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Battista S, Recenti F, Giardulli B, Testa M, Pchelnikova P, Ndosi M, Dell'Isola A. Geographical Differences in the Perspective of Osteoarthritis Care Management: A Cross-Sectional Study in Italy, Sweden and Russia. Musculoskeletal Care 2024; 22:e1934. [PMID: 39228073 DOI: 10.1002/msc.1934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND This study aimed to explore the awareness, experiences, and beliefs of individuals with osteoarthritis (OA) regarding their healthcare management, along with assessing their overall satisfaction levels. METHODS A cross-sectional online survey was conducted in Italy, Sweden, and Russia, rigorously developed based on OA international guidelines in collaboration with healthcare professionals and individuals with OA. Participants over 40 years of age with self-reported hip and/or knee OA were eligible. The analytical framework included descriptive analysis (assessment of awareness levels for 'recommended', 'optional', and 'not recommended' treatments), analysis of suggested treatments and taken treatments, exploration of beliefs, barriers and satisfaction analysis (0-100 scale). RESULTS A total of 401 participants (mean age: 59.7, 78.3% female, 28% Italian, 49% Swedish, 23% Russian) contributed to the study. In Sweden, 57%-72% accurately identified recommended treatments, while in Russia, the range was 34%-91%, and in Italy, it was 35%-73%. The predominant suggested and taken treatments were oral anti-inflammatory drugs in Italy (87/81%) and Russia (97/97%) and specific exercise in Sweden (84/79%). Notably, only Sweden reached a consensus on the effectiveness of exercise for everyone, while Russia and Italy insisted on radiographic findings as a prerequisite for exercise. Mean satisfaction levels were 59.7 (Italy), 47.4 (Sweden), and 35.2 (Russia). CONCLUSIONS This study uncovered variations in awareness, treatment preferences, and beliefs among the three countries, underscoring the necessity for tailored education on OA management that accounts for regional differences across Europe.
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Affiliation(s)
- Simone Battista
- School of Health and Society, Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
| | - Filippo Recenti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
| | - Benedetto Giardulli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | | | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Andrea Dell'Isola
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
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Camp N, Vagnetti R, Penner S, Ramos C, Hunter K, Hough J, Magistro D. It Is Not Just a Matter of Motivation: The Role of Self-Control in Promoting Physical Activity in Older Adults-A Bayesian Mediation Model. Healthcare (Basel) 2024; 12:1663. [PMID: 39201220 PMCID: PMC11353447 DOI: 10.3390/healthcare12161663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/10/2024] [Accepted: 08/18/2024] [Indexed: 09/02/2024] Open
Abstract
This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± 6.72) completed questionnaires regarding their perceived trait self-control, motivation towards leisure activities, and level of physical activity. A Bayesian mediation analysis was performed, controlling for demographics. We documented positive direct (c' = 0.021, 95%CI [0.001, 0.043]) and indirect (ab = 0.028, 95%CI [0.014, 0.043]) effects of intrinsic motivation on exercise, a fully mediated indirect effect of extrinsic motivation on exercise (ab = 0.027, 95%CI [0.011, 0.046]), and negative direct (c' = -0.281, 95%CI [-0.368, -0.194]) and indirect (ab = -0.161, 95%CI [-0.221, -0.105]) effects of amotivation on exercise. There was no direct association between extrinsic motivation and exercise (c' = 0.013, 95% CI [-0.013, 0.037]). In conclusion, trait self-control mediates motivation to influence exercise behaviour in older adults. Intrinsically motivated individuals resist sedentary living and show higher self-control, while extrinsically motivated ones rely on self-control and are more susceptible to non-adherence during mental fatigue. High amotivation is linked to less exercise and reduced self-control, suggesting potential non-compliance with structured exercise interventions.
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Affiliation(s)
| | | | | | | | | | | | - Daniele Magistro
- Department of Sport Science, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (N.C.); (R.V.); (S.P.); (C.R.); (K.H.); (J.H.)
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Marshall N, Bendotti C, Charlesworth J, Mullan B, Maxwell-Smith C. Food Banks as a "Treasure Trove": Users' Experiences of a Western Australian Food Relief Organization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1079. [PMID: 39200688 PMCID: PMC11354397 DOI: 10.3390/ijerph21081079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024]
Abstract
Food banks are providing crucial relief as food insecurity increases worldwide. While these services are essential for vulnerable populations, there is variability in foods available and users may experience poor nutritional quality, and an overabundance of discretionary foods, contributing to public health risks including overnutrition and obesity. Understanding how customers perceive food availability, variety, and quality is important to inform relief services and health interventions. This study reports the findings of a convergent parallel mixed-methods investigation of user experiences and perceptions of food availability, variety, and quality at a major food bank in Western Australia. Food bank customers (N = 207) at a food bank branch and mobile van locations completed a survey, with an option to complete a subsequent semi-structured interview (n = 15). Approximately 80% of the survey sample had low (48%) or very low (30%) food security, half of the sample had been using the food bank for longer than 6 months, and 77% reported the food bank as their first choice for food. Three-quarters (77%) reported financial barriers to a balanced diet in the past twelve months and described how limited availability and variety complicated shopping. Interviewees explained complex perceptions of these issues, including favouring healthy food while considering discretionary food as a "luxury" that enhanced their quality of life. Our findings suggest that food bank users experience barriers to maintaining a balanced diet, encounter variable supplies of healthy and nutritious foods, and have concerns about the impacts of frequent discretionary food consumption. These findings have implications for public health promotion.
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Affiliation(s)
| | | | | | | | - Chloe Maxwell-Smith
- Behavioural Science & Health Group, School of Population Health, Curtin University, Bentley, WA 6102, Australia; (N.M.); (C.B.); (B.M.)
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Gao Q, Chua KC, Mayston R, Prina M. Longitudinal associations of loneliness and social isolation with care dependence among older adults in Latin America and China: A 10/66 dementia research group population-based cohort study. Int J Geriatr Psychiatry 2024; 39:e6115. [PMID: 38923024 DOI: 10.1002/gps.6115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES With increasing life expectancy and rapid ageing, there is an expanding number of older people who have functional declines, greater needs for care and support and who are at increased risk of insufficient social interaction. Longitudinal investigations on the interplay between loneliness, social isolation and care dependence remain limited. This study thus aimed to investigate the longitudinal reciprocal association between social isolation/loneliness and care dependence among older adults in Latin America and China. METHODS We analysed data from the population-based cohorts from the 10/66 Dementia Research Group (DRG) project (baseline 2003-07 and follow-up 2007-2010). The 10/66 DRG study recruited and followed up older adults aged 65 years or above in 11 catchment areas in Latin America and China. A total of 15,027 older adults from Latin America and China (mean age = 73.5, standard deviation = 6.5) were included in our analyses. Cross-lagged panel models were used to investigate potential reciprocal associations. RESULTS Loneliness was positively associated with care dependence at baseline (β = 0.11, p < 0.001 in Latin America; β = 0.16, p < 0.05 in China]. Social isolation consistently had a stronger positive association with care dependence across all study sites in both waves. Longitudinally, care dependence positively predicted loneliness (β = 0.10, p < 0.001) and social isolation (β = 0.05, p < 0.001) in Latin American study sites but not in China. Yet there was no statistical evidence of lagged effects of loneliness and social isolation on care dependence in all study countries. CONCLUSIONS Older people with care dependence are at risk of developing loneliness and social isolation. It is crucial to develop complex care models using a societal approach to address social and care needs holistically, especially for the older group with declining functional capacity. Future longitudinal research is required to explore the causal mechanisms of relationships and cultural differences, in order to inform the development of culturally appropriate care models.
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Affiliation(s)
- Qian Gao
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- School of Public Health, Imperial College London, London, UK
| | - Kia-Chong Chua
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rosie Mayston
- Global Health & Social Medicine & King's Global Health Institute, Social Science & Public Policy, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Labèr R, Lautenbach G, Schweizer A. Reasons for scaphoid non-union: Analysis of behavior of health care providers and patients. HAND SURGERY & REHABILITATION 2024; 43:101662. [PMID: 38354948 DOI: 10.1016/j.hansur.2024.101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
To assess factors related to health-system and patient behavior in scaphoid fracture non-union, a retrospective analysis of 134 patients treated by scaphoid reconstruction was performed. Mean age at the accident was 26 years (range, 9-75 years), and the mean age at surgery was 28 years (range, 13-75 years). Mean time to first consultation was 233 days (range, 0-12,136 days), and time to surgery 740 days (range, 19-12,362 days). The physician was mainly a general practitioner (52.2%), or an orthopedist/traumatologist (17.9%), general surgeon (12.7%), or hand surgeon (17.2%). The initial diagnostic procedure was X-ray in 76.9% of cases, computed tomography (CT) in 20.9%, magnetic resonance imaging (MRI) in 13.4%, and none in 11.2%. A fracture was diagnosed in 32.8% of cases, and non-union in 14.9%. Patients mainly presented late: 63% within 3 weeks, and a minority on the day of the accident (39%). In 11% of cases, healthcare providers performed either no or inadequate imaging (77%) and missed correct diagnosis in 52% of cases. 128 patients had a second consultation, and 77 a third, with the same or different physicians, before surgery, leading to increased healthcare costs due to delayed diagnosis and treatment. Delayed presentation and lack of suspicion by attending physicians were the main reasons. Speeding up diagnosis and improving physician training are vital and could significantly reduce health care costs. CT or MRI should be performed if scaphoid fracture is suspected.
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Affiliation(s)
- Raffael Labèr
- Department for Hand Surgery, Balgrist University Hospital, Zurich, Switzerland.
| | | | - Andreas Schweizer
- Department for Hand Surgery, Balgrist University Hospital, Zurich, Switzerland
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Stapleton JL, Manne SL, Pagoto SL, Leip A, Greene K, Hillhouse JJ, Merritt AS, Shelton BJ. A Social Media-Delivered Melanoma Prevention Program for Young Women Engaged in Frequent UV Tanning: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e56562. [PMID: 38502173 PMCID: PMC10988380 DOI: 10.2196/56562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image and acceptance-based interventions. The intervention is delivered using Facebook secret groups, an approach designed to support behavior change and ensure scalability. OBJECTIVE This study aims to describe the rationale and methodology of a randomized controlled trial of a melanoma prevention program targeting young women engaged in frequent indoor or outdoor UV tanning. METHODS Participants are women aged 18-25 years who report high-risk tanning (ie, at least 10 indoor tanning sessions in the past 12 months or 10 outdoor sessions in the previous summer). After recruitment and screening, participants completed a baseline survey and were randomly assigned to receive the intervention or an attention-matched control condition. Both conditions were 8-week-long Facebook groups (approximately 25 members each) with daily posting of content. Follow-up surveys are administered at 3, 8, and 18 months after baseline. The primary trial outcome is the combined number of indoor and outdoor tanning sessions reported at the 8-month follow-up. Hypothesized intervention mediators are assessed at the 3-month follow-up. RESULTS This project was funded by a National Cancer Institute award (R01 CA218068), and the trial procedures were approved by the University of Kentucky Institutional Review Board in February 2020. Trial recruitment and enrollment occurred in 6 waves of data collection, which started in February 2022 and closed in May 2023. The study is closed to enrollment but remains open for follow-ups, and this protocol report was prepared before data analyses. As of February 2024, all participants have completed the 8-month follow-up assessment, and data collection is scheduled to close by the end of 2024 after the collection of the 18-month follow-up. CONCLUSIONS This trial will contribute unique knowledge to the field of skin cancer prevention, as no fully powered trials have examined the efficacy of an intervention designed for frequent indoor or outdoor tanning. The trial may also contribute evidence of the value in translating principles of body image and acceptance-based interventions into the field of skin cancer prevention and beyond. If successful, the use of the Facebook platform is intended to aid in dissemination as it provides a way to embed the intervention into individuals' everyday routines. TRIAL REGISTRATION ClinicalTrials.gov NCT03441321; https://clinicaltrials.gov/study/NCT03441321. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56562.
