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Zhao K, Zhu H, Huang L, Yang N, Othman SMA, Shi W, Hua H, Liang H, Xu Q. Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model. Diabetes Metab Syndr Obes 2024; 17:1887-1901. [PMID: 38711676 PMCID: PMC11070847 DOI: 10.2147/dmso.s455913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/17/2024] [Indexed: 05/08/2024] Open
Abstract
Background Diet and physical activity (PA) are pivotal behaviors for managing energy balance post-bariatric surgery. Given the need for dual behavioral management, understanding the interplay of cognitive factors influencing these behaviors is crucial. This study applied the compensatory carry-over action model (CCAM) to explore the impact of cognitive factors on behaviors and their subsequent effects on subjective health outcomes. Methods This cross-sectional study was conducted among patients at the third month after bariatric surgery in China. Data on diet and PA status, behavioral cognitive factors (intention, self-efficacy, compensatory belief, transfer cognition), and subjective health outcomes (perceived stress, well-being, quality of life) were collected. Structural equation model (SEM) was employed to test hypotheses in CCAM and assess mediation relationships. Results Analysis of data from 239 patients revealed the following: (1) Among antecedent cognitive factors, only compensatory belief significantly influenced diet (P<0.001). (2) Intention and self-efficacy directly correlated with their respective behaviors, while compensatory belief affected intention, and transfer cognition impacted self-efficacy (P<0.05), aligning with CCAM hypotheses. (3) PA demonstrated significant influence only on perceived stress (P=0.004), whereas diet significantly affected all subjective health outcomes (P<0.05). (4) Mediation analysis indicated intention partially mediated the relationship between compensatory belief and diet and fully mediated the relationship between compensatory belief and PA. Self-efficacy completely mediated the relationship between transfer cognition and diet and PA. Conclusion Transfer cognition's carry-over effect did not directly influence behaviors among antecedent cognitions. Interventions should primarily target improving diet by mitigating compensatory belief. Moreover, diet exhibited a more pronounced impact on overall health compared to PA. Consequently, prioritizing dietary intervention over PA intervention is warranted based on the analysis of CCAM and the aim of promoting joint behaviors post-bariatric surgery.
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Affiliation(s)
- Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Lidong Huang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Ningli Yang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | | | - Wenbing Shi
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hongxia Hua
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hui Liang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
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Deselaers C, Dahmen A, Lippke S. Impact of the COVID-19 Pandemic on CSR Activities of Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:368. [PMID: 36612690 PMCID: PMC9819171 DOI: 10.3390/ijerph20010368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Corporate social responsibility (CSR) is important for every company that cares for sustainable structures. Healthcare providers especially have made social responsibility their goal. However, crises such as the COVID-19 pandemic impacted different activities within the healthcare sector including CSR and its monitoring. However, theory-driven CSR research within the healthcare sector is scarce and monitoring requires a structured understanding of the processes. Therefore, the objective of this study was to investigate the CSR practices and activities which healthcare providers have implemented in an exemplified country namely Germany and the effect of the pandemic in this process. (2) Methods: Participants were sampled based on their field of care (general, psychiatric, or rehabilitation), the type of organization (public, private, or non-profit), and group membership. A total of 18 healthcare providers were initially recruited, out of which nine participated in the interviews. They represent companies with yearly revenue of between EUR 110 million and EUR 6 billion, and have between 900 and 73,000 employees. (3) Results: CSR-related activities were postponed due to times of crisis. There was a necessity to rapidly digitalize processes. Frequent and precise communication turned out to be important for keeping employees' well-being, motivation, and satisfaction levels high. Environmental efforts were counteracted by new hygienic requirements and a shift in priorities. Many study participants expressed the hope that after the pandemic, newly established methods, processes, and structures (e.g., digital meetings, quicker and more inclusive communication) would be maintained and developed further. (4) Conclusions: The pandemic has been challenging and at the same time, these challenges also created opportunities to strike a new path using the learnings to overcome future health-related or economic crises.
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Affiliation(s)
- Christina Deselaers
- School of Business, Social and Decision Science, Constructor University (Formerly Known as Jacobs University Bremen gGmbH), Campus Ring 1, 28759 Bremen, Germany
| | - Alina Dahmen
- School of Business, Social and Decision Science, Constructor University (Formerly Known as Jacobs University Bremen gGmbH), Campus Ring 1, 28759 Bremen, Germany
- Klinikum Wolfsburg, 38440 Wolfsburg, Germany
| | - Sonia Lippke
- School of Business, Social and Decision Science, Constructor University (Formerly Known as Jacobs University Bremen gGmbH), Campus Ring 1, 28759 Bremen, Germany
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Gunillasdotter V, Andréasson S, Hallgren M, Jirwe M. Exercise as treatment for alcohol use disorder: A qualitative study. Drug Alcohol Rev 2022; 41:1642-1652. [PMID: 36073088 PMCID: PMC9826429 DOI: 10.1111/dar.13527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Exercise is a promising treatment option for individuals with alcohol use disorder, but qualitative studies are lacking. Our aim was to explore experiences of yoga and aerobic exercise among non-treatment-seeking adults with alcohol use disorder. METHODS Semi-structured qualitative interviews (face-to-face or telephone) with 12 participants from a randomised controlled trial. Qualitative content analysis was used to analyse data. RESULTS One main category was identified, motivating and maintaining a lifestyle change, including four generic categories: (i) Initiating factors for lifestyle change, which describes how the concept of a lifestyle change initiated participants change; (ii) Influencing lifestyle change, explains how mood-enhancing effects from exercise influence exercise behaviours; (iii) Influencing physical and mental health, which describes how improvements in physical and mental health influence self-confidence and self-esteem; and (iv) Influencing alcohol consumption, which describes how exercise reduced alcohol cravings and that success in changing exercise behaviours made participants take healthier decisions regarding their alcohol intake. DISCUSSION AND CONCLUSIONS Exercise may help reduce alcohol intake, especially when presented in the context of a lifestyle change. Being able to self-select the type of exercise may increase compliance and optimise these benefits. Intentional planning and positive results from exercise may strengthen the individual's self-efficacy and increase the motivation to change behaviours associated with alcohol consumption.
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Affiliation(s)
- Victoria Gunillasdotter
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Sven Andréasson
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Mats Hallgren
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Maria Jirwe
- Department of Health SciencesSwedish Red Cross UniversityHuddingeSweden,Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
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Ju Q, Gan Y, Rinn R, Duan Y, Lippke S. Health Status Stability of Patients in a Medical Rehabilitation Program: What Are the Roles of Time, Physical Fitness Level, and Self-efficacy? Int J Behav Med 2022; 29:624-637. [PMID: 34940949 PMCID: PMC9525393 DOI: 10.1007/s12529-021-10046-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Individuals' physical and mental health, as well as their chances of returning to work after their ability to work is damaged, can be addressed by medical rehabilitation. AIM This study investigated the developmental trends of mental and physical health among patients in medical rehabilitation and the roles of self-efficacy and physical fitness in the development of mental and physical health. DESIGN A longitudinal design that included four time-point measurements across 15 months. SETTING A medical rehabilitation center in Germany. POPULATION Participants included 201 patients who were recruited from a medical rehabilitation center. METHODS To objectively measure physical fitness (lung functioning), oxygen reabsorption at anaerobic threshold (VO2AT) was used, along with several self-report scales. RESULTS We found a nonlinear change in mental health among medical rehabilitation patients. The results underscored the importance of medical rehabilitation for patients' mental health over time. In addition, patients' physical health was stable over time. The initial level of physical fitness (VO2AT) positively predicted their mental health and kept the trend more stable. Self-efficacy appeared to have a positive relationship with mental health after rehabilitation treatment. CONCLUSIONS This study revealed a nonlinear change in mental health among medical rehabilitation patients. Self-efficacy was positively related to mental health, and the initial level of physical fitness positively predicted the level of mental health after rehabilitation treatment. CLINICAL REHABILITATION More attention could be given to physical capacity and self-efficacy for improving and maintaining rehabilitants' mental health.
