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Ghaffari M, Sadeghi B, Dadipoor S, Safari-Moradabadi A. Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention. HEALTH EDUCATION RESEARCH 2024; 39:262-271. [PMID: 38687633 DOI: 10.1093/her/cyae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/11/2023] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.
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Affiliation(s)
- Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bita Sadeghi
- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Community-Oriented Nursing and Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Sara Dadipoor
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Safari-Moradabadi
- Department of Health Promotion and Education, School of Health, Alborz University of Medical Sciences, Alborz, Iran
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O’Brien N, Lawlor M, Chambers F, O’Brien W. State of Mind Ireland-Higher Education: A Mixed-Methods Longitudinal Evaluation of a Positive Mental Health Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155530. [PMID: 32751816 PMCID: PMC7432411 DOI: 10.3390/ijerph17155530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 12/22/2022]
Abstract
Objective: This study evaluates the impact of the State of Mind Ireland-Higher Education (SOMI-HE) Mental Fitness intervention on student wellbeing, resilience, and physical activity (PA) participation. Design: A mixed-methods research design, comprising of a self-report questionnaire, and semi-structured focus group interviews at pre, post and follow-up phases were employed. Participants were a sample of 134 higher education students (29% male: 71% female; mean age range 18 to 25 years old). The quantitative outcome measures of wellbeing, resilience and PA data were analysed using SPSS version 26.0, (IBM, Armonk, NY, USA) with appropriate statistical analysis. Qualitative data were analysed using thematic analysis to capture the long-term outcomes and impact of the intervention. Results: The results indicate a significant intervention effect on participants’ wellbeing (t (120) = −4.27, p < 0.001), PA levels (t (126) = 3.91, p < 0.001) and motivational readiness for exercise change (χ2 (1, n = 131) = 6.9, p < 0.009 (2–sided). Qualitative findings suggest a sustained long-term increase in PA and resilience skills for positive mental health, and reduced stigma and barriers to positive mental health. Conclusion: The findings demonstrate the effectiveness of the SOMI-HE evidence-based intervention, and beneficial outcomes of a salutary approach to higher education student mental health.
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Tessaro VCZ, Silva AMR, Loch MR. Stages of change for leisure time physical activity in Brazilian adults: longitudinal study. CIENCIA & SAUDE COLETIVA 2020; 26:2969-2980. [PMID: 34378690 DOI: 10.1590/1413-81232021268.18022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze the maintenance of and movement between stages of change for leisure time physical activity (LTPA) after four years and the association with sociodemographic characteristics. A cross-sectional population-based study was conducted with 1,180 individuals aged 40 years or over in 2011. In 2015, 885 participants were reinterviewed. The dependent variables were the maintenance of and movement between stages of change for LTPA behavior. The data was analyzed using adjusted Poisson regression. We found that around 40% of the study participants were still at the same stage they were at in the first assessment, while 31.6% had relapsed and 27% had advanced at least one stage. The stages that showed the highest frequencies were remained in precontemplation and maintenance. The risk of remaining at the precontemplation stage was higher among men (RR=1.59; 95%CI:1.21-2.11), respondents aged ≥60 years (RR=1.35; 95%CI:1.03-1.78), those with a lower level of education (RR=1.24; 95%CI:1.04-2.33), and those from economic classes C and D/E (RR=1.71; 95%CI:1.17-2.49 and RR=1.88; 95%CI:1.12-3.18, respectively). The frequency of individuals who remained at the maintenance stage was significantly lower in economic classes D/E than in classes A/B (RR=0.35; 95%CI:0.14-0.87).
