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Wei FC, Huang CH, Huang CY, Tsai YP, Jeng C. Effectiveness of health education and counseling on stages of change, decisional balance, and smoking cessation self-efficacy: A prospective self-control study. Patient Educ Couns 2024; 123:108206. [PMID: 38422949 DOI: 10.1016/j.pec.2024.108206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To examine the effectiveness of health education and counseling on the stages of change, decisional balance, and smoking cessations elf-efficacy in smokers with no intention of quitting. METHODS A prospective self-controlled design was conducted between December 2020 and December 2022. The research period was divided into a control stage (first to fourth weeks) and an experimental stage (fifth to eighth weeks). Patients with coronary artery disease (CAD) and habitually smoked were recruited. Pearson correlation and a one-factor repeated-measurement analysis were performed to assess the effectiveness of the intervention. RESULTS In total, 108 male CAD patients with a mean age of 58.1 years were recruited. After 4 weeks of the intervention, 55 (51%) exhibited behavior change (X 2 = 18.03, p = .001). The decisional balance and smoking cessation self-efficacy scores significantly improved in the experimental stage. No significant differences were observed in the control stage. CONCLUSIONS Four weeks of health education and counseling could effectively improve participants' stage of change, decisional balance, and smoking cessation self-efficacy. PRACTICE IMPLICATION Healthcare professionals can play key roles in helping CAD patients successfully quit smoking through individual education and counseling.
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Affiliation(s)
- Fang-Chun Wei
- School of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Cathay General Hospital, Taipei, Taiwan.
| | - Chi-Hung Huang
- Department of Cardiovascular Center, Cathay General Hospital, Taipei, Taiwan.
| | - Ching-Yi Huang
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan.
| | - Yen-Ping Tsai
- Department of Nursing, Cathay General Hospital, Taipei, Taiwan.
| | - Chii Jeng
- School of Nursing, Taipei Medical University, Taipei, Taiwan.
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Strässner AM, Hartmann C. Gradual behaviour change towards meat reduction: Development and validation of a novel decisional balance scale. Appetite 2023; 186:106537. [PMID: 36933833 DOI: 10.1016/j.appet.2023.106537] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/12/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Meat reduction is gaining attention among consumers, marketers, policymakers and scientists. Yet little is known about decision-making processes and behaviour change towards meat reduction. This paper explores the applicability of the decisional balance (DB) framework to the field of meat reduction. A novel DB scale to measure the perceived importance of beliefs about meat reduction at different stages of behaviour change was developed and validated in two studies with German meat eaters. In Study 1 (N = 309), the item inventory was tested using an exploratory factor analysis and then validated in Study 2 (N = 809). The results yielded two higher-order DB factors (pros and cons), which were subdivided into five lower-order factors (perceived benefits of a plant-based diet, downsides of factory farming, health barriers, legitimation barriers and feasibility barriers). The pros and cons were summarised in a DB index. All DB factors and the DB index were tested for internal consistency (Cronbach's alpha ≥.70) and aspects of validity. The typical DB pattern of the pros and cons of behaviour change was confirmed: the cons outweighed the pros for consumers who did not intend to reduce meat consumption, while the pros outweighed the cons for consumers who intended to reduce meat consumption. The new DB scale for meat reduction has proven to be a suitable measure to gain insights into consumers' decision making and could be used to develop targeted meat reduction interventions.
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Affiliation(s)
- Anna-Maria Strässner
- Zurich University of Applied Sciences, School of Management and Law, Institute of Marketing Management, Switzerland.
| | - Christina Hartmann
- ETH Zurich, Department of Environmental Systems Science, Consumer Behaviour, Switzerland.