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Affiliation(s)
- Qianqian Ju
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
| | - Robin Rinn
- University of Würzburg, Wurzburg, Germany
| | - Yanping Duan
- Hong Kong Baptist University, Kowloon, Hong Kong
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Nigg C, Burchartz A, Reichert M, Woll A, Niessner C. Children and adolescents do not compensate for physical activity but do compensate for sedentary behavior. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00808-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractLittle is known about behavioral transfer and compensation within and between moderate-to-vigorous physical activity (MVPA) and sedentary behavior. Thus, taking a within-person perspective, this study investigated across 1 week whether (a) children and adolescents compensate for increased MVPA and sedentary behavior with less of the respective behavior the next day and (b) transfer and compensation occur between these behaviors within 1 day and across 2 days. We obtained data from 2676 participants (6–17 years) of the national Motorik-Modul (MoMo) study in Germany. Participants wore an ActiGraph accelerometer (Pensacola, FL, USA) for 7 days. We analyzed within- and between-day associations using hierarchical linear modeling. If youth engaged in 2 h more sedentary behavior than typical on any given day, they engaged in 37.20 min less MVPA the same day (B = −0.31, p < 0.001) as well as in 4.80 min more MVPA (B = 0.04, p < 0.001) and 7.20 min less sedentary behavior (B = −0.06, p < 0.001) the next day. If youth engaged in 1 h more MVPA than typical on any given day, they engaged in 97.80 min less sedentary behavior the same day (B = −1.63, p < 0.001) and in 5.40 min less sedentary behavior the next day (B = −0.09, p < 0.001). No association with next-day MVPA was observed. Our results indicate that children do not compensate for enhanced MVPA but transfer to less sedentary behavior, while more sedentary behavior is compensated with less sedentary behavior and more MVPA the next day. This provides essential information for the design of intervention studies to tackle physical inactivity and sedentary behavior.
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Arroyo AC, Zawadzki MJ. The Implementation of Behavior Change Techniques in mHealth Apps for Sleep: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e33527. [PMID: 35377327 PMCID: PMC9132368 DOI: 10.2196/33527] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/21/2021] [Accepted: 01/07/2022] [Indexed: 01/19/2023] Open
Abstract
Background Mobile health (mHealth) apps targeting health behaviors using behavior change techniques (BCTs) have been successful in promoting healthy behaviors; however, their efficacy with sleep is unclear. Some work has shown success in promoting sleep through mHealth, whereas there have been reports that sleep apps can be adverse and lead to unhealthy obsessions with achieving perfect sleep. Objective This study aims to report and describe the use of BCTs in mHealth apps for sleep with the following research questions: How many BCTs are used on average in sleep apps, and does this relate to their effectiveness on sleep outcomes? Are there specific BCTs used more or less often in sleep apps, and does this relate to their effectiveness on sleep outcomes? Does the effect of mHealth app interventions on sleep change when distinguishing between dimension and measurement of sleep? Methods We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to review articles on mHealth app interventions for sleep published between 2010 and 2020. Results A total of 12 studies met the eligibility criteria. Most studies reported positive sleep outcomes, and there were no negative effects reported. Sleep quality was the most common dimension of sleep targeted. Subjective measures of sleep were used across all apps, whereas objective measures were often assessed but rarely reported as part of results. The average number of BCTs used was 7.67 (SD 2.32; range 3-11) of 16. Of the 12 studies, the most commonly used BCTs were feedback and monitoring (n=11, 92%), shaping knowledge (n=11, 92%), goals and planning (n=10, 83%), and antecedents (n=10, 83%), whereas the least common were scheduled consequences (n=0, 0%), self-belief (n=0, 0%), and covert learning (n=0, 0%). Most apps used a similar set of BCTs that unfortunately did not allow us to distinguish which BCTs were present when studies reported more positive outcomes. Conclusions Our study describes the peer-reviewed literature on sleep apps and provides a foundation for further examination and optimization of BCTs used in mHealth apps for sleep. We found strong evidence that mHealth apps are effective in improving sleep, and the potential reasons for the lack of adverse sleep outcome reporting are discussed. We found evidence that the type of BCTs used in mHealth apps for sleep differed from other health outcomes, although more research is needed to understand how BCTs can be implemented effectively to improve sleep using mHealth and the mechanisms of action through which they are effective (eg, self-efficacy, social norms, and attitudes).
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Affiliation(s)
- Amber Carmen Arroyo
- Department of Psychological Sciences, University of California, Merced, CA, United States
| | - Matthew J Zawadzki
- Department of Psychological Sciences, University of California, Merced, CA, United States
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Association between Fruit and Vegetable Intake and Physical Activity among Breast Cancer Survivors: A Longitudinal Study. Curr Oncol 2021; 28:5025-5034. [PMID: 34940061 PMCID: PMC8699935 DOI: 10.3390/curroncol28060422] [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: 10/30/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
This study examines the association between rates of change in daily fruit and vegetable intake and in weekly levels of moderate-to-vigorous intensity physical activity (MVPA) over a 15-month period in women following primary treatment completion for breast cancer. Breast cancer survivors (N = 199) self-reported fruit and vegetable intake and wore an accelerometer for 7 consecutive days to measure levels of MVPA on five occasions every 3 months. Multivariate latent growth modeling revealed that the rate of change in fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Baseline (Mean = 3.46 months post-treatment) levels of MVPA were not associated with the rate of change of daily fruit and vegetable intake; likewise, baseline fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Behavioral interventions promoting fruit and vegetable intake should not be assumed to yield concomitant effects in promoting MVPA or vice versa.
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8
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Zhao K, Xu X, Zhu H, Xu Q. Compensatory Belief in Health Behavior Management: A Concept Analysis. Front Psychol 2021; 12:705991. [PMID: 34512462 PMCID: PMC8429599 DOI: 10.3389/fpsyg.2021.705991] [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: 05/06/2021] [Accepted: 08/06/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose This study aimed to identify the exact definition of the concept of compensatory belief (CB) and to help clinicians and caregivers to distinguish patients who tend to form such beliefs. Methods This study is a conceptual analysis based on the strategy of Walker and Avant (2014). We retrieved studies from existing literature using databases such as PubMed, CINAHL, Wiley, and Web of Science, and extracted information from the results. No date limitations were applied. Results A total of 35 articles were sourced for data extraction. The identified attributes of CB were as follows: cognitive coping strategy, pleasure without guilt, compensatory behaviors, automatic motivated self-regulatory process, and implicit cognition. The observed antecedents were: failure to resist desire, reluctance, a conflicting motivational state, seeking appropriate balance, and self-image maintenance. The consequences of CB were lower health-related intentions, justification of unhealthy choices, relief from cognitive dissonance, continued existence of conflict feeling, and poor long-term health. Conclusion Compensatory belief stems from motivational dissonance or confliction. Despite causing feelings of pleasure and relief, it can negatively impact long-term health. Although CB is crucial to establish healthy behaviors, it is easily ignored in medical work.