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Affiliation(s)
- Jerod L Stapleton
- Markey Cancer Center, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Sherry L Pagoto
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, United States
| | - Allison Leip
- Department of Family Sciences, University of Kentucky, Lexington, KY, United States
| | - Kathryn Greene
- Department of Communication, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Joel J Hillhouse
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, United States
| | - Allison S Merritt
- Markey Cancer Center, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Brent J Shelton
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States
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Gao Q, Mak HW, Fancourt D. Longitudinal associations between loneliness, social isolation, and healthcare utilisation trajectories: a latent growth curve analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02639-9. [PMID: 38429539 DOI: 10.1007/s00127-024-02639-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE To explore the longitudinal associations between eight-year trajectories of loneliness, social isolation and healthcare utilisation (i.e. inpatient, outpatient, and nursing home care) in US older adults. METHODS The study used data from the Health and Retirement Study in 2006-2018, which included a nationally representative sample of American adults aged 50 and above (N = 6,832). We conducted latent growth curve models to assess the associations between trajectories of loneliness and isolation and healthcare utilisation over 8 years. RESULTS Independent of sociodemographic and health-related confounders, social deficits were associated with a lower likelihood of baseline physician visits (loneliness β= -0.15, SE = 0.08; social isolation β= -0.19, SE = 0.08), but there was a positive association between loneliness and number of physician visits (β = 0.06, SE = 0.03), while social isolation was associated with extended hospital (β = 0.07, SE = 0.04) and nursing home stays (β = 0.05, SE = 0.02). Longer nursing home stays also predicted better trajectories of loneliness and isolation over time. CONCLUSION Loneliness and social isolation are cross-sectionally related to complex patterns of different types of healthcare. There was no clear evidence that social deficits led to specific trajectories of healthcare utilisation, but nursing home stays may over time help provide social contact, supporting trajectories of isolation and potentially loneliness. Non-clinical services such as social prescribing could have the potential to address unmet social needs and further promote patients' health-seeking profiles for improving healthcare equity.
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Affiliation(s)
- Qian Gao
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- School of Public Health, Imperial College London, London, UK
| | - Hei Wan Mak
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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Bickmann P, Froböse I, Grieben C. An mHealth Application in German Health Care System: Importance of User Participation in the Development Process. J Med Syst 2024; 48:20. [PMID: 38353872 PMCID: PMC10866790 DOI: 10.1007/s10916-024-02042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
This paper addresses the challenges and solutions in developing a holistic prevention mobile health application (mHealth app) for Germany's healthcare sector. Despite Germany's lag in healthcare digitalization, the app aims to enhance primary prevention in physical activity, nutrition, and stress management. A significant focus is on user participation and usability to counter the prevalent issue of user attrition in mHealth applications, as described by Eysenbach's 'law of attrition'. The development process, conducted in a scientific and university context, faces constraints like limited budgets and external service providers. The study firstly presents the structure and functionality of the app for people with statutory health insurance in Germany and secondly the implementation of user participation through a usability study. User participation is executed via usability tests, particularly the think-aloud method, where users verbalize their thoughts while using the app. This approach has proven effective in identifying and resolving usability issues, although some user feedback could not be implemented due to cost-benefit considerations. The implementation of this study into the development process was able to show that user participation, facilitated by methods like think-aloud, is vital for developing mHealth apps. Especially in health prevention, where long-term engagement is a challenge. The findings highlight the importance of allocating time and resources for user participation in the development of mHealth applications.
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Affiliation(s)
- Peter Bickmann
- Institute of Movement Therapy, German Sport University Cologne, Cologne, Germany.
| | - Ingo Froböse
- Institute of Movement Therapy, German Sport University Cologne, Cologne, Germany
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Maxwell-Smith C, Breare H, Dominguez Garcia A, Sim TF, Blackford K, Chih HJ, Jancey J, Mullan BA. Pharmacists' perceptions and delivery of health behaviour change recommendations: Mapping the COM-B model. Res Social Adm Pharm 2024; 20:115-123. [PMID: 37926620 DOI: 10.1016/j.sapharm.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Pharmacists are trusted and accessible healthcare professionals who are well-positioned to deliver brief health behaviour change technique-based interventions for chronic health conditions. However, little is known about the factors influencing pharmacists' use of behaviour change techniques and their capacity to deliver these interventions within community pharmacy. OBJECTIVES This study employed the COM-B model to explore the factors that explain pharmacists' delivery of behaviour change techniques in practice. A secondary objective was to ascertain whether capability, opportunity, and motivation are associated with and explain significant variance in the use of behaviour change techniques during patient interactions. METHODS Two-hundred and eleven Australian pharmacists (mean age = 36.1, SD = 10.7) completed a survey on their capability, opportunity, and motivation to deliver behaviour change techniques, and their delivery and frequency of use in practice. RESULTS Most pharmacists (91.3%) use behaviour change techniques during patient interactions. Results from a simple linear regression showed that a composite COM score was associated with pharmacists' behaviour change technique use F(1,195) = 47.12, β = 0.44, 95 % CI [0.09, 0.16], p < .001, and their frequency of use (F(1,198) = 44.19, β = 0.43, 95 % CI [0.02, 0.06], p < .001). While capability, opportunity, and motivation were individually associated with the range and frequency of behaviour change technique used, motivation was the only significant variable in the composite model for range (β = 0.35, 95 % CI [0.11, 0.41], p < .001) and frequency of behaviour change technique use (β = 0.22, 95 % CI [0.01, 0.09], p < .05). CONCLUSIONS Pharmacist motivation was the most important construct explaining behaviour change technique use. Interventions should seek to foster pharmacist motivation and may benefit from adopting COM-B as a behaviour change framework, to understand the factors influencing the delivery of behaviour change interventions.
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Affiliation(s)
- Chloe Maxwell-Smith
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia; EnAble Institute, Curtin University, Bentley, Western Australia, Australia.
| | - Hayley Breare
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Alejandro Dominguez Garcia
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia; Pharmaceutical Society of Australia, Australia
| | - Krysten Blackford
- School of Population Health, Curtin University, Bentley, Western Australia, Australia; Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Hui Jun Chih
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jonine Jancey
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Barbara A Mullan
- Behavioural Science and Health Research Group, Curtin University, Bentley, Western Australia, Australia; School of Population Health, Curtin University, Bentley, Western Australia, Australia; EnAble Institute, Curtin University, Bentley, Western Australia, Australia
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Kelly JH, Lianov L, Shurney D, Guimarães ST, Palma M, Esselstyn C, Stoll S, Patel P, Rea B, Reddy K, Guthrie G, Reiss M, Karlsen MC. Lifestyle Medicine Intensivist Competencies: 2023 Expert Consensus Update. Am J Lifestyle Med 2024; 18:141-149. [PMID: 39184278 PMCID: PMC11339762 DOI: 10.1177/15598276231192846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVE The objective of this expert consensus process was to identify the competencies that lifestyle medicine (LM) Intensivists should be expected to have within their skill set. METHODS Expert panel members with experience in intensive, therapeutic lifestyle change (ITLC) updated and expanded a previously published set of competencies for this intensive LM practice, using an established process for developing consensus statements adapted for the topic. The previously published set of competencies was discussed for possible revision and expansion. Proposed changes were assessed for consensus using a modified Delphi process. RESULTS The expert panel revised the original list of 34 competencies, maintaining the 6 initial proposed topics that were previously published as Specialist Competencies: (1) Practice-Based Learning and Improvement, (2) Patient Care and Procedural Skills (3) Systems-Based Practice, (4) Medical Knowledge, (5) Interpersonal and Communication Skills, and (6) Professionalism. After a series of meetings and an iterative Delphi process of voting and revision, a final set of 46 competency statements for LM Intensivists achieved consensus. CONCLUSION These competencies define the scope of practice and desired skill set for LM Intensivists. Further, these competencies establish a standard for certification of LM Intensivists.
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Affiliation(s)
- John H. Kelly
- American College of Lifestyle Medicine, Chesterfield, MO, USA (JHK, MCK)
- Loma Linda University School of Medicine, Loma Linda, CA, USA (JHK, BR, GG)
| | - Liana Lianov
- Global Positive Health Institute, Inc, Fair Oaks, CA, USA (LL)
| | - Dexter Shurney
- Blue Zones Well Being Institute, Adventist Health, Roseville, CA, USA (DS)
| | | | - Mechelle Palma
- Philippine College of Lifestyle Medicine, Iloilo City, Philippines (MP)
| | - Caldwell Esselstyn
- The Cleveland Clinic Center of Wellness and Preventive Medicine, Cleveland, OH, USA (CE)
| | - Scott Stoll
- The Plantrician Project, Boynton Beach, FL, USA (SS)
| | - Padmaja Patel
- Lifestyle Medicine Center, Midland Health, Midland, TX, USA (PP)
| | - Brenda Rea
- Loma Linda University School of Medicine, Loma Linda, CA, USA (JHK, BR, GG)
- Department of Preventive Medicine, Lifestyle Medicine Intensivist Fellowship, Loma Linda University, Loma Linda, CA, USA (BR)
| | - Koushik Reddy
- James A. Haley Veteran’s Hospital, Tampa, FL, USA (KR)
- USF Health Morsani College of Medicine, Tampa, FL, USA (KR)
| | - George Guthrie
- Loma Linda University School of Medicine, Loma Linda, CA, USA (JHK, BR, GG)
- Department of Graduate Medical Education, AdventHealth Allopathic Family Medicine Residency, Winter Park, FL, USA (GG)
| | - Michelle Reiss
- Australian Society of Lifestyle Medicine, Thornbury, VIC, Australia (MR)
- Life Medical Centre, Erina, NSW, Australia (MR)
| | - Micaela C. Karlsen
- American College of Lifestyle Medicine, Chesterfield, MO, USA (JHK, MCK)
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Domosławska-Żylińska K, Włodarczyk D, Krysińska-Pisarek M. Cardiovascular disease threat and perceived efficacy of selected preventive behaviors among Polish men: an analysis based on the extended parallel process model. Front Public Health 2023; 11:1244302. [PMID: 38026338 PMCID: PMC10679673 DOI: 10.3389/fpubh.2023.1244302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Considering the low rate of preventive behaviors (5%), it is important to increase the effectiveness of actions that motivate the public to engage in health-promoting behaviors. The purpose of this study was to assess the way in which Polish men perceive the threat of cardiovascular diseases (CVDs) and the effectiveness of five preventive behaviors in the context of CVDs. We aimed to identify groups of recipients, based on the extended parallel process model (EPPM), for five preventive behaviors and to compare the identified groups in terms of selected characteristics. We conducted the survey in November 2022, using the computer-assisted web interviewing technique, on a representative sample of 1,000 men aged 18-65 years. Polish men showed relatively low levels of perceived susceptibility to CVDs (15.1%), but at the same time tended to perceive the consequences of CVDs as severe (54.2%). Segmentation of audiences according to the EPPM showed that regardless of the type of preventive behavior, the most numerous groups are responsive (31-37%) and indifferent (29-31%). This study revealed the need to increase awareness of the importance of a healthy diet to prevent CVDs among male population. Less than half of the men indicated that they would be able to implement effective stress management (49.8%) and smoking avoidance (39.4%), indicating the need to implement measures to increase self-efficacy in the areas.
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Affiliation(s)
- Katarzyna Domosławska-Żylińska
- Department of Education and Communication, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Dorota Włodarczyk
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Krysińska-Pisarek
- Department of Education and Communication, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
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Jayanna K. Integrative approach to lifestyle management: Implications for public health research & practice in the context of SDG-3. J Ayurveda Integr Med 2023; 14:100796. [PMID: 37738855 PMCID: PMC10692374 DOI: 10.1016/j.jaim.2023.100796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/13/2023] [Accepted: 08/07/2023] [Indexed: 09/24/2023] Open
Abstract
In the last 100 years, the communicable diseases have been replaced by non-communicable diseases as the leading cause of deaths across the world. Periodically, the communicable disease outbreaks continue to pose a challenge to the public health systems. Change in human behaviors and lifestyles are recognized as risk factors for the public health challenges we face today, which significantly affect wellbeing and quality of life. Healthy lifestyles are critical to not only controlling diseases, but also to promote good health and wellbeing. Modern Medicine has provided evidence-based approaches to lifestyle management, but there are challenges to implementing them effectively. The traditional disciplines such as Ayurveda, Yoga and Meditation are showing promise as complementary approaches to further community wellbeing. A new perspective and a model is proposed by the author called 'Integrative Lifestyle" which is informed by the evidence in the space of modern and traditional approaches to lifestyle management. The article describes the elements of the model, highlights the emerging evidence and implications for public health practice and research. The efforts by Government of India and its collaborators to promote integrative approaches is worthy of emulation and should be backed by sufficient investments into implementation research and population wide scale up for accelerating SDG-3 outcomes related to health and wellbeing.
