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Determinants associated with self-management behavior among type 2 diabetes patients in China: A structural equation model based on the theory of planned behavior. Int J Clin Health Psychol 2023; 23:100332. [PMID: 36168599 PMCID: PMC9471452 DOI: 10.1016/j.ijchp.2022.100332] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes self-management (DSM) is essential for patients to achieve better health outcomes. However, previous studies have demonstrated that the performance of DSM is not optimal. This study was designed to identify the significant determinants of self-management behavior in type 2 diabetes(T2DM) patients to improve DSM. Method A convenient sampling method was employed in this study. Data were collected from a community health center from January to February 2021 in Nanjing city, China. A total of 431 patients completed the self-administered questionnaires. A structural equation model based on the theory of planned behavior(TPB) was adopted for analysis. Results TPB model presents excellent goodness of fit of data. Attitude (β=0.161, P < 0.01), subjective norms (SN) (β=0.239, P < 0.001), and perceived behavior control (PBC) (β=0.197, P < 0.001) were strong predictors of intention. Intention (β=0.230, P < 0.001) and PBC (β=0.259, P < 0.001) had a direct effect on self-management behavior. The impact of attitude and SN on behavior was significantly mediated via behavioral intention. Conclusion The application of TPB to self-management behavior in T2DM patients can significantly enhance our understanding of theory-based self-management behavior. This predictive model could potentially be a valuable tool and provide a feasible approach for formulating more targeted and population-specific DSM interventions in future research.
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Applying the Reasoned Action Approach and Planning to Understand Diabetes Self-Management Behaviors. Behav Sci (Basel) 2022; 12:bs12100375. [PMID: 36285944 PMCID: PMC9598101 DOI: 10.3390/bs12100375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals managing diabetes are required to adhere to self-management behaviors to ensure the optimal regulation of their blood glucose levels. This study examined the psychological determinants underlying three important diabetes self-management behaviors (e.g., physical activity, diet, and blood glucose monitoring) using the reasoned action approach (RAA) and planning. A cross-sectional design was used, with participants (N = 273) completing measures of RAA constructs (e.g., experiential and instrumental attitude, descriptive and injunctive norm, and capacity and autonomy) and planning (e.g., action and control planning) at time 1 and participation in the behaviors one week later at time 2. Regressions showed that RAA constructs accounted for good variance in intention and behavior in all behaviors. Intention towards diet and blood glucose monitoring was significantly predicted by instrumental attitude, injunctive norm, and capacity. Intention towards physical activity was significantly predicted by instrumental attitude, experiential attitude, injunctive norm, capacity, and autonomy. All behaviors were significantly predicted by intention, action planning, and coping planning. Additionally, capacity significantly predicted physical activity and autonomy significantly predicted diet and blood glucose monitoring. Successfully intervening in the influential psychological constructs identified in the study could ensure optimal blood glucose regulation in those managing diabetes.
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Gao M, Chen P, Sun X, Feng X, Fisher EB. Integrating the Extended Theory of Planned Behavior With the Stages of Change to Predict Exercise Among Chinese People With Type 2 Diabetes. Front Public Health 2021; 9:772564. [PMID: 34869183 PMCID: PMC8640452 DOI: 10.3389/fpubh.2021.772564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: There have been very limited prospective studies examining social-cognitive models within stages of behavior change in the exercise domain. Purpose: We examined the utility of the theory of planned behavior (TPB), incorporating self-identity and descriptive norm constructs, to predict exercise behavior across the stages of change, in individuals with type 2 diabetes. Methods: Data were obtained from a longitudinal study. Multi-group structural equation modeling was used to estimate the association between extended TPB constructs and exercise within different stages groups. Results: 647 individuals completed a self-report questionnaire at baseline and at 3 months follow-up. The extended TPB model explained 8-15% variance of exercise behavior and 42-81% variance of exercise intention within three stages groups in the cross-sectional design. The extended TPB model explained 4%-13% variance of exercise behavior and 42-66% variance of exercise intention in the longitudinal design. Intention was significantly related to exercise behavior in the pre-action and action stages. Self-identity, perceived behavioral control and descriptive norms were stronger predictors of intention in different stages. Conclusion: Discontinuity patterns in the extended theory of planned behavior for the different stages groups were found. Intention was a significant predictor of exercise in the pre-action and action stages at 3 months.
