Use of the multi-theory model (MTM) in explaining initiation and sustenance of indoor tanning cessation among college students

Skin cancer, including melanoma, is the most common cancer worldwide and a significant public health concern. A significant risk factor for melanoma is through increased exposure to ultraviolet (UV) radiation through the use of indoor tanning beds. Although rates of indoor tanning bed use have decreased in recent years, young adults, particularly White, college-age women, comprise the majority of indoor tanning bed users in the United States. The purpose of this cross-sectional study was to explore and explain the initiation and sustenance of indoor tanning cessation among college students using the multi-theory model (MTM) of health behavior change. Data were collected from 254 college students who reported current indoor tanning use using a validated 46-item survey to assess demographics and the MTM constructs. Data were analyzed using multiple linear regression to determine the ability of the MTM constructs to predict the initiation and sustenance of indoor tanning cessation. For initiation of indoor tanning cessation, participatory dialogue: advantages (B = 0.038, p = 0.001), behavioral confidence (B = 0.129, p < 0.001) and changes in the physical environment (B = 0.088, p < 0.001) were significantly associated with indoor tanning cessation following covariate adjustment. For sustenance, only emotional transformation (B = 0.140, p < 0.001) demonstrated a significant relationship with indoor tanning cessation, following adjustment. Findings from this study demonstrate the utility of the MTM in explaining indoor tanning cessation and designing intervention strategies and clinical recommendations to encourage indoor tanning cessation among college students.

Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change

Background: Smoking continues to be a public health problem worldwide. Smoking and tobacco use are associated with cardiovascular diseases that include coronary heart disease, atherosclerosis, cerebrovascular disease, and abdominal aortic aneurysm. Programs for quitting smoking have played a significant role in reduction of smoking in the United States. The smoking cessation interventions include counseling, nicotine replacement therapy, buproprion therapy, and varenicline therapy. The success rates with each of these approaches vary with clear need for improvement. Moreover, there is a need for a robust theory that can guide smoking cessation counseling interventions and increase the success rates. A fourth generation approach using multi-theory model (MTM) of health behavior change is introduced in this article for smoking cessation. An approach for developing and evaluating an intervention for smoking cessation is presented along with a measurement tool.

Methods: A literature review reifying the MTM of health behavior change for smoking cessation has been presented. An instrument designed to measure constructs of MTM and associated smoking cessation behavior has been developed.

Results: The instrument developed is available for validation, reliability and prediction study pertaining to smoking cessation. The intervention is available for testing in a randomized control trial involving smokers.

Conclusion: MTM is a robust theory that holds promise for testing and application to smoking cessation.

Testing multi-theory model (MTM) in predicting initiation and sustenance of physical activity behavior among college students

BACKGROUND

Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students.

METHODS

Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did not engage in more than 150 minutes of moderate to vigorous intensity aerobic PA during the past week were included in this study.

RESULTS

Of the 495 respondents, 190 met the inclusion criteria of which 141 completed the survey. The majority of participants were females (72.3%) and Caucasians (70.9%). Findings of the confirmatory factor analysis (CFA) confirmed construct validity of subscales (initiation model: χ2 = 253.92 [df = 143], P < 0.001, CFI = 0.91, RMSEA = 0.07, SRMR = 0.07; sustenance model: χ2= 19.40 [df = 22], P < 0.001, CFI = 1.00, RMSEA = 0.00, SRMR = 0.03). Multivariate regression analysis showed that 26% of the variance in the PA initiation was explained by advantages outweighing disadvantages, behavioral confidence, work status, and changes in physical environment. Additionally, 29.7% of the variance in PA sustenance was explained by emotional transformation, practice for change, and changes in social environment.

CONCLUSION

Based on this study's findings, MTM appears to be a robust theoretical framework for predicting PA behavior change. Future research directions and development of suitable intervention strategies are discussed.