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Affiliation(s)
- Krishnamurthy Jayanna
- Department of Public Health, Faculty of Life and Allied Health Sciences, M S Ramaiah University of Applied Sciences, Bangalore, India; Centre of Integrative Health and Wellbeing, Bangalore, India.
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Dukelow T, Vassilev P, Lawrence EG, Jacobson L, Koychev I, Muhammed K, Kennelly SP. Barriers to brain health behaviours: results from the Five Lives Brain Health Ireland Survey. Front Psychol 2023; 14:1101514. [PMID: 37691817 PMCID: PMC10483831 DOI: 10.3389/fpsyg.2023.1101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/17/2023] [Indexed: 09/12/2023] Open
Abstract
Modifiable risk factors for dementia remain prevalent in Ireland. A detailed examination of barriers to risk reduction behaviours in an Irish context has heretofore been lacking. Many existing studies examining barriers to brain health behaviours fail to examine how they might vary across different modifiable risk factors. This study undertook a detailed assessment of barriers to individual risk reduction behaviours. As existing research suggests that barriers may vary across sociodemographic factors, we sought to investigate the distribution of barriers across age, gender, educational status, and household income. The Five Lives Brain Health Ireland Survey is a cross-sectional survey that was distributed online amongst a non-patient population. The survey captured the following: (1) Sociodemographic factors; (2) Barriers to brain health behaviours; (3) Exposure to, and knowledge of, modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, current low mood/depression, current smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury; (4) Participants' perceptions regarding potential for dementia prevention, and risk reduction. Lack of motivation was the most prevalent barrier to consuming a healthy diet (64%, n = 213), physical activity (77.7%, n = 167), smoking cessation (68%, n = 85), and moderation of alcohol intake (56.3%, n = 67). Practical factors were the most prevalent barriers to addressing low mood (56.5%, n = 87), air pollution (30.1%, n = 58), hearing impairment (63.8%, n = 44), diabetes (11.1%, n = 5), and head injury (80%, n = 8). Emotional factors were the most prevalent barriers to engaging in mentally stimulating activity (56.9%, n = 66), social activity (54.9%, n = 302), and good sleep (70.1%, n = 129). Lack of knowledge was the most prevalent barrier to hypertension control (14.4%, n = 29). Distribution of barriers varied across age, gender, educational status, and household income. This study investigated barriers to lifestyle change to improve brain health in an Irish sample of adults aged 50 and above. Detailed subtyping of barriers, as well as examination of differences according to age, gender, education, and income were undertaken. The heterogeneity of barriers to brain health behaviours revealed in this study highlights the necessity to tailor public health interventions to their target population, taking into account the gender, age, educational status, and income of recipients.
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Affiliation(s)
- Tim Dukelow
- Cork University Hospital (CUH), Cork, Ireland
| | | | - Erin Grace Lawrence
- Five Lives SAS, Tours, France
- Unit of Psychological Medicine, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary, University of London, London, United Kingdom
| | | | - Ivan Koychev
- Five Lives SAS, Tours, France
- Department of Psychiatry, University of Oxford, Oxford, England, United Kingdom
| | - Kinan Muhammed
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford, England, United Kingdom
| | - Sean P. Kennelly
- Department of Age Related Health Care, Tallaght University Hospital, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
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Velez M, Quintiliani LM, Fuertes Y, Román A, Heaton B. Photo-Enhanced Health Promotion Messages to Target Reduction in Dietary Sugar among Residents of Public Housing. Nutrients 2023; 15:2601. [PMID: 37299564 PMCID: PMC10255344 DOI: 10.3390/nu15112601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Interventions intended to reduce the consumption of dietary sugars among those population groups demonstrating disproportionately greater and more frequent consumption of sugar-sweetened beverages and foods (SSBF) would benefit from intervention strategies that are tailored to population-specific barriers and facilitators. The objective of this study was to develop and evaluate the acceptability of photo-enhanced and theory-based health promotion messages that target the reduction in SSBF among adult residents of public housing developments, a population known for their high rates of chronic disease. Using the message development tool as a framework, we developed a series of 15 SSBF reduction messages, using an iterative process with community member input. We then evaluated the acceptability of the messages and compared three delivery mechanisms: print, text, and social media. We recruited participants who were residents of urban public housing developments, and who spoke either English or Spanish. A majority of participants identified as being of Hispanic ethnicity (73%). The message acceptability scoring did not appear to differ according to the assigned delivery mechanism, despite some imbalances in participants' characteristics across delivery mechanisms. The messages that targeted motivation were least likely to be accepted. In conclusion, our findings suggest that engaging members of the community at all phases of the development process was a feasible method to develop SSBF reduction messages with a high perceived acceptability.
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Affiliation(s)
- Mabeline Velez
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, 3rd Floor, Rm 336, Boston, MA 02118, USA; (M.V.); (Y.F.); (A.R.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Lisa M. Quintiliani
- Section of General Internal Medicine, Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University and Boston Medical Center, Boston, MA 02215, USA;
| | - Yinette Fuertes
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, 3rd Floor, Rm 336, Boston, MA 02118, USA; (M.V.); (Y.F.); (A.R.)
| | - Annelli Román
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, 3rd Floor, Rm 336, Boston, MA 02118, USA; (M.V.); (Y.F.); (A.R.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Brenda Heaton
- Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, 3rd Floor, Rm 336, Boston, MA 02118, USA; (M.V.); (Y.F.); (A.R.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
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15
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Peckham E, Lorimer B, Spanakis P, Heron P, Crosland S, Walker L, Gilbody S. Health-risk behaviours among people with severe mental ill health: understanding modifiable risk in the Closing the Gap Health Study. Br J Psychiatry 2023; 222:160-166. [PMID: 36650735 PMCID: PMC10895492 DOI: 10.1192/bjp.2022.143] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND People with severe mental ill health (SMI) experience some of the largest health inequalities of any sector within society. For these inequalities to be reduced, an understanding of the behavioural determinants of health in this population is needed. AIMS Utilising data from the Closing the Gap Health Study, we aimed to assess the extent to which people with SMI report health-risk factors and behaviours, their interest in modifying them, and the factors associated with being motivated to modify these behaviours. METHOD Adult (≥18 years old) participants were recruited via primary and secondary care in the English National Health Service. To be eligible, participants needed to have a documented diagnosis of schizophrenia, psychotic disorders or bipolar disorder. Data were collected by survey on demographics, general physical health, diet, physical activity, alcohol, smoking and body mass index. RESULTS Between April 2016 and March 2020, n = 9914 participants were recruited. Among people with SMI, high rates of obesity (37.5%), infrequent physical activity (62.0%), not meeting current guidelines (≥5) for the consumption of fruit and vegetables (85.0%) and smoking (42.2%) were observed. However, most participants were motivated to reduce health-risk behaviours. Perceiving the importance of health-promoting behaviours, being of poorer general health and being female were significantly associated with being motivated to modify health-risk behaviours. CONCLUSIONS Despite experiencing poor physical and mental health outcomes compared with the general population, and contrary to popular misconceptions, people with SMI perceive health as important and are motivated to make behavioural changes to improve health.
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Affiliation(s)
- Emily Peckham
- Department of Health Sciences, University of York, UK
| | - Ben Lorimer
- Department of Health Sciences, University of York, UK
| | | | - Paul Heron
- Department of Health Sciences, University of York, UK
| | | | - Lauren Walker
- Department of Health Sciences, University of York, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, UK and Hull York Medical School, UK
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16
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Bente BE, Wentzel J, Schepers C, Breeman LD, Janssen VR, Pieterse ME, Evers AWM, van Gemert-Pijnen L. Implementation and User Evaluation of an eHealth Technology Platform Supporting Patients With Cardiovascular Disease in Managing Their Health After a Cardiac Event: Mixed Methods Study. JMIR Cardio 2023; 7:e43781. [PMID: 36961491 PMCID: PMC10131764 DOI: 10.2196/43781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/26/2023] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND eHealth technology can help patients with cardiovascular disease adopt and maintain a healthy lifestyle by supporting self-management and offering guidance, coaching, and tailored information. However, to support patients over time, eHealth needs to blend in with their needs, treatment, and daily lives. Just as needs can differ between patients, needs can change within patients over time. To better adapt technology features to patients' needs, it is necessary to account for these changes in needs and contexts of use. OBJECTIVE This study aimed to identify and monitor patients' needs for support from a web-based health management platform and how these needs change over time. It aimed to answer the following research questions: "How do novice and more advanced users experience an online health management platform?" "What user expectations support or hinder the adoption of an online health management platform, from a user perspective?" and "How does actual usage relate to user experiences and adoption?" METHODS A mixed methods design was adopted. The first method involved 2 rounds of usability testing, followed by interviews, with 10 patients at 0 months (round 1) and 12 patients at 6 months (round 2). In the second method, log data were collected to describe the actual platform use. RESULTS After starting cardiac rehabilitation, the platform was used frequently. The patients mentioned that they need to have an incentive, set goals, self-monitor their health data, and feel empowered by the platform. However, soon after the rehabilitation program stopped, use of the platform declined or patients even quit because of the lack of continued tailored or personalized advice. The reward system motivated them to log data, but most participants indicated that being healthy should be the main focus, not receiving gifts. A web-based platform is flexible, accessible, and does not have any obligations; however, it should be implemented as an addition to regular care. CONCLUSIONS Although use of the platform declined in the longer term, patients quitting the technology did not directly indicate that the technology was not functioning well or that patients no longer focused on achieving their values. The key to success should not be user adherence to a platform but adherence to healthy lifestyle habits. Therefore, the implementation of eHealth should include the transition to a stage where patients might no longer need support from a technology platform to be independently and sustainably adherent to their healthy lifestyle habits. This emphasizes the importance of conducting multi-iterative evaluations to continuously monitor whether and how patients' needs and contexts of use change over time. Future research should focus on how this transition can be identified and monitored and how these insights can inform the design and implementation of the technology.
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Affiliation(s)
- Britt E Bente
- Department of Psychology, Health, and Technology, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Jobke Wentzel
- Department of Psychology, Health, and Technology, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Department of Health Care and Social Work, University of Applied Sciences Windesheim, Zwolle, Netherlands
| | - Celina Schepers
- Department of Psychology, Health, and Technology, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Linda D Breeman
- Unit of Health, Medical, and Neuropsychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Veronica R Janssen
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Marcel E Pieterse
- Department of Psychology, Health, and Technology, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Andrea W M Evers
- Unit of Health, Medical, and Neuropsychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health, and Technology, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
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Uncovering Barriers and Facilitators of Weight Loss and Weight Loss Maintenance: Insights from Qualitative Research. Nutrients 2023; 15:nu15051297. [PMID: 36904294 PMCID: PMC10005538 DOI: 10.3390/nu15051297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011-2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.
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Laranjeira C, Carvalho D, Valentim O, Moutinho L, Morgado T, Tomás C, Gomes J, Querido A. Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3869. [PMID: 36900879 PMCID: PMC10001153 DOI: 10.3390/ijerph20053869] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers' evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness-and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Daniel Carvalho
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - Olga Valentim
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Lídia Moutinho
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Tânia Morgado
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Pediatric Hospital, Coimbra Hospital and University Centre, R. Dr. Afonso Romão, 3000-602 Coimbra, Portugal
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Catarina Tomás
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - João Gomes
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
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Kuningas K, Driscoll J, Mair R, Day E, Sharif A. Short-term Healthy Lifestyle Intervention and Long-term Behavior Change After Kidney Transplantation: Findings From the CAVIAR Study. Am J Kidney Dis 2023; 81:249-252. [PMID: 36228826 DOI: 10.1053/j.ajkd.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/11/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kulli Kuningas
- Department of Nephrology and Transplantation, University Hospitals Birmingham, UK
| | - Joanne Driscoll
- Department of Nutrition and Dietetics, University Hospitals Birmingham, UK
| | - Reena Mair
- Department of Nutrition and Dietetics, University Hospitals Birmingham, UK
| | - Edward Day
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Adnan Sharif
- Department of Nephrology and Transplantation, University Hospitals Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
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Sushko K, Sherifali D, Nerenberg K, Strachan PH, Butt M. Supporting self-management in women with pre-existing diabetes in pregnancy: a protocol for a mixed-methods sequential comparative case study. BMJ Open 2022; 12:e062777. [PMID: 36253034 PMCID: PMC9577889 DOI: 10.1136/bmjopen-2022-062777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION For women with pre-existing type 1 and type 2 diabetes, glycaemic targets are narrow during the preconception and prenatal periods to optimise pregnancy outcomes. Women aim to achieve glycaemic targets during pregnancy through the daily tasks of diabetes self-management. Diabetes self-management during pregnancy involves frequent self-monitoring of blood glucose and titration of insulin based on glucose measures and carbohydrate intake. Our objective is to explore how self-management and support experiences help explain glycaemic control among women with pre-existing diabetes in pregnancy. METHODS AND ANALYSIS We will conduct a four-phased mixed-methods sequential comparative case study. Phase I will analyse the data from a prospective cohort study to determine the predictors of glycaemic control during pregnancy related to diabetes self-management among women with pre-existing diabetes. In phase II, we will use the results of the cohort analysis to develop data collection tools for phase III. Phase III will be a qualitative description study to understand women's diabetes education and support needs during pregnancy. In phase IV, we will integrate the results of phases I and III to generate unique cases representing the ways in which self-management and support experiences explain glycaemic control in pregnancy. ETHICS AND DISSEMINATION The phase I cohort study received approval from our local ethics review board, the Hamilton Integrated Ethics Review Board. We will seek ethics approval for the phase III qualitative study prior to its commencement. Participants will provide informed consent before study enrolment. We plan to publish our results in peer-reviewed journals and present our findings to stakeholders at relevant conferences/symposia.