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Affiliation(s)
- Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xinyi Xu
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, China
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Nigg C, Nigg CR. It's more than climate change and active transport-physical activity's role in sustainable behavior. Transl Behav Med 2021; 11:945-953. [PMID: 33410486 DOI: 10.1093/tbm/ibaa129] [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: 01/11/2023] Open
Abstract
Considering the interdependence of human's and nature's health within the planetary health concept, we evaluated how physical activity (PA) can be conceptualized as sustainable behavior (SuB) and how PA relates to other types of SuBs within the United Nations' sustainable development goal (SDG) framework. Regarding social SDGs, PA contributes to improving malnutrition (SDG 2), health behaviors (SDG 3), education (SDG 4), reducing inequalities (SDG 10), sustainable cities (SDG 12), and peace (SDG 16). For ecological SDGs, PA contributes to sustainable consumption (SDG 11) and combating climate change (SDG 13). Therefore, PA is more than a health behavior, it contributes to planetary health and sustainable development. However, caution is warranted as PA also has the potential to contribute and reinforce unsustainability. Thus, PA as a SuB requires an own research agenda, investigating (a) PA as social and ecological SuB, (b) sustainable PA promotion, (c) sustainable PA measurement, (d) common underlying constructs of PA and SuB, and (e) technology's role to assess and promote PA and SuB.
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Affiliation(s)
- Carina Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, BW, Germany
| | - Claudio R Nigg
- Institute of Sport Science, University of Bern Bern, BE, Switzerland
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10
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Bai C, Guo M, Yao Y, Ji JS, Gu D, Zeng Y. Sleep duration, vegetable consumption and all-cause mortality among older adults in China: a 6-year prospective study. BMC Geriatr 2021; 21:373. [PMID: 34154548 PMCID: PMC8215744 DOI: 10.1186/s12877-021-02278-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep duration and vegetable consumption are associated with mortality at old age (termed as sleep-mortality linkage and vegetable-mortality linkage, respectively). Yet, little is known about the interplay of sleep duration and vegetable consumption on mortality. METHODS A dataset of nationwide longitudinal survey with 13,441 participants aged 65 years or older recruited in 2008 and followed up till 2014 was used. Sleep duration was classified into five groups (≤5, 6, 7-8, 9, and ≥ 10 h/day). Vegetable consumption was classified as either high frequency (eating vegetables almost daily) or low frequency. We used parametric Weibull hazard regression models to estimate associations of sleep duration and frequency of vegetable consumption with mortality, adjusting for demographics, socioeconomic factors, family/social support, health practice, and health conditions. RESULTS Over the six-year study period, when only demographics were present, participants sleeping ≤5, 6, 9, and ≥ 10 h/day had relative hazard (RH) of mortality 1.18 (p < 0.001), 1.14(p < 0.01), 1.06 (p > 0.1), and 1.30 (p < 0.001), respectively, compared to those sleeping 7-8 h/day. The HRs were attenuated to 1.08 (p < 0.05), 1.08 (p < 0.05), 1.09 (p < 0.1), 1.18(p < 0.001), respectively, when all other covariates were additionally adjusted for. High frequency of eating vegetables was associated with 22% lower risk of mortality (RH= 0.78, p < 0.001) compared to low frequency in the demographic model, and with 9% lower risk (RH = 0.91, p < 0.05) in the full model. Subpopulation and interaction analyses show that the sleeping-mortality linkage was stronger in female, urban, oldest-old (aged ≥80), and illiterate participants compared to their respective male, rural, young-old, and literate counterparts. High frequency of vegetable intakes could offset the higher mortality risk in participants with short-sleeping duration, but low frequency of eating vegetables could exacerbate mortality risk for participants with either short or long sleep duration; and except for few cases, these findings held in subpopulations. CONCLUSIONS Too short and too long sleep durations were associated with higher mortality risk, and infrequent vegetable consumption could exacerbate the risk, although frequent vegetable intake could offset the risk for short sleep duration. The relationship between these two lifestyles and mortality was complex and varied among subpopulations.
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Affiliation(s)
- Chen Bai
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Muqi Guo
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Yao Yao
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Danan Gu
- Independent Researcher, New York, NY, 10017, USA.
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, National School of Development, Peking University, No. 5 Yiheyuan Road, Beijing, 100871, Haidian District, China. .,Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, 27705, USA.
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Villanueva-Blasco VJ, García-Soidán JL, Isorna Folgar M, Arufe Giráldez V. Association between Tobacco Consumption and Problematic Internet Use and the Practice of Physical Activity in Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5464. [PMID: 34065308 PMCID: PMC8161240 DOI: 10.3390/ijerph18105464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 11/16/2022]
Abstract
The practice of physical activity (PA) is a healthy habit that offers health benefits. In contrast, the lack thereof may be associated with an increase in diseases, even at an early age. The objective of this study was to analyze the association between unhealthy behaviors, such as tobacco consumption and problematic internet use, and the practice of PA in adolescents. Protective factors (physical activity and sport) and risk factors (leading a sedentary life, tobacco use, and problematic internet use) were evaluated. Other variables such as sex, the intensity of physical activity, and being a member of a sports federation were also evaluated. The sample consisted of a total of 1222 Spanish adolescents. Univariate descriptive analysis and multiple linear regression were used, and confirmatory factor analyses and structural models were also estimated. The results confirm a significant positive association between physical activity, intensity, and being a member of a sports federation, as well as between cigarette consumption and internet use. It is advisable to implement public policies that promote the practice of sports as a direct investment in health, preventing the consumption of tobacco and other habits that are harmful to the health of adolescents.
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Affiliation(s)
| | - José Luis García-Soidán
- Faculty of Education and Sport Sciences, Campus A Xunqueira s/n, University of Vigo, 36005 Pontevedra, Spain;
| | - Manuel Isorna Folgar
- Faculty of Education and Social Work, Campus As Lagoas, University of Vigo, 32004 Ourense, Spain
| | - Víctor Arufe Giráldez
- Facultad de Ciencias de la Educación, Universidad de A Coruña, 15008 A Coruña, Spain;
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Lippke S, Dahmen A, Gao L, Guza E, Nigg CR. To What Extent is Internet Activity Predictive of Psychological Well-Being? Psychol Res Behav Manag 2021; 14:207-219. [PMID: 33642884 PMCID: PMC7903968 DOI: 10.2147/prbm.s274502] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Healthy internet activity (eg, making use of eHealth and online therapy) is positively associated with well-being. However, unhealthy internet activity (too much online time, problematic internet use/PIU, internet dependency/ID, etc.) is associated with reduced well-being, loneliness, and other related negative aspects. While most of the evidence is correlational, some research also shows that internet activity can be predictive for well-being. OBJECTIVE The aim of this article is to elaborate on the question as to what extent internet activity is predictive of psychological well-being by means of (a) a scoping review and (b) theoretical understanding which model the interrelation of internet activity and psychological well-being. METHODOLOGY We searched different electronic databases such as Web of Science by using the search terms "Internet" OR "App" OR "digital" OR "online" OR "mobile application" AND "Use" OR "Activity" OR "Behavior" OR "Engagement" AND "Well-being" OR "Loneliness" for (a, the scoping review) or CCAM for (b, the theoretical understanding). RESULTS The scoping review (a) summarizes recent findings: the extent to which internet activity is predictive for well-being depends on the internet activity itself: internet activity facilitating self-management is beneficial for well-being but too much internet activity, PIU and ID are detrimental to well-being. To understand (b) why, when and how internet activity is predictive for well-being, theoretical understanding and a model are required. While theories on either well-being or internet activity exist, not many theories take both aspects into account while also considering other behaviors. One such theory is the Compensatory Carry-Over Action Model (CCAM) which describes mechanisms on how internet use is related to other lifestyle behaviors and well-being, and that individuals are driven by the goal to adopt and maintain well-being - also called higher-level goals - in the CCAM. There are few studies testing the CCAM or selected aspects of it which include internet activity and well-being. Results demonstrate the potentials of such a multifactorial, sophisticated approach: it can help to improve health promotion in times of demographic change and in situations of lacking personnel resources in health care systems. CONCLUSION AND RECOMMENDATION Suggestions for future research are to employ theoretical approaches like the CCAM and testing intervention effects, as well as supporting individuals in different settings. The main aim should be to perform healthy internet activities to support well-being, and to prevent unhealthy internet activity. Behavior management and learning should accordingly aim at preventing problematic internet use and internet dependency.
