiu Yin
- Institute for Advanced Studies in Humanities and Social Sciences, Beihang University, Beijing, China
| | - Yimiao Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yang Jiang
- Jitang College, North China University of Science and Technology, Tangshan, Hebei, China
| | - Gongli Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Khanal MK, Karimi L, Saunders P, Schneider RH, Salerno J, Livesay K, Hallam KT, de Courten B. The promising role of Transcendental Meditation in the prevention and treatment of cardiometabolic diseases: A systematic review. Obes Rev 2024; 25:e13800. [PMID: 39072971 DOI: 10.1111/obr.13800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/30/2024]
Abstract
Psychological distress has a demonstrable impact on cardiovascular diseases (CVD) and risk factors. Transcendental Meditation (TM) has been shown to reduce stress and improve health and well-being. The current review aimed to synthesize the evidence on the effects of TM on cardiometabolic outcomes and identify gaps for future research. We searched PubMed/MEDLINE, EMBASE, SCOPUS, and Web of Science databases for relevant literature. Forty-five papers that reported studies of TM on cardiometabolic risk factors and diseases were included. Evidence shows that TM is effective in reducing blood pressure (BP). We found some evidence that TM can improve insulin resistance and may play a role in improving dyslipidemia, exercise tolerance, and myocardial blood flow, and in reducing carotid intima-media thickness and left ventricular mass. Studies show that long-term TM practice can reduce the risk of myocardial infarction, stroke, and CVD mortality. This review identified that certain studies have high participant drop-out rates, and fewer studies targeted comprehensive cardiometabolic outcomes beyond BP with longer follow-up periods. We found that most studies were conducted in specific populations, which may limit generalizability. In conclusion, TM has the potential to improve cardiometabolic health; however, research gaps highlight the need for larger phase III multicenter clinical trials with long-term follow-ups.
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Affiliation(s)
- Mahesh Kumar Khanal
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Leila Karimi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Peter Saunders
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Robert H Schneider
- College of Integrative Medicine, Maharishi International University, Fairfield, Iowa, USA
- Institute for Prevention Research, Vedic City, Iowa, USA
| | - John Salerno
- Institute for Prevention Research, Vedic City, Iowa, USA
| | - Karen Livesay
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Karen T Hallam
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Barbora de Courten
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
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Kapukotuwa S, Nerida T, Batra K, Sharma M. Utilization of the multi-theory model (MTM) of health behavior change to explain health behaviors: A systematic review. Health Promot Perspect 2024; 14:121-135. [PMID: 39291044 PMCID: PMC11403345 DOI: 10.34172/hpp.42887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/02/2024] [Indexed: 09/19/2024] Open
Abstract
Background The utilization of a theoretical framework is vital in health promotion research, particularly when endeavoring to modify health behaviors. This systematic review aimed at evaluating and synthesizing evidence through studies conducted using the fourth-generation multi-theory model (MTM) of health behavior change for its effectiveness. Methods A comprehensive article search was performed across MEDLINE, CINAHL, and Academic Search Premier. The search focused on studies utilizing MTM from 2016 to December 2023, following the PRISMA guidelines for systemic reviews. Results An initial pool of 7583 articles was narrowed down through screening of titles, abstracts, and full texts. A total of 69 articles met the inclusion criteria. These studies, encompassing a global range of diverse target groups and health behaviors, were categorized as qualitative, cross-sectional, or experimental. The six qualitative studies revealed MTM themes for diverse health behaviors. The fifty-six cross-sectional studies showed MTM constructs effectively predicting behavior change, albeit with varying statistical significance. The seven experiments demonstrated MTM's role in initiating and sustaining change. For the initiation model, operationalized by 49 studies, the mean adjusted R2 was 38.4% (SD=16.4%). For the sustenance model, operationalized by 45 studies, the mean adjusted R2 was 38.9% (SD=15.5%). Conclusion This systematic review corroborates the MTM as a potent framework for understanding, predicting, and facilitating health behavior changes. Its universal applicability and effectiveness underscore the model's potential as a foundational tool in designing future health promotion strategies and interventions aimed at positive and enduring behavior modifications.
