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Basics of qualitative research: Grounded theory procedures and techniques

Evaluating complex interventions is complicated. The Medical Research Council9s evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance

https://www.bmj.com/content/bmj/337/bmj.a1655.full.pdf

Developing and evaluating complex interventions: The new Medical Research Council guidance

The Theory of Planned Behaviour (TPB) has received considerable attention in the literature. The present study is a quantitative integration and review of that research. From a database of 185 independent studies published up to the end of 1997, the TPB accounted for 27% and 39% of the variance in behaviour and intention, respectively. The perceived behavioural control (PBC) construct accounted for significant amounts of variance in intention and behaviour, independent of theory of reasoned action variables. When behaviour measures were self-reports, the TPB accounted for 11% more of the variance in behaviour than when behaviour measures were objective or observed (R2s = .31 and .21, respectively). Attitude, subjective norm and PBC account for significantly more of the variance in individuals' desires than intentions or self-predictions, but intentions and self-predictions were better predictors of behaviour. The subjective norm construct is generally found to be a weak predictor of intentions. This is partly attributable to a combination of poor measurement and the need for expansion of the normative component. The discussion focuses on ways in which current TPB research can be taken forward in the light of the present review.

/pdf/efficacy-of-the-theory-of-planned-behaviour-a-meta-analytic-32gm69pazu.pdf

Efficacy of the Theory of Planned Behaviour: a meta-analytic review.

In this chapter a theory of motivation and emotion developed from an attributional perspective is presented Before undertaking this central task, it might be beneficial to review the progression of the book In Chapter 1 it was suggested that causal attributions have been prevalent throughout history and in disparate cultures Studies reviewed in Chapter 2 revealed a large number of causal ascriptions within motivational domains, and different ascriptions in disparate domains Yet some attributions, particularly ability and effort in the achievement area, dominate causal thinking To compare and contrast causes such as ability and effort, their common denominators or shared properties were identified Three causal dimensions, examined in Chapter 3, are locus, stability, and controllability, with intentionality and globality as other possible causal properties As documented in Chapter 4, the perceived stability of a cause influences the subjective probability of success following a previous success or failure; causes perceived as enduring increase the certainty that the prior outcome will be repeated in the future And all the causal dimensions, as well as the outcome of an activity and specific causes, influence the emotions experienced after attainment or nonattainment of a goal The affects linked to causal dimensions include pride (with locus), hopelessness and resignation (with stability), and anger, gratitude, guilt, pity, and shame (with controllability)

/pdf/an-attributional-theory-of-achievement-motivation-and-2eu5g13rxj.pdf

An attributional theory of achievement motivation and emotion.

Objectives: To examine the emotional and cognitive impact of personal and social comparison information about health risk. Methods: A total of 970 adults responded to vignettes describing risk presentation scenarios that varied in terms of having (a) a ‘real world’ analogue (cardiac event) versus no such analogue (a fictitious pancreatic disease) condition, (b) high versus low levels of personal risk, and (c) no comparison group information given, comparison group risk higher or lower than own risk. Results: For both the cardiac and pancreatic disease vignettes, respondents’ emotional responses and estimates of their own risk were influenced by both personal and social comparison risk information. The cardiac event vignettes produced larger effects than the pancreatic disease vignettes. Unfavourable social comparison information had no discernible impact, relative to not providing any social comparison information. Favourable social comparison information resulted in greater reassurance, less worry, and perceptions of lower susceptibility. Lower personal risk generally produced similar effects, relative to higher personal risk. Conclusions: In contrast to previous theory and research in this area, we found that both personal and (favourable) social comparison risk information have emotional and cognitive consequences. We hypothesize that the perceived clarity of the information may account for the different patterns of findings in the literature.

http://www.phpc.cam.ac.uk/pcu/wp-content/files/2012/01/Paper92.pdf

The impact of personal and social comparison information about health risk.

Using an expectancy-value approach, personal beliefs about the consequences of quitting were studied in a sample of 1,305 cigarette smokers derived from a representative sample of the United Kingdom population. Subjects evaluated 32 outcomes of continuing to smoke or stopping smoking in terms of how much they “wanted” or “feared” them (outcome evaluation, or OE) and then rated the likelihood of each outcome occurring under the two alternatives, yielding a likelihood difference (LD) score for each outcome. Subjects with relatively strong and relatively weak intentions to try to quit were compared with respect to their OE, LD, and OE × LD scores. The results showed consistent differences between intenders and nonintenders. Intenders rated every positive outcome as more desirable and every negative outcome as more undesirable. Intenders also believed that stopping smoking would lead to a larger increase in their chances of obtaining the benefits (health, financial, social, self-esteem) and a smaller increase in their chances of incurring the costs (negative affect, loss of enjoyment), compared with nonintenders. The product scores showing the largest relationships with intention were for the outcomes “feel proud of yourself”, “feel a sense of achievement”, “enjoy yourself”, “feel energetic”, and “set a good example to children”. The findings are discussed in terms of their implications for efforts to encourage more smokers to try to quit.

