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Yang M, Duan Y, Lippke S, Liang W, Su N. A blended face-to-face and eHealth lifestyle intervention on physical activity, diet, and health outcomes in Hong Kong community-dwelling older adults: a study protocol for a randomized controlled trial. Front Public Health 2024; 12:1360037. [PMID: 38774042 PMCID: PMC11106367 DOI: 10.3389/fpubh.2024.1360037] [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: 12/22/2023] [Accepted: 04/10/2024] [Indexed: 05/24/2024] Open
Abstract
Background Aging individuals are vulnerable to various Noncommunicable Diseases (NCDs). Different behaviors are closely related to a decreased risk of suffering from NCDs: sufficient Physical Activity (PA) (e.g., at least 150 mins Moderate-to-vigorous Physical Activity (MVPA) per week) and a healthy daily diet (e.g., at least five portions of Fruit and Vegetable Intake (FVI), 5-6 taels (189.0-226.8 g) Meat, Fish, Egg and Alternatives (MFEA)). Traditional face-to-face interventions were effective in behavior change. However, it was revealed to be resource-intensive and limited transfer due to poor self-regulation skills outside of face-to-face sessions. Thus, eHealth could be a supplement for older adults outside traditional face-to-face settings. The blended approach combining these two interventions might optimize the intervention effects on lifestyle behavior initiation and maintenance, but little research can be found among Hong Kong older adults. Therefore, the study aims to test a blended intervention to promote PA, diet, and health outcomes among Hong Kong community-dwelling older adults. Methods This study will adopt a 10-week three-arm randomized controlled trial. The blended group will receive weekly (1) two 60-min face-to-face sessions with one for PA and one for diet, and (2) two web-based sessions with one for PA and one for diet. The face-to-face group will receive the same intervention content as the face-to-face sessions in the blended group. The control condition will receive a biweekly telephone call. The outcomes will include MVPA (minutes/week), FVI (portions/day), MFEA consumption (taels/day), social-cognitive factors (self-efficacy, planning, social support, action control), physical health outcomes (clinical indicators, senior physical fitness), mental health outcomes (depression, loneliness) and health-related quality of life. Data collection will be implemented at the pre-test, post-test, and 3-month follow-up test. Discussion This is the first study evaluating a blended intervention promoting multiple health behaviors among Hong Kong community-dwelling older adults. If the effect of the blended intervention is superior to the traditional face-to-face group and the control group, it will enrich lifestyle intervention approaches and can be applied to older adults, helping them obtain health benefits. Furthermore, a better understanding of mechanisms will also have implications for theory-building. Clinical trial registration https://www.isrctn.com/ISRCTN32329348, ISRCTN32329348.
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Affiliation(s)
- Min Yang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Sonia Lippke
- School of Business, Social and Decision Sciences,Constructor University, Bremen, Germany
| | - Wei Liang
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Ning Su
- College of Physical Education, Shenzhen University, Shenzhen, China
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Haag D, Carrozzo E, Pannicke B, Niebauer J, Blechert J. Within-person association of volitional factors and physical activity: Insights from an ecological momentary assessment study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 68:102445. [PMID: 37665897 DOI: 10.1016/j.psychsport.2023.102445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Current health behavior models of physical activity (PA) suggest that not all PA intentions are translated into actual PA behavior, resulting in a significant intention-behavior gap (IBG) of almost 50%. These models further suggest that higher self-efficacy and specific planning can aid in decreasing this gap. However, as most evidence stems from between-person (trait level), questionnaire-based research, it is unclear how large short-term IBGs are, how self-efficacy and planning covary within-persons across time and whether they similarly predict smaller IBGs. It is likely that day-to-day changes in circumstances and barriers affect these variables thus the applicability of theoretical models is uncertain. Here, within-person prospective analyses of ecological momentary assessment (EMA) data can provide insights. METHODS 35 healthy participants (aged 23-67) completed four EMA-based questionnaires every day for three weeks. Each prompt assessed PA (retrospectively, "since the last EMA prompt"); PA intentions, planning specificity, self-efficacy, and intrinsic motivation (prospectively, "until the next EMA prompt") and momentary affect. Generalized logistic mixed-effect modeling was used to test predictors of PA. RESULTS Across the 2341 answered EMA prompts, PA intentions were not enacted in 25% of the episodes (IBG). In episodes with given intentions, PA likelihood increased with higher levels of self-efficacy, planning specificity, and intrinsic motivation. The latter two also positively predicted PA duration and intensity. CONCLUSIONS Short-term intention behavior gaps seem to be smaller than what is known from more long-term studies, most likely as individuals can anticipate the actual circumstances of PA. Further, current health behavior models show validity in explaining within-person dynamics in IBGs across time. Knowing the relevance of planning specificity, self-efficacy and intrinsic motivation for day-to-day variations in PA enactment can inform respective real-time mHealth interventions for facilitating PA.
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Affiliation(s)
- David Haag
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria; Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria; Digital Health Information Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Graz, Austria.
| | - Eleonora Carrozzo
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Björn Pannicke
- Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria; University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
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Miller CK, Nagaraja HN, Cheavens JS, Fujita K, Lazarus SA, Brunette DS. Sex Differences in Early Weight Loss Success During a Diabetes Prevention Intervention. Am J Health Behav 2023; 47:337-348. [PMID: 37226352 DOI: 10.5993/ajhb.47.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Objectives: Males often lose more weight than females during treatment, and early weight loss predicts weight loss longer-term. Yet, mechanisms for sex differences in early weight loss are unknown and were examined in this study.Methods: Adults≥21 years old with overweight or obesity and prediabetes (N=206) participated in a lifestyle intervention and completed baseline psychosocial questionnaires. Percent weight loss, session attendance, and number of days participants self-monitored dietary intake and weight were determined at week 5. Principal components, regression, and mediation analyses were conducted to determine whether weight loss differed by sex and potential mediators of weight change. Results: Mean (±SD) weight loss was greater for males (2.59±1.62%) than females (2.05±1.54%; p=.02). Attendance, self-monitoring, and beliefs regarding disease risk were independent predictors of weight loss (all p<.05) but did not explain sex differences. The association between attendance and weight loss was stronger for males than females (p<.05). Conclusions: Additional research is needed to identify mechanisms that explain sex differences in early weight loss. However, strengthening risk beliefs, attendance, and self-monitoring may promote greater early weight loss for all participants.
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Affiliation(s)
- Carla K Miller
- Professor, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Haikady N Nagaraja
- Professor Emeritus, The Ohio State University, College of Public Health, Division of Biostatistics, Columbus, OH, United States
| | - Jennifer S Cheavens
- Professor Kentaro Fujita & Daniel S. Brunette, Graduate Student, The Ohio State University, Department of Psychology, Columbus, OH, United States
| | - Kentaro Fujita
- Graduate Student, The Ohio State University, Department of Psychology, Columbus, OH, United States
| | - Sophie A Lazarus
- Clinical Assistant Professor, The Ohio State University, Department of Psychiatry & Behavioral Health, Columbus, OH, United States
| | - Daniel S Brunette
- Graduate Student, The Ohio State University, Department of Psychology, Columbus, OH, United States
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Nicholson L, Mullan B, Liddelow C. Investigating the role of morningness/eveningness in physical activity engagement. Health Psychol Behav Med 2022; 10:1003-1019. [PMID: 36277117 PMCID: PMC9586684 DOI: 10.1080/21642850.2022.2136183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Despite being aware of the positive health-related outcomes of physical activity, many people remain inactive. The aim of this study is to apply a combination of constructs from the health action process approach and self-determination theory, as well as habit and morningness/eveningness, to predict physical activity engagement. Methods A prospective design was used to collect data from 136 participants (16–64 years old), at two-time points, one week apart. The sample consisted of 99 women, 36 men and 1 individual who identified as non-binary. Participants preferred time-of-day was measured using the Morningness-Eveningness Stability Scale (MESSi), while physical activity engagement was measured using the International Physical Activity Questionnaire (short-version). Two hierarchical, multiple regressions were conducted, to predict motivation to engage and to directly predict physical activity engagement. Furthermore, a mediation analysis was conducted to determine the effect of planning on physical activity engagement. Results Results showed that younger individuals and those with greater self-efficacy were more motivated to engage while planning directly predicted physical activity engagement. However, morningness/eveningness did not significantly predict engagement. Additionally, planning was found to mediate the motivation-engagement relationship. Conclusion This study demonstrates how planning influences individuals’ physical activity engagement, as well as the role self-efficacy and age play in their motivation to engage. Even though morningness/eveningness was not an important predictor, behaviour change techniques related to action planning and the use of multi-component approaches to behaviour change, could be used in interventions focused on increasing individuals’ physical activity engagement.
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Affiliation(s)
- Lauren Nicholson
- School of Population Health, Curtin University, Perth, Australia
- Enable Institute, Curtin University, Perth, Australia
| | - Barbara Mullan
- School of Population Health, Curtin University, Perth, Australia
- Enable Institute, Curtin University, Perth, Australia
- WACPRU, Curtin University, Perth, Australia
| | - Caitlin Liddelow
- Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia
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The Moderating Power of Impulsivity: A Systematic Literature Review Examining the Theory of Planned Behavior. PHARMACY 2022; 10:pharmacy10040085. [PMID: 35893723 PMCID: PMC9326604 DOI: 10.3390/pharmacy10040085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023] Open
Abstract
The theory of planned behavior (TPB) states that behavioral intention is the best predictor of actual behavior change. However, intention explains only a portion of the variance in behavior. Of specific interest is the question of which moderating or mediating variables can be leveraged to aid health promotion interventions utilizing the tenets of behavioral economics (delay discounting and commitment contracts) in the intention–behavior pathway. Impulsivity has been postulated to fill this role and may be applied to multiple behaviors. We aim to determine if impulsivity moderates the association between intention and actual behavior in the TPB, to discover what other variables may moderate or mediate this association, and to apply the findings to future studies in the field of behavioral economics. To this end, a systematic review was conducted using the PubMed, PsychINFO, and Embase online databases. Eligible studies in peer-reviewed journals published prior to November 2021 were selected. Thirty-three studies were included in the final review, examining physical activity, diet, preventive health, mental health, addiction, and medication adherence behaviors. Three main concepts emerged: (1) impulsivity moderates the association between intention and behavior change; (2) self-efficacy moderates the association between intention and behavior change; and (3) planning and self-efficacy contribute to moderated mediation. This review demonstrates a gap in the literature regarding the application of the TPB to the intention–behavior pathway for health behaviors. Future studies in behavioral economics may leverage the variables of impulsivity, self-efficacy, and planning to predict follow-through in this area and to develop targeted change initiatives.