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Affiliation(s)
- Min Gao
- School of Public Health, Peking University Health Science Center, Beijing, China
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ping Chen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xinying Sun
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - XingLin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Edwin B. Fisher
- Department of Health Behavior, Gillings School of Global Public Health University, Chapel Hill, NC, United States
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Qiao X, Ji L, Jin Y, Si H, Bian Y, Wang W, Wang C. Development and validation of an instrument to measure beliefs in physical activity among (pre)frail older adults: An integration of the Health Belief Model and the Theory of Planned Behavior. PATIENT EDUCATION AND COUNSELING 2021; 104:2544-2551. [PMID: 33722429 DOI: 10.1016/j.pec.2021.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To develop and evaluate the psychometric properties of an instrument assessing beliefs in physical activity based on the integration of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) among (pre)frail older adults. METHODS A literature review and semi-structured interviews were conducted to generate the initial item pool of the instrument. A rural sample of 611 (pre)frail older adults was enrolled to examine the validity and reliability of the instrument. RESULTS The exploratory factor analysis extracted eight factors for this instrument, explaining 71.3% of the variance in beliefs in physical activity. The confirmatory factor analysis confirmed the eight-factor structure. Linear regression models found that the integrated HBM-TPB constructs explained 65.9% of the variance in physical activity intention and 13.6% in physical activity. The Cronbach's alpha coefficients for the factors ranged from 0.80 to 0.98, and ICCs ranged from 0.71 to 0.85. CONCLUSION This instrument has satisfactory construct validity, predictive validity, internal consistency reliability and test-retest reliability, and it can be used in (pre)frail older adults to measure beliefs in physical activity. PRACTICE IMPLICATIONS This instrument may help health care providers understand beliefs in physical activity and facilitate targeted interventions among (pre)frail older adults.
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Affiliation(s)
- Xiaoxia Qiao
- School of Nursing, Peking University, Beijing 100191, China.
| | - Lili Ji
- School of Nursing, Peking University, Beijing 100191, China.
| | - Yaru Jin
- School of Nursing, Peking University, Beijing 100191, China.
| | - Huaxin Si
- School of Nursing, Peking University, Beijing 100191, China.
| | - Yanhui Bian
- School of Nursing, Peking University, Beijing 100191, China.
| | - Wenyu Wang
- School of Nursing, Peking University, Beijing 100191, China.
| | - Cuili Wang
- School of Nursing, Peking University, Beijing 100191, China.
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Dilekler İ, Doğulu C, Bozo Ö. A test of theory of planned behavior in type II diabetes adherence: The leading role of perceived behavioral control. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alghafri T, Alharthi SM, Al Farsi YM, Bannerman E, Craigie AM, Anderson AS. Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman: a cross-sectional survey. BMJ Open 2017; 7:e016946. [PMID: 29102987 PMCID: PMC5722082 DOI: 10.1136/bmjopen-2017-016946] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Physical activity is fundamental in diabetes management for good metabolic control. This study aimed to identify barriers to performing leisure time physical activity and explore differences based on gender, age, marital status, employment, education, income and perceived stages of change in physical activity in adults with type 2 diabetes in Oman. DESIGN Cross-sectional study using an Arabic version of the 'Barriers to Being Active' 27-item questionnaire. SETTING Seventeen primary health centres randomly selected in Muscat. PARTICIPANTS Individuals>18 years with type 2 diabetes, attending diabetes clinic for >2 years and with no contraindications to performing physical activity. PRIMARY AND SECONDARY OUTCOME MEASURES Participants were asked to rate how far different factors influenced their physical activity under the following categories: fear of injury, lack of time, social support, energy, willpower, skills, resources, religion and environment. On a scale of 0-9, barriers were considered important if scored ≥5. RESULTS A total of 305 questionnaires were collected. Most (96%) reported at least one barrier to performing leisure time physical activity. Lack of willpower (44.4%), lack of resources (30.5%) and lack of social support (29.2%) were the most frequently reported barriers. Using χ2 test, lack of willpower was significantly different in individuals with low versus high income (54.2%vs40%, P=0.002) and in those reporting inactive versus active stages of change for physical activity (50.7%vs34.7%, P=0.029), lack of resources was significantly different in those with low versus high income (40%vs24.3%, P=0.004) and married versus unmarried (33.8%vs18.5%, P=0.018). Lack of social support was significant in females versus males (35.4%vs20.8%, P=0.005). CONCLUSIONS The findings can inform the design on physical activity intervention studies by testing the impact of strategies which incorporate ways to address reported barriers including approaches that enhance self-efficacy and social support.
