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Yu H, Zhu T, Tian J, Zhang G, Wang P, Chen J, Shen L. Physical activity and self-efficacy in college students: the mediating role of grit and the moderating role of gender. PeerJ 2024; 12:e17422. [PMID: 38803579 PMCID: PMC11129692 DOI: 10.7717/peerj.17422] [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: 11/15/2023] [Accepted: 04/28/2024] [Indexed: 05/29/2024] Open
Abstract
Background There is a paucity of knowledge concerning the psychological variables that serve to facilitate the connection between physical activity and self-efficacy, and the factors capable of moderating these pathways. This study aimed to examine the relationship between physical activity and self-efficacy among college students, with a focus on the mediating effect of grit and the moderating effect of gender. Methods This study recruited 3,228 undergraduate students from a university in Shanghai, China. They completed the General Self-Efficacy Scale, the Short Grit Scale, and the International Physical Activity Questionnaire. Statistical analysis was conducted using SPSS 26.0 and the Process v4.0 plugin. Results Physical activity had both a direct effect on self-efficacy (β = 0.07, 95% CI [0.04-0.11]) and an indirect effect through the two dimensions of grit: perseverance of effort (β = 0.06, 95% CI [0.04-0.07]) and consistency of interest (β = 0.03, 95% CI [0.02-0.04]). The mediating effect explained 53.27% of the total effect. Furthermore, gender moderated the relationship between perseverance of effort and self-efficacy, with a stronger effect observed in males (β = 0.08, t = 3.27, p < 0.01). Conclusion The results revealed that grit is an underlying psychological mechanism that links physical activity and self-efficacy. Moreover, gender moderates the effect of perseverance of effort on self-efficacy, with a stronger effect observed in males. These findings have practical implications for educators to design tailored physical activity interventions that foster grit and self-efficacy among college students.
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Affiliation(s)
- Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Tingfei Zhu
- Psychological Counseling Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Gang Zhang
- Shenzhen Shangbu Middle School, Shenzhen, China
| | - Peng Wang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Junxiong Chen
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Liqun Shen
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Latrille C, Hayot M, Bosselut G, Bughin F, Boiché J. Determinants of physical activity in newly diagnosed obstructive sleep apnea patients: testing the health action process approach. J Behav Med 2024:10.1007/s10865-024-00474-6. [PMID: 38413452 DOI: 10.1007/s10865-024-00474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France.
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France.
| | - Maurice Hayot
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Grégoire Bosselut
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
| | - François Bughin
- PhyMedExp, CNRS, CHRU, INSERM, University of Montpellier, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 avenue du Pic Saint-Loup, 34090, Montpellier, France
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Zhang D, Liu R, Li X, Yuan Y, Zhou G. How do self-exempt beliefs affect intentions to quit smoking? An exploration of the mediating role of threat appraisal and coping appraisal. Front Psychol 2023; 14:1260561. [PMID: 38098517 PMCID: PMC10720447 DOI: 10.3389/fpsyg.2023.1260561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Numerous smokers are cognizant of the detrimental effects associated with this habit yet exhibit a persistent reluctance to cease their tobacco consumption. Self-exempt beliefs serve as an obstacle to the cessation of this addictive behavior. This research explored the impact of self-exempt beliefs on the readiness to quit smoking based on the Protection Motivation Theory (PMT) model and the mediating roles of threat appraisal and coping appraisal. Methods Self-exempt beliefs, PMT constructs, and the intention to quit smoking constituted the theoretical model. The questionnaires were collected from 488 Chinese adult male smokers based on snowball sampling. Exploratory Factor Analysis (EFA) was used to examine the underlying factor structure of the pre-designed self-exempt beliefs scale. The reliability, validity, path coefficients, and explanatory power of the model were calculated using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results and discussion The results showed that : (1) three common factors (skeptic beliefs, bulletproof beliefs, and "worth it" beliefs) with a total of 11 items were retained after EFA; (2) skeptic beliefs and "worth it" beliefs had a significantly negative effect on both threat appraisal and coping appraisal, while bulletproof beliefs did not; (3) bulletproof beliefs had a significantly positive direct impact on intention to quit, "worth it" beliefs had a significantly negative direct impact on intention, while skeptic beliefs had no significantly direct impact on intention; (4) threat appraisal and coping appraisal positively and significantly predicted cessation intention; and (5) threat appraisal and coping appraisal, as two main cognitive processes, acted as full mediations between skeptic beliefs and the intention to quit, as complementary partial mediations between "worth it" beliefs and the intention, and as non-mediation between bulletproof beliefs and the intention. Our findings suggest that efforts to undermine or "prevent" these self-exempt beliefs, particularly "worth it" and skeptic beliefs, may be an effective tactic for health communication interventions for quitting smoking.
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Affiliation(s)
- Dan Zhang
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
- Guizhou Provincial Institute of Health Development, Guizhou Medical University, Guiyang, China
| | - Runhua Liu
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
- Guizhou Provincial Institute of Health Development, Guizhou Medical University, Guiyang, China
| | - Xinchen Li
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
| | - Yuanyuan Yuan
- Department of Management Engineering, Guizhou Traffic Technician and Transportation College, Guiyang, China
| | - Geyao Zhou
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Guiyang, China
- Guizhou Provincial Institute of Health Development, Guizhou Medical University, Guiyang, China
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Yongpet R, Seangpraw K, Ong-Artborirak P. Association between Perceived Protection Motivation, Preventive Behaviors, and Biomarkers among Diabetic Patients in Rural Areas of Thailand. Clin Pract 2023; 13:1400-1412. [PMID: 37987427 PMCID: PMC10660454 DOI: 10.3390/clinpract13060126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
The prevalence of diabetes mellitus (DM) is increasing rapidly worldwide. Without proper management, DM can have serious complications. We aimed to investigate the association between protection motivation theory (PMT) constructs, self-care behaviors, and biomarkers among diabetic patients in a community in northern Thailand. A cross-sectional study was conducted. Simple random sampling was used to select 422 subjects from patients enrolled in primary care in Chiang Rai Province. Data were collected using questionnaires and blood sampling to measure fasting blood sugar (FBS) and glycated hemoglobin (HbA1c). Pearson's correlation and multiple linear regression were used to analyze the data. The diabetic subjects' age was 62.25 years (standard deviation [SD] = 8.90), and the duration of diabetes was 9.07 years (SD = 7.23). Positive correlations were found between the DM knowledge score and the PMT score (r = 0.812, p < 0.01) and between the PMT score and the preventive behavior score (r = 0.817, p < 0.01). The preventive behavior score was negatively correlated with FBS (r = -0.319, p < 0.01) and HbA1c (r = -0.625, p < 0.01) and significantly associated with income (B = 0.15) and the PMT score (B = 0.71), accounting for 67.0% of the variance. Age (B = -0.73), sleep problems (B = 10.71), and the preventive behavior score (B = -1.15) were statistically significantly associated with FBS (R2 = 14.3%). Four variables, the female gender (B = -0.26), being married (B = -0.24), sleep problems (B = 0.42), and the preventive behavior score (B = -0.09), were statistically significantly associated with HbA1c levels (R2 = 41.6%). Health education programs should primarily target awareness of disease severity, complications, and self-efficacy enhancement to generate intention and behavior change. This may delay or reduce the occurrence of diabetes-related complications in people with type 2 diabetes.
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Affiliation(s)
| | | | - Parichat Ong-Artborirak
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand;
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Latrille C, Chapel B, Héraud N, Bughin F, Hayot M, Boiché J. An individualized mobile health intervention to promote physical activity in adults with obstructive sleep apnea: An intervention mapping approach. Digit Health 2023; 9:20552076221150744. [PMID: 36776408 PMCID: PMC9909081 DOI: 10.1177/20552076221150744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023] Open
Abstract
Objective Combining continuous positive airway pressure with physical activity (PA) might be a promising strategy to treat obstructive sleep apnea (OSA). This article describes how intervention mapping (IM) can guide the development, content, and mechanisms of action of a mobile application to promote PA in adults with OSA. Methods To develop the program, the IM approach was followed. This article presents the first three steps of IM to develop a mixed intervention (with interventionists and a digital application) aiming to: (1) assess patients' health problems and needs in a literature review to determine their expectations and perceived facilitators and barriers to PA behavior change and thus select the determinants of behavior; (2) formulate the expected intervention outcomes and objectives to be met to achieve the overall program goals; and (3) select and implement the behavior change techniques (BCTs) to achieve the change objectives. Results The literature review identified the relevant determinants (e.g., self-efficacy, coping, planning, and habit) of PA behavior using the health action process approach and multiprocess action control. These results were used to specify the program outcomes for PA adapted to physical, psychological, and social parameters. Overall, 11 performance objectives and 30 change objectives were defined. Lastly, BCTs and practical applications were identified. Conclusions The study provides a theoretical and methodological basis for researchers and practitioners given the current paucity of evidence-based PA interventions for adults with OSA. It addresses the lack of BCTs (framing and prompts/cue techniques) and meaningful behavioral determinants (identity and habit) in most interventions.