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Kawasaki Y, Nagao-Sato S, Yoshii E, Akamatsu R. Integrated consumers' sustainable and healthy dietary behavior patterns: Associations between demographics, psychological factors, and meal preparation habits among Japanese adults. Appetite 2023; 180:106353. [PMID: 36309231 DOI: 10.1016/j.appet.2022.106353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
The consumers' Sustainable and Healthy Dietary Behaviors (SHDBs) links sustainable behaviors related to eating (e.g., choosing, cooking, eating, and disposing of foods) with the level of "dietary behavior." It was hypothesized that SHDBs will vary depending on consumers' meal preparation habits, such as food selection, cooking frequency, and skill. This study examined (1) some of the behavioral patterns of SHDBs and (2) independent predictors of each pattern. In total, 508 Japanese adults who completed cross-sectional self-administered questionnaire surveys in December 2021 were included in the study. Principal component analysis (PCA) was used to identify the behavioral patterns of the 30-item SHDBs developed previously by the authors. Additionally, independent predictors of each component score were analyzed using multiple linear regression models, which included demographics, psychological factors concerning SHDBs (pros and cons for the decisional balance of SHDBs and number of environmental issues of interest), and meal preparation habits. Participants' median age was 41 (18-59) years (women: n = 259, 51.0%). Five SHDB patterns with several independent predictors were identified: amalgamation of all SHDBs, healthy food choices but unsustainable cooking, sustainable disposal, avoiding plastic products, and sustainable behaviors regarding expiry date. The multiple linear regression analysis demonstrated the independent predictors of the amalgamation of all SHDBs, such as being a man (β = -0.105), greater pros (β = 0.134), higher cooking frequency (β = 0.443) and skill (β = 0.244). Greater pros and/or smaller cons were associated with four of the five SHDB patterns, including an amalgamation of all SHDBs, healthy food choice and unsustainable cooking, avoiding disposal, and avoiding plastic products. Sustainable and healthy diet education must be implemented to ensure the adoption of all SHDBs.
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Affiliation(s)
- Yui Kawasaki
- Institute for SDGs Promotion, Organization for Social Implementation of Sustainability, Ochanomizu University, 2-1-1 Otsuka Bunkyo-ku, Tokyo, 112-8610, Japan.
| | - Sayaka Nagao-Sato
- Graduate School of Humanities and Science, Ochanomizu University, 2-1-1 Otsuka Bunkyo-ku, Tokyo, 112-8610, Japan.
| | - Emi Yoshii
- Department of Food and Health Sciences, Faculty of Health and Human Development, The University of Nagano, Japan.
| | - Rie Akamatsu
- Natural Science Division, Faculty of Core Research, Ochanomizu University, 2-1-1 Otsuka Bunkyo-ku, Tokyo, 112-8610, Japan.
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Chen YC, Huang HP, Tung TH, Lee MY, Beaton RD, Lin YC, Jane SW. The decisional balance, attitudes, and practice behaviors, its predicting factors, and related experiences of advance care planning in Taiwanese patients with advanced cancer. BMC Palliat Care 2022; 21:189. [PMID: 36324101 PMCID: PMC9628122 DOI: 10.1186/s12904-022-01073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 08/12/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Background
Patients with advanced cancer are prone to experience burdensome physical, psychological, and financial consequences. Healthcare providers may not fully appreciate advanced cancer patients’ medical care autonomy, such as at that emboded by Advance Care Planning (ACP), and by doing so may compromise their quality of end-of-life (EOL). Hence, it is essential for healthcare providers to effectively assess and communicate with patients’ regarding their medical decisions before their patients are incapacitated by their disease progression. The purpose of this investigation was to describe the decisional balance, attitudes, and practice behaviors of ACP and its predictors of ACP-related experiences in Taiwanese patients with advanced cancer. Methods
This cross-sectional, descriptive study employed a mixed-methodsquantitative and qualitative design with a sample of 166 patients that were purposely recruited from in-patient oncology units at a regional teaching hospital in southern Taiwan. Study data consisted of patient replies to a 34-item self-report tool, Decisional Balance, Attitudes, Practice Behaviors of ACP (DAP-ACP) and 4 semi-structured questions. Result
Findings indicated that, in general, study participants exhibited favorable ACP-decisional balance and positive ACP-attitudes & practice behaviors. The results also indicated that gender, educational level, and cancer diagnosis were associated with significant differences on the “ACP-decisional balance” and “ACP-attitudes” scales. In addition, our findings documented that the participants’ gender and educational level were significant predictors of both ACP-decisional balance and ACP-attitudes. Furthermore the participants’ ACP-practice behaviors were predicted by ACP-decisional balance, but not with their ACP-attitudes. The qualitative analysis of the semi-structured questions identified six themes in responses to current medical decision making (e.g., compliance with physician instructions, family engagement in treatment decision-making); and eight themes pertaining to future ACP-related concerns were identified (e.g., family conflict, effectiveness of time-limited trials). Conclusion
To promote patients’ engagement in ACP, the healthcare professional need to assess and advocate patients’ concerns or attitudes regarding ACP in a timely manner. In addition, factors or concerns that might influence patients’ responses to ACP derived from both the quantitative and qualitative findings of this current study need to be considered especially in initiating the dialogue regarding ACP with patients with advanced cancer. Trial registration No. CYCH 2,019,072, Date of registration 5 Dec 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01073-5.