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Affiliation(s)
- Thamra Alghafri
- Ministry of Health, Directorate General of Health Services, Muscat, Oman
- Centrefor Public Health Nutrition Research, Ninewells Hospitaland Medical School., University of Dundee, Dundee, United Kingdom
| | - Saud M Alharthi
- Ministry of Health, Directorate General of Health Services, Muscat, Oman
| | - Yahya Mohd Al Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Alkoudh, Oman
| | - Elaine Bannerman
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Angela Mary Craigie
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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Castonguay A, Miquelon P. Motivational profiles for physical activity among adults with type 2 diabetes and their relationships with physical activity behavior. Health Psychol Behav Med 2017. [DOI: 10.1080/21642850.2016.1272416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Alexandre Castonguay
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Paule Miquelon
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Ferreira G, Pereira MG. Physical activity: The importance of the extended theory of planned behavior, in type 2 diabetes patients. J Health Psychol 2016; 22:1312-1321. [PMID: 26841795 DOI: 10.1177/1359105315626787] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study focused on the contribution of the extended theory of planned behavior regarding intention to perform physical activity, adherence to physical activity, and its mediator role in the relationship between trust in the physician and adherence to physical activity, in a sample of 120 patients with type 2 diabetes. The results revealed that positive attitudes and perception of control predicted a stronger intention to do physical activity. The intention to do physical activity was the only predictor of adherence to physical activity. Planning mediated the relationship between trust in the physician and adherence. Implications for patients with type 2 diabetes are discussed.
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Tengku Ismail TA, Wan Muda WAM, Bakar MI. The extended Theory of Planned Behavior in explaining exclusive breastfeeding intention and behavior among women in Kelantan, Malaysia. Nutr Res Pract 2015; 10:49-55. [PMID: 26865916 PMCID: PMC4742311 DOI: 10.4162/nrp.2016.10.1.49] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES The purpose of this study is to utilize an extended Theory of Planned Behavior in identifying predictors of exclusive breastfeeding intention and behavior among women in Kelantan, Malaysia. SUBJECTS/METHODS A prospective cohort study was conducted, recruiting pregnant womenthrough two-stage cluster sampling. Their exclusive breastfeeding intention, attitude, perceived norm, perceived behavioral control and past behavior were obtained at baseline through interviewer-guided questionnaire. At one month after delivery, another interview was conducted to determine the two additional variables in the extended theory, which were their postpartum support and breastfeeding difficulty. The behavior, which was the actual duration of exclusive breastfeeding, was obtained from the second follow-up at six months. Pearson correlation and two hierarchical regression analyses were conducted. RESULTS A total of 200 women completed the study follow-up. Their median intended exclusive breastfeeding duration was 4.0 (IQR 5) months, and the median actual duration was 1.0 (IQR 4) month. The Theory of Planned Behavior explained 51.0% of the variance in intention, with perceived behavioral control and attitude were the significant predictors. It also explained 10.0% of the variance in behavior, but the addition of postpartum support and breastfeeding difficulty increased the amount of explained variance in behavior by 6.0%. The significant predictors of exclusive breastfeeding behavior were intention, postpartum support and breastfeeding difficulty. CONCLUSION The extended Theory of Planned Behaviorhad a good predictive ability in explaining exclusive breastfeedingintention and behavior. The women's intention to practice exclusive breastfeeding may be improved by improving their perceived behavioral control and attitude. Providing correct postpartum support and skills to handle breastfeeding difficulties after delivery will improve their exclusive breastfeeding behavior.