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Affiliation(s)
- Christophe Latrille
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France,PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France,Christophe Latrille, University of Montpellier, 700 avenue du Pic Saint-Loup, Montpellier 34090, France.
| | - Blandine Chapel
- Montpellier Research of Management MRM, University of Montpellier, Montpellier, France
| | - Nelly Héraud
- Direction de la recherche clinique et de l'innovation en santé, Korian SA, Lodève, France
| | - François Bughin
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Maurice Hayot
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Julie Boiché
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
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Vlcek C, Greenberg D, Yardley JE, Klaprat N, MacIntosh A, Greenberg M, Brandt J, Gregoire N, Dostie S, Boutin D, Pow C, Archibald M, McGavock J. "How we do it": A qualitative study of strategies for adopting an exercise routine while living with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 13:1063859. [PMID: 36686448 PMCID: PMC9849595 DOI: 10.3389/fendo.2022.1063859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction For people living with type 1 diabetes (T1D) the challenge of increasing daily physical activity (PA) is compounded by the increased risks of hypoglycemia and glucose variability. Little information exists on the lived experience of overcoming these barriers and adopting and maintaining an active lifestyle while living with T1D. Research Design and Methods We conducted a patient-led qualitative study consisting of semi-structured interviews or focus groups with 22 individuals at least 16 years old living with T1D. We used existing patient co-researcher networks and snowball sampling to obtain a sample of individuals who reported being regularly physically active and had been diagnosed with T1D for at least one year. We used an interpretive description analysis to generate themes and strategies associated with maintaining an active lifestyle while living with T1D. We involved patient co-researchers in study design, data collection, and interpretation. Results 14 self-identified women and 8 self-identified men (ages 19-62, median age 32 years) completed the study, led by either a researcher, or a patient co-researcher and research assistant regarding their strategies for maintaining an active lifestyle. We identified five themes that facilitate regular sustained PA: (1) Structure and organization are important to adopt safe PA in daily life "I can't do spontaneous exercise. I actually need a couple hours of warning minimum"; (2) Trial and error to learn how their body responds to PA and food "Once you put the time and effort into learning, you will have greater success"; (3) Psychosocial aspects of PA "…because it's not just your body, it's your soul, it's your mind that exercise is for"; (4) Diabetes technology and (5) Education and peer support. Strategies to overcome barriers included (1) Technology; (2) Integrating psychosocial facilitators; (3) Insulin and carbohydrate adjustments; and (4) Planning for exercise. Conclusions Living an active lifestyle with T1D is facilitated by dedicated structure and organization of routines, accepting the need for trial and error to understand the personalized glycemic responses to PA and careful use of food to prevent hypoglycemia. These themes could inform clinical practice guidelines or future trials that include PA interventions.
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Affiliation(s)
- Cristine Vlcek
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | | | - Jane E. Yardley
- Diabetes Action Canada, Toronto, ON, Canada
- Augustana Faculty, University of Alberta, Camrose, AB, Canada
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Alberta Diabetes Institute, Edmonton, AB, Canada
- Women and Children’s Health Research Institute, Edmonton, AB, Canada
| | - Nika Klaprat
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
| | - Andrea MacIntosh
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
| | | | | | | | | | | | - Conrad Pow
- Diabetes Action Canada, Toronto, ON, Canada
| | - Mandy Archibald
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan McGavock
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
- Diabetes Action Canada, Toronto, ON, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
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Maxwell CA, Roberts C, Oesmann K, Muhimpundu S, Archer KR, Patel MR, Mulubrhan MF, Muchira J, Boon J, LaNoue M. Health and wellness for disadvantaged older adults: The AFRESH pilot study. PEC INNOVATION 2022; 1:100084. [PMID: 37213747 PMCID: PMC10194225 DOI: 10.1016/j.pecinn.2022.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/23/2022] [Accepted: 09/13/2022] [Indexed: 05/23/2023]
Abstract
Introduction Older adults are unaware of the biological mechanisms that contribute to the development of disabilities, chronic conditions, and frailty, yet, when made aware, desire to employ lifestyle changes to mitigate these conditions. We developed the AFRESH health and wellness program and report on pilot testing undertaken in a local older adults apartment community. Materials and methods After program development, pilot testing was conducted. Participants: Older adults (N = 20; age 62+) residing in an apartment community. Procedures: Collection of baseline objective and self-report measures with a focus on physical activity; administration of the 10-week AFRESH program via weekly sessions; collection of follow-up data 12 and 36 weeks after baseline data collection. Data analysis: Descriptive statistics, growth curve analyses. Results Significant increases were observed for grip strength (lbs) (T1:56.2; T2:65.0 [d = 0.77]; T3:69.4 [d = 0.62], p = .001), the 6-min walk test (meters) (T1:327m: T2:388.7 m [d = 0.99]; T3:363.3 m [d = 0.60], p = .001), the Rapid Assessment of Physical Activity (RAPA) strength and flexibility score, and the Pittsburg Sleep Quality Index (PSQI) global score. These effects showed some attenuation by the final time point. Conclusion By combining novel educational content (bioenergetics), facilitation of physical activity, and habit formation, AFRESH is a multicomponent intervention that shows promise for future research.
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Affiliation(s)
- Cathy A Maxwell
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Corley Roberts
- Catholic Charities, 2806 McGavock Pike, Nashville, TN 37214, USA
| | - Kelsey Oesmann
- Urban Housing Solutions, 822 Woodland St., Nashville, TN 37206, USA
| | - Sylvie Muhimpundu
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Kristin R Archer
- Vanderbilt University Medical Center, 1215 21 Ave. South, Nashville, TN 37232, USA
| | - Maulik R Patel
- Vanderbilt University Biological Sciences, Box 351634, Nashville, TN 37235, USA
| | - Mogos F Mulubrhan
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - James Muchira
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Jeffrey Boon
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
| | - Marianna LaNoue
- Vanderbilt University School of Nursing, 461 21st Ave. South, Nashville, TN 37240, USA
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AlBurno H, Mercken L, de Vries H, Al Mohannadi D, Schneider F. Determinants of healthful eating and physical activity among adolescents and young adults with type 1 diabetes in Qatar: A qualitative study. PLoS One 2022; 17:e0270984. [PMID: 35793375 PMCID: PMC9258857 DOI: 10.1371/journal.pone.0270984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Qatar, as in the rest of the world, the sharp rise in the prevalence of type 1 diabetes (T1D) is a leading cause for concern, in terms associated with morbidity, mortality, and increasing health costs. Besides adhering to medication, the outcome of diabetes management is also dependent on patient adherence to the variable self-care behaviors including healthful eating (HE) and physical activity (PA). Yet, dietary intake and PA in adolescents and young adults (AYAs) with T1D are known to fall short of recommended guidelines. The aim of this study was to develop an in-depth understanding of the behavioral determinants of HE and PA adherence among Arab AYAs within the age range of 17-24 years with T1D attending Hamad General Hospital. METHODS Semi-structured, face-to-face individual interviews were conducted with 20 participants. Interviews were based on an integrative health behavior change model, the I-Change model (ICM). All interviews were audio-recorded, transcribed verbatim, and analyzed using the framework method. RESULTS More participants reported non-adherence than adherence. Several motivational determinants of adherence to HE and PA were identified. The majority of participants were cognizant of their own behaviors towards HE and PA. Yet, some did not link low adherence to HE and PA with increased risks of health problems resulting from T1D. Facilitators to adherence were identified as being convinced of the advantages of HE and PA, having support and high self-efficacy, a high level of intention, and a good health care system. CONCLUSION The suboptimal adherence in AYAs to HE and PA needs more attention. Supportive actions are needed to encourage adherence to a healthy lifestyle to achieve benefits in terms of glycemic control and overall health outcomes, with a special focus on adolescents. Interventions are needed to foster motivation by addressing the relevant determinants in order to promote adherence to these two behaviors in AYAs with T1D.