Microanalysis of Smokers' Beliefs about the Consequences of Quitting: Results from a Large Population Sample1

The inaccuracy of family health services authority (FHSA) registers has important implications for the breast and cervical screening programmes.'`3 For example, 35% of breast screening invitations in south east London did not reach the women they were intended for.' Although the problem is widely recognised, there has been little discussion on how the registers can be used more effectively, though one approach is to use them in combination' with the electoral register.4

https://www.bmj.com/content/bmj/306/6886/1167.full.pdf

Inaccuracy of FHSA registers: help from electoral registers.

Background: Mobile technologies for health (mHealth) represent a promising strategy for reducing type 2 diabetes (T2DM) risk. The PROPELS trial investigates whether structured group-based education alone or supplemented with a follow-on support program combining self-monitoring with pedometers and tailored text-messaging is effective in promoting and maintaining physical activity among people at high risk of T2DM. Objective: This paper describes the iterative development of the PROPELS follow-on support program and presents evidence on its acceptability and feasibility. Methods: We used a modified mHealth development framework with four phases: (1) conceptualization of the follow-on support program using theory and evidence, (2) formative research including focus groups (n=15, ages 39-79 years), (3) pre-testing focus groups using a think aloud protocol (n=20, ages 52-78 years), and (4) piloting (n=11). Analysis was informed by the constant comparative approach, with findings from each phase informing subsequent phases. Results: The first three phases informed the structure, nature, and content of the follow-on support program, including the frequency of text messages, the need for tailored content and two-way interaction, the importance of motivational messages based on encouragement and reinforcement of affective benefits (eg, enjoyment) with minimal messages about weight and T2DM risk, and the need for appropriate language. The refined program is personalized and tailored to the individual’s perceived confidence, previous activity levels, and physical activity goals. The pilot phase indicated that the program appeared to fit well with everyday routines and was easy to use by older adults. Conclusions: We developed a feasible and innovative text messaging and pedometer program based on evidence and behavior change theory and grounded in the experiences, views, and needs of people at high diabetes risk. A large scale trial is testing the effectiveness of this 4-year program over and above structured group education alone. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 83465245; http://www.controlled-trials.com/ISRCTN83465245/83465245 (Archived by WebCite at http://www.webcitation.org/6dfSmrVAe) [JMIR Mhealth Uhealth 2015;3(4):e105]

A Text-Messaging and Pedometer Program to Promote Physical Activity in People at High Risk of Type 2 Diabetes: The Development of the PROPELS Follow-On Support Program.

Aims To examine the effects of processes of change (POC) on forward stage movement directly, indirectly through decisional balance and temptation, and total effects as a test of the key hypothesis of the Transtheoretical Model (TTM). Design Prospective cohort study. Setting United Kingdom. Participants A total of 1160 adolescents aged 13–14 years who were current or former smokers at baseline. Measurements Stage was assessed with the standard algorithm three times, once every 3 months. On each occasion the POC, decisional balance and temptation were measured with the standard questionnaires. Path analysis was used to examine the direct, indirectly mediated and total contribution of POC and the other constructs to stage movement 3 months later. Findings Four of the 24 analyses showed evidence that the theoretically appropriate POC predicted stage transition, with statistically significant total effects. Effect sizes were small. When the POC were summarized to experiential and behavioural process means, one transition from pre-contemplation was predicted by experiential processes and, contrary to the TTM, one transition predicted by behavioural processes. There was slightly more evidence that decisional balance (attitudes towards smoking) and temptation (ability to resist the urge to smoke) was associated with stage transition. Conclusions POC use was not associated generally with stage transition and evidence that effects, if missed, must be modest, giving no support to the central tenet of the TTM.

http://www.phpc.cam.ac.uk/pcu/wp-content/files/2012/01/guo-et-al-2009-addiction.pdf

Do the Transtheoretical Model processes of change, decisional balance and temptation predict stage movement? Evidence from smoking cessation in adolescents.

Stephen Sutton

Papers

The impact of personal and social comparison information about health risk.

Microanalysis of Smokers' Beliefs about the Consequences of Quitting: Results from a Large Population Sample1

Inaccuracy of FHSA registers: help from electoral registers.

A Text-Messaging and Pedometer Program to Promote Physical Activity in People at High Risk of Type 2 Diabetes: The Development of the PROPELS Follow-On Support Program.

Do the Transtheoretical Model processes of change, decisional balance and temptation predict stage movement? Evidence from smoking cessation in adolescents.