1
|
Sharma M, Awan A, Kapukotuwa S. Mini review: possible role of the multi-theory model of health behavior change in designing substance use prevention and treatment interventions. Front Public Health 2024; 12:1298614. [PMID: 38496384 PMCID: PMC10940529 DOI: 10.3389/fpubh.2024.1298614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Many behavior change theories have evolved over time. Originally, the first conceptions prioritized interventions based on information, such as raising awareness and transferring knowledge. Second-generation theories prioritize the development of skills and the promotion of awareness. The emergence of evidence-based techniques in the 1990s gave rise to third-generation theories such as the Theory of Planned Behavior and Social Cognitive Theory. Presently, fourth-generation trends amalgamate various components from multiple theories to implement accurate treatments, employing technology and emphasizing targeted behavior change. This paper aims to do a concise evaluation of the multi-theory model (MTM) of health behavior change interventions in the context of planning substance use prevention and treatment. The current area of intervention programs aimed at preventing and treating substance use may benefit from MTM, an innovative fourth-generation behavior change model. Tobacco, alcohol, and other drugs have all been the subjects of experimental, cross-sectional, and qualitative research. We have presented that additional research is required to compare MTM with knowledge-based therapies or interventions grounded in other theories. A gold standard would be the randomized controlled trials and behavioral change interventions particularly useful for this purpose. In addition, research evaluating the interventions' efficacy must be carefully planned and executed.
Collapse
Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | - Asma Awan
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Sidath Kapukotuwa
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| |
Collapse
|
2
|
Bonsu L, Kumra P, Awan A, Sharma M. A systematic review of binge drinking interventions and bias assessment among college students and young adults in high-income countries. Glob Ment Health (Camb) 2024; 11:e33. [PMID: 38572263 PMCID: PMC10988166 DOI: 10.1017/gmh.2024.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/11/2024] [Accepted: 02/11/2024] [Indexed: 04/05/2024] Open
Abstract
Alcohol is the number one substance used by young people and people of college age. Binge drinking (BD) in this age group is considered one of the most important global health issues, as much harm accrues from it and even lives are lost. This study aimed to review the interventions to curb BD or encourage responsible drinking among college students and young adults. MEDLINE (PubMed), ERIC and APA PsycINFO were searched. The selected articles were published in English and had to evaluate a BD reduction program through a randomized control trial (RCT) among college students or young adults between the ages of 17-24 years. The exclusion criteria included research not published in English, systematic review articles, qualitative studies, designs other than RCTs and discussion articles on college students drinking with no findings. The three reviewers independently screened and extracted the data using the PRISMA guidelines. The overall quality of the studies was assessed. Then, 10 of the 12 interventions studied were found to be successful in reducing BD among college students, though the effect sizes were small to medium. A minority of the studies used behavior change theories. Effective interventions for reducing BD among college students and young adults should include robust behavior change theories, longer follow-up time and the operationalization of multiple outcomes. Process evaluation is needed to be conducted in these studies.
Collapse
Affiliation(s)
- Laurencia Bonsu
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Priyambda Kumra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Asma Awan
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
| | - Manoj Sharma
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV89119, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine, UNLV, Las Vegas, NV89106, USA
| |
Collapse
|
3
|
Sharma M, Batra K, Chen CC, Dai CL, Batra R, Cappelli DP. Predicting Flossing through the Application of the Multi-Theory Model (MTM) of Health Behavior Change among Minority Adolescents in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15106. [PMID: 36429824 PMCID: PMC9690246 DOI: 10.3390/ijerph192215106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Adolescents from minority groups are particularly susceptible to poor oral hygiene behaviors, including lack of daily flossing. This cross-sectional study aimed to conduct an exploratory behavioral research to identify evidence-based (theory-based) approaches to promote flossing behavior among African American/Black and Latinx/Hispanic (minority) adolescents. A 39-item psychometrically valid web-based questionnaire was used to collect responses from a nationwide sample of minority adolescents aged 10-17 years residing in the United States. The data were analyzed using bivariate and multivariate statistical methods. Of 520 minority adolescents (260 African American/Black and 260 Latinx/Hispanic adolescents), the proportion of flossing was nearly equally split in the sample. A significantly higher proportion of minority adolescents who were flossing had access to floss as opposed to those who were not flossing (86.8% vs. 69.8%, p < 0.001). A significantly higher proportion of minority adolescents who were not flossing did not visit the dentist over the past year as opposed to those who floss (25.2% vs. 14.7%, p < 0.001). Among the participants who were not flossing, gender, grade level, instruction in school regarding flossing, and multi-theory model (MTM) of health behavior change constructs were the significant predictors (p < 0.001) of initiating and sustaining flossing. The findings of this study will serve as baseline data for developing and evaluating effective evidence-based interventions using the MTM.