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Affiliation(s)
- Hanan AlBurno
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
| | - Liesbeth Mercken
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
- Faculty of Psychology, Department of Health Psychology, Open University of The Netherlands, Heerlen, The Netherlands
| | - Hein de Vries
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
| | - Dabia Al Mohannadi
- Department of Endocrinology and Diabetes, Hamad General Hospital, Doha, Qatar
| | - Francine Schneider
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands
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Acar D, Kıcali ÜÖ. An Integrated Approach to COVID-19 Preventive Behaviour Intentions: Protection Motivation Theory, Information Acquisition, and Trust. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:419-434. [PMID: 34962187 DOI: 10.1080/19371918.2021.2018082] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 has been a global threat since November 2019 due to its high transmission rates and the issue of unwillingness to vaccinate. Effective risk management requires accurate health communication and public compliance with reccomended preventive behaviors. Therefore, we investigated predictors of COVID-19 preventive behavior intention based on Protection Motivation Theory (PMT) in addition to frequency of public's use of and trust in a group of COVID-19 related information sources. This cross-sectional study was conducted on 458 adults in Turkey with online survey. Results showed that all PMT components (except perceived susceptibility) accounted for 49% of the variance in protection motivation and there was relationship between information sources and protection motivation. Overall, our study findings suggested that being more informed and having confidence in the feasibility (self-efficacy) and effectiveness (response efficacy) of preventive behaviors may particularly help slow the disease spread.
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Affiliation(s)
- Didem Acar
- Psychology Department, Bursa Uludağ University, Bursa, Turkey
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Maasoumi R, Kazemi S, Haghani S, Zarei F. Motivation for protection in sexual relationship during the COVID-19 quarantine: analysis of the sociodemographic variables of the Iranian population. BMC Public Health 2022; 22:1052. [PMID: 35619130 PMCID: PMC9133316 DOI: 10.1186/s12889-022-13475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Coronavirus is an infectious disease that has affected sexual life. Sexual activity has decreased for many people, and couples' physical contact has reduced. The present study aimed to determine the sexual relationship of Iranian people and related factors during the Corona home quarantine by focusing on all constructs of the protective motivation theory. Methods This cross-sectional online survey was conducted on Iranian people under in-home quarantine from July to December 2020 during the Covid-19 pandemic. Seven hundred sixteen people were selected by the convenience sampling method. The data was gathered by an ad-hoc tool consisting of demographic information and sexual relationship regarding protection motivation behavior in the Covid-19 pandemic. Participants should be able to complete the online questionnaire because the questionnaires were completed online. One-way ANOVA, independent T, and Pearson correlation tests were used to analyze the data in SPSS 16 software. Results Findings indicate the average age of the participants was 37.78 + 8.34 years. Most of them were women (%85.1), married (%91.3) and had a university education (%90.2). In addition, %42.5% of participants had Full-time jobs and %34.2 lived in Tehran. 49.9% obtained information about corona from TV. 63.3% of the participants and their spouses did not catch Covid-19. Employment status was the only variable that was significantly different from sexual relationships regarding protection motivation (p = 0.031). Perceived response efficiency with an average of 79.12 had the highest, and perceived self-efficacy with an average of 69.92 had the lowest mean score among the areas of sexual relationship. Among the protection motivation domains of sexual behavior that all had significant correlations, there was no significant correlation between perceived severity and perceived self-efficacy (p = 0.067). Conclusion and implication Perceived vulnerability is associated with employment status, place of residence, and age. Sexual relationships regarding protection motivations are only associated with employment status. Overall, participants in the present study reported high levels of perceived severity, perceived vulnerability, perceived response efficiency, and perceived costs Therefore, they reported a high level of motivation for protective and preventive behaviors in their sexual relationship. Our findings suggest that future interventions should focus on general cognition by developing appropriate knowledge about the severity and vulnerability of Covid-19 and sexual behaviors, improving perceived response efficiency, and self-efficacy of protective behavior through skills training.
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Affiliation(s)
- Raziyeh Maasoumi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Kazemi
- Department of Health Education & Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zarei
- Department of Health Education & Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box, Tehran, 14115-331, Iran.
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Lim TJ, Okine RN, Kershaw JC. Health- or Environment-Focused Text Messages as a Potential Strategy to Increase Plant-Based Eating among Young Adults: An Exploratory Study. Foods 2021; 10:foods10123147. [PMID: 34945698 PMCID: PMC8701197 DOI: 10.3390/foods10123147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Previous plant-based diet (PBD) adoption strategies have primarily focused on health rather than environmental rationale and meat reduction rather than plant-based protein promotion. In this study, we explored the effect of a theory-informed text-message intervention on dietary intentions and behaviors in young adult omnivores and the potential explanatory role of PBD beliefs, subjective norm, self-efficacy, moral norm, and health and environmental values. Participants completed baseline questionnaires and reported dietary intake before being randomly assigned to receive 2–3 health- or environment-focused text messages per week for eight weeks and then repeated baseline assessments. Although we did not see significant changes in meat or plant protein intake, we did observe a marked decrease in intentions to consume animal protein and a marginal increase in fruit and vegetable consumption intention. We identified subjective norms, self-efficacy, and moral satisfaction as the strongest predictors of changes in intention to consume animal or plant protein. Although few group differences were observed, those receiving environment-focused text messages experienced a greater change in values and were more likely to increase vegetable intake. Messages that improve sustainability awareness and provide practical adoption strategies may be part of an effective strategy to influence PBD intake among young adults.
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Affiliation(s)
- Tze Joo Lim
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Richard Nii Okine
- Department of Mathematics and Statistics, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Jonathan C. Kershaw
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
- Correspondence: ; Tel.: +1-419-372-4579
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12
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The Effect of Integrated Intervention Based on Protection Motivation Theory and Implementation Intention to Promote Physical Activity and Physiological Indicators of Patients with Type 2 Diabetes. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6637656. [PMID: 34258275 PMCID: PMC8245219 DOI: 10.1155/2021/6637656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/12/2021] [Indexed: 11/17/2022]
Abstract
Despite benefits of physical activity, the level of physical activity is not desirable in patients with type 2 diabetes. The aim of this study is the using of integration of intervention based on the theory of protection motivation and implementation intention in order to improve the level of activity in patients with diabetes. This field trial study has been performed on 125 patients with type 2 diabetes. Samples have been randomly selected, and they are divided into two intervention and control groups. In the intervention group, training sessions were conducted based on the protection motivation theory and implementation intention. Physical activity levels, VO2 max, and hemoglobin A1C were measured before and three months after the intervention in the two groups. Data were analyzed by using SPSS 18, and independent t-test, paired t-test, and equivalent nonparametric tests were used for analyzing abnormal data. The results of this study showed that the level of physical activity was higher in the intervention group (p = 0.02). Also, the amount of hemoglobin A1c in the intervention group has been decreased significantly three months later (p < 0.001). In this study, VO2 max and blood lipids were not significantly different in the two groups. However, there was higher VO2 max compared to before the intervention in the intervention group. The present study showed that combining motivational interventions and implementing intention intervention can be effective in promoting the physical activity of patients with type 2 diabetes.
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13
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Lee BK. Comparison of Prevalence of Hyperlipidemia, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study of 2018 Korea Medical Panel. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is to compare the difference in the prevalence of hyperlipidemia according to the level of physical activity in adults, and to compare the difference between annual personal medical expenses, hospitalization, emergency and outpatient use depending on the level of physical activity for hyperlipidemia patients.METHODS The 2018 Korea medical panel data was used (14,489 adults and 2,559 Hyperlipidemia). Physical activity was measured with short form of IPAQ and converted to MET-minutes per week. The days of hospitalization, and personal medical expenses were compared, and frequency analysis, logistic regression, ANOVA and chi-square were performed.RESULTS The prevalence of hyperlipidemia based on the inactive group were decreased both minimally active group (OR = 0.94) and the active group (OR = 0.74, p<0.01). Annual personal medical expenses I (p<.01) and II (p<.01) with hyperlipidemia were all showed significant differences depending on the level of physical activity. On active group basis, medical expenses showed slight differences of 3.0 to 3.2% with the minimally activity group, but that of the inactive group were 19.3 ~ 21.7% higher. The annual days of hospitalization were 6.8 ± 7.2 days in activity group, minimally activity group 7.1 ± 7.2 days, inactive group 11.7 ± 26.0 days. There was no significant difference in the annual days of hospitalization and emergency between the three groups. In particular, the annual days of outpatient increased sharply at the inactive group. Participation in physical activity has been shown to have a significant effect on hospitalization and decreasing use of emergency rooms.CONCLUSIONS Hyperlipidemia prevalence was similar to inactive groups and minimally activity groups, and that of activity groups was 0.74. On medical expenses of hyperlipidemia, the activity and minimally activity group was similar, the inactivity group was 19.3 to 21.7% higher. Physical activity was found to have a positive effect on hospitalization and emergency use reduction.