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Affiliation(s)
- Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, UniversitySains Malaysia, Health Campus, 16150 KubangKerian, Kelantan, Malaysia
| | - Wan Abdul Manan Wan Muda
- School of Health Sciences, UniversitySains Malaysia, Health Campus, 16150 KubangKerian, Kelantan, Malaysia
| | - Mohd Isa Bakar
- School of Health Sciences, UniversitySains Malaysia, Health Campus, 16150 KubangKerian, Kelantan, Malaysia
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Abstract
Purpose To systematically review the Theory of Planned Behaviour studies predicting self-care intentions and behaviours in populations with and at-risk of diabetes. Methods A systematic review using six electronic databases was conducted in 2013. A standardised protocol was used for appraisal. Studies eligibility included a measure of behaviour for healthy eating, physical activity, glucose monitoring, medication use (ii) the TPB variables (iii) the TPB tested in populations with diabetes or at-risk. Results Sixteen studies were appraised for testing the utility of the TPB. Studies included cross-sectional (n = 7); prospective (n = 5) and randomised control trials (n = 4). Intention (18%–76%) was the most predictive construct for all behaviours. Explained variance for intentions was similar across cross-sectional (28–76%); prospective (28–73%); and RCT studies (18–63%). RCTs (18–43%) provided slightly stronger evidence for predicting behaviour. Conclusions Few studies tested predictability of the TPB in populations with or at-risk of diabetes. This review highlighted differences in the predictive utility of the TPB suggesting that the model is behaviour and population specific. Findings on key determinants of specific behaviours contribute to a better understanding of mechanisms of behaviour change and are useful in designing targeted behavioural interventions for different diabetes populations. Intention was the most predictive construct for diabetes self-care behaviours (18% – 76% of explained variance). Studies included cross-sectional (n = 7); prospective (n = 5) and randomised control trials (n = 4). Explained variance for intentions were similar across the study designs and RCTs provided slightly stronger evidence for predicting diabetes-related behaviour. The predictive utility of the TPB is behaviour specific and depends largely on the target population.
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Moreau M, Gagnon MP, Boudreau F. Development of a fully automated, web-based, tailored intervention promoting regular physical activity among insufficiently active adults with type 2 diabetes: integrating the I-change model, self-determination theory, and motivational interviewing components. JMIR Res Protoc 2015; 4:e25. [PMID: 25691346 PMCID: PMC4376153 DOI: 10.2196/resprot.4099] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 12/24/2022] Open
Abstract
Background Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. Objective This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. Methods The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention’s usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. Results The intervention development cost was about CDN $59,700 and took approximately 54 full-time weeks. The intervention officially started on September 29, 2014. Out of 2300 potential participants targeted for the tailored intervention, approximately 530 people visited the website, 170 people completed the registration process, and 83 corresponded to the selection criteria and were enrolled in the intervention. Conclusions Usability evaluation is an essential step in the development of a Web-based tailored intervention in order to make pre-implementation improvements. The effectiveness and relevance of the theoretical framework used for the intervention will be analyzed following the process and impact evaluation. Implications for future research are discussed.
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Affiliation(s)
- Michel Moreau
- Interdisciplinary Group of Health Applied Research, Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Koch EJ. How Does Anticipated Regret Influence Health and Safety Decisions? A Literature Review. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2014. [DOI: 10.1080/01973533.2014.935379] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Heiss V, Petosa R. Correlates of Physical Activity Among Adults With Type 2 Diabetes: A Systematic Literature Review. AMERICAN JOURNAL OF HEALTH EDUCATION 2014. [DOI: 10.1080/19325037.2014.933139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Ecological momentary assessment of the relationship between intention and physical activity behavior in bariatric surgery patients. Int J Behav Med 2014; 20:82-7. [PMID: 22203518 DOI: 10.1007/s12529-011-9214-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Performing habitual physical activity (PA) is challenging for many bariatric surgery patients. PURPOSE We used electronic ecological momentary assessment to naturalistically examine whether insufficient PA among bariatric surgery patients was due to infrequent PA intentions or inadequate follow through on PA intentions. METHOD Twenty-one patients 6-months post-bariatric surgery were recruited from multiple clinics in Providence, Rhode Island, USA. Participants used a palmtop computer upon waking for 6 days to indicate whether they intended to be active, and if so, the amount of PA they intended to perform in bouts ≥10 min. Each evening, participants reported PA minutes and barriers encountered that day. RESULTS All 21 participants reported intending to be active on at least 1 day but only 9 (42%) intended to be active on ≥70% of days. Twelve (57%) participants performed PA on each of the days they intended, but none achieved the amount of PA they intended on all of these days. Overall, participants had PA intentions on 81 of 123 days (66%); these were partially implemented (≥10 PA minutes) on 49 days, but fully implemented on only 15 days. Participants spent 34 min in PA, or 20 fewer minutes than intended. "Lack of time" was the only frequently cited barrier, particularly on days that PA was neither intended nor performed. CONCLUSION Few patients intended to be active on a near daily basis and all patients had difficulty in implementing their intentions. Interventions that target planning strategies may help facilitate PA intentions and limit discrepancy between intended and actual PA.