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Affiliation(s)
- Yueh-Chun Chen
- Department of Nursing, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Hsiang-Ping Huang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ming-Yang Lee
- Division of Hematology/Oncology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Randal D Beaton
- Psychosocial & Community Health and Health Services, Schools of Nursing and Public Health, University of Washington, Seattle, USA
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Ko, Taiwan
| | - Sui-Whi Jane
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Ko, Taiwan. .,Dean of Academic Affairs, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Rd., Gui-Shan Dist, 33303, Tao-Yuan City, Taiwan.
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Lee MK. Decisional balance, self-leadership, self-efficacy, planning, and stages of change in adopting exercise behaviors in patients with stomach cancer: A cross-sectional study. Eur J Oncol Nurs 2021; 56:102086. [PMID: 34942589 DOI: 10.1016/j.ejon.2021.102086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE Previous studies have suggested the benefits of regular exercise in motivating the survivors of cancer; however, most survivors are insufficiently active, showing high rates of nonadherence to physical activity guidelines. Using the I-Change model, this study sought to determine the association of decisional balance and self-efficacy for exercise, planning, and self-leadership with the stages of change in exercise behavior among patients with stomach cancer. METHODS This cross-sectional study was conducted in February 2021 and included 145 patients diagnosed with primary stomach cancer via quota sampling in South Korea. Sociodemographics, comorbidity, decisional balance for exercise, self-efficacy for exercise, planning, self-leadership, and stages of change in exercise behavior were assessed. RESULTS Of the participants, 4% were in the precontemplation stage of exercise behavior, 10% contemplation, 37% preparation, 23% action, and 27% maintenance. The male sex (p = 0.043), higher self-efficacy for resisting relapse (p < 0.0001), higher coping planning (p = 0.029), and higher self-leadership for behavior awareness and volition (p = 0.023) were associated with more readiness for changes in exercise behavior. CONCLUSIONS From the results obtained using the I-Change model, self-efficacy for resisting relapse to previous habits, coping planning, and behavior awareness and volition were associated with more readiness for changes in exercise behavior. These findings may help reduce stomach cancer survivors' nonadherence to physical activity guidelines.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
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Bohlen LC, Emerson JA, Rhodes RE, Williams DM. A Systematic Review and Meta-analysis of the Outcome Expectancy Construct in Physical Activity Research. Ann Behav Med 2021; 56:658-672. [PMID: 34491296 DOI: 10.1093/abm/kaab083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/02/2023] Open
Abstract
BACKGROUND Cognition-based theories dominate physical activity (PA) research, and many include a construct broadly defined as "beliefs about the consequences of behavior" (e.g., outcome expectancies, perceived benefits) hereafter referred to as perceived consequences. PURPOSE With the quantity of available research on this topic, it is important to examine whether the literature supports perceived consequences as a predictor of PA. METHODS A meta-analysis examining longitudinal associations between perceived consequences and PA in adults was conducted. Studies were eligible if (a) perceived consequences were measured at a time point prior to PA, and (b) the target behavior was a form of PA. An omnibus meta-analysis estimating the mean effect of all included studies, and separate meta-analyses for perceived consequences content categories were conducted. RESULTS This search yielded 6,979 articles, of these, 110 studies met inclusion criteria. Studies were published between 1989 and 2020, with sample sizes ranging from 16 to 2,824. All studies were evaluated as moderate to high quality. A small positive bivariate association was identified (r = 0.11; 95% CI [0.09, 0.13]) between perceived consequences and PA. Significant associations were identified for time, health, self-evaluative, psychological, and affective consequences. There was no association between perceived weight-related consequences and PA. CONCLUSIONS The findings emphasize the variability with which existing studies have examined perceived consequences in the PA literature. Future research might examine whether these are important distinctions for understanding PA. Overall, the results suggest utility in examining perceived consequences as a predictor of PA, but constructs with more robust associations may require priority.