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14
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Cheval B, Maltagliati S, Sieber S, Beran D, Chalabaev A, Sander D, Cullati S, Boisgontier MP. Why Are Individuals With Diabetes Less Active? The Mediating Role of Physical, Emotional, and Cognitive Factors. Ann Behav Med 2021; 55:904-917. [PMID: 33491067 DOI: 10.1093/abm/kaaa120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite the key role of physical activity in the management of diabetes, many individuals with diabetes do not engage in the recommended levels of physical activity. However, our knowledge of the mechanisms underlying the relationship between diabetes and physical inactivity is limited. PURPOSE To investigate the associations between diabetes and the levels and evolution of physical activity across aging, and to determine whether physical, emotional, and cognitive factors mediate these associations. METHODS Data from 105,622 adults aged 50-96 years from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used in adjusted linear mixed models to examine whether diabetes was associated with physical activity levels and variations across aging. The potential mediators were subjective energy, muscle strength, physical and cognitive disability, sleep problems, depressive symptoms, and cognitive functions. The variables were measured up to seven times over a 13-year period. RESULTS Individuals with diabetes demonstrated a lower level and a steeper decrease in physical activity across aging than individual without diabetes. Mediators explained ~53% and 94% of the association of diabetes with the level of physical activity and with the linear evolution of physical activity across aging, respectively. All mediators were significantly associated with physical activity. Physical and cognitive disability as well as depressive symptoms were the strongest mediators, while sleep was the lowest one. CONCLUSIONS These findings suggest that the etiology of physical inactivity in individuals with diabetes can result from several physical, emotional, and cognitive changes associated with the emergence of this disease.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Stefan Sieber
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Switzerland
| | | | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Switzerland.,Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Matthieu P Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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15
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Mohammadi Zeidi I, Morshedi H, Shokohi A. Predicting psychological factors affecting regular physical activity in hypertensive patients: Application of health action process approach model. Nurs Open 2021; 8:442-452. [PMID: 33318852 PMCID: PMC7729665 DOI: 10.1002/nop2.645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/12/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022] Open
Abstract
Aim The aim of this study was to determine the factors affecting the behaviour of regular physical activity in patients with hypertension using the health action process approach (HAPA) model. Design This cross-sectional study was conducted on 176 hypertension patients, in Astaneh-e-Ashrafiyeh, Guilan, Iran, 2018-2019. Methods Data collection tools included demographic characteristics, medical history, the short form of International Physical Activity Questionnaire (IPAQ) and scales related to the HAPA model. The data were analysed using chi-square, independent t test, one-way ANOVA, Pearson's correlation coefficient and path analysis on AMOS, version 23.0. Results Action self-efficacy (β = 0.59), outcome expectancy (β = 0.20) and risk perception (β = 0.18) had a statistically significant effect on intention. Moreover, the path coefficient between intention (β = 0.35) and coping self-efficacy (β = 0.29) with physical activity was statistically significant. The results revealed that HAPA constructs were able to describe 45% of the variance in intention and 31% of the variance in physical activity behaviour. Conclusion The HAPA model is a useful framework for describing the factors affecting physical activity in hypertension patients.
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Affiliation(s)
- Isa Mohammadi Zeidi
- Social Determinants of Health Research CenterResearch Institute for Prevention of Non‐Communicable DiseasesQazvin University of Medical SciencesQazvinIran
| | - Hadi Morshedi
- Social Determinants of Health Research CenterResearch Institute for Prevention of Non‐Communicable DiseasesQazvin University of Medical SciencesQazvinIran
| | - Abdollah Shokohi
- Student Research CommitteeQazvin University of Medical SciencesQazvinIran
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16
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Chamroonsawasdi K, Chottanapund S, Pamungkas RA, Tunyasitthisundhorn P, Sornpaisarn B, Numpaisan O. Protection motivation theory to predict intention of healthy eating and sufficient physical activity to prevent Diabetes Mellitus in Thai population: A path analysis. Diabetes Metab Syndr 2021; 15:121-127. [PMID: 33340872 DOI: 10.1016/j.dsx.2020.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Diabetes mellitus is a global health problem causing premature death and economic burden. The study aimed to investigate an application of the protection motivation theory (PMT) model to explain the intention of healthy eating behaviors and physical activity among healthy Thais. METHODS This study was a part of a large case control focused only on the control group without noncommunicable diseases. Nine hundred ninety-seven subjects were drawn from eleven provinces of Thailand. A self-administered questionnaire was constructed based on the PMT model to gather information on predictive factors on eating behaviors and physical activity. Path analysis was used to determine whether the empirical data fit the PMT structure as well as to assess the strength of association among PMT constructed factors predicting behavioral intention. RESULTS The findings demonstrated that empirical data of eating behaviors (CMIN χ2 p-value = 0.462; CMIN/df = 0.901; NFI = 0.997; CFI = 1; RMSEA <0.001) and physical activity (CMIN χ2 p-value = 0.053; CMIN/df = 2.187; NFI = 0.987; CFI = 0.993; RMSEA = 0.035) fit the PMT. The strongest predictive factor of behavioral intention on eating behaviors was response efficacy (β = 0.146), while self-efficacy was found to be the strongest factor for physical activity (β = 0.11). Knowledge had the only indirect effect on behavior intention through perceived susceptibility and perceived severity. CONCLUSION In conclusion, information on susceptibility and severity should be incorporated in intervention strategies to enhance response efficacy and self-efficacy to prevent diabetes.
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Affiliation(s)
- Kanittha Chamroonsawasdi
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand.
| | - Suthat Chottanapund
- Bamrasnaradura Infectious Disease Institute, Ministry of Public Health, Nonthaburi, 11000, Thailand.
| | - Rian Adi Pamungkas
- Department of Nursing, Faculty of Health Sciences, Esa Unggul University, Jakarta, 11530, Indonesia.
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17
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Application of protection motivation theory to diabetic foot care Behaviours in Egypt. J Diabetes Metab Disord 2020; 19:869-873. [PMID: 33520808 DOI: 10.1007/s40200-020-00573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Foot care behaviours are considered the first line of defense against diabetic foot complications. In general, preventive behaviours are determined by multiple personal, social and psychological factors. The aim of this study was to assess foot care behaviours and their relation to protection motivation theory among a sample of adults with diabetes in Egypt. METHODS A self-administered questionnaire was used to collect data about foot care practices and protection motivation theory among a random sample of 300 adults with diabetes attending primary health care units in Egypt. RESULTS The results demonstrated that the foot care behaviours were inadequate amongst the sample(mean 5.13 ± 1.92 out of 11). Three constructs of protection motivation theory predicted the behaviours, namely: self-efficacy (p = 0.015), perceived seriousness (p = 0.013) and intention to adhere to foot care (p = 0.021). On the other hand, intention to adhere to foot care was correlated with higher levels of self-efficacy and perceived seriousness, and to lower levels of perceived barriers. CONCLUSION There was a low level of foot self-care amongst the sample. Health education programs reinforcing the intention to adhere to foot care behaviours can improve foot care practices among people with diabetes through increasing self-efficacy and perceived seriousness and reducing perceived barriers.
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18
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Brennan MC, Brown JA, Ntoumanis N, Leslie GD. Barriers and facilitators of physical activity participation in adults living with type 1 diabetes: a systematic scoping review. Appl Physiol Nutr Metab 2020; 46:95-107. [PMID: 32835497 DOI: 10.1139/apnm-2020-0461] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion/inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full-text articles were assessed for eligibility against the exclusion/inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Hypoglycaemia/fear of hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour-change interventions combined with targeted patient education is needed to address hypoglycaemia/fear of hypoglycaemia as a barrier to PA. Novelty: Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to PA in adults with T1D. Powered randomised controlled trials are required to establish efficacy of behaviour change interventions targeting these barriers to PA.