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Affiliation(s)
- Sonia Lippke
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Alina Dahmen
- Dr. Becker Klinikgruppe, Cologne, 50968, Germany
| | - Lingling Gao
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Endi Guza
- Department of Psychology & Methods/Focus Area Diversity, Jacobs University Bremen gGmbH, Bremen, 28759, Germany
| | - Claudio R Nigg
- Institute of Sport Science, University of Bern, Bern, 3012, Switzerland
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13
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Nudelman G, Peleg S, Shiloh S. The Association Between Healthy Lifestyle Behaviours and Coronavirus Protective Behaviours. Int J Behav Med 2021; 28:779-787. [PMID: 33569759 PMCID: PMC7875448 DOI: 10.1007/s12529-021-09960-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Based on models of cross-behavioural associations and the role of past behaviour in predicting behaviour, an association was hypothesized between healthy lifestyle behaviours prior to the COVID-19 pandemic and adherence to coronavirus protective behaviours. Self-assessed health was also examined as a potential moderator. METHODS A cross-sectional sample (N = 463) completed online questionnaires during a COVID-19-related lockdown that measured engagement in healthy lifestyle behaviours (e.g., exercising and eating fruits and vegetables), adherence to coronavirus protective behaviours (e.g., wearing a face mask and practicing social distancing), and self-assessed health (subjective evaluation of overall health). RESULTS As predicted, higher engagement in healthy lifestyle behaviours prior to the pandemic was significantly correlated with higher adherence to coronavirus protective behaviours (Pearson r(459) = .308, p < .001). Adherence levels were higher than engagement in healthy lifestyle behaviours, and self-assessed health was related to the latter but not to the former. Moderation was examined using model 1 in PROCESS for SPSS; as expected, the association was stronger among individuals with higher levels of self-assessed health (coefficient 95% CI [.04, .20]). CONCLUSIONS The findings highlight cross-behavioural facilitating processes, specifically between lifestyle behaviours and adherence to recommended protective behaviours during the pandemic. They also draw attention to the need to address individuals whose poorer evaluations of their general health might prevent them from implementing their behavioural intentions.
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Affiliation(s)
- Gabriel Nudelman
- The Academic College of Tel Aviv-Yaffo, Rabenu Yeruham St 2, Tel Aviv-Yafo, Israel.
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14
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Holahan CJ, Holahan CK, Lim S, Powers DA. Living with a Smoker and Multiple Health-Risk Behaviors. Ann Behav Med 2020; 55:287-297. [PMID: 32814951 DOI: 10.1093/abm/kaaa059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Behavioral medicine is showing growing theoretical and applied interest in multiple health-risk behaviors. Compared to engaging in a single health-risk behavior, multiple health-risk behaviors are linked to increased morbidity and mortality. A contextual determinant of multiple risk behaviors may be living with a smoker. PURPOSE This study investigated the role of living with a smoker in predicting multiple health-risk behaviors compared to a single health-risk behavior, as well as whether these multiple risk behaviors occur across both physical activity and dietary domains. Moreover, the study tested these effects across 3 years in longitudinal and prospective (controlling for health-risk behaviors at baseline) analyses. METHODS Participants were 82,644 women (age M = 63.5, standard deviation = 7.36, age range = 49-81) from the Women's Health Initiative Observational Study. Analyses used multinomial and binary logistic regression. RESULTS Living with a smoker was more strongly associated with multiple health-risk behaviors than with a single health-risk behavior. These multiple risk behaviors occurred across both physical activity and dietary domains. The effects persisted across 3 years in longitudinal and prospective analyses. Living with a smoker, compared to not living with a smoker, increased the odds of multiple health-risk behaviors 82% cross-sectionally and, across 3 years, 94% longitudinally and 57% prospectively. CONCLUSIONS These findings integrate research on multiple health-risk behaviors and on living with a smoker and underscore an unrecognized public health risk of tobacco smoking. These results are relevant to household-level interventions integrating smoking-prevention and obesity-prevention efforts.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Sangdon Lim
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Daniel A Powers
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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15
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Problematic Internet Use and Perceived Quality of Life: Findings from a Cross-Sectional Study Investigating Work-Time and Leisure-Time Internet Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114056. [PMID: 32517203 PMCID: PMC7311972 DOI: 10.3390/ijerph17114056] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
Avoiding the potential negative impact brought by problematic internet use is becoming more important. To better understand public health and addiction, this study investigated to what extent work-time and leisure-time internet use relate to problematic internet use and perceived quality of life among college students and highly educated adults. An online cross-sectional survey with 446 individuals was assessed in Germany. Linear regression analyses were used to predict problematic internet use. Ordinal regression analyses were applied to predict perceived quality of life. Results showed that leisure-time internet use, but not work-time internet use, was positively associated with problematic internet use. Participants whose work-time internet use could be considered balanced (5–28 h/week in this study) indicated a higher perceived quality of life compared to individuals with little or large amount of internet use for work. The findings still emerged when taking negative feelings, perceived stress, smoking status and alcohol consumption into account. As both work-time and leisure-time internet use can be risk factors for mental health in terms of problematic internet use and perceived quality of life, well-controlled internet use rather than excessive use is recommended. This should be kept in mind when dealing with the Coronavirus pandemic and its aftermath.
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16
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Allman-Farinelli M, Chen J, Chevance G, Partridge SR, Gemming L, Patrick K, Godino JG. The efficacy of electronic health interventions targeting improved sleep for achieving prevention of weight gain in adolescents and young to middle-aged adults: A systematic review. Obes Rev 2020; 21:e13006. [PMID: 32037672 DOI: 10.1111/obr.13006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/21/2019] [Accepted: 01/15/2020] [Indexed: 12/24/2022]
Abstract
Sleep is emerging as a modifiable risk factor in counteracting harmful weight gain. Electronic and mobile devices offer a channel for wide-reaching intervention delivery. This systematic review aimed to determine the efficacy of interventions that included sleep behaviour as part of health promotion for preventing weight gain. Seven databases were searched from 1 January 2000 until 28 June 2019. Eligible studies were controlled trials of weight gain prevention programs that addressed sleep in healthy participants aged 13 to 44 years of age. The primary outcome was change in measured or self-reported weight. From 824 publications located, only six eligible trials with a total of 3,277 participants were identified and all addressed multiple behaviours. One study demonstrated a decrease in weight for the intervention group, and two other studies showed a decreased prevalence of overweight and obesity. Only one trial showed improved sleep duration but failed to show differences in weight. No definitive conclusions concerning the efficacy of electronic weight gain prevention interventions that include sleep can be made, but future trials should provide more detail about intervention techniques used, employ objective sleep and physical activity measures and undertake mediation analysis to judge the contributions of changes in sleep to study outcomes. PROSPERO REGISTRATION: CRD42019121879.