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Affiliation(s)
- Lauren Connell Bohlen
- Brown University School of Public Health, Department of Behavioral and Social Sciences, 121 S Main St., Providence, RI 02906, USA
| | - Jessica A Emerson
- Brown University School of Public Health, Department of Behavioral and Social Sciences, 121 S Main St., Providence, RI 02906, USA.,Miriam Hospital, Center for Weight Control and Diabetes Research , Providence, RI, USA
| | - Ryan E Rhodes
- University of Victoria, Department of Exercise Science, Physical and Health Education, Victoria, BC, Canada
| | - David M Williams
- Brown University School of Public Health, Department of Behavioral and Social Sciences, 121 S Main St., Providence, RI 02906, USA
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Filleul V, Ladune R, Gruet M, Falzon C, Fuchs A, Mély L, Hayotte M, Vallier JM, Giovannetti P, Ramel S, Vuillemin A, Corrion K, d'Arripe-Longueville F. Development and validation of the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA). BMC Pulm Med 2021; 21:121. [PMID: 33853554 PMCID: PMC8048282 DOI: 10.1186/s12890-021-01471-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with cystic fibrosis (pwCF) derive several physiological and psychological benefits from regular physical activity (PA), but the practice is lower than recommended. Knowledge about the facilitators of and barriers to PA at the individual level is important to act positively on PA behaviors. This study validated the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA) for adults with CF. METHODS French adults with CF were recruited in several specialist centres in France. The CF-DB-PA scale was validated following a quantitative study protocol comprising four stages: (1) tests of the clarity and relevance of a preliminary 44-item version and reduction analysis, (2) confirmatory factor analysis and tests of dimensionality through equation modelling analysis, (3) tests of reliability with Cronbach alphas for the internal consistency and a test-retest with a 2-to-3 week interval for temporal stability, and 4) tests of construct validity with Spearman correlations to measure the associations between each subscale and the theoretically related constructs (i.e., quality of life, PA and exercise tolerance). RESULTS A total of 201 French adults with CF participated in the validation study. The CF-DB-PA comprises 23 items divided into two factors: facilitators of and barriers to PA. Each factor is divided into three subscales: physical, psychological and environmental. The factors (facilitators and barriers) can be used independently or combined as a whole. A general score of decisional balance for PA can also be calculated. The bi-factor model presented satisfactory adjustment indexes: χ2 (194) = 362.33; p < .001; TLI = .87; CFI = .90; RMSEA = .067. The scale showed satisfactory internal consistency (Cronbach's α = .77). The test-retest reliability was not significant for either subscale, indicating stability over time. The facilitators subscale correlated significantly with the self-reported score of PA (r = .33, p < .01) and quality of life (r = .24, p < .05). The barriers subscale correlated significantly with the self-reported scores of PA (r = - .42, p > .01), quality of life (r = - .44, p < .01), exercise tolerance (r = - .34, p < .01) and spirometry tests (r = - .30, p < .05). CONCLUSIONS The CF-DB-PA is a reliable and valid questionnaire assessing the decisional balance for PA, the facilitators of and the barriers to PA for adults with CF in French-speaking samples.
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Affiliation(s)
| | | | - Mathieu Gruet
- Université de Toulon, Unité de Recherche Impact de l'Activité Physique sur la Santé, Toulon, France
| | | | - Amélie Fuchs
- Laboratoire de thérapeutiques non médicamenteuses innovantes Mooven, Montpellier, France
| | - Laurent Mély
- Hôpital Renée Sabran, Centre de Ressources et de Compétences de la Mucoviscidose (CRCM), Giens, France
| | | | - Jean-Marc Vallier
- Université de Toulon, Unité de Recherche Impact de l'Activité Physique sur la Santé, Toulon, France
| | - Philippe Giovannetti
- Service de Pneumologie, Centre de Ressource et de Compétence de la Mucoviscidose (CRCM) adulte et pôle d'Activités Médicales Intersite de Médecine Physique et de Réadaptation APHM-CHU Hôpital Nord, Marseille, France
| | - Sophie Ramel
- Fondation Ildys, site de Perharidy, Roscoff, France
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Bauermeister JA, Tingler RC, Demers M, Connochie D, Gillard G, Shaver J, Chavanduka T, Harper GW. Acceptability and Preliminary Efficacy of an Online HIV Prevention Intervention for Single Young Men Who Have Sex with Men Seeking Partners Online: The myDEx Project. AIDS Behav 2019; 23:3064-77. [PMID: 30762190 DOI: 10.1007/s10461-019-02426-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prevention of new cases of HIV among young gay, bisexual and other men who have sex with men (YGBMSM; ages 18-24) remains a priority. We developed and pilot tested an online intervention (myDEx) using a pilot randomized trial design with 180 online-recruited single YGBMSM who reported recent unprotected anal intercourse, self-reporting as HIV negative or status-unaware, and who met sexual partners through online dating applications. myDEx participants reported higher overall satisfaction (d = 0.46) and willingness to recommend the intervention to friends (d = 0.48) than controls. myDEx participants were less likely to report foregoing condoms to achieve an emotional connection with a partner (d =0 .43), and more likely to report greater emotional regulation during their partner-seeking behaviors (d = 0.44). myDEx participants reported fewer partners with whom they had condomless receptive anal sex (d = 0.48). Our pilot results demonstrate the potential of the myDEx intervention, suggesting that a larger efficacy trial may be warranted in the future.