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Affiliation(s)
- Marian C Brennan
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Health Services, Diabetes WA, Subiaco, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Janie A Brown
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,St John of God Midland Public and Private Hospital, Midland, WA 6056, Australia
| | - Nikos Ntoumanis
- School of Psychology/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Gavin D Leslie
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
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19
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The demographic and Psychological determinants of performing Mammography among the Employed Women in Medical Professions in western Iran: the Role of Threat Appraisal and Coping Appraisal. PAJOUHAN SCIENTIFIC JOURNAL 2019. [DOI: 10.52547/psj.18.1.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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20
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Wilczynska M, Lubans DR, Paolini S, Plotnikoff RC. Mediating Effects of the 'eCoFit' Physical Activity Intervention for Adults at Risk of, or Diagnosed with, Type 2 Diabetes. Int J Behav Med 2019; 26:512-521. [PMID: 31270732 DOI: 10.1007/s12529-019-09800-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The study aim was to examine the mechanisms of physical activity behaviour change in the multi-component eCoFit randomised controlled trial (RCT) among adults diagnosed with, or at risk of, T2D. METHOD The RCT included two phases: phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring) and the use of the eCoFit smartphone application (app), and phase 2 (weeks 11-20), which included the use of the eCoFit smartphone application only. Participants (n = 84) were assessed at baseline and 10 and 20 weeks from baseline. Physical activity was assessed using pedometers, and the following mediators were tested: action self-efficacy, barrier self-efficacy, recovery self-efficacy, implementation intentions, intention to have regular physical activity, outcome expectations, risk perception and implicit associations related to physical activity. The PROCESS INDIRECT Macro was used to perform mediation analyses. RESULTS Significant mediation pathways were found for implementation intention measured at 10 weeks, AB (95% CI = 486.04 [128.19, 1073.42]). No significant pathways were found for the other social-cognitive and implicit attitudinal mediators. CONCLUSION Increased daily steps among the intervention participants were explained by increased implementation intentions. The eCoFit study successfully operationalised implementation intentions in the smartphone app designed to promote outdoor physical activity. TRIAL REGISTRATION The trial was approved by a University Human Research Committee and is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12615000990527).
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Affiliation(s)
- Magdalena Wilczynska
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia
- School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia
| | - Stefania Paolini
- School of Psychology, The University of Newcastle, SO E1.22 Science Offices, Ourimbah, NSW, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia.
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21
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Kim Y. The effects of a physical inactivity-related health risk message intervention on changes in risk perceptions and physical activity in middle-aged women. J Women Aging 2019; 32:546-562. [PMID: 31038394 DOI: 10.1080/08952841.2019.1607678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The study investigated the effects of the physical inactivity-related health risk message intervention on changes in risk perception for diseases. Forty-one women participated in the 16-week intervention. During this period, the study participants' physical activity, risk perceptions, and objective risk factors were measured. Results indicated that the intervention had a significant effect on improving perceived health risk of heart disease and obesity. Moreover, changes in perceived risk showed significant effect on changes in physical activity over the 16-week intervention. The study provided both theoretical and practical implications for perceived health risk as a predictor of physical activity.
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Affiliation(s)
- Youngho Kim
- Department of Sport Science, Seoul National University of Science and Technology , Seoul, Korea
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22
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Ghaffari M, Rakhshandehrou S, Tezval J, Harooni J, Armoon B. Skin cancer-related coping appraisal among farmers of rural areas: Applying protection motivation theory. J Cosmet Dermatol 2019; 18:1830-1836. [PMID: 30932297 DOI: 10.1111/jocd.12929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 11/07/2018] [Accepted: 02/25/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Skin cancers are the most common malignancies in Iran. According to the statistics, skin cancer is the most prevalent cancer in Ilam city. This study is conducted to evaluate skin cancer coping of farmers in rural areas of Ilam city. METHODS This is a cross-sectional study. Samples were collected by multistage random sampling. The required data were collected by a researcher-made questionnaire from 248 farmers in rural areas of Ilam city. Questions were based on the protection motivation theory, and they were related to the subscales of response efficacy, self-efficacy, and response costs. Collected data were analyzed by SPSS software version 16. RESULTS Results of this study indicated that efficacy and perceived self-efficacy in farmers were low and response cost was high. The efficacy and perceived self-efficacy were high in 18.1% and 4.8% of farmers, respectively, and only 4.4% of them had low response costs, in association with protective behaviors. Regarding coping appraisal status also results showed that 204 people of farmers (82.3%) were unacceptable, one person (0.4%) was in the borderline, and 43 people (17.3%) were acceptable. There was a statistically significant association between coping appraisal status and education level and also income amount (P < 0.001) but there was no statistically significant association between coping appraisal status and family size (P > 0.670). CONCLUSION The founding proved that a coping appraisal is a beneficial approach for predicting cognitive determinants of skin cancer behavior among rural farmers. The most farmers have been the low level of coping appraisal (82.3% were unacceptable).
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Affiliation(s)
- Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, Department of Health Education & Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshandehrou
- Environmental and Occupational Hazards Control Research Center, Department of Health Education & Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jafar Tezval
- Department of Health Education & Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran/Ilam University of Medical Sciences, Ilam Health Center, Ilam, Iran
| | - Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.,School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
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23
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Murphy ML, Lubans DR, Cohen KE, Robards SL, Wilczynska M, Kennedy SG, James EL, Brown WJ, Courneya KS, Sigal RJ, Plotnikoff RC. Preliminary efficacy and feasibility of referral to exercise specialists, psychologists and provision of a technology-based behavior change support package to promote physical activity in school teachers 'at risk' of, or diagnosed with, type 2 diabetes: The 'SMART Health' Pilot Study Protocol. Contemp Clin Trials 2019; 78:53-62. [PMID: 30639752 DOI: 10.1016/j.cct.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) is a global public health concern. Aerobic physical activity (PA) and resistance training (RT) play significant roles in the prevention and management of T2DM. The aim of this pilot trial is to determine the preliminary efficacy and confirm feasibility of referral to exercise physiologists, psychologists, and provision of a technology-based behavior change support package to promote aerobic PA and RT in school teachers 'at risk' of or diagnosed with T2DM. RESEARCH DESIGN AND METHODS The SMART (Support, Motivation and Physical Activity Research for Teachers') Health pilot study will be evaluated using a three-arm randomized controlled trial. The intervention will be guided by Social Cognitive Theory, Health Action Process Approach Model and Cognitive Behavioral Therapy strategies. The participants will be randomly allocated to one of three study groups: Group 1: wait-list control group; Group 2: 5 face-to-face visits with a psychologist and exercise specialist over 3 months; and Group 3: same as Group 2 plus technology-based behavior change support package for an additional 6 months. Assessments will be conducted at baseline, 3-, 9- (primary time-point) and 18-months post-baseline. The primary outcome will be PA measured with pedometers. DISCUSSION SMART Health is an innovative, multi-component intervention, that integrates referral to exercise specialists, psychologists and provision of a technology-based behavior support package to promote PA and RT in adults diagnosed with T2DM or 'at risk' of T2DM. The findings will be used to guide future PA interventions and to develop effective community-based diabetes prevention and treatment programs. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry No: ACTRN12616001309471.
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Affiliation(s)
- Maria L Murphy
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
| | - David R Lubans
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
| | | | - Sara L Robards
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
| | - Magdalena Wilczynska
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia; University of Newcastle, School of Psychology, Australia.
| | - Sarah G Kennedy
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
| | - Erica L James
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, Australia.
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, 1-113 University Hall, University of Alberta, Edmonton, Alberta T6G 2H9, Canada.
| | - Ronald J Sigal
- University of Calgary, 2500 University Dr, NW, Calgary, AB T2N 1N4, Canada.
| | - Ronald C Plotnikoff
- University of Newcastle, Australia, Priority Research Centre for Physical Activity and Nutrition, Level 3 Advanced Technology Centre (ATC316), Callaghan, NSW 2308, Australia.