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Shernoff ES, Ruork AK, Nadeem E, Rizvi SL. The feasibility and promise of Dialectical Behavior Therapy Skills Training with teachers and school personnel in high‐poverty schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elisa S. Shernoff
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Allison K. Ruork
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Erum Nadeem
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Shireen L. Rizvi
- School Psychology Department Rutgers University Piscataway New Jersey USA
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Kókai LL, van der Bijl MF, Hagger MS, Ó Ceallaigh DT, Rohde KIM, van Kippersluis H, van Lennep JER, Wijtzes AI. Perceived determinants of physical activity among women with prior severe preeclampsia: a qualitative assessment. BMC Womens Health 2022; 22:133. [PMID: 35477462 PMCID: PMC9043879 DOI: 10.1186/s12905-022-01692-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of this study was to (1) qualitatively identify the perceived determinants of physical activity among women who have experienced severe preeclampsia, and (2) examine whether these determinants are consistent with the overarching processes outlined in the integrated behavior change (IBC) model, a novel model that describes physical activity as being a result of motivational, volitional, and automatic processes. METHODS Patients (n = 35) of the Follow-Up PreEClampsia (FUPEC) Outpatient Clinic, Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were their perceived determinants of physical activity. Responses were analyzed using thematic analysis. RESULTS Thirteen themes emerged from the analysis. Six themes corresponded with motivational processes (future health, perceived ability, attitude, future reward or regret, physical appearance, and doing it for others), two with volitional processes (scheduling and planning), and two with automatic processes (affect and stress). Three themes were classified as environmental factors (time constraint, social support, and physical environment). CONCLUSIONS A range of facilitating and hindering factors were described by women with prior severe preeclampsia as the determinants of their physical activity. These factors corresponded well with the overarching motivational, volitional, and automatic processes described in the IBC model. In addition, motivational and environmental factors beyond the IBC model were described. Addressing these perceived determinants could enhance the efficacy of physical activity interventions in this population. TWEETABLE ABSTRACT Motivational, volitional, automatic, and environmental factors drive physical activity in women with prior severe preeclampsia.
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Affiliation(s)
- Lili L Kókai
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
| | | | - Martin S Hagger
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Diarmaid T Ó Ceallaigh
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Tinbergen Institute, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Kirsten I M Rohde
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Tinbergen Institute and Erasmus Research Institute of Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hans van Kippersluis
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Tinbergen Institute, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Anne I Wijtzes
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
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Increasing Physical Exercise through Action and Coping Planning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073883. [PMID: 35409564 PMCID: PMC8997544 DOI: 10.3390/ijerph19073883] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
The intention-behaviour gap has been a barrier to health behavioural change. A total of 85 participants (aged 18–56 years) were recruited for a study that examined how two types of planning (Action and Coping) could bridge the intention-behaviour gap and increase physical exercise behaviours. The online study took place over two weeks, with participants completing pre- and post- measures of past exercise habits, intentions to exercise, subsequent physical exercise behaviours, intrinsic motivation levels, and engagement in action and coping planning. A hierarchical regression analysis showed that intentions, past exercise habits and action planning were significant predictors of change in physical exercise behaviours. Positive correlations were observed between participants’ past habits and their exercise behaviours during the study. 71.8% of participants met the World Health Organization’s (WHO) recommended guidelines for physical activity at the end of the study compared to the initial 58.8%, which evidences a significant increase in participant physical exercise behaviours. Our findings revealed that while intentions are important predictors for behavioural change, cultivating habits to engage in regular exercise seems to outweigh the significance of intentions. Moreover, action planning could be a helpful intervention to bridge the intention-behaviour gap to increase overall physical exercise behaviours. In the long-term, this would improve an individual’s mental and physical wellbeing and potentially alleviate the costly burden on public health services.
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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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Application of the health action process approach model for reducing excessive internet use behaviors among rural adolescents in China: a school-based intervention pilot study. BMC Public Health 2021; 21:986. [PMID: 34039318 PMCID: PMC8152115 DOI: 10.1186/s12889-021-10999-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/29/2021] [Indexed: 11/22/2022] Open
Abstract
Objective There are few studies regarding Internet use behaviors of Chinese rural adolescents based on behavioral theory. The aim of this study is to examine the applicability and effectiveness of the health action process approach model (HAPA) in the intervention of excessive Internet use behaviors among rural adolescents in China. Methods Three hundred twenty-seven participants who met the excessive Internet use criteria were involved in this study. Four interventions based on the HAPA model were conducted during 2015–2017. The structural equation model (SEM) was applied to fit the HAPA model. Results The rate of average daily time spent online on weekends more than 4 h dropped from 57.2 to 39.1% (P < 0.001). The rate of daily game time more than 2 h decreased from 51.1 to 35.2% (P < 0.001). The result of SEM showed that both the applicability and effectiveness of the HAPA model were well in the intervention of excessive Internet use behaviors with good fitted indicators (χ2/df = 2.066, GFI = 0.889, CFI = 0.938, TLI = 0.928, IFI = 0.938, RMSEA = 0.057). The direct and indirect effects of the main pathways in the HAPA model were statistically significant (P < 0.05). The comparison analysis of HAPA model variables identified that outcome expectancy, intention, maintenance self-efficacy had been improved significantly after interventions. Conclusion The intervention measures based on the HAPA model can effectively reduce excessive Internet use behaviors of Chinese rural adolescents, mainly through strengthen outcome expectancy, intention, and maintenance self-efficacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10999-z.
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Applying Social Cognition Models to Explain Walking Duration in Older Adults: The Role of Intrinsic Motivation. J Aging Phys Act 2021; 29:744-752. [PMID: 33567407 DOI: 10.1123/japa.2020-0296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/09/2020] [Accepted: 10/21/2020] [Indexed: 11/18/2022]
Abstract
This study examined the applicability of the health action process approach (HAPA) to walking duration in older adults and the added value of extending the HAPA by intrinsic motivation. Self-reports from older adults (N = 309; Mage = 78.7, 70-95 years) regarding activity-related intrinsic motivation and HAPA variables were collected at the baseline of a fall prevention intervention study. Walking duration at ≥3 metabolic equivalents of task was measured for 7 days via body-worn accelerometers. Two structural equation models with walking duration as a manifest outcome were specified. In both models, the model fit was acceptable, but intention and planning were not associated with walking duration. Intrinsic motivation was significantly related to most HAPA variables and walking duration. Variance explained for walking duration was R2 = .14 in the HAPA and R2 = .17 in the extended model. For explaining older adults' walking duration, intrinsic motivation, but not HAPA-based intention and planning, seemed to be important.
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Eisele A, Schagg D, Krämer LV, Küffner R, Reusch A, Göhner W. Supporting patient adherence to physical activity and exercise: evaluation of a behavior change counseling training program for physiotherapists. Physiother Theory Pract 2021; 38:1426-1437. [PMID: 33444086 DOI: 10.1080/09593985.2021.1872128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background:Physiotherapists promote physical activity and exercise, yet patient adherence is often poor. To support patient adherence, behavior change techniques (BCTs) should be applied. These are insufficiently covered in physiotherapy curricula.Objective:The aim of this study was to evaluate a behavior change counseling training program for physiotherapists. The specific aims were to investigate: (1) physiotherapists' satisfaction with the training; (2) changes in physiotherapists' knowledge of BCTs and communication techniques immediately after the training and 6 weeks later; and (3) changes in physiotherapists' self-reported use of these techniques 6 weeks after the training.Methods:We conducted a single-group pre-post intervention study. Data of 56 physiotherapists (47 female, mean age 48.0 years) who participated in the training program "BeFo" (German: "Bewegungstherapie-Fortbildungen") were analyzed. Knowledge of BCTs and communication techniques, intention to apply these techniques, action and coping planning were assessed at baseline (t1), after the training (t2), and 6 weeks later (t3) using questionnaires. Participants' satisfaction was evaluated at t2, their use of BCTs and communication techniques at t1 and t3.Results:Fifty-four participants (96.4%) were satisfied with BeFo. One-way repeated-measures ANOVAs and Friedman's ANOVA revealed increased knowledge (Chi2(2) = 28.12, p < .001) and improved action planning (F(2, 98) = 22.65; p < .001) and coping planning (F(2, 100) = 19.28, p < .001) at t2 and t3. Higher use of BCTs and communication techniques at t3 was identified when participants with high baseline values were excluded.Conclusion:BeFo could be successfully implemented for physiotherapists. Our results imply that BeFo is a promising approach to improve physiotherapists' behavior change counseling skills.
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Affiliation(s)
- Angelika Eisele
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Daniela Schagg
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Lena Violetta Krämer
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Roland Küffner
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany
| | - Andrea Reusch
- Zentrum Patientenschulung und Gesundheitsförderung (ZePG e. V.), Geschäftsstelle und Wissenschaftsreferat, Würzburg, Germany
| | - Wiebke Göhner
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
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Influence of a Planning Intervention on Physical Activity Behavior: the Moderating Role of Intentions and Executive Functions in a Randomized Controlled Trial. Int J Behav Med 2020; 27:506-519. [PMID: 32077050 PMCID: PMC8009798 DOI: 10.1007/s12529-020-09864-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background Planning and executive functions (EFs; inhibition, updating, shifting) are self-regulatory variables that help people to become and stay physically active. The aim of this study was to examine how and for whom a planning intervention affects physical activity (PA) behavior in the short term. Therefore, the mediating role of planning and the moderating role of intentions and EFs for the planning–behavior link were examined. Method In a randomized control trial with two treatment groups (planning group vs. control group) and two points of measurement (t1 and t2, 1 week apart), n = 200 students participated in both measurements. At t1, participants filled in standardized questionnaires assessing PA behavior, intention, and planning. Computer-based tests assessed the following EFs: inhibition, updating, and shifting. At t2, planning and PA behavior were measured again. Moderated mediation analyses were conducted. Results A significant increase in PA between t1 and t2 was found for the planning group compared with the control group. Furthermore, planning cognitions significantly mediated the effect of the planning group on behavior and intention, as well as the EF updating moderated the association between planning and behavior. Forming plans was particularly beneficial for participants with high intentions and lower updating performance. Conclusion Planning enhances PA behavior, particularly when PA intention is high. Poor performance in updating can be compensated by planning since encouraging people to generate plans might facilitate automatic enactment of the behavior.