Collapse
Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
| | - Ching-Chen Chen
- Department of Counselor Education, School Psychology, and Human Services, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Chia-Liang Dai
- Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Ravi Batra
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Information Technology, Coforge Ltd., Atlanta, GA 30338, USA
| | - David P. Cappelli
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89102, USA
| |
Collapse
|
4
|
Sharma M, Batra K, Batra R, Dai CL, Hayes T, Ickes MJ, Singh TP. Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12139. [PMID: 36231439 PMCID: PMC9566211 DOI: 10.3390/ijerph191912139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. METHODS A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18-24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to predict the variance in the initiation and sustenance of vaping quitting behavior by predictor variables, such as demographic characteristics, history of behaviors, and MTM constructs. RESULTS Of 619 respondents, over 75% were White and nearly 70% had educational attainment equal to high school or some college. In total, 62% of respondents were using nicotine, followed by 33.3% were using cannabis. About 80% of the respondents reported being engaged in drinking alcohol, and nearly 45% were engaged in cigarette smoking. The predictive effect of all MTM constructs on vaping quitting initiation (adjusted R2 = 0.417, F (23, 595) = 20.215, p < 0.001) and sustenance (adjusted R2 = 0.366, F (23, 595) = 16.533, p < 0.001) was statistically significant. CONCLUSIONS The findings of this study point to the usability and applicability of MTM in operationalizing and developing vaping quitting behavior interventions targeting young adults.
Collapse
Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
| | - Ravi Batra
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Information Technology, Coforge Ltd., Atlanta, GA 30338, USA
| | - Chia-Liang Dai
- Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Traci Hayes
- College of Nursing, School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Melinda J. Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40509, USA
| | - Tejinder Pal Singh
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
| |
Collapse
|
5
|
Sharma M, Batra K, Wilkerson AH, Chirico F, Raich S. A multi-theory model based analysis of correlates for initiating and sustaining mammography screening behavior among Hispanic American women in the United States. Health Promot Perspect 2022; 12:110-119. [PMID: 35854851 PMCID: PMC9277286 DOI: 10.34172/hpp.2022.14] [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: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Despite the known advantages of mammography, screening rates among Hispanic American women are lower compared to other ethnic groups. Therefore, this cross-sectional study aimed to explore correlates of mammography screening behavior among a sample of Hispanic women aged 45-54 years living in the United States using the multi-theory model (MTM). Methods: A 50-item web-based survey consisting of psychometrically valid tools based on MTM theoretical framework was administered through non-random sampling procedures using Qualtrics. Univariate, bivariate, and multivariate statistics were used to analyze the data. Results: Out of 370 participants, nearly 49% (n=189) reported not having a mammogram in the past two years. The mean age of the sample was 48.8±2.8 years. A greater proportion of participants who have had a mammogram reported having health insurance compared to those who have not had a mammogram (93.1% vs. 75.7%, P <0.001). Results of hierarchical regression suggest that all MTM constructs, including participatory dialogue, behavioral confidence, and changes in the physical environment explained 33.4% of variance in initiating mammography behavior among those who have not had a mammogram. Similarly, practice for change, emotional transformation, and changes in the social environment explained 53% of the variance in sustenance of the behavior change. Conclusion: Along with the MTM subscales, this study points to the important correlates such as health insurance and messaging by healthcare providers to promote the mammography seeking behavior among Hispanic women.