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24
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Moghei M, Reid RD, Wooding E, Melo Ghisi G, Pipe A, Chessex C, Prince SA, Blanchard C, Oh P, Grace SL. A Longitudinal Examination of the Social-Ecological Correlates of Exercise in Men and Women Following Cardiac Rehabilitation. J Clin Med 2019; 8:jcm8020250. [PMID: 30781469 PMCID: PMC6406811 DOI: 10.3390/jcm8020250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 11/16/2022] Open
Abstract
Cardiac patients who engage in ≥150 min of moderate- to vigorous-intensity physical activity (MVPA)/week have lower mortality, yet MVPA declines even following cardiac rehabilitation (CR), and is lower in women. A randomized trial of nine socioecological theory-based exercise facilitation contacts over 50 weeks versus usual care (1:1 parallel arms) was undertaken (NCT01658683). The tertiary objective, as presented in this paper, was to test whether the intervention impacted socioecological elements, and in turn their association with MVPA. The 449 participants wore an accelerometer and completed questionnaires post-CR, and 26, 52 and 78 weeks later. At 52 weeks, exercise task self-efficacy was significantly greater in the intervention arm (p = 0.01), but no other differences were observed except more encouragement from other cardiac patients at 26 weeks (favoring controls). Among women adherent to the intervention, the group in whom the intervention was proven effective, physical activity (PA) intentions at 26 weeks were significantly greater in the intervention arm (p = 0.04), with no other differences. There were some differences in socioecological elements associated with MVPA by arm. There were also some differences by sex, with MVPA more often associated with exercise benefits/barriers in men, versus with working and the physical environment in women.
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Affiliation(s)
- Mahshid Moghei
- School of Kinesiology and Health Science, York University-Bethune 368, 4700 Keele St., Toronto, ON M3J 1P3, Canada.
| | - Robert D Reid
- Heart Institute, University of Ottawa, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
| | - Evyanne Wooding
- Heart Institute, University of Ottawa, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Gabriela Melo Ghisi
- Toronto Rehabilitation Institute, University Health Network, University of Toronto, 347 Rumsey Rd, Toronto, ON M4G 1R7, Canada.
| | - Andrew Pipe
- Heart Institute, University of Ottawa, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Caroline Chessex
- Toronto Rehabilitation Institute, University Health Network, University of Toronto, 347 Rumsey Rd, Toronto, ON M4G 1R7, Canada.
| | - Stephanie A Prince
- Heart Institute, University of Ottawa, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Chris Blanchard
- Department of Medicine, Dalhousie University, 5790 University Avenue, Halifax, NS B3H 1V7, Canada.
| | - Paul Oh
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
| | - Sherry L Grace
- School of Kinesiology and Health Science, York University-Bethune 368, 4700 Keele St., Toronto, ON M3J 1P3, Canada.
- Toronto Rehabilitation Institute, University Health Network, University of Toronto, 347 Rumsey Rd, Toronto, ON M4G 1R7, Canada.
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Lee BK. Comparison of Prevalence of Hypertension and Medical Expenses According to the Level of Physical Activity of Korean Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2018. [DOI: 10.15758/ajk.2018.20.4.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sabzmakan L, Ghasemi M, Asghari Jafarabadi M, Kamalikhah T, Chaleshgar Kordasiabi M. Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory. Subst Use Misuse 2018; 53:1511-1518. [PMID: 29313745 DOI: 10.1080/10826084.2017.1415356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. OBJECTIVE This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. METHOD The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. RESULTS The variables of perceived vulnerability (β = 0/137, P < 0.001), fear (β = 0/149, P < 0.001), self-efficacy (β = 0/249, P < 0.001), perceived intrinsic reward (β = -0.285, P < 0.001), threat appraisal (β = -0.25, P < 0.001), and coping appraisal (β = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (β = -0.158, P < 0.001), fear (β = -0.172, P < 0.001), self-efficacy (β = -0.288, P < 0.001), perceived intrinsic reward (β = 0.329, P < 0.001), threat appraisal (β = 0.265, P < 0.001), and coping appraisal (β = -0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (β = -1.156, P < 0.001). CONCLUSIONS The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.
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Affiliation(s)
- Leila Sabzmakan
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | - Mahmood Ghasemi
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | | | - Tahereh Kamalikhah
- c Department of Health Education & Promotion , Semnan University of Medical Sciences , Semnan , Iran
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Saqib NU. Predicting cross-cultural intentions to engage in physical activity. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2018. [DOI: 10.1108/ijphm-12-2016-0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This research identifies cross-cultural differences between perception and behavioral intentions of Western and South Asian consumers to engage in physical activity. The theory of planned behavior is applied. It aims to provide insights to healthcare marketers and managers to address the problems of being overweight and obese in South Asia.
Design/methodology/approach
Path analysis was used to conduct this research. Two online questionnaires were used to collect data from South Asian and North American respondents. Cross-cultural differences were identified based on results from structural equation models.
Findings
Path analysis shows that the theory of planned behavior effectively predicted the behavioral intentions of North American and South Asian respondents. South Asians are more strongly influenced by subjective norms and perceived behavioral control in their intentions to engage in physical activity. On the other hand, North Americans are more strongly influenced by their attitudes.
Practical implications
A consistent campaign to increase awareness about the risks of being overweight and obese will be necessary in South Asian countries to address this problem. Healthcare marketers need to emphasize marketing messages that lead to positive attitudes toward a healthy lifestyle in society and form public opinion such that it increases the role of social norms.
Originality/value
The research establishes the utility of the theory of planned behavior for South Asian populations. It identifies cross-cultural differences in terms of how behavioral intentions to engage in physical activity are formed in North American and South Asian populations. The findings are relevant to healthcare service managers and marketers in South Asia.
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Laithavewat L, Grundy-Warr C, Khuntikeo N, Andrews RH, Petney TN, Yongvanit P, Banchonhattakit P, Sithithaworn P. Analysis of a school-based health education model to prevent opisthorchiasis and cholangiocarcinoma in primary school children in northeast Thailand. Glob Health Promot 2018; 27:15-23. [DOI: 10.1177/1757975918767622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Infection with the liver fluke Opisthorchis viverrini is the major causative factor inducing cholangiocarcinoma in the Mekong region of Southeast Asia. Northeast Thailand has the highest incidence of this cancer worldwide leading to about 20,000 deaths every year. Infection with the liver fluke comes from eating raw or undercooked fish, a tradition in this area that can potentially be countered by education programs at school level. Here we develop a school-based health education model, based on protection motivation theory (PMT), including module design, learning materials, student activities, and capacity building amongst teachers. This education program was applied and tested in primary school to pupils (9–13 years) in Khon Kaen province, northeast Thailand. Using a randomized control trial, four schools served as intervention groups ( n = 118 pupils) and another four acted as controls ( n = 113 pupils). Based on PMT constructs, we found that the pupils in the intervention group had significantly greater knowledge and perceived the severity, vulnerability, response efficacy, and self-efficacy parameters concerning the dangers of eating raw fish and of developing cholangiocarcinoma than those in the control schools ( p < 0.05). All of the PMT constructs measured were significantly intercorrelated with each other ( p < 0.001). At the same time, some background knowledge, from community-based education programs, was present in the control schools. The result from this initial study suggests that PMT can be used to predict protective attitude as well as behavior changes in evaluating the consequence of school health intervention programs.