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Affiliation(s)
- Sidath Kapukotuwa
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Tara Nerida
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
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Jiang Y, Sun X, Jiang M, Min H, Wang J, Fu X, Qi J, Yu Z, Zhu X, Wu Y. Impact of a mobile health intervention based on multi-theory model of health behavior change on self-management in patients with differentiated thyroid cancer: protocol for a randomized controlled trial. Front Public Health 2024; 12:1327442. [PMID: 38282759 PMCID: PMC10808536 DOI: 10.3389/fpubh.2024.1327442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Theoretical models of health behavior are important guides for disease prevention and detection, treatment and rehabilitation, and promotion and maintenance of physical and mental health, but there are no intervention studies related to differentiated thyroid cancer (DTC) that use theoretical models of health as a guide. In this study, we used a microblogging platform as an intervention vehicle and mobile patient-doctor interactive health education as a means of intervention, with the aim of improving the health behaviors of DTC patients as well as the corresponding clinical outcomes. Methods This research project is a quantitative methodological study, and the trial will be a single-blind, single-center randomized controlled trial conducted at the Fourth Hospital of Harbin Medical University in Harbin, Heilongjiang Province. The study subjects are patients over 18 years of age with differentiated thyroid cancer who were given radioactive iodine-131 therapy as well as endocrine therapy after radical surgery for thyroid cancer. The intervention group will receive MTM-mhealth, and the realization of health education will rely on the smart terminal WeChat platform. Routine discharge education will be given to the control group at discharge. The primary outcome will be change in thyroid-stimulating hormone (TSH) from baseline and at 3 and 6 months of follow-up, and secondary outcomes will include change in self-management behavior, social cognitive and psychological, and metabolic control. Discussion This study will explore a feasible mHealth intervention program applied to a population of DTC patients using the Multi-theory model of health behavior change (MTM) as a guide, with the aim of evaluating the MTM-based intervention program for clinical outcome improvement in DTC patients, as well as determining the effectiveness of the MTM-based intervention program in improving self-management skills in DTC patients. The results of this study will indicate the feasibility as well as the effectiveness of the application of health theoretical modeling combined with mHealth applications in disease prognostic health management models, and provide policy recommendations and technological translations for the development of mobility-based health management applications in the field of health management.
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Affiliation(s)
- Yang Jiang
- Jitang College, North China University of Science and Technology, Tangshan, China
| | - Xiangju Sun
- Clinical Pharmacy, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Maomin Jiang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Hewei Min
- School of Public Health, Peking University, Beijing, China
| | - Jing Wang
- School of Public Health, Peking University, Beijing, China
| | - Xinghua Fu
- The Fourth School of Clinical Medicine, Harbin Medical University, Harbin, China
| | - Jiale Qi
- School of Journalism and Communication, Zhengzhou University, Zhengzhou, China
| | - Zhenjie Yu
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaomei Zhu
- Department of Pharmacy, Beidahuang Group General Hospital, Harbin, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
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Zhang W, Jin Y, Liu N, Xiang Z, Wang X, Xu P, Guo P, Mao M, Feng S. Predicting Physical Activity in Chinese Pregnant Women Using Multi-Theory Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13383. [PMID: 36293962 PMCID: PMC9603386 DOI: 10.3390/ijerph192013383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Physical activity (PA) brings many benefits to pregnant women and fetuses; however, the majority of pregnant women do not participate actively in PA during pregnancy. OBJECTIVES This study aimed to: (1) assess the utility of Multi-Theory Model (MTM) to explain the intentions of PA behavior in Chinese pregnant women; (2) analyze the predictors in initiating and maintaining PA behavior based on MTM. METHODS A cross-sectional study including pregnant women was conducted from March to June 2022 at a university hospital in Hangzhou, Zhejiang Province, China. Participants completed measures that included a self-developed demographic questionnaire and a 29-item MTM questionnaire. Descriptive statistics and stepwise multiple regression were used to analyze the data. The reliability was assessed by Cronbach's alpha and test-retest stability. The construct validity was evaluated by using exploratory factor (EFA) analysis and confirmatory factor analysis (CFA). RESULTS A total of 450 pregnant women participated in this study. The score of the magnitude of intention to initiate and maintain PA behavior during pregnancy was 2.30 (1.08) and 2.24 (1.09). The overall Cronbach's alpha value was 0.857. A four-factor structure for initiation model and a three-factor structure for maintenance model were determined. Results of the CFA confirmed construct validity of subscales (initiation model: χ2 = 206.123, df = 140, p < 0.001, χ2/df = 1.472, RMSEA = 0.046, SRMR = 0.0432, GFI = 0.913, CFI = 0.982; maintenance model: χ2 = 49.742, df = 29, p < 0.001, χ2/df = 1.715, RMSEA = 0.057, SRMR = 0.0432, GFI = 0.958, CFI 0.985). The result of regression indicated that participatory dialogue (β = 0.030; p = 0.002), behavioral confidence (β = 0.128; p < 0.001), changes in physical environment (β = 0.041; p = 0.005), trimester (β = -0.192; p = 0.001), and Gestational Diabetes Mellitus (GDM) (β = 0.408; p < 0.001) explained 52.1% variance in initiating PA behavior. Emotional transformation (β = 0.197; p < 0.001), practice for change (β = 0.083; p = 0.001), changes in social environment (β = 0.063; p < 0.001), pre-pregnancy exercise habit (β = -0.251; p = 0.001), and GDM (β = 0.298; p = 0.003) were significantly associated with pregnant women's intentions to maintain PA behavior and explained 49.1% variance. CONCLUSIONS The constructs of MTM were effective in explaining the intention to initiate and maintain PA behavior among Chinese pregnant women.
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Affiliation(s)
- Wei Zhang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Ying Jin
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Ningning Liu
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Zhenzhen Xiang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Xiaojuan Wang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Ping Xu
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Pingping Guo
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Minna Mao
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Suwen Feng
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
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