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Khazaee-Pool M, Jahangiry L, Pashaei T, Ramezani-Badr F, Nadrian H, Ponnet K. Development and psychometric properties of the methamphetamine decisional balance scale (METH-DBS) for young adults. Subst Abuse Treat Prev Policy 2018; 13:38. [PMID: 30373625 PMCID: PMC6206728 DOI: 10.1186/s13011-018-0175-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Drug misuse is a major problem that has an extreme negative effect on people's health. Methamphetamine (MA) is frequently used by young adults, despite its harmful consequences. The Transtheoretical Model (TTM) has been known to be very effective in explaining both the achievement and cessation of several health-related behaviors. Therefore, in this study, the TTM was used toward the domain of immoderate MA use among young adults. This study aimed to test the validity and reliability of a decisional balance scale for MA use in young adults. METHODS A multi-phase scale development approach was used to develop the scale. First, 41 university students enrolled in a qualitative study that generated content for a primary set of a 40-item instrument. In order to produce a pre-final version of the instrument, face and content validity were calculated in the next step. The instrument validation was assessed with a sample of 250 university students. Then, the construct validity (exploratory and confirmatory), convergent validity, discriminate validity, internal consistency applying test-retest reliability, and Cronbach's alpha of the scale were measured. RESULTS Forty items were initially generated from the qualitative data. After content validity, this amount was reduced to 25 items. The exploratory factor analysis revealed four factors (self and other cons, coping and social pros) containing 21 items that jointly accounted for 55.24% of the observed variance. The confirmatory factor analysis indicated a model with appropriate fitness for the data. Cronbach's alpha coefficient for the dimensions ranged from .74 to .87, and the Intraclass Correlation Coefficient (ICC) ranged from .83 to .91, which is within acceptable ranges. CONCLUSION The findings showed that the Methamphetamine Decisional Balance Scale is a valid and reliable scale that increases our ability to study motivational factors related to MA use among young adult. Consequently, the instrument could be applied in both practice and future studies.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Leila Jahangiry
- Department of Health Education and Health Promotion, Health Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahereh Pashaei
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Farhad Ramezani-Badr
- Department of Critical Care Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Haidar Nadrian
- Department of Health Education and Health Promotion, Health Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koen Ponnet
- Department of Communication Sciences, Faculty of Political and Social Sciences, imec-mict-Ghent University, Ghent, Belgium
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Davoodi SH, Agah B, Aghamolaei T, Ghanbarnejad A, Dadipoor S, Moradabadi AS. Fish consumption based on transtheoretical model among housewives. J Educ Health Promot 2018; 7:25. [PMID: 29629386 PMCID: PMC5852994 DOI: 10.4103/jehp.jehp_91_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/06/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Consuming fish plays a key role in human health and prevention of diseases. The aim of this study was using transtheoretical model to analyze the trend of fish consumption among women. MATERIALS AND METHODS In this descriptive-analytic research, 383 housewives who referred to health centers in Bandar Abbas were selected through a stratified sampling method. Data were collected by a questionnaire to determine fish consumption based on transtheoretical model and analyzed by using SPSS software version 19.0. with the significance level of P < 0.05. RESULTS Nearly 11.7% of the patients were found to be at the precontemplation stage; 3.9% were at the contemplation stage; 13.6% were at the preparation stage; 7.3% showed to be at the action stage, and 63.4% were at the maintenance stage. The results showed a significant relation of the constructs of the model with the stages of change of consuming one or two meals of fish a week. Moving through the stages of change from the precontemplation stage to maintenance stage was accompanied by an increase in decisional balance, self-efficacy, and processes of change (P < 0.05). CONCLUSION It is suggested that in designing educational interventions in the light of this model, more emphasis is placed on perceived benefits and self-efficacy. The processes of change are advised to be used more often, and perceived barriers to fish consumption need to be reduced as far as possible.