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Vergeld V, Wienert J, Reinwand DA, Tan SL, Lippke S. An 8-Week Study on Social-Cognitive Variables for Physical Activity and Fruit and Vegetable Intake: Are there Stage Transitions? Appl Psychol Health Well Being 2020; 13:109-128. [PMID: 32869518 DOI: 10.1111/aphw.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health behavior change can be modelled in terms of stages, and outcomes of transitions between stages can be categorized into progression, regression, and stagnation. Based on the Health Action Process Approach this study tested whether changes in social-cognitive variables are associated with transitions between stages regarding physical activity (PA) and fruit and vegetable intake (FVI). METHODS N = 132 participants (M = 50.86 years, SD = 13.17, 61.4% women) were assessed at baseline and 8 weeks later. Data were analysed using multivariate analyses of variance (MANOVA) and post-hoc comparisons. RESULTS Changes in motivational self-efficacy (η2 = 0.081), maintenance self-efficacy (η2 = 0.119), and recovery self-efficacy (η2 = 0.049) as well as positive outcome expectancies (η2 = 0.070), negative outcome expectancies (η2 = 0.055), and coping planning (η2 = 0.065) were associated with FVI stage progression. For PA, changes were not associated with stage progression. CONCLUSION To facilitate behavior change effectively, at least for FVI, it is essential to consider underlying mechanisms such as several aspects of self-efficacy in performing the desired health behaviors, outcome expectations, and planning how to overcome barriers. Additionally, the adoption of a stage approach may be a useful starting point to develop stage-matched interventions.
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Affiliation(s)
| | - Julian Wienert
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,University of Cologne, Cologne, Germany
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Ranjbaran S, Shojaeizadeh D, Dehdari T, Yaseri M, Shakibazadeh E. Determinants of medication adherence among Iranian patients with type 2 diabetes: An application of health action process approach. Heliyon 2020; 6:e04442. [PMID: 32695914 PMCID: PMC7364035 DOI: 10.1016/j.heliyon.2020.e04442] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/06/2020] [Accepted: 07/09/2020] [Indexed: 11/25/2022] Open
Abstract
To identify determinants of medication adherence among patients with type 2 diabetes based on the health action process approach. This cross-sectional study was conducted among 734 patients with type 2 diabetes attending to south Tehran health centers during June to December 2018. Data were gathered using the Morisky Medication Adherence Scale (MMAS-8-Item) and the health action process approach questionnaire. We used Mann-Whitney, Pearson Chi-Squared, Fisher's Exact and Independent Samples Tests for comparison of adherence medication by demographic characteristics; and linear regression analysis to predict factors related to medication adherence based on HAPA. P-value less than 0.05 considered statistically significant. A total of 232 men and 502 women participated in the study, Mean age was 61.61 ± 9.74. Most participants (82.3%) reported low medication adherence (females: 68.4%). Medication adherence was significantly associated with gender (p = 0.03). Medication adherence was significantly predicted by intention (β = 0.172, p = 0.0001), task self-efficacy (β = 0.172, p = 0.01), copping planning (β = 0.6, p = 0.0001) and copping self-efficacy (β = -0.244, p = 0.001). The level of adherence to medications among type 2 diabetes patients was low. The behavior intention, task self-efficacy, copping planning and copping self-efficacy were significant determinants contributed to the medication adherence. HAPA inventory includes various factors, especially types of self-efficacy. Thus, utilization of this comprehensive model in interventional studies is suggested. These determinants should be considered in developing interventional programs to improve adherence.
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Affiliation(s)
- Soheila Ranjbaran
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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16
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Peels DA, Verboon P, van Stralen MM, Bolman C, Golsteijn RHJ, Mudde AN, de Vries H, Lechner L. Motivational factors for initiating and maintaining physical activity among adults aged over fifty targeted by a tailored intervention. Psychol Health 2020; 35:1184-1206. [PMID: 32133871 DOI: 10.1080/08870446.2020.1734202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To provide insight into the motivational working mechanisms (i.e. mediators) of an effective physical activity (PA) intervention for adults aged over fifty.Design: The mediation model (N = 822) was investigated in an RCT for the total intervention population, participants who were not norm-active at baseline (targeting PA initiation) and norm-active participants (targeting PA maintenance) separately.Main Outcome Measures: Potential mediators (attitude, self-efficacy, intention, action planning and coping planning) of the effect on PA (6-months) were assessed at baseline, 3 and/or 6 months.Results: The intervention resulted in a decrease in intention (B= -.209; p=.017), and an increase in action planning (B=.214; p=.018) and PA (B=.220; p=.002). Intention and action planning did not mediate the effect on PA. Self-efficacy, although not significantly influenced by the intervention, was found to be the only motivational variable that predicted change in PA (B=.164; p=.007). These results were confirmed among participants initiating PA. Among norm-active participants no significant intervention effects were identified.Conclusion: The motivational factors cannot explain the intervention effect on PA. Most likely, the effect can be explained by an interaction between the motivational factors together. Differences between participants initiating versus maintaining PA, highlight the importance of performing mediation analyses per subgroup.
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Affiliation(s)
| | - Peter Verboon
- Department of Psychology, Open University, Heerlen, Netherlands
| | - Maartje M van Stralen
- Faculty of Science, Prevention and Public Health, Amsterdam Public Health Research Institute, VU University, Amsterdam, Netherlands
| | | | | | - Aart N Mudde
- Department of Psychology, Open University, Heerlen, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University Medical Centre+, Maastricht, Netherlands.,Care and Public Health Research Institute (Caphri), Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Lilian Lechner
- Department of Psychology, Open University, Heerlen, Netherlands
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17
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Joveini H, Rohban A, Eftekhar Ardebili H, Dehdari T, Maheri M, Hashemian M. The effects of an education program on hookah smoking cessation in university students: an application of the Health Action Process Approach (HAPA). JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1664655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hamid Joveini
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Alireza Rohban
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Maheri
- Department of Public Health, School of Health, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hashemian
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
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18
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Zhang CQ, Wong MCY, Zhang R, Hamilton K, Hagger MS. Adolescent sugar-sweetened beverage consumption: An extended Health Action Process Approach. Appetite 2019; 141:104332. [DOI: 10.1016/j.appet.2019.104332] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
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19
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Boulton E, Hawley-Hague H, French DP, Mellone S, Zacchi A, Clemson L, Vereijken B, Todd C. Implementing behaviour change theory and techniques to increase physical activity and prevent functional decline among adults aged 61-70: The PreventIT project. Prog Cardiovasc Dis 2019; 62:147-156. [PMID: 30685469 DOI: 10.1016/j.pcad.2019.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
The health and wellbeing benefits of engaging in physical activity (PA), and of improving strength and balance, are well documented. The World Health Organization's recommendations of 150 min per week of moderate intensity physical activity have been adopted across the world in policy and practice recommendations. However, the number of older adults engaging in this level of PA remains low. The European Project, PreventIT, has adapted the Lifestyle-integrated Functional Exercise (LiFE) programme, which reduced falls in people 75 years and over, for a younger cohort (aLiFE). aLiFE incorporates challenging strength and balance/agility tasks, as well as specific recommendations for increasing physical activity and reducing sedentary behaviour in young-older adults, aged 60-70 years. Personalised advice is given on how to integrate strength, balance and physical activities into daily life. aLiFE has been further developed to be delivered using smartphones and smartwatches (eLiFE), providing the opportunity to send timely motivational messages and real-time feedback to the user. Both aLiFE and eLiFE are behaviour change interventions, supporting older adults to form long-term physical activity habits. PreventIT has taken the original LiFE concept and further developed the behaviour change elements, explicitly mapping them to Social Cognitive Theory, Habit Formation Theory and 30 Behaviour Change Techniques (BCTs). Goal setting, planning, prompts and real-time feedback are used to deliver a person-centred experience. Over 1300 motivational messages have been written, mapped to psychological theory, BCTs and evidence regarding the importance of strength, balance and PA. A motivational assessment tool has been developed to enable us to investigate stated motivational drivers with actual performed behaviour within the feasibility Randomised Controlled Trial. The PreventIT mHealth intervention focusses on behaviour change from initiation to long-term maintenance, addressing the different phases of adopting a healthier lifestyle. As such, it makes a strong contribution to the developing field of evidence-based mobile health (mHealth).
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Affiliation(s)
- Elisabeth Boulton
- School of Health Sciences, University of Manchester, Manchester Academic Health, Science Centre, Manchester, UK.
| | - Helen Hawley-Hague
- School of Health Sciences, University of Manchester, Manchester Academic Health, Science Centre, Manchester, UK
| | - David P French
- School of Health Sciences, University of Manchester, Manchester Academic Health, Science Centre, Manchester, UK
| | - Sabato Mellone
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Anna Zacchi
- Doxee s.p.a., v.le Virgilio 48B, Modena, Italy; CINECA, Via Magnanelli, 6/3, 40033, Casalecchio di Reno BO, Italy
| | - Lindy Clemson
- The University of Sydney, Faculty of Health Sciences, Centre of Excellence in Population Ageing Research (CEPAR), Sydney, Australia
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Chris Todd
- School of Health Sciences, University of Manchester, Manchester Academic Health, Science Centre, Manchester, UK; Manchester University NHS Foundation Trust
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20
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Norman P, Webb TL, Millings A. Using the theory of planned behaviour and implementation intentions to reduce binge drinking in new university students. Psychol Health 2019; 34:478-496. [PMID: 30636436 DOI: 10.1080/08870446.2018.1544369] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Excessive alcohol consumption, including binge drinking, increases when students enter university. This study tests whether combining messages targeting theory of planned behaviour (TPB) constructs with if-then plans (i.e. implementation intentions) to avoid binge drinking reduces binge drinking in new university students. DESIGN One month after starting university, students (N = 407) were randomly assigned to condition in a 2 (TPB messages) × 2 (implementation intentions) factorial design. MAIN OUTCOME MEASURES Cognitions about binge drinking were assessed immediately post-intervention. Frequency of binge drinking was assessed at one-month follow-up (n = 205). RESULTS Participants who viewed the messages had significantly weaker intentions to engage in binge drinking and less favourable cognitions about binge drinking (affective attitude, descriptive norms, and self-efficacy) than those who did not view the messages. In addition, participants who formed an implementation intention to avoid binge drinking reported significantly fewer instances of binge drinking at follow-up. CONCLUSION The findings provide some support for the use of interventions based on the TPB to reduce intentions to engage in binge drinking and for forming implementation intentions to reduce the frequency of binge drinking in new university students. No evidence was found for the synergistic effect of combining the two interventions.