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Affiliation(s)
- Katelyn Sushko
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Diana Sherifali
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kara Nerenberg
- Medicine, Obstetrics & Gynaecology and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Patricia H Strachan
- Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Michelle Butt
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
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21
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Hubert PA, Fiorenti H, Duffy VB. Feasibility of a Theory-Based, Online Tailored Message Program to Motivate Healthier Behaviors in College Women. Nutrients 2022; 14:nu14194012. [PMID: 36235664 PMCID: PMC9572712 DOI: 10.3390/nu14194012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to test the feasibility of an online survey and tailored message program in young women. Recruited from college campuses, women (n = 189) completed an online survey assessing preference for and behaviors toward diet and physical activity as well as theory-based influencers of these behaviors (knowledge/information, motivation, and confidence). Health messages were tailored to the participant’s survey responses and learning style to address misconceptions and motivate or reinforce healthy physical activity and dietary behaviors. Most women reported the survey as relevant (92%) and useful for reflecting on their health (83%), with survey responses variable in level of nutrition and physical activity knowledge, motivation, and confidence. Each woman received four tailored messages—most reported the messages as relevant (80%) and learning new information (60%). Across all messages, nearly half of the participants (~48%) reported willingness to try or maintain healthier behaviors and confidence in their ability. Body size discrepancy and dietary restraint had small effects message responses of information learned, and the motivation and confidence in trying healthier behaviors. In summary, these data support the feasibility of this online tailored message program. The college women found the tailored message program acceptable and useful to motivate healthier behaviors. The findings provide direction for behaviorally focused interventions to improve dietary and physical activity behaviors.
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Laranjeira C, Piaça I, Vinagre H, Vaz AR, Ferreira S, Cordeiro L, Querido A. Vulnerability through the Eyes of People Attended by a Portuguese Community-Based Association: A Thematic Analysis. Healthcare (Basel) 2022; 10:1819. [PMID: 36292265 PMCID: PMC9601330 DOI: 10.3390/healthcare10101819] [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] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Vulnerability is associated with the individual's social and biological conditions, but also the conditions of their enveloping environment and society, leading to terms such as vulnerable populations or risk groups. This study aimed to give a voice to people with experiences of vulnerability and explore their perspectives, using a descriptive qualitative design. Purportedly vulnerable adults were recruited and interviewed with semi-structured questions on vulnerability. Data were organized, using WebQDA software, and submitted to thematic content analysis, as proposed by Clark and Braun, which generated a thematic tree. The study included six men and six women with a mean age of 43.8 [SD = 14.17] years old. Thematic analysis generated three themes: (1) Conceptions about vulnerability, (2) Barriers imposed by vulnerability, and (3) Strategies for dealing with vulnerability. The results highlight that vulnerability is a highly dynamic process of openness to circumstances that influence individual outcomes. However, there is a lack of conceptual clarity. Although being vulnerable is perceived as something negative, we need to transform the social mindset, because vulnerability also has the potential to change priorities in life for the better.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André—66–68, 2410-541 Leiria, Portugal
- Research in Education and Community Intervention (RECI I&D), Piaget Institute, 3515-776 Viseu, Portugal
| | - Inês Piaça
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Henrique Vinagre
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Ana Rita Vaz
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Sofia Ferreira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
| | - Lisete Cordeiro
- InPulsar (Associação para o Desenvolvimento Comunitário), Rua José Gonçalves LT 55—LJ 3 PISO-1, 2410-121 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André—66–68, 2410-541 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
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Welsh JA, Lange SJ, Figueroa J, Walsh S, Gooding H, Cheung P. Impact of a brief training on motivational interviewing and the 5A's approach on weight-related counseling practices of pediatricians. Obes Sci Pract 2022; 8:466-473. [PMID: 35949275 PMCID: PMC9358740 DOI: 10.1002/osp4.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 11/08/2022] Open
Abstract
Background Pediatric primary healthcare providers are well-positioned to provide healthy lifestyle and weight management related counseling but many lack training in evidence-based messages and methods. Objectives We assessed the impact of a brief, easy-to-access training for pediatric healthcare providers, (the Strong4Life Provider Training), designed to introduce/review current evidence-based messages and methods and improve healthy weight-related assessment and counseling practices. Methods Following their well-child visit, a convenience sample of children 12-17 years and parents of children 6-11 years (N = 121) of randomly selected Strong4Life trained (N = 15) and untrained (N = 15) pediatricians were administered a survey designed to assess the frequency, content, and patient satisfaction with weight management-related counseling provided. Results from parents and patients of trained pediatricians (N = 62) compared to those from parents and patients of untrained pediatricians (n = 59) were compared using chi-square tests. Generalized estimating equations were used to account for lack of independence among respondents from the same practice. P-values less than 0.05 were considered to be statistically significant. Results Parents/patients of trained pediatricians were more likely than those of an untrained pediatrician to report having been asked about child's consumption of fruit/vegetables, 57 (92%) versus 44 (75%), p = 0.04 and sugary drinks, 50 (81%) versus 29 (49%), p = 0.005, and their readiness for behavior change, 47 (76%) versus 29 (49%), p = 0.005, and to set a behavior change goal, 36 (59%) versus. 23 (40%), p = 0.005. Regardless of training status, physical activity, screen time, and weight status were assessed for most patients, and most were satisfied with the discussion. Few (21%) were asked about barriers to behavior change.
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Affiliation(s)
- Jean A. Welsh
- Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Child AdvocacyChildren's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Samantha J. Lange
- Department of Child AdvocacyChildren's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Janet Figueroa
- Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Child AdvocacyChildren's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Stephanie Walsh
- Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Child AdvocacyChildren's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Holly Gooding
- Department of PediatricsEmory University School of MedicineAtlantaGeorgiaUSA
| | - Patricia Cheung
- Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
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Communicating Health to Young Adults Using Social Media: How, Where, and When? Nutrients 2022; 14:nu14142967. [PMID: 35889924 PMCID: PMC9318771 DOI: 10.3390/nu14142967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/28/2022] [Accepted: 07/06/2022] [Indexed: 12/10/2022] Open
Abstract
Communication with young adults about healthy lifestyle behaviours needs to result in improvements in dietary choices to impact the prevalence of diet-related diseases. This paper presents the health beliefs, behaviours, and communication practices in young Australian adults (n = 2019) by their pre-defined psycho-behavioural characteristics: Lifestyle Mavens, Health-Conscious, Aspirational Healthy Eaters, Balanced-All Rounders, Contemplating Another Day, or Blissfully Unconcerned. The Lifestyle Mavens and Health-Conscious groups were more likely to actively seek out health information on social media (p < 0.05). Lifestyle Mavens were the most likely to engage with health and food content on social media, whereas the Blissfully Unconcerned were the least likely to engage (p < 0.05). Lifestyle Mavens are more likely to report creating food and health-related content for social media, whereas Aspirational Healthy Eaters are more likely to report searching for food and health-related content online, but are less likely to share or create content. Contemplating Another Day are more likely to report interactions with commercial content. This paper defines how psycho-behavioural segments communicate about health, where they look for information, how they may prefer to receive health messages, and when they are most receptive to messages. By applying existing robust market segmentation techniques, this paper provides nuanced information that challenges the assumption that online social media health information is preferred by all young adults.
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Stanislaw H, McCreary J. Identifying Core Values with a Hierarchical, Ipsative, Preference Assessment. J Pers Assess 2022; 105:329-341. [PMID: 35820075 DOI: 10.1080/00223891.2022.2090369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Values provide a foundation for decision making, behavior, and emotional reaction; they are often used by practitioners to design effective interventions for self-awareness and personal growth. This report describes a novel, user-friendly method that identifies core values with a hierarchical ipsatization procedure (HIP) that is transparent and efficient. Response bias, validity, and user satisfaction were examined in a study in which 602 respondents completed a survey asking them to rate 80 values and use HIP to identify their 4 most inspiring and motivating values. HIP enabled selecting these 4 core values from 80 candidates in 5-7 min, with minimal evidence of response bias. The selections made during HIP were consistent with the rating data, providing evidence for HIP's concurrent validity. 88% of the respondents felt the 4 values identified by HIP inspired and motivated them more than any other values they could think of. These findings suggest HIP is a useful tool for identifying core values, especially in applied settings.
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Affiliation(s)
- Harold Stanislaw
- Department of Psychology and Child Development, California State University, Stanislaus, Turlock, CA, USA
| | - Jamie McCreary
- Department of Psychology and Child Development, California State University, Stanislaus, Turlock, CA, USA
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Bytyci-Katanolli A, Merten S, Kwiatkowski M, Obas K, Gerold J, Zahorka M, Jerliu N, Ramadani Q, Fota N, Probst-Hensch N. Non-communicable disease prevention in Kosovo: quantitative and qualitative assessment of uptake and barriers of an intervention for healthier lifestyles in primary healthcare. BMC Health Serv Res 2022; 22:647. [PMID: 35568906 PMCID: PMC9107010 DOI: 10.1186/s12913-022-07969-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking, physical inactivity, low fruit and vegetable consumption, and obesity are common in Kosovo. Their prevention is a priority to relieve the health system of from costly non-communicable disease treatments. The Accessible Quality Healthcare project is implementing a primary healthcare intervention that entails nurse-guided motivational counselling to facilitate change in the domains of smoking, diet, alcohol consumption and physical inactivity for at-risk patients. This study quantitatively assesses the uptake of motivational counselling and the distribution of health behaviours and stages of health behaviour change of the participants according to the intervention, as well as qualitatively describes experiences and perceived benefits of motivational counselling. METHODS Study participants (n = 907) were recruited consecutively in 2019 from patients visiting the Main Family Medical Centres in 12 municipalities participating in the Kosovo Non-Communicable Disease Cohort study as part of the Accessible Quality Healthcare project. For the quantitative study, we used baseline and first follow-up data on smoking status, physical inactivity, obesity, fruit and vegetable as well as alcohol consumption, uptake of counselling, and stages for behavioural change. For the qualitative study, in-depth interviews were conducted with a subset of 26 cohort participants who had undergone motivational counselling. RESULTS Motivational counselling was obtained by only 22% of the eligible participants in the intervention municipalities. Unhealthy behaviours are high even in persons who underwent counselling (of whom 13% are smokers; 86% physically inactive; 93% with inadequate fruit and vegetable consumption; and 61% are obese); only the rate of smoking was lower in those who obtained counselling. Among smokers, over 80% were still in the pre-contemplation phase of behaviour change. More advanced stages of behaviour change were observed among the highly prevalent group of inactive persons and participants with poor dietary habits, among the 5 intervention municipalities. According to the qualitative study results, the participants who obtained motivational counselling were very satisfied with the services but requested additional services such as group physical activity sessions and specialized services for smoking cessation. CONCLUSIONS More tailored and additional primary health care approaches in accordance with patients' views need to be considered for the motivational counselling intervention to reach patients and efficiently facilitate lifestyle behaviour change.