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Affiliation(s)
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Guillaume Chevance
- Center for Wireless and Population Health Systems, The University of California San Diego, San Diego, California, USA
| | | | - Luke Gemming
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Kevin Patrick
- Center for Wireless and Population Health Systems, The University of California San Diego, San Diego, California, USA
| | - Job G Godino
- Center for Wireless and Population Health Systems, The University of California San Diego, San Diego, California, USA
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17
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Gao L, Gan Y, Whittal A, Yan S, Lippke S. The Mediator Roles of Problematic Internet Use and Perceived Stress Between Health Behaviors and Work-Life Balance Among Internet Users in Germany and China: Web-Based Cross-Sectional Study. J Med Internet Res 2020; 22:e16468. [PMID: 32391798 PMCID: PMC7248799 DOI: 10.2196/16468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/09/2019] [Accepted: 02/07/2020] [Indexed: 01/17/2023] Open
Abstract
Background Work-life balance is associated with health behaviors. In the face of digitalization, understanding this link requires a theory-based investigation of problematic internet use and perceived stress, which are so far unknown. Objective On the basis of the compensatory carry-over action model, this study aimed to determine whether problematic internet use and perceived stress mediate the relationship between health behaviors and work-life balance in two groups of internet users from different environments (residents in Germany and China). We also investigated whether the place of residence was a moderator. Methods An online questionnaire (N=877) was administered to residents from Germany (n=374) and China (n=503) in 3 languages (German, English, and Chinese). Moderated mediation analyses were run with health behaviors as the independent variable, work-life balance as the dependent variable, problematic internet use and perceived stress as the mediator variables, and place of residence as a potential moderator. Results On a mean level, individuals in Germany reported less problematic internet use and more health behaviors than individuals in China; however, they also had lower work-life balance and higher perceived stress. Results showed that health behaviors seem to be directly related to work-life balance in both groups. Among the residents of Germany, a partial mediation was revealed (β=.13; P=.01), whereas among the residents of China, a full mediation was found (β=.02; P=.61). The mediator role of perceived stress was compared with problematic internet use in all the serial models and the parallel model. Residence moderated the relationship between health behaviors and work-life balance: The interrelation between health behaviors and work-life balance was stronger in Germany (β=.19; P<.001) than in China (β=.11; P=.01) when controlling for other variables. Conclusions The findings of this study are in line with the compensatory carry-over action model. To promote work-life balance, individuals should perform health behaviors to help overcome problematic internet use and perceived stress. Both problematic internet use and perceived stress mediated health behaviors and work-life balance partially in German study participants and fully in Chinese study participants.
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Affiliation(s)
- Lingling Gao
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Yiqun Gan
- School of Psychological Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Amanda Whittal
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Song Yan
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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18
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Rinn R, Gan Y, Whittal A, Lippke S. Cardiopulmonary capacity and psychological factors are related to return to work in orthopedic rehabilitation patients. J Health Psychol 2020; 26:2505-2519. [PMID: 32345071 DOI: 10.1177/1359105320913946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Health psychology sheds light on the process of returning to work after sick leave and subsequent medical rehabilitation. A 15-month longitudinal study with N = 201 orthopedic rehabilitation patients is reported. It examined whether and how both physiological health (e.g. body mass index and oxygen reabsorption) and psychological/social-cognitive factors (e.g. self-efficacy and social support) are related to returning to work. It was found that social-cognitive and physiological variables, such as oxygen consumption at anaerobic threshold, are important for returning to work. While physical activity was significantly correlated with social-cognitive variables, it was not significantly correlated directly with returning to work. Results suggest that self-efficacy and oxygen consumption at anaerobic threshold should be improved during medical rehabilitation.
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Affiliation(s)
- Robin Rinn
- Jacobs University Bremen, Germany
- Julius-Maximilians-Universität Würzburg, Germany
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19
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Heredia NI, Fernandez ME, van den Berg AE, Durand CP, Kohl HW, Reininger BM, Hwang KO, McNeill LH. Coaction Between Physical Activity and Fruit and Vegetable Intake in Racially Diverse, Obese Adults. Am J Health Promot 2020; 34:238-246. [PMID: 31722544 PMCID: PMC7033009 DOI: 10.1177/0890117119884479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE There is minimal understanding of the potential for coaction, defined as action on one behavior increasing the likelihood of taking action on another behavior, between physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study was to assess the bidirectional coaction between FV intake and PA, as well as self-efficacy for these behaviors, in a racially diverse sample of obese adults. DESIGN This is a secondary analysis using data collected from the Path to Health study, a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03674229. SAMPLE Obese adults who completed baseline and 6-month follow-up assessments. MEASURES For this study, data on FV intake, leisure time PA, and 7-day accelerometer data were analyzed at baseline and 6-month follow-up. ANALYSIS We interchanged modeling the FV intake and PA change variables as the independent and dependent variables. We conducted multiple imputation and both linear and multinomial regression. RESULTS The sample (n = 168) was 59% female and mainly split between white (42%) and African American (42%). Change in self-efficacy for PA was predictive of change in self-efficacy for FV intake and vice versa. When compared with participants with no change in FV intake, someone with a positive change in FV intake was more likely to have a positive change in self-reported PA (adjusted risk ratio [RR] = 6.72, 95% confidence interval [CI] = 1.69-26.68). Likewise, when compared with no change, participants with a positive change in self-reported PA were more likely to report a positive change in FV intake (adjusted RR = 6.79, 95% CI = 1.70-27.17). CONCLUSION Findings suggest coaction between self-efficacy for FV intake and PA as well as between FV intake and PA. Coaction could be capitalized on to more effectively promote both energy-balance behaviors.
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Affiliation(s)
- Natalia I Heredia
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Suite FCT9.6073, Houston, TX 77030, USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, TX, USA
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, TX, USA
| | - Alexandra E van den Berg
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX, USA
| | - Casey P Durand
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX, USA
| | - Harold W Kohl
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Belinda M Reininger
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health in Brownsville, Brownsville, TX, USA
| | - Kevin O Hwang
- McGovern Medical School at UTHealth, Houston, TX, USA
| | - Lorna H McNeill
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Suite FCT9.6073, Houston, TX 77030, USA
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20
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Forestier C, Sarrazin P, Sniehotta F, Allenet B, Heuzé JP, Gauchet A, Chalabaev A. Do compensatory health beliefs predict behavioural intention in a multiple health behaviour change context? Evidence in individuals with cardiovascular diseases? PSYCHOL HEALTH MED 2019; 25:593-600. [PMID: 31402693 DOI: 10.1080/13548506.2019.1653476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Multiple health behaviour change (MHBC) represents one of the best ways to prevent reoccurrence of cardiovascular events. However, few individuals with cardiovascular diseases engage in this process. The present study examined the role of compensatory health beliefs (CHB; i.e., belief that a healthy behaviour compensates an unhealthy one) as a drag to engagement in this process. Some studies have shown that CHBs predict intention to engage in healthy behaviours, but no study has investigated CHBs in individuals who actually need to change multiple health behaviours. The goal was to better understand the role of CHBs in intentions formation process among individuals with cardiac diseases in an MHBC context. One hundred and four patients completed a questionnaire at the beginning of their cardiac rehabilitation program. Results showed that: (1) CHBs negatively predicted intentions (2) but only for participants with high self-efficacy or low risk perception; (3) CHBs predictions differed depending on the nature of the compensating behaviour, and were more predictive when medication intake was the compensating one. Findings only partially confirmed previous research conducted on healthy individuals who were not in an MHBC process, and emphasized the importance of considering CHBs for individuals in this process.