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Affiliation(s)
- Luxana Laithavewat
- Khon Kaen University, Khon Kaen, Thailand
- Office of Disease Prevention and Control 6, Khon Kaen, Thailand
| | | | | | - Ross H. Andrews
- Khon Kaen University, Khon Kaen, Thailand
- Imperial College, London, UK
| | - Trevor N. Petney
- Khon Kaen University, Khon Kaen, Thailand
- Karlsruhe Institute of Technology, Karlsruhe, Germany
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Yates T, Edwardson CL, Henson J, Gray LJ, Ashra NB, Troughton J, Khunti K, Davies MJ. Walking Away from Type 2 diabetes: a cluster randomized controlled trial. Diabet Med 2017; 34:698-707. [PMID: 27589017 DOI: 10.1111/dme.13254] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 12/31/2022]
Abstract
AIMS This study aimed to investigate whether an established behavioural intervention, Walking Away from Type 2 Diabetes, is effective at promoting and sustaining increased walking activity when delivered within primary care. METHODS Cluster randomized controlled trial involving 10 general practices recruited from Leicestershire, UK, in 2009-2010. Eight hundred and eight (36% female) individuals with a high risk of Type 2 diabetes mellitus, identified through a validated risk score, were included. Participants in five practices were randomized to Walking Away from Type 2 Diabetes, a pragmatic 3-h group-based structured education programme incorporating pedometer use with annual follow-on refresher sessions. The primary outcome was accelerometer assessed ambulatory activity (steps/day) at 12 months. Longer term maintenance was assessed at 24 and 36 months. Results were analysed using generalized estimating equation models, accounting for clustering. RESULTS Complete accelerometer data for the primary outcome were available for 571 (71%) participants. Increases in ambulatory activity of 411 steps/day [95% confidence interval (CI): 117, 704] and self-reported vigorous-intensity physical activity of 218 metabolic equivalent min/week (95% CI: 6, 425) at 12 months were observed in the intervention group compared with control; differences between groups were not sustained at 36 months. No differences between groups were observed for markers of cardiometabolic health. Replacing missing data with multiple imputation did not affect the results. CONCLUSIONS A pragmatic low-resource group-based structured education programme with pedometer use resulted in modest increases in ambulatory activity compared with control conditions after 12 months when implemented within a primary care setting to those at high risk of Type 2 diabetes mellitus; however, the results were not maintained over 36 months.
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Affiliation(s)
- T Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester, UK
| | - C L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester, UK
| | - J Henson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester, UK
| | - L J Gray
- Health Sciences, University of Leicester, Leicester, UK
| | - N B Ashra
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - J Troughton
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care - East Midlands (CLAHRC - EM) Leicester Diabetes Centre, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), Leicester Diabetes Centre, Leicester, UK
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Adoption of personal health records by chronic disease patients: A research model and an empirical study. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.09.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Reid R, Blanchard CM, Wooding E, Harris J, Krahn M, Pipe A, Chessex C, Grace SL. Ecologically optimizing exercise maintenance in men and women post-cardiac rehabilitation: Protocol for a randomized controlled trial of efficacy with economics (ECO-PCR). Contemp Clin Trials 2016; 50:116-23. [PMID: 27475772 DOI: 10.1016/j.cct.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation (CR) participation results in increased cardio-metabolic fitness, which is associated with reduced mortality. However, many graduates fail to maintain exercise post-program. ECO-PCR investigates the efficacy and cost-effectiveness of a social ecologically-based intervention to increase long-term exercise maintenance following the completion of CR. METHODS/DESIGN A three-site, 2-group, parallel randomized controlled trial is underway. 412 male and 192 female (N=604) supervised CR participants are being recruited just before CR graduation. Participants are randomized (1:1 concealed allocation) to intervention or usual care. A 50-week exercise facilitator intervention has been designed to assist CR graduates in the transition from structured, supervised exercise to self-managed home- or community-based (e.g., Heart Wise Exercise programs) exercise. The intervention consists of 8 telephone contacts over the 50week period: 3 individual and 5 group. Assessments occur at CR graduation, and 26, 52 and 78weeks post-randomization. The primary outcome is change in minutes of accelerometer-measured moderate to vigorous-intensity physical activity (MVPA) from CR graduation to 52weeks post-randomization. Secondary measures include exercise capacity, quality of life, and cardiovascular risk factors. Analyses will be undertaken based on intention-to-treat. For the primary outcome, an analysis of variance will be computed to test the change in minutes of MVPA in each group between CR graduation and 52week follow-up (2 [arm]×2 [time]). Secondary objectives will be assessed using mixed-model repeated measures analyses to compare differences between groups over time. Mean costs and quality-adjusted life years for each arm will be estimated.
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Affiliation(s)
- Robert Reid
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Chris M Blanchard
- Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada.
| | - Evyanne Wooding
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Jennifer Harris
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Murray Krahn
- University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada.
| | - Andrew Pipe
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
| | - Caroline Chessex
- University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
| | - Sherry L Grace
- University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada; York University - Bethune 368, 4700 Keele St., Toronto, ON M3J 1P3, Canada.
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Rationale and study protocol for the 'eCoFit' randomized controlled trial: Integrating smartphone technology, social support and the outdoor physical environment to improve health-related fitness among adults at risk of, or diagnosed with, Type 2 Diabetes. Contemp Clin Trials 2016; 49:116-25. [PMID: 27370229 DOI: 10.1016/j.cct.2016.06.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/24/2016] [Accepted: 06/26/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The prevalence and risk of Type 2 Diabetes (T2D) has dramatically increased over the past decade. Physical activity (PA) has significant benefits for the treatment and prevention of T2D. The aim of this study is to develop, implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. RESEARCH DESIGN AND METHODS The eCoFit pilot intervention will be evaluated using a randomized controlled trial (RCT) design. The 20-week (Phases 1 and 2) multi-component intervention was guided by Social Cognitive Theory, Health Action Process Approach Model, and Cognitive Behavior Therapy strategies. Phase 1 (Weeks 1-10) includes: i) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring; and ii) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active. Phase 2 (Weeks 11-20) includes the use of the eCoFit smartphone application only. Assessments are to be conducted at baseline, 10-weeks (primary end-point) and 20-weeks (secondary end-point) post-baseline. Primary outcomes are cardio-respiratory fitness and muscular fitness (lower body). Secondary outcomes include physical, behavioral, mental health and quality of life, and social-cognitive outcomes. DISCUSSION eCoFit is an innovative, multi-component intervention, which integrates smartphone technology, social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of, or diagnosed with T2D. The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry No: ACTRN12615000990527.
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Brouwer-Goossensen D, Genugten LV, Lingsma H, Dippel D, Koudstaal P, Hertog HD. Determinants of intention to change health-related behavior and actual change in patients with TIA or minor ischemic stroke. PATIENT EDUCATION AND COUNSELING 2016; 99:644-650. [PMID: 26561311 DOI: 10.1016/j.pec.2015.10.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 10/07/2015] [Accepted: 10/29/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess determinants of intention to change health-related behavior and actual change in patients with TIA or ischemic stroke. METHODS In this prospective cohort study, 100 patients with TIA or minor ischemic stroke completed questionnaires on behavioral intention and sociocognitive factors including perception of severity, susceptibility, fear, response-efficacy and self-efficacy at baseline. Questionnaires on physical activity, diet and smoking were completed at baseline and at 3 months. Associations between sociocognitive factors and behavioral intention and actual change were studied with multivariable linear and logistic regression. RESULTS Self-efficacy, response efficacy, and fear were independently associated with behavioral intention, with self-efficacy as the strongest determinant of intention to increase physical activity (aBeta 0.40; 95% CI 0.12-0.71), adapt a healthy diet (aBeta 0.49; 95% CI 0.23-0.75), and quit smoking (aBeta 0.51; 95% CI 0.13-0.88). Intention to change tended to be associated with actual health-related behavior change. CONCLUSION Self-efficacy, fear, and response-efficacy were determinants of intention to change health-related behavior after TIA or ischemic stroke. PRACTICE IMPLICATIONS These determinants of intention to change health-related behavior after TIA or ischemic stroke should be taken into account in the development of future interventions promoting health-related behavior change in these group of patients.
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Affiliation(s)
| | - Lenneke van Genugten
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Diederik Dippel
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Peter Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Heleen den Hertog
- Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Wong TS, Gaston A, DeJesus S, Prapavessis H. The utility of a protection motivation theory framework for understanding sedentary behavior. Health Psychol Behav Med 2016. [DOI: 10.1080/21642850.2015.1128333] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Johnson ST, Lubans DR, Mladenovic AB, Plotnikoff RC, Karunamuni N, Johnson JA. Testing social-cognitive mediators for objective estimates of physical activity from the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study. PSYCHOL HEALTH MED 2016; 21:945-53. [DOI: 10.1080/13548506.2016.1140900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moreau M, Gagnon MP, Boudreau F. Development of a fully automated, web-based, tailored intervention promoting regular physical activity among insufficiently active adults with type 2 diabetes: integrating the I-change model, self-determination theory, and motivational interviewing components. JMIR Res Protoc 2015; 4:e25. [PMID: 25691346 PMCID: PMC4376153 DOI: 10.2196/resprot.4099] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 12/24/2022] Open
Abstract
Background Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. Objective This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. Methods The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention’s usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. Results The intervention development cost was about CDN $59,700 and took approximately 54 full-time weeks. The intervention officially started on September 29, 2014. Out of 2300 potential participants targeted for the tailored intervention, approximately 530 people visited the website, 170 people completed the registration process, and 83 corresponded to the selection criteria and were enrolled in the intervention. Conclusions Usability evaluation is an essential step in the development of a Web-based tailored intervention in order to make pre-implementation improvements. The effectiveness and relevance of the theoretical framework used for the intervention will be analyzed following the process and impact evaluation. Implications for future research are discussed.