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Affiliation(s)
- Ariana Bytyci-Katanolli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Katrina Obas
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jana Gerold
- University of Basel, Basel, Switzerland
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Manfred Zahorka
- University of Basel, Basel, Switzerland
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Naim Jerliu
- National Institute of Public Health Kosovo, Prishtina, Kosovo
- University of Prishtina, Medical Faculty, Prishtina, Kosovo
| | | | - Nicu Fota
- Accessible Quality Healthcare Project, Prishtina, Kosovo
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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Aljabri D. Associations Between Obesity, Physical Inactivity, Healthcare Capacity, and the Built Environment: Geographic Information System Analysis. J Multidiscip Healthc 2022; 15:689-704. [PMID: 35399806 PMCID: PMC8985911 DOI: 10.2147/jmdh.s345458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obesity is one of the major critical health conditions affecting many people across the world. One of the major causes of obesity is identified to be sedentary lifestyles and physical inactivity, which may be associated with environmental factors. Objective The study analyzes variations in obesity and physical inactivity in the State of South Carolina, US, and their association with healthcare capacity and the built environment. Methods Data were obtained from different secondary sources and surveys, 2012, and then linked on the county-level using ArcGIS. Global Moran's I was used to examine the spatial distribution at the state level, and Anselin's local Moran's I was used to detect any significant clusters at the county level. Ordinary least squares regression models were calculated for obesity and physical inactivity separately. Results More than 70% of SC counties had high levels of obesity and physical inactivity. Spatial analysis showed statistical clusters of high obesity, high physical inactivity, and low access to exercise opportunities in rural areas compared to urban areas. Conversely, clusters of high density of health-care facilities appeared in urban areas. Through the regression models, the density of primary care physicians (p = 0.025) and access to exercise opportunities (p = 0.075) were negatively associated with obesity, while the low perception of own health (p = 0.001) and obesity rate (0.011) were positively associated with physical inactivity. Conclusion GIS was useful to illustrate and identify significant geographic variations and high clusters of obesity and physical inactivity in rural areas, compared with high clusters of access to exercise opportunities and health-care facilities in urban areas. The international health community is encouraged to utilize spatial information systems to examine variations and recommend evidence-based recommendations to redistribute equitable public health efforts. The development of strategies and initiatives toward reducing variation in health and sustainable development is key to promote the population wellbeing.
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Affiliation(s)
- Duaa Aljabri
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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28
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Battista S, Manoni M, Dell'Isola A, Englund M, Palese A, Testa M. Giving an account of patients' experience: A qualitative study on the care process of hip and knee osteoarthritis. Health Expect 2022; 25:1140-1156. [PMID: 35266257 PMCID: PMC9122415 DOI: 10.1111/hex.13468] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Despite the publication of clinical practice guidelines, the quality of the care process as experienced by patients with osteoarthritis (OA) appears suboptimal. Hence, this study investigates how patients with OA experience their disease and care process, highlighting potential elements that can enhance or spoil it, to optimise their quality of care. METHODS A qualitative study based on semi-structured interviews. Patients with hip and knee OA in Italy were interviewed. The interview guide was created by a pool of health professionals and patients. The interviews were analysed through a theme-based analysis following a philosophy of descriptive phenomenological research. RESULTS Our analysis revealed seven main themes: (1) Experiencing a sense of uncertainty, as interviewees perceived treatment choices not to be based on medical evidence; (2) Establishing challenging relationships with the self and the other, as they did not feel understood and felt ashamed or hopeless about their condition; (3) Being stuck in one's own or the health professionals' beliefs about the disease management, as a common thought was the perception of movement as something dangerous together with a frequent prescription of passive therapies; (4) Dealing with one's own attitudes towards the disease; Understanding (5) the barriers to and (6) the facilitators of the adherence to therapeutic exercise, which revolve around the therapy cost, the time needed and the patients' willingness to change their life habits and (7) Developing an uneasy relationship with food since the diet was considered as something that "you force yourself to follow" and overeating as a way "to eat your feelings". CONCLUSION The lack of clear explanations and a negative attitude towards first-line nonsurgical treatments (mainly physical exercise), which are considered as a way to fill the time while waiting for surgery, underlines the importance of providing patients with adequate information about OA treatments and to better explain the role of first-line intervention in the care of OA. This will enhance patient-centred and shared decision-making treatments. PATIENT CONTRIBUTION Patients with hip and knee OA participated in creating the interview and contributed with their experience of their care process.
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Affiliation(s)
- Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy.,Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Mattia Manoni
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Andrea Dell'Isola
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Martin Englund
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
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Fischer T, Stumpf P, Schwarz PEH, Timpel P. Video-based smartphone app ('VIDEA bewegt') for physical activity support in German adults: a single-armed observational study. BMJ Open 2022; 12:e052818. [PMID: 35078839 PMCID: PMC8796221 DOI: 10.1136/bmjopen-2021-052818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 01/05/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to investigate the effect of the video-based smartphone app 'VIDEA bewegt' over eight programme weeks on physical activity in German adults. DESIGN The study used a single-arm observational design, assessing the app's effectiveness under real-life conditions. Data were collected from July 2019 to July 2020. SETTING The app is enabling users to access video-based educational content via their smartphone. A clinical visit or in-person contact was not required. PARTICIPANTS All individuals registered in the freely available app were invited to take part in the study. INTERVENTIONS The app aims to increase physical activity in everyday life. It combines educative videos on lifestyle-related benefits and instructional videos of strength and endurance exercises to do at home with motivational components like goal setting, documentation of progress and personalised messages. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were physical activity based one MET minutes per week (metabolic equivalent) and step numbers.Secondary outcomes included physical self-efficacy (motivational, maintenance, recovery self-efficacy), health-related quality of life: Mental Health Component Summary score and Physical Health Component Summary score. RESULTS Of 97 people included in the data analysis, 55 successfully completed the programme and all questionnaires. Significant increases over eight programme weeks (between T0 and T2) were observed in physical activity based on MET minutes per week, health-related quality of life, and recovery self-efficacy. Time spent sitting and body mass index significantly decreased for those completing the programme. CONCLUSIONS Although significant benefits of physical activity were observed following a complete-case analysis, results should be dealt with caution. Studies with a larger and less heterogeneous sample and robust study designs able to measure causal effects would be desirable. TRIAL REGISTRATION NUMBER DRKS00017392.
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Affiliation(s)
- Tillmann Fischer
- Department for Prevention and Care of Diabetes, University Hospital Dresden Clinic and Polyclinic III, Dresden, Germany
| | - Paul Stumpf
- Department for Prevention and Care of Diabetes, University Hospital Dresden Clinic and Polyclinic III, Dresden, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, University Hospital Dresden Clinic and Polyclinic III, Dresden, Germany
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, University Hospital Dresden Clinic and Polyclinic III, Dresden, Germany
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Kohl PL, Gyimah EA, Diaz J, Kuhlmann FM, Dulience SJL, Embaye F, Brown DS, Guo S, Luby JL, Nicholas JL, Turner J, Chapnick M, Pierre JM, Boncy J, St Fleur R, Black MM, Iannotti LL. Grandi Byen-supporting child growth and development through integrated, responsive parenting, nutrition and hygiene: study protocol for a randomized controlled trial. BMC Pediatr 2022; 22:54. [PMID: 35062907 PMCID: PMC8780724 DOI: 10.1186/s12887-021-03089-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor child growth and development outcomes stem from complex relationships encompassing biological, behavioral, social, and environmental conditions. However, there is a dearth of research on integrated approaches targeting these interwoven factors. The Grandi Byen study seeks to fill this research gap through a three-arm longitudinal randomized controlled trial which will evaluate the impact of an integrated nutrition, responsive parenting, and WASH (water, sanitation and hygiene) intervention on holistic child growth and development. METHODS We will recruit 600 mother-infant dyads living in Cap-Haitien, Haiti and randomize them equally into one of the following groups: 1) standard well-baby care; 2) nutritional intervention (one egg per day for 6 months); and 3) multicomponent Grandi Byen intervention (responsive parenting, nutrition, WASH + one egg per day for 6 months). Primary outcomes include child growth as well as cognitive, language, motor, and social-emotional development. The study also assesses other indicators of child health (bone maturation, brain growth, diarrheal morbidity and allergies, dietary intake, nutrient biomarkers) along with responsive parenting as mediating factors influencing the primary outcomes. An economic evaluation will assess the feasibility of large-scale implementation of the interventions. DISCUSSION This study builds on research highlighting the importance of responsive parenting interventions on overall child health, as well as evidence demonstrating that providing an egg daily to infants during the complementary feeding period can prevent stunted growth. The multicomponent Grandi Byen intervention may provide evidence of synergistic or mediating effects of an egg intervention with instruction on psychoeducational parenting and WASH on child growth and development. Grandi Byen presents key innovations with implications for the well-being of children living in poverty globally. TRIAL REGISTRATION NCT04785352 . Registered March 5, 2021 at https://clinicaltrials.gov/.
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Affiliation(s)
- Patricia L Kohl
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Emmanuel A Gyimah
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Jenna Diaz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - F Matthew Kuhlmann
- Division of Infectious Diseases, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Sherlie Jean-Louis Dulience
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Fithi Embaye
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Derek S Brown
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Shenyang Guo
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Jennifer L Nicholas
- Department of Radiology, School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Jay Turner
- McKelvey School of Engineering, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Melissa Chapnick
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
| | - Joseline Marhone Pierre
- Unité de Coordination du Programme National d'Alimentation et de Nutrition, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | - Jacques Boncy
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, 1, Angle Avenue Maïs Gaté et, Rue Jacques Roumain, Port-au-Prince, Haiti
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA
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Shimazaki T, Okoshi H, Yamauchi T, Takenaka K, Suka M. The process of behavioral change in individuals who are uninterested in health: a qualitative study based on professional health knowledge. Environ Health Prev Med 2022; 27:32. [PMID: 35896370 PMCID: PMC9357552 DOI: 10.1265/ehpm.22-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/13/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In Japan and elsewhere, there is major concern over individuals who are uninterested in health and reluctant to change their health behaviors. While previous studies have investigated cognitive and behavioral characteristics in this population, there is limited evidence on whether they recognize the significance of health, nor is it clear how to motivate necessary behavior changes. This study identified specific characteristics of positive psychological and behavioral change in individuals who were uninterested in health, then constructed a model for their behavior change process, as advised via professional health expertise in the Japanese context. METHODS This qualitative survey study was conducted among 86 health professionals (public health nurses, registered dieticians, and city/prefectural employees). These participants reported their demographic characteristics (gender, age, job, and length of service) and entered free descriptions concerning perceived cognitive and behavior changes in individuals who were uninterested in health. Finally, we thematically analyzed the contents on psychological/behavioral change and constructed a thematic map. RESULTS We obtained 409 relative descriptive codes and four main themes, including (1) Health awareness: Recognize the significance of health via personal experience and/or illness among family/friends; (2) Psychological readiness: Preparative psychological state toward health behavior; (3) Gateway behavior: Precursory behavior leading to health behavior; and (4) Health behavior: Traditional healthy lifestyle behavior, with 45 subthemes. We constructed the abovementioned thematic map according to the Transtheoretical Model. Herein, health awareness may catalyze changes in health behavior, while changes in both psychological readiness (e.g., new interest in health behaviors and attitude toward appearance) and gateway behaviors (e.g., new points of discussion and information gathering) may arise before changes in health behavior. CONCLUSIONS This study clarified positive cognitive and behavior changes in individuals who were uninterested in health and elucidated their behavior change process. As behavior changes in such individuals tend to be rigid, they are often left behind by health care systems and programs. In this regard, we identified pertinent cognitive and behavioral characteristics during the behavior change process and constructed a relevant model. These findings should be useful in developing interventions that can motivate the desire for behavior change.