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Affiliation(s)
- Paul Norman
- a Department of Psychology , University of Sheffield , Sheffield , UK
| | - Thomas L Webb
- a Department of Psychology , University of Sheffield , Sheffield , UK
| | - Abigail Millings
- a Department of Psychology , University of Sheffield , Sheffield , UK
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21
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Radtke T, Luszczynska A, Schenkel K, Biddle S, Scholz U. A cluster randomized controlled trial comparing the effectiveness of an individual planning intervention with collaborative planning in adolescent friendship dyads to enhance physical activity (TWOgether). BMC Public Health 2018; 18:911. [PMID: 30041603 PMCID: PMC6056914 DOI: 10.1186/s12889-018-5818-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most adolescents do not meet the recommendations for physical activity (PA) of at least 1 h per day. Individual planning (IP) interventions, including forming plans for when, where and how (action planning) to engage in a behavior, as well as the planning for how to deal with arising barriers (coping planning), are effective to enhance PA in adults. Collaborative planning (CP) is conjoint planning of two individuals regarding a behavior which is performed together. It is assumed that CP stimulates social exchange processes between the planning partners. However, it remains unclear whether planning interventions of PA in adolescents are successful and which planning intervention is more effective. Thus, this cluster randomized controlled trial (RCT) examines changes in daily moderate-to-vigorous PA in adolescents' friendship dyads resulting from planning. Individual self-regulating mechanism and social exchange processes are proposed as mediating mechanisms of the effects of planning for health behavior change. METHODS A single-blind four-arm parallel-group cluster-RCT is used. The sample consists of 400 friendship dyads between 14 and 18 years of age. As the recruitment takes place in schools, a cluster randomization of the schools is used to enroll dyads to (a) an IP intervention, (b) a CP intervention or (c) one of the two no-planning control conditions. Devise-measured and self-reported PA as the primary outcomes, self-regulatory strategies, and social exchange processes as secondary outcomes are assessed at three or four time points. After baseline measurement, the baseline ecological momentary assessment of the main variables takes place for 8 days followed by the intervention and a 7-days diary phase. Follow-ups are 1 month and 6 months later. Subsequent to the six-month follow-up, another 7-days diary phase takes place. DISCUSSION This is the first study examining IP in comparison to CP in adolescents applying a single-blind cluster RCT. Consequently, the study allows for understanding the efficacy of individual and collaborative planning and the underlying mechanisms in adolescent dyads. TRIAL REGISTRATION This RCT was funded by the Swiss National Science Foundation (100019_169781/1) and was registered on 18/06/2018 at ClinicalTrials.gov : NCT03575559 .
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Affiliation(s)
- Theda Radtke
- Department of Psychology, Applied Social and Health Psychology, University of Zurich, Binzmuehlestrasse 14/14, 8050, Zurich, Switzerland. .,Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield Central, QLD, 4300, Australia.
| | - Aleksandra Luszczynska
- SWPS University of Social Sciences and Humanities, 30b Ostrowskiego Street, PL-53-238, Wroclaw, Poland.,Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO, 80918, USA
| | - Konstantin Schenkel
- Department of Psychology, Applied Social and Health Psychology, University of Zurich, Binzmuehlestrasse 14/14, 8050, Zurich, Switzerland
| | - Stuart Biddle
- Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield Central, QLD, 4300, Australia
| | - Urte Scholz
- Department of Psychology, Applied Social and Health Psychology, University of Zurich, Binzmuehlestrasse 14/14, 8050, Zurich, Switzerland
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22
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Collier-Meek MA, Sanetti LMH, Boyle AM. Barriers to implementing classroom management and behavior support plans: An exploratory investigation. PSYCHOLOGY IN THE SCHOOLS 2018. [DOI: 10.1002/pits.22127] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Whipps M, Yoshikawa H, Godfrey E. The Maternal Ecology of Breastfeeding: A Life Course Developmental Perspective. Hum Dev 2018. [DOI: 10.1159/000487977] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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24
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Yeager CM, Shoji K, Luszczynska A, Benight CC. Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study. JMIR Ment Health 2018; 5:e29. [PMID: 29636323 PMCID: PMC5938690 DOI: 10.2196/mental.9449] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/03/2018] [Accepted: 02/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.
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Affiliation(s)
- Carolyn M Yeager
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Kotaro Shoji
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Aleksandra Luszczynska
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,SWPS University of Social Sciences & Humanities, Wroclaw, Poland
| | - Charles C Benight
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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25
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Pinidiyapathirage J, Jayasuriya R, Cheung NW, Schwarzer R. Self-efficacy and planning strategies can improve physical activity levels in women with a recent history of gestational diabetes mellitus. Psychol Health 2018; 33:1062-1077. [PMID: 29629841 DOI: 10.1080/08870446.2018.1458983] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Regular physical activity can reduce the risk of developing diabetes in high risk populations including in women with gestational diabetes mellitus (GDM). This study applied the Health Action Process Approach (HAPA) to determine the motivational and volitional factors important in increasing physical activity among women with previous GDM. METHODS Women with GDM receiving obstetric care at a teaching hospital in Sri Lanka were invited to participate in a survey 6-36 months post-delivery. At baseline and 8 weeks later, 152 women completed postal and telephone surveys that collected socio-cognitive and physical activity data. The study hypotheses were tested using structural equation modelling. RESULTS The modified model fit the data well (CFI = .95, TLI = .94, RMSEA = .057) and explained 11% of the variance in behaviour. Action self-efficacy was the only important predictor of intention to be physically active. Intention as well as maintenance self-efficacy predicted planning, which, in turn, predicted physical activity. Planning mediated the effect of intention and self-efficacy (maintenance and recovery) on physical activity. CONCLUSION This study has identified predictors of physical activity among women with previous GDM that can inform intervention studies. Interventions targeting this population need to include planning strategies and enhance self-efficacy.
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Affiliation(s)
- Janani Pinidiyapathirage
- a Institute for Agriculture and the Environment , University of Southern Queensland , Toowoomba , Australia
| | - Rohan Jayasuriya
- b School of Public Health and Community Medicine , University of New South Wales , Sydney , Australia
| | - N Wah Cheung
- c Department of Diabetes and Endocrinology , Westmead Hospital , Sydney , Australia
| | - Ralf Schwarzer
- d Department of Psychology , Freie Universität Berlin , Berlin , Germany.,e Department of Clinical, Health, and Rehabilitation Psychology , SWPS University of Social Sciences and Humanities , Wroclaw , Poland
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26
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Abstract
BACKGROUND Most patients do not meet the recommended level of physical activity after bariatric surgery, and psychological factors underlying postoperative physical activity remain poorly understood. This study aimed at identifying self-regulatory predictors of physical activity after bariatric surgery. METHODS Questionnaire data including self-regulation variables and the short-version of the International Physical Activity Questionnaire were obtained in a prospective cohort of 230 patients 1 year after Roux-en-Y gastric bypass. The study sample consisted of participants consenting to wear an ActiGraph GT3X+ accelerometer for seven consecutive days, 18-24 months after surgery (n = 120). RESULTS A total of 112 participants with complete self-report data provided valid accelerometer data. Mean age was 46.8 years (SD = 9.3), and 81.3% was women. Preoperative and postoperative BMI was 44.8 ± 5.5 and 30.6 ± 5.0 kg/m2, respectively. Total weight loss was 28.9% (SD = 7.5). By objective measures, 17.9% of the participants met the recommended level of moderate-to-vigorous-intensity of physical activity of ≥150 min/week, whereas 80.2% met the recommended level according to self-reported measures. Being single, higher education level, and greater self-regulation predicted objective physical activity in multivariate regression analysis. Greater self-regulation also predicted self-reported physical activity. Weight loss 1 year after surgery was not associated with self-reported or objectively measured physical activity. CONCLUSIONS Despite large differences between accelerometer-based and subjective estimates of physical activity, the associations of self-regulatory factors and weight loss with postoperative physical activity did not vary depending on mode of measurement. Self-regulation predicted both objective and self-reported physical activity. Targeting patients' self-regulatory ability may enhance physical activity after gastric bypass.
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27
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Zarski AC, Berking M, Reis D, Lehr D, Buntrock C, Schwarzer R, Ebert DD. Turning Good Intentions Into Actions by Using the Health Action Process Approach to Predict Adherence to Internet-Based Depression Prevention: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res 2018; 20:e9. [PMID: 29326097 PMCID: PMC5785685 DOI: 10.2196/jmir.8814] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 01/08/2023] Open
Abstract
Background Many individuals engaging in Internet-based interventions fail to complete these treatments as intended. The processes responsible for treatment adherence in Internet-based interventions are still poorly understood. Objective The aim of this study was to investigate to what extent adherence in an Internet-based intervention can be predicted by motivational and volitional factors outlined in the health action process approach (HAPA). Methods This study investigated motivational and volitional factors included in HAPA in a randomized controlled trial to predict treatment adherence of N=101 individuals with subclinical depression in the intervention group of a depression prevention intervention (GET.ON Mood Enhancer). Adherence was operationalized as the number of completed treatment modules. Using longitudinal structural equation modeling, HAPA variables (motivational, maintenance, and recovery self-efficacy, outcome expectancies, intention, and planning) were assessed at baseline and their associations with adherence 7 weeks later. Results Planning predicted adherence. Better planning was, in turn, associated with higher levels of maintenance self-efficacy, and the latter significantly affected treatment adherence via planning. The other hypothesized direct associations were not significant. In total, the HAPA variables accounted for 14% of variance in treatment adherence. Conclusions Planning emerged as the strongest predictor of treatment adherence in highly motivated participants in an Internet-based intervention out of all HAPA variables investigated. Findings are in line with the hypothesis that planning facilitates the translation of good intentions into actions. The findings imply that systematically fostering planning skills and maintenance self-efficacy prior to or during Internet-based interventions would help participants to successfully complete these treatments. Trial Registration German Clinical Trials Register DRKS00005973; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00005973 (Archived by WebCite at http://www.webcitation.org/6uxCy64sy).