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Affiliation(s)
- Sayed Hossein Davoodi
- Department of Nutrition Research, Cancer Research Center, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahidbeheshti University of Medical Sciences, Tehran, Iran
| | - Banafsheh Agah
- Department of Health Education, Health School, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Social Determinants on Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Ghanbarnejad
- Social Determinants on Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Fertility and Infertility Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Safari Moradabadi
- Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Orouji MA, Shojaeizadeh D, Sadeghi R, Rafiei M. Effects of a theory-driven educational package and social support on durability of cigarette smoking cessation behavior: A community-based program. Electron Physician 2017; 9:5331-5338. [PMID: 29038718 PMCID: PMC5633234 DOI: 10.19082/5331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/20/2022] Open
Abstract
Background According to a World Health Organization (WHO) report, the prevalence of smoking in Iranian individuals aged 15–64 is up to 12%. Objective The aim of the current study was to determine the durability of smoking cessation behavior based on a trans-theoretical model. Methods This educational experimental study was conducted on smokers in Khomein City, Iran, in 2015. Sampling was done through a public announcement and then a random allocation of participants into two study group (50 persons) and control group (60 persons). Tools to gather data were as follows: an individual characteristics form and DiClemente’s stages of change, Velicer’s self-efficacy, Prochaska’s processes of change, Velicer’s decisional balance, and Fagerstrom’s nicotine dependency questionnaires. The study group received five sessions of 45-minute individual counseling each and were followed-up three and six months later. Data were analyzed by SPSS version 16, using paired-samples t-test, independent-samples t-test, and chi-square. Results Within six months of follow-up, 20 persons (40%) of the intervention group reached the maintenance stage of smoking cessation, while no one from controls managed to do that. Except for the perceived barriers and benefits of smoking cessation, all other constructs of the trans-theoretical model (cognitive and behavioral processes and smoking temptation) showed significant changes among the intervention group during six months’ follow-up (p<0.05). There was no significant relationship between variables of having smoker friends, occupation, marital status, education status, and success or failure in cigarette smoking cessation (p>0.05). Conclusion According to our study, selection of cigarette smokers who are willing to quit, delivery of individual counseling according to specific personal characteristics, and also provision of free nicotine replacement therapies should be taken into account in cigarette smoking cessation programs.
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Affiliation(s)
- Mohammad Ali Orouji
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rafiei
- Ph.D. of Biostatistics, Professor, Department of Biostatistics and epidemiology, School of medicine, Arak University of Medical Sciences, Arak, Iran
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Krigel SW, Grobe JE, Goggin K, Harris KJ, Moreno JL, Catley D. Motivational interviewing and the decisional balance procedure for cessation induction in smokers not intending to quit. Addict Behav 2017; 64:171-8. [PMID: 27619008 DOI: 10.1016/j.addbeh.2016.08.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/11/2016] [Accepted: 08/30/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The decisional balance (DB) procedure examines the pros and cons of behavior change and was considered a component in early formulations of Motivational Interviewing (MI). However, there is controversy and conflicting findings regarding the use of a DB exercise within the treatment of addictions and a need to clarify the role of DB as a component of MI. METHODS College tobacco smokers (N=82) with no intentions on quitting were randomly assigned to receive a single counseling session of either Motivational Interviewing using only the decisional balance component (MIDB), or health education around smoking cessation (HE). Assessments were obtained at baseline, immediately post-treatment, 1week, and 4weeks. RESULTS Compared to HE, the MIDB sessions scored significantly higher on the Motivational Interviewing Treatment Integrity (MITI) scale (all standardized differences d>1, p<0.001). Unexpectedly, self-report Pros of smoking scores increased for MIDB but decreased for HE (MIDB vs HE standardized difference d=0.5; 95%CI 0.1 to 1.0, p=0.021). Both groups showed significant reductions in smoking rates and increases in motivation to quit, quit attempts, and self-reported abstinence, with no significant group differences. Changes in the Pros of smoking were correlated with MITI scores, but not with cessation outcomes. In contrast, increases in the Cons of smoking and therapeutic alliance were predictive of better cessation outcomes. CONCLUSIONS The decisional balance exercise as formulated by earlier versions of MI may be counter-productive and cautions around its use are warranted. Instead, improved cessation outcomes appear associated with increasing perceived benefits of quitting and positive therapeutic alliance.