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Affiliation(s)
- Takashi Shimazaki
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine
| | - Hiroto Okoshi
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine
| | - Takashi Yamauchi
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine
| | | | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine
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Myers L, Goodwin BC, Ireland M, March S, Aitken J. Mail-out bowel cancer screening: Identifying the behavioural stumbling blocks. Psychooncology 2021; 31:816-823. [PMID: 34967054 DOI: 10.1002/pon.5866] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/22/2021] [Accepted: 12/14/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To describe the actions taken by recipients of mail-out faecal occult blood test (FOBT) kits and to identify the points at which progress towards kit completion typically stops. Differences according to gender, age, and screening intention were also examined. METHODS 1599 people completed an online survey identifying the actions they took upon receiving an FOBT kit. Latent class analysis was conducted to identify latent subgroups of participants that reported similar actions. Differences between gender, age, and intention status were assessed using non-invariance testing. RESULTS Four latent subgroups of FOBT invitees were identified: those who complete and return their FOBT kit ('completers'); those who bring the kit into their house but go no further ('ignorers'); those who open the package and read the bowel cancer information materials but go no further ('readers'); and those who read the instructions but do not place the kit near the toilet and do not complete their FOBT kit ('leavers'). Non-completers who intended to use the kit were most likely to be in the 'leavers' class, while those who had no intention were most likely to be in the 'readers' class. CONCLUSIONS Distinct subgroups of non-responders exist among bowel cancer screening invitees, suggesting different behaviour change interventions are needed to facilitate participation. Some invitees, especially those with high participatory intention, are likely to benefit from prompts to take the kit into the toilet, while others, with little participatory intention, often read the invitation materials presenting an opportunity to intervene with health messages.
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Affiliation(s)
- Larry Myers
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - Michael Ireland
- Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Sonja March
- Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Joanne Aitken
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,School of Public Health, The University of Queensland, Herston, Australia
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Buková A, Chovanová E, Küchelová Z, Junger J, Horbacz A, Majherová M, Duranková S. Association between Educational Level and Physical Activity in Chronic Disease Patients of Eastern Slovakia. Healthcare (Basel) 2021; 9:healthcare9111447. [PMID: 34828493 PMCID: PMC8619688 DOI: 10.3390/healthcare9111447] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 01/05/2023] Open
Abstract
Aims: This study aimed to investigate selected chronic diseases patients with different educational attainment regarding their awareness of and compliance with recommended physical activity. Method: This cross-sectional study was conducted from October 2018 to February 2019 in cooperation with chronic diseases clinics in eastern Slovakia. The study involved 893 patients. Results: People with higher education apparently recognise to a greater extent the importance of nutrition, diet, and the role of physical activity in treating their disease. Moreover, they have knowledge of physical exercises appropriate for their disease. Conversely, a noticeably higher number of less educated patients reported receiving general, respectively detailed information about the importance of physical activity in treating their disease. Differences in awareness of appropriate exercises and their implementation were not statistically significant. Conclusions: The results fail to prove educational attainment being a key determinant of chronic diseases. However, it can be reasonably argued that lower educational attainment may be a reliable risk signal of chronic diseases in later life.
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Affiliation(s)
- Alena Buková
- Institute of Physical Education and Sport, Pavol Jozef Šafárik University, 040 11 Košice, Slovakia; (Z.K.); (J.J.); (A.H.)
- Correspondence: ; Tel.: +421-552341624
| | - Erika Chovanová
- Faculty of Sport, University of Prešov, 080 01 Prešov, Slovakia;
| | - Zuzana Küchelová
- Institute of Physical Education and Sport, Pavol Jozef Šafárik University, 040 11 Košice, Slovakia; (Z.K.); (J.J.); (A.H.)
| | - Jan Junger
- Institute of Physical Education and Sport, Pavol Jozef Šafárik University, 040 11 Košice, Slovakia; (Z.K.); (J.J.); (A.H.)
| | - Agata Horbacz
- Institute of Physical Education and Sport, Pavol Jozef Šafárik University, 040 11 Košice, Slovakia; (Z.K.); (J.J.); (A.H.)
| | - Mária Majherová
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia; (M.M.); (S.D.)
| | - Silvia Duranková
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia; (M.M.); (S.D.)
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Nahidi F, Tehrani FR, Ghodsi D, Jafari M, Majd HA, Abdolahian S. The effectiveness of lifestyle training program promoting adolescent health with polycystic ovarian syndrome: A study protocol for a randomized controlled study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:351. [PMID: 34761037 PMCID: PMC8552287 DOI: 10.4103/jehp.jehp_15_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Lifestyle training is of a key important in adolescent age for better life in the future. Healthy lifestyle in adolescents can management of any disease such as diabetes and polycystic ovarian syndrome (PCOS). Schools can provide an important environment to identify and change the lifestyle of students. The aim of this protocol is designing and evaluating the effectiveness of school-based lifestyle training program improving the PCOS of adolescents. MATERIALS AND METHODS A cluster-randomized controlled trial will be conducted to examine the effectiveness of school-based lifestyle training program in 16 to 18 years old adolescent girls. The healthy lifestyle program will be designed by modification of behavioral habit, dietary intake, and physical activity and educated in eight sessions for adolescents and one session for parents in the intervention groups with sixty participants. RESULTS Changes in primary and secondary outcomes in PCOS and healthy adolescents before and after intervention in the intervention and control groups will be analyzed for evaluation effectiveness by one-way ANOVA or other nonparametric equivalents. CONCLUSION The current study will provide information on the effectiveness of school-based lifestyle training programs for adolescents. With increasing numbers of PCOS at risk for long-term and/or late effects of treatment and other chronic diseases, efforts for promoting the healthy lifestyle of this important group are urgently needed. This lifestyle program may provide valuable information relating to the development of other healthy lifestyle interventions for PCOS and result in appropriate behavior change and self-management strategies.
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Affiliation(s)
- Fatemeh Nahidi
- Department of Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Jafari
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Abdolahian
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Keerthirathne TP, Ross K, Fallowfield H, Whiley H. Examination of Australian backyard poultry for Salmonella, Campylobacter and Shigella spp., and related risk factors. Zoonoses Public Health 2021; 69:13-22. [PMID: 34482641 DOI: 10.1111/zph.12889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/18/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
Worldwide, foodborne illness is a significant public health issue in both developed and developing countries. Salmonellosis, campylobacteriosis and shigellosis are common foodborne gastrointestinal illnesses caused by the bacteria Salmonella spp., Campylobacter spp. and Shigella spp. respectively. These zoonotic diseases are frequently linked to eggs and poultry products. The aim of this study was to investigate the presence of these pathogens in Australian backyard poultry flocks and to determine risk factors for these pathogens. Poultry faeces samples were collected from 82 backyards and screened for Salmonella spp., Campylobacter spp. and Shigella spp. using qPCR. A questionnaire was administered to the backyard poultry owners to assess their knowledge regarding management of poultry and eggs and to identify potential risk factors that may contribute to the presence of zoonotic pathogens in the flocks. One composite faecal sample was collected from each backyard (82 samples). Composite sampling here means taking one or more grab samples from a backyard to make up approximately 10 grams. Four per cent of samples, that is 4% backyards tested, were positive for Salmonella spp., 10% were positive for Campylobacter spp. and none were positive for Shigella spp. A higher infection rate was seen in multi-aged flocks (24%) compared with the single-aged flocks (3%). The survey found that many participants were engaging in risky food safety behaviours with 46% of participants responding that they washed their eggs with running water or still water instead of wiping the dirt off with a damp cloth to clean the eggs and 19% stored their eggs at room temperature. This study demonstrated that backyard poultry may pose a potential risk for salmonellosis and campylobacteriosis. Additionally, Australian public health and food safety regulations should be modified and effectively implemented to address the risks associated with backyard poultry husbandry.
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Affiliation(s)
| | - Kirstin Ross
- Environmental Health, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
| | - Howard Fallowfield
- Environmental Health, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
| | - Harriet Whiley
- Environmental Health, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
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Poraj-Weder M, Pasternak A, Szulawski M. The Development and Validation of the Health Behavior Motivation Scale. Front Psychol 2021; 12:706495. [PMID: 34539508 PMCID: PMC8446656 DOI: 10.3389/fpsyg.2021.706495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
The article presents the construction and validation process of the Health Behavior Motivation Scale (HBMS), which measures the motivation toward pro-health behaviors in population of healthy adults. The tool is conceptually based on Self-Determination Theory (SDT) and more precisely on one of its subtheories-Organismic Integration Theory (OIT). In the first stage of the construction, the linguistic validation with competent judges procedure allowed to eliminate the items which were not correctly formulated. Next, the psychometric properties of the HBMS were assessed in three studies. In Study 1 (N = 323, M age = 31), the factorial structure of the HBMS was assessed with CFA. Since the preliminary structure was rejected, in order to identify the dimensionality of the items, EFA and Horn's Parallel Analysis were performed. The results showed that the HBMS scale has 5-dimensional structure (intrinsic regulation, integrated and identified regulation, introjected regulation, external regulation and amotivation). In Study 2 (N = 342, M age = 33), the structure of the HBMS has been confirmed by conducting CFA analysis. Analyses preformed in this study provided good evidence for convergent and discriminant validity as well as the internal reliability of the HBMS subscales. Finally, in the LPA analysis two classes with distinct regulatory profiles have been extracted, which showed differences in the extend of health-related behaviors. In Study 3 (N = 60, M age = 30) the test-retest reliability of the HBMS was confirmed. The scale can be therefore successfully used in future basic and applied studies as it possesses robust psychometric properties.
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Affiliation(s)
| | - Aneta Pasternak
- Institute of Pedagogy and Psychology, Warsaw Management University, Warsaw, Poland
| | - Michał Szulawski
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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37
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Barriers and Facilitators to the Uptake of Online and Telephone Services Targeting Health Risk Behaviours among Vocational Education Students: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179336. [PMID: 34501922 PMCID: PMC8430979 DOI: 10.3390/ijerph18179336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Abstract
Uptake of online and telephone services targeting health behaviours is low among vocational education students and barriers and facilitators are unknown. This study aimed to explore barriers and facilitators to uptake of online and telephone services for smoking, nutrition, alcohol, and physical activity (SNAP) risk behaviours via semi-structured individual telephone interviews with fifteen vocational education students. Two authors independently completed thematic analysis, classified themes according to the COM-B (Capability, Opportunity, Motivation, Behaviour) framework, and discussed disagreements until consensus was reached. Facilitators to uptake of online (e.g., desire to learn something new, cost-free, accessible) and telephone services (e.g., prefer to talk to provider, complements online support) primarily related to capability and opportunity. For telephone services, difficulty understanding accent/language was a capability-related barrier. Opportunity-related barriers for online and telephone services were preference for face-to-face interaction and lack of time, while preference for apps/online programs was a barrier for telephone services. For online and telephone services, not wanting to change SNAP behaviours was a motivation-related barrier and being able to change SNAP risk behaviours themselves was a motivation-related barrier for online services. Barriers and facilitators to online and telephone services are relevant for designing interventions vocational education students are more likely to use.
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Zamzuri M‘AIA, Jamhari MN, Faisal Ghazi H, Muhamad Hasani MH, Mohd Ali NK, Abd. Rashid MF, Hod R, Dapari R, Hassan MR. A unique double tango: Construct validation and reliability analysis of risk perception, attitude and practice (RPAP) questionnaire on dengue infection. PLoS One 2021; 16:e0256636. [PMID: 34428257 PMCID: PMC8384171 DOI: 10.1371/journal.pone.0256636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction/background Dengue fever remains a public health threat despite being preventable. A solution to the constant problem of dengue infection will require active intervention and a paradigm shift. Assessing perceived risk and correlating it with the attitude and practice of the community will help in designing appropriate measures. However, possible instruments for these assessments come with limitations. Objective The aim is to develop and validate a new scoring-based questionnaire, using dual statistical approaches to measure risk perception, attitude, and practices (RPAP) related to dengue in the community. Methods The RPAP questionnaire was developed bilingually using the International Society for Pharmacoeconomics and Outcome Research (ISPOR) guidelines. Content analysis was reviewed scrupulously by four expert panels. The initial 35-item scale was tested among 253 Malaysian respondents recruited non-probabilistically via multiple online platforms. Two statistical methods were employed to measure the construct validity: Exploratory Factor Analysis (EFA) as part of the Classical Test Theory (CTT) measurement, while Rasch Measurement Analysis (Rasch) was performed for the Item Response Theory (IRT) measurement. All results were cross-validated with their counterpart to ensure stability. Confirmatory Factor Analysis (CFA) was used to obtain a model fit index. Results 29 questions were retained after the final analysis. Both EFA and Rasch analysis detect multidimensionality. Nine latent factors were extracted from EFA, while only eight factors remained in the final model following CFA: 1) perceived susceptibility; 2) perceived severity; 3) perceived barrier; 4) perceived benefit; 5) cues to action; 6) self-efficacy; 7) attitude; and 8) practice. All items had adequate factor loadings and showed good internal consistency. The final model after CFA achieved a good fit with an RMSEA value of 0.061, SRMR of 0.068, PNFI of 0.649, and GFI of 0.996. Conclusion The RPAP questionnaire contains 29 items and is a reliable and accurate psychometric instrument for measuring the risk perception of dengue fever, attitude, and practice of the community in dengue prevention. The Rasch measurement provides additional rigour to complement the CTT analysis. This RPAP questionnaire is suitable for use in studies related to dengue prevention in the community.