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Affiliation(s)
- Anna-Carlotta Zarski
- Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Leuphana University Lüneburg, Lüneburg, Germany
| | - Matthias Berking
- Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Dirk Lehr
- Leuphana University Lüneburg, Lüneburg, Germany
| | - Claudia Buntrock
- Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Ralf Schwarzer
- SWPS University of Social Sciences and Humanities, Warszawa, Poland
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28
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Gray P, Murphy M, Gallagher A, Simpson EEA. A qualitative investigation of physical activity compensation among older adults. Br J Health Psychol 2017; 23:208-224. [PMID: 29171704 DOI: 10.1111/bjhp.12282] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 10/11/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study explored the mechanisms of physical activity (PA) compensation among older adults who recently reduced their non-exercise physical activity (NEPA) in response to a structured PA intervention. DESIGN A post-trial, retrospective qualitative process evaluation using interviews was employed. METHODS Levels of PA compensation were determined by comparing NEPA prior to and during the final week of a 4-week structured PA intervention. Those who reduced their NEPA by 10% or greater were considered as compensators. Interviews were conducted with older adult compensators (mean age = 58.56 ± 3.88 years; n = 9), employing thematic analysis to identify potential mechanisms of PA compensation. RESULTS The findings suggest that the majority of participants were unaware that they had compensated in their PA, suggesting that this may be a non-volitional process. Most participants perceived PA compensation to hold negative implications for health and well-being. Physiological processes of fatigue and delayed onset of muscle soreness were cited as the principal cause of PA compensation, whereas psychological processes including a drive to be inactive, fear of overexertion, deficient motivation, and perceived time constraints were cited to a lesser extent. CONCLUSION A range of physiological and psychological compensatory barriers were identified. Implications of and methods to overcome these compensatory barriers are discussed. Statement of contribution What is already known on this subject? Physical activity compensation holds negative implications for physical activity promotion and health. Older adults are an age group more likely to compensate in their physical activity levels. What does this study add? Physical activity compensation may be a result of a range of physiological and psychological processes including fatigue and delayed onset of muscle soreness, compensatory health beliefs, fear of overexertion, deficient motivation, and perceived time constraints. Most older adult compensators may be unaware they are compensating and, however, agree that physical activity compensation has negative implications for health and well-being.
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Affiliation(s)
- Phillip Gray
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Marie Murphy
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Northern Ireland
| | - Alison Gallagher
- Northern Ireland Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland
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29
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Bierbauer W, Inauen J, Schaefer S, Kleemeyer MM, Lüscher J, König C, Tobias R, Kliegel M, Ihle A, Zimmerli L, Holzer BM, Siebenhuener K, Battegay E, Schmied C, Scholz U. Health Behavior Change in Older Adults: Testing the Health Action Process Approach at the Inter- and Intraindividual Level. Appl Psychol Health Well Being 2017; 9:324-348. [PMID: 29024515 DOI: 10.1111/aphw.12094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Health behavior change theories usually claim to be universally and individually applicable. Most research has tested behavior change theories at the interindividual level and within young-to-middle-aged populations. However, associations at the interindividual level can differ substantially from associations at the intraindividual level. This study examines the applicability of the Health Action Process Approach (HAPA) at the inter- and the intraindividual level among older adults. METHODS Two intensive longitudinal studies examined the HAPA model covering two different health behaviors and two different time spans: Study 1 (physical activity, N = 52 × 6 monthly observations) and Study 2 (medication adherence, N = 64 × 30 daily observations). The HAPA constructs (risk awareness, outcome expectancy, self-efficacy, intention, action planning, action control), and self-reported behaviors were assessed. RESULTS Overall, at the interindividual level, results of both studies largely confirmed the associations specified by the HAPA. At the intraindividual level, results were less in line with the HAPA. Only action control emerged as consistent predictor of behavior. CONCLUSIONS This study emphasises the importance of examining health behavior change theories at both, the inter- and the intraindividual level.
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Affiliation(s)
- Walter Bierbauer
- University of Zurich, Switzerland University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Switzerland
| | - Jennifer Inauen
- Eawag: Swiss Federal Institute of Aquatic Science & Technology, Switzerland Columbia University, USA
| | - Sabine Schaefer
- Max Planck Institute for Human Development, Germany Saarland University, Germany
| | | | | | | | | | - Matthias Kliegel
- Department of Psychology, University of Geneva, Switzerland Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Andreas Ihle
- Department of Psychology, University of Geneva, Switzerland Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Lukas Zimmerli
- Cantonal Hospital Olten, Switzerland University Hospital Zurich, Switzerland
| | - Barbara M Holzer
- University Hospital Zurich, Switzerland Center of Competence Multimorbidity, University of Zurich, Switzerland
| | - Klarissa Siebenhuener
- University Hospital Zurich, Switzerland Center of Competence Multimorbidity, University of Zurich, Switzerland
| | - Edouard Battegay
- University Hospital Zurich, Switzerland Center of Competence Multimorbidity, University of Zurich, Switzerland
| | | | - Urte Scholz
- University of Zurich, Switzerland University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Switzerland Center of Competence Multimorbidity University of Zurich, Switzerland
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Abstract
Giving patients insight, knowledge, and skills, although important, may not alone be enough for behavior change maintenance. Rather, the health care provider (HCP) has an important role in fostering behavior change and maintenance by asking, "Why do people change?" and "What can I do to help?" This review highlights 4 evidence-based factors related to medication adherence, when lifestyle is the medicine. (1) Autonomy is the belief that one is the origin of his or her own actions, and must be supported by the HCP (eg, "My HCP listens to how I would like to do things regarding my health"). (2) Competence and confidence ensure that patients believe they can succeed. These are gained through mastery experience, vicarious experience, and through positive and constructive feedback on past performance (eg, "My HCP conveys confidence in my ability to make changes regarding my health"). (3) Coping planning is being able to formulate a plan of intention, with the awareness of barriers and emotional regulation that can inhibit patient behavior (eg, "I feel able to share my feelings with my HCP"). (4) Personal values of the patients are used to understand how and why they cope when there is a threat to these values (eg, "My HCP tries to understand how I see my health before suggesting any changes").
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Affiliation(s)
- Mark D Faries
- Texas A&M AgriLife Extension Service and Texas A&M University, College of Medicine, College Station, Texas (MDF)
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas (AA)
| | - Alyssa Abreu
- Texas A&M AgriLife Extension Service and Texas A&M University, College of Medicine, College Station, Texas (MDF)
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas (AA)
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Morais VP, Encantado J, Santos MI, Almeida P, Leal IP, Carvalho C. Increasing physical activity in older adults: Walking by prescription in primary care. PSYCHOLOGY, COMMUNITY & HEALTH 2017. [DOI: 10.5964/pch.v6i1.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim
The present study (PTDC/SAU-SAP/110799/2009) funded by the Portuguese Government (Fundação para a Ciência e Tecnologia – FCT) aimed to test the effectiveness of a behaviour based intervention combined with a cognitive based one, designed to increase physical activity levels in older adults at Primary Health Care Centres.
Method
A total of 108 participants aged over 65 years participated in the study. Participants were referred by their General Practitioner (GP) and randomized by gender and marital status at the moment they started the program (single vs. couple), and allocated into one of three conditions: goal intention, action planning, action planning and coping planning. All participants received a pedometer and a logbook and were asked to register their daily number of steps for a period of 24 weeks. Study follows a longitudinal design with five assessments over a 6-month after baseline.
Results
The test between subjects’ effects revealed an interaction between condition and participating in the study as single vs. couple. Older adults participating as singles walked more steps on average in the condition goal intention plus action planning and coping planning, whereas participants that entered in the study with their spouse, goal intention without any other planning intervention was the most effective intervention.
Conclusion
The 24-week physical activity program based on the recent developments of behavioural-cognitive framework, has proven useful increasing older adults daily walking behaviour.
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Hamilton K, Kothe EJ, Mullan B, Spinks T. The mediating and moderating role of planning on mothers' decisions for early childhood dietary behaviours. Psychol Health 2017; 32:1518-1533. [PMID: 28728445 DOI: 10.1080/08870446.2017.1351970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Examine the roles of action and coping planning on the intention-behaviour relationship for mothers' decisions for their young children's dietary behaviours. DESIGN Prospective design with two waves of data collection, one week apart. MAIN OUTCOME MEASURES Mothers (N = 197, Mage = 34.39, SD = 5.65) of children aged 2-3 years completed a main questionnaire assessing planning constructs and intentions, and a one-week follow-up of the target behaviours - 'healthy eating' and 'discretionary choices'. RESULTS Intention was the strongest predictor of behaviour for both dietary behaviours. For healthy eating, intention moderated the indirect relationship between intention-behaviour via planning; coping planning was less important when intention was strong. Further, intention was not a direct predictor of behaviour when intention was relatively low. Action planning was not a direct predictor of either behaviour after accounting for intention and coping planning; action planning on behaviour was mediated by coping planning (only for healthy eating). Intention was not a direct predictor of coping planning; intention on coping planning was mediated by action planning. Neither type of planning predicted discretionary choices. CONCLUSION Current findings contribute novel information on the mechanisms underpinning the effect of action and coping planning on the intention-behaviour relationship.
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Affiliation(s)
- Kyra Hamilton
- a School of Applied Psychology, Menzies Health Institute Queensland, Griffith University , Brisbane , Australia.,b Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University , Perth , Australia
| | - Emily J Kothe
- c School of Psychology, Deakin University , Geelong , Australia
| | - Barbara Mullan
- b Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University , Perth , Australia.,d School of Psychology, University of Sydney , Sydney, Australia
| | - Teagan Spinks
- a School of Applied Psychology, Menzies Health Institute Queensland, Griffith University , Brisbane , Australia
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¡Sólo Se Vive Una Vez! (You Only Live Once): A Pilot Evaluation of Individually Tailored Video Modules Aiming to Increase HIV Testing Among Foreign-Born Latino Men. J Acquir Immune Defic Syndr 2017; 74 Suppl 2:S104-S112. [PMID: 28079720 DOI: 10.1097/qai.0000000000001239] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although Latinos living in the United States are disproportionately affected by HIV, the development, implementation, and evaluation of HIV prevention, testing, and linkage to care interventions lag behind efforts occurring in other communities. To address sociocultural barriers to testing, we developed a multilevel intervention. This study is a pilot evaluation of the individual-level component of the intervention-animated video modules that address specific barriers to HIV testing common among foreign-born Latino men. METHODS We conducted a survey assessing HIV risk and barriers to testing with a convenience sample of 104 foreign-born Latino men in Baltimore, MD, who had not tested for HIV within the past year. Intention to test in the next 3 months was measured before and after viewing an intervention module selected based on survey responses. RESULTS Fifty-two (50.0%) participants had never tested for HIV. Of the participants who had previously tested for HIV, the mean time since their last test was 3.48 years (SD = 3.55). Participants' intention to test for HIV significantly increased after watching the module (t = -8.28, P < 0.001). Increased intention to test was not associated with any socio-demographic characteristics (ie, age, country of origin) or reported sexual behaviors (ie, number of sex partners in the past year). DISCUSSION These results suggest that our culturally sensitive, individually tailored intervention can be an additional tool to encourage HIV testing among previously untested foreign-born Latino men, one of the demographic groups at highest risk for delayed HIV diagnosis in the United States.