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Abstract
Interventions directed at health behavior change are increasingly being developed for cancer survivors. This study validates decisional balance measures for physical activity and fruit and vegetable (F/V) consumption among adult survivorship population. Participants were N = 86 patients who previously completed primary treatment for breast or prostate cancer for at least 5 years and were enrolled in an e-health intervention that aimed to improve physical activity and nutrition behaviors. Decisional balance, stage of change, F/V consumption, and physical activity were assessed at baseline and 3 months. Factor analysis was used to assess the structure of the decisional balance measures. The relationship between decisional balance, stage, and behavioral outcomes was assessed with mixed model analyses. The two factor structures of each measure were supported. Pros and cons differed across stages of change for both behaviors (p's < .0001). Total Metabolic Equivalent of Task units (METs) were related to decisional balance pros (p = .012) and cons (p = .003). F/V consumption was significantly associated with decisional balance pros (p = .0003), but not cons (p = .112). Overall, findings provide validation for these decisional balance measures as indicators of health behaviors and support the value of using these measures in further research to aid in understanding of behavior change in this population.
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Affiliation(s)
- Jonathan Shtaynberger
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA
| | - Paul Krebs
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA.
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14
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Sun Y, Sarma EA, Moyer A, Messina CR. Promoting mammography screening among Chinese American women using a message-framing intervention. Patient Educ Couns 2015; 98:878-83. [PMID: 25858632 DOI: 10.1016/j.pec.2015.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 03/12/2015] [Accepted: 03/21/2015] [Indexed: 05/14/2023]
Abstract
OBJECTIVES This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography. METHODS One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up. RESULTS Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message. CONCLUSIONS Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women. PRACTICE IMPLICATIONS The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive.
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Affiliation(s)
- Yiyuan Sun
- School of Nursing, Stony Brook University, Stony Brook, USA
| | | | - Anne Moyer
- Department of Psychology, Stony Brook University, Stony Brook, USA
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15
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Mostafavi F, Ghofranipour F, Feizi A, Pirzadeh A. Improving physical activity and metabolic syndrome indicators in women: a transtheoretical model-based intervention. Int J Prev Med 2015; 6:28. [PMID: 25949778 PMCID: PMC4410444 DOI: 10.4103/2008-7802.154382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 10/20/2014] [Accepted: 01/07/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed at investigating the impact of an educational intervention based on transtheoretical model to increase physical activity and improve metabolic syndrome indicators in women. METHODS In this quasi-experimental study, 142 women with metabolic syndrome were randomly assigned to the case and control group (each group 71 participants). SECQ (Marcus), processes of change (Marcus), decisional balance (Bandura) and self-efficacy (Nigg) questionnaires and International Physical Activities Standard Questionnaire in preintervention, 3 and 6 months after intervention were completed. Furthermore, abdominal obesity, triglycerides (TG), and high-density lipoprotein (HDL) were measured. Physical activity intervention based on transtheoretical model (TTM) was performed in the case group. Finally, data were analyzed by SPSS (16) (SPSS Inc., Chicago, IL, USA) and repeated measure ANOVA, independent t-test and Freidman was used. A two-tailed P value, lower than 0.05, was considered to be statistically significant. RESULTS After the intervention, physical activity level increased in the intervention group, and they also progressed in stages of change, but the people in the control group had regressed. All changes in TTM constructs were significant in the intervention group during the time and differences in pros and cons were not significant in the control group. Abdominal obesity and TG has significantly reduced, and HDL has increased in the intervention group. In the control group, there was a significant increase in TGs and a decrease in HDL. CONCLUSIONS Physical activity training based on TTM can improve physical activity and metabolic syndrome indicators in women.
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Affiliation(s)
- Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fazllolah Ghofranipour
- Department of Health Education and Promotion, School of Health, Tarbiat Modares University, Tehran, Iran
| | - Awat Feizi
- Department of Mathematics and epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asiyeh Pirzadeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Correspondence to: Miss. Asiyeh Pirzadeh, Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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16
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Foster DW, Young CM, Bryan J, Steers MLN, Yeung NCY, Prokhorov AV. Interactions among drinking identity, gender and decisional balance in predicting alcohol use and problems among college students. Drug Alcohol Depend 2014; 143:198-205. [PMID: 25127705 PMCID: PMC4161622 DOI: 10.1016/j.drugalcdep.2014.07.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 07/20/2014] [Accepted: 07/21/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aim of the present study was to test promising constructs (decisional balance and drinking identity) and their interaction with gender as predictors of risky college drinking. We expected that, consistent with previous work, drinking identity would be positively associated with alcohol consumption and problems. We further expected that drinking identity would be more strongly related to outcomes among individuals scoring low in decisional balance. Additionally, we expect the relationship between drinking identity and alcohol behavior to vary as a function of decisional balance. METHODS Participants included 329 undergraduates (M=23.11; SD=5.63; 74.47% female) who met heavy drinking criteria (defined as women who consumed 4 or more drinks per occasion and men who consumed 5 or more drinks per occasion) and completed an online survey comprised of self-report measures. RESULTS Decisional balance was negatively correlated with both drinking and problems, which partially supported expectations. As expected, drinking identity was positively correlated with drinking and problems. A two-way interaction emerged between drinking identity and decisional balance regarding problems, indicating that drinking identity was associated with more problems, especially among those lower in decisional balance. A three-way interaction between drinking identity, decisional balance, and gender emerged regarding problems such that drinking identity was associated with more problems for those lower in decisional balance and this effect was stronger among men. DISCUSSION Findings lend support to the perspective that decisional balance, drinking identity, and gender are all influential factors that are associated with the experience of alcohol problems.