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Affiliation(s)
- Michel Moreau
- Interdisciplinary Group of Health Applied Research, Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Bosone L, Martinez F, Kalampalikis N. When the model fits the frame: the impact of regulatory fit on efficacy appraisal and persuasion in health communication. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2015; 41:526-39. [PMID: 25680684 DOI: 10.1177/0146167215571089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In health-promotional campaigns, positive and negative role models can be deployed to illustrate the benefits or costs of certain behaviors. The main purpose of this article is to investigate why, how, and when exposure to role models strengthens the persuasiveness of a message, according to regulatory fit theory. We argue that exposure to a positive versus a negative model activates individuals' goals toward promotion rather than prevention. By means of two experiments, we demonstrate that high levels of persuasion occur when a message advertising healthy dietary habits offers a regulatory fit between its framing and the described role model. Our data also establish that the effects of such internal regulatory fit by vicarious experience depend on individuals' perceptions of response-efficacy and self-efficacy. Our findings constitute a significant theoretical complement to previous research on regulatory fit and contain valuable practical implications for health-promotional campaigns.
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Affiliation(s)
- Lucia Bosone
- Social Psychology Research Group (EA 4163), Université Lumière Lyon 2, France
| | - Frédéric Martinez
- Social Psychology Research Group (EA 4163), Université Lumière Lyon 2, France
| | - Nikos Kalampalikis
- Social Psychology Research Group (EA 4163), Université Lumière Lyon 2, France
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Sampson DL, Broadbent JA, Parker AW, Upton Z, Parker TJ. Urinary biomarkers of physical activity: candidates and clinical utility. Expert Rev Proteomics 2013; 11:91-106. [DOI: 10.1586/14789450.2014.859527] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Plotnikoff RC, Lubans DR, Penfold CM, Courneya KS. Testing the utility of three social-cognitive models for predicting objective and self-report physical activity in adults with type 2 diabetes. Br J Health Psychol 2013; 19:329-46. [PMID: 24308845 DOI: 10.1111/bjhp.12085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/11/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Theory-based interventions to promote physical activity (PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour. METHODS Participants were adults with type 2 diabetes (n = 287, 53.8% males, mean age = 61.6 ± 11.8 years). Theoretical constructs across the three theories were tested to prospectively predict PA behaviour (objective and self-report) across three 6-month time intervals (baseline-6, 6-12, 12-18 months) using structural equation modelling. PA outcomes were steps/3 days (objective) and minutes of MET-weighted PA/week (self-report). RESULTS The mean proportion of variance in PA explained by these models was 6.5% for objective PA and 8.8% for self-report PA. Direct pathways to PA outcomes were stronger for self-report compared with objective PA. CONCLUSIONS These theories explained a small proportion of the variance in longitudinal PA studies. Theory development to guide interventions for increasing and maintaining PA in adults with type 2 diabetes requires further research with objective measures. Theory integration across social-cognitive models and the inclusion of ecological levels are recommended to further explain PA behaviour change in this population. Statement of contribution What is already known on this subject? Social-cognitive theories are able to explain partial variance for physical activity (PA) behaviour. What does this study add? The testing of three theories in a longitudinal design over 3, 6-month time intervals. The parallel use and comparison of both objective and self-report PA measures in testing these theories.
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Affiliation(s)
- Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia
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Celano CM, Beale EE, Moore SV, Wexler DJ, Huffman JC. Positive psychological characteristics in diabetes: a review. Curr Diab Rep 2013; 13:917-29. [PMID: 24048687 DOI: 10.1007/s11892-013-0430-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Positive psychological characteristics, such as optimism, self-efficacy, and resilience, have been increasingly associated with improved outcomes in medically ill individuals. However, there has been minimal systematic review of these characteristics and their associations with outcomes in people with diabetes. We aim to review these associations, their potential mediating mechanisms, and the evidence supporting interventions targeting these qualities. In people with diabetes, positive psychological characteristics are significantly associated with improved glycemic control, fewer complications, and reduced rates of mortality. Potential mechanisms mediating these associations include behavioral factors (e.g., improved treatment adherence), reduced inflammation, and improved neuroendocrine and autonomic functioning. Most psychosocial treatments in this population have focused on improving self-efficacy and resilience; such interventions may improve quality of life, well-being, and diabetes self-care. While untested in diabetes, interventions to boost other positive characteristics have been effective in other medically ill patients and may warrant further study in this cohort.
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Caro-Bautista J, Martín-Santos FJ, Morales-Asencio JM. Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus. J Adv Nurs 2013; 70:1209-27. [PMID: 24237156 DOI: 10.1111/jan.12298] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 01/17/2023]
Abstract
AIM To determine the psychometric properties and theoretical grounding of instruments that evaluate self-care behaviour or barriers in people with type 2 diabetes. BACKGROUND There are many instruments designed to evaluate self-care behaviour or barriers in this population, but knowledge about their psychometric validation processes is lacking. DESIGN Systematic review. DATA SOURCES We conducted a search for psychometric or validation studies published between January 1990-December 2012. We carried out searches in Pubmed, CINAHL, PsycINFO, ProQuolid, BibliPRO and Google SCHOLAR to identify instruments that evaluated self-care behaviours or barriers to diabetes self-care. REVIEW METHODS We conducted a systematic review with the following inclusion criteria: Psychometric or clinimetric validation studies that included patients with type 2 diabetes (exclusively or partially) and which analysed self-care behaviour or barriers to self-care and proxies like self-efficacy or empowerment, from a multidimensional approach. Language: Spanish or English. Two authors independently assessed the quality of the studies and extracted data using Terwee's proposed criteria: psychometrics properties, dimensionality, theoretical ground and population used for validation through each included instrument. RESULTS Sixteen instruments achieved the inclusion criteria for the review. We detected important methodological flaws in many of the selected instruments. Only the Self-management Profile for Type 2 Diabetes and Problem Areas in Diabetes Scale met half of Terwee's quality criteria. CONCLUSION There are no instruments for identifying self-care behaviours or barriers elaborated with a strong validation process. Further research should be carried out to provide patients, clinicians and researchers with valid and reliable instruments that are methodologically solid and theoretically grounded.
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Affiliation(s)
- Jorge Caro-Bautista
- District of Primary Health Care of Málaga, Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Spain
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Macdonell K, Chen X, Yan Y, Li F, Gong J, Sun H, Li X, Stanton B. A Protection Motivation Theory-Based Scale for Tobacco Research among Chinese Youth. ACTA ACUST UNITED AC 2013; 4:154. [PMID: 24478933 PMCID: PMC3903136 DOI: 10.4172/2155-6105.1000154] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rates of tobacco use among adolescents in China and other lower and middle-income countries remain high despite notable prevention and intervention programs. One reason for this may be the lack of theory-based research in tobacco use prevention in these countries. In the current study, a culturally appropriate 21-item measurement scale for cigarette smoking was developed based on the core constructs of Protection Motivation Theory (PMT). The scale was assessed among a sample of 553 Chinese vocational high school students. Results from correlational and measurement modeling analysis indicated adequate measurement reliability for the proposed PMT scale structure. The two PMT Pathways and the seven PMT constructs were significantly correlated with adolescent intention to smoke and actual smoking behavior. This study is the first to evaluate a PMT scale for cigarette smoking among Chinese adolescents. The scale provides a potential tool for assessing social cognitive processes underlying tobacco use. This is essential for understanding smoking behavior among Chinese youth and to support more effective tobacco use prevention efforts. Additional studies are needed to assess its utility for use with Chinese youth in other settings.
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Affiliation(s)
- Karen Macdonell
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| | - Xinguang Chen
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Huiling Sun
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaoming Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Bonita Stanton
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
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Physical Activity and Stages of Change: A Longitudinal Test in Types 1 and 2 Diabetes Samples. Ann Behav Med 2010; 40:138-49. [DOI: 10.1007/s12160-010-9193-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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