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Miranda J, Côté J. The Use of Intervention Mapping to Develop a Tailored Web-Based Intervention, Condom-HIM. JMIR Public Health Surveill 2017; 3:e20. [PMID: 28428162 PMCID: PMC5415661 DOI: 10.2196/publichealth.7052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/07/2017] [Accepted: 02/18/2017] [Indexed: 01/29/2023] Open
Abstract
Background Many HIV (human immunodeficiency virus) prevention interventions are currently being implemented and evaluated, with little information published on their development. A framework highlighting the method of development of an intervention can be used by others wanting to replicate interventions or develop similar interventions to suit other contexts and settings. It provides researchers with a comprehensive development process of the intervention. Objective The objective of this paper was to describe how a systematic approach, intervention mapping, was used to develop a tailored Web-based intervention to increase condom use among HIV-positive men who have sex with men. Methods The intervention was developed in consultation with a multidisciplinary team composed of academic researchers, community members, Web designers, and the target population. Intervention mapping involved a systematic process of 6 steps: (1) needs assessment; (2) identification of proximal intervention objectives; (3) selection of theory-based intervention methods and practical strategies; (4) development of intervention components and materials; (5) adoption, implementation, and maintenance; and (6) evaluation planning. Results The application of intervention mapping resulted in the development of a tailored Web-based intervention for HIV-positive men who have sex with men, called Condom-HIM. Conclusions Using intervention mapping as a systematic process to develop interventions is a feasible approach that specifically integrates the use of theory and empirical findings. Outlining the process used to develop a particular intervention provides clarification on the conceptual use of experimental interventions in addition to potentially identifying reasons for intervention failures.
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Affiliation(s)
- Joyal Miranda
- Faculty of Community ServicesDaphne Cockwell School of NursingRyerson UniversityToronto, ONCanada
| | - José Côté
- Faculté des sciences infirmièresUniversité de MontréalMontreal, ONCanada
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Fuchs R, Seelig H, Göhner W, Schlatterer M, Ntoumanis N. The two sides of goal intentions: Intention self-concordance and intention strength as predictors of physical activity. Psychol Health 2016; 32:110-126. [PMID: 27775430 DOI: 10.1080/08870446.2016.1247840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present research introduces an extended conceptualisation of self-concordance, which is considered an attribute not only of goals, but also of goal intentions. Based on a corresponding operationalisation, we investigate the interplay of both intention strength and intention self-concordance in the prediction of physical activity. DESIGN Data were taken from a longitudinal study of 134 obese people who were asked to fill out a questionnaire three times every six months. MAIN MEASURES Physical activity and intention self-concordance were measured by validated scales. Intentions strength was assessed by an item typically employed in the extant literature. RESULTS Logistic regression analyses and path analyses showed both intention strength and self-concordance to be significant predictors of changes in physical activity over time. Additional analyses found self-efficacy to be a significant predictor of intention strength and self-concordance; for outcome expectations this was not the case. CONCLUSIONS Findings support the idea that intention strength and self-concordance are two critical facets of a goal intention that need to be considered in the prediction of physical activity participation. Whereas intention strength refers to the degree of determination with which a goal intention is adopted, self-concordance rather captures the quality of this intention.
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Affiliation(s)
- Reinhard Fuchs
- a Department of Sport Science , University of Freiburg , Freiburg , Germany
| | - Harald Seelig
- b Department of Sport, Exercise and Health , University of Basel , Basel , Switzerland
| | - Wiebke Göhner
- c Department of Health Psychology , Catholic University of Applied Sciences , Freiburg , Germany
| | | | - Nikos Ntoumanis
- d School of Psychology and Speech Pathology, Curtin University , Perth , Australia
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Keller J, Wiedemann AU, Hohl DH, Scholz U, Burkert S, Schrader M, Knoll N. Predictors of dyadic planning: Perspectives of prostate cancer survivors and their partners. Br J Health Psychol 2016; 22:42-59. [PMID: 27743412 DOI: 10.1111/bjhp.12216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 09/18/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy. DESIGN Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months. METHODS PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates. RESULTS Findings from two-level models nesting repeated assessments in individuals showed that context (patients' incontinence), target person (i.e., positive affect and self-efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients' and partners' accounts of dyadic planning differed. CONCLUSIONS Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals. Statement of contribution What is already known on this subject? Dyadic planning has been shown to be linked to health behaviour change. However, its role in behaviour regulation frameworks is not well investigated, especially regarding factors that might be predictive of dyadic planning. What does this study add? A framework of predictors of dyadic planning in the health behaviour change process is presented. The framework is investigated accounting for both planning partners' perspectives. Context, target person, and relationship factors were related to dyadic planning.
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Affiliation(s)
- Jan Keller
- Department of Educational Science and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Amelie U Wiedemann
- Department of Educational Science and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Diana Hilda Hohl
- Department of Educational Science and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
| | - Urte Scholz
- Department of Psychology, University of Zurich, Switzerland
| | - Silke Burkert
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Germany
| | - Mark Schrader
- Department of Urology, HELIOS Klinikum Berlin-Buch, Germany
| | - Nina Knoll
- Department of Educational Science and Psychology, Division Health Psychology, Freie Universität Berlin, Germany
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Iwasaki Y, Honda S, Kaneko S, Kurishima K, Honda A, Kakinuma A, Jahng D. Exercise Self-Efficacy as a Mediator between Goal-Setting and Physical Activity: Developing the Workplace as a Setting for Promoting Physical Activity. Saf Health Work 2016; 8:94-98. [PMID: 28344847 PMCID: PMC5355533 DOI: 10.1016/j.shaw.2016.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 08/01/2016] [Accepted: 08/31/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical activity (PA) is ranked as a leading health indicator and the workplace is a key setting to promote PA. The purpose of this study was to examine how goal-setting and exercise self-efficacy (SE) during a health promotion program influenced PA level among Japanese workers. METHODS Using a cross-sectional study design, we surveyed 281 employees. The short version of the International Physical Activity Questionnaire was used to assess PA level. Exercise SE was assessed using a partially modified version of Oka's exercise SE scale. Personal goals were assessed as the total numbers of "yes" responses to five items regarding "details of personal goals to perform PA". A mediational model was used to examine whether exercise SE mediates between the number of personal goals and PA level. RESULTS The mean age of the participants was 46.3 years, 76.2% were men, and the most common occupational category was software engineer (30.6%). The average PA level per week exceeded the recommended level in 127 participants (45.2%). One hundred and eighty-four participants (65.5%) set some form of concrete personal goal to perform PA. The relationship between the number of personal goals and PA level was mediated by exercise SE. CONCLUSION Our study showed that exercise SE mediates goal-setting and increases PA. The results suggest that the components of PA promotion programs should be tailored to enhance participants' confidence in performing PA.
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Affiliation(s)
- Yoshie Iwasaki
- Department of Human Intelligence Systems, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Fukuoka, Japan; Department of Health Care, NEC Corporation, Tokyo, Japan
| | - Sumihisa Honda
- Department of Nursing, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shuji Kaneko
- Department of Human Intelligence Systems, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Fukuoka, Japan
| | - Kazuhiro Kurishima
- Department of Human Intelligence Systems, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Fukuoka, Japan
| | - Ayumi Honda
- Department of Nursing, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Ayumu Kakinuma
- Department of Health Care, NEC Corporation, Tokyo, Japan
| | - Doosub Jahng
- Department of Human Intelligence Systems, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Fukuoka, Japan
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Koka A, Hagger MS. A brief intervention to increase physical activity behavior among adolescents using mental simulations and action planning. PSYCHOL HEALTH MED 2016; 22:701-710. [PMID: 27427434 DOI: 10.1080/13548506.2016.1211298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study evaluated the effectiveness of a brief integrated theory-based intervention to increase physical activity (PA) among adolescents over a three-month follow-up period. A 2 (mental simulation: present vs. absent) × 2 (action planning: present vs. absent) × 4 (time: baseline vs. one-month vs. two-month vs. three-month follow-up) mixed-model randomized controlled design was adopted. Adolescents aged 14-15 years (N = 267) completed baseline psychological measures and self-reported PA followed by the relevant intervention manipulation, if appropriate, with follow-up measures collected one, two, and three months later. Results revealed no significant effects for the mental simulation and action planning strategies nor the interaction of the two strategies. However, among participants with low levels of baseline PA, participants in both mental simulation alone and action planning alone groups reported significantly higher levels of PA at one-month follow up than other groups, suggesting that individual intervention components may be effective in low-active adolescents.
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Affiliation(s)
- Andre Koka
- a Faculty of Medicine , Institute of Sport Sciences and Physiotherapy, University of Tartu , Tartu , Estonia
| | - Martin S Hagger
- b Health Psychology and Behavioral Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Sciences , Curtin University , Perth , Australia.,c Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland.,d School of Applied Psychology and Menzies Health Institute Queensland, Behavioural Bases for Health , Griffith University , Brisbane , Australia
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Stacey FG, James EL, Chapman K, Lubans DR. Social cognitive theory mediators of physical activity in a lifestyle program for cancer survivors and carers: findings from the ENRICH randomized controlled trial. Int J Behav Nutr Phys Act 2016; 13:49. [PMID: 27075417 PMCID: PMC4831117 DOI: 10.1186/s12966-016-0372-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/06/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Despite increasing numbers of cancer survivors and evidence that diet and physical activity improves the health of cancer survivors, most do not meet guidelines. Some social cognitive theory (SCT)-based interventions have increased physical activity behavior, however few have used objective physical activity measures. The Exercise and Nutrition Routine Improving Cancer Health (ENRICH) randomized controlled trial reported a significant intervention effect for the primary outcome of pedometer-assessed step counts at post-test (8-weeks) and follow-up (20-weeks). The aim of this study was to test whether the SCT constructs operationalized in the ENRICH intervention were mediators of physical activity behavior change. METHODS Randomized controlled trial with 174 cancer survivors and carers assessed at baseline, post-test (8-weeks), and follow-up (20-weeks). Participants were randomized to the ENRICH six session face-to-face healthy lifestyle program, or to a wait-list control. Hypothesized SCT mediators of physical activity behavior change (self-efficacy, behavioral goal, outcome expectations, impediments, and social expectations) were assessed using valid and reliable scales. Mediation was assessed using the Preacher and Hayes SPSS INDIRECT macro. RESULTS At eight weeks, there was a significant intervention effect on behavioral goal (A = 9.12, p = 0.031) and outcome expectations (A = 0.25, p = 0.042). At 20 weeks, the intervention had a significant effect on self-efficacy (A = 0.31, p = 0.049) and behavioral goal (A = 13.15, p = 0.011). Only changes in social support were significantly associated with changes in step counts at eight weeks (B = 633.81, p = 0.023). Behavioral goal was the only SCT construct that had a significant mediating effect on step counts, and explained 22 % of the intervention effect at 20 weeks (AB = 397.9, 95 % CI 81.5-1025.5). CONCLUSIONS SCT constructs had limited impact on objectively-assessed step counts in a multiple health behavior change intervention for cancer survivors and their carers. Behavioral goal measured post-intervention was a significant mediator of pedometer-assessed step counts at 3-months after intervention completion, and explained 22 % of the intervention effect. Future research should examine the separate impact of goals and planning, as well as examining mediators of behavior maintenance in physical activity interventions targeting cancer survivors. TRIAL REGISTRATION Australian and New Zealand Clinical Trials registry ANZCTRN1260901086257 .