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Affiliation(s)
- Valéria Cristina Zamataro Tessaro
- Programa de Pós-Graduação em Fisioterapia, Universidade Estadual de Londrina. Av. Robert Koch 60 Caixa Postal 791, Bairro Cervejaria. 86038-440 Londrina PR Brasil.
| | - Ana Maria Rigo Silva
- Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual de Londrina. Londrina PR Brasil
| | - Mathias Roberto Loch
- Departamento de Fundamentos da Educação Física, Centro de Educação Física e Desportos, Universidade Estadual de Londrina. Londrina PR Brasil
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The Effect of Brain Breaks on Physical Activity Behaviour among Primary School Children: A Transtheoretical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214283. [PMID: 31690004 PMCID: PMC6862123 DOI: 10.3390/ijerph16214283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
Brain Breaks Physical Activity Solutions (BBPAS) is a web-based structured physical activity (PA) video that is specifically designed for school settings and can stimulate a student’s health and learning. The purpose of this study is to measure the effect of BBPAS on the stages of change, decisional balance, processes of change, self-efficacy and leisure-time exercise among Malay ethnic primary school children. A validated Malay version of three of the five constructs was derived with sound validity and was used in the present study. A total of 159 male and 163 female children aged 10 to 11 years old, mean (SD) = 10.53 (0.50), were recruited from two schools in Kelantan, Malaysia. Purposive sampling was used to divide the children into intervention (n = 177) and control (n = 145) groups. Children in the intervention group underwent BBPAS activity for an accumulated 30 min per week, while children in the control group were not involved in the BBPAS intervention. Mixed factorial analysis of variance (ANOVA) was used to examine the effect of BBPAS on the study variables. A mixed ANOVA showed significant changes (time effect) on cognitive process, F(1, 320) = 5.768, p-value = 0.017; behavioural process, F(1, 313) = 5.736, p-value = 0.017; and internal feeling, F(1, 312) = 6.050, p-value = 0.014. There was also a significant difference between groups on cons, F(1, 316) = 7.504, p-value = 0.007. A significant interaction effect was observed for stages of change, F(1, 319) = 7.861, p-value = 0.005; pros, F(1, 316) = 31.311, p-value = 0.001; internal feeling, F(1, 312) = 4.692, p-value = 0.031; and behavioural process, F(1, 313) = 7.312, p-value = 0.007. In conclusion, BBPAS was successful in improving four of the five constructs, and thus, should be recommended to be used in schools throughout Malaysia.
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Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
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Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Liu KT, Kueh YC, Arifin WN, Kim Y, Kuan G. Application of Transtheoretical Model on Behavioral Changes, and Amount of Physical Activity Among University's Students. Front Psychol 2018; 9:2402. [PMID: 30618907 PMCID: PMC6304387 DOI: 10.3389/fpsyg.2018.02402] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 11/14/2018] [Indexed: 11/13/2022] Open
Abstract
This study's purpose was to examine the structural relationship of the transtheoretical model (TTM) and the amount of physical activity (PA) among undergraduate students in health and medicine at Universiti Sains Malaysia. A cross-sectional study was carried out among students who took part in the co-curricular program. Co-curricular program includes activities that take place outside of the regular lectures or tutorials in the University. Students recruited through purposive sampling were informed that their participation was entirely voluntarily. Those interested completed the self-administered questionnaire, which consisted of the decisional balance, processes of change, self-efficacy, stages of change scales, and Godin leisure-time exercise questionnaire. Data were analyzed using Mplus version 8 for descriptive statistics and structural equation modeling analysis for inferential statistics. A total of 562 students participated in the study. The majority of the students was female (79.0%) and Malay (73.3%) and average of exercise sessions per week was 2.62, with a mean of 43.37 min per exercise session. The final structural model fit the data well based on several fit indices (SRMR = 0.046, RMSEA (CI: 90%) = 0.061 (0.045, 0.078), RMSEA p = 0.130). The model showed that stages of change significantly affected self-efficacy (p < 0.001), pros (benefits of exercise; p < 0.001), cons (barriers to exercise; p = 0.022), and processes of change (p < 0.001). The model also showed significant inter-relationships among the TTM constructs and supported seven hypotheses. Among all the variables examined, only processes of change significantly affected PA (p < 0.001). However, stages of change (p < 0.001) and pros (p =< 0.001) had significant indirect effects on PA via processes of change. The findings support that individuals' stages of change affect their self-efficacy level, or the ability to make positive and negative decisions and perform behavior accordingly. The study confirms that making correct decisions and taking action accordingly can increase PA levels.