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Affiliation(s)
- Mohd ‘Ammar Ihsan Ahmad Zamzuri
- Department of Community Health, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Seremban District Health Office, Seremban, Negeri Sembilan, Malaysia
- State Department of Health Negeri Sembilan, Seremban, Negeri Sembilan, Malaysia
| | - Mohd Nazrin Jamhari
- Department of Community Health, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
- State Department of Health Kedah, Alor Setar, Kedah, Malaysia
| | | | | | | | | | - Rozita Hod
- Department of Community Health, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Rahmat Dapari
- Department of Community Health, Universiti Putra Malaysia, UPM Serdang, Seri Kembangan, Selangor, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur, Malaysia
- * E-mail:
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Goodwin BC, March S, Crawford-Williams F, Chambers SK, Dunn J. "I'm not doing that." An in-depth examination of nonparticipation in mail-out bowel cancer screening programs. Transl Behav Med 2021; 10:1515-1524. [PMID: 31228202 DOI: 10.1093/tbm/ibz096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite a clear association between the early detection of bowel cancer and increased survival, participation in mail-out screening programs is poor. Several key barriers to participation have been identified, yet research has failed to examine the specific cognitions, actions, and individual contexts from which barriers emerge. The purpose of the current study was to gain a detailed understanding of the actual experience of kit receipt from the perspective of nonparticipants including their opinion on interventions that may be effective in promoting participation. Demographic differences in reasons for nonparticipation are also examined. Opt-out data from a national program was analyzed to detect demographic differences in reasons for nonparticipation. Qualitative interviews were conducted in a sample of "at risk" nonparticipants. Thematic analysis was conducted using an inductive phenomenological approach. Older, higher SES, male and previously screened participants were more likely to provide a medical reason for opting out of participation. Four key themes emerged from interview data. The first reflected intention; whereby participants were either intenders (i.e., they planned to participate) or refusers. Subsequent themes reflected practicalities, emotional reactions, and necessity. Differences between intenders and refusers within these themes as well as opinions regarding interventions were identified. Interventions involving interactions with health professionals, autonomous decision making, and those which emphasize the positive outcomes of screening may encourage refusers to participate in mail-out bowel cancer screening programs. Messages that reinforce the importance of screening or provide a practical reminder may be more useful for intenders.
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Affiliation(s)
- Belinda C Goodwin
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Sonja March
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Fiona Crawford-Williams
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Suzanne K Chambers
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, QLD, Australia
| | - Jeff Dunn
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, QLD, Australia.,School of Social Science, University of Queensland, Brisbane, QLD, Australia.,School of Medicine, Griffith University, Brisbane, QLD, Australia
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Domin A, Spruijt-Metz D, Theisen D, Ouzzahra Y, Vögele C. Smartphone-Based Interventions for Physical Activity Promotion: Scoping Review of the Evidence Over the Last 10 Years. JMIR Mhealth Uhealth 2021; 9:e24308. [PMID: 34287209 PMCID: PMC8339983 DOI: 10.2196/24308] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/12/2021] [Accepted: 04/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background Several reviews of mobile health (mHealth) physical activity (PA) interventions suggest their beneficial effects on behavior change in adolescents and adults. Owing to the ubiquitous presence of smartphones, their use in mHealth PA interventions seems obvious; nevertheless, there are gaps in the literature on the evaluation reporting processes and best practices of such interventions. Objective The primary objective of this review is to analyze the development and evaluation trajectory of smartphone-based mHealth PA interventions and to review systematic theory- and evidence-based practices and methods that are implemented along this trajectory. The secondary objective is to identify the range of evidence (both quantitative and qualitative) available on smartphone-based mHealth PA interventions to provide a comprehensive tabular and narrative review of the available literature in terms of its nature, features, and volume. Methods We conducted a scoping review of qualitative and quantitative studies examining smartphone-based PA interventions published between 2008 and 2018. In line with scoping review guidelines, studies were not rejected based on their research design or quality. This review, therefore, includes experimental and descriptive studies, as well as reviews addressing smartphone-based mHealth interventions aimed at promoting PA in all age groups (with a subanalysis conducted for adolescents). Two groups of studies were additionally included: reviews or content analyses of PA trackers and meta-analyses exploring behavior change techniques and their efficacy. Results Included articles (N=148) were categorized into 10 groups: commercial smartphone app content analyses, smartphone-based intervention review studies, activity tracker content analyses, activity tracker review studies, meta-analyses of PA intervention studies, smartphone-based intervention studies, qualitative formative studies, app development descriptive studies, qualitative follow-up studies, and other related articles. Only 24 articles targeted children or adolescents (age range: 5-19 years). There is no agreed evaluation framework or taxonomy to code or report smartphone-based PA interventions. Researchers did not state the coding method, used various evaluation frameworks, or used different versions of behavior change technique taxonomies. In addition, there is no consensus on the best behavior change theory or model that should be used in smartphone-based interventions for PA promotion. Commonly reported systematic practices and methods have been successfully identified. They include PA recommendations, trial designs (randomized controlled trials, experimental trials, and rapid design trials), mixed methods data collection (surveys, questionnaires, interviews, and focus group discussions), scales to assess app quality, and industry-recognized reporting guidelines. Conclusions Smartphone-based mHealth interventions aimed at promoting PA showed promising results for behavior change. Although there is a plethora of published studies on the adult target group, the number of studies and consequently the evidence base for adolescents is limited. Overall, the efficacy of smartphone-based mHealth PA interventions can be considerably improved through a more systematic approach of developing, reporting, and coding of the interventions.
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Affiliation(s)
- Alex Domin
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Donna Spruijt-Metz
- USC mHealth Collaboratory, Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Daniel Theisen
- ALAN - Maladies Rares Luxembourg, Kockelscheuer, Luxembourg
| | - Yacine Ouzzahra
- Research Support Department, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Research Group: Self-Regulation and Health, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Larsen RT, Korfitsen CB, Keller C, Christensen J, Andersen HB, Juhl C, Langberg H. The MIPAM trial - motivational interviewing and physical activity monitoring to enhance the daily level of physical activity among older adults - a randomized controlled trial. Eur Rev Aging Phys Act 2021; 18:12. [PMID: 34215176 PMCID: PMC8254217 DOI: 10.1186/s11556-021-00269-7] [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: 07/14/2020] [Accepted: 06/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background One in four older adults in Denmark and almost half of the very old above 75 do not meet the World Health Organization’s recommendations for a minimum of physical activity (PA). A cost-efficient and effective way to increase focus on and motivation for daily walking might be to use Physical Activity Monitors (PAMs) in combination with behavioural change intervention. Thus, the objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults. Methods This two-arm parallel group randomized controlled effectiveness trial compared a 12-weeks PAM-based intervention with additional MI (PAM+MI group) with a PAM-based intervention alone (PAM group). The primary outcome, average daily step count, was analysed with a linear regression model, adjusted for sex and baseline daily step count. Following the intention-to-treat principle, multiple imputation based on baseline step count, sex and age was performed. Results In total, 38 participants were randomized to the PAM intervention and 32 to the PAM+MI intervention arm. During the intervention period, PAM+MI participants walked on average 909 more steps per day than PAM participants, however insignificant (95%CI: − 71; 1889) and reported 2.3 points less on the UCLA Loneliness Scale (95%CI: − 4.5; − 1.24). Conclusion The use of MI, in addition to a PAM-based intervention among older adults in PA promoting interventions hold a potential clinically relevant effect on physical activity and should thus be investigated further with adequately powered RCTs. Trial registration This study was pre-registered in the clinicaltrials.gov database with identifier: NCT03906162.
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Affiliation(s)
- Rasmus Tolstrup Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Department of Occupational- and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Christoffer Bruun Korfitsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Camilla Keller
- Research Governance, Evaluation & Communication, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational- and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Henning Boje Andersen
- Department of Technology, Technical University of Denmark, Management and Economics, Lyngby, Denmark
| | - Carsten Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Henning Langberg
- Section of Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Jenkins EL, Legrand S, Brennan L, Molenaar A, Reid M, McCaffrey TA. Psycho-Behavioural Segmentation in Food and Nutrition: A Systematic Scoping Review of the Literature. Nutrients 2021; 13:1795. [PMID: 34070404 PMCID: PMC8226652 DOI: 10.3390/nu13061795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 01/08/2023] Open
Abstract
Inadequate dietary intakes are a key modifiable risk factor to reduce the risk of developing non-communicable diseases. To encourage healthy eating and behaviour change, innovative public health interventions are required. Social marketing, in particular segmentation, can be used to understand and target specific population groups. However, segmentation often uses demographic factors, ignoring the reasons behind why people behave the way they do. This review aims to explore the food and nutrition related research that has utilised psycho-behavioural segmentation. Six databases from were searched in June 2020. Inclusion criteria were: published 2010 onwards, segmentation by psycho-behavioural variables, outcome related to food or nutrition, and healthy adult population over 18 years. 30 studies were included; most were quantitative (n = 28) and all studies used post-hoc segmentation methods, with the tools used to segment the population varying. None of the segments generated were targeted in future research. Psycho-behavioural factors are key in understanding people's behaviour. However, when used in post-hoc segmentation, do not allow for effective targeting as there is no prior understanding of behaviours that need to change within each segment. In future, we should move towards hybrid segmentation to assist with the design of interventions that target behaviours such as healthy eating.
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Affiliation(s)
- Eva L. Jenkins
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill 3168, Australia; (E.L.J.); (S.L.); (A.M.)
| | - Samara Legrand
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill 3168, Australia; (E.L.J.); (S.L.); (A.M.)
| | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne 3000, Australia;
| | - Annika Molenaar
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill 3168, Australia; (E.L.J.); (S.L.); (A.M.)
| | - Mike Reid
- School of Economics, Finance and Marketing, RMIT University, Melbourne 3000, Australia;
| | - Tracy A. McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill 3168, Australia; (E.L.J.); (S.L.); (A.M.)
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Cheung DST, Takemura N, Chau PH, Ng AYM, Xu X, Lin CC. Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study. J Geriatr Oncol 2021; 12:1173-1180. [PMID: 33985930 DOI: 10.1016/j.jgo.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess exercise levels and exercise counselling /programming preferences among older cancer survivors. MATERIALS AND METHODS A mixed-methods study design was employed. Quantitative instruments on exercise levels, exercise counselling and programming preferences, frailty status, and cancer-related symptoms were administered to 290 post-treatment older cancer survivors aged ≥65. Twelve participants with different exercise levels and different views on exercise counselling and programming were purposively selected to participate in semi-structured interviews. RESULTS Overall, 58.3% of participants did not meet the recommended exercise guidelines, and 44.1% were not engaging in any vigorous or moderate exercise. Frail survivors were less likely to meet the guidelines (aOR = 0.194, 95%CI = 0.053, 0.712) compared to their robust counterparts. However, 66.9% and 62.8% of participants expressed a definite or possible interest in receiving exercise counselling and participating in an exercise program, respectively. Particularly, survivors who are male, did not receive chemotherapy, are less educated, and have higher symptom burden were less likely to show interest. Most preferred low-intensity exercise (59.8%) and wanted to start the exercise program after treatment (68.2%), which differs from the literature on general adult survivors. The major trigger to initiate and maintain exercise behaviors was the benefits of exercise and a common barrier to exercising was lack of time. CONCLUSION Most older cancer survivors did not meet the recommended exercise guidelines, but they were open to exercise counselling and programming. Reviewing education on the benefits of exercise is especially important after treatment completion to promote healthy lifestyles.