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Affiliation(s)
- F G Stacey
- School of Medicine and Public Health, The University of Newcastle, Hunter Medical Research Institute, Priority Research Centre for Health Behavior, Priority Research Centre in Physical Activity and Nutrition, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.
| | - E L James
- School of Medicine and Public Health, The University of Newcastle, Hunter Medical Research Institute, Priority Research Centre for Health Behavior, Priority Research Centre in Physical Activity and Nutrition, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia
| | - K Chapman
- Cancer Council New South Wales, 153 Dowling St, Woolloomooloo, NSW, Australia
| | - D R Lubans
- School of Education, and Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, ATC Building, Callaghan, NSW, 2308, Australia
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Hagger MS, Luszczynska A, de Wit J, Benyamini Y, Burkert S, Chamberland PE, Chater A, Dombrowski SU, van Dongen A, French DP, Gauchet A, Hankonen N, Karekla M, Kinney AY, Kwasnicka D, Hing Lo S, López-Roig S, Meslot C, Marques MM, Neter E, Plass AM, Potthoff S, Rennie L, Scholz U, Stadler G, Stolte E, Ten Hoor G, Verhoeven A, Wagner M, Oettingen G, Sheeran P, Gollwitzer PM. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. Psychol Health 2016; 31:814-39. [PMID: 26892502 DOI: 10.1080/08870446.2016.1146719] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans.
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Affiliation(s)
- Martin S Hagger
- a Health Psychology and Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences , Curtin University , Perth , Australia.,b School of Applied Psychology and Menzies Health Institute Queensland , Griffith University , Brisbane , Australia.,c School of Human, Health and Social Sciences , Central Queensland University , Rockhampton , Australia.,d Faculty of Sport and Health Sciences, Department of Sport Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - Aleksandra Luszczynska
- e University of Social Sciences and Humanities , Wroclaw , Poland.,f Trauma, Health, & Hazards Center , University of Colorado at Colorado Springs , Colorado Springs , USA
| | - John de Wit
- g Centre for Social Research in Health, Faculty of Arts and Social Sciences , University of New South Wales , Sydney , Australia
| | - Yael Benyamini
- h Bob Shapell School of Social Work , Tel Aviv University , Tel Aviv , Israel
| | - Silke Burkert
- i Institut für Medizinische Psychologie , Charité Universitätsmedizin Berlin , Berlin , Germany
| | - Pier-Eric Chamberland
- j Département de psychologie , Université du Québec à Trois-Rivières , Trois-Rivières , Canada
| | - Angel Chater
- k School of Pharmacy, Centre for Behavioural Medicine, Department of Practice and Policy , University College London , London , UK
| | - Stephan U Dombrowski
- l School of Natural Sciences, Division of Psychology , University of Stirling , Stirling , UK
| | - Anne van Dongen
- m Sanquin Blood Supply Foundation , Amsterdam , The Netherlands
| | - David P French
- n School of Psychological Science , University of Manchester , Manchester , UK
| | - Aurelie Gauchet
- o Laboratoire Interuniversitaire de Psychologie Personnalité, Cognition, et Changement Social , Université Grenoble Alpes , Grenoble , France
| | - Nelli Hankonen
- p Department of Social Research , University of Helsinki , Helsinki , Finland
| | - Maria Karekla
- q Department of Psychology , University of Cyprus , Nicosia , Cyprus
| | - Anita Y Kinney
- r Department of Internal Medicine , University of New Mexico , Albuquerque , USA
| | - Dominika Kwasnicka
- a Health Psychology and Behavioural Medicine, School of Psychology and Speech Pathology, Faculty of Health Sciences , Curtin University , Perth , Australia
| | - Siu Hing Lo
- s Research Department of Epidemiology and Public Health, Health Behaviour Research Centre , University College London , London , UK
| | - Sofía López-Roig
- t Departamento de Psicología de la Salud, Facultad de Medicina , Universidad Miguel Hernández de Elche , Elche , Spain
| | - Carine Meslot
- o Laboratoire Interuniversitaire de Psychologie Personnalité, Cognition, et Changement Social , Université Grenoble Alpes , Grenoble , France
| | | | - Efrat Neter
- v Ruppin Academic Centre , Emek Hefer , Netanya , Israel
| | - Anne Marie Plass
- w Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands
| | | | - Laura Rennie
- y B-Research/Université Paris-Ouest Nanterre La Défense , Paris , France
| | - Urte Scholz
- z Department of Psychology, Applied Social Psychology , University of Zurich , Zurich , Switzerland
| | - Gertraud Stadler
- aa Department of Psychology , Columbia University , New York , USA
| | - Elske Stolte
- ab Department of Sociology, Faculty of Social Sciences , VU Amsterdam , Amsterdam , The Netherlands
| | - Gill Ten Hoor
- ac Psychology and Neuroscience, Work and Social Psychology, Applied Social Psychology , Maastricht University , Maastricht , The Netherlands
| | - Aukje Verhoeven
- ad Clinical & Health Psychology, Faculty of Social Sciences , Utrecht University , Utrecht , The Netherlands.,ae Department of Clinical Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Monika Wagner
- af Department of Medical Psychology , Medizinischen Universität Innsbruck , Innsbruck , Austria
| | - Gabriele Oettingen
- ag Department of Psychology , New York University , New York , USA.,ah Department of Psychology and Human Movement , University of Hamburg , Hamburg , Germany
| | - Paschal Sheeran
- ai Department of Psychology , University of North Carolina , Chapel Hill , USA
| | - Peter M Gollwitzer
- ag Department of Psychology , New York University , New York , USA.,aj Department of Psychology , University of Konstanz , Konstanz , Germany
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Affiliation(s)
- Ralf Schwarzer
- a Institute of Positive Psychology and Education, Australian Catholic University , Sydney , Australia.,b Department of Clinical, Health and Rehabilitation Psychology , University of the Social Sciences and Humanities , Warsaw , Poland.,c Department of Psychology , Freie Universität Berlin , Germany
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Long ACJ, Hagermoser Sanetti LM, Collier-Meek MA, Gallucci J, Altschaefl M, Kratochwill TR. An exploratory investigation of teachers' intervention planning and perceived implementation barriers. J Sch Psychol 2016; 55:1-26. [PMID: 26931064 DOI: 10.1016/j.jsp.2015.12.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 11/09/2015] [Accepted: 12/09/2015] [Indexed: 11/26/2022]
Abstract
Increasingly teachers are the primary implementer responsible for providing evidence-based interventions to students. However, there is little knowledge regarding the extent to which teachers plan for intervention implementation, receive implementation support, or identify and address implementation barriers. This study explores survey data from over 1200 preschool through grade 12 teachers from 46 public school districts in a Northeastern state. Results indicate that teachers spend significant time engaging in intervention-related behavior and may be a primary source responsible for selecting student interventions. However, the current extent to which they plan for implementation and present levels of implementation support are inadequate to produce high levels of sustained intervention implementation. In addition, almost 60% of implementation barriers reported related to aspects of the intervention itself. Findings from this study provide guidance for future research and preliminary recommendations for ameliorating implementation barriers and proactively supporting treatment integrity in schools.
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Miller CK, Weinhold KR, Nagaraja HN. Impact of a Worksite Diabetes Prevention Intervention on Diet Quality and Social Cognitive Influences of Health Behavior: A Randomized Controlled Trial. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:160-9.e1. [PMID: 26787601 PMCID: PMC4788518 DOI: 10.1016/j.jneb.2015.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the impact of a worksite diabetes prevention intervention on secondary outcomes regarding the change in diet quality and components of the Health Action Process Approach (HAPA) theoretical framework. DESIGN Pretest-posttest control group design with 3-month follow-up. SETTING University worksite. PARTICIPANTS Employees aged 18-65 years with prediabetes (n = 68). INTERVENTION A 16-week group-based intervention adapted from the Diabetes Prevention Program. MAIN OUTCOME MEASURES Diet quality was assessed using the Alternative Healthy Eating Index 2010; HAPA components were assessed via written questionnaire. ANALYSIS Repeated-measures ANOVA compared the between- and within-group change in outcomes across time. RESULTS Significant difference occurred between groups for the change in consumption of nuts/legumes and red/processed meats postintervention and for fruits at 3-month follow-up (all P < .05); a significant increase in total Alternative Healthy Eating Index 2010 score occurred postintervention in the experimental group (P = .002). The changes in action planning, action self-efficacy, and coping self-efficacy from HAPA were significantly different between groups after the intervention; the change in outcome expectancies was significantly different between groups at 3-month follow-up (all P < .05). CONCLUSIONS AND IMPLICATIONS The worksite intervention facilitated improvement in diet quality and in planning and efficacious beliefs regarding diabetes prevention. Further research is needed to evaluate the long-term impact of the intervention.
