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Aulbach MB, Konttinen H, Gardner B, Kujala E, Araujo-Soares V, Sniehotta FF, Lintunen T, Haukkala A, Hankonen N. A dual process model to predict adolescents' screen time and physical activity. Psychol Health 2021:1-20. [PMID: 34662259 DOI: 10.1080/08870446.2021.1988598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Many adolescents report a lack of physical activity (PA) and excess screen time (ST). Psychological theories aiming to understand these behaviours typically focus on predictors of only one behaviour. Yet, behaviour enactment is often a choice between options. This study sought to examine predictors of PA and ST in a single model. Variables were drawn from dual process models, which portray behaviour as the outcome of deliberative and automatic processes. DESIGN 411 Finnish vocational school students (age 17-19) completed a survey, comprising variables from the Reasoned Action Approach (RAA) and automaticity pertaining to PA and ST, and self-reported PA and ST four weeks later. MAIN OUTCOME MEASURES Self-reported time spent on PA and ST and their predictors. RESULTS PA and ST correlated negatively (r = -.17, p = .03). Structural equation modelling revealed that intentions and habit for PA predicted PA while ST was predicted by intentions and habit for ST and negatively by PA intentions. RAA-cognitions predicted intentions. CONCLUSION PA and ST and their psychological predictors seem to be weakly interlinked. Future studies should assess more behaviours and related psychological influences to get a better picture of connections between different behaviours. HighlightsPhysical activity and screen time are largely mutually exclusive classes of behaviours and might therefore be related in terms of their psychological predictors.411 adolescent vocational school students self-reported variables from the Reasoned Action Approach and behavioural automaticity related to physical activity and leisure time screen time behaviours as well as those behaviours.Structural equation modelling revealed expected within-behaviour predictions but, against expectations, no strong connections between the two behaviour classes in terms of their predictors. Only intentions to engage in physical activity negatively predicted screen time.Future research should aim to measure a wider range of mutually exclusive classes of behaviours that cover a large share of the day to uncover relations between behaviours and their respective predictors.
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Affiliation(s)
| | - Hanna Konttinen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | | | - Emilia Kujala
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Vera Araujo-Soares
- Population Health Science Institute, Medical Faculty, Newcastle University, Newcastle, U.K.,Health Technology and Services Research, Technical Medical Centre, BMS, University of Twente, The Netherlands
| | - Falko F Sniehotta
- Population Health Science Institute, Medical Faculty, Newcastle University, Newcastle, U.K.,Faculty of Behavioural, Management and Social sciences, University of Twente, The Netherlands
| | - Taru Lintunen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ari Haukkala
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
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Hankonen N, Heino MTJ, Kujala E, Hynynen ST, Absetz P, Araújo-Soares V, Borodulin K, Haukkala A. What explains the socioeconomic status gap in activity? Educational differences in determinants of physical activity and screentime. BMC Public Health 2017; 17:144. [PMID: 28143461 PMCID: PMC5286840 DOI: 10.1186/s12889-016-3880-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/25/2016] [Indexed: 11/23/2022] Open
Abstract
Background Designing evidence-based interventions to address socioeconomic disparities in health and health behaviours requires a better understanding of the specific explanatory mechanisms. We aimed to investigate a comprehensive range of potential theoretical mediators of physical activity (PA) and screen time in different socioeconomic status (SES) groups: a high SES group of high school students, and a low SES group of vocational school students. The COM-B system, including the Theoretical Domains Framework (TDF), was used as a heuristic framework to synthesise different theoretical determinants in this exploratory study. Methods Finnish vocational and high school students (N = 659) aged 16–19, responded to a survey assessing psychological, social and environmental determinants of activity (PA and screen time). These determinants are mappable into the COM-B domains: capability, opportunity and motivation. The outcome measures were validated self-report measures for PA and screen time. The statistical analyses included a bootstrapping-based mediation procedure. Results Regarding PA, there were SES differences in all of the COM-B domains. For example, vocational school students reported using less self-monitoring of PA, weaker injunctive norms to engage in regular PA, and fewer intentions than high school students. Mediation analyses identified potential mediators of the SES-PA relationship in all of three domains: The most important candidates included self-monitoring (CI95 for b: 0.19–0.47), identity (0.04–0.25) and material resources available (0.01–0.16). However, SES was not related to most determinants of screentime, where there were mainly gender differences. Most determinants were similarly related with both behaviours in both SES groups, indicating no major moderation effect of SES on these relationships. Conclusions This study revealed that already in the first years of educational differentiation, levels of key PA determinants differ, contributing to socioeconomic differences in PA. The analyses identified the strongest mediators of the SES-PA association, but additional investigation utilising longitudinal and experimental designs are needed. This study demonstrates the usefulness of combining constructs from various theoretical approaches to better understand the role of distinct mechanisms that underpin socioeconomic health behaviour disparities.