Collapse
Affiliation(s)
- Manoj Sharma
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, USA
| | - Kavita Batra
- UNLV Medicine Trauma and Critical Care, Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, USA
| | | | - Francesco Chirico
- Università Cattolica del Sacro Cuore, Post-Graduate Specialization, Rome, Italy
| | - Siddharth Raich
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas, USA
| |
Collapse
|
6
|
Sharma M, Asare M, Lakhan R, Kanekar A, Nahar VK, Moonie S. Can the Multi-Theory Model (MTM) of Health Behavior Change Explain the Intent for People to Practice Meditation? J Evid Based Integr Med 2021; 26:2515690X211064582. [PMID: 34898284 PMCID: PMC8671666 DOI: 10.1177/2515690x211064582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Meditation is gaining popularity as adjuvant therapy for many chronic ailments, mental well-being, and spiritual growth. Behavioral theories have been underutilized in understanding meditation behavior. This study aimed to test if a fourth-generation multi-theory model (MTM) could explain the intent for starting and maintaining meditation behavior in a sample of US adults. A face and content valid 48-item instrument based on MTM was administered in a cross-sectional design through an online survey (n = 330). Internal consistency (Cronbach's alpha > 0.70) and construct validation using structural equation modeling of the subscales were all acceptable. Hierarchical multiple regression revealed that, after controlling for demographic covariates, the MTM constructs of participatory dialogue (β = 0.153; P = .002) and behavioral confidence (β = 0.479; P < .001) were statistically significant in predicting intent for starting meditation behavior and accounted for 32.9% of the variance. Furthermore, after controlling for demographic covariates, the MTM constructs of emotional transformation (β = 0.390; P < .001) and changes in the social environment (β = 0.395; P < .001) were statistically significant and accounted for 52.9% of the variance in the intent for maintaining meditation behavior. Based on this study, it can be concluded that MTM offers a pragmatic framework to design, implement, and evaluate evidence-based (theory-based) meditation behavior change interventions.
Collapse
Affiliation(s)
| | | | | | | | - Vinayak K Nahar
- 8083The University of Mississippi Medical Center, Jackson, USA
| | | |
Collapse
|
7
|
Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey. Healthcare (Basel) 2021; 9:healthcare9010055. [PMID: 33419211 PMCID: PMC7825622 DOI: 10.3390/healthcare9010055] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/25/2020] [Accepted: 01/03/2021] [Indexed: 12/18/2022] Open
Abstract
Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose of this cross-sectional study was to explore and explain the handwashing behavior among college students during the COVID-19 pandemic using a contemporary fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from 713 college students at a large public university in the Southern U.S. in October 2020 using a validated 36-item survey. Statistical analyses included independent samples t-tests, Pearson correlation, and hierarchical regression modeling. Among students not following handwashing recommendations, the constructs of participatory dialogue (β = 0.152; p < 0.05) and behavioral confidence (β = 0.474; p < 0.0001) were statistically significant and accounted for 27.2% of the variance in the likelihood of initiation of the behavior. Additionally, the constructs of emotional transformation (β = 0.330; p < 0.0001), practice for change (β = 0.296; p < 0.0001), and changes in the social environment (β = 0.180; p < 0.05) were statistically significant and accounted for 45.1% of the variance in the likelihood of sustaining handwashing behavior. This study highlights the applicability and usability of the MTM in designing and testing behavior change interventions and media messaging in campaigns targeting college students.