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Affiliation(s)
- Kien Ting Liu
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia, Kelantan, Malaysia
| | - Wan Nor Arifin
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia, Kelantan, Malaysia
| | - Youngho Kim
- Department of Sports and Health Science, Seoul National University of Science and Technology, Seoul, South Korea
| | - Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Malaysia, Kelantan, Malaysia
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The Impact of Behavioral and Psychological Factors on Physical Fitness in Medical and Nursing Students. Holist Nurs Pract 2018; 32:125-132. [PMID: 29642126 DOI: 10.1097/hnp.0000000000000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical activity improves general health and quality of life. A stressful academic environment can increase both physical and mental health disruptions in medical and nursing students, negatively impacting physical activity and fitness. We explored the relationship between the fitness profiles of 202 medical and graduate nursing students with self-reported levels of general and emotional health to elucidate the role of the psychosocial factors involved in choosing to exercise.
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Ickes MJ, McMullen J, Pflug C, Westgate PM. Impact of a University-based Program on Obese College Students' Physical Activity Behaviors, Attitudes, and Self-efficacy. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2015.1111178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thrul J, Klein AB, Ramo DE. Smoking Cessation Intervention on Facebook: Which Content Generates the Best Engagement? J Med Internet Res 2015; 17:e244. [PMID: 26561529 PMCID: PMC4704894 DOI: 10.2196/jmir.4575] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/20/2015] [Accepted: 10/07/2015] [Indexed: 11/13/2022] Open
Abstract
Background Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook. Objective This study aimed to identify which intervention content based on the TTM (Decisional Balance and 10 processes of change) generated the highest engagement among participants in pre-action stages of change (Precontemplation, Contemplation, and Preparation). Methods Participants (N=79, 20% female, mean age 20.8) were assessed for readiness to quit smoking and assigned to one of 7 secret Facebook groups tailored to their stage of change. Daily postings to the groups based on TTM Decisional Balance and the 10 processes of change were made by research staff over 3 months. Engagement was operationalized as the number of participant comments to each post. TTM content-based predictors of number of comments were analyzed and stratified by baseline stage of change, using negative binomial regression analyses with and without zero inflation. Results A total of 512 TTM-based posts generated 630 individual comments. In Precontemplation and Contemplation groups, Decisional Balance posts generated above average engagement (P=.01 and P<.001). In Contemplation groups, posts based on the TTM processes Dramatic Relief and Self-Liberation resulted in below average engagement (P=.01 and P=.005). In Preparation groups, posts based on Consciousness Raising generated above average engagement (P=.009). Participant engagement decreased over time and differed between groups within Precontemplation and Contemplation stages, but was independent of day of the week and time of day the content was posted to the groups. No participant baseline characteristics significantly predicted engagement. Conclusions Participants not ready to quit in the next 30 days (in Precontemplation or Contemplation) engaged most when prompted to think about the pros and cons of behavior change, while those in the Preparation stage engaged most when posts increased awareness about smoking and smoking cessation. Findings support tailoring intervention content to readiness to quit and suggest intervention components that may be most effective in generating high participant engagement on social media.
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Affiliation(s)
- Johannes Thrul
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States.
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Kim JH, Park EY. Mediating effect of self-control in relation to depression, stress, and activities of daily living in community residents with stroke. J Phys Ther Sci 2015; 27:2585-9. [PMID: 26357444 PMCID: PMC4563320 DOI: 10.1589/jpts.27.2585] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/15/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine whether self-control mediates the relation
between depression, stress, and activities of daily living in community residents with
stroke. [Subjects and Methods] This study is a secondary analysis of data from 108
community-dwelling stroke patients in Korea. Data were collected through self-reporting
questionnaires, including the Korean version of the Center for Epidemiological Studies
Depression Scale, Korean version of the Brief Encounter Psychosocial Instrument, and the
modified Barthel index. The path model was tested to investigate causal relations between
variables, obtain maximum-likelihood estimates of model parameters, and provide
goodness-of-fit indices. [Results] The proposed path model showed good fit to the data.
