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Moylett S, Hevey D. Testing threat-to-efficacy ratios in health communications about cardiovascular disease among an older population. Health Promot Int 2020; 35:255-266. [PMID: 30879077 DOI: 10.1093/heapro/daz019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To test threat-to-efficacy ratios within health communications about cardiovascular disease (CVD) for older individuals. Participants were randomly assigned to one of six messages: (i) 'standard' message with 1/1 threat-to-efficacy ratio, (ii) 'low efficacy' message with 1/0 threat-to-efficacy ratio, (iii) 'low threat' message with 0/1 threat-to-efficacy ratio, (iv) 'high efficacy' message with 1/2 threat-to-efficacy ratio; (v) 'high threat' message with 2/1 threat-to-efficacy ratio and (vi) 'overload' message with 2/2 threat-to-efficacy ratio. Participants had to be of 60 years of age or older (N = 242, Male = 92, Age: M = 68.29, SD = 6.71). Advanced univariate analyses and multiple regression modelling were conducted to examine associations between the message groups, and danger- and fear-control processes, as well as the impact of threat and efficacy appraisals on the relationship between the message groups and behavioural intentions. No differences were found between the message groups for danger-control processes. Those who received the 'overload' message did report higher levels of fear, nervousness and anxiety in comparison to the 'standard' message group. For physical activity, it was found that efficacy impacted the relationship between the message groups and behavioural intentions, as participants' levels of efficacy increased and if these individuals received high levels of efficacy information, their behavioural intentions for physical activity increased. Results from this study were dissimilar to those of previous research. However, they highlighted the impact of efficacy and negative emotional reactions when communicating to older individuals about CVD and the associated health behaviours.
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Affiliation(s)
- Sinéad Moylett
- School of Psychology, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
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Cheng YL, Shu JH, Hsu HC, Liang Y, Chou RH, Hsu PF, Wang YJ, Ding YZ, Liou TL, Wang YW, Huang SS, Lin CC, Lu TM, Leu HB, Lin SJ, Chan WL. High health literacy is associated with less obesity and lower Framingham risk score: Sub-study of the VGH-HEALTHCARE trial. PLoS One 2018; 13:e0194813. [PMID: 29590183 PMCID: PMC5874050 DOI: 10.1371/journal.pone.0194813] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 03/09/2018] [Indexed: 02/06/2023] Open
Abstract
Backgrounds Lower health literacy (HL) is associated with several cardiovascular disease (CVD) risk factors such as diabetes, hypertension, and metabolic syndrome (MS). The aim of our study was to investigate the association between HL and the Framingham 10-year risk score of CVD. Methods From 2015–2016, 1010 subjects aged 23 to 88 years receiving health check-up in Taipei Veterans General Hospital had complete clinical evaluations and laboratory examinations. Fatty liver was diagnosed by ultrasonography. The short form questionnaire adapted from the Mandarin Health Literacy Scale was used to assess HL. The Framingham risk score was calculated by patient characteristics. Results Subjects with higher BMIs were associated with lower HL scores. The proportion of subjects with MS was higher in the lower health literacy score group (≤ 9) at 28.8%; further analysis found that lower HL was significantly associated with MS in women but not in men. The Spearman’s rho demonstrated that the HL score was significantly associated with the BMI-based (rho = -0.11; P < 0.001) or lipid-based (rho = -0.09; P < 0.004) Framingham risk score. Conclusions Higher HL scores were associated with less CVD risk such as lower BMIs, less MS in women, and less fatty liver disease. Furthermore, HL had an inverse association with the Framingham risk score as expected. Therefore, HL in patients with CVD risk should be improved and considered as an important issue in terms of CVD reduction.
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Affiliation(s)
- Yuan-Lung Cheng
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Jiah-Hwang Shu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Chuan Hsu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying Liang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (YJW); (YL)
| | - Ruey-Hsing Chou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Pai-Feng Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Yuan-Jen Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (YJW); (YL)
| | - Yaw-Zon Ding
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Teh-Ling Liou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying-Wen Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shao-Sung Huang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Chi Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of public health, National Yang-Ming University, Taipei, Taiwan
| | - Tse-Min Lu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Bang Leu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Leong Chan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
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