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Affiliation(s)
- Carla K. Miller
- Professor, Department of Human Sciences, Human Nutrition, , 614-292-1391
| | - Kellie R. Weinhold
- Graduate Research Assistant, Department of Human Sciences, Human Nutrition,
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Wolff JK, Warner LM, Ziegelmann JP, Wurm S, Kliegel M. Translating good intentions into physical activity: older adults with low prospective memory ability profit from planning. J Behav Med 2016; 39:472-82. [DOI: 10.1007/s10865-015-9707-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/18/2015] [Indexed: 11/29/2022]
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Klusmann V, Musculus L, Sproesser G, Renner B. Fulfilled Emotional Outcome Expectancies Enable Successful Adoption and Maintenance of Physical Activity. Front Psychol 2016; 6:1990. [PMID: 26779095 PMCID: PMC4701923 DOI: 10.3389/fpsyg.2015.01990] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/05/2015] [Indexed: 11/13/2022] Open
Abstract
Although outcome expectancies are regarded as key determinants of health behavior change, studies on the role of their degree of fulfillment in long-term activity changes are lacking. This study investigated the impact of (un-)fulfilled outcome expectancies (OE) on (un-)successful attempts to increase physical activity, assuming that disengagement is the logical consequence of perceived futility. Participants (n = 138) of a longitudinal cohort study with three measurement waves were assigned to eight different groups according to a staging algorithm of their self-reported, 1-year-long physical activity behavior track. Stages were validated by objective changes in objective fitness, e.g., Physical Working Capacity (PWC). Social cognitive variables, self-efficacy, proximal and distal OE, and fulfillment of OE, were assessed via self-report. Discriminant analyses revealed that OE fulfillment was the predominant predictor for differentiating between successful and unsuccessful behavior change. Amongst OE, proximal OE concerning emotional rewards, in conjunction with action self-efficacy, further improved discriminatory power. OE adjustment warranting hedonic rewards appears to be a crucial mechanism as it facilitates long-term changes through interventions aimed at increasing physical activity rates. Theoretical models might benefit by including the concept of fulfilled expectations acting in terms of feedback loops between volitional and motivational processes.
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Affiliation(s)
- Verena Klusmann
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
| | - Lisa Musculus
- Department of Psychology, Psychological Assessment and Health Psychology, University of KonstanzKonstanz, Germany; Department of Psychology, German Sport University CologneCologne, Germany
| | - Gudrun Sproesser
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
| | - Britta Renner
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
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Streber R, Peters S, Pfeifer K. Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis. Arch Phys Med Rehabil 2016; 97:633-645.e29. [PMID: 26751247 DOI: 10.1016/j.apmr.2015.11.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/16/2015] [Accepted: 11/20/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS). DATA SOURCES PubMed and Scopus (1980 to January 2015) and reference lists of eligible studies. STUDY SELECTION Eligible studies include adults with multiple sclerosis; have a cross-sectional or prospective observational design; or examine the effect of a theory-based intervention trial on PA, including a mediation analysis. Eligible studies also apply a quantitative assessment of PA and correlates or proposed mediators and are published in English or German language. DATA EXTRACTION Two reviewers independently evaluated the risk of bias, extracted data, and categorized variables according to the International Classification of Functioning, Disability and Health. DATA SYNTHESIS Consistency and the direction of associations were evaluated with a semiquantitative approach. Fifty-six publications with data from observational studies and 2 interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy, self-regulation constructs, employment status, and educational level. One interventional study provided evidence for a causal relation between self-regulation and PA. However, 59 of the 86 investigated variables in observational studies are based on 1 or 2 study findings, and most results stem from cross-sectional designs. CONCLUSIONS Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors (eg, PA-related self-efficacy, self-regulatory constructs, sociodemographic factors). Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.
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Affiliation(s)
- René Streber
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Peters
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Klaus Pfeifer
- Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
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Rosen LJ, Tillinger E, Guttman N, Rosenblat S, Zucker DM, Stillman F, Myers V. Parental receptivity to child biomarker testing for tobacco smoke exposure: A qualitative study. PATIENT EDUCATION AND COUNSELING 2015; 98:1439-45. [PMID: 26160037 DOI: 10.1016/j.pec.2015.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 02/20/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Widespread tobacco smoke exposure (TSE) of children suggests that parents may be unaware of their children's exposure. Biomarkers demonstrate exposure and may motivate behavior change, but their acceptability is not well understood. METHODS Sixty-five in-depth interviews were conducted with parents of young children, in smoking families in central Israel. Data were analyzed using thematic analysis. RESULTS Consent to testing was associated with desire for information, for reassurance or to motivate change, and with concerns for long-term health, taking responsibility for one's child, and trust in research. Opposition to testing was associated with preference to avoid knowledge, reluctance to cause short-term discomfort, perceived powerlessness, and mistrust of research. Most parents expressed willingness to allow measurement by urine (83%), hair (88%), or saliva (93%), but not blood samples (43%); and believed that test results could motivate behavior change. CONCLUSIONS Parents were receptive to non-invasive child biomarker testing. Biomarker information could help persuade parents who smoke that their children need protection. PRACTICE IMPLICATIONS Biomarker testing of children in smoking families is an acceptable and promising tool for education, counseling, and motivation of parents to protect their children from TSE. Additionally, biomarker testing allows objective assessment of population-level child TSE.
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Affiliation(s)
- Laura J Rosen
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Efrat Tillinger
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dept. of Sociology, Faculty of Social Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Nurit Guttman
- Dept. of Communications, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shira Rosenblat
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dept. of Communications, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - David M Zucker
- Dept. of Statistics, Hebrew University, Jerusalem, Israel
| | - Frances Stillman
- Dept. of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Vicki Myers
- Dept. of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Girelli L, Hagger M, Mallia L, Lucidi F. From perceived autonomy support to intentional behaviour: Testing an integrated model in three healthy-eating behaviours. Appetite 2015; 96:280-292. [PMID: 26423363 DOI: 10.1016/j.appet.2015.09.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 11/30/2022]
Abstract
A motivational model integrating self-determination theory, the theory of planned behaviour, and the health action process approach was tested in three samples in three behavioural contexts: fruit and vegetable, breakfast, and snack consumption. Perceived support for autonomous (self-determined) forms of motivation from parents and autonomous motivation from self-determination theory were hypothesised to predict intention and behaviour indirectly via the mediation of attitude and perceived behavioural control from the theory of planned behaviour. It was also expected that planning strategies would mediate the effect of intention on behaviour. Relations in the proposed models were expected to be similar across the behaviours. A two-wave prospective design was adopted. Three samples of high-school students (total N = 1041; 59.60% female; M age = 17.13 years ± 1.57) completed measures of perceived autonomy support, autonomous motivation, theory of planned behaviour constructs, planning strategies and behaviour for each of the three behavioural contexts. Three months later, 816 participants (62,24% female; M age: 17.13 years, SD = 1.58) of the initial sample self-reported their behaviour referred to the previous three months. Structural equation models provided support for the key hypothesised effects of the proposed model for the three health-related behaviours. Two direct effects were significantly different across the three behaviours: the effect of perceived autonomy support on perceived behavioural control and the effect of attitude on intention. In addition, planning strategies mediated the effect of intention on behaviour in fruit and vegetable sample only. Findings extend knowledge of the processes by which psychological antecedents from the theories affect energy-balance related behaviours.
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Affiliation(s)
- Laura Girelli
- Department of Psychology of Development and Socialization Processes - Sapienza, University of Rome, Italy.
| | - Martin Hagger
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Australia
| | - Luca Mallia
- Department of Psychology of Development and Socialization Processes - Sapienza, University of Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome, "Foro Italico", Italy
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization Processes - Sapienza, University of Rome, Italy
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Moshier SJ, Szuhany KL, Hearon BA, Smits JAJ, Otto MW. Anxiety Sensitivity Uniquely Predicts Exercise Behaviors in Young Adults Seeking to Increase Physical Activity. Behav Modif 2015; 40:178-98. [DOI: 10.1177/0145445515603704] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals with elevated levels of anxiety sensitivity (AS) may be motivated to avoid aversive emotional or physical states, and therefore may have greater difficulty achieving healthy behavioral change. This may be particularly true for exercise, which produces many of the somatic sensations within the domain of AS concerns. Cross-sectional studies show a negative association between AS and exercise. However, little is known about how AS may prospectively affect attempts at behavior change in individuals who are motivated to increase their exercise. We recruited 145 young adults who self-identified as having a desire to increase their exercise behavior. Participants completed a web survey assessing AS and additional variables identified as important for behavior change—impulsivity, grit, perceived behavioral control, and action planning—and set a specific goal for exercising in the next week. One week later, a second survey assessed participants’ success in meeting their exercise goals. We hypothesized that individuals with higher AS would choose lower exercise goals and would complete less exercise at the second survey. AS was not significantly associated with exercise goal level, but significantly and negatively predicted exercise at Time 2 and was the only variable to offer significant prediction beyond consideration of baseline exercise levels. These results underscore the importance of considering AS in relation to health behavior intentions. This is particularly apt given the absence of prediction offered by other traditional predictors of behavior change.
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Steca P, Pancani L, Greco A, D'Addario M, Magrin ME, Miglioretti M, Sarini M, Scrignaro M, Vecchio L, Cesana F, Giannattasio C, Fattirolli F, Zanettini R. Changes in Dietary Behavior among Coronary and Hypertensive Patients: A Longitudinal Investigation Using the Health Action Process Approach. Appl Psychol Health Well Being 2015. [PMID: 26218746 DOI: 10.1111/aphw.12050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a major cause of worldwide morbidity and mortality. Nutrition plays an important role in the primary, secondary, and tertiary prevention of CVDs. The present longitudinal study used the Health Action Process Approach (HAPA) to investigate changes in dietary behavior in coronary patients (CPs) affected by acute coronary syndrome and hypertensive patients (HPs) affected by essential arterial hypertension. METHODS CPs (N = 250) and HPs (N = 246) completed a questionnaire during three measurement points (baseline, 6-month follow-up, and 12-month follow-up). Statistical analyses included a repeated measures ANOVA and a multi-sample structural equation model. RESULTS HPs showed no changes in dietary behavior, whereas CPs improved their nutrition at 6 months and then maintained the healthier diet. The multi-sample analysis indicated equivalence of the HAPA model for both patient populations. CONCLUSIONS These findings provide further evidence for the generalisability of the HAPA model, shedding light on dietary behavior among CVD patients and particularly on hypertensive patients which has received little attention. Moreover, the equivalence of the model suggests that the process of change is almost identical for individuals who are at high risk for a coronary event (i.e. HPs) and individuals who have already had the event (i.e. CPs).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Francesca Cesana
- Niguarda Ca' Granda Hospital, Milan and University of Milan "Bicocca", Italy
| | | | - Francesco Fattirolli
- University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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