Collapse
|
8
|
Claros E, Nahar VK, Mafi M, Eliadi C, Abu-Moustafa S, Sharma M. Using the multi-theory model of health behavior change to identify correlates of change in substance use behavior in a mental health clinic-based sample. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1745309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Edith Claros
- School of Nursing, MCPHS University, Worcester, MA, USA
| | - Vinayak K. Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Preventive Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Milad Mafi
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Carol Eliadi
- Behavioral Health Department, Harrington Memorial Hospital, Southbridge, MA, USA
| | | | - Manoj Sharma
- Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
- School of Health Sciences, Walden University, Minneapolis, MN, USA
- Health for All, Omaha, NE, USA
| |
Collapse
|
9
|
Sharma M, Largo-Wight E, Kanekar A, Kusumoto H, Hooper S, Nahar VK. Using the Multi-Theory Model (MTM) of Health Behavior Change to Explain Intentional Outdoor Nature Contact Behavior among College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176104. [PMID: 32825734 PMCID: PMC7504007 DOI: 10.3390/ijerph17176104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 01/14/2023]
Abstract
Nature contact is an emerging health behavior and is defined as the interaction between human beings and animals, plants, natural scenic views, or outdoor activities. Studies have shown that exposure to the outdoors (as a means of contact with nature) reduces perceived stress and promotes health and wellbeing among varying populations in many settings. To date, however, there are few studies exploring the impact of nature contact among college students, especially in the United States. In addition, the determinants of nature contact behavior have not adequately been explored using behavioral theories. The purpose of this study was to use the multi-theory model (MTM) of health behavior change, a contemporary fourth-generation behavioral theory in explaining intentional outdoor nature contact behavior among college students. Using a cross-sectional design, 401 students completed the validated survey based on MTM. Of these, 281 met the inclusion criteria. The mean score for perceived stress based on the Perceived Stress Scale (PSS-10) in the sample was 21.60 (7.08) units, with a possible minimum and maximum scores ranging from 0 to 40 units. Constructs of behavioral confidence (standardized coefficient = 0.591, p < 0.001) and changes in the physical environment (standardized coefficient = 0.271, p < 0.001) from MTM accounted for 57.5% of the variance in the initiation for intentional outdoor nature contact behavior. All the three constructs of MTM—namely, emotional transformation (standardized coefficient = 0.173, p = 0.021), practice for change (standardized coefficient = 0.317, p < 0.001), and changes in the social environment (standardized coefficient = 0.204, p = 0.002)—were statistically significant and contributed substantively toward the variance (31.0%) in sustenance. MTM provides a useful and pragmatic framework for designing interventions to promote intentional nature contact behavior among college students.
Collapse
Affiliation(s)
- Manoj Sharma
- Department of Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
| | - Erin Largo-Wight
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Amar Kanekar
- College of Business, Health and Human Services, University of Arkansas at Little Rock, Little Rock, AR 72204, USA;
| | - Hana Kusumoto
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Stephanie Hooper
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (H.K.); (S.H.)
| | - Vinayak K. Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Preventive Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Correspondence: ; Tel.: +1-(601)-495-5876
| |
Collapse
|
10
|
Brown L, Sharma M, Leggett S, Sung JH, Bennett RL, Azevedo M. Efficacy testing of the SAVOR (Sisters Adding Fruits and Vegetables for Optimal Results) intervention among African American women: A randomized controlled trial. Health Promot Perspect 2020; 10:270-280. [PMID: 32802764 PMCID: PMC7420176 DOI: 10.34172/hpp.2020.41] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/15/2020] [Indexed: 01/09/2023] Open
Abstract
Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a SistersAdding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks).SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (P<0.0001)Statistically significant changes (P<0.05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.
Collapse
Affiliation(s)
- LaVonne Brown
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Sophia Leggett
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Jung Hye Sung
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Russell L Bennett
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Mario Azevedo
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| |
Collapse
|
11
|
Nahar VK, Wilkerson AH, Stephens PM, Kim RW, Sharma M. Using the Multitheory Model to Predict Initiation and Sustenance of Physical Activity Behavior Among Osteopathic Medical Students. J Osteopath Med 2020; 119:479-487. [PMID: 31355888 DOI: 10.7556/jaoa.2019.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Context The multitheory model (MTM) is a newly developed fourth-generation theoretical framework that addresses both initiation and sustenance of health behavior change. Studies have shown that the MTM is efficacious in predicting a range of health behaviors. Objective To assess the utility of the MTM in predicting initiation and sustenance of physical activity behavior among osteopathic medical students. Methods In this cross-sectional study, a volunteer convenience sample was recruited from an osteopathic medical school student population at a university in the southeastern region of the United States. An online survey was used to collect self-reported data on sociodemographic information and MTM constructs. Multiple linear regression using the enter method for modeling was performed to determine the predictive ability of the MTM constructs. Results Of the 135 participants, 52.6% were women and 67.7% were white. The initiation model explained 25.8% of the variance (adjusted R2=0.238). Behavioral confidence was a statistically significant predictor of initiation of physical activity behavior change. The sustenance model explained 41.7% of the variance (adjusted R2=0.402). Changes in social environment and emotional transformation were statistically significant predictors of sustenance of physical activity behavior change. Conclusion The MTM appears to be a robust theoretical framework for designing behavior change interventions to increase physical activity among osteopathic medical students.