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Affiliation(s)
- Cyril Forestier
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France.,Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany
| | | | - Falko Sniehotta
- Institute of Health and Society, New Castle University, Newcastle, UK
| | | | | | | | - Aïna Chalabaev
- Laboratoire SENS, Univ. Grenoble Alpes, Grenoble, France
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21
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Liang W, Duan YP, Shang BR, Wang YP, Hu C, Lippke S. A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial. BMC Public Health 2019; 19:1097. [PMID: 31409381 PMCID: PMC6692951 DOI: 10.1186/s12889-019-7438-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022] Open
Abstract
Background This study aimed to describe the design and present the baseline characteristics of a web-based lifestyle intervention program, which comprises of sequentially and simultaneously delivered intervention modules targeting physical activity (PA) and fruit and vegetable consumption (FVC) in Chinese college students. Methods The study adopted a randomized placebo-controlled trial, using the Health Action Process Approach (HAPA) and the Compensatory Carry-Over Action Model (CCAM) as the theoretical backdrops. 556 Chinese college students participated in the 8-week web-based lifestyle intervention program. All eligible participants were randomly assigned to one of four groups: 1) the PA-first arm which received a 4-week intervention addressing PA followed by a 4-week intervention addressing FVC; 2) the FVC-first arm which received a 4-week intervention addressing FVC followed by a 4-week intervention addressing PA; 3) the PA + FVC simultaneous arm that received an 8-week intervention addressing both PA and FVC at the same time; and 4) the placebo-control arm that received 8 weeks of general health information, which is not relevant for changing actual PA and FVC behaviors. Data collection includes four time-points: at the beginning and end of the intervention, and a 3-month and 12-month follow-up after the intervention. Results At baseline, 41.7% of participants were male and 58.3% were female. 41.0% of the participants did not meet the standard PA-recommendations, while 69.6% did not adhere to the standard FVC-recommendations. In total, only 19.6% of participants met both PA and FVC recommendations. Baseline characteristics across the four groups had no significant differences (all P = .17–.99), indicating successful randomization. Conclusions The preliminary results indicate a high prevalence of unhealthy lifestyles in college students in China, which further supports the need for web-based health intervention programs. This is also the first study that examines the comparative effectiveness of simultaneously and sequentially delivered lifestyle interventions in the Chinese population. These findings may contribute to the creation of future web-based health behavior change interventions. Trial registration ClinicalTrails.gov: NCT03627949, 14 August, 2018. Electronic supplementary material The online version of this article (10.1186/s12889-019-7438-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei Liang
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Yan Ping Duan
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
| | - Bo Rui Shang
- Department of Kinesiology, Hebei Institute of Physical Education, Shijiazhuang, China
| | - Yan Ping Wang
- The National Physical Fitness Lab, Hubei Institute of Sport Science, Wuhan, China
| | - Chun Hu
- Department of Sport and Physical Education, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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22
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Cho D, Nguyen NT, Strong LL, Wu IHC, John JC, Escoto KH, Wetter DW, McNeill LH. Multiple Health Behaviors Engagement in an African American Cohort: Clustering Patterns and Correlates. HEALTH EDUCATION & BEHAVIOR 2019; 46:506-516. [PMID: 30776919 PMCID: PMC10069919 DOI: 10.1177/1090198119826207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigated class clustering patterns of four behaviors—physical activity, fruit and vegetable (F&V) intake, smoking, and alcohol use—in a faith-based African American cohort. Guided by socio-ecological models, we also examined the psychosocial and neighborhood social environmental factors associated with the clustering patterns. Participants were 1,467 African American adults recruited from a mega church in the metropolitan Houston, TX, in 2008-2009. They completed a survey and health assessment. Latent class analysis and multinomial regression analysis were conducted. Results supported a three-class model: Class 1 was characterized by low physical activity, low F&V intake, and low substance use (smoking and alcohol use). Class 2 was characterized by high physical activity, low F&V intake, and mild drinking. Class 3 seemed to be the healthiest group, characterized by high physical activity, moderate-to-high F&V intake, and low substance use. The probabilities of being included in Classes 1, 2, and 3 were .33, .48, and .19, respectively. Participants in Class 1 (vs. Class 3) reported lower physical activity norm ( p < .001) and higher smoking norm ( p = .002) and lower neighborhood social cohesion ( p = .031). Participants in Class 2 (vs. Class 3) reported higher cancer risk perception ( p < .001), lower F&V norm ( p = .022), lower physical activity norm ( p < .001), higher smoking norm ( p < .001), and lower social cohesion ( p = .047). As health behaviors are clustered together, future interventions for African Americans may consider targeting multiple health behaviors instead of targeting a single health behavior. Interventions addressing social norm and neighborhood social cohesion may enhance multiple health behaviors engagement in this population.
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Affiliation(s)
- Dalnim Cho
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nga T. Nguyen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Larkin L. Strong
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ivan H. C. Wu
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jemima C. John
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - David W. Wetter
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lorna H. McNeill
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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23
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Monzani D, D'Addario M, Fattirolli F, Giannattasio C, Greco A, Quarenghi F, Steca P. Clustering of Lifestyle Risk Factors in Acute Coronary Syndrome: Prevalence and Change after the First Event. Appl Psychol Health Well Being 2018; 10:434-456. [PMID: 30230683 DOI: 10.1111/aphw.12141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Healthy lifestyles are modifiable risk factors for acute coronary syndrome (ACS) onset and recurrence. While unhealthy lifestyles tend to cluster together within the general healthy population, little is known about the prevalence and clustering of these behaviours in people with ACS before and after the first acute event. The aim of this study was to identify lifestyle profiles of patients with ACS and to explore their change after their first coronary event. METHODS Three hundred and fifty-six patients completed self-report measures of healthy habits at the beginning of cardiac rehabilitation and 6 months later. By adopting a person-oriented approach, we analysed lifestyle clustering and its change over time. Differences in depression, anxiety, and negative illness perception among lifestyle profiles were assessed. RESULTS We identified seven profiles, ranging from more maladaptive to healthier clusters. Findings showed a strong interrelation among unhealthy habits in patients. We highlighted a moderate individual and group stability of cluster membership over time. Moreover, unhealthier lifestyle profiles were associated with higher levels of depression, anxiety, and negative illness perception. CONCLUSION These results may have implications for the development and implementation of multimodal interventions addressing wider-ranging improvement in lifestyles by targeting multiple unhealthy behaviours in patients with ACS.