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Participation in Regular Leisure-Time Physical Activity Among Individuals with Type 2 Diabetes Not Meeting Canadian Guidelines: the Influence of Intention, Perceived Behavioral Control, and Moral Norm. Int J Behav Med 2014; 21:918-26. [DOI: 10.1007/s12529-013-9380-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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The HOT (Healthy Outcome for Teens) project. Using a web-based medium to influence attitude, subjective norm, perceived behavioral control and intention for obesity and type 2 diabetes prevention. Appetite 2014; 72:82-9. [DOI: 10.1016/j.appet.2013.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/30/2013] [Accepted: 09/23/2013] [Indexed: 11/18/2022]
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Newton JD, Newton FJ, Ewing MT, Burney S, Hay M. Conceptual overlap between moral norms and anticipated regret in the prediction of intention: Implications for theory of planned behaviour research. Psychol Health 2013; 28:495-513. [DOI: 10.1080/08870446.2012.745936] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nelsen A, Gupta S, Trautner BW, Petersen NJ, Garza A, Giordano TP, Naik AD, Rodriguez-Barradas MC. Intention to adhere to HIV treatment: a patient-centred predictor of antiretroviral adherence. HIV Med 2013; 14:472-80. [PMID: 23551395 DOI: 10.1111/hiv.12032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Despite the effectiveness of highly active antiretroviral therapy (HAART), HIV remains a major cause of mortality in the USA, largely as a result of poor HIV treatment adherence. In this study we assessed the association between five patient-centred factors and adherence to HIV treatment. METHODS We surveyed 244 adults at two HIV clinics in Houston, Texas between October 2009 and April 2010. Participants were given a questionnaire and their charts were reviewed for clinical data. Survey items assessed the following factors: self-assessed HIV knowledge, awareness of disease biomarkers, intention to adhere to HIV treatment, health literacy and decision-making style. The primary outcome measure was HAART adherence during the previous month. Logistic regressions were performed to calculate the effect of each factor on adherence. RESULTS All participants had HIV/AIDS and were on HAART at enrolment. Eight per cent of participants were female, 57% were African-American and 16% were Hispanic. Mean age was 58.1 years. Sixty-eight per cent were adherent to HAART during the last month. On univariate analysis, a preference for wanting choices, correct knowledge of recent HIV viral load level, and intention to adhere to HIV treatment were significantly associated with adherence. On multivariate analysis, only intention to adhere to HIV treatment remained statistically significant after adjusting for other factors (odds ratio 2.2; 95% confidence interval 1.1 to 4.3). CONCLUSIONS Intention to adhere to HIV treatment was significantly associated with self-reported adherence to HAART. Interventions that bolster patients' intentions to adhere to HIV treatment during clinical encounters may improve adherence to HAART and HIV control.
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Affiliation(s)
- A Nelsen
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA
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Overstreet RE, Cegielski C, Hall D. Predictors of the intent to adopt preventive innovations: a meta-analysis. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013. [DOI: 10.1111/jasp.12058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Casey Cegielski
- Department of Aviation and Supply Chain Management; Auburn University
| | - Dianne Hall
- Department of Aviation and Supply Chain Management; Auburn University
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Nelsen A, Trautner BW, Petersen NJ, Gupta S, Rodriguez-Barradas M, Giordano TP, Naik AD. Development and validation of a measure for intention to adhere to HIV treatment. AIDS Patient Care STDS 2012; 26:329-34. [PMID: 22680281 DOI: 10.1089/apc.2011.0318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
We present the development and validation of a theory-derived scale measuring patients' behavioral intention to adhere to HIV care. Adherence to HIV care includes attendance at appointments and adherence to highly active antiretroviral therapy (HAART) regimens. These two components have been independently associated with long-term HIV outcomes. Items were chosen to reflect behavioral intention as defined by the Health Action Process Approach to health-seeking behavior. Items reflecting self-reported HIV knowledge were also included after expert panel review. The study took place from October 2009 to April 2010 at two HIV clinics in Houston, Texas. Participants were 287 adults with HIV/AIDS (10.1% female, mean age 50.8); 56.5% were African-American and 17% were Hispanic. Of the total, 87.1% were on HAART at enrollment. Factor analysis of survey items resulted in the retention of two domains, knowledge and intention, based on scree plot analysis of eigenvalues. Questions with factor loadings >0.4 were retained, yielding 4 knowledge questions and 10 intention questions. The survey had good internal consistency for knowledge (Cronbach's α=0.83) and for intention (Cronbach's α=0.81). In multivariate analysis, intention was associated with HIV viral suppression, defined as HIV-1 viral load <400 RNA copies/mL, (odds ratio [OR]=1.75, 95% .confidence interval [CI]=1.00-3.07). Knowledge was also associated with HIV suppression (OR=1.55, 95%, CI=1.09-2.12). The resulting study describes the development and preliminary validation of an HIV treatment-seeking intention measure. Additional studies are needed to validate this instrument in other populations.