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Affiliation(s)
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Alina Yee Man Ng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan; Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong
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Duarte D, Choi K. Psychographic Profiling of Adult Tobacco Users and Implications for Mediated Message Tailoring. Am J Health Promot 2021; 35:483-490. [PMID: 33084349 PMCID: PMC9347182 DOI: 10.1177/0890117120967193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate variations of psychographic profiles in adult tobacco users to inform message tailoring. DESIGN A cross-sectional design used data from the Simmons 2015 National Consumer Study. SETTING Data were voluntarily provided by US families through a mail survey on media, products, and services, brands, and attitudes. SUBJECTS US adult tobacco users (N = 4,609). MEASURES Participants answered questions about general opinion/attitudes and provided demographic and tobacco use information. ANALYSIS A factor analysis was conducted to determine the "best" latent psychographic factor structure based on model fit, factor loadings, and interpretability. A structural equation model was then applied to assess the associations between demographics, tobacco product use, and latent psychographic factors. RESULTS We identified 9 latent psychographic factors: (1) helplessness, (2) happiness, (3) achievements, (4) religion, (5) interest in art and culture, (6) conscience, (7) conformity, (8) family indulgence, and (9) creativity. Endorsement of these factors varied by demographics and tobacco product use. E.g. low income tobacco users showed stronger endorsement for "helplessness" (Adjusted Standardized Regression Coefficient [ASRC]: 0.42; 95% CI: 0.33, 0.51) and "religion" (ASRC: 0.24; 95% CI: 0.14, 0.33). Less educated tobacco users showed stronger endorsement for "conformity" (ASRC: 0.16; 95% CI: 0.07, 0.24). Young adults had significant positive associations for "achievements" (ASRC: 0.57; 95% CI: 0.48, 0.67). CONCLUSION Psychographic profiles of tobacco users vary by demographics and product use. Tailored anti-tobacco media campaigns to specific disparity groups matching their psychographic profiles may improve message effectiveness and reduce tobacco use disparities.
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Affiliation(s)
- Danielle Duarte
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Rüth M, Kaspar K. Educational and Social Exergaming: A Perspective on Physical, Social, and Educational Benefits and Pitfalls of Exergaming at Home During the COVID-19 Pandemic and Afterwards. Front Psychol 2021; 12:644036. [PMID: 33897546 PMCID: PMC8062880 DOI: 10.3389/fpsyg.2021.644036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/26/2021] [Indexed: 12/19/2022] Open
Abstract
Physical inactivity and coronavirus disease 2019 (COVID-19) signify two pandemics with negative physical, mental, and economic consequences. Younger and older people have not reached the recommended physical activity level for years. Societal restrictions due to COVID-19 additionally reduce opportunities for physical activity, and they increase social isolation. Here, we outline how playing exergames with others (social exergaming) at home could foster physical and mental health and promote communication and discussions on exergaming. Accordingly, we highlight the educational and social benefits of exergaming at home and delineate the concept of Educational and Social Exergaming (EASE). We outline specific benefits and pitfalls of exergaming regarding its physical and nonphysical effects, including educational values of discussing exergaming experiences and related topics. Moreover, we discuss the relevance of practical guidelines for educational and social exergaming at home as well as prospects for future research. Overall, educational and social exergaming could alleviate several detrimental effects of both pandemics on the health and well-being of people of all ages.
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Affiliation(s)
- Marco Rüth
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Kai Kaspar
- Department of Psychology, University of Cologne, Cologne, Germany
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Clayton M, Fabrellas N, Luo J, Alghamdi MG, Hafez A, Qadiri TA, Owise N, Attia D. From NAFLD to MAFLD: Nurse and allied health perspective. Liver Int 2021; 41:683-691. [PMID: 33453067 DOI: 10.1111/liv.14788] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 02/13/2023]
Abstract
Fatty liver disease associated with metabolic dysfunction is the most prevalent liver disease worldwide, though both patient and health professional still lack awareness of it. An international consensus panel has produced what is sure to be an influential report renaming the disease from non-alcoholic fatty liver disease (NAFLD) to metabolic (dysfunction) associated fatty liver disease (MAFLD) and suggesting how the disease should be diagnosed. This viewpoint explores the call from the perspective of nurse and allied health practitioners. This group have raised serious concerns on the existing nomenclature, which labels the disease as NAFLD, and its diagnostic criteria, including provoking nurse role confusion and representing a major barrier to various key aspects; patient-nurse communications, patient awareness, partnership working, motivation of patients to undertake lifestyle changes and multiple health behaviour change promotion and nurse-led clinics. Therefore, they are enthusiastically supportive of this call to reframe the disease that we believe will ultimately have a positive impact on nurse-patient communication, and through this, improve patient care and quality of life and reduce burden on health system.
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Affiliation(s)
- Michelle Clayton
- Lecturer in Liver Care, School of Healthcare, University of Leeds and Liver Nurse Educator, Leeds Liver Unit, St James's University Hospital, Chair of The British Liver Nurses' Association (BLNA), Leeds, UK
| | - Núria Fabrellas
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Jinkai Luo
- Department of Nursing, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mohammed G Alghamdi
- Ministry of Health, President of the Saudi Nurses Association at Saudi Commission for Health Specialties (SCFHS), Riyadh, Saudi Arabia
| | - Azaa Hafez
- Faculty of Nursing, Minia University, Minia, Egypt
| | | | - Nevin Owise
- Birzeit University, Modern university of college, Palestine medical complex, Palestine
| | - Dina Attia
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Korthauer LE, Denby C, Molina D, Wanjiku J, Daiello LA, Drake JD, Grill JD, Ott BR. Pilot study of an Alzheimer's disease risk assessment program in a primary care setting. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12157. [PMID: 33665347 PMCID: PMC7896638 DOI: 10.1002/dad2.12157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The goal of this study was to pilot a referral-based cognitive screening and genetic testing program for Alzheimer's disease (AD) risk assessment in a primary care setting. METHODS Primary care providers (PCPs; N = 6) referred patients (N = 94; M = 63 years) to the Rhode Island Alzheimer's Disease Prevention Registry for apolipoprotein E (APOE) genotyping and cognitive screening. PCPs disclosed test results to patients and counseled them about risk factor modification. RESULTS Compared to the Registry as a whole, participants were younger, more likely to be non-White, and had lower cognitive screening scores. Mild cognitive impairment participants correctly reported a higher perceived risk of developing AD. Patients who recalled being counseled about modifiable risk factors were more likely to report positive health behavior changes. DISCUSSION A referral-based program for cognitive and genetic AD risk assessment in a primary care setting is feasible, acceptable to patients, and yielded a more demographically diverse sample than an AD prevention registry.
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Affiliation(s)
- Laura E. Korthauer
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Charles Denby
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - David Molina
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Janet Wanjiku
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Lori A. Daiello
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Jonathan D. Drake
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
| | - Josh D. Grill
- Institute of Memory Impairments and Neurological DisordersDepartment of Psychiatry and Human BehaviorDepartment of Neurobiology and BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Brian R. Ott
- Department of NeurologyAlpert Medical School of Brown UniversityRhode Island HospitalProvidenceRhode IslandUSA
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Measurement Reactivity of Accelerometer-Based Sedentary Behavior and Physical Activity in 2 Assessment Periods. J Phys Act Health 2021; 18:185-191. [PMID: 33440344 DOI: 10.1123/jpah.2020-0331] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purposes of this study were to examine accelerometer measurement reactivity (AMR) in sedentary behavior (SB), physical activity (PA), and accelerometer wear time in 2 measurement periods and to quantify AMR as a human-related source of bias for the reproducibility of SB and PA estimates. METHODS In total, 136 participants (65% women, mean age = 54.6 y) received 7-day accelerometry at the baseline and after 12 months. Latent growth models were used to identify AMR. Intraclass correlations were calculated to examine the reproducibility using 2-level mixed-effects linear regression analyses. RESULTS Within each 7-day accelerometry assessment, the participants increased their time spent in SB (b = 2.4 min/d; b = 3.8 min/d) and reduced their time spent in light PA (b = -2.0 min/d; b = -3.2 min/d), but did not change moderate to vigorous PA. The participants reduced their wear time (b = -5.2 min/d) only at the baseline. The intraclass correlations ranged from .42 for accelerometer wear time to .74 for SB. The AMR was not identified as a source of bias in any regression model. CONCLUSIONS AMR may influence SB and PA estimates differentially. Although 7-day accelerometry seems to be a reproducible measure, our findings highlight accelerometer wear time as a crucial confounder in analyzing SB and PA data.
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Saintila J, Salinas Arias SA, Calizaya-Milla YE, Dávila Villavicencio R, Castellanos-Vazquez AJ, Turpo-Chaparro J, Pacheco-Espinoza JI, Apaéstegui-Huamán AK, Huancahuire-Vega S, Ruiz Mamani PG. Effectiveness of a Program Based on Telehealth in Nutritional Knowledge and Body Mass Index in Peruvian University Teachers. J Prim Care Community Health 2021; 12:21501327211023704. [PMID: 34109879 PMCID: PMC8202259 DOI: 10.1177/21501327211023704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND University teachers, as agents of socialization, are one of the most influential groups in improving public health, and their nutritional knowledge can influence both the eating behavior of students and the family. OBJECTIVE This study was carried out to evaluate the effect of a telehealth program on the level of nutritional knowledge and body mass index (BMI) of university teachers. METHODS A pre-experimental study was carried out from August to December 2020. A pretest and a posttest were applied. The number of teachers in the initial test was 88 and those included in the final evaluation, 83; and they were selected by nonprobability sampling for convenience. The telehealth-based program lasted 18 weeks and included basic information on nutrition and motivational messages. Sociodemographic and anthropometric data were collected through a predesigned questionnaire before and after the educational program. RESULTS Posttest knowledge scores increased significantly from 6.40 ± 1.70 to 10.59 ± 1.18 (P < .001). In relation to time, significant variations are observed in weight measurements (P < .001), BMI (P < .001), and basic nutritional knowledge (P < .001) before and after the intervention program. CONCLUSION The telehealth-based intervention improved basic nutritional knowledge levels and BMI. Likewise, the current findings provide evidence on the importance and need to develop future nutritional education programs that comprehensively encompass all study plans for the benefit of the university community.
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50
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Almusharraf F, Rose J, Selby P. Engaging Unmotivated Smokers to Move Toward Quitting: Design of Motivational Interviewing-Based Chatbot Through Iterative Interactions. J Med Internet Res 2020; 22:e20251. [PMID: 33141095 PMCID: PMC7671850 DOI: 10.2196/20251] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND At any given time, most smokers in a population are ambivalent with no motivation to quit. Motivational interviewing (MI) is an evidence-based technique that aims to elicit change in ambivalent smokers. MI practitioners are scarce and expensive, and smokers are difficult to reach. Smokers are potentially reachable through the web, and if an automated chatbot could emulate an MI conversation, it could form the basis of a low-cost and scalable intervention motivating smokers to quit. OBJECTIVE The primary goal of this study is to design, train, and test an automated MI-based chatbot capable of eliciting reflection in a conversation with cigarette smokers. This study describes the process of collecting training data to improve the chatbot's ability to generate MI-oriented responses, particularly reflections and summary statements. The secondary goal of this study is to observe the effects on participants through voluntary feedback given after completing a conversation with the chatbot. METHODS An interdisciplinary collaboration between an MI expert and experts in computer engineering and natural language processing (NLP) co-designed the conversation and algorithms underlying the chatbot. A sample of 121 adult cigarette smokers in 11 successive groups were recruited from a web-based platform for a single-arm prospective iterative design study. The chatbot was designed to stimulate reflections on the pros and cons of smoking using MI's running head start technique. Participants were also asked to confirm the chatbot's classification of their free-form responses to measure the classification accuracy of the underlying NLP models. Each group provided responses that were used to train the chatbot for the next group. RESULTS A total of 6568 responses from 121 participants in 11 successive groups over 14 weeks were received. From these responses, we were able to isolate 21 unique reasons for and against smoking and the relative frequency of each. The gradual collection of responses as inputs and smoking reasons as labels over the 11 iterations improved the F1 score of the classification within the chatbot from 0.63 in the first group to 0.82 in the final group. The mean time spent by each participant interacting with the chatbot was 21.3 (SD 14.0) min (minimum 6.4 and maximum 89.2). We also found that 34.7% (42/121) of participants enjoyed the interaction with the chatbot, and 8.3% (10/121) of participants noted explicit smoking cessation benefits from the conversation in voluntary feedback that did not solicit this explicitly. CONCLUSIONS Recruiting ambivalent smokers through the web is a viable method to train a chatbot to increase accuracy in reflection and summary statements, the building blocks of MI. A new set of 21 smoking reasons (both for and against) has been identified. Initial feedback from smokers on the experience shows promise toward using it in an intervention.
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Affiliation(s)
- Fahad Almusharraf
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, Canada
| | - Jonathan Rose
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Dalla Lana School of Public Health, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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