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24
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Tan SL, Storm V, Reinwand DA, Wienert J, de Vries H, Lippke S. Understanding the Positive Associations of Sleep, Physical Activity, Fruit and Vegetable Intake as Predictors of Quality of Life and Subjective Health Across Age Groups: A Theory Based, Cross-Sectional Web-Based Study. Front Psychol 2018; 9:977. [PMID: 29967588 PMCID: PMC6016042 DOI: 10.3389/fpsyg.2018.00977] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/28/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Due to the increase in unhealthy lifestyles and associated health risks, the promotion of healthy lifestyles to improve the prevention of non-communicable diseases is imperative. Thus, research aiming to identify strategies to modify health behaviors has been encouraged. Little is known about addressing multiple health behaviors across age groups (i.e., young, middle-aged, and older adults) and the underlying mechanisms. The theoretical framework of this study is Compensatory Carry-Over Action Model which postulates that different health behaviors (i.e., physical activity and fruit and vegetable intake) are interrelated, and they are driven by underlying mechanisms (more details in the main text). Additionally, restful sleep as one of the main indicators of good sleep quality has been suggested as a mechanism that relates to other health behaviors and well-being, and should therefore also be investigated within this study. The present study aims to identify the interrelations of restful sleep, physical activity, fruit and vegetable intake, and their associations with sleep quality as well as overall quality of life and subjective health in different age groups. Methods: A web-based cross-sectional study was conducted in Germany and the Netherlands. 790 participants aged 20–85 years filled in the web-based baseline questionnaire about their restful sleep, physical activity, fruit and vegetable intake, sleep quality, quality of life, and subjective health. Descriptive analysis, multivariate analysis of covariance, path analysis, and multi-group analysis were conducted. Results: Restful sleep, physical activity, and fruit and vegetable intake were associated with increased sleep quality, which in turn was associated with increased overall quality of life and subjective health. The path analysis model fitted the data well, and there were age-group differences regarding multiple health behaviors and sleep quality, quality of life, and subjective health. Compared to young and older adults, middle-aged adults showed poorest sleep quality and overall quality of life and subjective health, which were associated with less engagement in multiple health behaviors. Conclusion: A better understanding of age-group differences in clustering of health behaviors may set the stage for designing effective customized age-specific interventions to improve health and well-being in general and clinical settings. Trial Registration: A clinical trial registration was conducted with ClinicalTrials.gov (NCT01909349) https://clinicaltrials.gov/ct2/show/NCT01909349.
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Affiliation(s)
- Shu Ling Tan
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Institute of Sport and Exercise Sciences, Department of Social Sciences of Sport, University of Münster, Münster, Germany
| | - Vera Storm
- Institute of Sport and Exercise Sciences, Department of Sport Psychology, University of Münster, Münster, Germany
| | - Dominique A Reinwand
- Rehabilitative Gerontology, Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Julian Wienert
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Scientific Institute of TK for Benefit and Efficiency in Health Care (WINEG), Hamburg, Germany
| | - Hein de Vries
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Sonia Lippke
- Health Psychology and Behavioral Medicine, Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.,Bremen International Graduate School of Social Sciences, Jacobs University Bremen, Bremen, Germany
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25
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Amireault S, Fong AJ, Sabiston CM. Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors. Am J Lifestyle Med 2018; 12:184-199. [PMID: 30202391 PMCID: PMC6124968 DOI: 10.1177/1559827616661490] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/17/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.
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Affiliation(s)
- Steve Amireault
- Steve Amireault, PhD, Department of Health and Kinesiology, Purdue University, 800 West Stadium Avenue, Lambert Fieldhouse, Office 311A, West Lafayette, IN 47907; e-mail:
| | - Angela J. Fong
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
| | - Catherine M. Sabiston
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
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26
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Inauen J, Radtke T, Rennie L, Scholz U, Orbell S. Transfer or Compensation? SWISS JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1024/1421-0185/a000207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This study tested the effects of exercise on eating behavior. The transfer hypothesis proposes that exercise leads to a generalization of healthy behavior and therefore an improved diet. The compensation hypothesis assumes that exercise leads to increased caloric intake in order to “compensate” for the energy expenditure. We tested these hypotheses for actual as well as imagined exercise. Female university employees or students (N = 227) were randomly assigned to three experimental groups: actual exercise vs. imagined exercise vs. control. After baseline data had been obtained, the participants engaged in a 5-minute experimental task and were then left alone with unhealthy snacks. Participants who had imagined themselves exercising (M = 101 kcal, SD = 128 kcal) consumed significantly fewer calories than did controls (M = 129 kcal, SD = 142 kcal), consistent with a transfer effect. Participants who had engaged in actual exercise, but had been distracted from thinking about exercise, consumed quantities (M = 127 kcal, SD = 111 kcal) similar to those consumed by controls. This study suggests that transfer effects are underpinned by psychological processes, such as goal activation, which should be investigated in the future.
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Affiliation(s)
- Jennifer Inauen
- Department of Environmental Social Sciences, Eawag – Swiss Federal Institute of Aquatic Science & Technology, Dübendorf, Switzerland
| | - Theda Radtke
- Department of Psychology, University of Zurich, Switzerland
| | - Laura Rennie
- B-Research, Université Paris Ouest Nanterre La Défense, Nanterre, France
| | - Urte Scholz
- Department of Psychology & University Research Priority Program “Dynamics of Healthy Aging,” University of Zurich, Switzerland
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, UK
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27
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Rennie LJ, Uskul AK. Encouraging bigger-picture thinking in an intervention to target multiple obesogenic health behaviours. Appetite 2017; 118:144-148. [PMID: 28782571 DOI: 10.1016/j.appet.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/19/2017] [Accepted: 08/03/2017] [Indexed: 11/28/2022]
Abstract
Research has shown that use of the third-person perspective to visualise a behaviour results in increased motivation to engage in the behaviour relative to the first-person perspective. This effect is claimed to operate in part because the third-person perspective leads the individual to "see the bigger picture", linking the visualised behaviour to broader goals and identities. Reasoning that this effect could be harnessed to encourage engaging in multiple behaviours that serve the same broader goal, the present study manipulated the visual perspective participants used to imagine themselves exercising, and assessed effects on cognitions and behaviour related to both exercising and healthy eating. Baseline exercise levels were measured and explored as a moderation effect. As predicted, it was found that for participants who engaged in more exercise at baseline, visualising exercise using the third-person perspective resulted in them reporting stronger intentions to exercise and taking more leaflets showing local exercise classes. For those who engaged in less exercise at baseline, there was no effect of perspective. In terms of eating, there was a main effect of perspective, such that participants who imagined themselves exercising using the third-person perspective ate significantly less chocolate than those who used the first-person perspective, irrespective of baseline exercise levels. These results suggest that use of third-person perspective visualisation can be used to encourage engagement in multiple behaviours that serve the same broad goal, which may serve as an intervention technique that will be especially helpful for health outcomes with multiple contributing behaviours, such as obesity and overweight.
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Affiliation(s)
- Laura J Rennie
- B-Research/Université Paris-Ouest Nanterre la Défense, 8 Rue du Capitaine Madon, 75018 Paris, France; Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom
| | - Ayse K Uskul
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom; School of Psychology, University of Kent, Canterbury, CT2 7NL, United Kingdom.
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28
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Physical Activity Behavior and Competing Activities: Interrelations in 55- to 70-Year-Old Germans. J Aging Phys Act 2017; 25:576-586. [PMID: 28181825 DOI: 10.1123/japa.2016-0211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this study, we draw attention to time-competing activities and psychological variables as impeding or enabling factors of physical activity behavior in 55- to 70-year-old Germans. Cross-sectional data was used (n = 4,891). Results indicate that paid work has a negative relationship with sufficient physical activity. Persons who provide nursing care seem to be motivated to achieve sufficient physical activity behavior, but do not meet established recommendations. Active citizenship positively relates to higher physical activity levels. The investment of energy in life domains and a distinct internal locus of control characterize motivated underachievers. Those sufficiently physically active show higher values in conscientiousness. This suggests that time-consuming and strongly externally determined activities like nursing care and paid work hinder a sufficient level of physical activity, even if the motivation is existent. Active citizenship and physical activity seem to be linked processes.