Collapse
|
12
|
Factors Associated with Initiation and Sustenance of Stress Management Behaviors in Veterinary Students: Testing of Multi-Theory Model (MTM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020631. [PMID: 31963749 PMCID: PMC7014212 DOI: 10.3390/ijerph17020631] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 01/22/2023]
Abstract
Veterinary students across the United States face the challenge of stress during school every day. When managed improperly, stress can become chronic and manifest in physical and emotional consequences. The purpose of this study was to examine the utility of the multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of stress management behaviors among veterinary students. A cross-sectional design was used to study the efficacy of the MTM in predicting initiation and sustenance of stress management behaviors among veterinary students at a private College of Veterinary Medicine in the Southeast United States. Researchers collected data using a 54-item valid and reliable survey. Only students who did not already engage in daily stress management behaviors were included in the study. After recruitment and exclusion, a total of 140 students remained and participated in the study. Hierarchical multiple regression revealed that, for initiation of stress management behaviors, 49.5% of the variance was explained by depression, academic classification, and behavioral confidence. Regarding sustenance of stress management behaviors, 50.4% of the variance was explained by perceived stress, depression, academic classification, and emotional transformation. MTM serves as a promising framework for predicting initiation and sustenance of health behavior change. Based on the results of this study, interventions aimed to promote stress management behaviors in veterinary students should focus on the MTM constructs of behavioral confidence and emotional transformation.
Collapse
|
13
|
Nahar VK, Wilkerson AH, Patel FC, Kim RW, Stephens PM, Sharma M. Utilizing Multi-Theory Model in Determining Intentions to Smoking Cessation Among Smokers. Tob Use Insights 2019; 12:1179173X19843524. [PMID: 31065217 PMCID: PMC6487755 DOI: 10.1177/1179173x19843524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/19/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Smoking is a risk factor for lung cancers, and a myriad of other acute and chronic ailments. The purpose of this study was to predict initiation and sustenance of smoking cessation among smokers using a fourth-generation behavioral framework, multi-theory model (MTM) of health behavior change. Methods: A convenience sample of smokers from a shopping mall in rural, Appalachian Kentucky county was invited to participate in this cross-sectional study. A 38-item, face and content validated, MTM-based survey instrument was administered to the participants. Results: A total of 148 participants completed the study. The mean age of the participants was 35.53 (SD = 14.52) years. Most were male (58.1%) and Caucasian (95.9%). Participants reported smoking for an average of 16.45 (SD = 13.12) years. Participatory dialogue (β = 0.235, P = .003) and behavioral confidence (β = 0.305, P = .005) were significant predictors of intention for initiation for smoking cessation behavior. Emotional transformation (β = 0.319, P = .001) was a significant predictor of intention for sustenance for smoking cessation behavior. Discussion: Two of the MTM constructs for initiation and one of the MTM constructs for sustenance of change accounted for a moderate amount of variance in initiation and sustenance of smoking cessation behavior among community members in a rural, Kentucky county. MTM has utility for predicting both initiation and sustenance of smoking cessation behavior. Future interventions using MTM constructs should be developed for smoking cessation behavior change.
Collapse
Affiliation(s)
- Vinayak K Nahar
- Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, USA.,Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Amanda H Wilkerson
- Community Physical Activity and Health Lab, Department of Health and Exercise Science, College of Arts and Sciences, The University of Oklahoma, Norman, OK, USA
| | - Falguni C Patel
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Richard W Kim
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Philip M Stephens
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, MS, USA.,Health for All, Inc., Omaha, NE, USA
| |
Collapse
|