Depression and stress have a significant direct effect on self-control and a significant
indirect effect on activities of daily living through self-control. Depression and stress
accounted for 28.0% of the variance in self-control. Depression, stress, and self-control
accounted for 8.4% of the variance in explaining activities of daily living. [Conclusion]
The level of self-control is an important indicator of activities of daily living in
stroke patients. We suggest that interventions such as enhancement of confidence in one’s
self-control ability could be effective in improving the physical activity of stroke
patients with depressive mood and stress.
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Affiliation(s)
- Jung-Hee Kim
- Department of Nursing, College of Medicine, Dankook University, Republic of Korea
| | - Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Republic of Korea
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Choi JY, Chang AK, Choi EJ. Sex differences in social cognitive factors and physical activity in Korean college students. J Phys Ther Sci 2015; 27:1659-64. [PMID: 26180293 PMCID: PMC4499956 DOI: 10.1589/jpts.27.1659] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/07/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study examined sex differences in physical activity and social cognitive theory factors in Korean college students. [Subjects and Methods] A cross-sectional survey of 688 college students (285 men and 403 women) in Korea was conducted using a self-reported questionnaire. [Results] There was a significant difference in the level of physical activity between male and female students. The significant predictors of physical activity for male students were physical activity goals, physical activity self-efficacy, and sitting time. Meanwhile, those for female students were perceived weight, physical activity goal, physical activity outcome expectations, and sitting time. [Conclusion] Sex differences should be considered when developing interventions to increase physical activity.
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Affiliation(s)
- Jin Yi Choi
- Department of Nursing, College of Bio-medical and Health Science, Konkuk University, Republic of Korea
| | - Ae Kyung Chang
- Department of Nursing, College of Medicine, Chungbuk National University, Republic of Korea
| | - Eun-Ju Choi
- Division of Sport Science, College of Science and Technology, Konkuk University, Republic of Korea
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Santiago-Rivas M, Velicer WF, Redding C. Mediation analysis of decisional balance, sun avoidance and sunscreen use in the precontemplation and preparation stages for sun protection. Psychol Health 2015; 30:1433-49. [PMID: 26040293 DOI: 10.1080/08870446.2015.1056791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Mediation analyses of sun protection were conducted testing structural equation models using longitudinal data with three waves. An effect was said to be mediated if the standardised path between processes of change, decisional balance and sun protection outcomes was significant. DESIGN Longitudinal models of sun protection using data from individuals in the precontemplation (N = 964) and preparation (N = 463) stages who participated of an expert system intervention. MAIN OUTCOME MEASURES Nine processes of change for sun protection, decisional balance constructs of sun protection (pros and cons), sun avoidance behaviour and sunscreen use. RESULTS With the exception of two processes in the preparation stage, processes of change predicted the pros (r = .126-.614), and the pros predicted the outcomes (r = .181-.272). Three models with the cons as mediator in the preparation stage, and none in the precontemplation stage, showed a mediated relationship between processes and outcomes. CONCLUSION In general, mediation analyses found both the process of change-to-pros and pros-to-behaviour paths significant for both precontemplation and preparation stages, and for both sun avoidance and sunscreen use outcomes. Findings provide support for the importance of assessing the role of underlying risk cognitions in improving sun protection adherence.
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Affiliation(s)
- Marimer Santiago-Rivas
- a Department of Oncological Sciences , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Wayne F Velicer
- b Cancer Prevention Research Center , University of Rhode Island , Kingston , RI , USA
| | - Colleen Redding
- b Cancer Prevention Research Center , University of Rhode Island , Kingston , RI , USA
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