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29
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Paech J, Lippke S. Put two (and two) together to make the most of physical activity and healthy nutrition – A longitudinal online study examining cross-behavioural mechanisms in multiple health behaviour change. Res Sports Med 2017; 25:357-372. [DOI: 10.1080/15438627.2017.1314287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Juliane Paech
- Health Psychology, Jacobs University Bremen, Bremen, Germany
| | - Sonia Lippke
- Health Psychology, Jacobs University Bremen, Bremen, Germany
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30
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Future directions of multiple behavior change research. J Behav Med 2016; 40:194-202. [DOI: 10.1007/s10865-016-9809-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
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31
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James E, Freund M, Booth A, Duncan MJ, Johnson N, Short CE, Wolfenden L, Stacey FG, Kay-Lambkin F, Vandelanotte C. Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials. Prev Med 2016; 89:211-223. [PMID: 27311332 DOI: 10.1016/j.ypmed.2016.06.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 06/02/2016] [Accepted: 06/12/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors. PURPOSE This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and; c) differences in trial retention between simultaneously and sequentially delivered interventions. METHODS MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken. RESULTS Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches. CONCLUSIONS There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876.
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Affiliation(s)
- Erica James
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Megan Freund
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Angela Booth
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Mitch J Duncan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Natalie Johnson
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Camille E Short
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Fiona G Stacey
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Frances Kay-Lambkin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, The Central Queensland University, North Rockhampton, QLD, Australia
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Storm V, Dörenkämper J, Reinwand DA, Wienert J, De Vries H, Lippke S. Effectiveness of a Web-Based Computer-Tailored Multiple-Lifestyle Intervention for People Interested in Reducing their Cardiovascular Risk: A Randomized Controlled Trial. J Med Internet Res 2016; 18:e78. [PMID: 27068880 PMCID: PMC4844907 DOI: 10.2196/jmir.5147] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/17/2015] [Accepted: 01/17/2016] [Indexed: 01/07/2023] Open
Abstract
Background Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. Objective The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascular risk. In a randomized controlled design, self-reported changes in perceived habit strength, self-efficacy, and planning across different domains of physical activity as well as fruit and vegetable consumption were evaluated. Methods This study was a randomized controlled trial involving an intervention group (n=403) and a waiting control group (n=387). Web-based data collection was performed in Germany and the Netherlands during 2013-2015. The intervention content was based on the Health Action Process Approach and involved personalized feedback on lifestyle behaviors, which indicated whether participants complied with behavioral guidelines for physical activity and fruit and vegetable consumption. There were three Web-based assessments: baseline (T0, N=790), a posttest 8 weeks after the baseline (T1, n=206), and a follow-up 3 months after the baseline (T2, n=121). Data analysis was conducted by analyzing variances and structural equation analysis. Results Significant group by time interactions revealed superior treatment effects for the intervention group, with substantially higher increases in self-reported habit strength for physical activity (F1,199=7.71, P=.006, Cohen’s d=0.37) and fruit and vegetable consumption (F1,199=7.71, P=.006, Cohen’s d=0.30) at posttest T1 for the intervention group. Mediation analyses yielded behavior-specific sequential mediator effects for T1 planning and T1 self-efficacy between the intervention and habit strength at follow-up T2 (fruit and vegetable consumption: beta=0.12, 95% CI 0.09-0.16, P<.001; physical activity: beta=0.04, 95% CI 0.02-0.06, P<.001). Conclusions Our findings indicate the general effectiveness and practicality of Web-based computer-tailored interventions in terms of increasing self-reported habit strength for physical activity and fruit and vegetable consumption. Self-efficacy and planning may play major roles in the mechanisms that facilitate the habit strength of these behaviors; therefore, they should be actively promoted in Web-based interventions. Although the results need to take into account the high dropout rates and medium effect sizes, a large number of people were reached and changes in habit strength were achieved after 3 months. Trial Registration Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6g5F0qoft) and Nederlands Trial Register NTR3706 http://www.trialregister.nl/ trialreg/admin/rctview.asp?TC=3706 (Archived by WebCite at http://www.webcitation.org/6g5F5HMLX)
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Affiliation(s)
- Vera Storm
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany.
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33
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Storm V, Reinwand D, Wienert J, Kuhlmann T, De Vries H, Lippke S. Brief report: Compensatory health beliefs are negatively associated with intentions for regular fruit and vegetable consumption when self-efficacy is low. J Health Psychol 2016; 22:1094-1100. [PMID: 26826167 DOI: 10.1177/1359105315625358] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Compensatory health beliefs (the beliefs that an unhealthy behaviour can be compensated by a healthy behaviour) can interfere with adherence to fruit and vegetable consumption recommendations. Fruit and vegetable consumption, social cognitive variables and compensatory health beliefs were investigated via self-report at baseline (T0) and 8-week follow-up (T1) in N = 790 participants. Self-efficacy predicted fruit and vegetable consumption intentions. Planning mediated between intentions and T1 fruit and vegetable consumption. Compensatory health beliefs negatively predicted intentions at low self-efficacy levels only. The results propose the use of self-efficacy interventions to diminish the negative effects of compensatory health beliefs when forming fruit and vegetable consumption intentions and foster planning to translate intentions into behaviour.
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Affiliation(s)
| | - Dominique Reinwand
- 1 Jacobs University Bremen, Germany.,2 Maastricht University, Netherlands
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34
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Fleig L, Ngo J, Roman B, Ntzani E, Satta P, Warner LM, Schwarzer R, Brandi ML. Beyond single behaviour theory: Adding cross-behaviour cognitions to the health action process approach. Br J Health Psychol 2015; 20:824-41. [DOI: 10.1111/bjhp.12144] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 05/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Lena Fleig
- Health Psychology; Freie Universität Berlin; Germany
- Centre for Hip Health and Mobility; Vancouver British Columbia Canada
- Department of Family Practice; University of British Columbia; Vancouver British Columbia Canada
| | - Joy Ngo
- Nutrition Research Foundation; Barcelona Science Park; Spain
| | - Blanca Roman
- Nutrition Research Foundation; Barcelona Science Park; Spain
- EUSES Sports Science; University of Girona; Spain
| | - Evangelia Ntzani
- Clinical and Molecular Epidemiology Unit; Department of Hygiene and Epidemiology; University of Ioannina School of Medicine; Greece
| | - Paolo Satta
- Department of Surgery and Translational Medicine; University of Florence; Italy
| | | | - Ralf Schwarzer
- Institute for Positive Psychology and Education; Australian Catholic University; Sydney New South Wales Australia
| | - Maria L. Brandi
- Department of Surgery and Translational Medicine; University of Florence; Italy
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35
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Fleig L, Küper C, Lippke S, Schwarzer R, Wiedemann AU. Cross-behavior associations and multiple health behavior change: A longitudinal study on physical activity and fruit and vegetable intake. J Health Psychol 2015; 20:525-34. [DOI: 10.1177/1359105315574951] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline. Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals.
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Affiliation(s)
| | | | | | - Ralf Schwarzer
- Australian Catholic University, Australia
- University of Social Sciences and Humanities, Poland
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