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Affiliation(s)
- Dawn W Foster
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, United States.
| | - Chelsie M Young
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Jennifer Bryan
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Mai-Ly N Steers
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Nelson C Y Yeung
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Alexander V Prokhorov
- University of Texas MD Anderson Cancer Center, Cancer Prevention and Health Promotion Department, New Haven, CT, United States
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Greene GW, Redding CA, Prochaska JO, Paiva AL, Rossi JS, Velicer WF, Blissmer B, Robbins ML. Baseline transtheoretical and dietary behavioral predictors of dietary fat moderation over 12 and 24 months. Eat Behav 2013; 14:255-62. [PMID: 23910762 PMCID: PMC4008122 DOI: 10.1016/j.eatbeh.2013.01.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 01/07/2013] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Abstract
Longitudinal predictors of dietary behavior change are important and in need of study. This secondary data analysis combined primary data across three randomized trials to examine transtheoretical model (TTM) and specific dietary predictors of successful dietary change at 12 and 24 months separately in treatment and control groups (N = 4178). The treatment group received three TTM-tailored print interventions over 12 months between 1995 and 2000. Chi-square and MANOVA analyses were used to examine baseline predictors of dietary outcome at 12 and 24 months. Last, a multivariable logistic regression was conducted with all baseline variables included. Across all analyses in both treatment and control groups, the most robust predictors of successful change were for TTM-tailored treatment group, preparation stage of change, and increased use of dietary behavior variables such as moderating fat intake, substitution of lower fat foods, and increasing intake of healthful foods. These results provide strong evidence for treatment, stage and behavioral dietary severity effects predicting dietary behavior change over time, and for targeting these variables with the strongest relationships to outcome in interventions, such as TTM-tailored dietary interventions.
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Abstract
OBJECTIVE To investigate selected constructs of the transtheoretical model (TTM) of behavior change regarding smoking behavior among Iranian male students. MATERIALS AND METHODS A convenience sample of 578 smokers and ex-smokers from six universities during December 2009 to June 2010 completed three Persian versions of the short form smoking questionnaire based on TTM, developed by Prochaska, Velicer, and Diclemente. Data were analyzed using SPSS 15. Frequency analysis was conducted to demographic variables. Stages' differences were assessed with analysis of variance (ANOVA) followed by post-hoc multiple comparisons with Tukey's honestly significant difference (HSD) test. Alpha levels were set at P<0.05. RESULTS More than half of the subjects were in contemplation stage. The pros of smoking among subjects in the precontemplation stage were significantly higher than those of subjects in the preparation and maintenance stages. Meanwhile; the pros of smoking ratings were significantly higher for the contemplation and preparation stages than for the maintenance stage. Significant mean differences in cons of smoking behavior emerged across the stages of change. However, pros and cons of smoking in the action stage were not significantly different than other stages of change. In line with self-efficacy/temptation construct, the result showed that positive social efficacy, negative affect efficacy, and habit strength were significantly different between the stages of change. CONCLUSION The results provide support to the advantages of increased self-efficacy and the role of decisional balance for the intervention program development for smoking cessation.
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Affiliation(s)
- Abdurrahman Charkazi
- Golestan University of Medical Sciences, School of Para Medicine and Health, Department of Public Health, Gorgan
| | - Hossein Shahnazi
- Department of Health services, school of Health, Isfahan University of Medical Sciences, Isfahan
| | - Araz Berdi Ghourchaei
- Department of Anesthesiology, School of Medicine, Golestan university of Medical Sciences, Gorgan
| | - Kamal Mirkarimi
- Department of Health services, school of Health, Isfahan University of Medical Sciences, Isfahan
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