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Affiliation(s)
- Nelli Hankonen
- Department of Social Research, University of Helsinki, Helsinki, Finland. .,School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
| | - Matti T J Heino
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Emilia Kujala
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Sini-Tuuli Hynynen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Pilvikki Absetz
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Vera Araújo-Soares
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Katja Borodulin
- National Institute for Health and Welfare, Helsinki, Finland
| | - Ari Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland
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Haukkala A, Kujala E, Alha P, Salomaa V, Koskinen S, Swan H, Kääriäinen H. The return of unexpected research results in a biobank study and referral to health care for heritable long QT syndrome. Public Health Genomics 2013; 16:241-50. [PMID: 24029681 DOI: 10.1159/000354105] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In this study, we examined how biobank study participants, who were found to have long QT syndrome (LQTS), a potentially life-threatening but treatable cardiac arrhythmia condition, experienced the process of disclosure of unexpected results and referral to health care. METHODS All 27 subjects with a LQTS mutation finding were asked to complete a questionnaire. Four participants did not uptake the re-testing and 5 others did not respond to the questionnaire. We received 17 questionnaires from 6 males and 11 females, aged 46-82; 5 of them were also willing to participate in qualitative interviews. RESULTS Of the respondents, 16/17 had experienced the process of receiving the results as positive and useful, especially if they had had symptoms. One respondent experienced the process negatively due to concerns related to informing her children. All respondents felt that genetic results should be reported back to the participants, while 2 indicated that this should occur only in the case of treatable conditions. Respondents had informed all of their children about the genetic condition, except 2 minors. CONCLUSIONS The respondents from a population biobank study who were informed about an unexpected genetic finding evaluated this process as mainly positive. They considered that delivering genetic information about a life-threatening but actionable condition has more beneficial than adverse consequences. The feedback policy for biobanks should include how and who is informed, advise treatment or care pathways for actionable findings, and it should also include suitable options for those who do not want to know about such findings.
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Affiliation(s)
- A Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland
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Abstract
The tumour, node, metastasis (TNM) classification is a universal cancer staging system, which has been used for five decades. The current seventh edition became effective in 2010 and covers six ophthalmic sites: eyelids, conjunctiva, uvea, retina, orbit, and lacrimal gland; and five cancer types: carcinoma, sarcoma, melanoma, retinoblastoma, and lymphoma. The TNM categories are based on the anatomic extent of the primary tumour (T), regional lymph node metastases (N), and systemic metastases (M). The T categories of ophthalmic cancers are based on the size of the primary tumour and any invasion of periocular structures. The anatomic category is used to determine the TNM stage that correlates with survival. Such staging is currently implemented only for carcinoma of the eyelid and melanoma of the uvea. The classification of ciliary body and choroidal melanoma is the only one based on clinical evidence so far: a database of 7369 patients analysed by the European Ophthalmic Oncology Group. It spans a prognosis from 96% 5-year survival for stage I to 97% 5-year mortality for stage IV. The most accurate criterion for prognostication in uveal melanoma is, however, analysis of chromosomal alterations and gene expression. When such data are available, the TNM stage may be used for further stratification. Prognosis in retinoblastoma is frequently assigned by using an international classification, which predicts conservation of the eye and vision, and an international staging separate from the TNM system, which predicts survival. The TNM cancer staging manual is a useful tool for all ophthalmologists managing eye cancer.
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Affiliation(s)
- T Kivelä
- Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland.
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Kujala E, Toivonen P. Calculated tumour volume as a prognostic parameter for survival in choroidal melanomas. Eye (Lond) 2005; 20:123-4; author reply 124-5. [PMID: 15688050 DOI: 10.1038/sj.eye.6701806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Abstract
Although almost half of the hospitals in the United States are rural and small, they often are not seen as leaders in innovation. However, many practices now being adopted by large hospitals have been used in rural hospitals for many years. To understand excellence in rural hospitals, the authors present a study of rural hospitals of excellence, using procedures from the 1982 Magnet Hospitals Study. Part 1 was reported in the January issue of JONA.
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Abstract
Although almost half of the hospitals in the United States are rural and small, they are often not seen as leaders in innovation. However, many practices just now being adopted by large hospitals have been used in rural hospitals for many years. To understand excellence in rural hospitals, the authors present a study of rural hospitals of excellence, using procedures from the 1982 Magnet Hospitals Study. Part 2 will be published in the February issue.
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Kujala E. [Periodic physical examination by occupational health services--does health improve with check-ups?]. Duodecim 1993; 109:1559-1564. [PMID: 7736971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- E Kujala
- Metsä-Serla Paperi ja Kartonki, Oy, Kankaan paperitehdas, Jyväskylä
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Kreus KE, Viljanen AA, Kujala E, Kreus R. Treatment of steroid-dependent asthma patients with beclomethasone dipropionate aerosol. Scand J Respir Dis 1975; 56:47-57. [PMID: 1145151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Fifty-two steroid-dependent adults with chronic perennial asthma were transferred to beclomethasone dipropionate aerosol. The tests demonstrated a significant improvement with beclomethasone in terms of the diary score, bronchodilator use, and PEF and FEV1.0 measurements, as compared with the previous period of prednisolone treatment. Before the transfer, 26 of the patients displayed one or more diseases or symptoms which were probably due to systemic steroid medication. Morning cortisol levels, along with the response to tetracosactrin had in all cases returned to normal when tests were carried out 41 days after transfer to beclomethasone dipropionate. In a group of 12 patients with the lowest 11-OHCS basal values, the mean of their 11-OHCS values during prednisolone treatment was as low as 0.14 plus or minus 0.06 mumol/l, but tetracosactrin challenge induced an elevation to a normal level, 0.33 plus or minus 0.13 mumol/l. After 41 days of beclomethasone treatment, the corresponding values were 0.56 plus or minus 0.90 plus or minus 0.28 mumol/l. Thirty-seven patients experienced one or more disturbing symptoms after transfer to beclomethasone. In many cases, the symptoms of allergic rhinitis were troublesome and persistent leading to a sixfold increase in the use of antihistaminic tablets. When the patients had learned to exhale through the nose following beclomethasone inhalation, the use of antihistaminic tablets again diminished to some extent. Moreover, two cases of ulcerative colitis were encountered during the beclomethasone treatment. During a follow-up period of one year, 14 patients were again receiving prednisolone; most often, this was due to worsening of the asthma because of respiratory infections. During the beclomethasone treatment, a continuous significant improvement in PEF was noted after isoprenaline inhalation, suggesting that further benefit may be obtained by the employment of bronchodilator aerosols as an essential part of the treatment.
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