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Affiliation(s)
- Andrea Nelsen
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Menninger Department of Psychiatry and Behavioral Medicine, Baylor College of Medicine, Houston, Texas
| | - Barbara W. Trautner
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Nancy J. Petersen
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Sunita Gupta
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
- Thomas Street Clinic, Harris County Hospital District, Houston, Texas
| | - Maria Rodriguez-Barradas
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
- Thomas Street Clinic, Harris County Hospital District, Houston, Texas
| | - Thomas P. Giordano
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
- Thomas Street Clinic, Harris County Hospital District, Houston, Texas
| | - Aanand D. Naik
- Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas
- Menninger Department of Psychiatry and Behavioral Medicine, Baylor College of Medicine, Houston, Texas
- Department of Medicine, Baylor College of Medicine, Houston, Texas
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An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease. J Aging Phys Act 2011; 20:281-99. [PMID: 22190336 DOI: 10.1123/japa.20.3.281] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.
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23
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Boudreau F, Godin G, Poirier P. Effectiveness of a computer-tailored print-based physical activity intervention among French Canadians with type 2 diabetes in a real-life setting. HEALTH EDUCATION RESEARCH 2011; 26:573-585. [PMID: 21414998 DOI: 10.1093/her/cyr008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The promotion of regular physical activity for people with type 2 diabetes poses a challenge for public health authorities. The purpose of this study was to evaluate the efficiency of a computer-tailoring print-based intervention to promote the adoption of regular physical activity among people with type 2 diabetes. An experimental design was used; 325 participants between the age of 35 and 55 years old were randomized in one of two experimental conditions: the computer-tailoring intervention and the generic intervention. The two dependant variables were the frequency of participation and the intention to participate in leisure-time physical activities. Among the research hypotheses, only one was confirmed: the first computer-tailoring print on the practice of physical activity was more efficient than the first generic intervention at 1-month follow-up. Other similar studies will be necessary to determine the real potential of this type of approach for people with type 2 diabetes in a real-life setting.
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Affiliation(s)
- François Boudreau
- Department of Nursing, Université du Québec à Trois-Rivières, 3351 boul. des Forges, Trois-Rivières, QC, Canada.
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24
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Ghazanfari Z, Niknami S, Ghofranipour F, Hajizadeh E, Montazeri A. Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP). BMC Med Res Methodol 2010; 10:104. [PMID: 21062466 PMCID: PMC2998522 DOI: 10.1186/1471-2288-10-104] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Accepted: 11/09/2010] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study carried out to develop a scale for assessing diabetic patients' perceptions about physical activity and to test its psychometric properties (The Physical Activity Questionnaire for Diabetic Patients-PAQ-DP). METHODS An item pool extracted from the Theory of Planned Behavior literature was generated. Then an expert panel evaluated the items by assessing content validity index and content validity ratio. Consequently exploratory factor analysis (EFA) was performed to indicate the scale constructs. In addition reliability analyses including internal consistency and test-retest analysis were carried out. RESULTS In all a sample of 127 women with diabetes participated in the study. Twenty-two items were initially extracted from the literature. A six-factor solution (containing 19 items) emerged as a result of an exploratory factor analysis namely: instrumental attitude, subjective norm, perceived behavioral control, affective attitude, self-identity, and intention explaining 60.30% of the variance observed. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.54 to 0.8) and intraclass correlation coefficients (ranging from 0.40 to 0.92). CONCLUSIONS The Physical Activity Questionnaire for Diabetic Patients (PAQ-DP) is the first instrument that applies the Theory of Planned Behavior in its constructs. The findings indicated that the PAQ-DP is a reliable and valid measure for assessing physical activity perceptions and now is available and can be used in future studies.
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Affiliation(s)
- Zeinab Ghazanfari
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
- Department of Public Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Shamsaddin Niknami
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | | | - Ebrahim Hajizadeh
- Department of Biostatistics, Tarbiat Modares University, Tehran, Iran
| | - Ali Montazeri
- Department of Mental Health, Institute for Health Sciences Research, ACECR, Tehran, Iran
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